Fine-needle aspiration cytology of retroperitoneal lesions: a 5-year experience with an emphasis on cytohistological discrepancy.

BACKGROUND: The retroperitoneal space contains various organs which can be affected by various non-neoplastic and neoplastic pathological processes. A diagnosis of these retroperitoneal lesions is often difficult. Fine-needle aspiration cytology (FNAC) under image guidance is now becoming an effective tool for the initial evaluation of retroperitoneal lesions. OBJECTIVE: The present study was undertaken to evaluate the role of ultrasound-guided FNAC in the diagnosis of retroperitoneal lesions in comparison to histopathology and to assess the probable causes of failure in cases of pitfalls in cytodiagnosis. MATERIALS AND METHODS: During the study period of 5 years, a total of 104 cases of retroperitoneal lesions were aspirated under USG guidance. Seven cases yielded inadequate material, the remaining 97 cases were included in the study group. RESULTS: Out of 97 cases, the kidney was the most common organ aspirated (27 cases; 27.8%). Malignant lesions (68 cases; 70.1%) were much more frequent than benign or non-neoplastic lesions (29 cases; 29.9%). Tuberculosis was the most common non-malignant lesion (14 cases) and renal cell carcinoma was the most frequent malignant lesion encountered (15 cases). In 5 cases (7.9%), the histological diagnosis showed inconsistent results in comparison to cytodiagnosis. CONCLUSION: USG-guided FNAC is a safe, rapid, relatively cheap and fairly accurate procedure for the assessment of retroperitoneal lesions.

Revisiting cosmic microwave background radiation using blackbody radiation inversion.

Blackbody radiation inversion is a mathematical process for the determination of probability distribution of temperature from measured radiated power spectrum. In this paper a simple and stable blackbody radiation inversion is achieved by using an analytical function with three determinable parameters for temperature distribution. This inversion technique is used to invert the blackbody radiation field of the cosmic microwave background, the remnant radiation of the hot big bang, to infer the temperature distribution of the generating medium. The salient features of this distribution are investigated and analysis of this distribution predicts the presence of distortion in the cosmic microwave background spectrum.

Fine needle aspiration cytology of minor salivary gland tumors: A retrospective 5-year study of 42 cases in a tertiary care hospital.

BACKGROUND: Minor salivary gland tumors (MSGTs) are less common than major salivary glands and involve only 15-20% of all salivary gland tumors. Most of the cases originate at intra- and peri-oral region. Minor salivary gland lesion cytology has been studied rarely in India. AIMS: This present study was performed to evaluate the role of fine needle aspiration cytology (FNAC) in diagnosis of MSGTs and to explore the cases of cytohistological discrepancies in the study. MATERIALS AND METHODS: This retrospective study was conducted over a 5-year period on 42 cases of MSGTs. In all the cases, cytology was correlated with histology and cytohistological discrepancies were searched. Sensitivity, specificity, and diagnostic efficacy were calculated using histopathology as gold standard. RESULTS: We diagnosed 27 malignant (64.28%) and 15 benign (35.71%) MSGTs in cytological evaluation. We found two false negative and one false positive case in cytology. Sensitivity, specificity, and diagnostic accuracy of the study were 92.59%, 93.33%, and 92.85%, respectively. CONCLUSION: FNAC is a minimally invasive and cost-effective procedure with high accuracy (92.85%) in the assessment of MSGTs and helps in the management of benign and malignant tumors.

Cytological findings of microfilariae in different sites: A retrospective review of 22 cases from endemic region.

BACKGROUND: Filariasis is a major health problem in India. Despite the high prevalence, microfilariae are rarely found in cytology smears. Most of the cases are incidentally found, solely or in association with other pathologies. AIMS AND OBJECTIVES: The study was undertaken to analyze the prevalence and cytology findings of cases of incidentally found microfilariae in cytology smears (fine-needle aspiration cytology [FNAC]/body fluids) from different body parts. MATERIALS AND METHODS: This was a retrospective study over 5 years, where the cases of microfilariae in aspirates from swelling of different locations and body fluids were reviewed, and clinic-pathological data were analyzed. RESULTS AND ANALYSIS: Out of 16,738 cases of FNAC and 882 cases of fluid cytology, 22 cases (0.124%) of incidental finding of microfilaria were documented in cytology smears. The cases were diagnosed from lymph nodes (5 cases), skin and soft tissue (4 cases), scrotal (4 cases), breast (3 cases), thyroid (2 cases), and pleural fluid (2 cases). We found eosinophilia in 15 cases (68.18%) of filarial lesions. We found two cases of incidental findings of microfilariae in association with malignant lesions. CONCLUSION: Filariasis should be considered as differential diagnosis of swelling of lymph nodes, skin, soft tissue, inguinoscrotal region, and other sites as well. Careful screening of cytology smears may help in detection of incidental cases in the association of other pathologies.

Cytodiagnosis of Eccrine Porocarcinoma of the Scalp.

Eccrine porocarcinoma is a rare, malignant adnexal tumor of the duct of eccrine sweat gland. Cytology of eccrine porocarcinoma has been described in very few previous literature. Here, we present a case of fine needle aspiration cytology (FNAC) of eccrine porocarcinoma of the scalp, which is subsequently confirmed by histology. Accurate diagnosis of eccrine porocarcinoma by FNAC is very difficult, but determining the malignant nature of the lesion is crucial for curative surgery. FNAC can be a convenient, safe, and effective approach to solve difficult diagnostic dilemma.

Microfilaria in pleural fluid cytology: A rare finding.

Lymphatic filariasis is endemic in India and Southeast Asia. Detection of microfilaria is infrequently reported during cytological evaluation of various lesions or body cavity fluids. Presence of microfilaria in pleural fluid cytology is very rare finding even in endemic areas. Few cases of accidental finding of microfilaria have been reported in association with malignant pleural effusion. But pleural effusion of filarial origin is extremely rare manifestation. Here we report a classical case of microfilaria in pleural fluid cytology.

Placental Mesenchymal Dysplasia With Normal Fetus: A Rare Case Report.

Placental mesenchymal dysplasia (PMD) is a rare benign placental abnormality. It is characterized by hydropic degeneration of stem villi, placentomegaly, and increased maternal serum alpha-fetoprotein (AFP). It can be associated with different congenital abnormalities, karyotype abnormalities, and feto-maternal morbidities. It is difficult to differentiate PMDfrom partial mole, complete mole with twin pregnancy in ultrasound, and in macroscopic examination. The current paper presentsa rare case of placental mesenchymal dysplasia in a young primigravida mother who delivered a normal fetus withnormal karyotype.

Fine needle aspiration cytology of cylindroma of scalp: A case report.

Cylindromas are uncommon benign adnexal tumor. Multiple cylindromas are commonly genetically inherited and also known as "turban tumor." Cytology of dermal cylindroma is rarely discussed in previous literature. We have diagnosed a case of dermal cylindroma of scalp in an elderly female patient by fine needle aspiration cytology of the lesion and further confirmation was done by histopathology. Cytology consists of many clusters of small round to oval basaloid cells surrounded and attached with magenta coloured acellular hyaline material. The cells have very scanty cytoplasm and dark, round to oval hyperchromatic nuclei without any nuclear membrane irregularity. Histopathology revealed nests of tumor cells separated by dense pink, PAS positive basement membrane material with a jigsaw puzzle appearance. Cytology of cylindroma should be differentiated from adenoid cystic carcinoma and other benign adnexal tumor like spiradenoma. We have discussed the case of cylindroma of scalp diagnosed by cytology and confirmed by histopathology. Diagn. Cytopathol. 2016;44:1082-1084. © 2016 Wiley Periodicals, Inc.

Orbital Metastasis from Rectal Adenocarcinoma- Report of a Rare Case.

Colorectal carcinoma is a common malignancy in India as well as in world. Inspite of its high metastasizing ability to various organs and lymph node, orbital metastasis is exceptional. Very few cases have been reported in the world literature. We report orbital metastasis in a case of moderately differentiated rectal adenocarcinoma in a 58-year male patient from India in 2015. We want to focus on the rare metastatic pathway of rectal adenocarcinoma and early diagnosis of the orbital metastasis, which can help in application of therapy to save the eyesight.

Clinico-Pathological Study of Cutaneous Granulomatous Lesions- a 5 yr Experience in a Tertiary Care Hospital in India.

BACKGROUND: Granulomatous dermatoses are common skin pathology, often need histopathological confirmation for diagnosis. Histologically six sub-types of granulomas found in granulomatous skin diseases- tuberculoid, sarcoidal, necrobiotic, suppurative, foreign body & histoid type. The aims of the present study were clinico-pathological evaluation of granulomatous skin lesions and their etiological classification based on histopathological examination. METHODS: It was a five years (Jan 2009- Dec 2013) retrospective study involving all the skin biopsies. Detailed clinical and histopathological features were analyzed and granulomatous skin lesions were categorized according to type of granuloma & etiology. Special stains were used in few cases for diagnostic purpose. RESULTS: Among 1280 skin biopsies, 186 cases (14.53%) were granulomatous skin lesions with a ratio 1:24. In histopathological sub-typing, tuberculoid granuloma was most common type (126 cases, 67.74%). Most common etiology of granuloma in the study was leprosy (107 cases, 57.52%). Other etiologies were cutaneous tuberculosis, foreign body granulomas, fungal lesions, cutaneous leishmaniasis, sarcoidosis and granuloma annulare. CONCLUSION: Histopathology is established as gold standard investigation for diagnosis, categorization and clinico-pathological correlation of granulomatous skin lesions.

Clear cell carcinoma of cervix in a postmenopausal woman: A case report.

Clear cell carcinoma of cervix is a very rare neoplasm accounting only 4% of all cervical adenocarcinomas. Intrauterine exposure to diethylstilbestrol (DES) is supposed to be causative factor for clear cell adenocarcinoma in childhood and young-age patients. We are reporting a case of clear cell carcinoma of cervix in a 49-years-old multiparous post-menopausal woman, who had no exposure to DES (in-utero) or synthetic non-steroidal estrogen.

Evaluation of Clinico-Radio-Pathological Features of Tubular Adenoma of Breast: a Study of Ten Cases with Histopathological Differential Diagnosis.

BACKGROUND & OBJECTIVES: Tubular adenomas are rare benign epithelial tumours of breast affecting predominantly females of child bearing age group. Till now, very small number of cases have been reported in the literature. Present study was carried out to evaluate the clinico-pathological features of tubular adenoma cases diagnosed during three years study period along with discussion of possible differential diagnoses. METHODS: Overall, 346 female breast biopsies were diagnosed as benign lesions in three years (2010-2012), of which 10 cases of tubular adenomas were identified. Available clinical, radiological and cytological data of these cases were analysed retrospectively in detail. RESULT: Tubular adenomas were identified from 16 to 48 years of age with a predilection to younger age group (60% within 30 years). Most of the tubular adenomas were small and circumscribed mimicking fibroadenoma in almost all the cases. Diagnosis of tubular adenoma in each case was possible only after histological examination. Pre-operative diagnosis of tubular adenoma was not established by cytological and radiological evaluation in any case. CONCLUSION: Tubular adenomas are clinically indistinguishable from other benign breast neoplasms and it should be considered as potential differential diagnosis during histopathological evaluation of breast biopsies.

Fine-needle aspiration cytology of chondroid syringoma of fore arm: Report of a rare case.

Chondroid syringoma is a rare benign adnexal tumor of sweat glands with microscopic resemblance to the salivary gland pleomorphic adenoma. Cytology is rarely utilized for preoperative assessment of these slow-growing, small, nodular lesions. Definitive cytological diagnosis is also quite difficult, and majority of the aspirates are evaluated as benign adnexal tumors leading to mandatory histopathological examination for pinpoint diagnosis. Here, we report a case of chondroid syringoma of forearm, which was diagnosed by cytology and also confirmed after histopathological examination. Pinpoint cytological diagnosis can help early formulation of necessary management protocol.

Cytodiagnosis of filariasis from a swelling of arm.

Cytological demonstration of microfilaria and adult worms often helps in diagnosis of asymptomatic filarial cases. But demonstration of microfilaria in cytological smears from upper extremity lesions is seldom reported. We are presenting a 32-year-old female patient with elongated, small subcutaneous swelling in the medial aspect of right lower arm. Aspirates from the lesion demonstrate microfilaria though there is no eosinophilia or microfilaremia on subsequent examination of blood sample. In endemic areas, filariasis should always be considered as a possible diagnosis during cytological assessment of any swelling.

Clinicopathological study of rhinosporidiosis with special reference to cytodiagnosis.

BACKGROUND: Rhinosporidiosis is a chronic infective disorder caused by Rhinosporidium seeberi. It usually presents as a soft polypoidal pedunculated or sessile mass. Nose and nasopharynx are the commonest sites, followed by conjunctiva, maxillary sinuses, penis, urethra. AIMS: The aim of this study is to present the clinicopathological features of rhinosporidiosis in a large series of cases and to asses the role of cytology in diagnosis. MATERIALS AND METHODS: 63 cases were included in the study group. Diagnosis of rhinosporidiosis was confirmed in all cases by histology with or without cytological evaluation. May-Grünwald-Giemsa and hematoxylin and eosin (H and E) staining was used in all cases, and special stains like periodic acid Schiff and mucicarmine were used in a few cases. Detailed clinical history of all the cases was noted. Routine hematological investigations including ABO blood grouping were done in all possible cases. RESULTS: Evaluation of the clinical data in our series demonstrated male predominance (36 out of 63; 56%). Nose and nasopharynx were the commonest sites involved (74.6%). Routine hematology tests did not show any significant change in most of the cases. However, a significant proportion of the study population (18 out of 41; 44%) had blood group O. Cytodiagnosis attempted in 17 cases out of 63 cases achieved 100% correlation with histology. CONCLUSION: Morphological appearance alone in a few cases failed to give diagnosis of rhinosporidiosis. Cytology can be very helpful in diagnosis in these cases, but histology is the mainstay of diagnosis.