Journal of Cytology
Home About us Ahead of print Instructions Submission Subscribe Advertise Contact e-Alerts Reader Login
Users Online:520
  Print this page  Email this page Small font sizeDefault font sizeIncrease font size
Export selected to
Reference Manager
Medlars Format
RefWorks Format
BibTex Format
  Most popular articles (Since April 15, 2008)

  Archives   Most popular articles   Most cited articles
Hide all abstracts  Show selected abstracts  Export selected to
  Viewed PDF Cited
Cells in pleural fluid and their value in differential diagnosis
Rashmi Kushwaha, P Shashikala, S Hiremath, HG Basavaraj
October-December 2008, 25(4):138-143
Background : Both non-malignant and malignant causes of effusion can be identified by the relatively non-invasive technique of pleural fluid cytology. With this basis the present study on cytology of pleural fluids was taken up. The diagnostic significance of the cytologic study of the fluid may be attributable to the fact that the cell population present in the sediment is representative of a much larger surface area than that obtained by needle biopsy. Materials and Methods : One hundred samples of pleural fluid were examined for total cell count, cell type and cellular features. They were also subjected to biochemical study to find out the level of protein, glucose and chloride. Results : A total of 82% samples were exudative and 18% were transudative. Total leukocyte count (TLC) was less than 1000 cells/ in most (88.89%) of transudative effusions. Overall 52.44% of exudative effusions had TLC greater than 1000 cells/ It was noted that 96.88% of tuberculous effusions had more than 50% lymphocytes, 81.25% had protein greater than 5 gm/dl and 90.63% had glucose greater than 60 mg/dl. Approximately 28% of pleural effusions were positive for malignant cells. Most (82%) of malignant effusions were exudative. The primary site could be assessed by cytological examination in 57.14% of malignant effusions. Conclusions: The most useful test in establishing the diagnosis of pleural effusion is pleural fluid cytology and pleural fluid cell count. Cytologic study of pleural fluid is a complete diagnostic modality which aims at pointing out the etiology of effusion as well as, in certain cases, a means of prognostication of disease process.
  72,651 2,158 19
Cytology of soft tissue tumors: Benign soft tissue tumors including reactive, nonneoplastic lesions
Venkateswaran K Iyer
July-September 2008, 25(3):81-86
  51,389 1,577 13
DNA extraction and polymerase chain reaction
Nalini Gupta
April-June 2019, 36(2):116-117
DOI:10.4103/JOC.JOC_110_18  PMID:30992648
DNA extraction and polymerase chain reaction (PCR) are the basic techniques employed in the molecular laboratory. This short overview covers various physical and chemical methods used for DNA extraction so as to obtain a good-quality DNA in sufficient quantity. DNA can be amplified with the help of PCR. The basic principle and different variants of PCR are discussed.
  30,171 6,803 17
Tubal metaplasia of the endocervix
Dushyant Singh Gaur, Sanjeev Kishore, Anuradha Kusum, Neena Chauhan, Savita Bansal, Avneet Boparai
January-March 2008, 25(1):33-35
Metaplasia is a reversible reprogramming of stem cells of the epithelium. Usually, squamous metaplasia is observed in the endocervix. However, less frequently, tubal metaplasia may develop, replacing nonciliated columnar cells by ciliated columnar cells, similar to fallopian tube epithelium. Here we present a case of tubal metaplasia of the endocervical canal. A 40 year-old female presented with postcoital bleeding; her uterus was retroverted, normal-sized and the fornices were free. Erosion was seen around the external os with ulceration. The clinical diagnosis was chronic cervicitis. Cytobrush sampling showed abundant endocervical columnar cells. A distinct morphological variation showing apical ciliary plates with distinct cilia were noticed in many columnar cells. Mucoid, neutrophil-rich secretions were seen in the background but no malignant cells were seen, resulting in a diagnosis of tubal metaplasia of the endocervical epithelium. There was no Trichomonas vaginalis infection. Tubal metaplasia should be identified as a unique benign identity and should not be confused with early endocervical glandular neoplasia of the cervix. Cytobrush technique for endocervical smears helps detect such uncommon metaplastic changes.
  34,425 611 1
Cytology of soft tissue tumors: Malignant spindle cell tumors
Aruna Prayaga
July-September 2008, 25(3):87-88
  30,311 1,077 3
Role of fine needle aspiration cytology in diagnosis and ­management of thyroid lesions: A study on 434 patients
Uma Handa, Sukant Garg, Harsh Mohan, Nitin Nagarkar
January-March 2008, 25(1):13-17
Objectives: To evaluate the results of fine needle aspiration cytology (FNAC) in the diagnosis and management of thyroid lesions. Materials and Methods: A review was conducted of FNAC of diffuse or nodular thyroid lesions performed on 434 patients over a period of three years. The cytological results were correlated with clinical features, biochemical investigations, and subsequent histopathological examination and management of the patients. Results: The most frequently encountered lesion was the colloid goiter in 250 (57.60%) cases followed by thyroiditis in 119 (27.41%) cases, ten (2.30%) adenomatous goiters and two (0.004%) thyroglossal cysts. In the neoplastic group, 14 (1.38%) cases were reported as follicular/Hurthle cell neoplasms and 17 (3.91%) as malignant tumors. When compared with the clinical diagnosis, FNAC proved to be an improvement on the diagnosis of thyroiditis and malignancy when compared with that of goiter. FNA revealed a sensitivity of 97%, a specificity of 100%, a positive predictive value of 96% and a negative predictive value of 100%. Conclusions: FNAC is a minimally invasive, highly accurate and cost-effective procedure for the assessment of patients with thyroid lesions. It also helps in differentiating lesions that require surgery from those that can be managed otherwise.
  18,398 1,614 42
Malignant small round cell tumors
Arvind Rajwanshi, Radhika Srinivas, Gautam Upasana
January-March 2009, 26(1):1-10
DOI:10.4103/0970-9371.54861  PMID:21938141
Malignant small round cell tumors are characterised by small, round, relatively undifferentiated cells. They generally include Ewing's sarcoma, peripheral neuroectodermal tumor, rhabdomyosarcoma, synovial sarcoma, non-Hodgkin's lymphoma, retinoblastoma, neuroblastoma, hepatoblastoma, and nephroblastoma or Wilms' tumor. Other differential diagnoses of small round cell tumors include small cell osteogenic sarcoma, undifferentiated hepatoblastoma, granulocytic sarcoma, and intraabdominal desmoplastic small round cell tumor. Differential diagnosis of small round cell tumors is particularly difficult due to their undifferentiated or primitive character. Tumors that show good differentiation are generally easy to diagnose, but when a tumor is poorly differentiated, identification of the diagnostic, morphological features is difficult and therefore, no definitive diagnosis may be possible. As seen in several study reports, fine needle aspiration cytology (FNAC) has become an important modality of diagnosis for these tumors. The technique yields adequate numbers of dissociated, viable cells, making it ideally suitable for ancillary techniques. Typically, a multimodal approach is employed and the principal ancillary techniques that have been found to be useful in classification are immunohistochemistry and immunophenotyping by flow cytometry, reverse transcriptase polymerase chain reaction (RT-PCR), fluorescence in situ hybridization (FISH), and electron microscopy. However, the recent characterization of chromosomal breakpoints and the corresponding genes involved in malignant small round cell tumors means that it is possible to use molecular genetic approaches for detection.
  17,240 1,945 81
Fine needle aspiration cytology in the diagnosis of Hodgkin lymphoma: Hits and misses
TR Rashmi Kumari, T Rajalakshmi
January-March 2008, 25(1):10-12
Background: Fine needle aspiration (FNA) is said to have greater diagnostic accuracy in Hodgkin lymphoma (HL) as compared to non-Hodgkin lymphoma (NHL). In spite of this, HL accounts for most of the false negative cytodiagnoses among lymphomas. Aims: To evaluate the accuracy of FNA in HL and to identify the diagnostic pitfalls. Materials and Methods: A retrospective study of 18 biopsy-proven cases of HL that had a preceding FNA from the same lymph node. Results: Nine out of eighteen cases were labeled HL, which were diagnosed on the basis of atypical mononuclear cells in preference to classic Reed-Sternberg (RS) cells. Three cases were termed lymphoproliferative, which showed the presence of only atypical mononuclear cells with eosinophilic nucleoli. Six cases were false negative cases. Four of these were hypocellular with biopsy in two cases displaying marked fibrosis. The remaining two cases were labeled reactive and review also showed no additional findings. Conclusions: Presence of atypical mononuclear cells in cytology should prompt a cautious search as classic RS cells may not be a prominent feature in aspirates of HL. Focal involvement and abundance of reactive lymphoid cells may lead to false negative diagnoses. Hypocellularity of aspirates disproportionate to lymph node size warrant caution. Overall, FNA is useful in the diagnosis of HL, provided one is aware of the pitfalls. It is particularly valuable in screening cases that will require biopsy.
  17,319 935 4
Diagnostic utility and pitfalls of Tzanck smear cytology in diagnosis of various cutaneous lesions
Hemlata Panwar, Deepti Joshi, Garima Goel, Dinesh Asati, Kaushik Majumdar, Neelkamal Kapoor
October-December 2017, 34(4):179-182
DOI:10.4103/JOC.JOC_88_16  PMID:29118470
Aims: Tzanck smear is an old but useful test for diagnosis of cutaneous dermatoses. The aim of this study was to highlight the potential usefulness and diagnostic pitfalls of Tzanck smear for diagnosis of cutaneous dermatoses and infections. Materials and Methods: This hospital based cross-sectional study was carried out on all Tzanck smears received for a period of twenty months (January 2014–August 2015). The smears were assessed to establish the utility of Tzanck smears in corroborating or excluding a diagnosis of immunobullous lesion or herpetic infection. Cases with discrepant diagnosis on histopathology were reviewed to identify additional cytomorphological features. Results: A total of 57 Tzanck smears were performed during the study period. Out of the 18 clinically suspected cases of immunobullous disorders, Tzanck smear findings corroborated the clinical diagnosis in 7/18 cases, one case was diagnosed as cutaneous candidiasis, and diagnosis of immunobullous lesions could be excluded in 5/18 cases. Out of the 19 suspected cases of herpetic infections, viral cytopathic effect was observed in 8/19 cases. Besides immunobullous lesions and herpetic infections, acantholytic cells were also observed in spongiotic dermatitis and genodermatosis. Dyskeratotic keratinocytes seen in vacuolar interface dermatitis were not easily distinguishable from acantholytic cells on Tzanck smear. Conclusions: Tzanck smear test is an inexpensive and useful diagnostic tool for certain skin diseases. It can aid in establishing a rapid clinical diagnosis and can serve as a useful adjunct to routine histological examination. We recommend the use of Tzanck smear as a first-line investigation for vesiculobullous, erosive, and pustular lesions.
  16,226 914 11
Cytology of soft tissue tumors: Pleomorphic sarcoma
Manjula Jain, Priya Malhan
July-September 2008, 25(3):93-96
  14,970 726 7
Critical analysis of cell block versus smear examination in effusions
Meenu Thapar, Rajiv K Mishra, Amit Sharma, Vikas Goyal, Vibhuti Goyal
April-June 2009, 26(2):60-64
DOI:10.4103/0970-9371.55223  PMID:21938154
Objectives: To assess the utility of the cell block preparation method in increasing the sensitivity of cytodiagnosis of serous fluids and to know the primary site of malignant effusions. Materials and Methods: A total of 190 cases were subjected to routine smear examination as well as cell block preparation. After the cytological diagnosis, each case was objectively analysed for cellularity, arrangement (acini, papillae, cell balls, and proliferation spheres), cytoplasmic, and nuclear details. Results: Out of 190 cases, 70 cases were found to be malignant and had been examined in smears and paraffin-embedded cell blocks. Using a combination of the cell block and smear techniques yielded 13% more malignant cases than what were detected using smears by themselves. The combined technique helped to ascertain the primary site of malignancy in 83.3% of the cases, whereas the primary site could not be ascertained in 17.7% of the cases. Conclusions: The cell block technique not only increased the positive results, but also helped to demonstrate better architectural patterns, which could be of great help in making correct diagnosis of the primary site. The cell block technique was also useful for special stains and immunohistochemistry and can give morphological details by preserving the architectural patterns.
  14,292 1,166 30
Conventional Pap smear and liquid based cytology for cervical cancer screening - a comparative study
RK Sherwani, T Khan, K Akhtar, A Zeba, FA Siddiqui, K Rahman, N Afsan
October-December 2007, 24(4):167-172
The study was undertaken to evaluate liquid based cytology (Pap spin) and to compare the sensitivity of Pap spin with conventional Pap smear. Pap smears were taken from 160 patients with gynaecologic complaints with Ayre's spatula and endocervical cytobrush and slides prepared. The residual material on both the spatula and cytobrush were rinsed in Pap spin collection fluid and centrifuged. Direct smears were prepared from the cell button, fixed and stained by Papanicolaou stain. Colposcopy was performed in patients with abnormal smears and biopsy was performed in suspected malignant or dysplastic cases. LSIL and HSIL was diagnosed in 27 (64.4%) cases, mostly between 21-40 years, Commonest presenting complaint was discharge per vaginum seen in 68 (42.5%) cases. Cytological abnormality was found in 42 cases (26.2%) by Pap spin method, whereas conventional Pap smear detected abnormality in only 24 cases (15%). 133 cases (83.1%) were satisfactory for evaluation on Pap spin and 51 cases (31.9%) on conventional Pap smear. The commonest atypical finding on colposcopy was acetowhite area in 14 cases (31.1%). Sensitivity of Pap spin and conventional Pap smear was 97.6% and 53.7% respectively and specificity was 50% in each. Pap spin is strongly advocated in the best interest of public health as it improves the sample quality and reduces the likelihood of false negative results.
  14,097 1,239 20
The Bethesda system for reporting thyroid fine needle aspirates: A cytologic study with histologic follow-up
Santosh Kumar Mondal, Simanti Sinha, Bijan Basak, Dipanwita Nag Roy, Swapan Kumar Sinha
April-June 2013, 30(2):94-99
DOI:10.4103/0970-9371.112650  PMID:23833397
Background: The Bethesda system for reporting thyroid cytopathology represents a major step towards standardization, reproducibility, improved clinical significance, and greater predictive value of thyroid fine needle aspirates (FNAs). Aims: To elucidate the utility of the Bethesda system in reporting thyroid FNAs. Materials and Methods: We retrospectively reviewed thyroid FNAs between April 2009 and March 2012, classified them using the Bethesda system, found out the distribution of cases in each Bethesda category, and calculated the malignancy risk for each category by follow-up histopathology. Results: Of the 1020 FNAs, 1.2% were non-diagnostic, 87.5% were benign, 1% were atypical follicular lesion of undetermined significance (AFLUS), 4.2% were suspicious for follicular neoplasm (SFN), 1.4% were suspicious for malignancy (SM), and 4.7% malignant. Of 69 cases originally interpreted as non-diagnostic, 12 remained non-diagnostic after re-aspiration. In 323 cases, data of follow-up histopathologic examination (HPE) were available. Rates of malignancy reported on follow-up HPE were non-diagnostic 0%, benign 4.5%, AFLUS 20%, SFN 30.6%, SM 75%, and malignant 97.8%. Conclusions: Reviewing the thyroid FNAs with the Bethesda system allowed a more specific cytological diagnosis. In this study, the distribution of cases in the Bethesda categories differed from some studies, with the number of benign cases being higher and the number of non-diagnostic and AFLUS cases being lower. The malignancy risk for each category correlated well with other studies. The Bethesda system thus allows standardization in reporting, improves perceptions of diagnostic terminology between cytopathologists and clinicians, and leads to more consistent management approaches.
  13,915 1,004 47
Diagnostic utility of the cell block method versus the conventional smear study in pleural fluid cytology
Udasimath Shivakumarswamy, Surekha U Arakeri, Mahesh H Karigowdar, BR Yelikar
January-March 2012, 29(1):11-15
DOI:10.4103/0970-9371.93210  PMID:22438610
Background: The cytological examinations of serous effusions have been well-accepted, and a positive diagnosis is often considered as a definitive diagnosis. It helps in staging, prognosis and management of the patients in malignancies and also gives information about various inflammatory and non-inflammatory lesions. Diagnostic problems arise in everyday practice to differentiate reactive atypical mesothelial cells and malignant cells by the routine conventional smear (CS) method. Aims: To compare the morphological features of the CS method with those of the cell block (CB) method and also to assess the utility and sensitivity of the CB method in the cytodiagnosis of pleural effusions. Materials and Methods: The study was conducted in the cytology section of the Department of Pathology. Sixty pleural fluid samples were subjected to diagnostic evaluation for over a period of 20 months. Along with the conventional smears, cell blocks were prepared by using 10% alcohol-formalin as a fixative agent. Statistical analysis with the 'z test' was performed to identify the cellularity, using the CS and CB methods. Mc. Naemer's χ2 test was used to identify the additional yield for malignancy by the CB method. Results: Cellularity and additional yield for malignancy was 15% more by the CB method. Conclusions: The CB method provides high cellularity, better architectural patterns, morphological features and an additional yield of malignant cells, and thereby, increases the sensitivity of the cytodiagnosis when compared with the CS method.
  13,504 1,224 51
Pleural fluid analysis - role in diagnosing pleural malignancy
DS Gaur, N Chauhan, A Kusum, M Harsh, M Talekar, S Kishore, VP Pathak
October-December 2007, 24(4):183-188
This study aimed to assess the role of pleural fluid analysis in diagnosing pleural malignancy. Thoracentesis and closed needle biopsy of parietal pleura, using Cope's needle, were performed in 45 cases of pleural effusion coming to Department of Pulmonary Medicine. Samples were processed and studied as per standard methods. The male to female ratio was 4.6:1. Age range was 18-74 years. Two pleural effusions were transudates. Amongst the 43 exudates, 17 cases were malignant on pleural fluid analysis. Cyto­histological correlation was 68.4% for malignancy. Adenocarcinoma was the most common malignancy. Pleural fluid showed good sensitivity, specificity and accuracy. In developing countries, where investigations and health facilities are inadequate and cost of treatment is un-affordable, careful analysis of pleural fluid still remains a very convenient, low-cost and safe investigation that helps in diagnosing cases of malignant pleural effusion. Its combination with pleural closed needle biopsy can further enhance its usefulness in diagnosing pleural malignant lesions.
  13,879 821 3
Grey zone lesions of breast: Potential areas of error in cytology
Suvradeep Mitra, Pranab Dey
July-September 2015, 32(3):145-152
DOI:10.4103/0970-9371.168812  PMID:26729973
Fine-needle aspiration cytology (FNAC) of the breast is a rapid, cost-effective, and sensitive procedure to diagnose breast lesions, and was widely employed to diagnose breast lesions in the past. However, in recent times, core needle biopsy of the breast is gaining popularity and acceptability, although FNAC still looms large. There are some intrinsic disadvantages to FNAC, of which the most important is probably difficulty in classification of a significant percentage of breast lesions. Such lesions are usually denoted by the rubric "grey zone lesions of the breast." This article attempts to review these grey zone lesions and highlight the difficulties in diagnosing them.
  13,672 938 7
Pleomorphic lobular carcinoma of the breast - a diagnostic dilemma
H Kini, R Pai, AR Rau, FD Lobo, AJ Augustine, BS Ramesh
October-December 2007, 24(4):193-195
Pleomorphic lobular carcinoma of the breast has been identified as a histological variant of infiltrating lobular carcinoma (ILC) with poor prognosis. Thus, cytological recognition of this tumour is important. It is characterized by pleomorphism to a degree that contrasts with the cytologic uniformity of classic ILC. Due to this feature it is often misinterpreted as infiltrating ductal carcinoma and diagnosed only on appreciating the Indian file and targetoid pattern of lobular carcinomas on histology. We report three cases with this unusual tumour that can present a diagnostic dilemma on cytology.
  13,626 382 1
Comparative evaluation of six cytological grading systems in breast carcinoma
Kaushik Saha, Gargi Raychaudhuri, Bitan Kumar Chattopadhyay, Indranil Das
April-June 2013, 30(2):87-93
DOI:10.4103/0970-9371.112647  PMID:23833396
Background: Cytological grading is a useful tool for selection of therapy and prognosis in breast carcinoma. Despite having many cytological grading systems, there is still no agreement among pathologists to accept one of them as a gold standard. Aim: This study was undertaken to evaluate six such three-tier cytological grading systems to determine which system corresponds best to histological grading done by Nottingham modification of Scarff Bloom Richardson (SBR)'s method. Materials and Methods: In a double-blind study, preoperative cytological grades obtained by six systems on fine-needle aspiration cytology (FNAC) smears were compared by testing concordance, association and correlation with histological grade derived postoperatively by the SBR's method in 57 patients of breast carcinoma. Bivariate correlation studies and multiple linear regressions were done to assess the significance of the different cytological parameters to predict final cytological grades. Results: Robinson's system demonstrated the best correlation (ρ = 0.799; P = 0.000 and τ = 0.765; P = 0.000), maximum percent agreement (77.19%) and a substantial kappa value of agreement (κ = 0.62) with the SBR's grading system. All the six cytological grading systems correlated with histological grading strongly and positively. In multiple regression analysis, all of the cytological parameters of Robinson's system except cell size and nucleoli had significance in predicting the final cytological grade. Conclusions: Robinson's grading system is simple, more objective and reproducible, and demonstrated the best concordance with histological grading. So, Robinson's system should be used routinely for breast carcinoma aspirates.
  11,720 1,459 8
Cervical acid phosphatase detection: A guide to abnormal cells in cytology smear screening for cervical cancer
Prabal Deb, Venkateswaran K Iyer, Neerja Bhatla, O Markovic, Kusum Verma
January-March 2008, 25(1):1-5
Background: Cervical acid phosphatase-Papanicolaou (CAP-PAP) test has recently been described for detection of acid phosphatase enzyme in abnormal squamous cells, and has been proposed as a biomarker-based technology for the screening of cervical cancer. Materials and Methods: Eighty-one consecutive cervical smears were subjected to routine Papanicolaou (Pap) staining as well as CAP-PAP, which combined cytochemical staining for acid phosphatase with modified Pap stain. Statistical evaluation of its utility was examined. Results: Of 81 smears, 16 (19.75%) showed the presence of mature squamous cells with acid phosphatase by CAP-PAP technique and were considered positive. Of these 16, atypical squamous cells of undetermined significance (ASCUS) or above were initially diagnosed in five of the corresponding routine Pap smears. After re-evaluation with CAP-PAP, eight of the routine Pap smears were considered to have ASCUS or above. Of these eight, three were reported as low-grade squamous intraepithelial lesions and five as ASCUS on conventional Pap smears. The remaining 8/16 CAP-PAP-positive cases were negative for atypical squamous cells on the corresponding Pap smears. None of the CAP-PAP-negative smears were positive on routine Pap smear screening. Conclusions: This study highlights the efficacy of CAP-PAP in quality assurance of cervical smear screening. It is also an inexpensive method for segregating smears for subsequent re-screening. In the absence of trained cytologists in peripheral laboratories, this technique can be adopted for identifying smears that would require proper evaluation.
  11,982 814 4
Pleural effusion: Role of pleural fluid cytology, adenosine deaminase level, and pleural biopsy in diagnosis
Biswajit Biswas, Sudershan Kumar Sharma, Rameshwar Singh Negi, Neelam Gupta, Virender Mohan Singh Jaswal, Narsimhalu Niranjan
July-September 2016, 33(3):159-162
DOI:10.4103/0970-9371.188062  PMID:27756990
Objective: The present study is designed to evaluate the role of pleural fluid analysis in diagnosing pleural diseases and to study the advantages and disadvantages of thoracocentasis and pleural biopsy. Materials and Methods: We prospectively included 66 consecutive indoor patients over a duration of 1 year. Pleural fluid was collected and cytological smears were made from the fluid. Plural biopsy was done in the same patient by Cope needle. Adequate pleural biopsy tissue yielding specific diagnosis was obtained in 47 (71.2%) cases. Results: Tuberculosis was the commonest nonneoplastic lesion followed by chronic nonspecific pleuritis comprising 60% and 33.3% of the nonneoplastic cases respectively and tuberculosis was predominantly diagnosed in the younger age group. Majority (70.8%) of malignancy cases were in the age group of >50-70. Adenocarcinoma was found to be the commonest (66.7%) malignant neoplasm in the pleurae followed by small-cell carcinoma (20.8%). Conclusion: Pleural biopsy is a useful and minimally invasive procedure. It is more sensitive and specific than pleural fluid smears.
  12,061 608 9
Efficacy of broncho-alveolar lavage and bronchial brush cytology in diagnosing lung cancers
DS Gaur, NC Thapliyal, S Kishore, VP Pathak
April-June 2007, 24(2):73-77
Of all the cases investigated for suspected lung cancer between June 1999 and June 2003, 196 cases were selected where flexible bronchoscopic samples of broncho-alveolar lavage (BAL) and bronchial brush (BB) cytology as well as bronchial biopsy were taken and processed as per standard procedures of cytology and histology. The aim of this study was to compare the diagnostic efficacy of BAL and BB cytology in diagnosing lung cancer, taking bronchial biopsy as the 'Gold Standard' diagnostic test. Sensitivity of BB was 87.3%; while that of BAL was 39.4%. Specificity of BB and BAL was 97.6% and 89.6%, respectively. BB was better than BAL in morphological typing of lung cancers. We conclude that bronchial brushing is a much superior technique in the diagnosis and morphological typing of lung cancers.
  11,506 828 -
Differentiation of hepatocellular carcinoma from metastatic carcinoma of the liver - clinical and cytological features
A Ahuja, N Gupta, R Srinivasan, N Kalra, Y Chawla, A Rajwanshi
July-September 2007, 24(3):125-129
Differentiation of hepatocellular carcinoma (HCC) from metastatic carcinoma in liver may be difficult on fine needle aspiration cytology (FNAC), when both appear as moderate to poorly differentiated tumours. The present study was done to assess clinical, serological, biochemical, radiological and detailed cytomorphological features to distinguish HCC from metastatic carcinoma in FNAC of the liver masses. The individual cytomorphological features which helped in differentiating HCC from metastatic carcinoma were: hepatocytic appearance of cells (92%), trabecular pattern (92%), naked nuclei (76%), intranuclear inclusions (52%) and bile (40%). The most common clinical presentation in HCC cases was pain abdomen (40%). Positivity for HBsAg was found in 7 (33.3%) cases while anti HCV antibody was detected in 4 (19%) cases. The level of serum alpha fetoprotein (AFP) was elevated in 88.9% cases, but 40% cases showed mild elevation of AFP level. 17/25 cases of HCC had solitary space occupying lesion (SOL) and 8 cases had multiple SOLs. The present study reveals that most useful cytomorphological features in the distinction of HCC from metastatic carcinoma include trabecular pattern, hepatocytic cells, bile pigment, intranuclear inclusions and atypical stripped nuclei in HCC. Viral markers and alpha-fetoprotein estimation can supplement the results.
  11,656 603 4
Intraoperative neurocytology of primary central nervous system neoplasia: A simplified and practical diagnostic approach
Suash Sharma, Prabal Deb
October-December 2011, 28(4):147-158
DOI:10.4103/0970-9371.86339  PMID:22090687
Intraoperative consultations may pose considerable diagnostic challenge to the neuropathologist in diagnosing primary and metastatic neoplasms of the central nervous system (CNS). Cytological preparations in the form of squash, touch, imprint or smears are few of the available modalities in addition to the frozen section (FS). Although the latter is superior in providing both histologic patterns and cytomorphologic details yet smears are of vital importance when tissue available is limited (stereotactic biopsy), scrutinisation of intercellular matrix (astrocytoma versus oligodendroglioma) and evaluation of discohesive cells (lymphoma, pituitary adenoma) and in inflammatory lesions. This review is intended to emphasize the value, applicability and limitations of neurocytology aiming to expedite the intraoperative smear-based diagnoses of CNS neoplasia as per the World Health Organization (WHO) classification. We recommend that whenever possible, both smears and FS should be examined concomitantly and in a correlative manner. In the unlikely event of a mismatch between the findings on smear and FS, intraoperative diagnosis is primarily based on FS, if adequate tissue is available. However, each case must be evaluated on its own merit and in difficult cases relevant differential diagnoses should be offered to facilitate surgical decisions and optimally triage patient management.
  11,368 702 20
Milan system for reporting salivary gland cytopathology: An experience with the implication for risk of malignancy
Chayanika Kala, Sanjay Kala, Lubna Khan
July-September 2019, 36(3):160-164
DOI:10.4103/JOC.JOC_165_18  PMID:31359916
Introduction: Fine-needle aspiration cytology (FNAC) is a well-established technique for evaluation of salivary gland lesions, but because of the heterogenicity and morphological overlap between spectrum of lesion, there are a few challenges in its wide use. Recently, “The Milan system for reporting salivary gland cytopathology” (MSRSGC) was introduced, providing guide for diagnosis and management according to the risk of malignancy (ROM) in different categories. The current study was conducted retrospectively to reclassify the salivary gland lesions from previous diagnosis and to evaluate the ROM in different categories. Material and Methods: Clinical data, FNAC specimen, histological, and clinical follow-up of cases were retrieved, cytological features were re-evaluated, and cases were reclassified as follows: Category 1: Non-diagnostic (ND); Category 2: Non-neoplastic (NN); Category 3: Atypia of undetermined significance (AUS); Category 4a: Neoplasm: benign (NB), Category 4b: Neoplasm: salivary gland neoplasm of uncertain malignant potential (SUMP); Category 5: suspicious of malignancy (SM); and Category 6: Malignant (M). Result: Total 293 cases were evaluated cytologically, and histological follow-up was available in 172 cases. The distribution of cases into different categories was as follows ND (6.1%), NN (38.2%), AUS (2.7%), NB (33.4%), SUMP (2.0%), SM (2.4%), and M (15%). Overall, ROM reported were 25%, 5%, 20%, 4.4%, 33.3%, 85.7%, and 97.5%, respectively for each category. Overall, sensitivity was 83.33%, specificity was 98.31%, positive predictive value was 95.74%, and negative predictive value was 92.80%. Conclusion: MSRSGC is a recently proposed six category scheme, which places salivary gland FNAC into well-defined categories that limit the possibilities of false negative and false positive cases.
  11,010 932 32
Idiopathic calcinosis of scrotum: Cytological diagnosis of a case
Rana K Sherwani, Bharat Kumar Varshney, Veena Maheshwari, Khaliqur Rahman, MA Khan
January-March 2008, 25(1):23-24
A 35 year-old male presented with multiple asymptomatic, tense, cystic to firm, skin-colored nodules within the scrotal skin with a provisional clinical diagnosis of a sebaceous cysts of the scrotum. Fine needle aspiration cytology (FNAC) was performed and a diagnosis of idiopathic calcinosis of the scrotum was suggested as no epithelial cells were found around amorphous, basophilic, calcified material. Histopathological examination confirmed the diagnosis. We report this case for its rarity.
  11,241 462 2
  The Journal 
  Site Statistics 
  My Preferences 
  Online Submission