This study was conducted with an aim to recognize different cytomorphological features of malignant cells in body fluids to facilitate the diagnosis and to locate primary site especially in clinically obscure cases. Fifty eight cases of malignant effusions from different serous cavities were analysed by examination of cytospin smears and cell block preparations taking detailed account of clinical and radiological data. Of the 58 cases, peritoneal, pleural and pericardial effusions accounted for 32, 25 cases and 1 case respectively. The maximum number of cases were in 51-60 years of age group (34.6%). Female patients outnumbered the males (56.9% vs. 43.1%). Detailed cytomorphologic study of each type of malignant effusion revealed some very consistent features which helped in reaching the primary site. On correlating clinical, radiological and cytological features, primary site could be determined with 89.7% accuracy, while in 10.3% cases cytologic features were inconclusive and could not be associated with primary site. Lung (29.3%) was the commonest primary site, followed by ovaries (15.4%) and gastrointestinal tract (8.6%). It was also concluded that compared to the time and energy required for cell block preparation, cytospin was found to be a better method.

Fine needle aspiration of testis and scrotal lesions is not commonly done. FNA was done in 18 patients with epididymal nodules or thickening. Epididymal nodules constituted 0.6% of total FN As done over a period of five years. Granulomatous lesions were the commonest. Spermatocele and adenomatoid tumours were next common lesions encountered. Six cases were available for histopathologic correlation. Diagnostic accuracy in these cases was 100%. Most of the epididymal nodules were non-neoplastic, which is in keeping with the high prevalence of tuberculosis and filariasis in our region. Thus FNAC served as an important tool to screen and diagnose all palpable lesions of epididymis and should be used with increased frequency.

The various devices have been extensively compared for adequate endocervical component sampling. The prescence of endocervical cells traditionally is taken as a yardstick of adequacy. We compared the endocervical brush and the traditional Ayre's spatula for cervical smear adequacy as per the criteria laid down by the Bethesda system and looked for the feasibility of the use of either of the two devices alone in obtaining an adequate smear. The endocervical brush proved to be better at endocervical component sampling and as good as the spatula at squamous cell sampling. Chances of hemorrhage were found to be more with the endocervical brush, though statistically not significant. The endocervical brush picked up intraepithelial lesions of the uterine cervix better. The increased chance of picking up endocervical cells reduces the need for repeat smears thereby improving the cost effectiveness and reducing the psychological trauma to the patient.

Fine needle aspiration cytology is a commonly used procedure in diagnostic pathology. It is also used for diagnosing bone and soft tissue swellings as a primary tool in early stage of the lesion. But there are only a few studies which are related with role of FNAC in bony lesions in paediatric and adolescence age group. A total of 75 cases of 0-21years age were studied of which 46.7% were malignant bone tumours (Group-1), 18.7% were benign bony lesions excluding giant cell lesions (Group- 2), 13.3% were benign giant cell lesions (Group-3) and 21.3% were inflammatory lesions (Group-4). It was found that FNAC was conclusive in 94.4% in Group-1,71.4% in Group-2,80% in Group-3 and 93.7% in Group-4. FNAC is an important tool for diagnosis of bony lesions, and found to be more conclusive in malignant bony lesions.

A total of 296 tumour and tumour - like lesions of the bone were studied between 1990 and 2003 (14 years) in Goa medical college and we report the utility of FNAC in the diagnosis of osteosarcomas. Osteosarcomas comprised 31 cases out of 296 and they were the most common malignant primary bone tumour. Of these, 27 were conventional osteosarcomas, 2 cases were small cell osteosarcomas, one case was telangiectatic type of osteosarcoma and one was multicentric or multifocal osteosarcoma. In this paper the utility of FNAC in these lesions along with the clinical and radiological correlation is also discussed. For the diagnosis of osteosarcoma great importance is to be given to the age of the patient, site in the bone, type of bone affected, the radiologic and the cytologic picture. The cytology smears are hypercellular or moderately cellular with hyperchromatic, pleomorphic, bizarre cells, mononuclear as well as multinucleated tumour giant cells with osteoid. The cytology must be evaluated in a total clinical - radiological and pathological scenario. Small cell osteosarcomas can be confused with Ewing's sarcoma and malignant lymphoma. Telangiectatic osteosarcoma yields mainly blood on aspiration. FNAC is also invaluable in the diagnosis of multicentric or multifocal osteosarcoma.

Fine needle aspiration cytology of salivary glands was performed on 135 cases during a period of three years. Of the total lesions, benign tumours constituted 73 cases (57.1%), malignant tumours 21 cases (15.5%) and tumour like lesions 41 cases (30.4%). The parotid glands were involved in majority of lesions (73.4%) followed by submandibular glands (20.2%) and minor salivary glands (6.30%). The cytological diagnosis was correlated with histopathology in 76 cases. The diagnostic accuracy for benign, malignant and tumour like lesions were 94.7%, 71.4% and 95.8% respectively with an overall accuracy of 90.7%. The sensitivity of FNAC was 78.5% with a specificity of 100%, thereby enabling FNAC to be a useful and simple tool for an early diagnosis of salivary gland tumours.

The commonest childhood malignancy arising from paratesticular structures such as tunica vaginalis, spermatic cord and connective tissue of testicular coverings is rhabdomyosarcoma. Of this, the commonest type seen in the paratesticular region is embryonal rhabdomyosarcoma. We report 3 cases of paratesticular embryonal rhabdomyosarcoma which were diagnosed by FNAC and confirmed by histopathology.

This study is to evaluate the role of fine needle aspiration cytology in diagnosis of cutaneous and subcutaneous metastatic deposits. Analysis of twenty two cases of subcutaneous nodules was done from January 2004 till date. Out of these eight nodules were diagnosed as metastatic deposits. In four cases primary was undiagnosed and four were from diagnosed primaries. Fine needle aspiration is a very reliable and safe procedure and is of diagnostic importance because they may be the first manifestation of an undiagnosed internal malignancy, the first indication of a metastatic deposit in a adequately treated malignancy.

This report is based on cytologic analysis of pleural fluid of a 52 year old man who came to hospital with non specific complaints of weakness, lethargy and pleuritic chest pain on the right side. X-ray chest showed right sided pleural effusion. Montoux test was negative and so were the three consecutive sputum samples for AFB. Thoracocentesis was done, which showed blood-tinged fluid with elevated protein. Cytology showed abnormal plasma cells with multinucleated forms. Pleural biopsy was negative. Further examination revealed one very small supra-clavicular lymph node less than 0.5 cm in size. Biopsy of this lymph node was done and it showed abnormal plasmacytoid cells and the diagnosis of plasmacytoma was confirmed.

Pseudomyxoma peritonei is defined as peritoneal involvement by a mucinous neoplasm accompanied by collections of intraabdominal mucus (mucinous ascites). Cytologic examination of ascitic fluid, which is usually a thick and gelatinous material may appear to be devoid of cells except for an occasional macrophage. However, if enough fluid is examined, it is possible to find tumor cells with varying cytologic appearances ranging from benign mucinous epithelium to poorly differentiated adenocarcinoma based on the histology of the primary neoplasm. We studied ascitic fluid in a patient whose main complaint was rapidly increasing ascites unresponsive to antituberculous treatment.There were whorls of signet ring cells in a background of abundant mucin. A diagnosis of pseudomyxoma peritonei was followed by a peritoneal biopsy which confirmed a signet ring cell carcinoma. Colonoscopy and subsequent biopsy of caecal ulcer revealed primary tumor in the caecum.

A cytohistopathological study of a case of embryonal rhabdomyosarcoma of spermatic cord in a 16 year old boy is presented. Since this tumor has propensity for young and is highly malignant in nature, a preoperative FNA proves to be an effective tool in the early diagnosis and treatment.