Revised Bethesda System for Reporting Thyroid Cytology: Lessons learned from an appraisal of 5 years of experience in a central hospital.

Objective: The Bethesda System for Reporting Thyroid Cytology (BSFRTC) is widely adopted in the management of thyroid nodules. The system was updated in 2017, and its impact is the subject of this paper.

Methods: All thyroid fine needle aspirations from 2016-2020 using the BSFRTC, with follow-up surgical pathology, were reviewed.

Hepatic fibrinogen storage disease due to the fibrinogen γ375 Arg → Trp mutation "fibrinogen Aguadilla" is present in Arabs.

The mutation γ375Arg → Trp (fibrinogen Aguadilla) is one of four mutations (Brescia, Aguadilla, Angers, and AI duPont) capable of causing hepatic storage of fibrinogen. It has been observed in four children from the Caribbean, Europe, and Japan, suffering from cryptogenic liver disease. We report the first case of hepatic fibrinogen storage disease in Arabs due to a mutation in the fibrinogen γ-chain gene in a 3-year-old Syrian girl presenting with elevated liver enzymes.

Eosinophilic esophagitis in a developing country: is it different from developed countries?

Background and Objective. Despite the extensive reporting of eosinophilic esophagitis (EoE) from industrialized developed countries, reports from developing countries are rare. The aim of our study was to determine the epidemiological, clinical, and endoscopic features of EoE and response to therapy in children and adults from a developing country, Saudi Arabia.

Generalized lymphadenopathy as the first presentation of granulocytic sarcoma: a diagnostic challenge.

Introduction. Granulocytic sarcoma (GS), also known as chloroma or extramedullary myeloblastoma, is a solid tumor composed of primitive precursors of the granulocytic series that include myeloblasts, promyelocytes, and myelocytes. Granulocytic sarcoma is a rare tumor that may develop during acute myeloid leukemia (AML) but less frequently may precede its presentation.

Cytological clues in the distinction between phyllodes tumor and fibroadenoma.

Background: Fine-needle aspiration (FNA) sensitivity in discriminating between phyllodes tumor and its benign mimicker fibroadenoma (FA) remains low. Because a preoperative categorization of phyllodes tumor is crucial for their appropriate management, the authors undertook this study in an effort to improve the outcome of FNA by identifying reliable distinguishing features.

Methods: FNA smears from 15 and 12 histologically proven cases of phyllodes tumor and FA, respectively, were reviewed.

Esophageal trachealization: a feature of eosinophilic esophagitis.

Eosinophilic esophagitis (EE) is an inflammatory condition characterized by intense eosinophilic infiltration of the esophagus. EE is frequently misdiagnosed as gastroesophageal reflux disease. Here, we present a child with EE and a characteristic endoscopic finding, "ringed esophagus".

Haematogenous dissemination of tuberculous lymphadenitis.

Objective: To determine whether Mycobacterium tuberculosis infection spreads through the blood to different lymph-node groups in patients with tuberculous lymphadenitis.

Design: Prospective analytical study.

Setting: The patients were recruited, managed and followed at the lymphodenopathy clinic, Central Police Hospital, Burr, Khartoum, Sudan.

FNA of breast fibroadenoma: observer variability and review of cytomorphology with cytohistological correlation.

Objective: To determine the observer variability in reporting fibroadenoma of the breast by fine needle aspiration (FNA) and to review the cytomorphological features of the lesion with cytohistological correlation.

Methods: Retrospective analysis of FNA smears from 110 cases diagnosed as fibroadenoma of which surgical pathology follow-up was available in 33. Two pathologists were asked to categorize smears from 67 cases of breast lesions while blinded to the clinical finding as fibroadenoma, epithelial hyperplasia (usual and atypical) and malignant.

Three cases of malacoplakia of the gallbladder.

Malacoplakia is a granulomatous disease with a histiocytic infiltrate containing calcified bodies called Michaelis-Gutmann bodies considered to represent an abnormal response to infection involving defective lysosomes and abnormal microtubular assembly. The disease most frequently involves urinary and genital tracts, but has also been described from most organs. Reports from the gallbladder are extremely rare and as it might simulate specific infection, parasitic infestation as well as malignancy it is of importance for the surgeon and pathologist to be aware of the entity.

Mast cells in testicular lesions.

The study was performed on orchidectomized tissue and testicular biopsies sent for histopathological examination which included; 9 cases of orchitis, 6 pyocele, 9 haematocele, 13 seminomas, 5 embryonal cell carcinoma, 2 teratocarcinoma, 2 lymphoma, 4 yolk sac tumor, 17 infertility lesions and 6 normal. Toluidine blue stained sections were examined under high power magnification (hpm) and the number of mast cell present in 10 consecutive fields was counted. There was a considerable variation in the number and distribution of mast cells in various testicular lesions.

Benign follicular thyroid lesions versus follicular variant of papillary carcinoma: differentiation by architectural pattern.

Differentiation between benign and malignant follicular lesions is one of the difficult diagnostic areas in thyroid fine needle aspiration (FNA). Nuclear criteria are usually used to distinguish between them. In this study the microarchitectural pattern of common benign follicular lesions, namely nodular hyperplasia (NH) and follicular adenoma (FA) were analysed in comparison with those of follicular variant of papillary carcinoma (FVPC) in order to aid in their differentiation.

Diagnosis of tuberculous lymphadenitis by FNAC, microbiological methods and PCR: a comparative study.

Despite its usefulness in the diagnosis of tuberculous lymphadenitis, fine needle aspiration cytology (FNAC) faces several limitations, and its sensitivity and specificity are not well established. The diagnostic accuracy and limitations of FNAC were studied in comparison with conventional microbiological methods and polymerase chain reaction (PCR). Sixty patients with lymphadenopathy and a clinical diagnosis of tuberculous lymphadenitis were subjected to FNA.

The role of FNA in the initial management of thyroid lesions: 7-year experience in a district general hospital.

Fine needle aspiration (FNA) cytology plays a major role in the diagnosis of the thyroid lesions in university hospitals and tertiary referral institutions. Our aim was to find out if this was possible in small district hospitals with limited resources. Over a 7-year period, from October 1994 to April 2002, 303 patients with thyroid swellings underwent FNA with an overall adequacy rate of 97.

Fine needle aspiration cytology of head and neck masses. Seven years' experience in a secondary care hospital.

Objective: To study the value of fine needle aspiration (FNA) in the diagnosis of head and neck masses in a secondary care hospital.

Study Design: FNA from 225 patients with head and neck masses were reviewed. The results were analyzed, according to anatomic location, into 3 groups: inflammatory, congenital and neoplastic.

Follicular thyroid lesions coexisting with Hashimoto's thyroiditis: incidence and possible sources of diagnostic errors.

Our objectives were to study the types and incidence of thyroid follicular lesions coexisting with Hashimoto's thyroiditis (HT), the pitfalls in their cytodiagnosis, and the effect on management. All cases of HT diagnosed by fine-needle aspiration (FNA) and/or histology over a 7-yr period were retrospectively studied. HT coexisted with follicular adenoma (FA) in 6 cases, follicular variant of papillary carcinoma (FVPC) in 1 case, and goitrous nodule (GN) in 2 cases.

Fine-needle aspiration cytology of metastatic nasopharyngeal carcinoma in cervical lymph nodes: comparison with metastatic squamous-cell carcinoma, and Hodgkin's and non-Hodgkin's lymphoma.

Our objective was to study the cytomorphological features of metastatic nasopharyngeal carcinoma (NPC) as compared to squamous-cell carcinoma (SCC) of nonnasopharyngeal origin, Hodgkin's lymphoma (HL), and non-Hodgkin's (NHL) lymphoma in the neck lymph nodes. The aim of this study was to find simple cytological criteria using routine stains that can help in differentiating between these entities. All fine-needle aspiration (FNA) smears of metastatic NPC, SCC, HL, and NHL from neck nodes available in our files were included in this study.

Pattern and incidence of cancer in Northern Saudi Arabia.

Objective: To study the pattern and incidence of cancer in the Al-Jouf region of Saudi Arabia.

Methods: The record of all confirmed cancer cases were retrieved and studied from the files of the Histopathology and Cytology Department, Prince Abdulrahman Al-Sudairy Central Hospital, Al-Jouf, Kingdom of Saudi Arabia (KSA) during the period 1994 to 2001. The major types of cancer were ranked in order of relative frequency.

Extrauterine placental site trophoblastic tumour in association with a lithopedion.

Aim: We describe an unusual case of extrauterine placental site trophoblastic tumour located in pouch of Douglas in association with a lithopedion.

Methods And Results: A 35-year-old female presented with acute abdomen and peritonitis following rectal perforation. The patient gave a history of 5 months amenorrhoea followed by vaginal bleeding 5 years prior to admission.

Supra-sternal notch tuberculous abscess: a report of three cases.

Extra-pulmonary tuberculosis remains a diagnostic and therapeutic challenge; its clinical presentation can mimic a wide range of pathological conditions. Here we report on 3 female patients who presented with supra-sternal masses that were suspected clinically to be of thyroid origin. By use of fine-needle aspiration cytology (FNAC), they were proved to be tuberculous lesions involving the pre-tracheal lymph nodes.

Blood supply and vasculature of mycetoma.

The blood supply to the mycetoma lesion and its vasculature were studied in patients with various types of mycetoma using histological, ultrastructural, angiographic and sonographic techniques. The mycetoma lesion proved to be well vascularized. However, certain vascular abnormalities were demonstrated.