Sensitivity of Sinus Radiography Compared to Computed Tomogram: A Descriptive Cross-sectional Study from Western Region of Nepal

Introduction: Radiography of the paranasal sinuses is commonly used diagnostic modality. However, the trustworthiness of plain radiographic findings of paranasal sinuses is debatable. The intention of this study was to weigh the diagnostic soundness of plain radiograph of the paranasal sinuses to that of computed tomogram scan. Methods: This is a descriptive cross sectional study carried out in 110 participants in Department of Radiology of Gandaki Medical College from November 2017 to April 2018. Ethical approval is obtained from Institution review board (Ref. No.39/074/075). Sample size was calculated taking confidence level of 95%, expected prevalence of 14% and precision of 6.5% in population of 492098 in Province 4 of Nepal. Random sampling method was used. Data was enter in Statistical Package for the Social Sciences version 17 software and analysed. Results: A total of 110 participants are included in this study of which 62 (56.4%) are females and 48 (43.6%) are males with an overall mean age of 34.5 years. The commonly involved sinus was maxillary 56 (50.9%) followed by ethmoid 33 (30%) sinus. The overall sensitivity and specificity of detecting sinusitis by sinus radiography is higher for maxillary sinus (89.7% and 87%) followed by ethmoid (69.7% and 96.1%) and frontal (61.5% and 96.9%) sinuses. Conclusions: Sinus radiography is more sensitive for detecting pathologies in maxillary sinuses, while it is moderate for frontal, ethmoid sinuses and least for sphenoid sinuses. Diagnostic accuracy of computed tomogram scan is more, hence should be recommended to characterize the complex pathology and anatomy of the osteomeatal complex

Warty Carcinoma Penis: An Uncommon Variant

Penile carcinoma frequency varies widely in different parts of the world and comprises 1–10% of all the malignancies in males. Majority of the cases of penile carcinoma are squamous cell carcinoma of penis comprising 60% to 70% of all cases. Warty carcinoma of penis is an unusual neoplasm and a variant of penile squamous cell carcinoma comprising 5%–10% of all the variants. The other histological variants include basaloid, verrucous, papillary, sarcomatous, mixed, and adenosquamous carcinoma. The various histological entities with an exophytic papillary lesions including warty carcinoma are together referred to as the “verruciform” group of neoplasms. The warty carcinoma has to be differentiated from these lesions and is typically distinguished by histological features of hyperkeratosis, arborescent papillomatosis, acanthosis, and prominent koilocytosis with nuclear pleomorphism. We present a case of 65-year-old male with growth measuring 6×4 cm in the penis who underwent total penectomy and was diagnosed as warty carcinoma penis

of Struma Ovarii: A Rare Ovarian Tumor

Abstract Struma ovarii or monodermal teratoma is a specialized ovarian neoplasm which mainly constitutes mature thyroid tissue. It is a rare tumor which comprises 1% of all ovarian tumors and 2.7% of all dermoid tumors. Thyroid tissue can be observed in 5-15% of dermoid tumors but to designate the tumor as struma ovarii, it must comprise more than 50% of the ovarian tissue. This study was conducted in the Department of Pathology, Manipal Teaching Hospital in Pokhara, Nepal over a period of 10 years (Jan 2006 to Sep 2015. Age, clinical findings, preoperative imaging diagnosis, size and side of the tumor, gross and microscopic findings along with type of surgery performed are included in the study. During this 10 years period, there were 7 cases of struma ovarii with age ranging from 26 to 56 years. 2 cases had tumor on the right and 4 cases had tumor on the left side while 1 case had bilateral struma ovarii. Initial presenting symptom was palpable mass, abdominal pain and vaginal bleeding. The size of the tumor ranged from 4 to 15 cm. The capsule was smooth and cut surface shows multiloculated cyst filled with greenish to pale brown gelatinous thick fluid. Microscopic examination revealed well encapsulated tumor composed entirely of thyroid follicles. Diagnoses of struma ovarii were made in all cases. The preoperative imaging may not exactly give the diagnosis. Clinically, lesser age group was more affected and left side is more commonly involved in our series, in contrary to other literature. Out of 7 cases, bilateral struma ovarii was seen in 1 patient. No malignant features were seen in any of these cases

Benign Skin Neoplasms among the Histopathological Specimens of Skin Neoplasm in a Teaching Hospital: A Descriptive Cross-sectional Study

Introduction: Skin tumors are relatively uncommon malignancies worldwide, but its incidence has been progressively increased over the last few decades. Skin tumor belongs to a diverse group of neoplasms arising from the epidermis, adnexal structures and dermis rendering the classification difficult. The study aims to find out the prevalence of benign skin neoplasm among the histopathological specimens of skin neoplasm of a teaching hospital. Methods: A descriptive cross-sectional study among the hospital records of histopathological samples of skin neoplasm in the Department of Pathology of a tertiary care center from January 2017 to December 2020. Ethical approval was taken from the Institutional Review Committee (Ref: MEMG/IRC/427/GA). Convenient sampling was done. Data were entered in Microsoft Excel and analyzed using Statistical Package for the Social Sciences version 21 software. Point estimate at 95% Confidence Interval was calculated with frequency and descriptive statistics. Results: Out of total skin neoplasm samples, 121 (57.34%) (50.67-64.01 at 95% Confidence Interval) benign skin neoplasms were present. Among them, the majority were keratinocytic tumor 81 (66.9%) followed by skin appendageal 23 (19.0%) and melanocytic tumors 17 (14.0%). Acrochordan 18 (14.9%) and pilomatricoma 12 (9.9%) were the predominant keratinocytic and appendageal neoplasms respectively. Most of the cases occurred in head and neck region 64 (52.9%). Conclusions: The study concluded that the prevalence of benign skin neoplasm was slightly lower compared to the other studies. Most of the benign skin neoplasms were keratinocytic tumors followed by appendageal and melanocytic tumors. Acrochordan was the commonest benign keratinocytic tumor.</jats:p

Fine needle aspiration cytology diagnosis of Aspergilloma -- A case report.

Fine needle aspiration cytology, a simple and inexpensive technique can aid in early diagnosis of aspergilloma. Here, we present a case of 55 years old female with a past history of tuberculosis. Fine needle aspiration cytology of the right lung cavitary lesion was performed which confirmed the diagnosis of aspergilloma.</jats:p

Ganglioneuroblastoma in a newborn with multiple metastases: a case report

Abstract Background Ganglioneuroblastoma is a tumor of peripheral neuroblastic tissue which occurs predominantly in the pediatric age group; it is a rare occurrence in the newborn period with only one case reported at birth to date. Case presentation We report the case of a newborn male baby of Brahmin ethnicity from Nepal who presented with respiratory distress and blueberry muffin skin lesions after birth. A computed tomography scan showed a mass lesion in the posterior mediastinum, which was diagnosed as ganglioneuroblastoma on fine-needle aspiration cytology. He also had metastases to multiple sites including heart, lungs, skin and brain. Conclusions Ganglioneuroblastoma is a rare tumor in newborns. Any newborn presenting with respiratory distress associated with blueberry muffin skin lesions should be evaluated for neuroblastic tumor

Sensitivity of Sinus Radiography Compared to Computed Tomogram: A Descriptive Cross-sectional Study from Western Region of Nepal

Introduction: Radiography of the paranasal sinuses is commonly used diagnostic modality. However,the trustworthiness of plain radiographic findings of paranasal sinuses is debatable. The intentionof this study was to weigh the diagnostic soundness of plain radiograph of the paranasal sinuses tothat of computed tomogram scan.&#x0D; Methods: This is a descriptive cross sectional study carried out in 110 participants in Departmentof Radiology of Gandaki Medical College from November 2017 to April 2018. Ethical approval isobtained from Institution review board (Ref. No.39/074/075). Sample size was calculated takingconfidence level of 95%, expected prevalence of 14% and precision of 6.5% in population of 492098 inProvince 4 of Nepal. Random sampling method was used. Data was enter in Statistical Package forthe Social Sciences version 17 software and analysed.&#x0D; Results: A total of 110 participants are included in this study of which 62 (56.4%) are females and48 (43.6%) are males with an overall mean age of 34.5 years. The commonly involved sinus wasmaxillary 56 (50.9%) followed by ethmoid 33 (30%) sinus. The overall sensitivity and specificity ofdetecting sinusitis by sinus radiography is higher for maxillary sinus (89.7% and 87%) followed byethmoid (69.7% and 96.1%) and frontal (61.5% and 96.9%) sinuses.&#x0D; Conclusions: Sinus radiography is more sensitive for detecting pathologies in maxillary sinuses,while it is moderate for frontal, ethmoid sinuses and least for sphenoid sinuses. Diagnostic accuracyof computed tomogram scan is more, hence should be recommended to characterize the complexpathology and anatomy of the osteomeatal complex.</jats:p

A 14 Years Hospital Based Study on Clinical and Morphological Spectrum of Hydatid Disease

Introduction: Hydatid disease is endemic in sheep and cattle-raising areas worldwide. Its prevalence is high in Nepal. The study was carried out to determine the clinical, radiological and pathological presentations of hydatid disease. Methods: This was a retrospective study of all hydatid disease cases reported in Department of Pathology, from August 1996 to July 2010. All the clinical, radiological and pathological data were collected and collated. Results: A total of 51 cases of hydatidosis were studied. Patients presented with related symptoms in 47 cases, 92.16% with CI (84.78, 99.54) and asymptomatic in four cases, 7.84% with CI (0.46, 15.22). Involvement of liver and lung was found in 35 (68.63%) cases and 10 (19.61%) cases respectively. Involvement of other organs like kidney, pelvis and broad ligament were seen in 6 of the cases. Total 29 cases, 56.86% with CI (43.2, 70.46) had solitary cyst while rest of the cases had multiloculated cyst. All cases had radiological correlation and histopathological confirmation. Conclusions: Most cases presented with organ related vague symptoms, however it should be considered as a differential diagnosis especially in asymptomatic cases and cases with unusual sites. Imaging studies is useful in preoperative diagnosis and postoperative histopathology is confirmatory. A multicentric hospital based study will help to decrease the incidence. _______________________________________________________________________________________ Keywords: echinoccocus; hydatid cyst; hydatidosis