1.Application of the Milan System of reporting salivary gland cytopathology: A retrospective cytohistological study in a Tertiary Medical Center
Carolyn Marie Legaspi ; Elizabeth Ann Alcazaren ; Jose Carnate Jr.
Philippine Journal of Pathology 2022;7(1):15-23
Background:
A fine needle aspiration biopsy has been established as a safe, minimally invasive procedure in evaluation of salivary gland lesions. The complex overlapping cytomorphology of these lesions are challenging for pathologists, hence the introduction of an evidence-based system, the Milan System of Reporting Salivary Gland Cytopathology, to improve overall patient care. The study was taken up to reclassify salivary gland lesions from previous FNA biopsies in order to determine sensitivity, specificity, positive and negative predictive values of FNA, and evaluate the risk of malignancy of the various categories of the Milan system.
Methodology:
This was a 6-year retrospective descriptive study in a tertiary medical center. All salivary gland FNA cases were reviewed by two pathologists, and re-classified into the six categories of the Milan System. The number of false positive, false negative, true positive and true negative cases were obtained by comparing with the final histopathology diagnosis, and the risk of malignancy per category were calculated.
Results:
A total of 76 cases were reviewed and the overall average of the two readers diagnostic accuracy were 85.02% (95% CI: 84.50-85.60%), sensitivity and specificity were 80.77% (95% CI: 79.90-81.60%) and 86.19% (95% CI: 85.70-86.70%), respectively; positive and negative predictive values were 62.16% (95% CI: 60.70-63.60%) and 94.17% (95% CI: 94.00-94.40%), respectively.
Conclusion
The Milan System category with highest risk of malignancy was Malignant (Category VI – 100%). FNAB is still a reliable tool for clinicians, and use of the Milan System of Reporting Salivary Gland Cytopathology is beneficial in increasing efficacy of communication among clinicians to improve patient care.
Cytology
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Salivary Glands
2.SARS-CoV-2 RT-PCR Ct Value and Laboratory Tests: Clinicopathologic characteristics among adult Filipino Inpatients diagnosed with COVID-19 in a tertiary medical center.
Carolyn Marie Legaspi ; David Jerome Ong ; Jose Inigo Remulla ; Rose Lou Marie Agbay
Philippine Journal of Pathology 2023;8(1):32-40
INTRODUCTION:
The role of the laboratory during the COVID-19 pandemic is not limited to just diagnosis of the
disease, but also in clinical decision-making, by providing information on relevant laboratory biomarkers.
Clinicians also use Ct value to guide patient management. There are limited studies available locally
regarding the significance of Ct value and pertinent laboratory biomarkers in COVID-19 patients. This study
aimed to assess the aforementioned laboratory data, along with the clinicopathologic characteristics of
affected patients, and determined if this information may be useful for robust clinical decision-makin
METHODOLOGY:
In this retrospective analytic study, we identified 325 out of 1,049 adult Filipino inpatients
diagnosed with COVID-19 and analyzed their Ct values and pertinent laboratory biomarkers such as
neutrophil and lymphocyte count, platelet count, LDH, ferritin, procalcitonin, CRP, AST/SGOT, ALT/SGPT, PT/
INR, and D-dimer, and correlated them with the severity of the disease.
RESULTS:
Two hundred twenty (67.7%) patients had non-severe disease, while 105 (32.3%) had severe disease.
Lower Ct values of ORF1ab (median = 26.4) and N (median = 24.8) genes were seen in the severe group
compared to the non-severe group and were found to be significant (p<0.001). Laboratory markers
(neutrophil, platelet counts, LDH, ferritin, procalcitonin, CRP, AST, PT/INR, and D-dimer) were associated
with severe COVID-19. On the other hand, ALT was not associated with severe disease.
CONCLUSION
The laboratory biomarkers together with Ct value and overall clinical picture may provide
valuable information to physicians for more robust clinical decision-making.
COVID-19
;
laboratory biomarkers
;
SARS-CoV-2
;
RT-PCR
3.Gastric glomus tumor: A case report
Gio Earnest de la Cruz ; Carolyn Marie Legaspi ; Jose Carnate, Jr.
Philippine Journal of Pathology 2021;6(2):55-58
Glomus tumor is an uncommon mesenchymal neoplasm usually described in the distal extremities, and rarely involving visceral organs. We report the case of a 27-year-old Filipino female with a history of low hemoglobin count and a submucosal gastric mass. This was demonstrated on microscopic and immunohistochemical studies to be a gastric glomus tumor (GGT). Although rare, GGTs should be part of the differential diagnoses of submucosal gastric masses.
Glomus Tumor
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Stomach Neoplasms
;
Immunohistochemistry