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ABSTRACT: Fine-needle aspiration cytology (FNAC) of orbital lesions is now increasingly popular. Because of its unique location and the occurrence of varieties of lesions, diagnosis of orbital lesion is a challenge to the cytopathologists. FNAC of orbital and eyelid tumors is a suitable diagnostic technique that necessitates close co-operation between the ophthalmologist and pathologist. No radical procedure should be planned on the basis of FNAC, but it allows the diagnosis of a new primary lesion or the recurrence or metastasis of a tumor and can be done to identify lesions that require either specific medical therapy, as in nonresectable, inflammatory, and lymphoid tumors, or limited surgery for benign resectable neoplasms. With the help of various ancillary techniques a definitive diagnosis is possible on orbital and adnexal lesions. It is essential to have a detailed knowledge on the FNAC of these lesions and their potential pitfalls. In this present review, we have discussed various orbital lesions, their clinical presentations, cytomorphology, and ancillary techniques to confirm the diagnosis. Diagn. Cytopathol. 2013;. © 2013 Wiley Periodicals, Inc.
Diagnostic Cytopathology 03/2013; · 1.16 Impact Factor
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ABSTRACT: Carcinoid of the ovary is an uncommon tumor. In the present article we have described the cytological features of carcinoid of the ovary in a 53-year old post-menopausal female. The patient presented with abdominal discomfort and loose stools. Ultrasound-guided fine-needle aspiration cytology (FNAC) of the left adnexal mass showed clusters and also scattered, relatively monomorphic population of tumor cells with vague rosette-like structures. Cytological diagnosis of malignant ovarian tumor possibly sex cord stromal tumor or carcinoid of ovary was offered and subsequent histopathology and immunohistochemistry confirmed the diagnosis of carcinoid. Diagn. Cytopathol. 2013;. © 2013 Wiley Periodicals, Inc.
Diagnostic Cytopathology 03/2013; · 1.16 Impact Factor
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ABSTRACT: Aim: This study was undertaken to evaluate the diagnostic utility and pitfalls of fine needle aspiration cytology (FNAC) in oral and oropharyngeal lesions. Materials and Methods: This was a retrospective audit of oral and oropharyngeal lesions diagnosed with FNAC over a period of six years (2005-2010). Results: Oral/oropharyngeal lesions [n=157] comprised 0.35% of the total FNAC load. The age ranged 1-80 years with the male: female ratio being 1.4:1. Aspirates were inadequate in 7% cases. Histopathology was available in 73/157 (46.5%) cases. Palate was the most common site of involvement [n=66] followed by tongue [n=35], buccal mucosa [n=18], floor of the mouth [n=17], tonsil [n=10], alveolus [n=5], retromolar trigone [n=3], and posterior pharyngeal wall [n=3]. Cytodiagnoses were categorized into infective/inflammatory lesions and benign cysts, and benign and malignant tumours. Uncommon lesions included ectopic lingual thyroid and adult rhabdomyoma of tongue, and solitary fibrous tumor (SFT), and leiomyosarcoma in buccal mucosa. A single false-positive case was dense inflammation with squamous cells misinterpreted as squamous cell carcinoma (SCC) on cytology. There were eight false-negative cases mainly due to sampling error. One false-negative case due to interpretation error was in a salivary gland tumor. The sensitivity of FNAC in diagnosing oral/oropharyngeal lesions was 71.4%; specificity was 97.8% with diagnostic accuracy of 87.7%. Conclusions: Salivary gland tumors and squamous cell carcinoma (SCC) are the most common lesions seen in the oral cavity. FNAC proves to be highly effective in diagnosing the spectrum of different lesions in this region. Sampling error is the main cause of false-negative cases in this region.
Journal of cancer research and therapeutics 10/2012; 8(4):626-9. · 0.83 Impact Factor
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ABSTRACT: The aim of this study is to compare micronucleus assay in buccal smear of breast carcinoma patients versus normal benign cases as control group. In this prospective study, we selected a total 32 patients of carcinoma of breast and 49 patients of benign breast lesions diagnosed in fine needle aspiration cytology (FNAC). Acridine orange stain was done on buccal smears of these cases and micronucleus (MN) scoring was performed in 40× 0bjective in a fluorescent microscope. The MN score was expressed as positivity per 1,000 cells. The MN scoring in buccal smear was compared in malignant and benign breast cases. In fluorescence microscope, the micronucleus was detected as round orange shaped small intracytoplasmic structure around the nucleus. The mean MN scores in buccal smears of benign and carcinoma cases were 0.5014 ± 0.45768 and 2.1938 ± 1.08656 cases respectively. Independent sample Student's t test showed significantly high MN score in buccal smear of the cancer patients (P < 0.001). Micronucleated cells are significantly increased in buccal cells of the breast carcinoma cases. The increased number of MN in buccal smears raises the possibility that the genetic damage in breast cancer patients is generalized. In future, MN scoring could be used as biomonitoring of DNA damage and in early detection of high risk cases of carcinoma of breast.
Diagnostic Cytopathology 08/2012; 40(8):664-6. · 1.16 Impact Factor
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ABSTRACT: The role of fine-needle aspiration (FNA) cytology in the evaluation of thyroid lesions in not as well established in children when compared with adults. Hence we aimed to ascertain the utility and limitations of FNA in childhood thyroid lesions. This was a retrospective analysis of all thyroid FNA performed in children less than 14 years of age over a 4-year period (2005-2009). Histopathological follow-up was available in six cases. A total of 77 cases were included in the analysis. The most common cytological diagnosis was lymphocytic thyroiditis (49.3%), followed by colloid goiter (18.2%), hyperplasia (10.4%), and benign aspirate (7.8%); malignancy was identified in six cases (7.8%). Of these six cases, three were papillary thyroid carcinoma. There was one false-positive case reported as a Hurthle-cell neoplasm, which on histology showed Hashimoto's thyroiditis. One case each of rhabdomyosarcoma and spindle epithelial tumor with thymus like differentiation was wrongly diagnosed as thyroid neoplasm, NOS, and medullary carcinoma (spindle variant), respectively. The overall diagnostic accuracy was 98.6% with 100% sensitivity, 98.6% specificity, 80% positive predictive value, and 100% negative predictive value. FNA is extremely valuable in the initial evaluation of thyroid swelling in children. Rare neoplasms masquerading as thyroid nodules in children can pose difficulties in diagnosis; however, papillary carcinoma is easily recognized. In lymphocytic thyroiditis, it provides a tissue diagnosis, thereby avoiding more invasive procedure for merely diagnostic purposes.
Diagnostic Cytopathology 05/2012; 40 Suppl 1:E33-7. · 1.16 Impact Factor
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ABSTRACT: To introduce a new field of multifractal spectrum in distinguishing between endometrial well-differentiated adenocarcinoma (WDAC) and complex atypical hyperplasia (CAH).
Thirteen cases of CAH and 16 of WDAC were selected from radical hysterectomy specimens, and multifractal spectrum was measured from at least 4-5 representative digitized images of each case. The data were collected from f(alpha) vs. alpha curves. The values of alpha max, alpha min, and their difference delta alpha (alpha max-alpha min) were recorded and the data compared.
The mean +/- SD of alpha max, alpha min, and delta alpha of CAH were 2.36357 +/- 0.111623, 1.71357 +/- 0.032160, and 0.64214 +/- 0.094248, respectively. The mean +/- SD of alpha max, alpha min, and delta of WDAC were 2.50640 +/- 0.104545, 1.72100 +/- 0.036436, and 0.77620 +/- 0.108268, respectively. The mean of alpha max, alpha min, and delta alpha of WDAC were higher than in CAH. Mann-Whitney U test showed significant difference (p < 0.0001) of alpha max and delta alpja of WDAC and CAH.
Multifractal dimension is significantly different in WDAC and CAH. The multifractal dimension is a new area in pathology. This study demonstrates the potential usefulness of multifractal analysis in histopathology.
Analytical and quantitative cytology and histology / the International Academy of Cytology [and] American Society of Cytology 04/2012; 34(2):105-8. · 0.41 Impact Factor
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ABSTRACT: Hepatoblastoma (HB) is classified into epithelial, mixed (epithelial/mesenchymal), and small-cell (anaplastic) type. Wnt/β-catenin pathway plays a key role in hepatic development, regeneration, and tumorigenesis, and HB is known to present β-catenin mutations (50-90%). The present study was undertaken to delineate the cytomorphologic features of HB and to evaluate the feasibility of subtyping of HB on fine-needle aspiration cytology (FNAC). The expression of β-catenin in these tumors was also evaluated both of histopathologic sections and on the aspirated material. Thirty-three cases with fine-needle aspirates of HB were retrieved over a period of 12 years. Cytologic diagnosis was reviewed in the light of clinicoradiological data, response to therapy, and subsequent histopathology. Immunochemistry for β-catenin was performed in 19 of 33 cases on histopathologic sections (n = 10)/cell blocks (n = 6)/cytosmears (n = 3). Based on the cytologic features, the cases were divided into fetal HB (n = 17), embryonal HB (n = 4), combined epithelial HB (n = 8), and mixed HB (n = 4). Four cases of histopathologically proven mixed HB were reported as pure epithelial HB on FNAC, as mesenchymal elements were not represented in the cytology smears. Cytoplasmic as well as nuclear staining for β-catenin was noted in a total of 10 of 19 cases. FNAC can accurately categorize epithelial HB; however, in mixed type, the accuracy depends on number of areas sampled. Cell block can be of help to perform ancillary investigations especially β-catenin for both diagnostic and therapeutic purposes. Cytopathol. 2012; © 2012 Wiley Periodicals, Inc.
Diagnostic Cytopathology 02/2012; · 1.16 Impact Factor
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Diagnostic Cytopathology 02/2012; · 1.16 Impact Factor
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ABSTRACT: To study the morphometric features of insular carcinoma (IC) of thyroid and follicular carcinoma (FC) in fine needle aspiration cytology (FNAC) smear to evaluate the role of the morphometric features to distinguish these two groups. We performed image morphometry in Hematoxyline and Eosin stained FNAC smears of eight each histopathology proven cases of IC and FC of thyroid. Nuclear area, diameter, perimeter, and standard deviation of nuclear area (SDNA) of these two groups were studied and compared. Nuclear area, diameter, perimeter, and SDNA of IC and FC were 30.43 μ(2) , 7.31 μ, 23.01 μ, 8.81 and 38.43 μ(2) , 7.66 μ, 25.63 μ, 10.83, respectively. Student's t-test analysis did not show any significant difference (P > 0.05) in these two groups. Nuclear morphometry data indicate that the nuclear size and shape of IC and FC are essentially similar and it is not possible to differentiate these two entities with the help of image morphometric data.
Diagnostic Cytopathology 02/2012; 40(2):188-9. · 1.16 Impact Factor
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ABSTRACT: The aim of this study was to explore the role of fractal dimension (FD) of chromatin texture in routinely stained Papanicolaou's smears and to distinguish the different grades of cervical intraepithelial lesions and normal cervical cells. We selected 14 each cases of normal, low grade cervical intra epithelial lesions (LSIL), and high-grade cervical intra epithelial lesions (HSIL) of Papanicolaou's stained cervical smears. Fractal dimension of the pseudo three-dimensional grey image of the nuclear chromatin was measured in 140 nuclei of each group. Mean FD of the normal cases, LSIL cases, and HSIL cases were 2.4225 ± 0.06410, 2.5159 ± 0.03291, and 2.5905 ± 0.06840, respectively. ANOVA test showed significant differences of mean FD in all these three groups (P < 0.000). Fractal dimension of the chromatin texture is easy to perform and can be done in routinely stained Papanicolaou's smear. It is reproducible and gives valuable information about the chromatin texture of the nucleus. In future, this promising variable can be incorporated along with other image morphometric features for accurate classification of dysplastic cells in cervical smear.
Diagnostic Cytopathology 02/2012; 40(2):152-4. · 1.16 Impact Factor
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ABSTRACT: To evaluate the role of micronuclei (MN) scoring in urinary cytology of bladder transitional cell carcinoma (TCC).
Eighty cases of freshly voided urine samples were used for scoring of MN using acridine orange (AO)-stained smears under fluorescence microscope and routine Papanicolaou-stained smears under light microscopy. MN score for cytologic lesions was compared.
In AO-stained slides, the mean MN scores were 0.171 +/- 0.395 and 1.489 +/- 1.871 in smears with "no malignant cells seen" and TCC cases, respectively. In Papanicolaou-stained slides the mean MN scores were 0.194 +/- 0.419 and 1.84 +/- 1.876 in smears with "no malignant cells seen," and TCC cases, respectively. Independent sample t test showed significant difference of MN scoring in Papanicolaou-stain and AO stain in no malignancy vs. TCC. Pearson's correlation test showed strong positive correlation between mean MN score by AO and Papanicolaou stains and Pearson's correlation coefficient.
MN score was significantly high in TCC cases, which may be due to chromosomal damage in bladder carcinoma. In difficult cases, MN may help distinguish benign from malignant cells in urine samples. Routine Papanicolaou stain may also be used for MN score because DNA-specific AO-stained smear gives almost similar results.
Analytical and quantitative cytology and histology / the International Academy of Cytology [and] American Society of Cytology 02/2012; 34(1):56-60. · 0.41 Impact Factor
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ABSTRACT: Micronucleus (MN) is a small additional nucleus and is readily identifiable by light microscopy. Biologically, micronuclei are the chromosome fragments or whole chromosomes that lag behind at anaphase during nuclear division. MN occurs due to genetic damage of the cell and the MN scoring is the indicator of the genetic damage. Therefore MN scoring can be used in various clinical setting such as to supervise genotoxicity, biomonitoring of diseases, screening of preneoplastic diseases and identification of high risk patients. In this brief review, the morphology, etiology, estimation, and applications of MN have been discussed.
Diagnostic Cytopathology 01/2012; 40(1):84-90. · 1.16 Impact Factor
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Diagnostic Cytopathology 12/2011; · 1.16 Impact Factor
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ABSTRACT: Calcinosis cutis is characterized by deposition of calcium salts in the subcutaneous tissues in the body. In this study, we described a case of calcinosis cutis that was diagnosed by fine needle aspiration (FNA) in a 15-year-old male. The patient presented with multiple nodules over right forearm and right knee. FNA smears showed flakes of amorphous material indicating calcium along with few macrophages. The presence of amorphous calcium salts along with histiocytes in the appropriate clinical settings is diagnostic of calcinosis cutis.
Diagnostic Cytopathology 12/2011; 39(12):917-8. · 1.16 Impact Factor
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ABSTRACT: Herein, we described a case of a 29-year-old female with a large ovarian mass. Fine needle aspiration cytology (FNAC) of the mass showed discrete round to oval cells in a fatty vacuolated background. FNAC diagnosis of dysgerminoma was suggested. The histology of the tumors showed features of poorly differentiated Sertoli-Leydig cell tumors. We discussed the diagnostic pitfalls of this case on FNAC. Diagn. Cytopathol. 2011. © 2011 Wiley Periodicals, Inc.
Diagnostic Cytopathology 11/2011; · 1.16 Impact Factor
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ABSTRACT: To build an artificial neural network (ANN) model for the detection of carcinoma in effusion cytology.
We selected a total of 114 effusion cytology cases consisting of 57 each benign and malignant case. In all these cases, detailed cytological features, image morphometric data, densitometric data, and chromatin textural data were collected. Based on these data, we made a back propagation ANN model for diagnosing malignancy in effusion cytology. This network was designed as 25-2-1 (input nodes-hidden nodes-output node). Online back propagation method was applied for training the network. The training of the network was continued until the network error was reduced to 0.000654. Simultaneously, we also performed logistic regression (LR) analysis test to compare with ANN model performance.
ANN model worked excellent after adequate training. With the help of this model, it was possible to identify correctly all the malignant cases in validation and test set. The result of the multivariate LR analysis was also similar as that of ANN model and all the cases were also classified correctly.
In this study, we successfully constructed an ANN model to diagnose metastatic carcinoma in effusion cytology. ANN is very promising in the diagnosis of metastatic carcinoma in effusion cytology. In future, ANN model may help the cytopathologist to diagnose the difficult cases in effusion fluid.
Cytometry Part B Clinical Cytometry 11/2011; 82(2):107-11. · 2.53 Impact Factor
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ABSTRACT: In this article, we have described an extremely uncommon entity of adrenal rest in testis in fine-needle aspiration cytology in a 7-year-old male child with symptoms of precocious puberty. The patient had a raised serum testosterone level along with a well-defined solitary mass in the testis. Fine-needle aspiration cytology smears show a dispersed population of large cells with abundant finely granular cytoplasm, eccentric nuclei, coarse nuclear chromatin, and multiple prominent nucleoli. Considering the clinical, radiological, biochemical, and also cytological features, a diagnosis of adrenal cell rest was made.
Diagnostic Cytopathology 11/2011; 39(11):849-51. · 1.16 Impact Factor
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ABSTRACT: In this study, we applied artificial neural network (ANN) for the diagnosis of lobular carcinoma in fine-needle aspiration cytology (FNAC) material. We selected a total of 64 cases of histology proven breast lesions consisting of 20 fibroadenomas, 28 infiltrating ductal carcinomas (IDC), and 16 infiltrating lobular carcinomas (ILC). Detailed cytomorphological features were studied on representative Haematoxylin-Eosin (H&E) and May-Grunwald Giemsa stained slides. Image morphometric analysis was performed on Haematoxylin-Eosin stained smears to study nuclear area, diameter, perimeter, roundness, convex area, and convex perimeter. Both the qualitative cytological features and objective morphometric data were collected and a total of 18 variables were studied. Back propagation ANN was designed and this data were used as input values. ANN network was designed as 34-17-3. There were a total of 34 first layers neurons, 17 hidden neurons and three output neurons. The total cases were randomly divided automatically by the program into three groups: training set (40), validation set (8), and test set (16). After the successful training, the program was able to differentiate all the benign and lobular carcinoma cases and majority of the ductal carcinoma cases. In test set, the ANN program successfully classified all the cases of benign, and ILC cases and six of seven IDC cases. A suitably designed ANN may be able to diagnose the lobular carcinoma of breast on FNAC material. ANN is an efficient software program with immense potential. Diagn. Cytopathol. 2011;. © 2011 Wiley-Liss, Inc.
Diagnostic Cytopathology 10/2011; · 1.16 Impact Factor
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ABSTRACT: Chromosomal instabilities (CIN) manifesting as structural or numerical alterations in the chromosomes are common in malignancies like breast cancer. Assessment of CIN in breast cancer may help to understand its etiopathogenesis. Micronucleus (MN) scoring and aneuploidy have been used to assess the presence of CIN in lymphocytes of various malignancies in the past. In this study, spontaneously occurring MN were counted in epithelial cells on fine needle aspiration cytology (FNAC) smears from 50 patients with benign and malignant breast lesions. Further, the ploidy status and S-phase fraction (SPF) of the samples was determined by flow cytometry. All these were then correlated with grades of breast cancer at cytology. Most IDC cases showed variable number of MN (n = 16, MN mean = 9.3), in contrast to the benign lesions (n = 26) where they were consistently absent. Aneuploidy and SPF analysis also showed a significant difference between benign (n = 10, mean DNA index [DI] = 0.96 ± 0.04, mean SPF= 8.07% ± 2.93) and malignant (n = 10, mean DI = 1.5 ± 0.41, mean SPF = 25.05% ± 10.35) lesions. On statistical analysis, a positive correlation was observed between the grades of IDC and presence of aneuploidy and high SPF (P-values < 0.05); however, the difference between the MN scores of grade 2 and 3 cancers was not significant. The study suggests that MN scoring and aneuploidy may be used to assess the presence of underlying CIN in IDC on FNAC smears. Further, collectively they may be explored for their role as biomarkers for predicting the tumor behavior in the breast cancer patients. Diagn. Cytopathol. 2011; © 2011 Wiley-Liss, Inc.
Diagnostic Cytopathology 10/2011; · 1.16 Impact Factor
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Diagnostic Cytopathology 09/2011; 39(9):711-3. · 1.16 Impact Factor
