Cytopuncture microbiopsy during transcanalicular endoscopic lacrimal duct recanalization: A novel approach

Objective@#To describe the cytopuncture microbiopsy (CM) technique performed during transcanalicular endoscopic lacrimal duct recanalization (TELDR) in patients with primary acquired nasolacrimal duct obstruction (PANDO) as an alternative to open biopsy, the standard method used in collecting specimen.@*Methods@#This is a noncomparative, interventional case series with histopathologic correlation. Patients diagnosed with complete PANDO who underwent TELDR with balloon dacryoplasty and silicone intubation with CM at University of Santo Tomas Hospital from October 2014 to January 2017 were included.@*Results@#Twenty (20) tissue specimens from the lacrimal sac and nasolacrimal duct were obtained from 18 patients. There were 16 females and 2 males included in the study. Mean age was 57.5 years. All specimens revealed few clusters of benign epithelial cells with few degenerated mononuclear cells and lymphocytes, and singly scattered lymphocytes that are set in fibrinous background. Tissue cytology studies were negative for malignant cells.@*Conclusion@#CM is a minimally invasive procedure that offers an alternative to open biopsy technique that can be done routinely during TELDR.

Le cancer de sein diagnostiqué chez l'homme à Kinshasa: à propos de 4 cas / NA

Même si les seins des hommes sont moins développés que ceux des femmes, La littérature mondiale note que le cancer du sein chez l'homme intervient dans moins de 1 % des cas des cancers, et traditionnellement les hommes avec cancer du sein présentent un risque spécial de développer un autrecancer. Les métastases du cancer du sein sont prioritairement au niveau des os avec 62 %. Les causes du cancer du sein chez l'homme demeurent encore inconnues, toutefois les facteurs de risque qui sont documentés concernent les antécédents familiaux du cancer de sein, une prédisposition génétique dans environ 15 % de cas de cancer du sein chez l'homme, liée à une mutation génétique héritée du gène BRCA2. Durant une année (2020), nous avons reçu 4 patients avec cancer de sein au Centre d'imagerie médicale Kokolo à Kinshasa, 3 patients résidants à Kinshasa et un patient venu de la province voisine du Kongo Central; et les investigations sonographiques nous ont permis de classer ces masses tumeur maligne, d'où l'indication de la microbiopsie écho guidée. Cette dernière nous permis de conclure au carcinome infiltrant et l'immunohistochimie nous a permis de classer ces masses en Luminal à cause de la positivité des récepteurs ostrogéniques, les rendant éligibles au schéma tamoxifène. Le cancer de sein est donc aussi une réalité chez l'homme congolais de Kinshasa et du Kongo Central.

Even if men's breasts are less developed than those of women, World literature notes that breast cancer in men occurs in less than 1% of cancer cases, and traditionally men with breast cancer have a special risk of developing another cancer. Breast cancer metastases are primarily in the bones with 62%. The reasons of breast cancer in men are still unknown, however the risk factors that are documented relate to a family history of breast cancer, a genetic predisposition in about 15% of breast cancer cases in humans, linked a genetic mutation inherited from the BRCA2 gene. During the year 2020, we received 4 male patients with breast cancer at the Kokolo Medical Imaging Center in Kinshasa, 3 patients residing in Kinshasa and one patient from the neighboring province of Kongo Central; and sonographic investigations allowed us to classify these malignant tumor masses, hence the indication for echo-guided microbiopsy

The significance of microbiopsies in cytological smears.

Background: The role of fi ne needle aspiration cytology (FNAC) in the diagnosis of malignant lesions is well documented. Conventionally obtained fi ne needle aspiration (FNA) smears frequently contain well preserved viable intact tissue fragments (microbiopsies). Aims: The present study was aimed at evaluating the microbiopsies and carrying out further cyto-histopathologic correlation in order to assess what additional information they could provide. Materials and Methods: A total of 116 FNA smears from clinically suspected malignant lesions were examined, of which 81 smears (70.0%) contained representative tissue fragments of the tumors. Histopathological details were available in 75 cases. Immunocytochemistry (ICC) was applied in selected smears as and when required. Results: Tumors in which microbiopsies aided in diagnosis chiefl y included soft tissue malignancies (12 cases), typed into malignant peripheral nerve sheath tumor, fi brosarcoma, spindle cell sarcoma and malignant melanoma; lung tumors (14 cases) classifi ed as small cell carcinoma, large cell carcinoma, squamous carcinoma and adenocarcinoma; breast tumors (08 cases), typed into ductal, medullary and lobular carcinoma; and lymph node metastasis (19 cases) from primaries in lung, larynx and thyroid. The cyto-histopathologic concordance was raised from 81.2% in the absence of microbiopsies to 93.2% in their presence. Conclusions: FNA smears containing microbiopsies are of ample help in establishing fi rm diagnosis, tumor typing, and predicting possible primary sites in metastatic tumors which were not possible by cytology alone. Hence, this technique can be utilized to enhance the diagnostic accuracy of FNAC, if put into practice in evaluation of routine cytology smears, without increasing any fi nancial burden on patients.