Effect of Umbilical Cord Ferritin Level on Auditory Brainstem Response Threshold in Newborns.

INTRODUCTION: Iron plays an important role in myelination. Ferritin is a reliable indicator of the tissue iron store and umbilical cord ferritin level reflects the in utero iron stores. Objective is to study the effect of the umbilical cord ferritin level on the ABR recording in the newborn. MATERIALS AND METHODS: The study was conducted in a tertiary care hospital in India with a sample of 250. The study group was divided into Group A (with umbilical cord ferritin level of ≤ 75ng/ml) and Group B (umbilical cord ferritin level > 75ng/ml). Correlation analysis was carried out to study the relation between ferritin level and latency of wave I,III and V. Two sample t test was done between the two groups to study the significance of latency and amplitude of various ABR waves. RESULTS: There was no correlation between the ferritin and ABR threshold as well as latency and amplitude of ABR waves. A significant prolongation of the absolute latency of wave V and the interwave latency of III - V and I -V of both the ears was found in Group A. The amplitude of the ABR waves did not show any statistical difference between the two groups. CONCLUSION: Ferritin levels effect the latency of wave V of ABR and this may be attributed to slow conduction time secondary to altered myelination. Measurement of serum ferritin may be considered as a routine protocol in newborn babies after delivery or before discharge from hospital.

Fine-Needle Aspiration of De Quervain's Thyroiditis (Subacute Granulomatous Thyroiditis): A Cytological Review of 20 Cases.

INTRODUCTION: De Quervain's Thyroiditis (DQT) is a self limiting inflammatory disease of the thyroid gland that presents with pain and sore throat. Although the diagnosis is usually made clinically, Fine Needle Aspiration (FNA) may provide assistance, particularly in excluding other thyroid lesions. AIM: The objective of this study was to reveal the cytological characteristics of DQT. MATERIALS AND METHODS: We retrospectively reviewed the clinical and FNAC findings of 20 cases of DQT to find the most reliable features for a confident cytological diagnosis. RESULTS: Among the cases reviewed, the common cytological features present in all 20 cases were follicular epithelial cells with degenerative changes and dirty background comprising of cellular debris and mixed inflammatory cells (lymphocytes and macrophages and occasional polymorphs). The next common finding observed was Multinucleated Giant Cells (MNGCs) seen in 19 cases followed by epithelioid cell clusters in 15 and colloid in 13 cases. CONCLUSION: Presence of follicular epithelial cells, large MNGCs and dirty background of cellular debris, mixed inflammatory cells with predominance of lymphocytes and macrophages were the most striking and consistent features for diagnosis of DQT in cytological smears. The above findings in consideration with the clinical history will help us to reach a definitive diagnosis. FNA also proves to be a useful tool in excluding other thyroid lesions with similar clinical presentations.

Kimura's disease: A diagnostic challenge experienced with cytology of postauricular swelling with histopathological relevance.

Kimura's disease is a rare, chronic inflammatory disorder of unknown cause. It is endemic in Asia, affecting more number of males than females, with a ratio of 3:1. The typical clinical manifestations include a triad of painless unilateral cervical lymphadenopathy or subcutaneous masses predominantly in the head and neck region, blood and tissue eosinophilia, and an elevated serum immunoglobulin E (IgE) levels. Variable conditions both benign and malignant may mimic Kimura's disease both clinically and on fine needle aspirates. The confirmatory diagnosis is established only by histopathological examination. We report a case of Kimura's disease in a patient who underwent multiple investigations in view of her past history and family history of pulmonary Koch's. Fine needle aspiration cytology (FNAC) was performed thrice with consistently similar result of reactive lymphadenitis with numerous histiocytes and eosinophilia. The final diagnosis of Kimura's disease could finally be established only on histopathological examination.

Koch's Disease Presenting as an Isolated Testicular Mass- An Unusual Occurance.

Isolated testicular tuberculosis (TB) is rarely seen. A 72-year-old, farmer presented with complaints of discharging sinus from scrotum along with pain and swelling. The patient had no sign of tuberculosis. On examination a hard mass arising from the left testis was noted along with a discharging fistula on the overlying scrotal skin. Chest x-ray and ultrasound examination of the abdomen were within normal limits. After assessing the testicular mass, an informed consent was taken thereafter left orchiectomy and fistulectomy performed. Histopathological examination revealed caseating granulomas along with numerous Langhan's giant cells consistent with tuberculous orchitis. The patient received anti-TB treatment for six months. The rare involvement of testis by tuberculosis needs to be mentioned.

A weeping umbilical hernia: bilateral ovarian mucinous cystadenoma with disseminated peritoneal adenomucinosis.

A young woman was referred to us for the management of an umbilical hernia with macerated overlying skin through which massive ascites was leaking. On examination we found a jelly-like substance seeping out of the opening. A contrast-enhanced CT scan of the abdomen revealed bilateral ovarian cystadenocarcinoma with pseudomyxoma peritonei. The patient underwent cytoreductive surgery along with hysterectomy and bilateral oophorectomy followed by hyperthermic intraperitoneal chemotherapy with mitomycin C. Histopathological examination showed bilateral borderline cystadenoma with peritoneal adenomucinosis. Follow-up at 1 year showed no signs of recurrence.

Sclerosing Lobular Hyperplasia- Correlation between Cytomorphological and Histological Findings.

Sclerosing lobular hyperplasia of the mammary gland is an uncommmon benign lesion which is mainly seen in adolescents and young women. The breast lobules are enlarged due to ductal and acinar proliferations but they have normal architecture. There is extensive fibrosis of the intralobular stroma, and to a lesser degree, of the interlobular parenchyma. Patients generally complain of a palpable, painless/slightly tender and well-defined lump in breast. Fine-needle aspiration cytology of sclerosing lobular hyperplasia is non diagnostic with features similar to fibroadneoma except for the absence of stromal fragments. In order to reach a definitive diagnosis, a histopathologic evaluation is needed. However, a distinction between the two benign entities is of no clinical significance.We are describing a case of sclerosing lobular hyperplasia that occurred in the left breast of a 26-year-old lady.