Preeti Diwaker

Cytokeratin 20 immunocytochemistry on urine sediments: A potential low-cost adjunct to cytology in the diagnosis of low-grade urothelial carcinoma

Urine cytology is the corner‐stone for the diagnosis of urothelial neoplasia; however, a substantial proportion of low‐grade carcinomas are reported as inconclusive owing to scant cellularity and subtle cytological features. Biomarkers applied on urine sediment smears of such patients are likely to be clinically relevant. Access to Food and Drug Administration approved urinary biomarkers in resource limited setting is poor. Detection of cytokeratin 20 (CK20) in urine sediments, although still a research tool, is a promising marker as immunocytochemistry is performed regularly in several Indian laboratories.

Cytomorphological features of oncocytic variant of papillary thyroid carcinoma with lymphocytic thyroiditis

Cytological diagnosis of hurthle cell lesions of thyroid is a diagnostic dilemma. Presence of hurthle cells on fine needle aspiration (FNA) leads to a wide range of differential diagnosis including benign and malignant entities. The oncocytic variant of papillary thyroid carcinoma (PTC) is one entity of the vast list of differentials of which very few cases have been reported to date. We report a case of oncocytic variant of PTC in a 28-year-old female diagnosed on cytomorphology. The findings of FNA smears of the first aspirate were not sufficient for a definitive diagnosis. Repeat FNA was done to rule out the possibility of autoimmune thyroiditis/thyroid neoplasm. The repeat FNA smears showed oncocytic cells present in papillary and loosely cohesive clusters. Many of the cells displayed nuclear features of PTC and the case was finally diagnosed as PTC; oncocytic variant. Thyroidectomy specimen revealed PTC; oncocytic variant with lymphocytic thyroiditis in the surrounding tissue. Thus, in cytology practice, concurrent autoimmune thyroiditis may pose a problem in diagnosis of PTC; oncocytic variant.

Intraparenchymal Angiomatous Meningioma: A Diagnostic Dilemma.

Meningioma arises from the arachnoid cap cells of the cerebrum. Intraparenchymal meningiomas or meningiomas without dural attachment are rare. We report a case of 40-year-old male who presented with a history of headache, dizziness and gradual loss of vision since one year. Clinicoradiological diagnosis of a high grade glioma was considered. Tumour was excised and haematoxylin and eosin stained sections revealed a tumour comprised predominantly of variable sized blood vessels showing hyalinization in a background of plump spindle cells with oval vesicular nuclei. In view of these features angiomatous meningioma was suspected. However, to confirm the diagnosis, a panel of immunohistochemical markers including vimentin, EMA and GFAP was done and a final diagnosis of angiomatous meningioma was offered. Angiomatous meningioma is a rare variant of meningioma and even much rarer in the intraparenchymal location. Angiomatous meningioma should be considered in the differential diagnosis of highly vascular intraparenchymal brain tumours.

Diagnostic role and limitations of FNAC in oral and jaw swellings.

Fine‐needle aspiration cytology (FNAC) of oral lesions has not been widely utilized for diagnosis due to rarity and diversity of lesions, peculiar anatomy of maxillofacial region, difficulty in aspirating these lesions, and limited experience. Aim of this study was to determine the role of FNAC in the diagnosis of oral and jaw swellings.

Osseous metaplasia of ovarian cyst: a rare case report

Osseous metaplasia has been described in many places, but previous reports of osseous metaplasia in ovarian lesions are rare. It is most commonly associated with dermoid cysts, or ovarian teratomas with additional features such as hair, cartilage and muscle, etc. Other causes of this ossification include osseous metaplasia in serous or stromal-rich mucosal neoplasms or mucus. In ultrasound, a hardened endometriotic cyst (brown cyst) may be misdiagnosed as a calcified ovarian teratoma or tumor. The hardened endometriotic cyst (brown cyst) is not an indication of the operation itself, but other lesions are treated primarily by surgery. This type of ambiguity, which occurs after ultrasound, disappears only with the histopathology of the sample resected with clinical correlation.

Multiple cutaneous metastasis of sacral chordoma, mimicking neurofibromas clinically

Chordoma is a rare primary bone tumor of notochordal origin, constituting 1-4% of malignant primary bone tumors. Chordomas are slow growing tumors and show aggressive local extension, multiple recurrences and metastasis. Cutaneous metastasis of chordoma is very rare. We report a case of a 61-year-old man presenting with multiple cutaneous metastasis of primary sacral chordoma.

Seroprevalence & changing trends of transfusion-transmitted infections amongst blood donors in a Regional Blood Transfusion Centre in north India

Background & objectives: Transfusion-transmitted infections (TTIs) are the major problem associated with blood transfusion. Accurate estimates of risk of TTIs are essential for monitoring the safety of blood supply. The present study was undertaken to determine the percentage of voluntary donors (VDs) and replacement donors (RDs) and also, to estimate and compare the seroprevalence and changing trends of TTIs amongst VDs and RDs in a regional blood transfusion centre in north India. Methods: This retrospective study was based on the records of all voluntary and replacement donations which were collected from January 2008 to December 2014 in a Regional Blood Transfusion Centre placed in a tertiary care hospital in Delhi, India. Results: Of the total 220,482 donations, 163,540 (74.17%) were voluntary and 56,942 (25.83%) were replacement donation. The overall seroprevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and malaria were 0.32, 1.61, 0.73, 1.62 and 0.06 per cent, respectively. Furthermore, the TTIs were more frequently encountered in RDs in comparison to VDs. Interpretation & conclusions: The increase in public awareness regarding voluntary blood donation, meticulous donor screening, counselling and use of highly sensitive tests can help in reducing the risk of TTIs.

Aneurysmal Bone Cyst: An Uncommon Secondary Event in Calcaneal Chondroblastoma.

Chondroblastoma is an uncommon benign bone tumour, involvement of epiphysis of long bones is typical. Chondroblastoma of the calcaneum is uncommon and its association with secondary aneurysmal bone cyst is even rarer. Only two cases of calcaneal chondroblastoma associated with secondary aneurysmal bone cyst have been reported till date. A 22-year-old male presented to the department of orthopaedics with complains of pain and swelling in the left heel since the last 10 months. On clinico-radiological grounds differentials considered were giant cell tumour of bone and aneurysmal bone cyst. In view of the histopathological findings of bone curettage and results of special stain and immunohistochemical marker, final diagnosis of chondroblastoma with secondary aneurysmal bone cyst, left calcaneum was rendered. Although rare, chondroblastoma should always be considered in osteolytic lesions of calcaneum. The identification of secondary aneurysmal bone cyst component is important as it has higher chances of recurrence than usual chondroblastoma.

Annular atrophic plaque over the arm

DOI: 10.4103/2229-5178.185474 melanoma. Perilesional depigmentation has been reported in metastatic melanoma.[8] This is the first Indian report of multiple brain metastases in acral lentiginous melanoma with acute hemiparesis as the presenting manifestation. It was noteworthy that he also had vitiligo. Since the chance of late metastasis cannot be ruled out even in treated cases, it is emphasized that all patients with acral lentiginous melanoma should be thoroughly investigated and followed up for a life time as brain metastases can be effectively treated when detected early.

Aquagenic syringeal acrokeratoderma.

1. Weedon D. Weedon’s Skin Pathology. 3rd ed. London: Churchill Livingstone, Elsevier, 2010. p. 799‐800. 2. Takeda H, Mitsuhashi Y, Hayashi M, Kondo S. Eccrine syringofibroadenoma: Case report and review of the literature. J Eur Acad Dermatol Venereol 2001;15:147‐9. 3. Bandyopadhyay D, Chattopadhyay S, Saha S. Reactive eccrine syringofibroadenoma on a leprous foot. Indian J Dermatol Venereol This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.