Oneal Gupta

Cylindroma of the breast: A rare case report

Cylindroma is a benign adnexal tumor, which occurs as solitary dermal nodules on the scalp and forehead. Cylindroma of the breast is a rare lesion. Fine-needle aspiration is often the first line of investigation. In this communication, we illustrate the cytomorphological feature of cylindroma in a 61-year-old female patient who presented with a breast lump. Fine-needle aspiration cytology in this case reveals the islands of tumor cells formed a “jig-saw” pattern, along with the bland, basaloid cells associated with globular, extracellular material. These features are typical of cylindroma, but differential diagnosis of adenoidcystic carcinoma should always be kept in mind as the management of both tumors are different.

Malignant fibrous histiocytoma of the spleen: an extremely rare entity.

Primary malignant fibrous histiocytoma (MFH) of the spleen is extremely rare. Since the first description of primary splenic MFH reported by Govoni et al in 1982, to the best of our knowledge, only twelve cases of MFH of the spleen have been reported in the literature. We herein report a rare case of primary splenic MFH in a 30-year-old Indian male who presented with abdominal pain with a history of recurrent hydatid cyst of liver and spleen. A computed tomography (CT) scan was performed and a diagnosis of splenic hydatid cyst was made. Splenectomy was done. On histopathological examination, a diagnosis of malignant mesenchymal tumor, possibly storiform variant of malignant fibrous histiocytoma, was made. On immunohistochemistry, the tumor was positive for vimentin and CD68. The post operative period was uneventful. Compared with the twelve previously cases of MFH of the spleen, our patient is the youngest case reported so far.

Cytological diagnosis of parasites presenting as superficial nodular swelling: report of 35 cases

Parasitic infestation often present with superficial nodular swelling. Fine needle aspiration cytology plays an important role in prompt diagnosis of the disease. To study the role of FNAC in the diagnosis of parasites presenting as skin or subcutaneous nodules. Total 361 cases of superficial swellings at various sites were subjected to fine needle aspiration cytology. Out of the 361 cases, 35 cases were diagnosed as suggestive of parasitic infestation. These 35 cases form the study group. In 14 cases out of 35 cases, a definitive diagnosis of parasitic infestation was made as parasite or fragments of parasite were seen in the aspirate. In 21 cases, neither parasite nor fragments could be identified on the aspirates and a diagnosis of parasitic inflammation was suggested on the basis of other cytomorphological findings. In 17 of these cases, a biopsy correlation was available, which revealed definitive parasite in 8 cases and the remaining 9 were reported as suggestive of parasitic cyst. The cytological diagnosis was confirmatory in cases where the parasite fragment were identified in the smears. However, in other cases, clear aspirate, presence of eosinophils, macrophages and typical granular dirty background are the features which should prompt the cytologist to the possibility of parasitic infestation.

Acute Myeloid Leukemia (AML-M2) with Translocation (8;21) (q22;q22) and Abnormal Eosinophilic Precursors in the Bone Marrow—A Case Report

The translocation (8;21)(q22;q22) is frequently associated with M2 subtype of AML. The authors herein present a case of AML-M2 in a nine-year-old boy without hepatosplenomegaly, lymphadenopathy or any bleeding diathesis. Bone marrow examination revealed high number of eosinophilic precursors (60%) among the total nucleated bone marrow cells. Cytogenetic study with G- banding method showed 46, XY, t (8;21)(q22;q22). The morphological abnormalities in eosinophils observed in AML suggested that eosinophils may be a part of leukemic process.

Erythema nodosum leprosum: Report of two cases

Erythema nodosum leprosum (ENL) or type 2 lepra reaction is an inflammatory reaction, which may occur in the course of hanseniasis, may compel the patient to seek medical attention and may result in nerve function impairment and subsequent disability. Thus, recognition and timely management of these patients is critical in order to avoid permanent disability. Fine‐needle aspiration cytology is simple and effective tool that aids in the correct diagnosis and management of ENL. Herein, we present two cases of ENL, one with typical and another with atypical presentation. Diagn. Cytopathol. 2013;41:366–368.

Declining total leucoyte count, an indication of transient abnormal myelopoisis

Neonates with Down syndrome have an increased predisposition to transient abnormal myelopoisis, a haematological abnormality which is characterized by uncontrolled proliferation of myeloblasts. The unique ability of this disorder to spontaneously enter in to a state of remission led to the creation of a new class in 2008 World Health Organization (W.H.O.) classification of haemopoitic and lymphoid tumours. It has now been classified as transient abnormal myelopoisis (TAM). The cause of remission is still not clear although it is possibly linked to the abnormal expression of GATA-1 transcription factor and to a switch from hepatic haematopoesis to medullary haematopoesis. Simple laboratory monitoring by serial complete blood count and peripheral smear can give indication of this rare disorder. As very few cases of this disorder exist we share our experience and report a case of transient myeloproliferative disorder in a male newborn having Down syndrome.