This is a two year study of 530 liver aspirates that included 40 benign and292malignanttumours. Smears from hepatocellular carcinomas were cellular and showed a complex ramifying "Staghorn" pattern. Nodular aggregates covered by endothelium and projecting within sinusoids were characteristic. Smears of cirrhosis showed smaller fragments with loosely arranged hepatocytes. Cytological variation within single cell clusters was seen in contrast to uniform atypia within a single cell cluster in hepatocellular carcinoma. Metastatic tumours showed interspersed clusters of normal hepatocytes and cytological features specific to the primary tumour. The commonest metastatic tumour was gastrointestinal adenocarcinoma. In 16cases, it was impossible to differentiate the primary or the metastatic nature of the tumour. In 16 cases, it was difficult to pinpoint the source of the metastasis. The general diagnostic yield of FNAC was 62.6% whereas that of guided FNAC was 53.8%. We attribute the latter to small sample size and the fact that guided FNAC was reserved for inaccessible, deep seated lesions and sometimes doubtful lesions.

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Bronchial regenerative cells with nuclear atypia are often a cytodiagnostic pitfall in the evaluation of respiratory tract cytology. Creola bodies is the term given for these cytological mimics of malignant cells, when observed in the study of sputum cytology. We hereby report their presence in a young bronchial asthmatic patient.

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A case of primary extracranial meningioma of temporal region was diagnosed on aspiration cytology in clinically unsuspected case. Presence of whorling pattern, nuclear pseudoinclusions and psammoma bodies helped in arriving at a correct diagnosis. Histology showed muscle infiltration. Possibility of recurrence remains inspite of complete excision. Follow up is necessary

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The paucicellular variant of Anaplastic carcinoma of thyroid (ANTC) is an uncommon entity. It can pose diagnostic difficulty both in cytology and histology. Its recognition is important as it has an aggressive clinical course with poor outcome. We report here a forty two year old female patient who presented with a midline neck swelling and painful deglutition of three months duration. A diagnosis of subacute thyroiditis was entertained clinically and on initial cytologic evaluation. The subsequent frozen and paraffin section diagnosis considered was Riedei's thyroiditis. Patient's rapid clinical course and fatal outcome necessitated a review which led to the recognition of ANTC-paucicellular variant. Because of the paucicellular nature of the lesion, this variant is likely to be underdiagnosed in aspiration cytology. The clue to recognising it in histology lies in paying attention to the areas of cellularity, atypical cells and the infarcioid type of necrosis; features not associated with Riedei's thyroiditis.

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Fine needle aspiration (FNA) of clinically suspicious cutaneous nodules was carried out in 68 patients with or without any evidence of malignancy elsewhere. They comprised 4.24% of all malignant cytologies from various body sites. About half of all the nodules were metastases from distant primaries and about one third post therapy local recurrences of tumours, while direct extension from underlying tumours and primary cutaneous malignancies were relatively less common. The commonestsite of primary was lungs in males and cervix, breast followed by ovary in females. In three out of six cases with unknown primary tumour, cytology proved useful in suggesting the source of metastasis to be hepatocellular carcinoma, melanoma and mucin secreting adenocarcinoma of GIT. FNA was found to be extremely useful in the diagnosis and management of malignant cutaneous nodules when utilized in context of clinical and radiological findings, eliminating the need of a surgical biopsy.

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The diagnostic utility of nipple discharge (ND) in different breast lesions was assessed retrospectively in 81 patients. The spectrum of diagnoses offered were : malignant (six), suspicious of malignancy (nine), benign cystic lesion (43), inflamator/ lesion ( 12), and inadequate (eight). Three cases were cytologically negative but had strong clinical suspicion for cancer. The frequency of milky discharge decreased and bloody discharge increased with age Sixty percent of the malignant and only 9-10% benign cases had bloody discharge. About86.67% of unilateral and 80% of single duct discharge were associated with carcinoma. In 21 cases with palpable lump FNAC was performed which confirmed diagnosis of duct carcinoma (DC) in eight, papillary lesion in four and fibrocystic disease in nine cases. Histological findings were correlated in nine cases. In two cases of ND without associated lump, cytology showed frank malignant cells. Histology of one of them confirmed the diagnosis of infiltrating duct carcinoma. Cytoiogical examination of ND is a non-invasive, simple and rapid technique. It is helpful in guiding the management of the patient specially in non palpable breast lesions.

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Adenomatoid tumor is a relatively uncommon but a well recognised benign neoplasm of the paratesticular region. We report a case of adenomatoid tumor of the epididymis diagnosed by FNAC, thus giving a rapid and reliable preoperative diagnosis enabling a definitive surgical approach.

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The cytological findings in cervical smears from 18,815 women screened between April 1971 to July 1998 at Queen Mary's Hospital, Lucknow, have been re-classified according to the Bethesda system to find out its utility to the clinicians. The prevlence rate of low and high grade intraepithelial lesions (LSIL and HSIL) and squamous cells carcinoma were found maximum in women showing clinical lesions on the cervix. Further, bleeding problems such as contact bleeding and postmenopausal bleeding showed high percentage of frank carcinoma than other associated symptoms. Both HSIL and squamous cell carcinoma showed rise with increasing age and parity. This warrants for mandatory inclusion of women of high age above 35 years and multiparity (with 2 children or more) in a cytological surveillance programme.

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The object of the present study is to determine the AgNOR quantitation in fine needle aspirates of thyroid lesions by two different observers and to analyze the interobserver variability by using Bland Altman plot. Forty five cases were taken for this study including 5 cases of thyroiditis, 6 cases of colloid goitre, 15 cases of follicular adenoma, 4 cases of follicular carcinoma, 6cases of papillary carcinoma and 9 cases of anaplastic carcinoma. These smears were stained by one step silver staining colloidal technique and AgNOR dots were counted by two different methods i.e. m AgNOR and p AgNOR by two different observers independently. Malignant lesions had higher number of AgNOR counts in comparison to the goitres and neoplasm. Statistical analysis was done to observe the correlation coefficient and interobserver variability. The correlation coefficient for mAgNOR was 0.78 andforpAgNOR was 0.96. The correlation coefficient between difference and average (r=0.22) indicate that there was an increasing average with difference between the two observers. Our findings also indicate a negative correlation between the difference and the average of p AgNOR counts (r=0.06). There was no statistical evidence of variability between the two observers. Although observers counts do not differ significantly still no cut o ff point could be established to differentiate thyroid lesions.

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