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ORIGINAL ARTICLES |
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A statistical analysis of fine needle aspiration biopsies in palpable benign (Neoplastic and Non-neoplastic) Breast lesions |
p. 64 |
RGW Pinto, Kulwant Singh
Over a period of seven years (1993-1999), 582 fine needle aspirations of the breast were done with subsequent histologic samples received. The youngest patient was 12 and the oldest 82. Females comprised 555 (95.4%) and males 27 (4.6%). Out of 582 aspirations 295 cases (50.7%) were negative (benign) an cytology and in 107 cases (18.4%) the smears were inconclusive and biopsy was advised. Fibroadenoma (188 cases) was the most common benign neoplasm. In males gynaecomastia was the commonest lesion (21 cases out of 27). The cytohistologic correlation was 89.7% for fibroadenoma, 65.2% for fibrocystic change, 60% for benign phyloides tumor, 57.1% for fibroadenosis and 33.3% for breast abscess.
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Sexually transmitted diseases and cytopathology of cervix |
p. 68 |
JS Misra, V Das, U Singh
The association between STDs and cytopathological changes in the cervical epithelium have been investigated in the cervical cytology smears available in 30,415 women during 30 years of screening. Routine cervical cytological screening is in progress in women attending gynaecology OPD of Queen Mary's Hospital, Lucknow since April 1971 and till December 2002, a total of 30,415 women have been cytological examined for early detection of cervical cancer and presence of four STDs namely Trichomonas vaginalis, Candida albicans, Herpes simplex and Condyloma (HPV). Trichomonal infection was found to be the most common STDs infecting the lower female genital tract (2.7%). The viral STDs-HSV and HPV were seen in 0.3% and 0.6% of cases respectively. These pathogens were highly associated with squamous intraepithelial lesion (SIL) of cervix and invasive carcinoma. All the four STDs were more frequently encountered with erosion cervix and vaginal discharge. The two non-viral STDs and HPV were more prevalent in younger sexually active women between 21-40 years while 65.9% of HSV cases were found in older women above 40 years age. The accumulated data indicate a possible role of viral STDs in the etiology of cervical cancer predominately in its pre-invasive phase. Hence the cytological detection of STDs should be made mandatory in a cytological surveillance programme for checking the onset/progression of the disease.
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Spectrum of langerhans cell histocytosis with prognostic parameters |
p. 73 |
Swapan Kr Sinha, Sarbani Chattopadhyay, Sharmila Sen, Keya Basir, Aparna Bhattacharyya, Rita Basumitra, Sapnokamal Sengupta
Thirteen patients, eight males and five females, age ranging from 10 months to 24 years, presented with solitary lytic lesions in three cases (23%), more than one lytic bone lesions in two cases (15.38%) and disseminated disease with lytic bone lesions, lymphadenopathy, hepatosplenomegaly, endocrinopathy (diabetes insipidus), exophthalmos and skin lesion in eight cases (61.5%). FNA cytology was performed in all the cases and the diagnosis was Langerhans Cell Histiocytosis (LCH). Histological examination done in seven patients confirmed the diagnosis of LCH. CD la was done on tissue sections in four cases and three tested positive. Ten had anaemia (77%), two had leucopenia (15%), three had thrombocytopenia (23%) and one had pancytopenia (7.5%). Bone marrow was aspirated in six cases and involvement was present in two cases (all disseminated form of the disease). Prognostic parameters were evaluated on the basis of clinical, radiological, haematological and histological features.
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Role of FNAC of pelvic masses in gynaecological practice |
p. 77 |
RG W Pinto, Vijay B Kumar, Savita Chandra, Prasad Nevrenkar, Domnic Lobo
61 patients were included in this study from October 1998 to May 2001. 34 cases were adnexal masses and 27 cases were uterine masses. All these 61 patients were subjected to a transabdominal or transvaginal FNAC using a 22 gauge lumber puncture needle and 10 ml. syringe. There were no complications except mild pain in 3.27% of the cases. The correlation of the cytological and histological diagnosis in benign adnexal masses was 85.7% and 73.3% in malignant adnexal masses. The sensitivity and specificity of FNAC in diagnosis of FNAC in diagnosing malignant adnexal mass was 100%. The specificity of FNAC to exclude malignancy in a patient with a uterine smooth muscle tumor is 100%.
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Cytomorphological features of in-situ carcinoma of breast in fine needle aspiration cytology |
p. 82 |
Sanjib Kumar Pattari, Pranab Dey, Subhas K Gupta, Kusum Joshi
Fine needle aspiration cytology (FNAC) is an important tool in investigating palpable breast lesions. Its sensitivity and specificity are quite high in benign and malignant lesions. However carcinoma-in situ (CIS) cases are very difficult to diagnose in FNAC. CIS cases are frequently misdiagnosed. The aim of this present study is to compare various cytomorphological features to distinguish CIS and infiltrating ductal carcinoma (IDC) cases. Eight cases of CIS and 10 cases of IDC were taken for the study. Various cytomorphological features i.e. cellularity, cell dissociation, cell size, cell uniformity, nucleoli, nuclear margin, chromatin character, mitosis alongwith number of myoepithelial cells were compared in both groups. We noted that the cells of CIS cases were smaller in size, less pleomorphic with more regular nuclear margin and inconspicuous nucleoli than IDC cases. The number of myoepithelial cells was significantly higher in CIS cases than IDC cases. These features can be used to distinguish CIS and invasive ductal carcinomas.
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Retrospective study of hepatic and retroperitoneal masses |
p. 85 |
AL Hemalatha, R Vidyadhar, TM Kariappa
Trans-peritoneal percutaneous ultrasound guided fine needle aspiration has revolutionised the evaluation of hepatic and retroperitoneal lesions which were formerly followed invariably by biopsy/exploratory laparotomy. The present study involves 77 cases of hepatic/retroperitoneal masses evaluated by ultrasound- guided FNAC of which, 65 cases had adequate material for cytodiagnosis. Correlation by either cell block study or histopathological examination of biopsy done following FNAC was available in 59 cases and these contributed to the calculation of various indices. Our study showed a sensitivity of 88.67% and specificity of 100%. There was no false positive diagnosis for malignancy in the study. False negative diagnosis for malignancy was encountered in 6 cases (92%). The high diagnostic accuracy of 90.76% observed in our study upholds the unquestionable value of guided FNAC as a mandatory diagnostic procedure in the assessment of hepatic and retroperitoneal masses.
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Cytological detection of Candida Albicans During routine outpatient screening for early detection of carcinoma cervix |
p. 91 |
JS Misra
Cytological detection of Candida albicans have been carried out during routine outpatient screening of cervical smears at Queen Mary's Hospital, Lucknow. The incidence of the candidal infection was found to be 1.3% in the total of 28,805 women screened during 31 years duration (April 1971 - March 2002). The squamous intra-epithelial lesions of cervix (SIL) was seen in 8.2% of the candidal infested smears. However, majority of SIL cases (7.7%) were LSIL. The fungal infection was commonly associated with vaginitis and erosin cervix and vaginal discharge. As expected, the candidal infection was found maximum in women of high sexual activity between 21-30 years of age (49.8%). The cervical cytological screening provides excellent opportunity for diagnosis of the C. albicans.
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CASE REPORTS |
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Cytodiagnosis of primary peripheral lymphonodular cryptococcosis - A case report |
p. 93 |
Ajay A Gangshettiwar, Rajani Bodade, NP Pande, Anuradha Shrikhande
Twenty two years male presented with generalised lymphadenopathy, low grade fever, anorexia and weight loss. Clinical diagnosis was lymphoma. X-ray chest, USG abdomen, USG-thorax revealed no significant pathology. Fine Needle Aspiration Cytology performed from cervical and axillary lymph node. H and E, Pap and MGG stained smears revealed numerous, spherical to oval yeast cells with clear haloes around them. Cytodiagnosis of Cryptococcosis was made, which was later confirmed by mucicarmine stain. Later on patient was found to be HIV positive. Cryptococcosis presenting primarily as peripheral lymphadenopathy in the absence of pulmonary or cerebromeningeal involvement is rare. We are reporting this case of primary peripheral lymphonodular cryptococcosis to emphasize the role of FNAC in diagnosing this lesion with minimal complications.
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Morphological spectrum of Cysticercus Cellulosae on cytology in a case of a malnourished child |
p. 95 |
Bharat Rekhi, Usha Burra, Geeta Vidyadharan, Sunita Saxena
Cysticercosis is a parasitic disease caused by larva of Taenia solium. Human infection is caused mainly by consumption of uncooked pork. It can also occur in cases of associated immunodeficiency as a result of malnutrition. A six years old vegetarian malnourished female child presented with soft to firm painless swellings on the dorsum of both feet. On aspiration whitish fluid was obtained. Smears prepared revealed scolices, hooklets and wall like structures along with inflammatory cells consisting of lymphocytes, eosinophils, neutrophils and macrophages against a background of amorphous material. A diagnosis of cysticercosis was made. Fine needle aspiration cytology can serve as an early cost effective diagnostic tool in saving such patients from fatal neurological complications.
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Bile duct hyperplasia — An unusual finding in primary hepatocellular carcinoma |
p. 97 |
Shanthakumari , V Pushpavallimohan, Suma B Pillai
Fine needle aspiration cytology is commonly used in assessing the neoplastic lesions of the liver and is the most sensitive test for diagnosing liver cell malignancies.The diagnosis of primary HCC rests on well defined criteria laid down by many authors in various textbooks of cytology.This case is reported here as bile duct epithelium was present in sheets as against the criteria of absence of bile duct epithelium to diagnose HCC.
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Fine needle aspiration cytology of "Sister Joseph's Nodule" - Report of three cases |
p. 99 |
Sanjay Kumar, B Arora, Shikha Mittal, Sonia Chhabra
The umbilical lesion termed as "Sister Joseph's Nodule", a rare site for metastases from internal malignancies is generally associated with poor prognosis. Fine needle aspiration cytology is a simple, rapid, inexpensive diagnostic procedure which preclude the need for umbilical biopsy or other complicated diagnostic investigations. We present three cases of Sister Joseph's nodule diagnosed on aspiration cytology.
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FNAC diagnosis of soft tissue granular cell tumor |
p. 101 |
Sanjay L Khandekar, Kiran S Bharati, Jaywant W Mahadani, DH Mandke, MS Walde
A case of granular cell tumor (GCT), of soft tissue of anterior abdominal wall in a 45 year female is reported for its rarity. Granular cell tumor is not only a rare lesion but this site too is rare for this lesion to occur. Besides, there are very few case reports of granular cell tumor which are diagnosed on fine needle aspiration biopsy.
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Diagnosis of cutaneous leishmaniasis by fine needle aspiration cytology: Report of three cases |
p. 103 |
Mansoor Ahmed Laharwal, Syed Besina Yasin, Sheikh Bilal Ahmed
Cutaneous leishmaniasis is an endemic parasitic disease, the diagnosis of which is important for it's successful management. Three cases of cutaneous leishmaniasis diagnosed by Fine needle aspiration cytology (FNAC) are reported. The initial cutaneous lesions were painless, erythematous nodules on face, chin and tip of nose respectively. The pathognomic cytopathological picture consisted of lymphocytes, plasma cells and epitheloid granulomas intermingled with histiocytes. Numerous Leishmania organisms were observed within the histiocytes and extracellularly. These cases emphasize the utility of FNAC in diagnosing cutaneous leishmaniasis.
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Hodgkin's lymphoma masquerading as tuberculous lymphadenitis |
p. 106 |
Geeta Singh, Vatsala Misra, PA Singh, Mamta Singh
Tuberculosis is the prototype of the various granulomatous diseases consisting of epithelioid cells. Epithelioid cells can also be seen in neoplastic conditions like Hodgkin's disease (HD) and Lennert's lymphoma. The presence of epithelioid cells on fine needle aspiration cytology (FNAC) smears may sometime lead to overdiagnosis of tuberculosis if careful search for other abnormal cells is not done. We report here two cases of Hodgkin's disease (lymphocytic and/or histiocytic (L & H) predominance) which were misdiagnosed as tuberculous lymphadenitis on cytological examination.
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Fine needle aspiration cytology of pilomatrixoma |
p. 109 |
Subhprakash Sanyal, Anand Monickam, G Komala, Surendra Kumar Verma
Pilomatrixoma is a benign tumour of appendageal origin. Although it is a localized tumour, it may sometimes show aggressive behaviour. Rare cases of malignant pilomatrixoma have been reported. It may be confused with malignant tumours like basal cell carcinoma and benign lesions like reactive lymph node. Hence the correct diagnosis is important. Diagnosis of pilomatrixoma by FNAC is safe, easy and simple. We report a case of pilomatrioxoma in a 45 year old male diagnosed by FNAC and confirmed by histopathology.
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LETTERS TO THE EDITOR |
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Fine needle aspiration cytology in keloid and hypertrophic scar  |
p. 111 |
S Poflee, M Munshi, V Lele, S Bobhate |
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Primary cervical neuroblastoma imprint cytology |
p. 111 |
Radha R Pai, Prema Saldanha, Urmila N Khadilkar, P Sadashiva Rao |
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Solid and papillary epithelial neoplasm (SPEN) of the pancreas - A fine needle aspiration diagnosis |
p. 113 |
Sunitha Jacob, Naveen Kakkar |
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