Kiran Alam

Histological diagnosis of madura foot (mycetoma): a must for definitive treatment.

Mycetoma, an uncommon chronic infection of skin and subcutaneous tissues in tropical countries is caused by true fungi (eumycetoma) or by filamentous bacteria (actinomycetoma). Since the treatment of these two etiologies is entirely different, a definite diagnosis after histopathological and microbiological examination is mandatory. We hereby present five cases of Madura foot.

The value of fine-needle aspiration cytology in the evaluation of pediatric head and neck tumors

OBJECTIVE To study the efficacy of fine-needle aspiration cytology (FNAC) of head and neck masses in pediatric patients. STUDY DESIGN Of the 128 cases studied, FNAC was performed in 74 patients and their cyto-histological correlation done. Sensitivity and specificity of cytological diagnosis was then computed. RESULTS Benign lesions were found to be more common than the malignant variety, the commonest being soft tissue tumors (46.87%). Lymphomas were the commonest tumors (22.6%) in the malignant category. Cytology was done in 74 patients of whom smears from 21 patients were unsatisfactory for diagnosis. There was one false positive and two false negative cases resulting in the specificity and sensitivity of FNAC in pediatric head and neck tumors to be 95.65% and 93.3% respectively. CONCLUSION FNAC is a useful and reliable tool in the diagnosis of head and neck masses with no contraindications and minimal complications even in children.

Solitary eosinophilic granuloma of the ulna: Diagnosis on fine needle aspiration cytology

Solitary eosinophilic granuloma is a part of the spectrum of Langerhans cell histiocytoses (LCH) which are rare diseases with varied clinical presentations. They comprise of three major overlapping syndromes: solitary eosinophilic granuloma (unifocal disease), Hand-Schueller-Christian disease (multifocal, unisystem), and Letterer-Siwe disease (multifocal, multisystem). A case of solitary eosinophilic granuloma of the ulna is presented here for its relatively uncommon incidence and the difficulty in making an accurate diagnosis based on the radiological picture alone. We hereby, emphasize the importance of a quick and reliable diagnosis based on fine needle aspiration cytology, and the need to consider the possibility of LCH in the differential diagnoses of a slide showing a large number of histiocytes and eosinophils, as in tuberculosis, Hodgkins disease, and other primary and metastatic bony lesions. Characteristic nuclear grooves and a large number of eosinophils help in clinching the cytological diagnosis.

Apoptosis in premalignant and malignant squamous cell lesions of the oral cavity: a light microscopic study.

BACKGROUND Oral cancers are a major health problem in India. Recently, parameters of cell proliferation and cell death have emerged as important diagnostic and prognostic tools. AIMS The aim was to study apoptosis in premalignant and malignant squamous cell lesions of the oral cavity and to evaluate its prognostic role in oral cancers. MATERIALS AND METHODS The study included 175 patients presenting with oral lesions. Evaluation of apoptotic index (AI) (using light microscopy) was performed on hematoxylin and eosin-stained sections. STATISTICAL ANALYSIS USED Students t test was performed. RESULTS The mean AI increased progressively with increasing dysplasia, with the maximum AI in well-differentiated (WD) squamous cell carcinoma, and a fall was noted with progression toward higher grades. The difference between WD SCC and poorly-differentiated SCC was significant (P < 0.05). Cases with lymph node metastasis had significantly (P < 0.05) lower mean AI values. CONCLUSION Apoptosis can be fairly accurately assessed using light microscopy. Tumors that exhibit less apoptosis tend to show aggressive behavior and have a greater potential for metastasis.

Diagnostic utility of fine needle aspiration cytology in pediatric tumors

Background and Aims: Fine needle aspiration cytology (FNAC) is a relatively new technique for the diagnosis of pediatric tumors. Most of the studies conducted so far have dealt only with malignant neoplasms or neoplasms of a particular organ/organ system in the pediatric population. Our work included a comprehensive study of both benign and malignant tumors in children younger than 15 years of age to correlate their clinical, cytological, and histological findings and to evaluate the effectiveness of FNAC in their diagnosis. Materials and Methods: We studied 588 cases over a period of ten years. Data was collected retrospectively as well as prospectively, and included all patients younger than 15 years of age, who presented with tumors or associated symptoms. Clinical, cytological, and histopathological correlations were done. Results: Benign soft tissue tumors formed the largest group among all pediatric tumors (41.5%). Lymphomas were the most common (25.1%) of all malignant tumors, followed closely by small round cell tumors (SRCTs, 21.3%). FNAC was performed in 342 (55.1%) cases, cyto-histological correlation was possible in 226 (38.4%) cases; and a concordant diagnosis was seen in 218 (37.1%) cases, giving an overall diagnostic accuracy of 96.46% with FNAC. Occasional rare cases like Dabskas tumor and intraabdominal desmoplastic small round cell tumor could also be diagnosed by FNAC. Conclusions: We conclude that FNAC is an effective method for the evaluation and screening of pediatric masses, as well as for follow-up of patients with a history of malignancy.

Adenomatoid tumour of testis

Adenomatoid tumour is a rare neoplasm of mesothelial origin commonly seen in male and female genital tract. In this case report, the authors present a case of adenomatoid tumour in a 35-year-old male who presented with 1-year history of scrotal swelling. A clinical diagnosis of testicular neoplasm was made but final diagnosis of adenomatoid tumour was made after excisional biopsy.

Fine-needle aspiration diagnosis of GIST: a diagnostic dilemma.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. The authors take this opportunity to report two cases of GISTs of large bowel diagnosed on cytology and confirmed by histopathology and immunohistochemistry. Diagn. Cytopathol. 2012.

Coexistent non‐Hodgkins lymphoma and ductal carcinoma breast: Diagnosis on fine needle aspiration cytology

Synchronous occurrance of multiple neoplastic processes is not very common, and the relationship between breast cancer with lymphoproliferative diseases is unusual as well. Furthermore, breast involvement by non‐Hodgkins lymphoma is a rare event and primary breast non‐Hodgkins lymphoma is even rarer. The authors take this opportunity to report a case of primary B‐cell non‐Hodgkins lymphoma breast occurring in association with invasive ductal carcinoma in a 47‐year‐old female for its rare synchronous association. Diagn. Cytopathol. 2010.

Bilateral sertoli-leydig cell tumor of the ovary: A rare case report

Sertoli leydig cell tumors also known as arrhenoblastoma, are a rare member of the sex cord-stromal tumor group of ovarian and testicular cancers, comprising less than 1% of all ovarian tumors, which occur in young adults and are almost always unilateral. We hereby report a case of a 17-year-old female presenting with a short history of irregular menses and an abdominal lump, which was histologically proven to be a bilateral sertoli leydig cell tumor of the ovary, an exceptionally rare entity in itself.

Dedifferentiated acinic cell tumour: the harlequin of salivary gland neoplasms—an unusual variant

We present a case of a salivary gland tumour in a 25-year-old woman with lymphadenopathy and a clinical suspicion of lymphoma. The patient had a history of rapidly enlarging mass near angle of jaw which was resected and sent for histopathological examination. A final diagnosis of acinic cell tumour with dedifferentiation was made by histomorphological and immunohistochemical studies. Acinic cell tumour can mimic any salivary neoplasm phenotypically because of its varied architectural patterns of presentation with varied cell types, hence called the harlequin of salivary gland. Acinic cell tumour with dedifferentiation is a rare aggressive variant and requires adjuvant radiotherapy for better prognosis, hence the need for accurate diagnosis and communication to the surgeon