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Publications (396)
Lymphoepithelial carcinoma (LEC) of salivary glands are rare tumours and present as gradually progressing painless masses. LECs have good prognosis and accurate differentiation from secondary tumours and nasopharyngeal carcinoma is essential to dictate management. We present a case of an elderly male presenting with a parotid swelling diagnosed as...
Background
After a series of standardized reporting systems in cytopathology, the Sydney system was recently introduced to address the need for reproducibility and standardization in lymph node cytopathology. Since then, the risk of malignancy for the categories of the Sydney system has been explored by several studies, but no studies have yet exam...
Objectives
Immunosuppressed individuals are more prone for opportunistic infections. Pneumocystis jiroveci pneumonia (PJP), previously known as Pneumocystis carinii pneumonia (PCP), is the most common opportunistic infection affecting people living with HIV. As PJP can cause life threatening serious infection to a patient, treatment should not be d...
Objective:
Adult granulosa cell tumors (AGCTs) are rare ovarian malignant neoplasms; their etiopathogenetic mechanisms remain largely unelucidated. Lately, defects in mismatch repair (MMR) have been implicated in the pathogenesis of AGCTs. Demonstration of MMR deficiency in these tumors can help identify patients potentially eligible for immune ch...
Objective To evaluate the role of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of solid pancreatic head lesions (SPHL).
Methods This prospective study comprised consecutive patients with SPHL who underwent CEUS evaluation of the pancreas. Findings recorded at CEUS were enhancement patterns (degree, completeness, centripetal enh...
Objectives
Bone is a frequent site of metastases and typically indicates a short-term prognosis in cancer patients. The majority of skeletal metastases are due to breast and prostate cancer. Bone metastasis is actually much more common than primary bone cancers, especially in adults. Fine-needle aspiration cytology (FNAC) provides reasonably accura...
Context:
Liquid-based cytology (LBC) is a cyto-preparatory technique that may be applied to fine-needle aspiration (FNA) samples. However, its efficacy over conventional smears (CS) in thyroid is controversial.
Aims:
The aim of this study was to compare CS versus LBC (SurePath, BD) preparations in thyroid FNA samples for diagnostic efficacy.
Se...
Orbital metastasis, as the initial clinical presentation in hepatocellular carcinoma (HCC), is a rare manifestation. A 66-year-old male patient presented with a history of protrusion of the eyeballs, double vision, and swelling over the left side of the head for 8 months. Magnetic resonance imaging of the brain with orbit revealed a heterogeneous l...
Objectives
Peritoneal fluid cytology is done routinely in cases with serous carcinoma of ovary. However, morphologic features of borderline serous tumors (BSTs) of ovary in ascitic fluid have been rarely described. The aim of our study was to evaluate the morphologic features of BST with and without ascitic fluid involvement (BST+ and BST-, respect...
Sebaceous carcinoma of the ocular adnexa is a rare malignant neoplasm. These lesions have high morbidity and mortality owing to clinical resemblance with benign and non-neoplastic lesions. A female presenting with a painless lower lid mass masquerading a chalazion, showed loose cohesive clusters of tumour cells with hyperchromatic nuclei, conspicuo...
Small cell neuroendocrine carcinoma (SCNEC) of the cervix is a rare, highly aggressive tumour with poor prognosis and high propensity for distant metastases. The cytological features of SCNEC have rarely been described in cervical samples, and to the best of our knowledge, there are no previous reports using SurePath™ liquid-based cytology. In the...
Context:
Fine-needle aspiration cytology (FNAC) is a rapid and accurate first-line diagnostic modality in lymphadenopathy.
Aims:
To determine the utility of FNAC for the diagnosis of lymphoma and highlight the various pitfalls in morphological interpretation.
Settings and design:
This was a retrospective study of 3 years duration in which cyto...
Objective:
Determination of the molecular status is mandatory for personalized treatment of patients with non-small cell lung carcinoma. The present study was performed to detect anaplastic lymphoma kinase (ALK) rearrangements in pulmonary adenocarcinoma on cytology samples, using immunocytochemistry (ICC) and fluorescence in situ hybridization (F...
Introduction:
The present study was undertaken to assess the accuracy of fine needle aspiration cytology (FNAC) and cell-block immunocytochemistry, and to estimate the risk of malignancy, using a categorical reporting system, in the diagnosis of ovarian masses.
Methods:
This was a 5-year retrospective study of FNAs of ovarian masses. The cytolog...
Candidal peritonitis is a rare entity usually occurring in patients undergoing repeated peritoneal dialysis. The condition is associated with high morbidity and mortality despite aggressive anti‐fungal treatment; hence, establishing a prompt diagnosis is essential for better patient outcome. A case is described in a young female which was diagnosed...
Steroid cell tumors of the ovary are rare sex-cord stromal tumors, accounting for approximately 0.1% of all ovarian neoplasms. Majority of these tumors are benign, occur in pre-menopausal women and are associated with hyperandrogenism. However, around one-third of cases are malignant and do not present with hormonal manifestations. A 48-year-old po...
BACKGROUND
Fine‐needle aspiration cytology (FNAC) is one of the most commonly used techniques for evaluating lymphadenopathy. Recently, the Sydney system was proposed for assessing the performance, classification, and reporting of lymph node (LN) cytopathology. The present study was conducted to assess the risk of malignancy associated with each of...
Objective
Paediatric malignant renal neoplasms are subjected to neoadjuvant chemotherapy as per Societe Internationale d'Oncologie Pediatrique; International Society of Pediatric Oncology (SIOP) protocol. An accurate tissue diagnosis is required prior to institution of chemotherapy, and hence the aim of this study was to evaluate the diagnostic acc...
Objective
Juvenile granulosa cell tumor(JGCT) is an uncommon ovarian sex-cord stromal tumor, with diverse clinical, radiological and histopathologic features. The present study describes the clinicopathological and histomorphological spectrum of JGCTs, and highlights the key differentiating features from its mimics.
Methods
A retrospective analysi...
Introduction
Involvement of body fluids by lymphoreticular malignancies (LRM) is rare and often associated with poor prognosis and decreased overall survival. The present study was conducted to analyze the characteristic cytomorphologic, flow cytometric and immunocytochemical features of LRMs in serous effusions.
Materials and methods
This was a t...
Aim
PD‐L1 immune check‐point inhibitor expression was evaluated in high grade serous carcinoma (HGSC) ovary in the context of the overall immune landscape to determine its prognostic value.
Methods
Consecutive cases of HGSC, 50 who underwent upfront surgery followed by adjuvant chemotherapy (HGSC‐U) and 50 who underwent neo‐adjuvant chemotherapy (...
A 17‐years‐old male presented with right parotid region swelling for one year which was gradually increasing in size. There was no history of fever, cough, dysphagia, dyspnoea, change in voice or facial weakness. On examination, the swelling was 3x3 cm, with restricted mobility. Fine needle aspiration (FNA) done outside was reported as Spindle cell...
Objective:
Comparison of virtual CT enteroscopy (VCTE) using carbon dioxide with small-bowel enteroclysis (SBE) and capsule endoscopy (CE) in small-bowel tuberculosis (SBTB).
Methods:
This prospective study comprised consecutive patients suspected to have SBTB. VCTE and SBE were performed on the same day and evaluated by independent radiologists...
Introduction
Any type of cutaneous metastasis indicates dismal outcome of the disease. Skin is an unusual location for metastatic deposits from any tumour and has an incidence of about 0.8%‐5%. Fine needle aspiration cytology (FNAC) helps in the rapid diagnosis of metastasis with minimum pain.
Aim
To study the cytomorphological spectrum of cutaneo...
Giant‐cell tumour involving the calvarial bones is extremely rare. This case of a young man with unilateral hearing loss and earache associated with a mass over the temporal region was accurately diagnosed pre‐operatively by fine needle aspiration cytology. Knowledge of the characteristic cytological features can help to distinguish it pre‐operativ...
Renal angiomyolipoma (AML) is a rare, benign mesenchymal neoplasm which can occur sporadically or in association with tuberous sclerosis complex. In the absence of typical radiologic features, a definitive diagnosis of AML requires microscopic examination of the tumor tissue supplemented by cell‐block immunocytochemistry.
Background:
Fine needle aspiration is a well-established technique for evaluating primary and secondary bony lesions. With use in selected cases, it achieves a diagnostic yield comparable to biopsies.
Methods:
Cases of osteosarcoma with available histological follow-up were retrieved over a ten-year period. Detailed morphological evaluation was...
Background:
Bacille Calmette-Guerin (BCG) adenitis is a common complication of post-BCG vaccination. Awareness of this lesser known entity in fine-needle aspiration (FNA) is important to prevent misdiagnosis.
Aim:
This study described the clinical presentation, cytomorphological features and disease pattern in patients with BCG adenitis.
Materi...
Ameloblastomas are rarely encountered in clinical practice, accounting for only 1% of tumors and cysts of the jaw although they are one of the most common odontogenic neoplasms. The cytological features are described in a few case reports only. The aim of this study was to describe the morphological features of ameloblastoma in fine‐needle aspirati...
Epithelial-myoepithelial carcinoma (EMC) is a rare, low-grade, malignant salivary neoplasm. Establishing an accurate cytological diagnosis is often challenging owing to its rarity, bland cytologic appearance and variable representation of cell populations in the smears. The diagnostic struggle is more so when the aspiration is from a metastatic sit...
Background
Small cell carcinoma of ovary (SCCO) is extremely rare. Two types of SCCO are recognized, the pulmonary type (SCCOPT) and the hypercalcemic type (SCCOHT). Establishing an accurate diagnosis is challenging, owing to its rarity and paucity of data describing the distinctive histopathologic and immunohistochemical (IHC) features.
Methods
T...
A 28‐year old female presented with complaints of abdominal pain for 2 weeks and vomiting for 1 week. Abdominal ultrasonography (USG) revealed a 3x3 cm space‐occupying solid lesion with necrotic areas in the pancreas. The patient was a known case of Ewing sarcoma of the pubic bone, diagnosed one year previously. USG guided fine‐needle aspiration (F...
Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon, benign, inflammatory disorder involving the skin and microvasculature with an undetermined etiopathogenesis. Although the histopathology is well‐characterized, the cytologic features of this entity have been rarely described in literature. This study was conducted to describe in det...
Background
Bronchoalveolar lavage (BAL), is a safe, minimally invasive procedure to sample the terminal airways and the lung parenchyma. Although frequently used, there is lack of contemporary literature regarding the diagnostic utility of BAL for various pulmonary diseases. This study was conducted to evaluate the utility of BAL in diagnosis of va...
Objective:
The aim of the study was to study the clinical and morphological spectrum of histoplasmosis diagnosed by fine needle aspiration cytology (FNAC).
Study design:
A total of 17 patients diagnosed with histoplasmosis on FNAC were studied over a period of 5 years. The cytology smears were studied and analysed for the cytomorphological spect...
Langerhans cell histiocytosis (LCH) is a clonal proliferative disorder of the antigen presenting Langerhans’ cells, predominantly occuring in children with rare cases in adults. A definitive cytologic diagnosis can be established on the basis of characteristic cytomorphology and immunocytochemical features. We present a case of an adult male presen...
A 50‐year‐old man presented with loss of weight, appetite and fever, weakness and malaise. The patient was a known case of lepromatous leprosy (LL) diagnosed clinically and histopathologically, a year back, completed treatment and now presenting with recurrent episodes of high‐grade fever with lymphadenopathy. He was clinically diagnosed as having...
Background:
The evaluation of lymph nodes (LN) by fine-needle aspiration cytology (FNAC) is routinely used in many institutions but it is not uniformly accepted mainly because of the lack of guidelines and a cytopathological diagnostic classification. A committee of cytopathologists has developed a system of performance, classification, and report...
Fine needle aspiration biopsy cytopathology (FNAC) of lymph nodes is a very common, inexpensive, and rapid diagnostic procedure and can lead to the accurate and timely diagnosis of one of the wide range of pathological processes that involve lymph nodes. These diagnoses include specific reactive processes, specific infections such as tuberculosis,...
Venous leiomyoma is an extremely rare entity. We present an interesting case of femoral vein leiomyoma that could be accurately diagnosed pre‐operatively based on fine needle aspiration cytology supplemented by immunocytochemistry. The present case demonstrates that a multimodal approach involving appropriate radiologic investigations and fine need...
Aims and objective
To determine the diagnostic efficacy of fine needle aspiration cytology (FNAC) in cases of pancreatic solid pseudopapillary neoplasm (PSPN) with emphasis on the cytomorphologic features and to evaluate the contribution of immunochemistry on FNAC cell block (CB) in cases of PSPN.
Material and method
It is a retrospective study in...
PurposeThis institutional audit was conducted to analyze the surgical and survival outcomes in advanced epithelial ovarian cancers treated with neoadjuvant chemotherapy and interval debulking surgery.Methods
Clinical records of patients of advanced epithelial ovarian cancers treated between January, 2011, and December, 2014, were retrospectively re...
Objectives:
High-grade serous carcinoma (HGSC) is the most common ovarian malignancy. The role of cytopathology in obtaining tissue diagnosis before institution of neoadjuvant chemotherapy (NACT) was evaluated.
Methods:
All histopathology-proven HGSC specimens between 2015 and 2018 with prior cytopathologic diagnosis by ascitic fluid evaluation...
Background
Exfoliated endometrial cells are often seen as hyperchromatic crowded groups (HCGs) in cervical samples. It is challenging for the cytopathologists to discriminate between HCGs of benign and malignant endometrial cells. Fractal dimension (FD) analysis has proved to be a useful tool in discriminating between different types of cell groups...
Hepatoblastoma, is a rare primary hepatic malignancy, most commonly seen in infants and children less than 3 years of age. We present a rare case of mixed fetal‐embryonal hepatoblastoma, diagnosed on fine needle aspiration cytology supplemented by immunocytochemistry on cell‐block. Knowledge of the characteristic cytomorphologic and immunocytochemi...
Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) is presently the preferred modality for sampling mediastinal lymph nodes. There is an unmet need for standardization of processing and reporting of cytology specimens obtained by EBUS-TBNA. The manuscript is a state-of-the-art review on the technical aspects of processin...
Secretory carcinoma is a recently described salivary gland neoplasm that shares the same histologic appearance and ETV6 gene (12p13) rearrangement as secretory carcinoma of the breast.Establishing a definite diagnosis requires microscopic examination and immunohistochemical confirmation. The major cytologic differential diagnoses include myoepithel...
COVID-19, caused by the SARS-CoV-2 virus, has been declared a pandemic by the World Health Organization. This scenario has impacted the way we practice cytopathology. Cytology laboratories receive fresh and potentially infectious biological samples including those from the respiratory tract, from COVID-19 positive or suspected patients. Hence, the...
Mesoblastic nephroma (MN), also known as congenital mesoblastic nephroma or fetal renal hamartoma, is a rare renal mesenchymal tumor with low malignant potential, occurring most commonly in infants. We present a rare case of cellular mesoblastoma, which could be diagnosed on fine needle aspiration cytology complemented with cell‐block immunocytoche...
Background
The majority of patients in low‐ and middle‐income countries (LMIC) are unable to receive optimal therapy, including autologous stem cell transplant (ASCT) for high‐risk neuroblastoma. Management is intensive and multidisciplinary; survival is often poor. We report a single‐center outcome of high‐risk neuroblastoma, with adaptations opti...
Ovaries are a common niche for metastasis. Metastatic malignancies account for 5-30% of all ovarian malignancies. Hepatocellular carcinoma (HCC) is one of the rare malignancies to metastasize to the ovaries. Of all the variants of hepatocellular carcinoma, fibrolamellar variant (FLHCC) is extremely uncommon and accounts for around 1% of all HCC cas...
Tuberculosis of the female genital tract is often difficult to diagnose owing to the variable and non‐specific clinical presentations in these patients. Cervical tuberculosis is rare and a proportion of these patients may present with cervical growth, which may clinically mimic cervical carcinoma. Cervical Papanicolaou smear examination is a non‐in...
A 49‐year male presented with a firm, nodular swelling measuring 1.5 cm diameter over the right parotid region for six months with a recent increase in size. There was no associated pain, fever, or tenderness in the affected area. There was no evidence of any facial nerve palsy. Fine needle aspiration cytology (FNAC) was performed from the swelling...
Introduction:
Hydatid disease (HD) is caused by the tapeworm of the genus Echinococcus. Fine-needle aspiration cytology (FNAC) is an expedient diagnostic technique that may be used for its rapid diagnosis.
Aim:
To study the clinical and cytomorphological spectrum of HD diagnosed by cytology.
Material and methods:
A total of 24 patients diagnos...
A 54-year male presented with fever for 2 weeks and altered sensorium for 1 week. There was history of loss of weight. A lumbar tap was done, and CSF was sent to the cytology laboratory. Cerebrospinal fluid (CSF) cytospin smears were prepared and stained with Papanicolaou and May-Grunwald-Giemsa (MGG) stains.
Background:
Neuroendocrine carcinomas (NEC) are rare tumours with multiple morphologic mimics. The cytologist may miss these cases if not aware.
Aims and objects:
We focused upon the clinical presentation, cytological features and problems in the diagnosis of NEC.
Materials and methods:
We studied the detailed cytomorphology of 19 cases of NEC...
Cytological examination plays an important role in the initial work-up of the serous cavity effusion fluids to find out the possible etiology as benign or malignant. Among malignant effusions, cytology is helpful in determining the exact type, site, and stage of the tumor. However, for reporting effusion cytology specimens, there is no consistent a...
Objective: Cervical cytology and Human papillomavirus (HPV) testing are effective screening techniques but both have limitations. A few recent studies in the literature have highlighted the role of co-expression of p16INK4a and Ki-67 for cervical cancer screening. The present study was undertaken to evaluate the diagnostic performance of the CINtec...
Cytological examination plays an important role in the initial work-up of the serous cavity effusion fluids to find out the possible etiology as benign or malignant. Among malignant effusions, cytology is helpful in determining the exact type, site, and stage of the tumor. However, for reporting effusion cytology specimens, there is no consistent a...
Introduction:
Hematopoiesis usually occurs in bone marrow in adults and when it occurs at sites except for bone marrow, it is termed as extramedullary hematopoiesis (EMH). It is usually found in organs, which are vigorously involved in fetal hematopoiesis, including liver, spleen, and lymph nodes. FNAC is easy and rapid method to diagnose EMH.
Ai...
Aim:
To explore the cytological spectrum of the gastrointestinal stromal tumour (GIST) including its metastatic sites.
Material and methods:
A Total of 42 patients (45 sites) diagnosed with GIST or its metastases on fine-needle aspiration cytology (FNAC) were studied over a period of 5 years. May Grunwald Giemsa (MGG) and Hematoxylin and Eosin s...
Introduction:
Adenoid cystic carcinoma is a ubiquitous tumour which can occur in several sites of the human body. Commonly, it affects the salivary glands but can rarely occur in various extra-salivary locations also.
Aim:
To study the clinical and cytological features of extra-salivary adenoid cystic carcinoma (ACC) on fine-needle aspiration cy...
Background:
Tubercular lymphadenitis (TBLA) is one of the most common extrapulmonary manifestations of tuberculosis in patients with HIV. With several other pathological conditions presenting as lymphadenitis and lack of consensus regarding a gold standard test, the diagnosis of TBLA remains a challenge for the clinician.
Objectives:
and design:...
Background: Adenoid cystic carcinoma (ACC) is a malignant neoplasm involving mainly the exocrine glands. The most common site of involvement is the head and neck region. However, the neoplasm can be seen rarely arising in the breast, lacrimal gland, trachea–bronchial tree, lungs, cervix, brain and paranasal sinuses. Bartholin's glands in the vulva...
Patients with non‐small cell lung carcinoma (NSCLC) with mutations in the epidermal growth factor receptor (EGFR) gene show a remarkable initial response to treatment with EGFR‐tyrosine kinase inhibitors. However, inevitably, within a few months, acquired resistance develops and the disease starts progressing again. We present a rare case of SCLC t...
Splenic involvement by lymphomas is rare. Secondary involvement of the spleen in lymphomas is more commonly seen as a part of the disseminated disease in contrast to primary splenic lymphomas. Non‐Hodgkin's lymphomas are more common in spleen as compared to Hodgkin's lymphoma. Herein, we present a case of splenic Hodgkin's lymphoma in a young adult...
Primary ovarian non-Hodgkin lymphoma (PONHL) is extremely rare, accounting for 0.5% of all NHLs and 1.5% of all ovarian tumors. Establishing an early and accurate clinical as well as histopathological diagnosis, although challenging, is essential for the appropriate management of these patients and to avoid unnecessary surgeries. Furthermore, it is...
Introduction:
Malignant melanoma accounts for around 3% of all malignancies. Fine-needle aspiration cytology (FNAC) is a convenient diagnostic procedure for the diagnosis of melanoma and its metastases.
Aim:
To explore the cytological spectrum of malignant melanoma including the rare metastatic sites.
Material and methods:
A total of 51 patien...
Exfoliated tumor cells from extrauterine origin are rarely identified in the cervical samples, however, may represent the first manifestation of an underlying malignancy. The present case describes the distinctive cytomorphologic features of a low‐grade ovarian serous carcinoma metastasizing to the cervix in the SurePathTM preparation and highlight...
Objective:
The aim of this analysis was to describe the cytopathology spectrum of peripheral neuroblastic tumours including neuroblastoma (NB), ganglioneuroblastoma (GNB) and ganglioneuroma (GN). Feasibility of applying the International Neuroblastoma Pathology Classification (INPC) to further subtype neuroblastic tumours in cytology was evaluated...
Small cell carcinoma of the ovary is an extremely rare ovarian malignancy with an aggressive clinical course. Establishing an early and accurate clinical diagnosis is challenging, owing to the rarity and non‐specific clinical presentations. Definite diagnosis can be established by cytologic or histopathologic examination of the tissue followed by i...
Objective:
There is a need to develop and validate biomarkers for treatment response and survival in tubo-ovarian high-grade serous carcinoma (HGSC). The chemotherapy response score (CRS) stratifies patients into complete/near-complete (CRS3), partial (CRS2), and no/minimal (CRS1) response after neoadjuvant chemotherapy (NACT). Our aim was to revi...
Swyer syndrome also known as pure or complete gonadal dysgenesis is a very rare disorder of sex development wherein the individuals are phenotypically females with 46, XY genotype and preserved mullerian structures. These individuals characteristically have dysgenetic streak gonads which carry an increased risk of malignant transformation. Prophyla...
Tuberculosis (TB) of the urinary tract is a common disease in developing countries of the world. Establishing a clinical diagnosis is challenging owing to the variable clinical presentations of the disease and often a high index of suspicion is required. Identification of epithelioid cell granulomas, Langhans’ type of multinucleated giant cells, va...
Objective
The type of soft tissue lesions seen in children differs from that seen in adults. The role of FNAC in their diagnosis is not well documented.
Aim
To study the cytopathological spectrum of paediatric soft tissue tumours to highlight uncommon benign and malignant lesions and the challenges in their diagnosis.
Methods
A 3‐year retrospecti...
Small cell carcinoma of the ovary (SCCO) is an exceedingly rare malignant neoplasm. It has been classified into two types: hypercalcemic and pulmonary type, the former being relatively more common. These are highly aggressive neoplasms with rapid down‐hill course and poor disease‐outcome. A high index of clinical suspicion, systematic radiological...
Pilomatricoma is a relatively rare, benign skin appendageal neoplasm with predilection for head and neck region, young age, and female sex. Cytological diagnosis is often challenging owing to the lack of awareness and failure to identify the characteristic cytomorphological features, often leading to misdiagnoses. Development of multiple pilomatric...
Lymphangioma circumscriptum is a benign hamartomatous malformation involving the lymphatic system of skin and subcutaneous tissue. It can involve any part of the body with maximum predilection for proximal parts of limbs. Vulvar involvement is quite infrequent. Based on the aetiopathogenesis, it can be either primary or secondary, with the secondar...
Background: Disseminated peritoneal leiomyomatosis (DPL), also known as leiomyomatosis peritonealis disseminata, is a rare benign disease characterized by the presence of multiple leiomyomas scattered throughout the entire peritoneal cavity. Clinically as well as radiologically, the condition is often misdiagnosed as a malignant disease, with the m...
Leishmania is a protozoan parasite that can cause cutaneous as well as visceral disease in humans. Leishmaniasis is a vector‐borne disease and is transmitted by the bite of infected sandflies. A definitive diagnosis of visceral leishmaniasis can be obtained by microscopic identification of the organisms in smears or tis