biopsy

Background: CT-guided lung biopsy is routinely performed minimally invasive procedure. Imaging findings in the lung can have a broad differential diagnosis; therefore, it is indicated for definitive determination of pulmonary nodules or masses. Post-biopsy complications are common with most of them manageable in daycare. As pneumothorax is the most common complication, frequency and severity of pneumothorax with assessment of risk factors and follow-up for resolution is necessary.Methods: A prospective evaluation of 123 biopsies with automated coaxial biopsy of 18 gauge was done. Post-biopsy pneumothorax was evaluated for its incidence and resolution. The studied risk factors were; patient age, sex, lesion location, lesion size, shortest pleural lesion depth, traversed lung parenchymal distance, presence of emphysema, fissure penetration, needle thoracic wall angle, and lesion characteristics.Results: Reported immediate post-procedural pneumothorax was 22% with 19% of mild, 4% of moderate and 2.4% of severe cases. 51.9% of cases showed resolution within 24 hours. The intervention was required in only 4.8% of biopsy cases. A significant p - value of pneumothorax with the nodule depth increased traversed lung parenchymal distance, acute needle angle, fissure puncture, and presence of emphysema was seen. Emphysema was an independent variable in pneumothorax in multivariate analysis.Conclusion: Pneumothorax is an unamenable consequence of CT-guided lung biopsy and a cautious approach should be kept in view of the variables that are associated with it to reduce its incidence and severity in patients.

Bartholinitis, or Bartholin's gland abscess, is a relatively common gynecological condition among women of reproductive age. Its annual incidence is estimated at approximately 0.5 per 1,000 women, which corresponds to a lifetime cumulative risk of about 2%. The condition primarily affects patients between 20 and 50 years old, with a peak frequency observed between 35 and 50 years.After menopause, due to the natural involution of the gland, Bartholin's cysts and abscesses become less frequent, although they can still occur. Moreover, in women over 50, the appearance of a new mass in the gland region should prompt caution, as it may, in rare cases, indicate a carcinoma of the Bartholin's gland or an adjacent vulvar cancer. Therefore, for patients over 40 presenting with a newly emerged cyst or abscess, clinical guidelines recommend performing a biopsy or excision to rule out malignancy. We present the case of a 50-year-old woman with no significant medical history, who was urgently referred to the gynecological emergency department due to confusion, unexplained fever of 40 °C, and resistant leucorrhoea following a week of corticosteroid antibiotic therapy. Clinical examination revealed a large, tender right vulvar mass, indicative of an acute Bartholin's abscess. The patient exhibited signs of septic shock and was admitted to the ICU. Following a diagnosis of sepsis, broad-spectrum antibiotic therapy was initiated, alongside fluid resuscitation and norepinephrine support. Surgical drainage of the abscess confirmed the presence of E. coli. The patient's condition improved rapidly, and she was discharged on postoperative day 8 with no complications. This case underscores that while Bartholin's abscess is typically benign, severe complications, including septic shock, can occur—especially in patients over 50. The appearance of a new Bartholin's region mass in older women should prompt consideration of malignancy, necessitating biopsy or excision. Recent studies compare various therapeutic approaches including simple incision and drainage, Word catheter placement, marsupialization, silver nitrate application, and complete gland excision. Each method has its advantages and drawbacks, with marsupialization offering lower recurrence rates and higher patient satisfaction in many instances. 

Background: Acral Fibromyxoma (AFM) is a rare benign soft tissue tumour which is described as a fibromatous and myxoid tumour of skin and soft tissue. Case details: A 40-year-old  male presented to the Dermatology outpatient department with swelling over the wrist of one year duration. The swelling was associated with mild pain, and it gradually increased in size to reach its present size. Cutaneous examination revealed a 2x2 cm mobile, cystic to firm, non-tender swelling over the dorsum of the right wrist. Based on its location and clinical features, it was provisionally diagnosed as a ganglion cyst  and excision biopsy was done. Histology showed stellate-shaped cells in a myxoid background with round to oval nuclei having a small, inconspicuous nucleolus. Acral fibromyxoma presents a distinct histopathology including a myxoid stroma and spindle-shaped cells, which are essential for accurate diagnosis and management.

Background: Postmenopausal bleeding (PMB) is bleeding from the genital tract after 12 months of amenorrhea in a woman over the age of 50, or 24 months if below the age of 50 years, in 10% of women presented with PMB, the cause is endometrial cancer.Purpose: To assess the clinical presentation types and outcomes of diagnostic measures provided for women presenting with PMB at Saad Abu-Alela Hospital, Khartoum, Sudan.Methodology: It was a descriptive, cross-sectional study conducted at Saad Abu-Alela Teaching Hospital in the period from January to December 2022.An interview questionnaire was used for data collection. Fifty-nine (59) postmenopausal women were included in this study, age, parity, risk factors, duration of bleeding, duration of menopause, ultrasound findings, and hysteroscopy findings were recorded.Results: The majority of study participants were aged between 50-54 years, menopause duration was most 1-4 years, most of the participants were educated and medically free, DM and HTN, and most of the participants were multiparous. Duration of PMB ranged between weeks in a third of cases and up to more than a year in some cases, amount of bleeding was mild in more than half. Ultrasound is used to assess the endometrial thickness and other findings, also hysteroscopy and biopsy or Dilation and curettage and hysterectomy.Conclusion: The ultrasound and endometrial biopsy via inpatient hysteroscopy and dilatation and curettage were the best tools for evaluation of (PMB), benign conditions were the most frequent outcome and endometrial cancer.

Introduction: Pleomorphic Carcinoma (PC) is a subset of poorly differentiated non–small cell lung cancer that is diagnostically challenging because it is a rare malignancy of the lung. It shows varying dual-cell components; spindle or giant cells and epithelial cells.Method: We report a case of 68-year-old non-smoking female who presented with cough, fever, pain in the left side of chest & weight loss of recent onset and an abnormal shadow on her chest X-ray. Computed tomography of chest revealed a well defined heterogeneously enhancing cavitatory soft tissue lesion in the posterior basal segment of the left lower lobe with mediastinal lymphadenopathy.Results: Fine needle aspiration cytology& percutaneous lung biopsy confirmed poorly differentiated malignant tumor. Patient underwent a left lower lobectomy. A diagnosis of PC was confirmed after Immunohistochemistry (IHC). Mutation analysis revealed an EGFR exon 21 mutation within the tumor cells. The patient is on Gefitinib based chemotherapy and has remained disease-free for three years post-surgery.Conclusion: PC of the lung is a rare pathological entity. Definite diagnosis may only be made on a resected tumor along with the use of IHC. Surgical resection is the main modality of the treatment. Such rare cases should be documented to establish an optimal management plan and to provide a further insight to targeted therapy.