Anchana Gulati

Cutaneous leishmaniasis presenting as a submandibular nodule - a case report

A 42 year old male from Kinnaur district of Himachal Pradesh presented with a subcutaneous nodule in the submandibular region. It was 2x3 cm in size, firm, mobile and non-tender. Lymphadenitis and sialadenitis were kept as differential diagnosis. Fine-needle aspiration revealed Leishman Donovan (L-D) bodies along with non-caseating epithelioid cell granulomas. We are presenting this report for its rarity.

Diagnostic accuracy of endoscopic brush cytology in malignancies of upper gastrointestinal tract: A prospective study of 251 patients in North India

AIM To find the spectrum and frequency of upper gastrointestinal malignancies and diagnostic accuracy of endoscopic brush cytology in their diagnosis. MATERIALS AND METHODS This study was a prospective study carried out on 251 patients over 1-year in the Department of Pathology. Brushing material was smeared directly on to at least two clean glass slides and was stained with May-Grunwald-Giemsa stain. The endoscopic biopsies were examined grossly and were fixed in 10% formalin, processed, and stained with hematoxylin and eosin stain. OBSERVATION AND RESULTS The age range of the patients varied from 8 to 90 years, with the mean being 56 years. Male to female ratio was 2.5:1. On brush cytology, out of 251 cases, 110 had benign lesions and 97 had malignant lesions. Forty-four samples were considered suspicious of malignancy. On histopathology, benign lesions were present in 105 patients while malignant lesions were seen in 139 patients. In seven cases, results were inconclusive due to inadequate/superficial biopsy. STATISTICAL ANALYSIS Statistical analysis revealed the overall sensitivity of upper gastrointestinal brush cytology as 83.45% and specificity 80.95%. The accuracy of brush cytology came out to be 82.37% in upper gastrointestinal tract. CONCLUSION Brush cytology is a reliable, safe, inexpensive, and rapid method of diagnosing upper gastrointestinal lesions. Although endoscopic biopsies are established gold standard for diagnosing gastrointestinal malignancy, use of both biopsy and brushing together increases the diagnostic accuracy.

Collagenous spherulosis: An interesting cytological finding in breast lesion

Collagenous spherulosis (CS) is a rare and interesting entity associated with benign breast lesions. CS is an incidental finding picked up only on 0.2% of cytology specimen. Typically cytologically of CS of breast consists of central spherical hyaline spherule surrounded by myoepithelial cells. The central hyaline spherule has been found to be basement membrane material histochemically and immunohistochemically. The importance of recognizing CS of breast lies in the fact that similar hyaline globules can occur in adenoid cystic carcinoma of the breast (ACCB). The two lesions need to be differentiated on cytology failing which inappropriate treatment can be given for either of the two lesions. We present here a case of CS associated with benign breast lesion and a case of ACCB to describe their cytological features and key points to differentiate them cytologically.

Primary Endometrioid Carcinoma of the Broad Ligament: A Rare Case Report

Although secondary involvement of the broad ligament by malignant tumours arising elsewhere in the abdomen is common, primary tumours in this location are rare. Most neoplasms in this region whether benign or malignant usually present clinically with vague symptoms and are often discovered either during a routine gynaecological examination or on abdominal exploration because of the presence of a pelvic mass and vague lower abdominal discomfort or pain [1]. The present case which was diagnosed clinically as left ovarian tumour and histopathologically as endometrioid carcinoma of the broad ligament is reported for its rarity and for the unique histological finding of transitional cell differentiation associated with the primary tumour.

Non-Hodgkin's lymphoma presenting as an ovarian mass

Involvement of the ovary by malignant lymphoma is a well-known late manifestation of disseminated nodal disease. Lymphoma presenting with ovarian mass as an initial manifestation is a rare entity and may cause confusion for the clinician since its presentation might resemble other, much more frequent primary ovarian tumors. We present a case of non-Hodgkins lymphoma where the initial presentation was an ovarian tumor. The patient underwent surgery and was receiving chemotherapy when she developed generalized lymphadenopathy. She did not respond well to the therapy, had a progressive disease and expired after 5 months.

Angiolipoma of the mammary region: A report of two cases

Angiolipoma is a benign variant of lipoma that is rare in the breast and may be confused clinically, radiologically and pathologically with other benign tumours. It accounts for 5 - 17% of all benign fatty tumours. Clinicians, radiologists and pathologists in particular should not forget the existence of an angiolipoma of the breast to avoid unnecessary re-aspiration of the lesion considering the smears with only adipose tissue fragments as inadequate. We report two cases of angiolipoma who presented with solitary lumps in the breast, and a clinical diagnosis of fibroadenoma was suggested in both the cases. Both were diagnosed as lipoma on cytology and, on subsequent histopathology, a diagnosis of angiolipoma was given.

Cytological diagnosis of lepromatous leprosy: A report of two cases with review of literature

The “gold standard” for the diagnosis and classification of leprosy to date, is histological examination of skin biopsy in correlation with the bacteriological indices. These are, however, time-consuming. An attempt was made to diagnose leprosy using fine needle aspiration cytology (FNAC) which is a simple, safe, cost-effective and time-saving procedure with minimal trauma and complications. This case report highlights the role of FNAC in rapid diagnosis and early management, in patients of leprosy.

Inguinal endometriosis: A case report

Inguinal (noncutaneous) endometriosis is an uncommon presentation of endometriosis. It usually presents as a painful, typically right-sided, hernia-like inguinal mass with catamenial exacerbation. Here we report a case of inguinal endometriosis in which fine needle aspiration cytology was instrumental in reaching the diagnosis which was subsequently confirmed on histopathology.

The diagnostic accuracy of colonoscopic brush cytology in diagnosis of colorectal malignancies: A study of 49 patients

Aims: To find the spectrum and frequency of lower gastrointestinal malignancies and diagnostic accuracy of colonoscopic brush cytology in their diagnosis. Materials and Methods: This was a prospective study carried out on 49 patients in the Department of Pathology over 1 year. Brushing material was smeared directly onto at least two clean glass slides. The air dried smears were stained with May Grunwald Giemsa stain. The endoscopic biopsies were examined grossly and were fixed in 10% formalin, processed and stained with Hematoxylin and Eosin stain, respectively. Special stains were used wherever required. Observation and Results: The study was done on 49 patients presented with colorectal and anal lesions. Age of the patients ranged from 17 to 72 years with male to female ratio being 1.57:1. On statistical analysis, the sensitivity of colonoscopic brush cytology was found to be 85.71% and specificity 61.53%. The accuracy came out to be 79.16%. Conclusion: Brush cytology is a reliable, safe, inexpensive, and rapid method of diagnosing gastrointestinal lesions. Since brushing is a relatively noninvasive procedure, routine use of brushings of colonoscopically visible lesions should be done, in addition, to biopsy to increase the diagnostic yield.

Cytological diagnosis of xanthogranulomatous appendicitis

Xanthogranulomatous reaction can occur in any organ but the most common sites are kidney and gallbladder. Xanthogranulomatous appendicitis (XA) is a rare clinical entity. There are a few case reports of XA diagnosed on histopathology but none on cytology. Here we report a case of a 47-year-old lady who presented with acute abdomen and was found to have a mass lesion in the right iliac fossa. She was diagnosed with XA intraoperatively on imprint cytology that was subsequently confirmed on histopathological examination. Due to the rarity of XA itself and the use of imprint cytology for intraoperative diagnosis the case is being presented.