Journal of Cytology
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   2012| October-December  | Volume 29 | Issue 4  
    Online since November 28, 2012

 
 
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ORIGINAL ARTICLES
A comparative study for selectivity of micronuclei in oral exfoliated epithelial cells
S Grover, ABR Mujib, A Jahagirdar, N Telagi, PG Kulkarni
October-December 2012, 29(4):230-235
DOI:10.4103/0970-9371.103940  PMID:23326025
Background: Micronucleus (MN) represents small, additional nuclei formed by the exclusion of chromosome fragments or whole chromosomes lagging at mitosis. MN rates, therefore, indirectly reflect chromosome breakage or impairment of the mitotic apparatus. During the last few decades, micronuclei ("MNi") in oral exfoliated epithelial cells are widely used as biomarkers of chromosomal damage, genome instability and cancer risk in humans. However, until now only little attention has been given to the effect of different staining procedures on the results of these MN assays. Aim: To compare the MNi frequencies in oral exfoliated epithelial cells using three different stains, i.e.,Feulgen stain, Papanicolaou stain (Pap) and hemotoxylin and eosin stain (H and E). Materials and Methods: Oral exfoliated cells from 45 cases of potentially malignant disorders (15 oral submucous fibrosis, 15 lichen planus and 15 leukoplakia) and 15 controls with healthy mucosa, were taken and MNi frequencies (No. of MNi/1000 cells) were compared using three different stains. Results: Mean MNi frequency in cases was found to be 3.8 with Feulgen stain, 16.8 with PAP and 25.9 with H and E. In controls, mean MNi frequency was 1.6 with Feulgen stain, 7.7 with PAP and 9.6 with H and E stain. Statistically significant value (P < 0.01) were observed when the three stains were compared together using Kruskal Walli's ANOVA test. Conclusion: Feulgen being a DNA-specific stain gave the least counts, although statistically significant results from the comparison of MNi frequency between cases and controls were obtained with all the three stains.
  5,352 810 10
Comparison of modified ultrafast Papanicolaou stain with the standard rapid Papanicolaou stain in cytology of various organs
Priyanka Choudhary, S Sudhamani, Ajita Pandit, VM Kiri
October-December 2012, 29(4):241-245
DOI:10.4103/0970-9371.103942  PMID:23326027
Background: Since the first introduction of Papanicolaou (Pap) stain in 1942 there have been many modifications. Of these, the Ultra-Fast Pap stain has become popular. This technique was further modified in India as many of the reagents were not available in our country. Our study was conducted by adapting this modified staining technique which involves the replacement of Gill's hematoxylin with Harris hematoxylin. Aims: The aim of our prospective study was to assess the use of the modified Ultra-Fast Pap stain (MUFP) for fine needle aspiration cytology (FNAC) of various organs in comparison with the standard rapid Pap stain. Materials and Methods: A total of 100 FNAC cases were studied by random sampling. Two smears were prepared for each case and stained by both, the MUFP and the rapid Pap stain. Scores were given and the quality index was calculated, followed by the statistical analysis. The number of cases was as follows: lymph node (43), thyroid (25), breast (23), salivary gland (02), and soft tissues (07). Scores were given on four parameters: Background of smears, overall staining pattern, cell morphology and nuclear staining. Quality index was calculated from the ratio of score achieved to the maximum score possible. Statistical Analysis: Results were analyzed using Mean, Median, Standard Deviation, 't' paired test, 'P' value and M-diff for statistical significance. Results: Correct diagnosis was made in all cases. The quality index of MUFP smears was better compared to the rapid Pap stain in all the organs, and was statistically significant. MUFP smears showed a clear red blood cells background, transparent cytoplasm and crisp nuclear features. Conclusion: MUFP is a reliable and rapid technique for cytology diagnosis.
  4,847 487 3
The utility of periodic acid schiff with diastase and alcian blue stains on fine needle aspirates of breast and salivary gland neoplasms
NK Panicker, PH Jariwala, AC Buch, M Joshi
October-December 2012, 29(4):221-225
DOI:10.4103/0970-9371.103938  PMID:23326023
Background: Fine needle aspiration cytology (FNAC) is extensively used in the diagnosis of various clinically palpable lesions of breast and salivary glands. Much interest has been gained in mucosubstances produced in tumors arising from these organs. Aims : To evaluate the utility of Periodic acid Schiff with diastase (PAS-D) and Alcian blue (AB) staining pattern on fine needle aspirates of breast and salivary gland neoplasms. Materials and Methods : Seventy-five cases of different neoplasm of breast and salivary gland were studied. The staining pattern of PAS-D and AB stains on smears of these neoplasm were observed. Results : Among cases of neoplasms of breast, intracytoplasmic PAS-D positive globules were restricted to carcinoma except in one case where PAS-D-positive globules were seen in fibroadenoma. The background substance of both mucinous carcinoma and fibroadenoma with myxoid change stained positive with PAS-D, but the pattern was different. The cases of pleomorphic adenoma and mucoepidermoid carcinoma of salivary gland showed intracytoplasmic PAS-D-positive globules. The cases of pleomorphic adenoma showed stromal positivity which was not seen in basal cell adenoma on smears. Conclusion : Intracytoplasmic PAS-D-positive globules may be useful in differentiating benign and malignant lesions of breast. The presence of PAS-D positive granules are useful in differentiating various lesions of salivary glands. AB staining of stromal fragments in pleomorphic adenoma is useful in differentiating it from basal cell adenoma.
  4,510 442 6
Significance of micronucleus in cervical intraepithelial lesions and carcinoma
BN Gayathri, R Kalyani, A Hemalatha, B Vasavi
October-December 2012, 29(4):236-240
DOI:10.4103/0970-9371.103941  PMID:23326026
Background: The micronuclei (MNi) test on exfoliated cells has been successfully used to screen population groups at risk for cancers of oral cavity, urinary bladder, cervix and esophagus. Their frequency appears to increase in carcinogen-exposed tissues long before any clinical symptoms are evident. There are only limited numbers of studies on MN scoring in cervical pre-neoplastic and neoplastic conditions. Aims : To compare the micronucleus (MN) score in the whole spectrum of cervical lesions including normal, inflammatory, abnormal squamous cells of undetermined significance (ASC-US), abnormal squamous cells cannot exclude HSIL (ASC-H), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL) and invasive cancer (IC) and to evaluate the role of MN as a biomarker in different pre-neoplastic and neoplastic lesions. Materials and Methods: A total of 221 slides, comprised of normal (32), inflammatory (32), ASC-US (31), ASC-H (31), LSIL (32), HSIL (31) and IC (32), were studied. All the cases were reviewed by two pathologists independently. Histopathological correlation was done in a few cases of ASC-US, ASC-H, HSIL and IC which were available in the department. Two observers separately and independently counted the number of micronucleated cells per 1,000 epithelial cells in oil immersion magnification and were expressed as MN score per 1,000 cells. Results : The mean MN scores ± SD in normal, inflammatory, ASC-US, ASC-H, LSIL, HSIL and IC cases of cervical lesions were 0.84±0.68, 1.06±0.84, 3±0.73, 4.78±1.43, 4.06±1.13, 8.03±1.64 and 10.5±2.01, respectively. MN scores of IC and HSIL were significantly high compared to normal (P<0.000), inflammatory (P<0.000), ASC-US (P<0.000), ASC-H (P<0.000) and LSIL (P<0.000) group (analysis of variance test). LSIL showed significant difference with the normal (P<0.000), inflammatory (P=0.001), ASC-US (P=0.028), HSIL (P<0.000) and IC (<0.000), but not with the ASC-H (P=0.64) group. Conclusions: MN scoring on the epithelial cells of cervix could be used as a biomarker in cancer screening. This is an easy, simple, reliable, reproducible and objective test which can be performed on routinely stained pap smears.
  3,467 429 5
Clinicopathological study of rhinosporidiosis with special reference to cytodiagnosis
Anuradha Sinha, Jyoti P Phukan, Gautam Bandyopadhyay, Sanjay Sengupta, Kingshuk Bose, Rajib K Mondal, Manoj K Choudhuri
October-December 2012, 29(4):246-249
DOI:10.4103/0970-9371.103943  PMID:23326028
Background: Rhinosporidiosis is a chronic infective disorder caused by Rhinosporidium seeberi. It usually presents as a soft polypoidal pedunculated or sessile mass. Nose and nasopharynx are the commonest sites, followed by conjunctiva, maxillary sinuses, penis, urethra. Aims: The aim of this study is to present the clinicopathological features of rhinosporidiosis in a large series of cases and to asses the role of cytology in diagnosis. Materials and Methods: 63 cases were included in the study group. Diagnosis of rhinosporidiosis was confirmed in all cases by histology with or without cytological evaluation. May-Grünwald-Giemsa and hematoxylin and eosin (H and E) staining was used in all cases, and special stains like periodic acid Schiff and mucicarmine were used in a few cases. Detailed clinical history of all the cases was noted. Routine hematological investigations including ABO blood grouping were done in all possible cases. Results: Evaluation of the clinical data in our series demonstrated male predominance (36 out of 63; 56%). Nose and nasopharynx were the commonest sites involved (74.6%). Routine hematology tests did not show any significant change in most of the cases. However, a significant proportion of the study population (18 out of 41; 44%) had blood group "O." Cytodiagnosis attempted in 17 cases out of 63 cases achieved 100% correlation with histology. Conclusion: Morphological appearance alone in a few cases failed to give diagnosis of rhinosporidiosis. Cytology can be very helpful in diagnosis in these cases, but histology is the mainstay of diagnosis.
  3,611 220 5
CASE REPORTS
Hepatoblastoma in the neonatal period: An unusual presentation
Sarbani Chattopadhyay, Sumana Mukherjee, Anup Boler, Abhishek Sharma, Sumitra Kumar Biswas
October-December 2012, 29(4):252-254
DOI:10.4103/0970-9371.103945  PMID:23326030
Hepatoblastoma (HBL) is a rare primary malignant liver tumor affecting mainly pediatric patients in the age group 6 months to 3 years. Presentation of HBL in the neonatal period is rare. HBL can be diagnosed on cytology along with subtyping. Estimation of serum alpha-fetoprotein (AFP) is essential as a tumor marker. Fetal type HBL usually shows high AFP level. In this report, diagnosis of HBL in a 10-day-old baby with low serum AFP is being described for its unusual presentation.
  2,800 162 4
ORIGINAL ARTICLES
The presence of eosinophil leucocytes in cervicovaginal smears with Actinomyces-like organisms: Light microscopic examination
Dilek Kaya, Sayeste Demirezen, Mehmet Sinan Beksaç
October-December 2012, 29(4):226-229
DOI:10.4103/0970-9371.103939  PMID:23326024
Background: Actinomyces species are part of mucosal surfaces of oral cavity, gastrointestinal and genital tracts. When these mucosal surfaces disrupt, Actinomyces become pathogen and cause infection. Eosinophil leucocytes participate in host defense against helminthic infestation and they generally play a role in asthma and allergy. However, the role of eosinophil leucocytes in host defense against bacteria is conflicting. Aim: To determine whether there is a relationship between Actinomyces-like organisms (ALOs) and eosinophil leucocytes at light microscopic level. Materials and Methods: Cervicovaginal samples obtained from 200 patients were examined by both Pap smear microscopy and anaerobic culturing. Since the results obtained by these methods were not concordant for diagnosis of genital Actinomyces, 6 of 200 patients (3%) diagnosed with ALOs by Pap smear microscopy became the study group. Patients without any infectious agents (n=134) were the control group. Statistical analyses were conducted with χ2 test using SPSS program. Results: The study and control groups were compared statistically in view of the presence of eosinophil leucocytes and it was found that there was a significant correlation between the presence of ALOs and eosinophil leucocytes (P<0.05). Abundant polymorphonuclear leucocytes (PMNLs) and macrophages were also detected in the study group. Conclusion: This study implies that eosinophil leucocytes might have a role in host defense against Actinomyces in addition to PMNLs and macrophages.
  2,705 203 1
CASE REPORTS
Pulmonary hamartoma: Cytological study of a case and literature review
T Umashankar, Acharya K Devadas, G Ravichandra, Parasappa J Yaranal
October-December 2012, 29(4):261-263
DOI:10.4103/0970-9371.103948  PMID:23326033
Pulmonary hamartomas are the most common but rare benign tumor-like lesions of the lung arising from the embryonic rest. They are more common in males and in aged. Majority are asymptomatic and seen as coin lesions with popcorn calcification in the chest radiograph. Fine needle aspiration cytology (FNAC) helps to diagnose and distinguish them from the cancerous lesions of the lung. The cytological material is characterized by fibromyxoid stroma, cartilage, bronchial cells, adipose tissue and bone. Bronchial cells with reactive atypia may be a source of false-positive result. Symptomatic cases need surgical intervention such as enucleation or segmental resection. We report a case of a 74-year-old male who had a lung mass that did not progress over 4-year on chest radiograph. The CT-guided FNAC smears showed benign bronchial epithelial cells, fibro-myxoid spindle cell stroma and fat spaces that aided the diagnosis of pulmonary hamartoma avoiding surgical intervention.
  2,666 121 5
Pigmented basal cell carcinoma: Cytological diagnosis and differential diagnoses
Manjula Jain, Neha K Madan, Shilpi Agarwal, Smita Singh
October-December 2012, 29(4):273-275
DOI:10.4103/0970-9371.103952  PMID:23326037
Pigmented basal cell carcinoma is a rare cutaneous neoplasm with only a few cases reported so far. Review of the literature yielded only an occasional fine-needle aspiration report of the cytologic features of the tumor.We report a rare case of pigmented basal cell carcinoma occurring on the thigh of a 55-year-old woman. The cytological features are described with discussion over the possible differential diagnoses.
  2,326 142 6
Imprint cytology facilitating the diagnosis of primary cutaneous anaplastic large cell lymphoma of iliac fossa
Suman Singh, Neelam Gupta, Geeta R Tekta
October-December 2012, 29(4):267-269
DOI:10.4103/0970-9371.103950  PMID:23326035
Primary cutaneous anaplastic large cell lymphoma (C-ALCL) is a form of cutaneous T-cell lymphoma that is characterized by solitary nodules and plaques. In this report, the authors present an unusual case of a 59-year-old male with a solitary ulcerofungative mass in the left iliac fossa clinically masquerading as sqaumous cell carcinoma. The imprint smears of the lesion had characterstic morphological features which helped in the diagnosis. Subsequently, the imprint cytology correlated well with the histopathology and immunohistochemical studies highlighting its utility as simple, rapid, and easy test.
  2,336 79 -
Fine needle aspiration cytology of pseudosarcomatous reactive lesions of soft tissues: A report of two cases
Suchitha Satish, Sheeladevi Chandakavadi Shivalingaiah, Sunila Ravishankar, Manjunath Gubbanna Vimalambika
October-December 2012, 29(4):264-266
DOI:10.4103/0970-9371.103949  PMID:23326034
Pseudosarcomatous lesions are reactive proliferative lesions of the soft tissue, that are likely to be misdiagnosed as malignant, based on clinical and histological features. The most common lesions are nodular fasciitis, proliferative fasciitis, proliferative myositis and myositis ossificans. These rapidly growing soft-tissue lesions can represent a variety of diagnoses involving radically different treatment modalities. Accurate diagnosis is important to avoid unnecessary and often mutilating surgery. We report two cases to illustrate the importance of correct identification of these lesions by fine needle aspiration cytology.
  2,191 109 2
FNA diagnosis of osteoclast-like giant cell tumor of the pancreas
Shanthakumari Sivanandham, Priya Subashchandrabose, Rajeshwari K Muthusamy
October-December 2012, 29(4):270-272
DOI:10.4103/0970-9371.103951  PMID:23326036
Osteoclast-like giant cell tumor of the pancreas is a rare non-endocrine neoplasm composed of reactive multinucleated giant cells admixed with mononuclear stromal cells. We report a case of osteoclast-like giant cell tumor of the pancreas in a 58-year-old female with vague clinical symptoms. Endoscopic ultrasound-guided aspirate from the mass revealed numerous characteristic osteoclast-like giant cells.
  2,066 117 1
Giant primary ovarian fibrosarcoma: Case report and review of pitfalls
Sumit Ray, Biplab K Biswas, Subhalakshmi Mukhopadhyay
October-December 2012, 29(4):255-257
DOI:10.4103/0970-9371.103946  PMID:23326031
Primary ovarian fibrosarcomas are very uncommon neoplasms; less than one hundred cases have been reported. Diagnosis can be difficult to establish and other similar appearing mesenchymal lesions must be ruled out. A 23 year old nulliparous woman presented with a huge right ovarian tumor (25 × 17 × 12 cm). Ultrasonography guided aspiration was performed and a strong possibility of fibrosarcoma was suggested based on cytomorphological findings. No epithelial element was noted. She underwent surgical excision which confirmed the diagnosis of primary ovarian fibrosarcoma (the largest till date to our knowledge). Immunohistochemical analyses showed vimentin and CD 34 positivity. We speculate that ovarian fibrosarcoma at the preoperative examination might be considered in the differential diagnosis whenever a unilateral, heterogeneous, largely round solid ovarian lesion is detected.
  2,065 99 1
Solitary intramammary schwannoma mimicking phylloides tumor: Cytological clues in the diagnosis
MU Thejaswini, KP Padmaja, V Srinivasamurthy, M Sudha Rao
October-December 2012, 29(4):258-260
DOI:10.4103/0970-9371.103947  PMID:23326032
A 30-year-old woman presented with a huge exophytic lobulated mass in the right breast, clinically and radiologically resembling phylloides tumor. Fine needle aspiration cytology smears showed clusters and singly scattered spindle cells along with structures reminiscent of verocay bodies. However, the epithelial elements were absent. A cytological diagnosis of benign mesenchymal spindle cell lesion, suggestive of schwannoma was rendered. Subsequent histopathological examination and strong S-100 positivity of tumor cells on immunohistochemistry confirmed the diagnosis.Breast is an uncommon location for benign schwannoma. The present case describes the unusual clinical picture, highlights cytological features and discusses the differential diagnoses of schwannoma from other benign spindle cells lesions of the breast on cytology smears.
  1,902 96 1
IMAGES IN CYTOPATHOLOGY
Fine needle aspiration diagnosis of pulmonary hamartoma
Uma Handa, Irneet Mundi, Varinder Saini
October-December 2012, 29(4):250-251
DOI:10.4103/0970-9371.103944  PMID:23326029
  1,715 103 -
LETTERS TO EDITOR
Strongyloides stercoralis hyperinfection with features of acute intestinal obstruction in a patient operated for prolapse disc
Kanakalata Dash, Sima Chauhan, Rajashree Tripathy, Sukumar Chakravorty
October-December 2012, 29(4):278-279
DOI:10.4103/0970-9371.103955  PMID:23326040
  1,620 91 2
Cytodiagnosis of cutaneous metastases from gall bladder carcinoma on scalp
Madhu Kumar, Madhu Mati Goel, Harvinder Singh Pahwa, Awanish Kumar
October-December 2012, 29(4):277-278
DOI:10.4103/0970-9371.103954  PMID:23326039
  1,534 83 2
Subependymal giant cell astrocytoma: Cytological findings
Negar Azarpira, Sara Pakbaz, Mohamad Rakei
October-December 2012, 29(4):276-277
DOI:10.4103/0970-9371.103953  PMID:23326038
  1,408 74 -
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