Amita Giri

Radio-pathological diagnosis of hepatobiliary ascariasis: A rare entity.

Ascariasis is the commonest helminthic infection in humans, caused by the nematode Ascaris lumbricoides. The adult worms usually reside in the small intestine. Rarely, they migrate into the bile duct and pancreatic ducts, but involvement of the gall bladder and/or liver parenchyma is extremely rare. Here, we describe a case of a 32-year-old woman who presented with fever, anorexia, right upper quadrant pain and mild hepatomegaly. Ultrasonography revealed a liver abscess and a concurrent moving adult worm in the gall bladder. Fine-needle aspiration cytology (FNAC) from the liver abscess showed presence of fertilized eggs of Ascaris lumbricoides. A diagnosis of gall bladder and hepatic ascariasis was made. The patient responded well to conservative management. Ascaris-induced liver abscess with concurrent living adult worm in gall bladder has rarely been reported. Ultrasonography and FNAC are important diagnostic modalities for detection of such lesions. Conservative management appears to be the treatment of choice for hepatobiliary ascariasis.

Cytohistopathological correlation of a case of squamous cell carcinoma of gallbladder with lymph node metastasis.

Primary carcinomas of the gallbladder are rare malignancies and adenocarcinoma is the more common subtype. Primary squamous cell carcinoma of the gallbladder has rarely been diagnosed by aspiration cytology. Here, we present a case of a 62-year old female patient suffering from abdominal complaints who underwent ultrasound-guided fine-needle aspiration cytology and was diagnosed as keratinizing squamous cell carcinoma of gallbladder. The diagnosis was confirmed on subsequent histopathological examination that also revealed metastasis in the cystic lymph node. Histogenesis and biological behavior of squamous cell carcinoma of gallbladder remains a matter of debate but the role of aspiration cytology in diagnosing these lesions cannot be undermined.

Computed tomography guided fine needle aspiration cytology of mass lesions of lung: Our experience

Context: Computerized tomography (CT) guided fine needle aspiration cytology (FNAC) of lung lesions has rapidly emerged as a less-invasive, cheap, rapid and fairly accurate diagnostic aid in lung lesions. Aims: The purpose of this present study was to evaluate the effectiveness of CT-guided FNAC in the diagnosis of pulmonary mass lesions (both benign and malignant) and to determine the complication rate of this procedure. Settings and Design: We conducted an institution-based, prospective study on 127 patients who presented with pulmonary mass lesions. Materials and Methods: After proper consent was obtained, CT-guided transthoracic fine needle aspiration was done and their diagnoses were confirmed by appropriate methods. The results were analyzed statistically. Results: Out of 127 cases selected for the study, 59.8% were males while the rest were females. Cough was the most common symptom present in 71.2% cases, followed by weight loss (62.4%). 21.2% cases were cytologically benign. Adenocarcinoma (54.2%) was the commonest malignant tumor. FNAC provided at least 96% sensitivity and 100% specificity in diagnosing lung tumors. Among the benign lesions, specific diagnoses were obtained in 48.1% cases. Thus, altogether a specific diagnosis was obtained in 109 of 127 cases, i.e. 85.8%. No major complication was noted. Conclusions: CT-guided FNAC is an extremely valuable and fairly accurate diagnostic aid of intrathoracic mass lesions, with a reasonable rate of complication.

Transfer learning of tissue photon interaction in optical coherence tomography towardsin vivo histology of the oral mucosa.

Oral cancer evolves from different premalignant conditions and the key to save lives is through diagnosis of early symptoms. The conventional practice of post biopsy histopathology reporting is dependent on specificity of sampling site and optical coherence tomography (OCT) imaging is clinically used for guidance. Clinicians infer the tissue constitution by interpreting intensity images and are challenged by inter-and intra-observer variability. In this paper we propose transfer learning of tissue specific photon interaction statistical physics in swept-source OCT for characterizing the oral mucosa with the aim of reducing this reporting variability. The source task models statistical physics of ballistic and near-ballistic photons and its intensity attenuation and target task learns the parameters obtained by solving the source task to identify co-located heterogeneity of tissues. Performance is compared with conventional histopathology of healthy, premalignant and malignant oral lesions supporting its use towards in vivo histology of the oral mucosa for pre-biopsy screening.

Idiopathic granulomatous mastitis-utility of fine needle aspiration cytology (FNAC) in preventing unnecessary surgery

OBJECTIVE Granulomatous mastitis is a benign disorder which closely mimics malignancy clinico-radiologically. A simple and cost effective modality like fine needle aspiration cytology (FNAC) can help in prompt diagnosis and avoid unnecessary surgery. MATERIAL AND METHODS A retrospective study where data were collected for granulomatous lesions of the breast diagnosed by histopathology in a five year period and review of FNAC slides. Cases positive for Mycobacterium tuberculosis either on ZN stain or Polymerase chain reaction (PCR) and fungus were excluded. A total of 8 cases were included in our study for analysis. RESULTS All the cases showed the presence of granuloma composed of epithelioid histiocytes against a background of giant cells, polymorphs with absence of necrosis. CONCLUSION Cytological diagnosis of granulomatous mastitis is difficult as it overlaps with other etiologies like tuberculosis which is prevalent in this part of the world. However, with the use of ancillary techniques like PCR and negative microbiological investigations, a definitive diagnosis can be made.

Sarcomatoid chromophobe renal cell carcinoma: Cytohistopathological correlation of a case.

Sarcomatoid renal cell carcinomas of the kidney are rare neoplasms constituting about 1-5% of all renal malignant neoplasms. These are aggressive tumors and are commonly associated with conventional (clear cell) renal cell carcinomas, but cases associated with chromophobe renal cell carcinomas are sparse. Cytological features of such lesions have rarely been reported. Here, we report a unique case of a 48-year-old male patient who presented with right flank lump and pain. A fine needle aspiration was performed from the lesion under ultrasound guidance and a cytological diagnosis of pleomorphic sarcoma was made. A right-sided radical nephrectomy was carried out and subsequent histopathology revealed a sarcomatoid renal cell carcinoma with wide areas of necrosis coexisting with chromophobe renal cell carcinoma with calcification. Differentiation of pleomorphic sarcoma from a sarcomatoid renal cell carcinoma is, thus, challenging from cytopathology smears and the differential diagnoses should always be borne in mind while giving a cytopathological opinion.

Cytologic diagnosis of undifferentiated high grade pleomorphic sarcoma of breast presenting with brain metastasis

Primary sarcoma of breast are rare. Diagnosis by aspiration cytology is difficult due to nonspecific cytomorphologic features. An initial presentation with neurological symptoms due to metastasis of breast sarcoma to the brain has not been previously reported. Here, we describe a case of a 60-year-old female who presented with headache, dizziness and convulsion and was subsequently diagnosed with undifferentiated high grade pleomorphic sarcoma of breast with cerebellar metastasis.

Infratentorial medulloepithelioma with divergent differentiation: Possibly a predictor of poor outcome.

Medulloepitheliomas (WHO grade IV) are rare, malignant embryonal tumors of pediatric population, classified under the central nervous system (CNS) primitive neuroectodermal tumors (PNET). Histologically, these tumors are characterized by neoplastic neuroepithelium recapitulating the embryonic neural tube. We describe a rare case of infratentorial medulloepithelioma with divergent differentiation in a 1-year-old male child who presented with headache, vomiting, and seizures. Histopathologic examination of the excised tumor revealed the characteristic neuroepithelium, along with other areas showing primitive neuroectodermal (blastemal) cells in sheets, ependymoblastic rosettes, and nodular areas of neuronal differentiation. Possibly, this proliferating immature neuroepithelium is the cause of poor outcome in medulloepitheliomas. Due to the rarity of these tumors, it remains to be established whether infratentorial location or tumors with divergent differentiation are also predictors of adverse prognosis.

Cytohistopathological Correlation of a Case of Squamous Cell Carcinoma of Gallbladder with Lymph Node Metastasis / Lenf Nodu Metastazlı Bir Safra Kesesi Skuamöz Hücreli Karsinomu Olgusunda Sitohistopatolojik Korelasyon

ABSTRACT Primary carcinomas of the gallbladder are rare malignancies and adenocarcinoma is the more common subtype. Primary squamous cell carcinoma of the gallbladder has rarely been diagnosed by aspiration cytology. Here, we present a case of a 62-year old female patient suffering from abdominal complaints who underwent ultrasound-guided fine-needle aspiration cytology and was diagnosed as keratinizing squamous cell carcinoma of gallbladder. The diagnosis was confirmed on subsequent histopathological examination that also revealed metastasis in the cystic lymph node. Histogenesis and biological behavior of squamous cell carcinoma of gallbladder remains a matter of debate but the role of aspiration cytology in diagnosing these lesions cannot be undermined. ÖZ Safra kesesinin primer karsinomları nadir malignansilerdir ve adenokarsinom en sık görülen alt tiptir. Safra kesesinin primer skuamöz hücreli karsinomuna aspirasyon sitolojisiyle nadiren tanı konmuştur. Burada abdominal şikayetlerle gelen, ultrason rehberliğinde ince iğne aspirasyon sitolojisi yapılan ve safra kesesinin keratinize skuamöz hücreli karsinomu tanısı konan, 62 yaşında bir kadın hasta sunuyoruz. Tanı daha sonra histopatolojik incelemeyle doğrulandı. Ayrıca kistik lenf düğümünde metastaz da saptandı. Safra kesesinin skuamöz hücreli karsinomunun histogenezi ve biyolojik davranışı tartışmalıdır ama bu lezyonlara tanı koymakta aspirasyon sitolojisinin rolünün önemi inkar edilemez.

Eccrine angiomatous hamartoma: A rare entity

proportionately with the patient. He was embarrassed noticing excessive sweating over elevated lesion, more so in summer. He also had pain in the lesion. Past medical history was insignificant. There was neither suggestive family history nor any history of trauma to the part. Physical examination revealed a single plaque of 8x6 cm, with an overlying blackish brown surface beginning from mid posterior aspect of right thigh extending to the lateral aspect were of varying firmness and had no pulsations or bruits. Sweating was comparatively more on the skin over the lesions compared to the surrounding skin. It was tender and associated with contracture at hip and knee joint (Fig.1) resulting in decrease range of movement. Examination of the hair, nails and mucous membranes were unremarkable. His blood reports were normal as was his chest radiograph.