Cutaneous metastasis from follicular variant of papillary thyroid carcinoma: a case diagnosed on cytology.

A 40-year-old woman presented with a scalp swelling. A careful clinical examination revealed a left-sided deep-seated thyroid nodule. Fine needle aspiration from both sites disclosed a microfollicular architectural pattern on Giemsa stain and pale nuclei with nuclear grooves on Papanicolaou stain, indicating the possibility of follicular variant of papillary thyroid carcinoma with metastasis to the scalp. Histologic tissue evaluation confirmed the diagnosis. Thus, a diligent search for nuclear features should be performed to enable a diagnosis of follicular variant of papillary thyroid carcinoma on cytology. This helps in patient management obviating the need for a second surgical intervention.

Cytodiagnosis of filarial infections from an endemic area.

OBJECTIVE: To throw light on cytologic findings as a possible mode of diagnosis of lymphatic filariasis. STUDY DESIGN: Filariasis has worldwide distribution, but lymphatic filariasis predominantly affects tropical and subtropical regions. Demonstration of microfilaremia, the specific test for diagnosis of lymphatic filariasis, often shows false negative results in endemic areas. The present study, done in an endemic area, showed the presence of microfilariae or adult worms of Wuchereria bancrofti in fine needle aspirates collected from amicrofilariaemic cases. In a few cases the discovery was incidental. A total 4,534 cases undergoing cytologic evaluation were carefully screened for the presence of adult worms or larvae, irrespective of clinical diagnosis. Microfilariae were demonstrated in both clinically suspected cases of filariasis and asymptomatic cases. RESULTS: A total of 1 positive cases were found; in 4 cases the clinical diagnosis was lymphatic filariasis, and 7 cases were asymptomatic. All 11 cases were amicrofilariaemic. CONCLUSION: Various sophisticated investigations are used for diagnosis of lymphatic filariasis without microfilaremia. Fine needle aspiration cytology, being a cheap, simple and easy procedure, may have some role in this field, but further detailed studies are needed before any final claim.

CT guided fine needle aspiration cytology of thoracic mass lesions: a prospective study of immediate cytological evaluation.

To evaluate the role of CT guided FNAC as diagnostic and supportive investigation for thoracic lesions, 190 patients were studied during two years period from March 2003 to February 2005 in our institution. A total number of 163 (85.8%) lung lesions, 22 (11.6%) mediastinal lesions and 05 (2.6%) pleural lesions were obtained; only neoplastic lesions were categorized as per WHO classification. The diagnostic sensitivity for malignancy was 97.71% and specificity 100%. Though our priority was cytological assessment, the cytological diagnosis was corroborated with clinico-radiological parameters and transbronchial biopsies whenever applicable.

Recurrent and aggressive chondroblastoma: a case report.

Recurrent chondroblastoma with pulmonary and palatal metastasis is a rare occurrence. We report the cytological and histological findings of such a case in a 33 years old male, where the primary diagnosis of metastatic chondroblastoma was made on FNAC, which was later confirmed on histopathology. The present case highlights that, some chondroblastomas do exist, that are capable of pursuing a malignant course.

Platelet Aggregation Study in Patients With Hemoglobin Eß Thalassemia in India.

Hemoglobin Eß thalassemia is a major public health problem in India, especially in the state of West Bengal. Various thromboembolic events are common, especially in splenectomized patients. Platelet hyperactivity most likely plays a pathogenetic role. To investigate the role of platelets in hypercoagulability, platelet aggregation tests were undertaken in the present study. Platelet-rich plasma from 30 patients with Eß thalassemia (15 splenectomized and 15 nonsplenectomized) were studied and compared with 15 healthy participants. The 4 agonists used were adenosine 5-diphosphate, adrenaline (epinephrine), collagen, and ristocetin. The current study shows both splenectomized and nonsplenectomized patients had abnormal aggregation compared to normal healthy controls. Splenectomized patients had higher platelet aggregation than nonsplenectomized patients for all 4 agonists; but statistically significant difference among 2 groups was found only for collagen. The present study confirms a role of splenic absence in platelet hyperaggregation.

Malignant mixed mullerian tumour of the fallopian tube of heterologous variety--a case report.

A female aged 49 years presented with pain and progressive swelling of right lower abdomen. She was operated upon and gross examination revealed a proliferative growth in the fimbrial end of the right fallopian tube. Microscopically the tumour comprised of adenocarcinoma and component of spindle cell stromal sarcoma with areas of chondrosarcoma as heterologous element. A diagnosis of malignant mixed mullerian tumour of the fallopian tube, clinically FIGO stage III was made, which is extremely rare in available literature.

Sertoli Leydig cell tumour of ovary with heterologous element--a case report.

A 16 years old female who presented with abdominal swelling and secondary amenorrhoea was subsequently diagnosed as Sertoli Leydig cell tumour of ovary revealing intermediate differentiation with heterologous element. The case is reported in view of its rarity.

Adenoid cystic carcinoma on the dorsum of the tongue.

Adenoid cystic carcinoma is a relatively rare epithelial tumor of the salivary glands accounting for about 5-10% of all salivary gland neoplasms. Approximately, 31% of salivary gland neoplasms affect minor salivary glands particularly the palate. It involves tongue in only 19.8% of cases and even rarely the dorsum of the tongue. We report such a rare case that affected dorsum of the tongue in a 45-year-old-female patient.

Endometrial hyperplasia: a clinicopathological study in a tertiary care hospital.

OBJECTIVE: To evaluate the clinical as well as histomorphologic features in different cases of endometrial hyperplasia along with its relative occurrence. MATERIALS AND METHODS: A one-and-a-half-year prospective study was conducted on histopathologically diagnosed cases of endometrial hyperplasia in a tertiary care hospital. Apart from relevant clinical findings, histomorphologic details were noted and statistically analyzed. OBSERVATIONS: Maximum number (46.5 %) of endometrial hyperplasia occurred in patients of 41-50 years age group. Majority (55.2 %) of the patients were found to be premenopausal. Menorrhagia was the most common (49.6 %) clinical presentation followed by postmenopausal bleeding (30.8 %). Simple hyperplasia without atypia was the most common type (95.6 %) followed by complex hyperplasia without atypia (3.6 %) and complex hyperplasia with atypia (0.8 %), respectively. The study of gland-stroma ratio revealed 65:35 to be the most frequent (34 %) ratio; variable-sized glands with cystic dilatation (60.4 %) was the commonest gland architecture and most of the cases (99.2 %) showed the absence of atypia. Associated histopathological findings included a case each of endometrial adenocarcinoma and undifferentiated endometrial stromal sarcoma along with the common leiomyoma and progesterone effects. CONCLUSION: Menorrhagia was the most common presenting complaint in cases of endometrial hyperplasia. The cases were mostly in the premenopausal age group. Simple endometrial hyperplasia without atypia was the commonest type diagnosed histopathologically. Histopathological examination along with clinical details is essential to give the final opinion regarding the diagnosis.

Fine needle aspiration cytology of ovarian tumors with histological correlation.

BACKGROUND: Till today, there has been some hesitation to accept the role of fine needle aspiration cytology (FNAC) in pelvic mass. We have tried to study the role of ultrasonography (USG) and computed tomography (CT) guided FNAC as diagnostic and supportive investigation for ovarian tumors. AIM: To evaluate the current status of image-directed percutaneous aspiration of ovarian neoplasm for the purpose of early detection of malignancy. MATERIALS AND METHODS: Seventy-four fine needle aspirations of ovarian neoplasms were performed between January 2007 and December 2008 by transabdominal approach under USG and CT guidance and correlated with histopathological findings and tumor markers. RESULTS: A total of 47 (63.5%) cases were assessed as malignant and 21 (28.3%) as benign and 6 (8.1%) as inconclusive. The neoplastic lesions were categorized as per World Health Organization (WHO) classification. CONCLUSION: With the availability of modern techniques, USG and CT guided FNAC can be an optimum modality for the diagnosis of primary and metastatic ovarian neoplasms and evaluation of recurrent malignant tumors, which has great impact on patient management consequently.

Pattern of cancer occurrence in rural population of West Bengal--a hospital-based study.

Incidence of cancer in India is lower than in the West and the commonly affected sites are very different. Cancers of the upper alimentary and respiratory tracts (oral cavity, pharynx, larynx) contribute more than half of the cancers in men and about a quarter in women. Indigenous habits of chewing and smoking seem to be primarily responsible for the high incidence of these cancers. During a 10-year study period, out of a total 20072 cases biopsied, 3226 (16.07%) were malignant. The maximum number of malignancies were from cervix uteri ie, 1499 (44.92%); next oral cavity and pharynx (n = 437; 13.55%) frequently found in males; breast was third in the series. Cancer of the cervix uteri is a major problem in women. Practical measures are to be taken for the prevention of these cancers common in India.

Sirenomelia: a case report.

Sirenomelia (Mermaid syndrome) is a rare anomaly of caudal region of the body, presented with fusion of the lower limbs. Genito-urinary, gastro-intestinal, neural tube and vertebral anomalies are found in most cases. Here a case of sirenomelia born of a 5th gravida mother is reported. The body had fusion of both lower limbs, absent genitalia, absent anal orifice and single umbilical artery. It died 2 1/2 hours after birth. Autopsy was undertaken to verify various anomalies.

A study of fine needle aspiration cytology of salivary gland lesions with histopathological corroboration.

The diagnostic utility of fine needle aspiration cytology as initial work up of salivary gland enlargement was assessed in one hundred and eighty-five salivary gland specimens over three years period and corroborated with histopathology, whenever feasible. All smears were evaluated according to cell size, amount of cytoplasm, cytologic atypia and presence of lymphocytes. (a) Variable cytologic appearances of pleomorphic salivary adenoma were observed. (b) Cellular pleomorphic adenoma and adenoid cystic carcinoma showed basaloid cell features. (c) Tumours with intermediate size cells and bland cytology included low grade muco-epidermoid carcinoma and cystic lesions. (d) Warthin's tumour, oncocytoma, salivary duct carcinoma and high grade muco-epidermoid carcinoma revealed large cells and abundant cytoplasm with or without atypia. A major diagnostic categories were inflammatory lesions (n = 7 5), cystic lesions (n = 9), benign tumours (n = 81), malignant neoplasms (n = 1 8) and normal acinar pattern (n = 2). Malignant tumours included muco-epidermoid carcinoma (n = 5), adenoid cystic carcinoma (n = 3), acinic cell carcinoma (n = 2), adenocarcinoma (n= 2), squamous cell carcinoma (n = 1), undifferentiated carcinoma (n= 4) and malignant lymphoma (n = 1). Histopathological correlation was possible in 40% of benign and 80% of malignant neoplasms. The overall sensitivity, specificity and diagnostic accuracy were very high. So it can be concluded that fine needle aspiration cytology can play important role in early diagnosis and subsequent therapeutic planning of salivary gland lesions.