This study was conducted with the aim of increasing diagnostic yield and comparing the diagnostic utility of cell block technique versus smears in reporting of malignant effusion cases. At total of 75 malignant effusion cases were examined prospectively in paraffin embedded cell blocks and in smears. The number of positive malignant cases obtained with the combined cell block and smear technique was 29.3% more than that of specimens examined by smears only. Moreover with combined technique, primary site of malignancy could be determined with 81.3% accuracy, while in 18.7%, the site of primary malignancy could not be ascertained even by combined approach. Smears stained with Papanicolaou technique generally had good definition of malignant cellular changes, whereas cell blocks were particularly useful when cytologic abnormalities were misleading, such as in reactive mesothelial cells, or obscure, as in occasional well differentiated adenocarcinomas. It is therefore recommended that both cell blocks and smears be used in evaluating all malignant serous fluids submitted to cytology laboratory to increase the diagnostic utility.

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We describe an unusual case of metastatic disease to the thyroid in 47 year old female who clinically presented as acute thyroiditis. No nodules were palpable and fine needle aspiration cytology of left lobe was performed. It showed metastatic deposits of papillary adenocarcinoma and was followed by total thyroidectomy. Histological examination revealed extensive intrasinusoidal deposits of papillary adenocarcinoma. Such atypical clinical and cytologic presentation may cause undue confusion with a primary neoplasm of the thyroid, mainly papillary thyroid carcinoma.

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The diagnosis of infectious mononucleosis in cytology is difficult due to its close resemblance to Hodgkin’s lymphoma and absence of any clinching feature of the disease. Here, we are presenting the cytological findings of two cases of atypical reactive hyperplasia of lymph nodes with a possibility of infectious mononucleosis. The diagnoses were further confirmed by peripheral blood smear and histopathological examination and heterophile antibody test.

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Pleural effusion in 168 suspected tuberculous patients was studied by cytological examination as well as sputum for acid-fast bacilli by Zeihl-Neelsen stain and culture in Lowenstein-Jensen medium; pleural fluid smear for acid fast bacilli staining and culture, pleural biopsy and response to anti-tuberculous therapy. The cytological diagnosis of tubercular pleural effusion on hematoxylin and eosin and Papanicalaou stain were correlated and confirmed with findings of other methodology.

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Medulloepithelioma is a congenital intraocular tumor arising from primitive medullary epithelium. Distant metastasis is uncommon. Here, we present an unusual case of metastatic malignant teratoid medulloepithelioma in a 5-year old boy.

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Endovascular papillary angioendothelioma also known as Dabska tumour is a rare vascular neoplasm that usually involves the skin or subcutaneous tissue of children. We present here the cytological features of this rare tumour on fine needle aspiration cytology.

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The study was done to evaluate the role of morphometry in various thyroid lesions with cytological and histological correlation. Cytology and histology of 100 cases of non-neoplastic, benign and malignant thyroid lesions were compared, together with the role of morphometric nuclear parameters with the aid of an ocular morphometer attached to the 6x eye-piece of a microscope using a 40x high-dry objective. Analysis of Variance (ANOVA) among definite adenomatoid goitre, suspicious lesions and definite follicular neoplasm as identified by FNAC and between non-neoplastic lesions, follicular neoplasm and other carcinomas in FNAC after histological correlation was highly significant (p<0.0001). ANOVA among nonneoplastic, benign and malignant in histology (p<0.0001) and t-test between Papillary carcinoma and follicular carcinoma in histology (p<0.0028) were also highly significant. Morphometry correlated with cytology and histology proved to be an extremely valuable tool in case of thyroid lesions increasing the sensitivity of FNAC from 59.09% to 82.61%, predictive value of negative test from 87.84% to 93.85%, accuracy rate from 89.66% to 95.24% and decreased the Percentage of false negative from 40.91% to 17.39%.

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Fine needle aspiration cytology (FNAC) of 298 neoplastic lesions with and without ultrasonography guidance is presented. The study covers a period of 21 years from 1984-2005. Biopsy of liver and other involved secondary sites was available in 211 cases. In the remaining cases, similarity of the morphologic features of aspiration smears to those of histologically confirmed cases gave a reasonable certainty of diagnosis. Adequacy of fine needle aspirates was found to be better than trucut needle biopsy where adequacy of material was only 80%. There were 115 hepatocellular carcinoma, 174 metastatic tumours, 3 hepatoblastomas 1 cholangiocarcinoma and 5 unspecified malignancies. The false negative rate was 10.43%. There was no false positivity. The sensitivity was 90% and specificity 100%. FNAC was found to be a safe, cost effective accurate procedure which could be repeated without any complications.

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The varied cellular morphology seen in lipomatous tumours makes their diagnosis on cytology a difficult task. We studied 77 cases of tumours of adipose tissue, utilizing aspiration smears, imprint smears and tissue sections for cytohistological correlation. The aim was to determine the diagnostic accuracy of fine needle aspiration cytology and imprint cytology in lipomatous tumours and the features necessary for differentiation from other lesions. The results showed 96% rate of accuracy on aspiration cytology, in contrast to only 39% on imprint smears. The presence of atypical lipoblasts was the single most diagnostic criterion for a malignant adipose tissue tumour. Diagnosis of lipomatous lesions should be made after obtaining the findings of the clinical examination and ancillary investigations.

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Adenoid cystic carcinoma of breast (ACCB) is a rare variant of breast malignancy with a favourable prognosis. Its cytomorphological features are identical to that of its salivary counterpart but its prognosis is markedly different. A 60-year old female presented with a painful subareolar breast lump. Fine-needle aspiration was done and smears prepared. The smears were highly cellular and comprised of a uniform population of small cells with scanty cytoplasm and hyperchromatic nuclei. These cells were arranged in tight three-dimensional clusters around globules of homogeneous hyaline extra-cellular material and also scattered in the background. The cytodiagnosis of ACCB was later confirmed on histopathology. Inspite of its rarity, a fairly accurate diagnosis of ACCB can be made on cytology after ruling out other entities in which similar extracellular material is seen. Based on the cytodiagnosis further surgical management can be planned.

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Medullary carcinoma is an uncommon tumour and its association with multiple endocrine neoplasias (MEN syndromes) is well documented. Recurrence is well known specially in partially removed thyroids. Findings of the fine needle aspiration cytology (FNAC) are typical and diagnostic. We report one such case and the FNAC findings.

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