Needle Aspiration Cytology Smears Research Articles

Clinical and Pathological Findings of Ulcerative Prepuce Squamous Cell Carcinoma in a Marwari Horse

Squamous cell carcinoma is one of the muco-cutaneous soft tissue growths occurs in horses. Proliferative external genitalia squamous growth is a common type. This case report is about ulcerative squamous growth which is common in eyeball but uncommon in prepuce area. A Marwari 11 year old stallion was presented to the Veterinary Clinical Complex, Veterinary College and Research Institute, Namakkal with the history of mass in the external genitalia which had increased in size gradually over 12 months with ulceration shown in the last 5 weeks of that period. On clinical examination, ulcerated mass was noticed in the prepuce. Pudental nerve block was done for physical examination. Fine needle aspiration cytology and impression smear didn’t reveal tumour pathology. The presented case was tentatively diagnosed as preputial tumour and planned to perform surgical excision. Under xylazine and ketamine anaesthesia and triple drip maintenance, the preputial tumour mass was excised and samples were sent for histopathology which revealed poorly differentiated squamous cell carcinoma. Post-operative antibiotics, painkillers were administered and wound dressing done for 5 days. Animal had an uneventful recovery without recurrence.

Reporting Pancreatic FNAC using the Papanicolaou System: Still a Diagnostic Challenge.

The Papanicolaou Society of Cytopathology System for reporting Pancreaticobiliary Cytology (PSCPC) is a reliable method to classify pancreatic fine needle aspiration cytology (FNAC) smears. However, it is not without practical problems which can diminish the diagnostic accuracy of the cytological diagnosis. To determine the diagnostic pitfalls while reporting cytomorphology of pancreatic lesions according to PSCPC on correlating FNAC findings with histopathology. Retrospective analysis of pancreatic FNAC smears received in the Department of Pathology of our tertiary care institute over a period of 2 years was done. The cytological diagnoses were classified according to the Papanicolaou Society of Cytopathology system of reporting pancreaticobiliary cytology and correlated with histopathology. The reasons of cyto-histological discordance were analyzed. Out of 50 cases in which both FNAC and biopsy of pancreatic lesions were done, 34 cases were positive/malignant (Category VI), eight cases were suspicious for malignancy (Category V), three cases were neoplastic (Category IV), two cases were atypical (Category III), two cases were negative for malignancy (Category II), and one case was non-diagnostic (Category I). Out of 50 cases, histopathology was non-diagnostic due to inadequate material in six cases. The cytological diagnoses were compared with histopathology in the remaining 44 cases. Categories III, IV V, and VI were considered as positive for neoplastic pathology. The sensitivity of FNAC to predict neoplastic pathology was 97.5%, while the specificity was 25%. The positive predictive value was 92.9%. Two cases reported as atypical (Category III) turned out to be adenocarcinoma on histopathology. One case reported as neuroendocrine tumor and two cases reported as adenocarcinoma on cytology displayed features of chronic pancreatitis on histology. One case reported as neoplastic mucinous cyst (Category IV) turned out to be adenocarcinoma on histology (limited concordance). The cytopathologist needs to be wary of the potential pitfalls to improve the diagnostic accuracy of FNACs.

Cytological, Histopathological and Immunohistochemical Studies on Naturally Occurring Cutaneous Melanomas in Cattle in and Around Namakkal, Tamil Nadu, India

Background: Melanomas are tumours that originate from melanoblasts. The studies on bovine tumours are of clinical concern since some melanocytic tumours are congenital and occur in young animals. The present work was carried out to study the pathomorphological characteristics of melanomas in cattle for early diagnosis and intervention. Methods: Tumour samples were collected from suspected cases of neoplasia from four animals during the study period. Data pertaining to the animals were collected. Fine needle aspiration cytology and impression smear were stained with Giemsa stain. Tissue samples were collected in 10 per cent neutral buffered formalin for histopathological examination. Special staining with Fontana silver stain and immunohistochemistry with Melan- A and S- 100 markers for confirmatory diagnosis of melanin pigment was done. Result: Cytology revealed neoplastic cells with vacuolation and pleomorphism. Cytoplasm contained abundant melanin pigments. Microscopically, the cytoplasm contained abundant brown, black coloured melanin pigment granules. Tissue sections stained with Fontana silver impregnation method revealed the presence of black coloured granules. Immunohistochemistry with Melan-A and S-100 revealed strong expression of brown coloured reaction in the cytoplasm of the neoplastic cells.

Grading of Hashimoto’s thyroiditis in cytology and its association with ultrasonographic and biochemical parameters

Introduction and Aim: In the post-iodization period, Hashimoto's thyroiditis (HT) is most likely the most prevalent cause of goitre and hypothyroidism, particularly in women of reproductive years. This study was undertaken to grade HT on Fine Needle Aspiration Cytology smears and determine their usefulness in predicting thyroid damage in association with clinical history, radiological and biochemical findings. Materials and Methods: Total of 151 cases were diagnosed cytologically in duration of over 2 years as Hashimoto’s thyroiditis/lymphocytic thyroiditis. Cytology scoring technique was used to analyse smears and were correlated with radiological, biochemical findings and were evaluated statistically by ANOVA and Kruskal Wallis tests. Results: In the current study, the most frequent group of individuals with Hashimoto's thyroiditis were between the ages of 40 and 50. Females (145 cases, 96%) were commonly affected and the commonest presentation was a diffuse (125 cases ,82.8%) thyroid enlargement. Cytological grading of Hashimoto’s thyroiditis were as follows,54 (35.8%) patients were Grade I, 81(53.6%) patients were Grade II thyroiditis and 16 (10.6%) patients were Grade III thyroiditis. Biochemically, 78 (56.5%) of the cases were hypothyroid, 51 (37%), euthyroid, and 9 (6.5%) were hyperthyroid. Ultrasonography revealed 76 (50.3%) patients with hypoechoic micronodules, 71 (47%) with echogenic septae, 101 (66.9%) with increased vascularity, and 6 (4%) with normal findings. The grades of lymphocytic thyroiditis and the biochemical data were found to be statistically significant (p=0.001). Furthermore, there was a strong correlation between the grades and specific ultrasound findings, such as echogenic septae (p=0.042) and diffuse hypoechogenicity (p=0.046). Conclusion: Cytological scoring system in Hashimoto’s thyroiditis can predict thyroid functional status and aid in determining the severity of the disease.

Role of FNAC in Early Detection and Diagnosis of Lung Lesions with Histo-radiological Correlation and Clinical Insights in a Tertiary Care Centre

Background: Carcinoma of lung has now become increasingly frequent during the last 60 years; this increase is seen in males and especially in the females. Cytological evaluation from respiratory tract is the initial investigation along with radiological investigations in patients suspected to have pulmonary diseases. The various cytological samples included transbronchial needle aspiration, guided fine needle aspiration cytology (FNAC) smears and pleural fluid. Present study was undertaken to study the spectrum of lesions diagnosed by cytomorphological analysis of various cytological samples and correlation of the histopathology, cytology and radiology of lung lesions. Materials and Methods: Centrifuged and direct smears from received samples were stained with MGG and PAP stain. Cytohistological correlation was done when biopsy was available with radiological correlation & comparison of topographic display. Results: Present study was carried out during the period of December 2018 to November 2019. During this period, of total 52 cases, 36 (69.2%) were males and 16 (30.8%) were females. Their age ranged from 26 years to 73 years, most patients (53.8) belonged to the age group of 56 – 65 years. The literacy status of the patients was assessed. 2 out of 52 (3.8%) patients were illiterate, 8 out of 52 (15.4%) patients were educated above H.S. level. Adenocarcinoma was seen to be the most prevalent 29 (55.7%) followed by squamous cell carcinoma 12 (23.0%) among the cases studied. Smoking was seen to be the most common addiction i.e. 34 out of 52 cases (65.4%). Among non-smokers 66.7% presented with adenocarcinoma and 16.6% cases with squamous cell carcinoma. The topography of the neoplasms within the lungs was assessed radiologically. On chest X ray (82.6%) lung lesions were identified; (48%) of patients were found to have pleural effusion. By using CT SCAN, all masses were located definitely. Conclusion: A good correlation between cytology and histopathology is revealed in our study. Guided FNAC helps in early detection and diagnosis of lung lesions and facilitates appropriate management of patients. Keywords: Lung, Carcinoma, Detection, Diagnosis, Fine needle aspiration, Cytology, Histopathology, Radiology, Correlation

Cytological Features of "Non-Invasive Follicular Tumour with Papillary like Nuclear Features" - A Single Institutional Experience in India.

The term noninvasive follicular tumor with papillary-like nuclear features (NIFTP) was introduced as a surrogate for noninvasive encapsulated follicular variant of papillary thyroid carcinoma with a defined set of histopathologic criteria. There are very few studies depicting the cytological cues for the diagnosis of NIFTP. The objective of the study was to determine the spectrum of cytological features in fine needle aspiration cytology (FNAC) smears of cases histopathologically diagnosed as NIFTP. This was a retrospective cross-sectional study conducted over a duration of four years between January 2017 and December 2020. All surgically resected cases (n-21), who met the diagnostic criteria of NIFTP on histopathology and who underwent preoperative FNAC were included and reviewed in the study. Out of a total of 21 cases, at FNAC, diagnosis of benign, suspicious for malignancy, follicular variant of papillary thyroid carcinoma, and classic papillary thyroid carcinoma (PTC) was rendered in 14 (66.6%), 2 (9.5%), 2 (9.5%), and 3 (14.28%), respectively. Scanty cellularity was noted in 12 (57.1%) cases. Papillae, sheets, and microfollicles were seen in 1 (4.7%), 10 (47.6%), and 13 (61.9%) cases, respectively. Nucleomegaly, nuclear membrane irregularities, nuclear crowding, and overlapping were seen in 7 (33.3%), 9 (42.8%), and 9 (42.8%), respectively. Nucleoli, nuclear grooving, and inclusions were seen in 3 (14.2%) 10 (47.6%), and 5 (23.8%) cases, respectively. At FNAC, NIFTP can be found in every category of The Bethesda System for Reporting Thyroid cytopathology (TBSRTC). Nuclear membrane irregularities, nuclear grooving, mild nuclear crowding, and overlapping were noted in a modest number of cases. However, the absence or rare occurrence of features such as papillae, inclusions, nucleoli, and metaplastic cytoplasm may help prevent an overdiagnosis of malignancy.

Clinico-cytomorphological Spectrum of Calcinosis Cutis.

The deposition of calcium in the skin is known as calcinosis cutis. It can affect any part of the body and can mimic soft tissue or bony lesions clinically. To describe the clinical and cytomorphologic features of calcinosis cutis on fine needle aspiration cytology smears. A total of 17 cases reported as calcinosis cutis on fine needle aspiration cytology were reviewed for the available clinical and cytological details. The cohort included both adult and pediatric patients. Clinically, the lesions appeared as painless swellings of variable sizes. The common sites affected were the scrotum, iliac region, scalp, pinna, neck, axilla, elbow, arm, thigh, and gluteal region. Aspirate was chalky white, paste-like in all the cases. The cytologic evaluation revealed amorphous crystalline deposits of calcium along with histiocytes, lymphocytes, and multinucleated giant cells. Calcinosis cutis has a wide spectrum of clinical presentations. Fine needle aspiration cytology is a minimally invasive approach for diagnosing calcinosis cutis, thus eliminating the need for more extensive biopsy procedures.

Study of micronuclei as a potent biomarker in breast cytology aspirates

: Micronuclei scoring can be used as a bio-marker of genotoxic and chromosomal damage. Fine needle aspiration cytology (FNAC) is applied as the primary tool for diagnosis in breast masses because of its ease and rapidity. Micronucleus (MN) scoring is carried out in benign (fibroadenoma) and malignant (infiltrating ductal carcinoma) breast lesions to evaluate the role of Micronuclei as a biomarker in breast carcinomas.: To study Micronuclei (MN) scores as a biomarker on breast cytology aspirated smears. This was a prospective study done for duration of two years in the Department of Pathology, A.C.S Medical College and Hospital, Chennai. The features of micronuclei in 60 breast aspirate smears were studied and compared in benign conditions, proliferative and malignant conditions.The most common diagnosis was of fibroadenoma seen in 38 (63.3%) cases. Adenosis was seen in 10 (16.6%) cases. Usual ductal hyperplasia in 6.6% cases and Invasive ductal carcinomas in 6 (10%) cases. The Average Micronucleus score/1000 cells and the range of micronucleus score was higher in malignancy as compared to benign conditions. : Micronuclei can be used as a biomarker on fine needle aspiration cytology smears of breast lesions. An increase in micronuclei is usually seen in malignant conditions as compared to benign tumours. Attention to features of micronuclei can give a clue to the presence of malignancy.

Evaluation of Fine-needle Aspiration Cytology (FNAC) Sensitivity Compared to PCR for Diagnosing Tuberculosis Lymphadenitis

Background: Tuberculosis (TB) is a major healthcare burden in Sudan and other developing countries, it is considered the second most common cause of death from infectious diseases after those due to AIDS. In Sudan, TB lymphadenitis (TBLA) remains one of the major health problems. This descriptive cross-sectional study was conducted at the University of Medical Sciences and Technology (UMST) and Total Labcare Diagnostic Center (TDC). The study aims to compare the sensitivity of Fine Needle Aspiration Cytology (FNAC) smears with that of the Polymerase Chain Reaction (PCR) for the diagnosis of TBLA. Materials and Methods: Fifty-five dry smears were obtained using fine-needle aspiration (FNA) from an enlarged lymph node. PCR was applied to detect the target gene (IS6110). May-Grunwald-Giemsa (MGG) or Diff quick stains were used. Results: Two (4%) patients with TBLA were non-necrotic, while fifty-three of them (96%) were necrotic. Moreover, 17 (30%) fine-needle lymph node aspiration specimens were confirmed by PCR to be positive for Mycobacterium tuberculosis complex (MTB complex) while 38 (70%) of them were negative. Conclusion: There was no significant difference between the sensitivity of PCR and that of FNAC (P-value = 0.33).

Parasitic infections encountered by a cytopathologist: An institutional experience

Background: Parasitic infections are one of the leading causes of morbidity and mortality worldwide. Cytological examination can be of great help in providing economical, accurate, and fast diagnosis. Aims and Objectives: The aim of the study was to analyze the cytomorphological features of various parasites on fine needle aspirates and vaginal smears. Materials and Methods: This study was a retrospective study of 5.5 years during the time period from July 2015 to December 2020. The study included cases which were already diagnosed as having or suspicious of various parasitic infections on cytological examination. Results: There were total of 37 specimens comprising of 28 fine needle aspiration cytology (FNAC) smears and nine vaginal smears. The parasites on FNAC included 17 cases of cysticercus, eight cases of filariasis, two cases of hydatid disease, and one case of leishmaniasis. All the nine vaginal smears were interpreted as trichomonas vaginitis. Conclusion: Cytomorphological examination helps in early definitive diagnosis and exclusion of various parasitic infections. Diagnosis is important as most of these parasites are treatable and have several systemic ramifications.

Neuroblastoma: Application of International Neuroblastoma Pathology Classification on fine needle aspiration cytology smears

Neuroblastoma (NB) is the fourth most common tumor of childhood. There is a paucity of literature on its subtyping of cytology and prognostic utility. We aimed to study the cytopathological features of NB on the aspirated material, subtype it, and assess the role of International Neuroblastoma Pathology Classification (INPC) classification on cytology smears in the preoperative prognosis of NB. Fifteen cases of NB reported on fine-needle aspiration cytology (FNAC) in the past 3 years were included. Detailed clinical, radiological, and cytological features were noted. Smears were assessed for characteristics such as cellularity, neuroblasts (cytoplasmic, nuclear details), rosettes, neuropil, Schwann cells, fibroblasts, calcification, and necrosis. Afterward, cases were categorized as undifferentiated (UD), poorly differentiated (PD), and differentiating (D) subtypes. Mitotic-karyorrhectic index (MKI) was calculated and correlated with histopathology. Follow-up was done to date. The age ranged from 19 days to 10 years with an M: F ratio of 3:1. Twelve cases were retroperitoneal, two cervical, and one mediastinal. Metastatic disease was seen in six cases, one to the cervical, four to the bone marrow, and two to the scalp. The International Neuroblastoma Risk Group (INRG) staging system was available in all cases, out of which three were in stage L1, six in stage L2, four in stage M, and two in stage Ms. On cytology, four cases were differentiating NB, five PD NB, and six UD NB. The MKI was high (>4%) in 80% of UD, intermediate (2-4%) in 100% of PD, and low (<2%) in 75% of D cases. MKI corroborated in both histology and cytology, except in one case. NB can be subtyped on cytology on the basis of characteristics of neuroblasts, presence of neutrophils, rosettes, and necrosis. UD NB has a high MKI and is associated with a poor prognosis. A preoperative comprehensive reporting of NB on cytology can be very useful in guiding appropriate chemotherapy with some increment in survival. However, larger studies are needed to validate the calculation of MKI on FNA smears.

Tufts of microfilarial worms in cytological aspirate of spermatic cord: A rare case presentation

Filariasis is a major health problem in many tropical countries including India. Most commonly affected organs are lymphatics of lower limbs, retroperitoneal tissue, spermatic cord, epididymis and breast. Despite high incidence, it is infrequent to find microfilariae in fine needle aspiration cytology smears and body fluids. Microfilaremia is usually detected in blood or skin specimens. Cytological examination with FNAC is an investigation of choice especially in patients with evident swelling with difficult clinical diagnosis. We present a case of spermatic cord microfilariasis in a 32 years male presented with right scrotal swelling with dancing filarial sign on ultrasonograpghy, while the peripheral blood smear was negative for the organism.

Comparison of Fluorometric and UV Spectrophotometric Findings for DNA Isolated From Formalin-Fixed Paraffin-Embedded Blocks, Fine Needle Aspiration Cytology Smears, and Blood

Introduction: Fine needle aspiration cytology (FNAC) smear may serve as a convenient sample for DNA extraction for molecular pathology in addition to more commonly used formalin-fixed paraffin-embedded (FFPE) sections. DNA quantification done by fluorometer is more accurate than UV vis spectrophotometer regardless of the source. This study was conducted to compare DNA yield and quality from cytology smears, FFPE sections and peripheral blood using both fluorometer and spectrophotometer. Further, introspection was made to check for the adequacy of DNA extracted from cytology smears with respect to DNA extracted from core biopsies.Method: DNA was extracted from 10 fresh peripheral blood samples, core biopsies and FNAC smears. The DNA was quantified using a fluorimeter and UV vis spectrophotometer in all cases.Results: Statistically significant difference was seen between the data obtained from UV vis spectrophotometry and flourometry. The quantity of DNA extracted from FNAC smears was higher than that of core biopsy as per fluorometry data (mean DNA of core biopsy = 1.9ng/µl, of FNAC = 3.3ng/µl).Conclusion: DNA estimation by fluorometry is more accurate and precise than spectrophotometry in FFPE, FNAC and whole blood samples. DNA yield from FNAC slides is comparable to that from core biopsies.

Application of cell transfer technique in the diagnosis of fine needle aspiration cytology

Objective: To study the application of cell transfer technology to solve the problem of the limited number of fine needle aspiration cytology (FNAC) smears for various immunocytochemistry (ICC) staining and other auxiliary tests, and to enhance accurate cytological diagnosis. Methods: Thirty-four cases of FNAC smears from January 2020 to April 2020 in the Department of Pathology of Beijing Hospital were collected for investigation of the cell transfer technique. The materials in the most cell smear were divided and transferred to several glass slides. After de-staining, the recipient slides were stained with EnVision ICC. The technique was validated by comparing the consistency of the ICC of transferred cell smears and the corresponding immunohistochemical (IHC) staining on biopsies. Results: There were a total of 180 cell transfer slides from 34 cases, of which 174 had the same cell morphology, size and structure as the original smears, with the success rate of cell transfer of 96.7% (174/180). Totally 174 ICC stains were performed on the successfully transferred cell smears, of which 153 smears had available corresponding IHC staining of histologic specimens. Of these, 148 showed concordance between ICC staining and the IHC staining. Cells were successfully transferred in 96.7 % (148/153) of the cell sheets, keeping the same morphology and structure as compared to their original smears. The diagnosis of all 34 FNAC cases was the same to that of their corresponding pathology on biopsies with 100 % concordance. Conclusions: The cell transfer technique is a simple and effective way to make full use of diagnostic cells on a cell smear, and is valuable for accurate cytological diagnosis.

Cytological and histopathological characterization of squamous cell carcinoma from mammary region in a male dog : A case study

Cancer is a fatal malignant disturbance of growth and one of the major causes of morbidity and mortality among canines. Squamous cell carcinoma (SCC) is relatively more common and a highly malignant neoplasm, known to affect dogs. However, SCC of the mammary region is rare in occurrence in both veterinary and human medicine. The present study describes a case of well differentiated SCC of the mammary region in a male dog. An eleven-year-old intact male Pit Bull was presented in Veterinary Polyclinic Lalhri Distt Una, with a history of multiple cutaneous ulcerative lesions in the region of right posterior mammary gland. Fine needle aspiration and touch impression cytology smears were stained with giemsa examined on the day of presentation revealed large number of malignant squamous epithelial cells occurring either individually or in clusters exhibiting marked pleomorphism, anisocytosis and anisokaryosis suggestive of SCC. Surgical resection of the lesion involving mammary tissue was done. The excised mass grossly presented as grayish, irregular in size, lobulated subcutaneous tissue. The representative tissue pieces preserved in 10% neutral buffered formalin were subjected to histopathological evaluation. Histopathological examination revealed cords and nests of proliferating neoplastic cells in the dermis consisting of immature polyhedral cells at the periphery and eosinophilic laminated keratin pearls at the centre separated by thin fibrous tissue stroma confirmed it for well differentiated form of SCC. The diagnosis of a well differentiated SCC was made on the basis of cytological findings and further confirmed on histopathological evaluation besides special staining.

Correlation between bi-rads categories and cytological findings of breast lesions

The Triple Assessment in breast lump diagnosis includes a combined approach by clinical examination, mammosonography and Fine Needle Aspiration Cytology. Correlation between BI-RADS categories & cytological findings are useful approach to establish an accurate preoperative diagnosis and for planning treatment. The present study included 100 patients with palpable breast lesions. Detailed history of patients and mammosonography findings (BI-RADS category) were noted. Fine Needle Aspiration Cytology (FNAC) smears were stained by Pap stain, H & E stain and Giemsa stain. Microscopic examination & reporting were done in correlation with BI-RADS categories. In present study majority of patients were between 41-50 years age with right side predominance. In FNAC findings, 45 patients had malignant lesions (predominantly Ductal carcinoma) & 55 patients had benign lesions (predominantly Fibroadenoma). It showed overall 93% concordance with BI-RADS categories.

Cytologic grading of canine and feline spindle-cell sarcomas of soft tissues and its correlation with histologic grading

In humans, soft tissue spindle cell sarcomas (STSCS) grading is considered a useful parameter in determining prognosis and therapy, and it is recognized as an important prognostic factor in canine STSCS. The purpose of this study was to assess the utility and the accuracy of a cytologic grading system on fine needle aspiration cytology (FNAC) smears of canine and feline cutaneous and subcutaneous STSCS .Thirty-three cases of cytologically diagnosed STSCS were included. The smears and their tumour sections were cytologically and histologically graded, according to established methods in human oncology.Canine STSCS showed a cyto/histologic concordance in 12/20 cases (60%). Concordance was observed in 4/8 (50%) of grade 1, in 8/12 (67%) of grade 2, and in 0 cases of grade 3. Feline STSCS showed concordance in 11/13 cases (85%). Concordance was observed in 5/6 (83%) of grade 1, in 4/4 (100%) of grade 2, and in 2/3 (66.6%) of grade 3 cases. The overall concordance in the entire canine and feline population was 70%. The gradewise concordance was 65% in grade 1, 75% in grade 2, and 66% in grade 3 cases. The overall concordance is similar to that reported in humans. Although a wider population is required to strengthen our findings, these results suggest that cytologic grading of STSCSs may be a useful tool for therapeutic and prognostic evaluations in dogs and cats.

Key Role of Image Guided Fine Needle Aspiration Cytology in Diagnosing Intra-Abdominal Lesions

Background: Masses in the abdominal cavity are often deep, non-palpable and palpable at times which can be inflammatory, benign or malignant. With increased sophistication of radiologic imaging techniques these deep seated lesions are detected more frequently and confirmed tissue diagnosis is essential for both planning of treatment and staging in case of malignant lesions. Image guided aspiration is an effective way to obtain diagnostic material and avoid diagnostic laparotomy. This study was conducted to categorize various intra-abdominal lesions according to their site of involvement, study their cytomorphological features, and classify them as benign, malignant and inflammatory and assess the utility of image-guided cytology in the diagnosis of intra-abdominal lesions. Methods: This cross sectional study approved was done on image guided fine needle aspiration cytology smears of intra-abdominal masses. Age, sex and site details were retrieved from the archives. Hematoxylin and Eosin stained smears were reviewed by the Cytopathologist and diagnosis was arrived at after correlating with clinical and radiological data. Core biopsy or excision biopsy of the available cases were also reviewed and checked for correlation. Result: A total of 120 cases were studied with age ranging from 18-81years, 30% of patients were in the 61-70 years age group, followed by 27% cases in 51-60 years age group and 20% cases in 41-50 years age group. The male to female ratio was 1.03:1. 62.5% of cases were from hepatobiliary region, followed by 17.5% cases from pancreatic masses and 11 cases (9.16%) from ovarian masses. 80% cases were malignant, 10% were inflammatory cases, 9.2% cases were inconclusive and 1 (0.8) benign lesion. Among the malignant lesions primary malignancies (Hepatocellular carcinomas and Adenocarcinomas) were more common than secondary deposits. This study showed 88.9% sensitivity, 83.3% specificity and 87.5% of diagnostic accuracy. Conclusion: Image guided aspiration of intra-abdominal lesion is a simple, economical, less complicated and less time consuming procedure that differentiates between malignant and non malignant conditions with high accuracy and can be used as pre-operative diagnostic procedure for planning further management of patient.

Clinicopathological Study of Mucinous Carcinoma of Breast with Emphasis on Cytological Features: A Study at Tertiary Care Teaching Hospital of South India.

Introduction Mucinous carcinoma (MC) is a rare form of breast cancer. It accounts for 1 to 7% of the cases and characterized by the presence of extracellular mucin (ECM). Depending on the amount of mucin, it is classified into pure mucinous carcinoma (> 90%, PMC) and mixed mucinous carcinoma (MMC; < 90%). In comparison to most common subtypes, MC is having better prognosis. There exist clinicopathological differences among PMC and MMC and also MC and IDC-NOS. Materials and Methods MCs diagnosed between January 2012 and December 2017 were included. Fine needle aspiration cytology smears were screened for cellularity, ECM, nuclear pleomorphism, signet ring cells (SRC), mucinophages, and myxovascular fragments (MVF). Histopathology slides were screened to confirm the diagnosis. Immunohistochemistry slides were graded as per the standard protocol. Statistical analyses were performed by SPSS software. Results In the present study, MC constituted 3.3%. The mean age of the patients was 50.9 years. ECM, mucinophages, and SRC were the key diagnostic cytological features. The PMC and MMC were clinicopathologically distinct with respect to gross findings and lymph node status. MMCs were highly proliferative. The mean duration of follow-up was 24.5 months. Complications were more common in MMC than PMC. Lymph node involvement is the key prognostic factor and it is independent of other prognostic factors like age, size, and hormonal receptor status. Conclusion PMC are rare subtype of breast cancer. The diagnostic cytological features are ECM, MVF, and SRC. MMC and PMC are clinicopathologically and genetically distinct.

Solid variant of papillary thyroid carcinoma: an under-recognized entity.

Solid variant of papillary thyroid carcinoma (SVPTC) is a rare morphological variant of papillary thyroid carcinoma (PTC). SVPTC is histologically characterized by predominant solid, trabecular and insular nests of tumor cells while cytological features of PTC such as nuclear grooves and nuclear inclusions are preserved. In fine needle aspiration cytology smears, tumor cells of SVPTC may be presented in cohesive, syncytial or trabecular clusters accompanied by some discohesiveness in the absence of necrosis. Although SVPTC and poorly differentiated thyroid carcinoma (PDTC) share similar histological findings of solid nests, SVPTC can be differentiated from PDTC in the lack of tumor necrosis, severe nuclear atypia, and a higher mitotic index. Immunohistochemical expression of CK19 and HBME-1, common markers of PTC, is decreased in solid nests of SVPTC. In pediatric patients exposed to radiation after the Chernobyl nuclear accident, there was a higher prevalence of SVPTC with RET/PTC3 type rearrangement. BRAF mutations are also reported in a small number of adult patients with SVPTC without any prior radiation exposure. Patients with SVPTC may have a slightly higher incidence of metastasis and recurrence of the tumor compared to conventional PTC, although overall survival rate is comparable. In this article, the current knowledge of SVPTC will be reviewed and discussed with an emphasis on the histopathological feature.