Niti Singhal

Neutrophil phagocytosis by tumor cells—A cytological study

Cell cannibalism is defined as the ability of a cell to phagocytose another cell. Malignant tumor cells may develop phagocytic property and demonstrate phagocytosis of own cells or cells of other series like neutrophils and lymphocytes. We report 11 cases in which the tumor cells showed evidence of neutrophil phagocytosis/emperipolesis on FNAC smears.

Utility of ultrasound-guided fine-needle aspiration in splenic lesions.

Indications of fine‐needle aspiration (FNA) of spleen have increased as more splenic lesions are detected because of advanced imaging techniques. A retrospective analysis of cytological material of 36 patients on whom ultrasound‐guided splenic FNA was performed was done. No complications were noted. There were 16 inflammatory lesions, 12 neoplastic and 8 cases were reported as descriptive either because of scant cellularity, blood only, or normal splenic cytology. Inflammatory lesions included nine cases of acute abscess, five cases of tuberculosis, and one case each of leishmaniasis and infarct. Neoplastic lesions included two benign (benign cyst and inflammatory pseudotumor) and 10 malignant lesions. Among malignant lesions, eight were non‐Hodgkin lymphoma (NHL), one suspicious of NHL, and one desmoplastic small round cell tumor. FNA proved to be an effective procedure for reaching a microscopic tissue diagnosis and thus a splenectomy could be avoided in cases where it was not required. Diagn. Cytopathol. 2013;41:1038–1042.

FNA in diagnosis of orbital lesions causing proptosis in adults.

The orbit is affected by a wide range of pathologic lesions, for which a morphologic diagnosis is needed to allow adequate therapy. With increasing use of fine needle aspiration (FNA) in diagnostic pathology, the procedure has been applied for the diagnosis of space occupying lesions of the orbit. We present the cytomorphological diagnosis on orbital FNA in adult patients presenting with proptosis.

Cytologic features and differential diagnosis in a case of extraskeletal mesenchymal chondrosarcoma: a case report.

BACKGROUND Extraskeletal myxoid chondrosarcoma (EMC) is an uncommon tumor. On fine needle aspiration (FNA) it has to be distinguished from other benign and malignant soft tissue lesions. CASE FNA was done on an 85-year-old man with painful swelling of the forearm. Smears showed fragments comprised of polygonal cells with eccentric nuclei and peripheral fine cytoplasmic vacuoles embedded in a dense, metachromatic matrix. Cell block showed similar cells in a chondromyxoid stroma. The cells were positive for S100 and negative for cytokeratin. CONCLUSION FNA is a useful tool in the diagnosis of EMC in conjunction with radiology. A preoperative diagnosis can be made due to its distinct cytologic and immunohistochemical features, obviating the need for a biopsy.

A rare case of ovarian and pelvic filariasis

Lymphatic filariasis is an important tropic disease associated with significant morbidity. The patients in endemic areas mostly experience problems related to lymphatic obstruction. Physicians practicing in non- endemic areas rarely consider filariasis, especially if it is an uncommon presentation. We present a young woman who posed a significant problem in the diagnosis of ovarian filariasis.

Intra-thoracic desmoid tumor

Desmoid tumor is a rare, benign soft tissue tumor having potential for local invasion. It commonly arises in abdominal wall, presenting as a palpable mass. We describe a case of thoracic desmoid tumor in a middle aged male arising from the chest wall. Unlike the usual presentation, two separate non-palpable tumor masses protruded into left thoracic cavity mimicking lung carcinoma. The patient underwent successful complete surgical excision of the tumor. Such tumors, being rare, may pose diagnostic problems if not considered in the initial work up.

Inflammatory pseudotumor of the spleen: A rare case diagnosed on FNAC

Inflammatory pseudotumor (IPT) is a rare space‐occupying lesion of unknown etiology that can mimic malignancy on clinic‐radiological and pathological examination. We present a case of IPT of the spleen which was clinically suspected to be malignant. This case was initially suggested accurately on fine needle aspiration (FNA) of the mass and subsequently confirmed on histopathology of the resected specimen. Diagn. Cytopathol. 2012.

Cytologic diagnosis of intravascular papillary endothelial hyperplasia: a report of two cases and review of cytologic literature.

Background: Intravascular papillary endothelial hyperplasia (IPEH), previously known as ‘Masson’s hemangioma’, is a reactive endothelial proliferation that occurs most commonly in the vessels of the head, neck, and extremities. The cytologic findings of the lesion are varied and depend on the age of the lesion. Cases: Case 1 is a 61-year-old man who presented with a swelling on the medial aspect of the forearm. The clinical diagnosis was lipoma. Cytologic smears showed spindle cells tagging onto a rich capillary network and smaller round cells arranged around hyaline cores. The cytologic diagnosis was benign vascular tumor. On histolopathogic examination a diagnosis of IPEH was given. Case 2 is a 45-year-old man who presented with swelling on the dorsal aspect of the wrist. The cytologic diagnosis of giant cell tumor was made based on the presence of scattered spindled cells and multinucleate giant cells. The giant cells had various shapes like round or crescent and had 10–25 nuclei. The lesion was excised and a diagnosis of IPEH was rendered. Conclusion: These two cases highlight the varied cytomorphology of IPEH making the pinpoint diagnosis of this lesion difficult on cytologic smears.

Fine needle aspiration cytology of spindle cell carcinoma of the tongue: a case report with emphasis on the diagnostic difficulties

Spindle cell carcinoma is a rare but well-documented variant of squamous cell carcinoma. It is a biphasic tumour comprising malignant spindle cells along with associated squamous cell carcinoma. The tumour has a predilection for the upper aerodigestive tract; the larynx and the oral cavity are the most commonly involved sites. The diagnosis of spindle cell carcinoma requires the demonstration of both the carcinomatous and the sarcomatoid component. Cytological diagnosis can be difficult, especially when only one of the components is aspirated due to limited and selective sampling by fine needle aspiration (FNA). Herein, we describe a case that was initially reported as spindle cell tumour of the tongue on FNA cytology but histological examination revealed spindle cell carcinoma.

Cytological diagnosis of carcinoma ex-pleomorphic adenoma

Carcinoma ex-pleomorphic adenoma (Ca ex-PA) is uncommon; however, its accurate diagnosis is important, as the prognosis is better than other salivary gland malignancies, when it is within the pleomorphic adenoma. Fine needle aspiration cytology may be used for its diagnosis. Smears of five cases of Ca ex-PA diagnosed on fine-needle aspiration (FNA) and confirmed on histopathology were analyzed and diagnostic features were assessed. All cases had history of long-standing masses with recent increase in size. Smears showed high grade carcinoma with differential diagnoses of mucoepidermoid carcinoma, adenocarcinoma NOS and salivary duct carcinoma. Features suggestive of PA origin included chondromyxoid stroma: Benign epithelial cells and scattered plasmacytoid cells. The overall agreement between cytological findings and histopathological diagnosis was 100%. Diagnosis of Ca ex-PA may be possible on FNA by correlation with clinical history and detection of chondromyxoid stroma and benign myo-epithelial cells.