Srabani Chakrabarti

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.

Evaluation of Ultrasound-Guided Fine-Needle Aspiration Cytology of Ovarian Masses with Histopathological Correlation.

Background: Preoperative cytodiagnosis of ovarian masses is a difficult process, and sampling of pelvic masses is quite easier after the improvement of imaging techniques. Though histopathology is the gold standard, fine-needle aspiration cytology (FNAC) under ultrasound (US) guidance can be a valuable tool for pre-operative diagnosis of ovarian lesions, especially in the hands of an experienced pathologist. Objective: The present study was performed to evaluate the role of US-guided FNAC in pre-operative cytological diagnosis of ovarian masses in comparison with histopathology, and to assess the pitfalls and limitations of cytological interpretation. Materials and Methods: This study was conducted over a 2-year period on 70 cases of ovarian masses, which were evaluated by US-guided FNAC. Sensitivity, specificity and diagnostic efficacy were calculated using histopathology as gold standard. Results: On cytological evaluation, non-neoplastic cysts, and benign and malignant ovarian tumours were diagnosed in 8, 18 and 40 cases, respectively. On histopathology, 62 cases were concordant with cytology. Sensitivity and specificity were 95.23 and 95.83%, respectively, in the present study. Diagnostic accuracy was 93.94% in respect to the correct diagnosis. Cytohistological discrepancies and limitations of the study are discussed. Conclusion: US-guided FNAC has proved as a quick, economic and safe procedure in diagnosing ovarian masses with brilliant accuracy.

Cytological and Morphometric Study of Urinary Epithelial Cells with Histopathological Correlation

This study has been done to asses the utility and accuracy of urinary cytology and morphometric study of exfoliated cells in early detection and follow-up of urothelial neoplasms and thereby help to reduce the disease-related mortality and morbidity. A total 100 patients with urinary symptoms were studied by cytological examination of urine along with morphometric analysis of suspicious epithelial cells. Immunostaining to detect CK-20 expression and p53 over expression was done in smears showing atypical cells. Histopathological confirmation was done in cases which were suspicious on cystoscopy. P value was determined by using unpaired t-test. Statistically significant difference was found between neoplastic and non-neoplastic lesions of the urinary bladder as far as morphometry is concerned. Urinary cytology along with morphometry is an important tool in early detection of urothelial neoplasms. It is also helpful to find out the recurrences during post-operative follow-up period. Overexpression of CK-20 and p53 immunostain in cytology can act as an adjunct to the cytological diagnosis.

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.

Cytological Study of Breast Carcinoma Before and After Oncotherapy with Special Reference to Morphometry and Proliferative Activity

Our study was done to assess the cytological changes due to oncotherapy in breast carcinoma especially on morphometry and proliferative activity. Cytological aspirates were collected from a total of 32 cases of invasive ductal carcinoma both before and after oncotherapy. Morphometry was done on the stained cytological smears to assess the different morphological parameters of cell dimension by using the ocular morphometer and the software AutoCAD 2007. Staining was done with Ki-67 and proliferating cell nuclear antigen (PCNA) as proliferative markers. Different morphological parameters were compared before and after oncotherapy by unpaired Student’s t test. Statistically significant differences were found in morphometric parameters, e.g., mean nuclear diameter, mean nuclear area, mean cell diameter, and mean cell area, and in the expression of proliferative markers (Ki-67 and PCNA). Statistical analysis was done by obtaining p values. There are statistically significant differences between morphological parameter of breast carcinoma cells before and after oncotherapy.

Cytodiagnosis of Extra-nasal Rhinosporidiosis: A Study of 16 Cases from Endemic Area.

Context: Extra-nasal rhinosporidiosis is not uncommon in endemic region like India. Clinical presentations of extra-nasal rhinosporidiosis lesion often lead to diagnostic dilemma. Cytology can help in the preoperative diagnosis of such lesions. Aims: The aims of our study were to find the clinico-pathological presentation of extra-nasal rhinosporidiosis and to evaluate the role of cytology in diagnosing these lesions preoperatively. Settings and Design: Fine-needle aspiration cytology is often used for preoperative diagnosis of sub-cutaneous lesions of the head and neck region. This retrospective study was designed to include the cytologically diagnosed cases of rhinosporidiosis and to compare with final histopathology of the lesions. Materials and Methods: A total of 21 cases of extra-nasal rhinosporidiosis were diagnosed in our study period of 18 months. Cytology was approached in 17 cases and 16 cases were diagnosed as rhinosporidiosis, which were included in the study group. Twelve cases were sampled by fine-needle aspiration and four cases by scrap technique. Histopathological confirmation was possible in all cytologically diagnosed cases. Results: Head and neck region were involved in 15 cases and only one case was on the skin of right upper arm. Orbital region was the most common extra-nasal site of involvement. Most of the cases (13 cases, 81.25%) belonged to the age group of 11-30 years. All cytologicaly diagnosed cases of rhinosporidiosis were concordant with histopathology. Only one false-negative case was cytologically diagnosed as suppurative inflammatory lesion. Sensitivity and specificity of cytology in diagnosis of extra-nasal rhinosporidiosis were 94.11% and 100% respectively. Conclusions: Extra-nasal rhinosporidiosis is an important differential diagnosis of nodular, polypoid mass of head-neck-face region. Cytology can be used as an important tool in preoperative diagnosis of extra-nasal rhinosporidiosis.

Morphometric and Histological Study of Breast Lesions with Special Reference to Proliferative Activity and Invasiveness

Breast carcinoma is the most common cause of carcinoma death in women. Sometimes, difficulty arises to differentiate between premalignant lesions and carcinoma by routine histopathology. Our study was done to establish the role of morphometry and immunohistochemistry to solve this problem. In this study, total 60 cases of different breast lesions were included and 10 controls were also included to compare the results with the normal findings. They were studied by hematoxylin and eosin-stained sections for morphometry and routine histological study; as well as by proliferative markers such as proliferating cell nuclear antigen and p53. Invasiveness was studied using immunohistochemical staining with 34 βE12 monoclonal antibody. Statistically significant differences were found in morphometric parameters and in expression of proliferative markers between most of them. Morphometry and immunohistochemistry help in the proper diagnosis of different breast lesions that lie in the gray zone on routine histopathology.