Journal of Cytology
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   2009| January-March  | Volume 26 | Issue 1  
    Online since August 4, 2009

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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.
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Cytological diagnosis of microfilariae in filariasis endemic areas of eastern Uttar Pradesh
Shaila K Mitra, Rajiv K Mishra, Pallavi Verma
January-March 2009, 26(1):11-14
DOI:10.4103/0970-9371.51333  PMID:21938142
Background: Filariasis is a major health problem in tropical countries including India. Fine needle aspiration cytology plays an important role in prompt recognition of disease. Aim: To assess the role of fine needle aspiration cytology (FNAC) in diagnosis of filariasis at all possible sites. Materials and Methods : Total 250 cases of superficial swellings at various sites were subjected to fine needle aspiration cytology. Results: Out of 250 cases, 24 cases of filariasis were detected which include breast lumps (8 cases), lymph nodes (6 cases), scrotal swellings (4 cases), thyroid swellings (3 cases), soft tissue swellings (2 cases) and ascitic fluid (1 case). Eosinophilia was present in 8 out of 24 cases with a percentage ranging from 12-24%. Significant adherence of inflammatory cells and macrophages to microfilariae was present in 3 out of 24 cases. Conclusions: In endemic areas, it should be considered one of the differential diagnoses of a superficial swelling. Careful screening of FNAC smears help in detecting microfilaria even in asymptomatic patients and thus plays a significant role in recognition of the disease and institution of specific treatment.
  16 3,858 380
Role of scrape cytology in ovarian neoplasms
Shalinee Rao, N Sadiya, Leena Dennis Joseph, S Rajendiran
January-March 2009, 26(1):26-29
DOI:10.4103/0970-9371.54864  PMID:21938145
Aim: The present study was done to evaluate the role of scrape cytology in the diagnosis of ovarian neoplasm and its utilization for teaching pathology residents. Materials and Methods: This was a prospective study on 50 solid/solid-cystic ovarian neoplasms sent in 10% buffered formalin. Scrapings obtained from the fresh cut surface of tumors were smeared uniformly on to glass slides, immediately fixed in 95% ethyl alcohol and stained with hematoxylin and eosin stain. Results: The overall diagnostic accuracy of scrape cytology has been satisfactory with 92% of cases correlating with the final diagnosis. Characteristic cytological pattern was noted in various types of surface epithelial, sex cord stromal and germ cell tumors. The technique had limited value in mucinous tumors to distinguish borderline cases from invasive carcinoma. Two mucinous carcinomas were diagnosed as borderline mucinous tumor and two endometrioid carcinomas were misinterpreted as cystadenocarcinoma on scrape cytology. Formalin did not interfere or produce any remarkable changes in cytomorphology. Conclusions: Scrape cytology is a simple, rapid, accurate, inexpensive adjunctive cytodiagnostic technique and its routine utilization in ovarian lesions could aid in expanding the cytological knowledge of ovarian neoplasms.
  10 3,703 475
Clinical utility of Liqui-PREPô cytology system for primary cervical cancer screening in a large urban hospital setting in China
Hao Deshou, Wang Changhua, Li Qinyan, Liu Wei, Fu Wen
January-March 2009, 26(1):20-25
DOI:10.4103/0970-9371.54863  PMID:21938144
Background: Liquid based cytology (LBC) has been reported to increase the sensitivity of cervical cytology, in comparison with conventional cytology Pap smear (CPS). Most LBC systems though require expensive automated devices. Aims: To evaluate the efficiency of a new and inexpensive LBC system - LPT cytology system. Materials and Methods: Cervical screening was performed on 31500 patients utilizing the LPT cytology system test from January 2006 to May 2007. A similar number (n = 31500) of CPS were performed from January 2004 to July 2006. All cytology positive patients underwent colposcopy and cervical biopsy with histopathology examination. Fifty cases positive both on cytology and biopsy were submitted to the high-risk human papillomavirus (HPV) L1 protein (HR-HPV L1) tests. Results: The LPT cytology system adequately preserved cellular structure for morphologic evaluation. There was a significant difference of the histology/cytology diagnosis concordant rate between that of the CPS and LPT systems [93.6 vs. 78.4%, p=0.001]. The significant higher concordant rate was also seen in the low grade intraepithelial lesion (LSIL) (95.4 vs. 78.9%, p=0.001) and in high grade intraepithelial lesion (HSIL) (90.2 vs. 76.1%, p=0.001) cytology diagnosis. There was no statistical difference in rate in atypical glandular cells (AGC) (61.5 vs. 60%) and glandular cell carcinoma (GCC) (83.3 vs. 80%). LPT resulted in a marked increased global detection over the CPS. Nuclear expression of HPV L1 was seen in 34% (17/50) of cases. Conclusions: LPT showed an increase in detection rate compared to CPS (P = 0.001) and a significantly higher histological versus cytological concordant referral rate.
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Adenomatatoid tumor: Cytological diagnosis of two cases
R Kalyani, Subhashish Das
January-March 2009, 26(1):30-32
DOI:10.4103/0970-9371.54865  PMID:21938146
Adenomatoid tumor is a benign neoplasm of mesothelial cell origin that occurs in both male and female genital tracts. Fine needle aspiration cytology has an important role in the preoperative diagnosis of the male genital adenomatoid tumor and is a rapid, reliable, conclusive, and cost-effective diagnostic tool that can be used to take appropriate surgical decisions. Pathologists should be aware of the cytological features of such lesions so as to avoid diagnostic pitfalls. We present here two cases, one in the testis and another in the epididymis in a 35 year-old and a 30 year-old male respectively, which were diagnosed by fine needle aspiration cytology and later confirmed by histopathology. We present the cytological features and histopathological correlation of these cases.
  7 2,417 198
Giant cell tumor of soft tissue: Cytological diagnosis of a case
Sarita Asotra, Sudershan Sharma
January-March 2009, 26(1):33-35
DOI:10.4103/0970-9371.54866  PMID:21938147
Giant cell tumors of soft tissue (GCT-STs) are rare neoplasms and are mainly seen in adults and in the elderly population, usually in the extremities. When evaluated along with clinical features, the cytological features are sufficient to distinguish GCT-STs from other more common tumors with giant cell morphology. We report here a case of a giant cell tumor of soft tissue diagnosed on the basis of fine needle aspiration cytology and confirmed after histopathology.
  4 3,947 271
Fine-needle aspiration cytology of Kikuchi Fujimoto disease
Mehboob Hasan, Sufian Zaheer, Lateef Ahmed Sofi, Anjum Parvez
January-March 2009, 26(1):43-45
DOI:10.4103/0970-9371.54870  PMID:21938151
Kikuchi disease (KD) is an enigmatous, self-limiting, rarely fatal, disease of young females. The self-limiting disorder usually occurs in Asian women in their late 20s or early 30s. Typically it runs a benign course and appears to resolve spontaneously one to six months after definitive diagnosis. We report a 27 years old lady presenting with cervical lymphadenopathy. Fine needle aspiration cytology of the node clinched the diagnosis revealing crescentic histiocytes, plasmacytoid monocytes, extracellular (karyorrhectic) debris and necrosis. The diagnosis was subsequently confirmed by histopathology.
  4 3,352 263
Cytomorphology of fibromatosis colli
V Rajalakshmi, G Selvambigai, Jaiganesh
January-March 2009, 26(1):41-42
DOI:10.4103/0970-9371.54869  PMID:21938150
Fibromatosis colli is a peculiar, benign fibrous growth of the sternocleidomastoid that usually appears during the first few weeks of life and is often associated with muscular torticollis. Fibromatosis colli (FC) is seen in children born after difficult, prolonged labor, assisted delivery, and breech deliveries. Clinically, FC has to be differentiated from congenital lesions, inflammatory lesions, and neoplastic conditions-both benign and malignant-that may occur at that site. Fine-needle aspiration cytology (FNAC) is a simple technique that will help in excluding the above conditions and also in avoiding surgical procedures. Fibromatosis colli also resembles other forms of infantile fibromatosis, but its behavior, microscopic appearance, and its treatment distinguish it from other forms of infantile fibromatosis. In contrast to other forms of fibromatosis, a noninvasive, conservative management is usually the line of treatment for FC in most of the cases. FNAC is a noninvasive method of diagnosis of FC that is thus useful in its management. We report here a case of Fibromatosis colli diagnosed by FNAC.
  3 2,622 172
Extraskeletal myxoid chondrosarcoma: Diagnosis of a rare soft tissue tumor based on fine needle aspiration cytology
Anuradha Ananthamurthy, R Nisheena, Bhanumati Rao, Marjorie Correa
January-March 2009, 26(1):36-38
DOI:10.4103/0970-9371.54867  PMID:21938148
Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue sarcoma with limited literature available on its cytological features. We report here one such case where a diagnosis of EMC was made based on fine needle aspiration cytology (FNAC). A 51 year-old male presented to our FNAC clinic with a slowly growing mass in the left thigh, which was subjected to fine needle aspiration biopsy. Radiological images showed no involvement of the underlying bone. Magnetic resonance imaging was suggestive of a malignant neoplasm. The FNA smears showed cell fragments and cords of monotonous cells embedded in abundant myxoid stroma. A diagnosis of a myxoid sarcoma favoring an EMC was made in this patient. Subsequent excision of the mass for histopathological examination confirmed this diagnosis. EMC has distinctive cytological features that are helpful in confidently making a diagnosis in the appropriate clinical setting.
  2 4,713 236
Testicular embryonal carcinoma presenting as chest wall subcutaneous mass
Lubna Khan, Shubhra Verma, PK Singh, Asha Agarwal
January-March 2009, 26(1):39-40
DOI:10.4103/0970-9371.54868  PMID:21938149
Embryonal carcinoma affects young males in the prime of life with a majority of these tumors already having metastasis at the time of diagnosis. Subcutaneous metastasis from embryonal carcinoma are very rare and often associated with wide spread disease and poor prognosis. We report a case of chest wall subcutaneous metastasis of embryonal carcinoma in a 27 year-old man that was the first presentation of the disease and was diagnosed on fine needle aspiration cytology (FNAC). Subsequent search led to the discovery of the primary in the testis. The cytomorphological features of embryonal carcinoma are quite distinctive and FNAC plays a vital role in early diagnosis. The criteria for diagnosis includes presence of cellular smears exhibiting disperse cells as well as cell aggregates forming microglandular patterns. Cells have large nuclei with prominent nucleoli and pale indistinct often vacuolated cytoplasm. Early diagnosis and treatment with platinum based chemotherapy in conjunction with radiotherapy and surgery have high cure rate.
  2 3,853 187
Glomus tumor mimicking eccrine spiradenoma on fine needle aspiration
K Vidyavathi, M Udayakumar, CSBR Prasad, ML Harendra Kumar
January-March 2009, 26(1):46-48
DOI:10.4103/0970-9371.54871  PMID:21938152
Glomus tumors are usually small painful nodules situated most commonly in the subungual region, and subcutis of upper and lower extremities. The histologic features of glomus tumor are characteristic and do not pose any diagnostic difficulty. However, cytomorphologic features have been poorly defined and rarely reported. We present a case of glomus tumor which mimicked a cutaneous adnexal neoplasm - eccrine spiradenoma on fine needle aspiration.
  2 2,597 166
Role of cytology in diagnosis of soft tissue sarcomas with special reference to false positive cases
Sanjay Sengupta, Santosh Kumar Mondal, Mamata Guha Mallick, Pranab Biswas, Nandita Basu
January-March 2009, 26(1):15-19
DOI:10.4103/0970-9371.54862  PMID:21938143
Background: Histological diagnosis of soft tissue sarcomas is a difficult job not only for diverse architecture of different variants but also for variability in picture among different parts of a single tumor. Thus, cytodiagnosis of these tumors is one of the most challenging jobs. Aims: To evaluate the role of fine needle aspiration cytology in diagnosis of soft tissue malignancies and discuss the false-positive cases with particular reference to causes of misdiagnosis and possible ways of correction. Materials and Methods: In the present study, we used cytology for categorization of 59 soft tissue malignancies according to predominant cell type and also on the basis of differentiation. Results: Out of 59 cytodiagnosed malignant soft tissue tumors, 36 were classified as high grade and rest as low grade. Spindle cell sarcoma was the commonest diagnosis, followed by pleomorphic variant. Histological correlations were performed in 47 cases showing consistency in 41 cases. Rest six cases with disparity were further discussed to ascertain causes of failures and to chalk out possible plans to evade these pitfalls in future. Conclusions: Overall our study established the role of cytology in diagnosis of soft tissue sarcomas with good cytohistological correlation rate (87.2%).
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