Kingshuk Bose

Clinicopathological study of rhinosporidiosis with special reference to cytodiagnosis

Background: Rhinosporidiosis is a chronic infective disorder caused by Rhinosporidium seeberi. It usually presents as a soft polypoidal pedunculated or sessile mass. Nose and nasopharynx are the commonest sites, followed by conjunctiva, maxillary sinuses, penis, urethra. Aims: The aim of this study is to present the clinicopathological features of rhinosporidiosis in a large series of cases and to asses the role of cytology in diagnosis. Materials and Methods: 63 cases were included in the study group. Diagnosis of rhinosporidiosis was confirmed in all cases by histology with or without cytological evaluation. May-Grünwald-Giemsa and hematoxylin and eosin (H and E) staining was used in all cases, and special stains like periodic acid Schiff and mucicarmine were used in a few cases. Detailed clinical history of all the cases was noted. Routine hematological investigations including ABO blood grouping were done in all possible cases. Results: Evaluation of the clinical data in our series demonstrated male predominance (36 out of 63; 56%). Nose and nasopharynx were the commonest sites involved (74.6%). Routine hematology tests did not show any significant change in most of the cases. However, a significant proportion of the study population (18 out of 41; 44%) had blood group O. Cytodiagnosis attempted in 17 cases out of 63 cases achieved 100% correlation with histology. Conclusion: Morphological appearance alone in a few cases failed to give diagnosis of rhinosporidiosis. Cytology can be very helpful in diagnosis in these cases, but histology is the mainstay of diagnosis.

Fine-needle aspiration cytology of retroperitoneal lesions: a 5-year experience with an emphasis on cytohistological discrepancy.

Background: The retroperitoneal space contains various organs which can be affected by various non-neoplastic and neoplastic pathological processes. A diagnosis of these retroperitoneal lesions is often difficult. Fine-needle aspiration cytology (FNAC) under image guidance is now becoming an effective tool for the initial evaluation of retroperitoneal lesions. Objective: The present study was undertaken to evaluate the role of ultrasound-guided FNAC in the diagnosis of retroperitoneal lesions in comparison to histopathology and to assess the probable causes of failure in cases of pitfalls in cytodiagnosis. Materials and Methods: During the study period of 5 years, a total of 104 cases of retroperitoneal lesions were aspirated under USG guidance. Seven cases yielded inadequate material, the remaining 97 cases were included in the study group. Results: Out of 97 cases, the kidney was the most common organ aspirated (27 cases; 27.8%). Malignant lesions (68 cases; 70.1%) were much more frequent than benign or non-neoplastic lesions (29 cases; 29.9%). Tuberculosis was the most common non-malignant lesion (14 cases) and renal cell carcinoma was the most frequent malignant lesion encountered (15 cases). In 5 cases (7.9%), the histological diagnosis showed inconsistent results in comparison to cytodiagnosis. Conclusion: USG-guided FNAC is a safe, rapid, relatively cheap and fairly accurate procedure for the assessment of retroperitoneal lesions.

Fine-needle aspiration cytology of chondroid syringoma of fore arm: Report of a rare case

Chondroid syringoma is a rare benign adnexal tumor of sweat glands with microscopic resemblance to the salivary gland pleomorphic adenoma. Cytology is rarely utilized for preoperative assessment of these slow-growing, small, nodular lesions. Definitive cytological diagnosis is also quite difficult, and majority of the aspirates are evaluated as benign adnexal tumors leading to mandatory histopathological examination for pinpoint diagnosis. Here, we report a case of chondroid syringoma of forearm, which was diagnosed by cytology and also confirmed after histopathological examination. Pinpoint cytological diagnosis can help early formulation of necessary management protocol.

Microfilaria in fine needle aspiration cytology of breast lump: An unusual finding

Filariasis is a common health problem in India. Lymphatic filariasis is mostly caused by Wuchereria bancrofti and Brugia malayi. Microfilariae are often found in cytology smears from swelling at various sites and it is rarely associated with neoplasms. However, filarial breast nodule is a very rare finding even in an endemic region. Here, we present a rare case of filarial breast lump diagnosed by fine needle aspiration cytology.

Mandibular metastasis from follicular variant of papillary carcinoma of thyroid: Report of an uncommon initial presentation

Follicular carcinomas of thyroid have more prone to metastasize through hematogenous route and commonly involve bone, whereas papillary carcinomas spread through lymphatics. However, mandibular metastasis from thyroid malignancy is rare. Few cases have been reported until now. We are presenting a case of metastatic carcinoma of mandible and gingiva from follicular variant of papillary carcinoma of thyroid and interestingly secondary malignancy identified before the diagnosis of primary tumor.

Cytodiagnosis of filariasis from a swelling of arm

Cytological demonstration of microfilaria and adult worms often helps in diagnosis of asymptomatic filarial cases. But demonstration of microfilaria in cytological smears from upper extremity lesions is seldom reported. We are presenting a 32-year-old female patient with elongated, small subcutaneous swelling in the medial aspect of right lower arm. Aspirates from the lesion demonstrate microfilaria though there is no eosinophilia or microfilaremia on subsequent examination of blood sample. In endemic areas, filariasis should always be considered as a possible diagnosis during cytological assessment of any swelling.

Fine needle aspiration cytology of minor salivary gland tumors: A retrospective 5-year study of 42 cases in a tertiary care hospital

Background: Minor salivary gland tumors (MSGTs) are less common than major salivary glands and involve only 15–20% of all salivary gland tumors. Most of the cases originate at intra- and peri-oral region. Minor salivary gland lesion cytology has been studied rarely in India. Aims: This present study was performed to evaluate the role of fine needle aspiration cytology (FNAC) in diagnosis of MSGTs and to explore the cases of cytohistological discrepancies in the study. Materials and Methods: This retrospective study was conducted over a 5-year period on 42 cases of MSGTs. In all the cases, cytology was correlated with histology and cytohistological discrepancies were searched. Sensitivity, specificity, and diagnostic efficacy were calculated using histopathology as gold standard. Results: We diagnosed 27 malignant (64.28%) and 15 benign (35.71%) MSGTs in cytological evaluation. We found two false negative and one false positive case in cytology. Sensitivity, specificity, and diagnostic accuracy of the study were 92.59%, 93.33%, and 92.85%, respectively. Conclusion: FNAC is a minimally invasive and cost-effective procedure with high accuracy (92.85%) in the assessment of MSGTs and helps in the management of benign and malignant tumors.

Microfilaria in pleural fluid cytology: A rare finding

Lymphatic filariasis is endemic in India and Southeast Asia. Detection of microfilaria is infrequently reported during cytological evaluation of various lesions or body cavity fluids. Presence of microfilaria in pleural fluid cytology is very rare finding even in endemic areas. Few cases of accidental finding of microfilaria have been reported in association with malignant pleural effusion. But pleural effusion of filarial origin is extremely rare manifestation. Here we report a classical case of microfilaria in pleural fluid cytology.

Cytodiagnosis of eccrine porocarcinoma of the scalp

Eccrine porocarcinoma is a rare, malignant adnexal tumor of the duct of eccrine sweat gland. Cytology of eccrine porocarcinoma has been described in very few previous literature. Here, we present a case of fine needle aspiration cytology (FNAC) of eccrine porocarcinoma of the scalp, which is subsequently confirmed by histology. Accurate diagnosis of eccrine porocarcinoma by FNAC is very difficult, but determining the malignant nature of the lesion is crucial for curative surgery. FNAC can be a convenient, safe, and effective approach to solve difficult diagnostic dilemma.

Limbal complex choristoma – A rare unexpected lesion diagnosed by histopathology

Complex choristoma contains a variety of tissues derived from more than one germ layer. Complex ocular choristoma is a very rare lesion. Very few cases have been reported so far. It may or may not cause visual abnormality depending on its location. Sometimes, it is associated with other congenital abnormalities. Here, we report a case of complex limbal choristoma which was diagnosed at adult age in a 58-year-old male patient and confirmed by histopathological examination.