Comparative Evaluation of Cell Block Method and Smear Cytology in Fine Needle Aspiration Cytology of Intra-abdominal Mass Lesions.

BACKGROUND & OBJECTIVE: Fine needle aspiration cytology (FNAC) is an easy, rapid, and less hazardous tool to diagnose the intra-abdominal lesions with various imaging modalities adding to its sensitivity and accuracy. However, sometimes it does not yield adequate information for precise diagnosis and the risk of false-negative and indeterminate diagnosis is always present. Cellblock preparations may be particularly helpful in such problematic cases. The current study aimed atevaluating and comparing the cytological as well as histopathological features of different intra-abdominal mass lesions. METHODS: Image-guided FNAC followed by cell block were performed on 167 patients from June 2012 to May 2013. Histologically correlated 111 cases were evaluated. Results of conventional smear, cell block, and combination of FNAC with cell block were compared with histopathological findings regarding diagnostic sensitivity, specificity, and accuracy of diagnosis. RESULTS: Cell block was more specific to diagnose these lesions than FNAC (95.49% versus 90.09%). Combined application of cell block with FNAC was more specific (96.39%) than cell block alone with 100% diagnostic accuracy. CONCLUSION: Application of a combination of cell block with FNAC was more useful to diagnose intra-abdominal mass lesions.

Two cases of primary non-Hodgkin's lymphoma of female breast: Role of fine-needle aspiration cytology and cell-block immunohistochemistry.

Primary breast lymphoma (PBL) is an uncommon neoplastic condition. Though HIV-infection is a known risk factor for the development of extranodal lymphomas, mammary involvement is still a rarity. Radiologically, PBL appears as well circumscribed, heteroechoic, noncalcifying mass. Fine-needle aspiration cytology (FNAC) is commonly used to diagnose this neoplasm; however, subcategorization requires immunophenotypic characterization of the neoplastic cells. Herein, we report two cases of PBL, including a HIV-infected lady; in both the cases FNAC expressed features of non-Hodgkin's lymphoma. Finally, immunohistochemistry on cell-block with CD20 diagnosed both the cases as diffuse large B-cell lymphoma (DLBCL).

Fractal dimension of chromatin texture of squamous intraepithelial lesions of cervix.

The aim of this study was to explore the role of fractal dimension (FD) of chromatin texture in routinely stained Papanicolaou's smears and to distinguish the different grades of cervical intraepithelial lesions and normal cervical cells. We selected 14 each cases of normal, low grade cervical intra epithelial lesions (LSIL), and high-grade cervical intra epithelial lesions (HSIL) of Papanicolaou's stained cervical smears. Fractal dimension of the pseudo three-dimensional grey image of the nuclear chromatin was measured in 140 nuclei of each group. Mean FD of the normal cases, LSIL cases, and HSIL cases were 2.4225 ± 0.06410, 2.5159 ± 0.03291, and 2.5905 ± 0.06840, respectively. ANOVA test showed significant differences of mean FD in all these three groups (P < 0.000). Fractal dimension of the chromatin texture is easy to perform and can be done in routinely stained Papanicolaou's smear. It is reproducible and gives valuable information about the chromatin texture of the nucleus. In future, this promising variable can be incorporated along with other image morphometric features for accurate classification of dysplastic cells in cervical smear.

Fine needle aspiration cytology in sclerosing stromal tumor of the ovary: a series of three cases.

Sclerosing stromal tumor (SST) of the ovary is a distinct subtype of sex cord-stromal tumor, which is derived from the ovarian stroma and, in turn, from the sex cords of the embryonic gonads. It is a benign tumor, predominantly, unilateral in nature and mostly involves the right side of the ovary. Histopathological features are characteristic and are well described in the literature; however to the best of our knowledge fine needle aspiration cytology (FNAC) has not been described previously. We present FNAC findings in a series of three cases of SST and discuss the cytomorphological features. We have described Call-Exner like bodies in one of our cases and hence, suggest that these may not be an exclusive feature of granulosa cell tumor.

Fine needle aspiration cytology of oral and oropharyngeal lesions with an emphasis on the diagnostic utility and pitfalls.

AIM: This study was undertaken to evaluate the diagnostic utility and pitfalls of fine needle aspiration cytology (FNAC) in oral and oropharyngeal lesions. MATERIALS AND METHODS: This was a retrospective audit of oral and oropharyngeal lesions diagnosed with FNAC over a period of six years (2005-2010). RESULTS: Oral/oropharyngeal lesions [n=157] comprised 0.35% of the total FNAC load. The age ranged 1-80 years with the male: female ratio being 1.4:1. Aspirates were inadequate in 7% cases. Histopathology was available in 73/157 (46.5%) cases. Palate was the most common site of involvement [n=66] followed by tongue [n=35], buccal mucosa [n=18], floor of the mouth [n=17], tonsil [n=10], alveolus [n=5], retromolar trigone [n=3], and posterior pharyngeal wall [n=3]. Cytodiagnoses were categorized into infective/inflammatory lesions and benign cysts, and benign and malignant tumours. Uncommon lesions included ectopic lingual thyroid and adult rhabdomyoma of tongue, and solitary fibrous tumor (SFT), and leiomyosarcoma in buccal mucosa. A single false-positive case was dense inflammation with squamous cells misinterpreted as squamous cell carcinoma (SCC) on cytology. There were eight false-negative cases mainly due to sampling error. One false-negative case due to interpretation error was in a salivary gland tumor. The sensitivity of FNAC in diagnosing oral/oropharyngeal lesions was 71.4%; specificity was 97.8% with diagnostic accuracy of 87.7%. CONCLUSIONS: Salivary gland tumors and squamous cell carcinoma (SCC) are the most common lesions seen in the oral cavity. FNAC proves to be highly effective in diagnosing the spectrum of different lesions in this region. Sampling error is the main cause of false-negative cases in this region.

Calcinosis cutis: diagnosis by fine needle aspiration cytology--a rare case report.

Calcinosis cutis is characterized by deposition of calcium salts in the subcutaneous tissues in the body. In this study, we described a case of calcinosis cutis that was diagnosed by fine needle aspiration (FNA) in a 15-year-old male. The patient presented with multiple nodules over right forearm and right knee. FNA smears showed flakes of amorphous material indicating calcium along with few macrophages. The presence of amorphous calcium salts along with histiocytes in the appropriate clinical settings is diagnostic of calcinosis cutis.

Adrenal rest in testis diagnosed by fine-needle aspiration cytology.

In this article, we have described an extremely uncommon entity of adrenal rest in testis in fine-needle aspiration cytology in a 7-year-old male child with symptoms of precocious puberty. The patient had a raised serum testosterone level along with a well-defined solitary mass in the testis. Fine-needle aspiration cytology smears show a dispersed population of large cells with abundant finely granular cytoplasm, eccentric nuclei, coarse nuclear chromatin, and multiple prominent nucleoli. Considering the clinical, radiological, biochemical, and also cytological features, a diagnosis of adrenal cell rest was made.

Fine needle aspiration cytology of myositis ossificans.

In this case report, we described the fine needle aspiration cytology (FNAC) of myositis ossificans (MO) in a young boy. The patient presented with a painful hard mass in the upper right thigh and restricted range of motion around hip joint since 2 weeks. He had history of trauma. Computerized tomographic (CT) scan showed a heterogeneous mass in the upper part of quadriceps with peripheral areas of calcification and central hyperlucency. The FNAC smear of MO shows fibroblasts, osteoblasts, multinucleated giant cells, degenerated muscle cells and osteoid. Clinical presentation along with cytology and radiologic findings are helpful to diagnose this entity.

Fine needle aspiration cytology of malignant endovascular papillary angioendothelioma.

Here we described a rare case of malignant endovascular papillary angioendothelioma (Dabska tumor) in an adult female. On fine needle aspiration, the smear showed many small clusters of tumor cells with rosettoid arrangement along with papillary fragments with fibrovascular core and hobnail like arrangement of the cells. Histopathological examination revealed a vascular tumor in the form of papillary projection into the vascular lumina, lined by atypical endothelial cells.