Journal of Cytology
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   2007| October-December  | Volume 24 | Issue 4  
    Online since July 18, 2008

 
 
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ORIGINAL ARTICLES
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
DOI:10.4103/0970-9371.41891  
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.
  12,902 778 1
CASE REPORTS
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
DOI:10.4103/0970-9371.41894  
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.
  12,791 351 1
ORIGINAL ARTICLES
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
DOI:10.4103/0970-9371.41888  
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.
  11,367 1,121 7
CASE REPORTS
Limitations of fine needle aspiration cytology in subtyping breast malignancies - a report of three cases
A Joshi, S Maimoon
October-December 2007, 24(4):203-206
DOI:10.4103/0970-9371.41899  
Fine needle aspiration cytology (FNAC) is a very accurate and safe procedure for the diagnosis of breast malignancies. Although rare, the various malignant tumours like squamous cell carcinoma, metaplastic carcinoma and other types can be diagnosed by their cytomorphological characteristics. But there are certain limitations of FNAC which require final histopathological diagnosis for determining prognosis and therapy (particularly conservative) in patients of breast malignancies. The difficulties encountered, and limitations of FNAC in sub typing three cases of breast carcinoma are discussed.
  5,861 303 1
ORIGINAL ARTICLES
Urethral cytology and penioscopy as screening tests for male consorts of females with human papilloma virus infection
MM Kamal, SM Jaiswal, SP Nayak
October-December 2007, 24(4):179-182
DOI:10.4103/0970-9371.41890  
Human Papilloma virus (HPV) infection of uterine cervix is known to be a very important risk factor for the development of cervical intraepithelial neoplasia and invasive cancer. This infection, that affects partners, is presently being investigated mostly in females. This study utilized a simple technique of urethral cytology and penioscopy to screen 38 male consorts of women with HPV infection of uterine cervix. A simple naked eye examination and examination under magnification of the male genitalia i.e."Penioscopy" was performed. A cytologic smear was obtained from the urethra using a cytobrush. Five percent acetic acid was then applied and acetowhite areas, if any, were noted. Smears were studied for features indicative of HPV infection. 10 male consorts, all of whom were asymptomatic, showed evidence of HPV infection.
  5,320 219 -
CASE REPORTS
Touton like giant cell in lymph node in a case of langerhans cell histiocytosis
S Mukhopadhyay, PK Mitra, S Ghosh
October-December 2007, 24(4):191-192
DOI:10.4103/0970-9371.41893  
Aspiration cytology of lymph node of a one-year old girl suffering from acute disseminated Langerhans cell histiocytosis revealed pleomorphic histiocytes and multinucleated giant cells, including Touton like giant cells. Histology of the same lymph node showed atypical histiocytes but no giant cell. We report this case because presence of Touton like giant cells in aspiration cytology smear of lymph node is a rare finding.
  4,381 178 1
ORIGINAL ARTICLES
Ultrasound guided fine needle aspiration biopsy of gastrointestinal masses
SS Ahmad, K Akhtar, SS Akhtar, SH Arif, A Nasir, M Khalid, T Mansoor
October-December 2007, 24(4):173-177
DOI:10.4103/0970-9371.41889  
The study was undertaken to evaluate the role of ultrasound guided fine needle aspiration cytology (FNAC) of gastrointestinal masses in providing higher diagnostic yield and assess its reliability in distinguishing between benign and malignant gastrointestinal lesions. 86 patients with gastrointestinal masses after thorough clinical examination underwent ultrasonographic examination. Those found to have a mass were subjected to FNAC. Smears prepared were fixed in 95% ethyl alcohol and stained with Haematoxylin and Eosin and Papanicolaou stains. Forty (46.5%) were males and 46 (53.5%) females with majority of patients in the third decade in both sexes. Malignant lesions constituted the maximum number of 42 (48.8%) cases, followed by 36 (41.8%) cases of benign and inflammatory lesions. Adenocarcinoma was the most common malignancy accounting for 36 (85.7%) cases; out of which 16 (44.4%) cases were adenocarcinoma stomach and 20 (55.6%) cases were adenocarcinoma intestine. Among the inflammatory and benign lesions, 30 (83.3%) cases were tuberculous followed by 4 (11.1%) cases appendicitis, The mean age of malignancy was 39.2 years and the average age of tuberculous patients in our study was 25.5 years. On cytohistological correlation, 30 were found to be true positive for malignancy, 5 true negative and 1 false negative. There were no false positive cases. We obtained a sensitivity of 93.8%, specificity of 100% and diagnostic accuracy of 94.4% in our study. Ultrasound guided FNAC is an effective and useful method which eliminates the need for surgical biopsy and provides sufficient information for the initiation of therapy.
  4,305 229 -
CASE REPORTS
Cytological diagnosis of adenoid cystic carcinoma of the parotid metastatic to kidney and lung
S Srivastava, R Jaiswal, A Agarwal, PK Singh, SN Singh
October-December 2007, 24(4):201-202
DOI:10.4103/0970-9371.41897  
Metastasis of adenoid cystic carcinoma to the kidney is rare. We present a case of a 50 year old male with complaints and radiological findings suggestive of renal cell carcinoma and lung deposits. However, fine needle aspiration was suggestive of adenoid cystic carcinoma metastatic deposits. It was later elicited that the patient had undergone surgery for parotid tumour seven years back which on histology was an adenoid cystic carcinoma. The case is being presented for its rarity.
  3,986 169 1
Clavicular metastasis, an initial manifestation of a malignant pheochromocytoma - a case report
K Karabi, S Ghosh, TK Ghosh, S Bhattacharya
October-December 2007, 24(4):189-190
DOI:10.4103/0970-9371.41892  
We present a 55 years old lady having an unusual presentation of abdominal pain and a clavicular mass as the initial manifestations of a nonfunctioning malignant pheochromocytoma. Fine needle aspiration of the clavicular mass revealed a metastatic adenocarcinoma. A search for primary site revealed a mass in left adrenal and multiple space occupying lesions in the liver. The aspirations were identical to that from the clavicle. Surgical biopsy of the clavicular mass revealed, features of metastatic pheochromocytoma. Urinary catecholamine was normal. Malignant pheochromocytoma can present with atypical features and guided fine needle aspiration cytology can be a safe diagnostic procedure.
  3,870 103 -
Nodular fasciitis of the hand - a potential diagnostic pitfall in fine needle aspiration cytology
K Mardi, J Sharma, H Kaur
October-December 2007, 24(4):197-198
DOI:10.4103/0970-9371.41895  
Nodular fasciitis is an uncommon, benign myofibroblastic soft tissue tumour. It is infrequently seen in the hand. A case of nodular fasciitis involving the thumb of a 4-year-old male child is presented. Main significance lies in clinical and pathological recognition of the lesion to avoid over-treatment. Nodular fasciitis remains a difficult diagnosis by fine needle aspiration cytology, particularly when it occurs in locations such as the hand.
  3,364 153 1
Malignant pericardial effusion and cutaneous metastasis - an initial presentation of adenocarcinoma of lung
JH Vachhani, K Jessalpara, B Goswami, PM Santwani
October-December 2007, 24(4):199-200
DOI:10.4103/0970-9371.41896  
Cardiac tamponade is a life threatening condition. It is rarely the first sign of malignancy which can be diagnosed by cytological examination of pericardial fluid. Subcutaneous metastatic nodules also are an uncommon first sign of underlying cancer. In this report we present a 62 years old case of lung cancer who initially presented with the above two rare clinical signs. He was admitted with cardiac symptoms, chest pain and dyspnea since last 6 months. Chest radiographs showed cardiomegaly and diagnosis of cardiac tamponade was made. Pericardiocentesis showed malignant cells, morphologically suggestive of an adenocarcinoma. Fine needle aspiration of the subcutaneous nodules showed a similar picture. Search for the primary revealed a mass in the lung on computed tomography.
  2,609 125 -
A case of pilomatrixoma misdiagnosed as metastatic carcinoma on fine needle aspiration cytology
TR Preethi, K Jayasree, EK Abraham
October-December 2007, 24(4):207-208
DOI:10.4103/0970-9371.41900  
We report a case of pilomatrixoma of the posterior triangle of the neck in a twenty-eight year old gentleman, which was suspected as metastatic carcinoma on fine needle aspiration cytology. The cytomorphological features of pilomatrixoma and major pitfalls in diagnosis are also discussed.
  2,217 136 1
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