Harendra Kumar

Giant chondroid syringoma with divergent differentiation: Cyto-histo-immuno correlation

Chondroid syringoma is a rare benign skin adnexal tumor of eccrine/apocrine origin affecting commonly the head and neck region. It is also called as mixed tumor of skin because of the presence of both the epithelial and mesenchymal components. There are very few case reports of chondroid syringoma diagnosed on fine needle aspiration cytology (FNAC). We hereby report a case of giant chondroid syringoma occurring over the lower back in a 50-year-old male, diagnosed initially on cytology and confirmed by histopathology. This case is reported for its unusual size and site of occurrence. We describe the clinical features, cytology, histopathology, immunohistochemistry, and differential diagnosis of giant chondroid syringoma along with review of literature.

Cysticercus cellulosae lies in the eyes of the beholder

Context: Cysticercosis is quite common in the tropics. Fine needle aspiration cytology (FNAC) plays an important role in prompt diagnosis of this disease. Aims: The aim of this study was to study the role of FNAC in the diagnosis of cysticercosis. Materials and Methods: Among all the subcutaneous swellings referred for FNAC to our tertiary care hospital during the time period from 2009 to 2011, we found thirty cases of cysticercus infestation which were clinically diagnosed as tuberculous lymphadenitis, reactive lymphadenitis and lipoma. We also reviewed all the reported subcutaneous swellings during that period, which were already classified as acute suppurative processes (forty), for the presence of any parasite fragments. Results: In twenty-eight cases, a definitive diagnosis of cysticercosis was obtained in the form of fragments of parasite bladder wall, and biopsy confirmed the diagnosis in three cases. Two of the forty cases, which were initially reported as acute suppurative lesions during routine reporting, were retrospectively reviewed and parasite fragments were observed. Remaining 38 cases were extensively searched for any evidence of the parasite: however, they only showed acute suppurative inflammation with eosinophils, neutrophils and histiocytes. Conclusions: FNAC for diagnosis of cysticercosis is a low-cost, outpatient procedure. The cytological diagnosis is quite clear where the actual parasitic structures are seen in the smears. However, in other cases, the presence of eosinophils, histiocytes, and a typical granular dirty background should always alert the pathologist to the possibility of this condition. In endemic areas, it should be considered as one of the differential diagnoses for all subcutaneous swellings.

Gastric adenocarcinoma deposits presenting as multiple cutaneous nodules: a case report with review of literature.

Metastases to the skin from internal tumors are uncommon, yet they may be the first presentation of such malignancies. They usually arise from the breast, lung and large bowel. Cutaneous metastases from gastric adenocarcinoma are extremely rare. We report a case of gastric adenocarcinoma that at presentation had multiple clinically benign looking skin nodules. Fine needle aspiration cytology of the cutaneous nodule revealed metastatic deposits. The current literature on cutaneous metastases of gastric carcinoma is reviewed in this case report.

Clear cell hidradenocarcinoma of the eyelid: a case report with a review of the literature

Clear cell hidradenocarcinomas are extremely rare neoplasms, with very few well-documented cases reported in the literature. The most common sites are the head and neck regions. These tumors are histologically malignant but are not always aggressive. They are known for recurrence and may metastasize widely. Treatment is wide local resection. We report on a case of clear cell hidradenocarcinoma occurring over the eyelid together with a review of the literature.

Anticoagulant induced artefacts in peripheral blood smears.

Microscopic evaluation of a peripheral blood smear is one of the most beneficial test. But anticoagulant induced artefacts could lead to misinterpretation of the smears. The present study was undertaken to identify the anticoagulant induced artefacts and avoid misinterpretation of peripheral blood smears. The blood samples were collected using Ethylene Diaminetetraacetic acid (EDTA) and Sodium citrate, mixed thoroughly and smears were made immediately as well as 1hr apart for 6 hrs, stained and examined under oil immersion microscope. Direct smears were used as controls. Significant morphological artefacts were observed in our study. Artefacts were marked at the end of 2 hrs with EDTA but seen almost immediately with citrate blood. At 6 hrs, artefacts were marked but more severe with citrates than EDTA. Thus the practice of making blood smears before addition of anticoagulant is recommended and a delay up to 1hr is permissible with EDTA blood but not beyond.