Conventional Papanicolaou Research Articles

CLINICAL PRESENTATION OF TRICHOMONAS VAGINITIS IN TERTIARY CARE CENTRE IN KATHMANDU

Background: Cervical-vaginal infections are common problems in women of reproductive age groups. Trichomonas vaginalis is one of the major organisms causing vaginitis. Trichomonas vaginalis is an anerobic, flagellated protozoan. The main objective of this study was to study the clinical findings of women with Trichomonas vaginitis.
 Methods: This was a hospital based descriptive study carried out in the Department of Pathology and Gynaecology of Nepal Medical College Teaching Hospital in one year (January- December 2020). A total of 163 Pap smear examination were included in study. Specimen were stained using conventional Papanicolaou method. After staining, slides were examined under the light microscopy. The cytological diagnosis was correlated with the clinical findings. The collected data was analyzed using SPSS software version 16. Mean, Standard deviation, frequencies and percentages were calculated.
 Results: A total of 163 cases were evaluated. The mean age of women who underwent Pap smear examination was 37.5 10.5 years. Out of 163 cases, there were 42 cases of Trichomonas vaginitis. The prevalence of Trichomonas vaginalis was 25.8%. The common age group was 20 to 40 years. Most of the women were symptomatic (64.3%) while rest were asymptomatic (35.7%). Per vaginal discharge (35.7%) was the most common complain followed by vulval itching (16.7%).
 Conclusions: Trichomonas vaginalis are commonly found in reproductive age group presented with clinical manifestations or may be asymptomatic at all too. Vaginal discharge is the commonest presentation.

Comparison of Conventional Papanicolaou Stain with Enviro Papanicolaou Stain in Buccal Smear

Comparison of Conventional Papanicolaou Stain with Enviro Papanicolaou Stain in Buccal Smear

Effectiveness of Rapid, Economic, Acetic Acid, Papanicolaou Stain (REAP) Over Conventional Papanicolaou Stain in Oral Exfoliative Cytology

Effectiveness of Rapid, Economic, Acetic Acid, Papanicolaou Stain (REAP) Over Conventional Papanicolaou Stain in Oral Exfoliative Cytology

Aspergillus as a contaminant on conventional cervicovaginal papanicolaou smear

Majority of the cases of fungal infections to be detected in the cervicovaginal smears, are caused by Candida species. Aspergillus infections are not just rare, but should also raise alarm regarding the immune status of the patient. Here we report the case of an adult female with cervicovaginal smears showing non-Candida fungal elements, going on to prove contamination of the wooden spatula by Aspergillus fumigatus.

Clinical significance of immunocytochemical staining for peritoneal lavage cytology in pancreatic cancer

BackgroundPeritoneal lavage cytology for pancreatic ductal adenocarcinoma is conducted with both an intraoperative rapid diagnosis by Papanicolaou staining (cytology–rapid) and a final diagnosis by immunocytochemical staining at a later date (cytology–final) in our hospital. However, the clinical significance of cytology–final has not yet been elucidated. MethodsA total of 675 pancreatic ductal adenocarcinoma patients who underwent pancreatectomy and cytology between 2002 and 2018 were retrospectively reviewed. Diagnostic results of cytology–rapid and cytology–final and survival outcomes were analyzed. ResultsA total of 43 patients (6.4%) were diagnosed as cytology–rapid (+), and all of them were ultimately diagnosed as cytology–final (+). Among the 632 patients with cytology–rapid (–), 19 (3.0%) were eventually diagnosed as cytology–final (+). The overall survival of patients with cytology–rapid (+) and that of patients with cytology–rapid (–) did not differ to a statistically significant extent (median survival time 26.4 vs 32.9 months; P = .106). In contrast, the overall survival of patients who were diagnosed as a false-negative result by cytology–rapid was significantly worse than that of patients diagnosed as a true negative (18.7 vs 34.8 months; P = .031). The overall survival of patients with cytology–final (+) was significantly worse than that of patients with cytology–final (–) (23.6 vs 34.8 months; P = .012). A multivariate analysis showed that cytology–final (+) was an independent prognostic factor for the OS (hazard ratio = 1.43; P = .049), whereas cytology–rapid (+) was not. ConclusionImmunocytochemical staining may be a useful complement to a diagnosis of cytology by conventional Papanicolaou staining in pancreatic ductal adenocarcinoma patients.

COMPUTER AIDED DIAGNOSTIC SYSTEM FOR WHOLE SLIDE IMAGE OF LIQUID BASED CERVICAL CYTOLOGY SAMPLE CLASSIFICATION USING CONVOLUTIONAL NEURAL NETWORK

Cervical cancer screening with Papanicolaou test and liquid based cytology relies on the expertise of the pathologist. Liquid based cytology is proven to be more efficient than conventional Papanicolaou test when it comes to sample preparation and possibility of conducting several tests on the same sample. However, specificity and sensitivity of the test are in the range of the Papanicolaou test accuracy metrics, with false negative results still being the main drawback of these manually performed tests. Advances in technology and availability of digital data have enabled succesfull application of machine learning models in diagnostics. Images of cervical cells are now used as input to different deep learning models currently tested in studies concerning computer aided diagnostic systems. This study explores different architectures of convolutional neural network for cervical cancer detection based on Optomagnetic imaging spectroscopy and liquid based cytology samples. The proposed VGG16 based model achieved 93.3% sensitivity and 67.8% specificity in the binary classification problem. Results highlight the need for more balanced dataset in order for suggested deep model to achieve better performance.

Ultra fast papanicolaou stain versus conventional papanicolaou stain in oral cytology smears

Background:Exfoliative cytology is the technique of microscopic examination of shed or desquamated cells from the epithelial surface of mucous membrane. Papanicolaou stain (PAP) is the common stain used for these cytological smears. Conventional PAP (cPAP) stain has undergone many modifications, of these ultrafast PAP (UFPAP) is a popular stain used as it shortens the staining time and quality. UFPAP was discovered as a fusion of Romanowsky and PAP.Aim and Objectives:To evaluate and estimate the quality of UFPAP and c PAP stains in oral cytology smears of normal mucosa (NM), oral squamous cell carcinoma (OSCC), and oral potentially malignant disorders (OPMDs).Materials and Methods:50 samples/smears were collected from outpatients from the Government Dental College and Hospital, Hyderabad. Samples include 10 cases of NM, 20 cases each of OPMDs (leukoplakia) and OSCC. Two cytological smears of representative areas were obtained and each smear is stained by the cPAP and UFPAP stains, respectively.Results and Observation:The quality index is obtained for the comparison of UFPAP and cPAP stains by using four parameters like - nuclear details, over all staining, background staining, and cell morphology. QI for all parameters of UFPAP staining was good compared to cPAP and percentage of UFPAP for NM, OPMDs and OSCC was 92.7%, 88.1%, 66.3% respectively.Conclusion:The study concludes that UFPAP staining is used for diagnosis in a regular oral cytology smears to offer immediate diagnosis of OPMDs and OSCCs.

Small-cell neuroendocrine carcinoma of the cervix accompanied by adenocarcinoma and high-grade squamous intraepithelial lesion.

Few cytological reports have described small-cell neuroendocrine carcinoma (SCNEC) in the female genital tract. In the present study, we describe a cytological case of SCNEC accompanied by adenocarcinoma, as well as high-grade squamous intraepithelial lesion (HSIL). A Japanese woman (42 years old) presented with abnormal genital bleeding. A conventional Papanicolaou smear revealed an inflammatory condition with three neoplastic components: SCNEC as irregular aggregates of neoplastic small round cells with nuclear molding and granular chromatin; adenocarcinoma as columnar cell clusters with peripherally located large nuclei, and HSIL as sheets or clusters of dysplastic basal-type squamous cells with irregular hyperchromatic nuclei. Accordingly, a cytodiagnosis of SCNEC with adenocarcinoma and HSIL was made. Owing to the rarity of cervical SCNEC, cytological diagnosis may be difficult. Due to its aggressive clinical behavior, the presence of an SCNEC component should be verified in any cytodiagnosis of adenocarcinoma or HSIL.

Papanicolaou Test in Women with Abnormal Bacteriologic Exam Results

Abstract The normal vaginal flora is complex and includes various organisms, many of them conditioned pathogens. The vaginal microbiome is controlled by estrogens that is why a major difference it encountered between pre-menopausal and menopausal women. Bacterial vaginosis was associated with inflammatory changes on Papanicolaou (PAP) smears and chronic inflammation may eventually tead to potentially precancerous and cancerous processes of the cervix. We asses the importance of PAP test and early discovery of vaginal infections because bacterial vaginosis has been associated with inflammatory changes on PAP smears. Materials and metods: Were analysed 50 patients with bacteriologic exam and PAP smear, from ambulatory (Polyclinic Constanța). Bacteriological exam was performed on smears stained Gram from vaginal secretion, collected during the same ginecological examination when PAP smears were collected. The PAP smear was conventional PAP. Samples were obtained by cervical brushing. Results and discussions: These patients were aged between 21 and 64 year and were examined for various symptoms. The patients were classified in pre-menopausal 35% and post-menopausal 65%.The result of the bacteriologic exam showed normal flora (absence of infection) in 44% of cases and abnormal vaginal flora in 56% of the cases. The predominant pathology was bacterial vaginosis with non-specific flora (Gram positive coci and Gram negative bacilli, absence of lactobacilli) in 38% of cases. Candida infection was present in 12% of the cases and Trichomonas vaginalis and Actynomices in 3% of the cases each. Conclusions The majority of patients with bacterial vaginosis (Candida, Trichomonas,Actinomyces) had Pap tests negative for intraepithelial lesion or malignancies NILM or NILM and cellular changes associated with inflammation. There may be infectious causes of abnormal Pap tests other than HPV.

Computer-Aided Analysis of Oral Conventional Papanicolaou Cytology Samples

Computer-Aided Analysis of Oral Conventional Papanicolaou Cytology Samples

Liquid-Based Cytology in the Detection of Premalignant Lesions in Patients with "Atypia in Squamous Cells" in Conventional Cytology.

The management of patients with "Atypical Squamous Cells" (ASC) in conventional papanicolaou smears (CPS) is based on the risk of high-grade squamous intraepithelial lesion (HSIL). The efficacy of liquid-based cytology (LBC) to detect this premalignant lesion is variable, with little evidence of its performance in Colombian patients. The aim of this study is to determine the performance of LBC in the detection of premalignant lesions, in patients with ASC in CPS. Were obtained patients who attended colposcopy clinic due the result of ASC in CPS. An LBC was taken, which was interpreted by two pathologists without access to other results. The performance of LBC to detect HSIL, was determined, considering as a gold standard: histopathological study/negative-satisfactory colposcopy. Were included 114 patients, with a mean age of 38.4 years (SD ± 13.3). LBC had abnormal results in 40.36% (n = 46), with a slightly higher proportion of low-grade squamous intraepithelial lesion (LSIL) than HSIL. The total of abnormal diagnoses by colposcopy and/or biopsy was 51.75% (n = 59), with a predominance of LSIL (36.84%). The sensitivity of the liquid-based cytology to detect premalignant lesions was 76.5%, specificity: 66.0%, positive predictive value: 28.3% and negative predictive value: 94.1%; The Cohen's kappa index of LBC for detecting HSIL was 0.2492 for the total population and 0.2907 for ≥30 years. Although LBC decreases abnormal cytology and increases the detection of HSIL, which improves diagnostic accuracy; sensitivity and predictive values for detecting HSIL are not significantly different between CPS and LBC.

The reporting rates of high-grade squamous intraepithelial lesions and their human papillomavirus testing and histologic follow-up results: A comparison between ThinPrep and SurePath preparations.

Liquid-based cytology (LBC) tests SurePath (SP) and ThinPrep (TP) have largely replaced conventional Papanicolaou (Pap) tests for cervical cytology screening due to higher sensitivity. However, comparison between SP and TP test sensitivity and efficacy in detecting squamous abnormalities is lacking. Our study aims to compare high-grade squamous intraepithelial lesion (HSIL) reporting rates, human papillomavirus (HPV) positivity rates, and histologic outcome between these two LBC methods. We performed a retrospective search of the period between January 2014 and June 2017, when both TP and SP were utilized at our institution, to identify HSIL cases and collect the HPV testing and histologic follow-up results for those cases. One hundred twenty-five HSILs were identified from the 15 382 TP specimens (0.81%) and 93 HSILs were identified from the 25 105 SP specimens (0.37%), a statistically significant difference (P < .0001). The corresponding HPV positivity rates were 95.6% and 89.7% in TP-HSILs and SP-HSILs, respectively, a statistically non-significant difference. Histologic follow-up showed HSILs or carcinomas were identified in 78% (49/63) of TP-HSILs and 79% (45/57) of SP-HSILs, with no statistically significant difference. TP demonstrated a higher HSIL detection rate than SP with no significant difference in follow-up HPV or histologic results.

Frequency of high-grade squamous cervical lesions among women over age 65 years living with HIV

Current US cervical cancer screening guidelines recommend screening cessation at the age of 65 years provided women have adequate previous screening and no history of precancer. Women living with HIV are at higher risk of cervical cancer than women living without HIV. Furthermore, limited data exists to quantify the risk of cervical cancer among women who otherwise would qualify for screening cessation. This study aimed to determine whether guidelines recommending women to discontinue cervical cancer screening at the age of 65 years are appropriate for women living with HIV. Semiannual Papanicolaou testing was performed as part of surveillance visits in the Women's Interagency HIV Study. Launched in October 1994, the Women's Interagency HIV Study is a federally funded US multisite cohort study that has enrolled 3678 women living with HIV and 1304 women living without HIV; we included data throughout September 2019 onward. Conventional Papanicolaou tests were collected at scheduled 6-month visits and read centrally according to the 1991 Bethesda System criteria. Results were analyzed among women at least 65 years of age. The primary endpoint was high-grade cytology, including high-grade squamous intraepithelial lesions; atypical glandular cells; atypical squamous cells, cannot exclude high-grade lesions; and malignant cytology. Wilcoxon rank-sum tests were used to compare the continuous variables, and Chi-square tests or the Fisher exact tests were used to compare the categorical variables. The Kaplan-Meier method was used to calculate the cumulative incidence. Poisson regression was used to compare 2 incidence rates. Of 169 eligible women (121 women living with HIV and 48 women living without HIV) who contributed 678.4 person-years of observation after reaching the age of 65 years, 2.2% had high-grade cytologic abnormalities. However, no cancer was found. Furthermore, 20 women had previous precancer results, and 74 women had abnormal Papanicolaou test results in the previous decade. Among 50 women (38 women living with HIV and 12 women living without HIV) with a previous hysterectomy and no history of cervical precancer, the cumulative incidence rates of high-grade squamous intraepithelial lesions were 0.6 (95% confidence interval, 0.0-3.2) per 100 person-years for women living with HIV and 0.0 (95% confidence interval, 0.0-8.1) per 100 person-years for women living without HIV (P=.61). Only 48 women (27 women living with HIV and 21 women living without HIV) had cervices and met the current guidelines to discontinue screening; their risk of experiencing high-grade squamous intraepithelial lesions was 2.2 (95% confidence interval, 0.6-5.5) per 100 person-years overall and did not vary by HIV status (2.3 [95% confidence interval, 0.5-6.8] per 100 person-years for women living with HIV and 1.8 [95% confidence interval, 0.0-9.8] per 100 person-years for women living without HIV; P=.81). Most women living with HIV do not meet the criteria for cervical cancer screening cessation and will need to continue screening over the age of 65 years; however, women who meet the criteria for screening cessation have risks of high-grade squamous lesions similar to women living without HIV and may choose to discontinue.

Spectrum of pap smear cytology in women presenting in a tertiary care center in north India-a two year study

Context: Cervical cancer is the second most common cancer in the world after breast cancer and is the most common gynecological cancer in the developing countries. Pap Smear is a simple and cost effective screening tests for early diagnosis of premalignant and malignant cervical lesions. Aim: The aim of this study is to evaluate the spectrum of cervical pap smear cytology in a tertiary hospital. The reporting of the pap smear was based on 2014 Bethesda system Materials and Methods: This is a retrospective two year study done in a tertiary Hospital in TSM Hospital from June 2016 to June 2018. All Pap smears received from women were included in our study. Total of 450 pap smears were stained by conventional papanicolaou technique and reported by Bethesda system 2014. Results: Out of 450 cases, 411 cases (91.3%) were reported as negative for intraepithelial lesion/malignancy, 31 cases (6.9%) were showing epithelial cell abnormality and 8 cases (1.7%) were unsatisfactory. In negative for intraepithelial lesion cases, 4 cases (0.9%) were atrophic smears, 357 cases (79.3%) were inflammatory and the remaining 50 cases (11.1%) were showing no other changes. In inflammatory cases 53 cases(11.7%)showed presence of microorganisms. 31 cases showing an intraepithelial lesion - 15 cases(3.3%) were ASCUS, 3 cases (0.6%) were AGUS, 6 cases (1.2%) were LSIL, 4 cases(0.8%) of ASC-H ,2 cases(0.4%) were HSIL and one case(0.2%) of squamous cell carcinoma cervix. Conclusion: Premalignant and malignant lesions of cervix are common and can be diagnosed early by conventional PAP smears. Key message: Conventional pap smears are essential not only to diagnose premalignant lesions but also to identify the infectious etiologies and guide proper treatment. Keywords: PAP smear, Malignant, Premalignant, Bethesda system.

Comparative evaluation of centrifuged liquid-based cytology method over conventional brush cytology in normal oral mucosa

Introduction: Liquid-based cytology (LBC) is a new monolayer slide preparation method introduced to overcome the limitations of conventional Papanicolaou (PAP) smears which is used in cancer screening. The study was aimed to compare the efficacy of modified technique, centrifuged LBC (CLBC) with that of conventional brush cytology in normal oral mucosa. Materials and Methods: Two smears were obtained from 100 cases of normal mucosa using a cytobrush. One smear was spread on to the slide by conventional technique, and the other smear was prepared by CLBC. Regular PAP staining was done for both the smears. Both the smears were evaluated for cellularity, cell distribution, cellular overlapping, cell elongation, and cellular background and were graded using the grading criteria. Mann–Whitney U-test was used, and P ≤ 0.05 was considered statistically significant. Results: The mean score of the criterias was found to be more desirable in CLBC than conventional technique, but there was no statistical significance found. Conclusions: LBC offers a significant advantage over conventional smear preparation in most of the criteria to advocate its use for routine diagnostic and mass screening procedures.

Cervical cancer detection in pap smear whole slide images using convNet with transfer learning and progressive resizing.

Cervical intraepithelial neoplasia (CIN) and cervical cancer are major health problems faced by women worldwide. The conventional Papanicolaou (Pap) smear analysis is an effective method to diagnose cervical pre-malignant and malignant conditions by analyzing swab images. Various computer vision techniques can be explored to identify potential precancerous and cancerous lesions by analyzing the Pap smear image. The majority of existing work cover binary classification approaches using various classifiers and Convolution Neural Networks. However, they suffer from inherent challenges for minute feature extraction and precise classification. We propose a novel methodology to carry out the multiclass classification of cervical cells from Whole Slide Images (WSI) with optimum feature extraction. The actualization of Conv Net with Transfer Learning technique substantiates meaningful Metamorphic Diagnosis of neoplastic and pre-neoplastic lesions. As the Progressive Resizing technique (an advanced method for training ConvNet) incorporates prior knowledge of the feature hierarchy and can reuse old computations while learning new ones, the model can carry forward the extracted morphological cell features to subsequent Neural Network layers iteratively for elusive learning. The Progressive Resizing technique superimposition in consultation with the Transfer Learning technique while training the Conv Net models has shown a substantial performance increase. The proposed binary and multiclass classification methodology succored in achieving benchmark scores on the Herlev Dataset. We achieved singular multiclass classification scores for WSI images of the SIPaKMed dataset, that is, accuracy (99.70%), precision (99.70%), recall (99.72%), F-Beta (99.63%), and Kappa scores (99.31%), which supersede the scores obtained through principal methodologies. GradCam based feature interpretation extends enhanced assimilation of the generated results, highlighting the pre-malignant and malignant lesions by visual localization in the images.

Role of cervical cytology in the detection of uterine glandular lesions

Background: Diagnosis of atypical glandular cells (AGCs) is challenging to the cytopathologist due to the overlapping features of various neoplastic and nonneoplastic lesions. The aim of this study was to assess the utility of conventional Papanicolaou (Pap) smears in detecting uterine glandular lesions. Materials and Methods: Archived records of all histopathologically diagnosed endometrial adenocarcinoma and endocervical adenocarcinoma during the study period were identified. Corresponding Pap smears, if available, were retrieved. In addition, all cytologically reported AGCs and adenocarcinoma during the same period were retrieved. Pap smears of histopathology discordance cases were reviewed. The prevalence of AGC and sensitivity and specificity of Pap smears in detecting glandular lesions were calculated. Results: The prevalence of AGC was 0.65%. There were 11 false negatives and 10 false positives initially, which were reduced to 6 and 5, respectively, after the review. The sensitivity and specificity of Pap smear in detecting AGC was 72.9% and 99.81% initially, which improved marginally to 81.8% and 99.9%, respectively. Conclusions: The prevalence of AGC in Pap smears is low with a moderate sensitivity and good specificity. As the association of clinically significant lesion is high, all cases with AGC diagnosis must be followed up with colposcopic and histopathologic examination of uterus and cervix.

Rapid nasopharyngeal brush-smear cytology with Epstein-Barr virus DNA load and viral marker analysis for detection of nasopharyngeal carcinoma

Background: Nasopharyngeal carcinoma (NPC) is a prevalent cancer in Indonesia, usually identified at late stage. Epstein-Barr virus (EBV) gene products are present in all tumor cells. Early-stage NPC diagnosis is clinically important but difficult due to non- specific symptoms. In patients suspected of having NPC, nasopharyngeal (NP) brush-cytology may provide a simple non-invasive procedure for rapid on-site detection of NPC tumour cells that can be combined with EBV markers. Methods: Patients (N=83) suspected of having NPC underwent nasoendoscopy-guided NP brushing before a biopsy from clinically suspicious areas. The loaded brush was first smeared onto glass slides that were directly immersed in ethanol, followed by Papanicolaou (PAP) staining and on-site interpretation of tumour cell presence. Thereafter, slides were used for EBER RNA in situ hybridization (EBER-ISH) and LMP-1 immunocytochemistry (ICC). The brush left-over was used for EBV-DNA load measurement using real-time PCR. Biopsy specimens were taken from the same NP site and processed for routine pathology and EBER-ISH on tissue sections. Result: Morphological detection of NPC tumour cells on PAP-stained brush-smears gave a sensitivity and specificity of 87% and 100%, respectively. EBER-RISH and LMP1 ICC combined showed 100% positivity for NPC cases. Expression of LMP-1 was detected in 77.8% of cases. Median EBV-DNA load in left-over brush material from NPC cases was 5.06 × 106 copies/brush (range 777 to 242,400,000 copies/brush), whereas median value in non-NPC cases was 4.4 x 103 copies/brush (range 484 - 297,200; P < 0.001). Conclusion: Minimal invasive NP-brush cytology with conventional PAP staining allows rapid, simple and cheap “on site” detection of NPC tumour cells in suspected NP lesions. The method can be modified for direct demonstration of EBV involvement using EBER-ISH and LMP1-ICC or EBV-DNA load measurement. This NP brush procedure may be useful for primary screening in patients considered at risk for NPC.

Comparison of Liquid-Based Cytology and Conventional Papanicolaou Smear for Cervical Cancer Screening: An Experience From Pakistan.

IntroductionAfter the introduction of cervical cancer screening program with cervical cytology, a marked decline in deaths secondary to cervical cancer was observed in developed countries. Two methods are used for cervical cytology. The first one is the conventional Papanicolaou (PAP) and the second one is liquid-based cytology (LBC). Although various studies in western countries established the role of LBC in cervical cancer screening, no large-scale study was conducted in our population to compare the two techniques for cervical cancer screening. Therefore, in this study, we compared the diagnostic utility of these two techniques for detecting cervical epithelial lesions.MethodsA total of 3,929 patients, who presented to the Gynecology Clinic, Liaquat National Hospital, for cervical cancer screening from January 2015 until December 2019, over a period of five years, were included in the study. A total of 1,503 specimens were prepared by LBC, and 2,426 specimens were prepared by a conventional PAP smear method. All smears were interpreted using the Bethesda System of Reporting Cytopathology.ResultsThe mean age of the patients was 39.46±11.14 years. For cytological evaluation, 98.7% of specimens were adequate. The inadequacy rate was 1.3% for conventional PAP smear and 1.2% for LBC. While 97.2% of specimens were reported as negative for intraepithelial lesion or malignancy, 1.1% of specimens showed squamous epithelial lesions. There was a significant difference in the detection rate of squamous epithelial lesions using the two techniques. The detection rate of squamous intraepithelial lesions using LBC was 2.1%, which was higher than that of the conventional PAP smear (0.6%). The detection rates of glandular lesions using LBC and conventional PAP smear were 0.5% and 0.2%, respectively.ConclusionWe found a higher disease detection rate of squamous epithelial lesions using LBC compared to conventional PAP smear. Therefore, we recommend a widespread use of LBC for mass cervical cancer screening in our population.

Utility of fine needle aspiration cytology (FNAC) in the diagnosis of soft tissue tumors and tumor like lesions

Introduction: Fine needle aspiration cytology (FNAC) forms one of the first diagnostic tools in evaluation of soft tissue lesions. Aim of this study was to evaluate the role of FNAC in the primary diagnosis of soft tissue tumors and tumor like lesions and to assess the effectiveness of FNAC in the histological subtyping and grading of soft tissue tumors. Materials and Methods: We reviewed FNAC smears of 170 soft tissue tumors and tumor like lesions over a 3 years period and correlated with the histopathological features which were available in 117 cases. Conventional Papanicolaou (PAP) and Giemsa staining was done in all cases. Results: 152 out of 170 cases [89.41%] were neoplastic, of which 130 tumors were labelled as benign. Lipoma constituted 83.07% of benign tumors. Based on the predominant cytomorphological features and background, the tumors were classified into myxoid (4), spindle cell (20), pleomorphic (2), small round cell(4), epithelioid /polygonal cell (7), lipomatous (108) and miscellaneous (7). The non-neoplastic lesions included tuberculosis, filariasis, actinomycosis, scar endometriosis and calcinosis cutis. Conclusion: FNAC proved to be helpful in distinguishing between neoplastic and non-neoplastic soft tissue lesions, differentiating metastatic carcinoma and melanoma in soft tissue from primary soft tissue tumors and differentiating benign and malignant soft tissue tumors. Accurate subtyping was possible in many tumors of myxoid category and round cell tumors. Spindle cell tumors of intermediate grade were difficult to grade on FNAC. Pleomorphic sarcomas were of high grade and their subtyping could not be done on FNAC. Keywords: FNAC, Soft tissue lesions, Soft tissue tumors.