One hundred cases of poorly differentiated tumors were studied by immunocytochemical staining on fine needle aspiration smears by indirect immunoperoxidase technique using monoclonal antibodies to cytokeratin (CK), vimentin (VIM), leucocyte common antigen (LCA), neuron specific enolase (NSE), and desmin (DES) to see the utility of immunocytochemistry in the routine diagnostic work-up of poorly differentiated tumors. Eighty seven percent of carcinomas were positive for CK. Small cell carcinomas formed a heterogenous group with 50.0% cases positive for both CK and NSE and 16.6% positive for NSE alone. Co-expression of CK and VIM was seen in 4 carcinomas. Seventy five percent of lymphomas showed positivity with LCA. VIM was positive in 72.7% sarcomas. After immunostaining a conclusive result could be obtained in 74 % of the cases. Immunostaining was least useful in the categorisation of soft tissue sarcomas and most useful in the diagnosis of round cell tumors (RCT) where it was helpful in arriving at a diagnosis in 61% cases.

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One thousand three hundred and nintythree endoscopic G.I. cytology samples submitted for diagnosis between 1992-1996 were analysed. The sites of collection in order of frequency were : 846 gastric, 421 oesophageal, 91 colon and rectal and 35 duodenal. Brush cytology was used alone in 267. In the remaining multiple sampling methods such as imprint and crush smears with or without brush cytology and/or endoscopic suction cytology and FNAC smears were used. Biopsies for comparison were a vailable in all cases. The principal role of cytology was to rule out or confirm malignancy in a large majority of cases. Of the cases examined, 25% were reported as malignant and 66.5% as negative for malignant cells. Cytology was suggestive of malignancy in 3.9% and suspicious in 2.9%. Of the malignant cases as confirmed by histopathology, cytology gave a definite diagnosis of malignancy in 70% of squamous and adenocarcinoma (NOS) cases, in 78.7% poorly differentiated carcinoma cases, and in 45% of the signet ring cell carcinoma cases. Exact morphological subtyping of malignancy was possible in 60% of squamous cell carcinoma, 51.4% of adenocarcinoma and 71.4% of poorly differentiated carcinoma. None of the signet ring cell carcinoma cases could be specifically designated so. 90.6% of cases with suggestion of malignancy and 63.4% of cases with suspicious cytology were confirmed to be malignant. Of the eight histologically diagnosed NHL cases, cytology gave a diagnosis of NHL only in three of which two were high grade lymphoma. Cytology in addition picked up two more cases of NHL where the biopsy was non-committal to the diagnosis of NHL. Overall, although cytology missed the diagnosis of malignancy in 22.3% of cases, it also picked up 43 cases of malignancy which were missed on biopsy. Cytology also played a useful role in detecting H. pylori (positive correlation with histopathology: 74%), 3 cases of Candida, 4 cases of tuberculosis and one case of Barret's oesophagus which was clinically suspected to be carcinoma. Thus, endoscopic G.I. cytology is a useful adjunct to biopsy.

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The role of clinical data in arriving at a cytological diagnosis is evaluated in 431 cases. Four parameters are studied.

1. Predictive accuracy of cytological diagnosis given with the help of only preliminary data (P.O.) of age, sex and site versus that given when complete clinical data (C.C.D.) is needed for diagnosis.
2. Identifying areas where clinical data helps in diagnosis.
3. Identifying factors which necessitate the help of clinical data.

Fine needle aspirates were performed by cytologists and the findings were interpreted with only P.D. (Gp.lf n=281) and with C.C.D. (Gp.ll, n=151) In group I the predictive accuracy for diagnosis of malignancy was high (100%) and in group II it was 98.93% C.C.D. helped in confirmation of diagnosis in atypical cases, helped in tumour typing, predicting site of primacy, diagnosing rare entities and in borderline lesions.

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A case of bilateral parotid gland tuberculosis diagnosed by FNAC and later confirmed by histopathological examination, clinically mimicking bilateral parotid neoplasms is being reported due to its unusual presentation.

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Three cases of Burkits lymphoma of breast diagnosed by fine needle aspiration are reported. The FNA smears contained monotonous population of small round cells with moderate amount of basophilic cytoplasm containing small vacuoles. Nucleus had a prominent nuclear membrane and multiple nucleoli suggesting the presence of Burkitt's lymphoma. FNA cytology was found to be quite reliable for arriving at the diagnosis ofBurkitt type lymphoma. Radical surgery was avoided in these cases because of FNAC.

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A case of hemangiopericytoma (HP) of soft tissue occuring in a 28 year old lady diagnosed by FNAC is reported. Smears were cellular and revealed numerous discretely lying round to oval cells with bland nuclear features and scanty amounts of cytoplasm. Perithelial arrangement of cells could also be demonstrated. A striking feature was the presence of numerous mast cells intimately admixed with tumörcells. The diagnosis was confirmed by histopathologic examination of the excised specimen.

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A case of metastatic squamous cell carcinoma thyroid diagnosed by FNAC and later confirmed by histopathology is being reported in a patient who was treated for poorly differentiated squamous cell carcinoma of the cervix 2 years back. The utility of FNAC over diagnostic surgical operation on the neck has been highlighted.

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The present study was undertaken to detect Condylomatous changes in the cervix during course of Cytological Screening at Queen Mary's Hospital, Lucknow, (March 1989-June 1997). The prevalence rate of Condyloma among the 11,389 women examined was found to be 0.6% (75 cases). Condyloma was associated with dysplasia in 33.3% of cases and with malignancy in 2 cases (2.6%). Clinically, cervices which bled on touch and those which were hypertrophied were found to show maximum incidence of condylomas. The highest prevalence of condyloma was detected in women complaining of contact bleeding and leucorrhea. Condylomatous changes in the cervix were found most commonly in younger women of 21-30 years and after 1-5 years of consumation of marriage. This may be related to the frequency of sexual activity during this period.

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During a study of five years from January 1993 to January 1998, a total of 6056 patients were subjected to FNAC at this Institute. Of these, 165 (3.05%) had symptoms and signs related to scrotum and testis. Ninety two of these patients were being investigated for infertility (49.73%), 77(41.61%) had non-neoplastic lesions and 16 patients (8.66%) were found to have neoplasms. Of the 92 patients referred for workup of male infertility, 43 (46.66%) were found to have severe atrophy with Sertoli cells only, 22 (23.91%) had hypospermatogenesis, 22 (23.91%) showed normal spermatogenesis, and 5 patients (5.52%) had maturation arrest. Among the patients with non-neoplastic lesions, 40 (51.94%) had inflammatory masses (nonspecific inflammation 22 cases, granulomas in 17 and malakoplakia in one) and the remaining 37 could be grouped as noninflammatory lesions which included fluid filled lesions. Sixteen patients were found to have neoplasms of which 2 were benign (12.5%) and the rest (87.5%) malignant. Seminoma was the commonest malignancy encountered (71.4%). One patient with bilateral testicular mases was diagnosed as non-Hodgkins lymphoma by FNA. Further investigations revealed bilateral adrenal and pulmonary involvement. No complications were encountered except for mild transient local discomfort. Good patient compliance was obtained.

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