Fine needle aspiration cytology of palpable supraclavicular lymph nodes

Background: Fine needle aspiration cytology as a first line of investigation has assumed importance in diagnosing a variety of disease process. The aim of this study was to assess the diagnostic value of fine needle aspiration cytology in the evaluation of palpable supraclavicular lymph nodes. Materials and methods: This was a retrospective study of fine needle aspiration cytology of palpable supraclavicular lymph node done between January 1, 2007 and December 31, 2009. Fine needle aspiration cytology was performed on 149 patients (49 cases at Om Hospital & Research Centre and 100 cases at Tribhuvan University Teaching Hospital). Results: The right supraclavicular lymph node was enlarged in 55% cases, while the left supraclavicular lymph node alone was palpable in 40.3% cases and in 7 of 149 (4.7%) cases, bilateral supraclavicular lymph nodes were palpable. Cytological diagnoses were categorized as reactive (8.7%), tuberculosis (41.6%), lymphoma (4.8%) and metastasis (44.9%). Of a total of 74 cases of malignancy, 90.5% were non-lymphoid and 9.5% were lymphoid (5 Non-Hodgkin lymphoma and 2 Hodgkin lymphoma). Of the 67 cases of metastatic disease, three major types of malignancy found in supraclavicular lymph nodes were Squamous cell carcinoma (28 cases), adenocarcinoma (21 cases) and others (small cell carcinoma, papillary thyroid carcinoma etc). Adenocarcinoma tended to metastasize to the left supraclavicular lymph node. Lung was the most common primary site (43.3%), followed by stomach, ovary, breast and larynx. However, in 28.4% cases, no primary site was found. Conclusion: The fine needle aspiration cytology can be used as a first line investigation in the evaluation of supraclavicular lymphadenopathy due to its low cost, simplicity and minimal invasiveness. Keywords: Supraclavicular lymph node; Fine needle aspiration cytology; Metastasis DOI: 10.3126/jpn.v1i1.4441 Journal of Pathology of Nepal (2011) Vol.1, 8-12  

INFECTIVE ENDOCARDITIS DUE T O SALMONELLA TYPHI

Rheumatic Heart Disease (RHD) remains an important predisposing lesion for infective endocarditis (IE)in developing countries. IE due to Salmonella typhi is rare but associated with potentially morbidcomplications.We report a case of Salmonella typhi in a patient with rheumatic heart disease. The diagnosisof IE was confirmed on the basis of Duke’s clinical criteria. She responded to ciprofloxacin and gentamicin.Key Words: Rheumatic Heart Disease, Infective endocarditis, Salmonella typhi.

Spectrum of cutaneous manifestations in lupus erythematous -a dermatologist perspective

Background: The cutaneous manifestations of lupus erythematosus (LE) specific skin disease consists of acute cutaneous LE (ACLE), Subacute cutaneous (SCLE) and Chronic cutaneous (CCLE). Objective: To evaluate the spectrum of cutaneous manifestation in patients of LE. Methods: A case series of 41 clinically diagnosed cases of LE attending the outpatient department of Dermatology, BPKIHS were evaluated for the specific and non-specific skin changes. Results: All the patients enrolled in the study were female,with the age ranging from 14-64 years. ACLE was detected in 22/41(78.04%). Malar rash was the frequent skin lesion. CCLE was seen in 6/41 (14.63%) patients with classical discoid lesions (localized and generalized) in 4/6(66.66%) and 2/6(33.33%) respectively. Non specific skin lesions were found in 30/ 41(73.17%) of patients. Mucosal ulcers were seen in 23/41(56.09%), Facial telangiectasias 20/41(48.78%), Raynaunds phenomena 22/41(53.65%), Chronic urticaria 9/41(21.95%), Nail changes 12/41(29.26%) and non scarring alopecia was seen in 6/41(14.63%) patients. Eye involvement was seen in 3/41(7.3%), cutaneous vasculitis in 5/41(12.19%) and scaring alopecia in 3/41(7.3%) patients. Conclusion: The cutaneous manifestations of patients with lupus erythematosus (LE) are very frequent, show a great variety and can occur at any stage of the disease. DOI: http://dx.doi.org/10.3126/hren.v10i1.5999 HREN 2012; 10(1): 8-11

Growth inhibitory action of saccharin and cyclamate on rats receiving a poor rice diet

1. The effect of saccharin and cyclamate on growth of young rats fed on a poor rice diet or a balanced diet was investigated.

2. Saccharin and cyclamate retarded the growth of rats on the multi-deficient diet but not of those on the well-balanced diet during an 8-week feeding period.

3. The sweeteners did not produce any macroscopic or microscopic changes in the liver, kidneys, intestines, spleen or lungs of the animals receiving the poor rice diet other than the changes resulting from the nutritional deficiency of the diet.

4. The sweeteners did not inhibit the liver xanthine oxidase activity of rats receiving the poor rice diet to an extent greater than the inhibition brought about by the deficiency of protein in the diet.

5. When given by intubation to healthy rats, the sweeteners inhibited the induction of liver tryptophan oxygenase; given in vitro, they inhibited the succinate dehydrogenase activity of rat liver mitochondria.