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April-June 2008 Volume 25 | Issue 2
Page Nos. 45-78
Online since Saturday, August 9, 2008
Accessed 73,766 times.
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ORIGINAL ARTICLES |
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Diagnostic utility of fine needle aspiration cytology in pediatric tumors |
p. 45 |
Veena Maheshwari, Kiran Alam, Anshu Jain, Surabhi Aggarwal, RS Chana DOI:10.4103/0970-9371.42440 Background and Aims: Fine needle aspiration cytology (FNAC) is a relatively new technique for the diagnosis of pediatric tumors. Most of the studies conducted so far have dealt only with malignant neoplasms or neoplasms of a particular organ/organ system in the pediatric population. Our work included a comprehensive study of both benign and malignant tumors in children younger than 15 years of age to correlate their clinical, cytological, and histological findings and to evaluate the effectiveness of FNAC in their diagnosis.
Materials and Methods: We studied 588 cases over a period of ten years. Data was collected retrospectively as well as prospectively, and included all patients younger than 15 years of age, who presented with tumors or associated symptoms. Clinical, cytological, and histopathological correlations were done.
Results: Benign soft tissue tumors formed the largest group among all pediatric tumors (41.5%). Lymphomas were the most common (25.1%) of all malignant tumors, followed closely by small round cell tumors (SRCTs, 21.3%). FNAC was performed in 342 (55.1%) cases, cyto-histological correlation was possible in 226 (38.4%) cases; and a concordant diagnosis was seen in 218 (37.1%) cases, giving an overall diagnostic accuracy of 96.46% with FNAC. Occasional rare cases like Dabska's tumor and intraabdominal desmoplastic small round cell tumor could also be diagnosed by FNAC.
Conclusions: We conclude that FNAC is an effective method for the evaluation and screening of pediatric masses, as well as for follow-up of patients with a history of malignancy. |
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Conjunctival cytology in glaucomatous patients using long-term topical therapy |
p. 50 |
Rana K Sherwani, Roobina Khan, Mohd Arif Pervez, Asma Tauheed, H Ashraf, FA Jilani DOI:10.4103/0970-9371.42442 Background: Long-term use of antiglaucoma drugs induces adverse changes on the conjunctival surface.
Aim: To evaluate the cytological changes in the conjunctival scrape smears of patients receiving long-term antiglaucoma medication and their histopathological correlation.
Materials and Methods: Conjunctival scrape smears were taken from the eyes of patients on long-term antiglaucoma therapy for over three months (n = 75), patients taking antiglaucoma medication for less than three months (n = 100) and from glaucomatous patients in whom trabeculectomy was done as a primary procedure. Inflammatory cell counts, fibroblasts, and the degree of metaplasia were then evaluated both cytologically and histologically. The t-test was used to determine the predictive values of these parameters for the surgical outcome of trabeculectomies.
Results: Long-term use of antiglaucoma therapy leads to a higher stage of metaplasia with an increase in the number of fibroblasts, subepithelial collagen deposition, and inflammatory infiltrate within the substantia propria of the conjunctiva.
Conclusions: Long-term antiglaucoma medications induce a significant degree of metaplasia in the conjunctival surface that adversely affects the outcome of filtration surgery. |
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Role of gastric brush cytology in the diagnosis of giardiasis |
p. 55 |
Deepali Varma, Shyama Jain, Nita Khurana DOI:10.4103/0970-9371.42443 Background: Giardiasis, common in developing countries, has mostly nonspecific clinical symptoms, resulting in a limited role for preliminary tests.
Aims: The present study aims to highlight the utility of endoscopic brush cytology (EBC) in the diagnosis of giardiasis in clinically unsuspected cases.
Materials and Methods: Endoscopic brush smears (EBS) are routinely obtained in all patients presenting with gastric symptoms. The present study is a retrospective analysis of EBS, consisting of 12 cases whose smears had revealed trophozoites of Giardia lamblia . Biopsy correlation was available in five cases.
Results: The patients ranged in age from 15 to 78 years (mean age: 34.08 years) with a 1:1 sex ratio. Stool examination in all 12 cases yielded negative results for giardiasis. Upper gastrointestinal endoscopy was normal in all these cases. EBS from these cases revealed Giardia trophozoites, which were identified by their typical morphology.
Conclusions: Endoscopic brush cytology can be used as a reliable screening tool in the diagnosis of gastro-duodenal giardiasis in clinically unsuspected cases, especially in developing countries where parasitic infections are common. |
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Critical appraisal of cytological nuclear grading in carcinoma of the breast and its correlation with ER/PR expression |
p. 58 |
Vidhi Bhargava, Manjula Jain, Kiran Agarwal, S Thomas, Smita Singh DOI:10.4103/0970-9371.42445 Background: Cytological nuclear grading is one of the several key prognostic factors that should be addressed in cytological analysis of breast carcinomas.
Aims: To evaluate different cytological nuclear grading methods on fine needle aspirates of breast carcinomas and its correlation with histopathological nuclear grading as well as with the immunocytochemical expression of estrogen receptor (ER) and progesterone receptor (PR).
Materials and Methods: The smears from 30 cytologically proven cases of breast carcinoma were graded by - Nottingham's modification of Scarff Bloom Richardson, Fisher's modification of Black's nuclear grading and Robinson's cytological grading methods. 18 cases were available for correlation with histology grading.
Results: Robbinson's cytological grading system was found to have the best correlation with histopathology grades (P < 0.001) as well as ER (P = 0.003) and PR (P = 0.001) expression on smears.
Conclusions: The Richardson's cytology grading method is recommended for cytological nuclear grading along with ER / PR expression, without which the cytological diagnosis of breast carcinoma is incomplete. |
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CASE REPORTS |
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Cytological diagnosis of acanthomatous ameloblastoma |
p. 62 |
Vaishali A Walke, Maitreyee M Munshi, Wamanrao K Raut, Sudhakar K Bobahate DOI:10.4103/0970-9371.42447 Ameloblastomas show wide morphological spectra and may pose diagnostic difficulties. Of the many types encountered, acanthomatous ameloblastoma is a rare variant that possesses distinctive features. To the best of our knowledge, there have been no previous reports on the cytology of acanthomatous ameloblastoma (AA). An elderly male presented with a radiolucent jaw swelling. Cytology smears showed combinations of basaloid cells with peripheral palisading, stellate cells as well as squamous cells in groups and in isolation. A diagnosis of acanthomatous ameloblastoma was made and subsequently confirmed on histology. Although AA is a rare jaw tumor, it possesses distinctive cytological features that permit confident preoperative cytodiagnosis. |
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Osteoclastoma-like anaplastic carcinoma of the thyroid |
p. 65 |
Leena D Joseph, A Ravi, A Rekha, Shalinee Rao, Rajkumar Aarthi, Vinod K Panicker DOI:10.4103/0970-9371.42450 Anaplastic carcinoma is a highly malignant tumor that is partially or totally undifferentiated. The use of fine needle aspiration cytology (FNAC) to diagnose anaplastic carcinoma with osteoclast-like giant cells, has been rarely reported. We report here a case of osteoclastoma - anaplastic carcinoma - that was diagnosed on cytology in a 58 year-old female patient, who presented with a progressively increasing swelling over the anterior aspect of the neck. Multinucleated giant cells resembling osteoclasts are rarely seen in the giant cell variant of anaplastic carcinoma. |
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Orbital pseudotumor: Diagnosis on fine needle aspiration cytology |
p. 67 |
Ashwini Agarwal DOI:10.4103/0970-9371.42451 Orbital pseudotumors are inflammatory lesions of the orbit of unknown etiology, which clinically and radiologically mimic an orbital neoplasm. Fine needle aspiration cytology (FNAC) is a useful tool in evaluating patients with presumed pseudotumors. We are presenting here a case of an orbital pseudotumor that was diagnosed with the aid of FNAC. A 43 year-old male presented with a complaint of unilateral proptosis in the right eye that had developed a year ago. Differential diagnoses of lymphoproliferative disorder and malignancy were considered after radiological evaluation. FNAC revealed features suggestive of reactive lymphoid hyperplasia and a diagnosis of an orbital pseudotumor was suggested that was confirmed later by histopathological examination. We report this case to emphasise the usefulness of FNAC in providing invaluable diagnostic information for proper clinical management. Thus, FNAC may save the patient the inconvenience of unnecessary exploratory orbital surgery. |
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Ewing's sarcoma of short bones and girdle: A short series of five cases |
p. 70 |
Meetu Dhingra, Richa Pandey, Chayanika Pantola, PK Singh, Asha Agarwal DOI:10.4103/0970-9371.42453 Only a few cases of Ewing's sarcoma are diagnosed in adults; however, they are well described in the long bones of individuals in the 5-20 years' age group. With the following case series, we have tried to emphasize the wider age range and the involvement of short bones observed in Ewing's sarcoma patients. Fine needle aspiration has a definitive role in the early diagnosis and hence, better prognosis of this disease. |
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Inguinal endometriosis: A case report |
p. 73 |
Rajni Kaushik, Anchana Gulati DOI:10.4103/0970-9371.42455 Inguinal (noncutaneous) endometriosis is an uncommon presentation of endometriosis. It usually presents as a painful, typically right-sided, hernia-like inguinal mass with catamenial exacerbation. Here we report a case of inguinal endometriosis in which fine needle aspiration cytology was instrumental in reaching the diagnosis which was subsequently confirmed on histopathology. |
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LETTERS TO THE EDITOR |
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Cytological diagnosis of malignant mesothelioma of the tunica vaginalis of the testis |
p. 76 |
Gopi N Barui, Rupam Karmakar, Amitava Sinha, Aparna Bhattacharya DOI:10.4103/0970-9371.42457 |
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Amylase crystalloids in a cystic lesion of the parotid salivary gland diagnosed by fine needle aspiration cytology |
p. 77 |
Gurdeep Singh, Venkateshwaran K Iyer DOI:10.4103/0970-9371.42459 |
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