Online ISSN: 2515-8260

Keywords : Histopathology


Dr. P. Swarnalatha, Dr. R.Swarupa Rani , Dr. S.Rajasekhar Reddy , Dr. Shaik. Raja Husne Kalam

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 12-39

Breast cancer affects women more than men. From puberty to death, breasts go through
constant physical and physiological changes related to menstruation, pregnancy, and
menopause. The goal was to classify different types of breast lesions and conduct a
clinicopathological study on them.Methodology: In the present study carried out at the
department of Pathology of ACSR Govt Medical College, Nellore AP during the period
from January 2019 to June 2021 (18 months) a total number of 150 FNAs were performed
on patients with breast lumps. Results: The youngest patient in this study was 12 years
and the oldest 79 years. Majority of the patients were in the age group of 21-40 years. In
majority of the patients i.e. From 150 aspirates, 65 were from the right breast and 70 from
the left. 15 cases involved both breasts.Upper outer quadrant of right and left breast had 39
and 35 cases of breast lumps, respectively. Lower outer quadrant of the right breast had 11
cases and upper medial had 11 cases. Two breast cases showed diffuse all-quadrant
involvement. 2 of the 45 cases were clinically suspected of malignancy and 1 of
fibroadenosis, but FNAC showed fibroadenoma. Three clinicocytologically discordant cases
lacked excision biopsy. 15 cases of breast cancer were in the right breast and 9 in the left.
Upper outer quadrant is most common for breast lumps. Side and quadrant distribution are
shown below. All 20 cases were confirmed by excision biopsy. FNAC diagnosed 18 IDC
NOS cases and 2 IDC Mucinous cases.CONCLUSION: FNAC is the procedure that is most
commonly used since it is an initial outpatient procedure that is straightforward, risk-free,
quick, and dependable. Additionally, it contributes to an early preoperative diagnosis of any
lump in the breast.


Kesavachandra Gunakala, P.M. Rekharao, Seshadri Sahaja, Vennela Mude

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 2338-2359

Background: Pipelle endometrial sampling versus Dilatation and curettage in collecting a sufficient endometrial sample for histopathological diagnosis was the subject of this observational clinical correlation diagnostic study. Aim: The present study is done in our hospital to know if Pipelleaspiration endometrial sampling can replace D&C for histological examination in cases of AUB.
Materials and Methods: This was an observational clinical correlation diagnostic study designed to compare the efficacy of Pipelle endometrial sampling with Dilatation and curettage in obtaining an adequate endometrial sample for histopathological diagnosis. After obtaining informed consent to participate and determining fitness for the procedure, 100 patients who reported with AUB to the Department of Obstetrics &Gynaecology at Government Medical College, Kadapa, were enrolled in the study. The study was carried out from October 2019 to September 2021. The patient underwent a thorough clinical evaluation in the outpatient department, which included a history, physical examination, and baseline investigations. Prior to the procedure, TAS/TVS were done. Endometrial sampling was performed using the Pipelle device, followed by a diagnostic reference standard and D&C endometrial sampling under anaesthesia.
Results: The most common age group presented with AUB is between 41 and 45 years. Most of the patients (45%) had < 6months duration of AUB. Pre and perimenopausalwomen made up 94% of the study population, whereas postmenopausal women made up 6%. Among the study group, 4% were nulliparous, and the remaining 96% were parous women. Of the study group, the ET thickness varies as - 13 had < 6mm, 18 had ET between 6.1- 9mm, 50 had ET between 9.1-12mm, 13 had ET between 12.1-15mm, 4 constitute between 15.1-18mm, 2 had >18mm ET. In Pipelle and D & C, sampling inadequacy was significantly more in menopausal women compared to pre-menopausal women. (P<0.05). In 16 cases, Pipelle sampling was deemed challenging. Sampling was difficult in nulliparous women when compared to parous women. Histopathology reports were obtained in 93 of the 100 Pipelle samples and 94 of the 100 D&C samples in current study.  The most frequent endometrial pattern observed was Hyperplasia without atypia (21%) , followed by proliferative phase of the endometrium (20%), no evidence of malignancy (14%), Secretory phase (11%),  disordered proliferative phase (11%), atrophic endometrium (4%), nonsecretory phase in (4%), endometrial polyp (2%), Hyperplasia with atypia (2%), early secretory phase (1%), endometrial carcinoma (1%), late secretory phase (1%), Endometrial glandular hypertrophy (1%). When comparing Pipelle to D&C, the chi-square test shows that Pipelle has a sensitivity of 98.9% for retrieving sufficient tissue and a specificity of 100%. The positive predictive value is 100 percent, while the negative predictive value is 85.7%. The p-value estimated is< 0 .001, which is statistically significant. Out of 100 cases that had Pipelle sampling, 91 had no complications. 5 had pain, and 4 had bleeding. Out of 100 cases that had D & C, 59 had no complications, 29 had pain, 5 had bleeding, and 7 had both pain and bleeding.
Conclusion: Pipelle sampling can be used as an effective screening procedure in the outpatient department.


Dr. Prashant Gupta, Dr. Rohini Bansal, Dr. Shraddha Agarwal, Dr. Pankaj Bansal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 2178-2183

Background: Cervical cancer is the third most common cancer among women worldwide, with 85% of its global burden occurring in less-developed countries. The present study was conducted to evaluate the pattern of cervical Pap smear cytology and to correlate it with histopathological findings.
Materials & Methods: 360 females of age ranged 18-60 years were enrolled. Cervical smears were taken with the help of Ayer’s spatula and cyto brush to collect specimen from thesquamocolumnar junction. Thesmears were stained with Papanicolaou stain(PAP stain) and slides wereexamined under light microscope following 2001 Bethesda system.
Results: Age group 18- 30 years had 68 patients, 31-40 years had 112, 41-50 years had 120 and 51-60 years had 60 patients. The difference was significant (P< 0.05). Maximum number of cases 160 were categorized as negative for intraepithelial lesion or malignancy (NILM). Atypical squamous cells of undetermined significance (ASCUS) seen in 54 followed by followed by low gradesquamous intraepithelial lesion (LSIL) in 50 and high gradesquamous intraepithelial lesion (HSIL) in 30, squamous cell carcinoma 4 and cases of adenocarcinoma 2. 88%diagnosed on Pap smears correlated on histopathology findings.
Conclusion: Pap smears found to be effective in screening for earlydetection of premalignant and malignant lesionsof cervix.

A Prospective Study to Evaluate the PAPSmear and Acetic Acid Test (VIA) as Cervical Cancer Screening Tools with Histopathological Correlation at Tertiary Care Center

Neha Gupta, Ruchi Agrawal, Shweta Agarwal, Suneeta Meena

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1383-1387

Background: Cervical cancer is the second most common cancer among women
globally. There are different methods for control and prevention of cervical cancer
which include conventional cytology (Pap smear), liquid-based cytology, human
papillomavirus (HPV) screening, and vaccination against HPV. The aim of this study to
evaluate the pap smear and acetic acid test as cervical cancer screening tools with
histopathological correlation.
Material & Methods: The present study was carried out in department of pathology at
SMS Medical College, Jaipur, Rajasthan, India for one year period. A total of 150
patients attending the gynecology OPD were enrolled in the study. All the patients in the
study were subjected to colposcopy. The cervix was inspected with the naked eye than
with a colposcope. After taking the Pap smear with Ayre’s spatula and cytobrush and
was evaluated by the Bethesda system and then cervix was washed with normal saline
and visualized, followed by application of 3% acetic acid and visualization by
colposcope. Collected data was statistically analyzed to determine specificity and
sensitivity, PPV, NPV of Pap smear, VIA.
Results: Our study shows that majority of cases were seen in 40-50 years of age
group.Sensitivity of VIA was found to be 90% (versus Pap smear, which had 40%) and
specificity of VIA was 87.85% (versus Pap smear, which had specificity of 96.42%).
Conclusion: PAP smear screening needs good infrastructure, trained manpower to
make & interpret the slides which is not feasible considering the facilities available in
the periphery. However, VIA can be done even by sisters in the remotest place with
minimum facilities & patient is diagnosed.

A Prospective Study Evaluating Correlation Between Preoperative Histopathology And Morphologywith Recurrence Of PterygiumAfter CLAU Surgery

Dr. Neetu Kori Shankhwar, Dr. Shweta Walia, Dr. DivyaKhandelwal, Dr. V. Bhaisare, Dr. Preeti Rawat, Dr. Manushree Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 317-323

Aim- To observe recurrence rate after conjunctival limbal autograft (CLAU) and tocorrelate
this with preoperative histopathological and morphologicalcharacteristics of pterygium.
Design: Interventional, Prospective, Hospital-Based Study.
Methods: 107 patients with primary pterygium were examined, managed by CLAU and
histopathology sample sent. The outcomes were assessed in terms of clinically significant or
insignificant recurrence till 6 months follow-up.
Results: 57% patients were female. 17.8% participants had Stockers Line and all patients
having stocker’s line had stationary type of pterygium. Fuchs spots were seen in 4.7% of
patients. Histopathology findings includeEpithelial Hyperplasia (80.4%), Vascularity
Overwhelms Fibrosis (39.1%), Vascularity Similar to Fibrosis (28.3%), Fibrosis Overwhelms
Vascularity (34.8%), Perivascular Stromal Inflammation (54.3%), Diffuse Stromal
Inflammation (37.0%). The following variables were significantly associated (p<0.05) with
the Recurrence: Age, Fuchs Spots, higher vascularity and Diffuse Stromal Inflammation on
Conclusion: Factors such as younger age group,higher redness and thickness of pterygium,
Fuchs Spots, higher vascularity and diffuseinflammation on histopathological examination
can be considered as a risk factor for recurrence. However, occupation, laterality, location
and type of pterygiumwere found not to be related to recurrence.

A Study to Correlate Preoperative Ultrasonographic Tirads Scoring System and Postoperative Histopathology of Thyroid Swellings

J.Parthasarathi, D.Ravisundar, M.Praveena, M. Anurag

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2451-2460

Background:Aim & Objectives: To correlate preoperative TIRADS scoring system with postoperative histopathology of thyroid swellings.
Materials and Methods: A total of 66 patients of thyroid swellings who were treated at the Department of General Surgery, Govt Medical College, Nalgonda, with an age range of 20 – 68 years, were evaluated in this study with respect to age, sex, symptoms type and symptom duration and were investigated with routine hemogram, thyroid profile, FNAC and USG with TIRADS score. The results of USG TIRADS score were compared with the histopathology after excision of the thyroid swelling.
Results: Thyroid swellings are more common in females than in males (M:F ratio = 1:4). Majority of the patients are in the age group of 30-50 years. Swelling in front of the neck is the most common complaint. Majority of the patients had an average duration of symptoms of 6months to 3 years. On clinical evaluation all patients had swelling of thyroid. On USG with TIRADS scoring, TIRADS – 3 is the most common category of the thyroid swelling with 30 patients (45%). On USG TIRADS score, majority were benign lesions 55 (83%), while the rest were malignant 11 (17%). On histopathology, 55 lesions (83%) were benign, while 11 lesions (17%) were malignant. Incidence of malignancy with respect to TIRADS score is TIRADS 2- 4%, TIRADS 3 – 16.7%, TIRADS 4 – 50%, TIRADS 5 – 0%. The present study has a USG TIRADS score sensitivity of 45.5%, specificity of 89.1%, positive predictive value of 45.5%, negative predictive value of 89.1% and accuracy of 81.8%.  The prevalence of malignancy among the patients with thyroid swellings in the present study is 16.7%. USG proved to be a more sensitive modality to evaluate the nodularity of thyroid swellings than clinical evaluation.
Conclusion: The present study was undertaken to evaluate the usefulness of clinical evaluation and USG TIRADS score in management of thyroid nodules High resolution ultrasound is an accurate technique, that has helped to analyse the suspicious sonographic features of thyroid swellings and to assess the risk of malignancy and quantify it using TIRADS score.

Histopathological Study of Ovarian Lesions at a Tertiary Level Hospital

Samir Ranjan Bhowmik, Ranbir Singh Chawla, Prabhat Kumar Lal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2724-2729

Background:Ovary is a common site of both neoplastic and non-neoplastic lesions. Ovarian cancer presents with non-specific symptoms and majority of these are in advanced stage. The histopathological patterns of these lesions is helpful in treatment. Hence, the present study was done to determine the prevalence and distribution of various types of lesions of ovary.
Materials and Methods: The present study was cross-sectional descriptive in nature conducted on a total of 100 samples of ovary brought to the department of pathology for histopathology. The specimens were prepared using normal histopathological procedures and findings were noted.
Results: Corpus luteal cyst was the most common non-neoplastic lesion seen (49.1%). Serous cystadenoma (41.9%) was frequent benign lesion seen while Serous adenocarcinoma (4.7%) was the most common malignant lesion. 82.5% of the lesions were benign, 12.3% were malignant and 5.3% were borderline in nature.
Conclusion: Luteal cyst was common in non-neoplastic lesions. Serous cystadenoma was commonest benign tumour, whereas serous cystadenocarcinoma was frequent in malignant ones.

Evaluation of Ohmann Score in the Diagnosis of Acute Appendicitis in Patients Admitted in a Tertiary Care Hospital

Nandula Sai Bharath, M. Anurag, Lavudya Srinivas, Ganesh Banothu

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 4729-4737

Background:To Diagnose Acute Appendicitis based on Ohmann score and correlating it
with postoperative histopathological report.
Materials and Methods: This study was undertaken in 80 patients with a provisional
diagnosis of acute appendicitis getting operated over a period of 18. months.Ohmann
score was applied in the preliminary diagnosis, which was confirmed by intra operative
and histopathological findings.
Results: Fifty-eight patients were males and 22 were females. There was no statistical
significance in the male to female ratio. The highest incidence was found in the age
group of 21-30 and the lowest was seen in the age group of >40. Ohmann score of 13.5
was found in 11 patients and score of 14 was also seen in 11 patients .1.5 was least
ohmann score seen who had a normal appendix on histopathology. As ohmann score
was categorised into 3 categories,3 patients had Ohmann score of less than 6 out of
which 2 had a normal appendix on histopathology and the other patient had
appendicitis on histopathology. Depending on the cut-off value taken, sensitivity ranges
from 100% to 4.54%, specificity ranges from 14.28% to 100%, positive predictive value
ranges from 84.61% to 100% and negative predictive value ranges from 100% to
Conclusion: Ohmann scoring system significantly reduces the number of negative
laparotomies without increasing overall rate of appendicular perforation. It can work
effectively in routine practice as an adjunct to surgical decision making in questionable
acute appendicitis. It is simple to use and easy to apply since it relies only on history,
clinical examination and basic lab investigations.

Histomorphological Spectrum of Leprosy: Study in a Tertiary Care Centre in South India

Himaja Sayana, Grace Madhuri Kambala, M.Vijayasree, Sai Kiranmai, Shalini

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 9994-10002

Background:The clinical manifestations of leprosy are so different and of wide range,
that they can mimic variety of unrelated diseases, so for correct and adequate
treatment, the diagnosis must be made early and it should be accurate. Various methods
of diagnosis, further improve the accuracy of diagnosis and also give idea about
immunological status. The aim is to diagnose and categorize Leprosy into various types,
based on histopathological examination and to correlate the findings withFite-Faraco
staining of the sections.
Materials and Methods: The data base of skin biopsies, suspicious of leprosy were
studied in Department of Pathology, Siddhartha Medical College, Vijayawada
retrospectively for a period of one year and total 62 cases diagnosed as leprosy on
histopathological examination ofpatients with clinically suspicious signs, ofall age
groups, were included in the study.
Results: A total of 62 cases diagnosed as leprosy on histopathological examination were
evaluated. 32 cases (51.61%) were between age group of 21-40 years.In this study
66.12% were males and 33.8% were females. Highest No of cases,30 werediagnosed
onhistopathological examinationas Borderline Tuberculoid type, amounting to 48.38%
of all cases. Strength of agreement, during correlation study was higher in Tuberculoid
(TT), Lepromatous (LL), and Histoid (HL) subtypes of leprosy, but was found lower in
Borderline Lepromatous (BL) group.
Conclusion: Histopathological examination and demonstration of acid-fast lepra bacilli
in sections is recommended in all cases suspicious of leprosy for a good diagnostic
accuracy, which would ultimately help in thecorrect diagnosis and treatment of the
patient, and give idea about the Immunological status of the patient.


Dr.Pradip Butale, Dr. Syed Waseem, Dr. BalawantKove

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1149-1158

Background: Chronic colitis, regardless of type, is defined histologically by chronic
inflammation, mainly plasmacytosis, in the lamina propria. Specific diagnosis of chronic
colitides in biopsies can be challenging for practicing pathologists. The present research was
undertaken to study complete clinico-pathology of chronic colitis, pathological pattern and
spectrum of colitis, also study correlation of colonoscopy and histopathology of these
lesions.Method:This study was a retrospective and prospective analysis of 187 cases
ofhistopathologicallyproven colitis on colonic biopsies over a period of 5 years from June 2015
to May 2020. Results:Majority of specimen were rectal biopsies (57.22%) followed by mapping
biopsies (34.22%). Of 85 cases where both colonoscopy and histopathology diagnosis was
available, 61 (71.76%) colonoscopy diagnosis were consistent with histopathology. Among 187
cases, 107 were inflammatory bowel disease (57.22%), they were further sub classified as
ulcerative colitis (UC) (96.26%), Crohn’s (0.93%) and indeterminate colitis (2.8%). Cases of
UC had features of basal plasmacytosis (97.19%), crypt distortion (93.45%), crypt loss
(70.09%) and goblet cell depletion.48cases diagnosed as non-specific colitis. Infectious colitis
comprised 8.56% of total colitis cases. It included tuberculosis 4 (2.14%), CMV colitis
2(1.07%) and 5.35% cases of acute self-limiting colitis. 5(2.67%) cases were diagnosed as
lymphocytic colitis and 2 cases showed focal active colitis. Also, found single case of
eosinophilic colitis and radiation proctitis each.Conclusion:Good clinico-pathological
correlation helps to reduce number of cases diagnosed as non-specific colitis. To improve the
detection rate of microscopic colitis, it is important to take multiple biopsies from normal
looking colon on colonoscopy.


Madhavi Bodepudi; Lakshmi P; Bharani K

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1111-1114

AIMS and Objectives: To study the incidence, clinical and histopathological correlation of various types of endometrial lesions in premenopausal and postmenopausal women. To study the clinicopathological spectrum and histopathological evaluation of endometrium in abnormal uterine bleeding in peri-menopausal and post-menopausal age groups. 


Yadav P; Kolta N; Kaundal V

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1115-1120

Aim: To evaluate the role of Fine Needle Aspiration Cytology in Diagnosis of Thyroid lesion. Materials and Methods: A retrospective research was conducted at the Department of Pathology, Assiut University and Hospital, Egypt. An overall total of 200 patients with a single thyroid nodule who met the inclusion criteria were included in the research. In the case of fine needle aspiration cytology, the sensitivity, specificity, positive predictive value, and negative predictive value were determined based on histopathologic examination, which was the gold standard. Results: There were 120 females and 80 men in attendance, resulting in a female to male ratio of 1.5:1. The patients' ages varied from 14 to 71 years, with a mean age of 43.69 years plus standard deviation (12.49 years). The majority of the patients are between the ages of 30 and 40. Neck oedema was the most common symptom among these patients (100 percent), followed by vocal cord palsy (15 percent), breathing difficulties 11 percent, and dysphagia 9 (4.5 percent), respectively. The thyroid nodule varied in size from 2 to 6.9 cm, with a mean of 4.51 +/- S.D. 1.89 cm and a standard deviation of 1.89 cm. Based on the results of this study, nodular goitre accounted for 52 percent of solitary thyroid nodules, with benign cyst accounting for 32 percent of benign lesions, 33 percent of follicular carcinoma, 17 percent of papillary carcinoma, and three cases being suspicious of neoplasm among the benign lesions. Conclusion: FNAC has key rule in diagnosis of solitary thyroid nodule because it is safe, minimally invasive and cost effective diagnostic tool. 


Dr. Varinder Kaur, Dr. Tejinder Kaur, Dr. SK Malhotra

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1482-1487

Background: Dermoscopy can act as an alternative diagnostic method to mucosal biopsy for diagnosis of various oral mucosal lesions.
Aim: To study the dermoscopic and histopathological characteristics of oral mucosal lesions.
Methods: The present prospective study was conducted among 53 patients of oral mucosal lesions presenting to the indoor and outdoor facilities in Department of Dermatology, Venereology and Leprosy. After performing routine investigations, dermoscopic evaluation was done in all the cases and recorded in the prestructured proforma. Oral mucosal lesions were evaluated by using non-contact videodermatoscope (AM7515MZT Dino-Lite), polarised mode. It was followed by mucosal biopsy from the same site.
Results: Nonvascular findings were the predominant features on dermoscopy. Structureless grey areas was the most common finding, seen in 72.41% patients of lichen planus. In lichen planus, it is suggested that structureless grey areas on dermoscopy corresponded histologically to hyperkeratosis. Vascular findings in form of light to intense red areas was seen in all patients of pemphigus vulgaris as well as both cases of aphthous ulcer and in each case of actinic cheilitis, bullous pemphigoid, disseminated discoid lupus erythematosus.
Conclusion: Theresultsof this rare pioneer study revealed that dermoscopy of mucosa may prove to be a valuable tool for diagnosis and may obviate need for mucosal biopsy.


Dr. IndumathiSelvanathan; Dr.Sivasakthi Arumugham; S.M.Fazeela Mahaboob Begum

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 7712-7721

Objective: Monoterpenes plays an essential role to fight against various diseases. Among the various monoterpenes an efficientd-Limonene plays a fundamental role to fight against hepatotoxicity caused by cancer chemotheraphy treatment. Hence the presence study is to evaluate hepatoprotective function of d-limonene against adraimycin induced hepatotoxicity.
Methods: Male albino Wistar rats were administrated with ADR (15mg/Kg body weight) in six equal injection, and the protection efficacy of d-limonene (100mg/Kg body weight) was examined with reference to tissue AST level and the pathological studies was examined by microscopic study.
Results: Rats treated with ADR results in elevated level of liver AST marker enzymes, whereasthe level of AST was controlled when administrated with d-Limonene. However Histopathological proof added more protective role of rats treated with d-limonene against hepatotoxicity.
Conclusion:ADR administration of 15mg/Kg body weight of rats increase the level of hepatotoxicity by increasing the marker enzyme activity and show severe morphological changes. The final outcome from our result suggests that d-limonene (100mg/Kg body weight) a vibrant monoterpene act as latent hepatoprotective negotiator by attenuating ADR induced hepatotoxicity

Multi-Stage Classification Technique for Breast Cancer Detection in Histopathology Images using Deep Learning

Nagamani Gonthina; C. Jagadeeswari; Prabhavathi V; Sneha B

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 4, Pages 1104-1110

This research paper proposes the past decenary, substantial improvement in computational ability and betterment in algorithms for analysis of Images has gained vast fame in resolving challenges in the area of medical diagnosis. Subsequently, computerized tissue histopathology at present is becoming tractable towards the implementation of digitized analysis of images and deep learning methods. Cancer is a cluster of disorders involving irregular cell maturation with the capability to conquer or proliferate to other organs of the body. Detection of cancer in the earlier stages is a exacting task due to which many people are prone to death. Treatment of cancer benefits from the pace, perfection of Deep Learning-obliged practice of diagnosis. Deep Learning techniques are utilized to diagnose the features of progressed carcinoma with enhanced perfection compared to individual pathologist. This paper suggests a deep convolution neural network for categorizing a tissue as malicious, there after segregate the tissue then ultimately perform multi-class detection and classification of Breast Cancer disease and its stages in histopathology images

“Assessment of lymph node status in cases of metastatic malignancy by frozen section and imprint cytology”

Dr Miheer Milind Jagtap; Dr Samarth Shukla; Dr Sunita , Vagha; Dr Ankita Tamhane; Dr Sourya Acharya; Dr. Miheer Milind , Jagtap

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 2557-2551

Abstract: Introduction: Dissemination of cancers most commonly occurs by the lymphatic
route and is generally favoured by carcinomas. The best achievable goal of any surgical
procedure is removal of all the affected tissue and leave behind healthy tissue which is
entirely free of any malignant cells. Though histopathological examination is gold
standard, it is time consuming and cannot be implemented as an intraoperative diagnostic
tool. The present study utilises frozen section analysis and touch imprint cytology as
intraoperative tools and analyses their diagnostic accuracy to detect lymph node metastasis
in comparison with routine histopathology in epithelial malignancies.
Aim: To evaluate the efficacy of intraoperative diagnosis by touch imprint cytology and
frozen section analysis for the assessment of metastatic lymph node deposits.
Materials and methods: Total 76 cases of primary malignancy with suspicious metastatic
lymph nodes were investigated. Metastatic nodes were subjected to frozen section and 
touch imprint cytology and these findings were compared with routine histopathology and
the sensitivity, specificity, positive predictive value, negative predictive value and accuracy
were calculated.
Results: The sensitivity, specificity, positive predictive value, negative predictive value and
diagnostic accuracy of frozen section was found to be 97.30%, 100%, 100%, 97.5% and
98.68%. The values of the same parameters for imprint cytology was found to be 75.68%,
100%, 100%, 81.25% and 67% respectively.
Conclusions: Frozen section analysis proved superior to imprint cytology in detecting
lymph node metastasis intraoperatively. Apart from detecting the presence of metastasis,
frozen section is able to provide details regarding micro-metastasis, macro-metastasis and
perinodal fat invasion. This study predominantly evaluated epithelial malignancies and
thus proves the utility of these two intraoperative modalities in them. It also opens new
avenues for research pertaining to the utility of these modalities in various malignant
mesenchymal tumours.