How fine needle aspiration cytology and flow cytometry helped in diagnosing a high-grade B-cell lymphoma masquerading as leukaemia.

High-grade B-cell lymphoma (HGBL) has recently been introduced into the category of aggressive, mature B-cell lymphomas. It is biologically different from diffuse large B-cell lymphoma and Burkitt lymphoma and exhibits an aggressive course. Leukaemic presentation, though known in various types of mature B-cell and mature T-cell lymphomas, is rare in high-grade B-cell lymphoma. We report one such case of a high-grade B-cell lymphoma which was masquerading as acute leukaemia with a soft tissue infiltration, with added emphasis on the role of fine needle aspiration cytology and flow cytometry in the diagnosis, and their therapeutic significance.

What Changed in CNS5? A Mini-Review on General Changes and Adult Diffuse Gliomas.

The fifth edition of the WHO classification of tumors of the central nervous system (WHO CNS5) was published in 2021 which is the sixth version of the international standard for the diagnostics of CNS tumors. Regular updates of the consortium to inform molecular and practical approaches to CNS tumor taxonomy (cIMPACT-NOW) shaped the WHO CNS5 which continues the trend of incorporating the molecular characteristics of tumors into the histological and immunohistochemical findings. The various updates can be classified into general changes across all tumors and specific changes within the tumor groups. This mini-review highlights the general changes and the major changes in adult diffuse gliomas.

RésuméLa cinquième édition de la classification OMS des tumeurs du système nerveux central (WHO CNS5) a été publiée en 2021, soit la sixième version de la norme internationale pour le diagnostic des tumeurs du SNC. Mises à jour régulières du consortium pour informer les chercheurs moléculaires et pratiques les approches de la taxonomie des tumeurs du SNC (cIMPACT-NOW) ont façonné le CNS5 de l'OMS, qui poursuit la tendance à incorporer la méthodologie moléculaire caractéristiques des tumeurs dans les résultats histologiques et immunohistochimiques. Les différentes mises à jour peuvent être classées en modifications générales dans toutes les tumeurs et les changements spécifiques au sein des groupes de tumeurs. Cette mini-revue met en évidence les changements généraux et les changements majeurs dans gliomes diffus de l'adulte.

An observation of a potential metastatic mimic in bone marrow aspirate smears.

We present an interesting observation of crushed erythroid precursors in bone marrow aspirate smears mimicking metastatic deposits. These artefactual clusters could be due to anticoagulation with ethylenediaminetetraacetic and also due to shearing forces exerted on the cells during aspiration and smearing. It is important to be aware of this potential mimic as in a given clinical context it can get misdiagnosed as metastasis.

Concomitant Diagnosis of Plasmablastic Lymphoma and Chronic Lymphocytic Leukemia: A Rare Phenomenon.

Plasmablastic lymphoma (PBL) is a rare, aggressive non-Hodgkin lymphoma which shows blastic morphology and an immunophenotype of plasma cell differentiation while chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma is an indolent B-cell lymphoma and has a variable clinical course. A CLL transforming into a PBL and the coexistence of CLL with PBL are both extremely rare findings. We report an unusual case of a 72-year-old HIV-negative male who presented with a gingival swelling which was diagnosed as PBL with simultaneous CLL in the blood and bone marrow. Further, in this case, the PBL spontaneously regressed postbiopsy adding to the peculiarity and rarity of this case. This could be due to immune system modulation and can open up a new window to the treatment strategies of PBL in the future.

Utility of urine reagent strips in cerebrospinal fluid analysis: An aid to bedside diagnosis of meningitis.

CONTEXT: The provision of initial treatment to a patient with suspected meningitis depends greatly on early recognition and rapid diagnostic evaluation of cerebrospinal fluid (CSF) leukocytes, proteins, and glucose. The diagnosis is time critical and timely intervention has an implication on the prognosis and outcome. Reasonably, sound laboratorial setups are not available in our country in the primary health-care level and, even in the settings where they are available, long waiting periods precede the availability of results. AIMS: We conducted this study to emphasize the role of urine reagent strip test as a rapid diagnostic tool in CSF analysis. SETTINGS AND DESIGN:: This is a prospective single-blinded study on 100 consecutive CSF samples received with in 1h of tap. SUBJECTS AND METHODS: All the 100 samples were subjected to definitive test being CSF microscopy and biochemical analysis of proteins and sugar and index test being a semi quantitative analysis of CSF leukocytes, proteins, and sugar by urinary reagent strips. STATISTICAL ANALYSIS USED: The diagnostic accuracy of the reagent strip for different cutoff levels was estimated and tabulated in the form of sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio. RESULTS: 77% of cases were in the pediatric age group and 23% cases were adults. The sensitivity and specificity for leukocytes by the strip method for ≥15 cells/cumm were 89.28% and 98.61%, respectively, which increased to 100% with an increase in the counts. The reagent strip test had a sensitivity of 85.71% and a specificity of 95.65% for the protein levels >30 mg/dl which increased to 100% with an increase in protein levels. The reagent strip test for glucose was highly specific (100%) but less sensitive. CONCLUSIONS: The results indicate that urine reagent strip is instrumental in bedside CSF analysis and has a future stand in the diagnosis of meningitis.