Objective : To evaluate the role of fine needle aspiration cytology (FNAC) in the distinction between neoplastic and nonneoplastic ovarian masses. Materials and Methods : One hundred and twenty patients with ovarian masses were studied. After detailed history and clinical examination, ultrasound (USG)-guided FNAC was performed in 92 clinical benign cases while FNAC and/or imprints of surgically resected ovarian masses was performed in 28 clinically suspected malignant cases. The smears were stained with Papanicolaou stain and histopathological sections were stained with hematoxylin and eosin stain with inclusion of special stain whenever required. Serum b-human chorionic gonadotrophin and a-fetoprotein estimations were carried out in cytologically diagnosed germ cell tumors. Results : The overall sensitivity, specificity and diagnostic accuracy of FNAC in diagnosing various ovarian masses were 79.2%, 90.6% and 89.9%, respectively. Conclusions : The clinical examination, pelvic ultrasound and FNAC were complementary and none of the methods was, in itself, diagnostic. However, USG-guided FNAC was found to be a fairly specific and accurate technique and should be employed as a routine, especially in young females with clinically benign ovarian lesions. The reasons for false diagnosis and limitations of USG and FNAC have been analyzed.

Background : Distinguishing adenocarcinoma cells from reactively proliferated mesothelial cells and macrophages is one of the greatest challenges in the cytodiagnosis of effusions. Aberrant glycosylation of cell surface glycoconjugates is emblematic to malignancy, and lectins being an important class of probes to demonstrate these aberrations, lectin cytochemistry is of great interest to differentiate adenocarcinoma cells from reactive mesothelial cells. Aim : The present study analyzed the potential of a plant lectin to distinguish malignant cells from reactive mesothelial cells and macrophages. Materials and Methods : Snake gourd lectin (SGL) was isolated, purified and conjugated to horse radish peroxidase (HRP) and incubated with the cells of benign (46) as well as malignant (39) effusions using the standard immunocytochemical method with diaminobenzidine as the chromogen. The lectin-bound areas were quantitatively assessed as mild, moderate and intense binding. Statistical Analysis : The mean score for benign and malignant effusions were statistically analyzed. Student's 't'-test was performed to assess the significance. Results : The lectin HRP complex bind to the cytoplasm of benign and malignant cells as well as macrophages. A significantly higher score for intense binding (P = 0.001) was found to differentiate malignant cells from reactive mesothelial cells. Macrophages showed intense irregular binding. Conclusions : SGL binding assay can play a role in the differential diagnosis of metastatic adenocarcinoma in effusions.

Background : Cytological grading (CG) on aspirates of breast carcinoma is a useful tool for surgical maneuver and prognosis. Aims : An endeavor was made to use CG on aspirates of breast carcinoma using Robinson's grade and to correlate it with Bloom Richardsons' histopathological grading. Materials and Methods : A total of 59 patients of breast carcinoma, aged 28-57 years, were aspirated and the smears were graded using Robinson's criteria. All the cases were correlated with Bloom Richardson's grade on histopathology in mastectomy specimens. Lymphadenopathy in 38 cases was aspirated and stained with Papanicolaou and Romanowsky stain. Results : Robinson's CG correlated well with Bloom Richardson's histopathological grading. For grade I and II tumors, there was substantial strength of agreement between cytology and histopathology, while in grade III, the concordance was nearly perfect. Lymph node metastasis was found in 27 of 32 axillary nodes, three of five cervical nodes and the only palpable supraclavicular node. Lymph node metastasis was observed in three with cytological grade II, 28 of grade III and none of grade I. All grade I had stage A, two of grade II had stage B, while all grade III had either stage B or stage C disease. Conclusions : Thus, CG of breast carcinoma correlates well with histopathological grading and may well be useful as a prognostic marker.

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.

Human immunodeficiency virus infection associated lymphadenitis of the salivary glands (HIVLSG) and benign lymphoepithelial cysts are described as early events in HIV patients. The diagnosis is not usually made clinically as it mimics a salivary gland tumor. We present here a patient with two painless nodules in the right parotid and submandibular glands. The cytological diagnosis was florid reactive lymphoid hyperplasia. Histopathology revealed features of HIVLSG with multiple, small, cystic, benign lymphoepithelial lesions.

Herpes simplex virus (HSV) is a rare cause of breast infection. Few cases of maternal-infant transmission of the virus during breastfeeding resulting in nipple lesions have been documented. Only three cases have been reported in nonlactating women. We report an additional case of HSV mastitis in a 36-year-old nonlactating female who was diagnosed on scrape cytology smears.

Besides peripheral blood smears, microfilariae have been described in aspirate smears from different sites. Identification of microfilariae in the chylous urine of otherwise asymptomatic filarial patients has been rarely described. One such case is presented.

Somatostatinomas are rare pancreatic endocrine neoplasms (PEN). We present a case of a PEN in a 63-year-old lady having diabetes mellitus, cholelithiasis, steatorrhea, weight loss, indigestion, nausea and fatigue. Ultrasonography revealed a large calcified mass occupying the liver, pancreas and emboli in the splenic vein. Fine needle aspiration cytology (FNAC) of the metastatic mass in the liver showed features of neuroendocrine tumor. Correlating the clinical picture, computed tomography and cytological findings, a diagnosis of pancreatic somatostatinoma was suggested. Serum somatostatin levels and biopsy findings confirmed the same. The patient was put on chemotherapeutic agents and octreotide and is doing well after two years of follow-up. We discuss the FNAC findings of pancreatic endocrine tumors and its differentiating features from hepatoma and other small round cell tumors.

Eosinophilic granuloma is a variety of histiocytosis-X with unknown etiology. Eosinophilic granuloma occurs as single or multiple lesions of bone destruction. It is seen more commonly in children or young adults although it may be found at all ages. Other sites like the lung and the gastrointestinal tract may also be affected. This is a rare case of eosinophilic granuloma which presented as frontal headache. The radiographic and cytological findings were characteristic of the disease.

Primary intracystic squamous cell carcinoma (SCC) of the breast is an extremely rare entity and has a low incidence in comparison with other breast cancers. We report a rare case of primary intracystic SCC in a 45-year-old woman who presented with a cystic lump in the right breast. Cytological smears of the fluid aspirated from the breast tumor revealed malignant squamous cells dispersed in single and occasional groups along with numerous cyst macrophages, suggesting cystic SCC. Histological study of the mastectomy specimen confirmed the diagnosis of primary intracystic SCC. Although the presence of abundant foamy macrophages in the background of fine needle aspiration cytology smears of the breast suggest benign breast lesion, when associated with malignant squamous cells, these suggest cystic primary SCC or metastatic SCC. The primary SCC should not be confused with metaplastic change in other breast carcinomas.

Amyloid material on lymph node cytology smears can mimic caseous necrosis. We report one such case where a 50-year-old lady presented with a nasal mass and cervical lymphadenopathy. Fine needle aspiration cytology smears of the cervical lymph node were interpreted as tuberculous lymphadenitis based on the presence of an occasional epithelioid cell and caseous material. The patient did not respond to antituberculous therapy and was revaluated. Repeat aspiration from the lymph node showed numerous plasma cells and myeloma cells in addition to the amorphous material which was confirmed to be amyloid on staining with congo red. A diagnosis of plasmacytoma with amyloidosis was rendered. Imprint smears from nasal mass, detailed hematology workup and subsequent histology confirmed the diagnosis.