Sudarshan Sharma

Ziehl–Neelsen sputum smear microscopy image database: a resource to facilitate automated bacilli detection for tuberculosis diagnosis

Abstract. Ziehl–Neelsen stained microscopy is a crucial bacteriological test for tuberculosis detection, but its sensitivity is poor. According to the World Health Organization (WHO) recommendation, 300 viewfields should be analyzed to augment sensitivity, but only a few viewfields are examined due to patient load. Therefore, tuberculosis diagnosis through automated capture of the focused image (autofocusing), stitching of viewfields to form mosaics (autostitching), and automatic bacilli segmentation (grading) can significantly improve the sensitivity. However, the lack of unified datasets impedes the development of robust algorithms in these three domains. Therefore, the Ziehl–Neelsen sputum smear microscopy image database (ZNSM iDB) has been developed, and is freely available. This database contains seven categories of diverse datasets acquired from three different bright-field microscopes. Datasets related to autofocusing, autostitching, and manually segmenting bacilli can be used for developing algorithms, whereas the other four datasets are provided to streamline the sensitivity and specificity. All three categories of datasets were validated using different automated algorithms. As images available in this database have distinctive presentations with high noise and artifacts, this referral resource can also be used for the validation of robust detection algorithms. The ZNSM-iDB also assists for the development of methods in automated microscopy.

Papillary cystadenocarcinoma of submandibular salivary gland: a rare case report.

Papillary cystadenocarcinoma is an extremely rare malignant neoplasm characterized by cysts and papillary endophytic projections. It was first defined in 1991 by World Health organization as a separate entity. Major locations of this neoplasm are the parotid gland, the sublingual gland, and minor salivary glands, while occurrence in the submandibular gland is extremely rare. We present a case of papillary cystadenocarinoma arising from the submandibular gland in a 67-year-old male patient. Further, we have discussed the cytological and histopathological features of this rare entity and reviewed the current literature.

Nephrolithiasis Associated Rare Renal Tumors Masquerading Non-Functional Kidney

Two cases - primary squamous cell carcinoma of renal parenchyma and adenocarcinoma of renal pelvis are added to those so far reported. There is very scant literature on primary squamous cell carcinoma of renal parenchyma making it a very rare tumor. Association with long standing chronic infection and nephrolithiasis is emphasized. Presence of a renal stone and occult gross appearance of most of these tumors and may lead the pathologist to overlook their presence and be overwhelmed with nephrolithiasis only. Hence, any kidney with nephrolithiasis should be examined carefully to look for the presence of any tumorous growth.

Cytomorphological features of Hürthle cell carcinoma: A report of two cases with review of literature

The use of the term “Hürthle cell neoplasm” as the gold standard should be discouraged as it makes evaluating these lesions more confusing. Recently, a number of studies have been conducted to define criteria that are more specific for Hürthle cell carcinoma (HCC). We herein report two cases of HCC of thyroid which were accurately diagnosed preoperatively using various cytological features described in the recent studies. A review of the literature is also presented.

Cyto-histological correlation of sarcomatoid carcinoma of kidney

Sarcomatoid renal cell carcinoma (RCC) is a rare malignancy constituting 0.7% to 13.2% of all renal parenchymal malignancies. It is also called anaplastic carcinoma, spindle cell carcinoma or carcinosarcoma. The sarcomatoid differentiation is not a distinct histological entity, but it confers high aggressiveness on any subtype of RCC. Cytology of sarcomatoid RCC has rarely been described in literature. We describe cytology of a renal tumor that was later proven to be sarcomatoid RCC on histopathology and immunohistochemistry.

Cytodiagnosis of Ewing's sarcoma and its confirmation by histopathology and immunohistochemistry

Ewing sarcoma (EWS) is a rare malignant round cell tumor. It is the second common primary tumor of the bone found in children. The most common site in which it occurs is in the pelvis, the femur, the humerus, and the ribs. Due to its morphological overlap, there is diagnostic difficulty and for accurate diagnosis, requires special studies such as immunohistochemistry, electron microscopy, and molecular genetic analysis. We report a case of EWS in a 19 years boy who presented with pain and tenderness of left thigh. Fine-needle aspiration cytology was done and reported as Malignant round cell tumor suggestive of EWS. Diagnosis of EWS was confirmed with special stains and immunohistochemistry.

Pleural biopsy: A superior procedure than pleural fluid cytology in diagnosing pleural malignancy

Background: The present study is designed to evaluate the role of pleural fluid cytology and pleural biopsy in diagnosing pleural diseases and to study the advantages and disadvantages of thoracocentasis and pleural biopsy. Materials and Methods: We prospectively included 66 consecutive indoor patients over a duration of 1-year. Pleural fluid was collected, cytological smears were made from the fluid. Plural biopsy was obtained in the same patient by Cope′s needle. Adequate pleural biopsy tissue yielding specific diagnosis was obtained in 47 (71.2%) of cases. Results: Tuberculosis was the commonest nonneoplastic lesion followed by chronic nonspecific pleuritis comprising 60% and 33.3% of the nonneoplastic cases respectively and tuberculosis was predominantly diagnosed in younger age group. Majority (70.8%) of malignancy were in the age group of >50-70. Adenocarcinoma was found to be the commonest (66.7%) malignant neoplasm in the pleurae followed by small cell carcinoma (20.8%). Conclusion: Pleural biopsy is a useful and minimally invasive procedure. It is more sensitive and specific than pleural fluid smears.

Askin tumor in an adult female

Askin tumor is extremely rare and difficult to diagnose. We present a 55-year-old female with multiple pleural and diaphragm based masses on the right side. Contrast enhanced computed tomography chest showed multiple pleural and diaphragm based masses on the right side. Fine-needle aspiration cytology and Plural biopsy were done. Both studies proved it to be Askin tumor. Immunohistochemistry for cluster of differentiation 99 was positive. This case to our knowledge is very rare as the patient is elderly, and the previously reported cases of Askin tumor were male. Here, we discuss the dilemma in clinical and pathological diagnosis of such a rare case with previously reported cases in the literature.

Cytodiagnosis of biphasic synovial sarcoma of anterior chest wall: A rare case report

Synovial sarcoma (SS) is a rare malignant neoplasm comprising 8% of mesenchymal tumors. Only few reports defining cytological findings in SS of anterior chest wall have been described in the literature. We hereby report a case of biphasic SS of anterior chest wall, which was diagnosed on fine-needle aspiration. Cytological smears revealed bimodal cell population comprising of spindle cells and epithelial cells. Spindle cells were arranged in dense clusters, having elongated nuclei, fine nuclear chromatin and scanty cytoplasm. Epithelial cells were arranged in a glandular pattern, with central to eccentric, round nuclei, fine nuclear chromatin and scanty cytoplasm. A possibility of biphasic SS was suggested, which was later confirmed on histopathology and immunohistochemistry. Prompt diagnosis and aggressive surgical resection is mandatory for primary SS of the chest wall because of its aggressive behavior.