Cytomorphological analysis of effusion fluids for detection of malignant cells in a tertiary care hospital in northern India.

INTRODUCTION: All body cavities are lined by monolayered mesothelial cells and contain a minimal amount of fluid for lubrication and for protecting the underlying viscera. The peritoneal, pleural, cerebrospinal, sputum, urine, and pericardial fluids comprise the major chunk of body fluids. MATERIAL AND METHODS: The study was conducted in the Department of Pathology of a tertiary care hospital in northern India, over a period of 1 year, from January 2021 to December 2021. A total of 241 samples were included in the study. RESULTS: Out of the 241 samples studied, 99 were peritoneal fluid, 94 were pleural fluids, 29 were CSF, and 18 were sputum samples. Maximum number of patients affected were in the age group of 41-50 years. Female preponderance was seen with male to female ratio of 1:1.7. A total of 143/241 cases (59.33%) were of transudative nature and 98/241 (27.8%) cases were exudative. Out of 241 cases, 43 (17.84%) were neoplastic, 190 (78.83%) were non-neoplastic, four (1.65%) were suspicious for malignancy, and four (1.65%) were where no opinion was possible. Peritoneal fluid was the most frequently encountered fluid accounting for 99 cases (41.07%). Adenocarcinoma was the most common malignancy accounting for 29 cases (67.44%) out of 43 malignant effusions in the present study. CONCLUSION: Cytological evaluation of body fluids is of significant utility in diagnostic medicine as it allows us to distinguish between benign and malignant etiologies and at the same time offers rapid diagnosis and staging of metastatic disease.

Skin appendageal tumors: A 1 year data from a tertiary care institute.

BACKGROUND: Skin appendageal tumors (SAT) are a rare group of tumors that are classified according to their line of appendageal differentiation along eccrine, apocrine, follicular, and sebaceous lines. However, they are relatively uncommon and create diagnostic difficulties for the pathologist. Recognition of malignant transformation adds to the importance of an accurate diagnosis. A paucity of clinicopathological data from the Himalayan region of India, in particular, prompted the conduct of this study. AIM: To study the clinical and histopathological spectrum of SAT during a period of 1 year received at our hospital. MATERIALS AND METHODS: A retrospective study was carried out at the Pathology department of our hospital. All relevant clinical characteristics were noted in addition to the histopathological features. Slides stained with both hematoxylin and eosin and special stains where necessary were used to supplement the diagnoses. RESULTS: A total of 17 cases were diagnosed in 1 year (January 2021 to December 2021) at our institute. The predominant age group was 40-59 years. Females outnumbered males, with a male: female ratio of 0.8:1. The most common location of tumors was in the head and neck (90.90%). The majority of cases were benign (90.90%). The majority of tumors were of follicular differentiation (54.55%). We found one malignant tumor of sebaceous differentiation. CONCLUSION: The clinical presentation is remarkably similar to most SAT. In our study, we found that majority of tumors were benign and located in the head and neck. The importance of an accurate histopathological diagnosis is essential in these tumors to diagnose the malignant counterparts and differentiate them from more common skin tumors with different prognoses.

Primary vaginal malignant melanoma: A rare entity with review of literature.

Primary vaginal malignant melanoma (PVMM) is an extremely rare tumor of the female genital tract, accounting for only 3% of melanomas of the female genital tract and 0.3%-0.8% of all melanomas in females. Vaginal melanoma is a very aggressive tumor with a 5-year survival rate of 5%-25%. High incidence of recurrence, spread to regional lymph nodes, and distant metastasis are responsible for poor prognosis of PVMM. Grossly, amelanotic melanoma of the vagina may be mistaken for other primary vaginal malignancies. Differentiation of malignant melanoma from other primary vaginal melanomas is essential because of better prognosis of most of other vaginal malignancies as compared to melanoma. Despite having poor prognosis, early detection and early treatment of PVMM may improve the prognosis.

Hemangioma of rib masquerading a malignancy.

Hemangioma of bone is a rare bone tumor accounting for <1% of all osseous tumors. Hemangiomas are common in skull and vertebrae but uncommon in rib. Rib hemangiomas may increase in size over a period and may cause symptoms due to increasing size. Preoperative diagnosis is not always possible due to overlapping radiological features between benign and malignant lesions. Use of preoperative aspiration and biopsy has their own risks and benefit. Excision of rib in case of monostotic rib lesions is the treatment of choice due to low risk of recurrence and no reported postoperative complications. We report a case of rib hemangioma which mimicked a malignancy preoperatively.

Basal cell adenocarcinoma of submandibular salivary gland-problems in cytologic diagnosis.

Basal-cell adenoma and basal-cell adenocarcinoma of the salivary gland are rare tumors. Fine-needle aspiration cytology of these tumors, particularly those of basal-cell adenocarcinoma, has rarely been described in the literature. In this report, we describe the clinical, cytomorphologic and histopathologic features of basal cell adenocarcinoma in a 48-year-old male patient. Fine-needle aspiration specimen showed abundant cohesive groups of basaloid cells revealing focal anisonucleosis and nuclear atypia. The tumor cells also showed rosette-like arrangement around central eosinophilic globule. Pertinent literature is reviewed and differential diagnosis are discussed.

Giant cell tumor of soft tissue: Cytological diagnosis of a case.

Giant cell tumors of soft tissue (GCT-STs) are rare neoplasms and are mainly seen in adults and in the elderly population, usually in the extremities. When evaluated along with clinical features, the cytological features are sufficient to distinguish GCT-STs from other more common tumors with giant cell morphology. We report here a case of a giant cell tumor of soft tissue diagnosed on the basis of fine needle aspiration cytology and confirmed after histopathology.

Metastatic ovarian tumor.

58-year-old woman with a history of breast carcinoma presented with a bilateral ovarian tumor. On fine needle aspiration cytology, diagnosis of metastatic adenocarcinoma was made. At subsequent hysterectomy and bilateral salpingo-oophrectomy, specimen showed extensive metastatic carcinoma involving both ovaries.