Cytologically diagnosed Pap smear of sixty cases comprising of cervical intraepithelial neoplasia were reviewed to identify and grade the presence of tumor diathesis. The smears were classified into pattern I -where tumor diathesis was remarkable, present from nearly one end of the smear to the other, and with nebulous morphology of cells, pattern II - diathesis was minimal and morphology of cell was better preserved, pattern III - smears without tumor diathesis. Smears were subjected to DNA ploidy analysis. Pattern I was observed in twenty (33%) cases, pattern II in 17(28.3%) and pattern III in 23 (38.3%) cases. Amongst them, aneuploid DNA pattern was revealed in 15/20 (75%) pattern I, 11/17 (64.1%) pattern II and 15/23 (65.1%) pattern III. From the results, a decreasing trend of aneuploid DNA pattern was observed from pattern I to pattern II and III.

Clinically unsuspected soft tissue fungal infections and early eumycotic mycetomas may be easily missed on cytology, as the fungal elements are easily masked by inflammatory cells and necrotic debris. We decided to use the property of autofluorescence of fungi in Papanicolaou stained cytology smears to clearly delineate the fiingal structure and observe whether this improves the accuracy rates. Three cases of eumycotic foot mycetomas and one case each of soft tissue aspergillosis and rhinosporidiosis were analyzed using this method. This method helped us in picking up fungal elements that had been missed during the original ordinary microscopic evaluation. It failed in a single case where the fungus was deeply embedded in the soft tissue and was hence probably not included in the aspirates. Fluorescent screening of Papanicolaou stained smears is a useful technique and could be used to screen nonspecific soft tissue inflammations in immunocompromised patients and farmers with foot swellings to rule out presence of a fungus.

Twelve cases of malignant germ cell tumours were diagnosed by Fine Needle Aspiration Cytology (FNAC) (9 cases) and crush preparation (3 cases) between January 1994 and October 1999. Five were intraabdominal, three intracranial, three testicular and one was from a supra-orbital mass. In all cases, the cytology showed features of a malignant germ cell tumour. In seven cases, subsequent histopathological examination confirmed the diagnosis. In the other five, clinical correlation and serum levels of alpha-fetoprotein (AFP) and β-human chorionic gonadotropin (β-HCG) were useful in making the diagnosis.

Forty cases of testicular malignancy were selected for FNAC study in the Dept. of Pathology, Medical College, Calcutta since March 1990 to June 2000. This comprised only 31% of the total testicular lesions (129), which also included benign tumors and non-neoplastic conditions. Of all malignant tumors, seminoma was most common (82%), occurring mostly in the 4th decade of life. Apart from seminoma, embryonal carcinoma (12%), teratoma (3%) and lymphoma (3%) were observed in the descending order of frequency. Out of 40 cases, 34 were confirmed by histopathological exmination. Amongst these 34 cases, 5 (14.7%) were associated with cryptorchidism.

A case of neuroblastoma with divergent vimentin and cytokeratin positivity in an 11 year old boy is presented. The initial radiological impression was of a left renal mass consistent with Wilms' tumor. FNA revealed a tumor with an essentially discrete population of small round cells, and a few rosette-like structures. However, the presence of rare epithelial looking cells and stromal fragments coupled with vimentin and cytokeratin positivity prompted a diagnosis of a malignant round cell tumor consistent with Wilm's tumor. The appearance of skull metastasis a few weeks later prompted a review of the diagnosis. A repeat CECT scan clearly indicated a left adrenal origin of the mass. Material from a repeat FNA was submitted for electron microscopy. The detection of neurites confirmed a neuroblastoma. The earlier vimentin and cytokeratin positivity, confirmed by flowcytometry, was taken as evidence of a divergent immunophenotype. The subject of divergent differentiation in small round-cell tumors with neural features is reviewed.

Multifocal Ewing Sarcoma (EWS) is a rare entity reported in literature. Clinically and radiologically it can mimic osteomyelitis. FNAC is helpful in the diagnosis and management as it provides a quick and accurate report.

FNAC of a scalp swelling in a clinically unsuspected case led to diagnosis of metastatic renal cell carcinoma (RCC). Presence of sheets of polygonal cells with round uniform nuclei with vacuolated cytoplasm helped in arriving at diagnosis. Histopathology confirmed the diagnosis of clear cell type of RCC. The patient is doing fine six months after management by surgery, radiotherapy and chemotherapy. Regular follow-up is necessary to diagnose the recurrences.

A case of Cutaneous Juvenile Xanthogranuloma of the scalp in a 9 months old male baby diagnosed by FNAC is presented. Juvenile Xanthogranuloma is a pathologic histiocytic proliferation of benign nature that should be treated conservatively.