Vijay S. Nijhawan

Fine needle aspiration cytology of amyloid goiter : A report of four cases

BACKGROUND Amyloid goiter is a very rare clinical entity. It can be confused easily with a neoplastic goiter both clinically and cytologically. CASES In four cases of amyloid goiter the diagnosis was established preoperatively by fine needle aspiration cytology. Abundant violet to pink amorphous material with staining characteristics of amyloid was obtained in all cases. This material was morphologically distinct from colloid. Abdominal fat aspiration was done in all four cases. Two of the four abdominal fat aspirates were positive for amyloid. CONCLUSION Attention to the morphology of cells accompanying amyloid allows exclusion of medullary thyroid carcinoma, thereby avoiding unnecessary surgery. Moreover, aspirates from the abdominal pad of fat and the thyroid and salivary glands, when enlarged, are useful in the workup of suspected amyloidosis, especially since it is a safe, easily performed procedure.

Prevalence of Helicobacter pylori, cytomegalovirus, and Chlamydia pneumoniae immunoglobulin seropositivity in coronary artery disease patients and normal individuals in North Indian population

BACKGROUND In present day atherosclerosis is perceived as a chronic inflammatory vascular condition and infectious diseases are believed to contribute to its pathophysiology. In this context, the microorganisms which are believed to play a role in the pathophysiology include Chlamydia pneumoniae, cytomegalovirus (CMV), and Helicobacter pylori. METHOD A case control study (retrospective) was conducted over a two-year period. The study population was divided into two groups with 200 individuals in each group. The first group comprised cases of coronary artery disease (CAD) and the second comprised healthy controls selected from the general population after matching for age and sex. Enzyme-linked immunosorbent assay (ELISA) was done for immunoglobulin (IgG) antibodies to H. pylori, C. pneumonia, and CMV. They were also evaluated for conventional risk factors including hypertension, diabetes, obesity, and dyslipidaemia. Epi Info™ version 6 six software was used for analysis of data. Odds ratio, χ(2) for trend and multiple logistic regression analysis were used to find out statistically significant results. RESULTS Seropositivity for H. pylori was present in 119 patients of CAD (59.5%) but it was present in only 76 controls (38%) (P = 0.001). There was a statistically significant association between seropositivity for H. pylori and CAD. There was no statistically significant association between C. pneumoniae and CMV seropositivity with CAD. Multiple logistic regression analysis was done with CAD as the outcome (dependent variable). The predictor covariates (independent) variables were seropositivity to H. pylori, C. pneumoniae, and CMV, hypertension, obesity, diabetes, and dyslipidaemia. It was found that seropositivity to H. pylori, hypertension, obesity, and dyslipidaemia were significant risk factors for CAD. CONCLUSION Our study shows an association between IgG antibody response to H. pylori and CAD. Multiple logistic regression analysis showed that this association was retained even on comparison with the other risk factors.

Correlation of microvessel parameters in invasive ductal carcinoma of the breast and fibroadenomas: a morphometric study

Modifications of microvascular configuration are essential features encountered during the progression of breast tumors. Our objectives were to correlate morphometrically evaluated microvessel parameters (microvessel density [MVD], microvessel caliber [VC], microvessel cross-sectional area [VCSA], percentage of total VCSA [%TVCSA], and total microvessel boundary density [TVBD]) with histologic grades of invasive ductal carcinoma (IDC) of the breast and benign breast lesions. Sixty cases of IDC presented with modified radical mastectomy, and 20 benign breast fibroadenomas were evaluated for various microvessel parameters, using CD34-immunostained histologic sections by computerized image morphometry. Samples were divided into 4 histologic groups: benign, grade 1, grade 2, and grade 3; mean with SD and range was evaluated for each group. Histologic grades showed a strong positive correlation with %TVCSA (ρ=0.773) and TVBD (ρ=0.811) and a moderate positive correlation with MVD (ρ=0.607), VC (ρ=0.609), and VCSA (ρ=0.616) when analyzed for all samples of the 4 groups. Except MVD, all parameters including age was the lowest (P<.001) for the benign group. Among the IDCs, differences of mean VC and VCSA were not significant; MVD, %TVCSA, and TVBD were the lowest in grade 1 and the highest in grade 3. Upper cutoff value of benign lesions for MVD was 155mm-2; VC, 9.94μm; VCSA, 94.42 μm2; %TVCSA, 1.33; and TVBD, 4.37mm-1. Total microvessel boundary density included the information of microvessel concentration and size showed the best correlation with grades. Microvessel density showed a positive correlation with grades in the IDCs, but for the differentiation of benign from malignant, VC, VCSA, %TVCSA, and TVBD showed excellent area under the receiver operating characteristic curve (area under the curve > 0.990), unlike MVD (area under the curve = 0.797).

Anti-neutrophil cytoplasmic antibody negative crescentic paucimmune glomerulonephritis in a case of scleroderma with systemic lupus erythematosus overlap

Renal Involvement in scleroderma is a known problem and the manifestations are well described. Renal involvement in systemic lupus erythematosus (SLE) is also well known. However, in scleroderma and SLE overlap syndrome, the renal findings may vary being a combination of features of immune complex mediated glomerulonephritis as well as thrombotic microangiopathy. We report a case in which the renal manifestation in such a situation was of a focal necrotising pauci-immune glomerulonephritis with crescents, anti-neutrophil cytoplasmic antibody negative. To the best of our knowledge, such manifestations have not been described before. Renal dysfunction in a normotensive setting in such a case should direct one towards evaluation for other causes and should prompt a kidney biopsy. This would be valuable in delineating the pathological process in the kidney and would help in guiding therapy.

Subject Index Vol. 52, 2008

Analytical and Quantitative Cytology and Histology: Volume 29, Number 6 (December 2007), 2008; 52:114–116 Analytical and Quantitative Cytology and Histology: Volume 30, Number 1 (February 2008), 2008;52: 255–258 Analytical and Quantitative Cytology and Histology: Volume 30, Number 2 (April 2008), 2008;52: 373–376 Analytical and Quantitative Cytology and Histology: Volume 30, Number 3 (June 2008), 2008;52:505– 508 Analytical and Quantitative Cytology and Histology: Volume 30, Number 4 (August 2008), 2008;52: 631–634 Analytical and Quantitative Cytology and Histology: Volume 30, Number 5 (October 2008), 2008;52: 736–738 Acid-fast bacilli Role of Modified Bleach Method in Staining of Acid-Fast Bacilli in Lymph Node Aspirates. (Gangane et al), 2008;52:325–328 Adenocarcinoma CK5/6 in Effusions: No Difference Between Mesothelioma and Pulmonary and Nonpulmonary Adenocarcinoma. (Dejmek), 2008;52: 579–583 Cytology of Pseudomyxoma Peritonei Associated with Well-Differentiated Appendiceal Adenocarcinoma. (Siddaraju et al), 2008;52:391–394 (Letter) Diagnosis of Linitis Plastica–Type Gastric Adenocarcinoma by Endoscopic Ultrasound-Guided Fine Needle Aspiration: A Case Report. (Carter et al), 2008;52:725–728 Improved Identification of Malignant Cells in Serous Effusions Using a Small, Robust Panel of Antibodies on Paraffin-Embedded Cell Suspensions. (Grefte et al), 2008;52:35–44 Adenocarcinoma, clear cell Clear Cell Carcinoma in a Background of Endometriosis: Case Report of a Finding in a Midline Abdominal Scar 5 Years After a Total Abdominal Hysterectomy. (Rust et al), 2008;52: 475–480 Adenoma Cytologic Features of Pulmonary Alveolar Adenoma. (González et al), 2008;52:739–740 (Letter) Adenoma, microcytic Preoperative Fine Needle Aspiration Cytology Diagnosis of Microcystic Adenoma of the Pancreas: Fact or Fiction? A Report of 2 Cases. (Fitzhugh et al), 2008;52:240–246 Adenoma, pleomorphic Chondromyxoid Fibroma of the Mandible: A Diagnostic Pitfall on Aspiration Cytology of Parotid. (Daneshbod and Khademi), 2008;52:636–638 (Letter) Fine Needle Aspiration Biopsy of Pleomorphic Adenoma and Adenoid Cystic Carcinoma of the Lacrimal Gland. (Siddaraju et al), 2008;52:515– 517 (Letter) Adenoma, pleomorphic metastazing Pleomorphic Adenoma of the Parotid Gland Metastasizing to the Scapular Region: A Case Report. (Ghosh et al), 2008;52:733–735 Adnexa Cytologic Features of Primary Malignant Tumors of Skin and Adnexae. (Prayaga et al), 2008;52: 702–709 Adolescent Fine Needle Aspiration Cytology of Breast Masses in Children and Adolescents: Experience with 1,404 Aspirates. (Kapila et al), 2008;52:681–686 Adult T-cell leukemia/lymphoma Diagnostic Considerations in Prolymphocytes in Pleural Fluid: A Case Report. (Anand et al), 2008; 52:251–254 Africa Into Africa: Cytology for One World. (Kaminsky), 2008;52:399 Alcian blue Cytology of Pseudomyxoma Peritonei Associated with Well-Differentiated Appendiceal Adenocarcinoma. (Siddaraju et al), 2008;52:391–394 (Letter) Analytical and Quantitative Cytology and Histology

Contributors Index Vol. 52, 2008

Abascal-Agorreta M (see Vera-Alvarez et al). 2008;52: 264–266 (Letter) Abdali K (see Shamsi et al). 2008;52:187–190 Abdul-Karim FW (see Farag et al). 2008;52:294–296 Abnet CC (see Pan et al). 2008;52:14–23 Abraham EK (see Ramadas et al). 2008;52:396–398 (Letter) Adán A (see Saro et al). 2008;52:87–90 Afarid M (see Mostaghni et al). 2008;52:597–601 Aisner S (see Fitzhugh et al). 2008;52:240–246 Akbulut M, Zekioglu O, Kapkac M, Erhan Y, Ozdemir N. Fine Needle Aspiration Cytology of Glycogen-Rich Clear Cell Carcinoma of the Breast: Review of 37 Cases with Histologic Correlation. 2008;52:65–71 Akbulut M, Zekioglu O, Ozdemir N, Kapkac M. Fine Needle Aspiration Cytology of Mammary Carcinoma with Choriocarcinomatous Features: A Report of 2 Cases. 2008;52:99–104 Aktepe F (see Tokyol et al). 2008;52:235–239 Al-Abbadi M (see Vella et al). 2008;52:377–378 (Letter) Al-Abbadi MA (see Feng et al). 2008;52:434–438 Al-Agha OM, Khader SN, Cajigas A, Blank W, Grafstein N, Seymour AW. Fine Needle Aspiration of Urethral Recurrence of Urothelial Carcinoma After Radical Cystectomy Presenting as a Perineal Mass: A Case Report. 2008;52:94–98 Al-Ayadhy B (see Kapila et al). 2008;52:681–686 Al-Mosawy FA (see Kapila et al). 2008;52:681–686 Al-Sebeih K (see Palmieri et al). 2008;52:691–696 Aledavud A (see Daneshbod et al). 2008;52:387–389 (Letter) Ales A (see Terčelj et al). 2008;52:584–590 Almeida JD, Lima CF, Brandão AAH, Cabral LAG. Evaluation of Staining Methods for Cytologic Diagnosis of Oral Lesions. 2008;52:697–701 Altay M (see Demir et al). 2008;52:309–312 Alvarez-Santín C. Endometrial Adenocarcinoma: Prevention and Early Diagnosis. 2008;52:748 (Book Review) Amadori PL (see Bonzanini et al). 2008;52:541–548 Amano S (see Komatsu et al). 2008;52:591–596 Ambaye AB (see Sherman et al). 2008;52:659–664 Anand M, Sharma S, Kumar R, Raina V. Diagnostic Considerations in Prolymphocytes in Pleural Fluid: A Case Report. 2008;52:251–254 Ang L-C (see Keith et al). 2008;52:260–263 (Letter) Angeloni C (see Maccallini et al). 2008;52:568–574 Anshu (see Gabhane et al). 2008;52:354–356 Anshu (see Gangane et al). 2008;52:325–328 Anshu (see Gangane et al). 2008;52:619–622 Antonelli C (see Maccallini et al). 2008;52:568–574 Apice G (see Fulciniti et al). 2008;52:612–618 Arabi MA (see Daneshbod et al). 2008;52:268–270 (Letter) Argüelles M (see González et al). 2008;52:490–494 Armbruster C, Bernhardt K, Setinek U. Pulmonary Tumorlet: A Case Report of a Diagnostic Pitfall in Cytology. 2008;52:223–227 Aron M (see Mathur et al). 2008;52:740–743 (Letter) Arora VK (see Mathur et al). 2008;52:740–743 (Letter) Arundhati (see Garbyal et al). 2008;52:204–206 Arundhati (see Ghosh et al). 2008;52:733–735 Ashfaq R (see Patino et al). 2008;52:718–720 Ashraf MJ (see Azarpira et al). 2008;52:220–222 Ashraf MJ, Azarpira N, Vasei M, Tavakol MH, Khademi B. Thyroid Paraganglioma: Diagnostic Pitfall in Fine Needle Aspiration Biopsy. 2008;52: 745–747 (Letter) Assiri AH (see Mokhtar et al). 2008;52:169–177 Asthana AK (see Ghosh et al). 2008;52:733–735 Athanassiadou P, Grapsa D. Value of Endoscopic Retrograde Cholangiopancreatography–Guided Brushings in Preoperative Assessment of Pancreaticobiliary Strictures: What’s New? 2008;52:24–34 Azarpira N (see Ashraf et al). 2008;52:745–747 (Letter) Azarpira N, Ashraf MJ, Shishegar M. Fine Needle Aspiration Findings in Angiofollicular Hyperplasia with Eosinophilia: A Case Report. 2008;52:220–222