Pub Date : 2023-04-01Epub Date: 2023-05-22DOI: 10.4103/joc.joc_122_21
Sabina Khan, Inara Abeer, Musharraf Husain, Sujata Jetley
Background: Pilomatrixoma (PMX) is a relatively uncommon benign cutaneous neoplasm arising from skin adnexa. It presents as a subcutaneous asymptomatic nodule mostly in the head and neck region and is frequently misdiagnosed by the clinicians. Although easily diagnosed on histopathology, the cytologic features of PMX are less distinctive, depending on the stage and evolution of disease and may mimic other benign or even malignant lesions.
Aim: To study the cyto-morphological features of this uncommon neoplasm and identify its potential diagnostic pitfalls on fine needle aspiration cytology (FNAC).
Material and methods: Archival records of histopathologically diagnosed Pilomatrixoma were analyzed during study period of 2.5 years. Clinical diagnosis, preoperative FNA characteristics, and histopathological details were studied in each case. Cytologic pitfalls resulting in misdiagnosis of PMX cases on FNAC were evaluated in discordant cases.
Results: The series showed male preponderance, with head and neck being the commonest site. Out of 21 histopathologically proven cases of PMX, cytological correlation was available in 18 cases. A correct cytologic diagnosis of PMX/adnexal tumor was rendered in 13 cases. Erroneous diagnosis was given in 5 cases mainly because of the predominance of one component over the other or non-representative-aspirated material.
Conclusion: The present study highlights the importance of careful screening of FNAC smears keeping in mind the variability in the relevant cytologic features of PMX and creates awareness about the lesions that can mimic Pilomatrixoma resulting in diagnostic dilemma.
{"title":"Cytological Diagnosis of Pilomatrixoma and its Diagnostic Pitfalls.","authors":"Sabina Khan, Inara Abeer, Musharraf Husain, Sujata Jetley","doi":"10.4103/joc.joc_122_21","DOIUrl":"10.4103/joc.joc_122_21","url":null,"abstract":"<p><strong>Background: </strong>Pilomatrixoma (PMX) is a relatively uncommon benign cutaneous neoplasm arising from skin adnexa. It presents as a subcutaneous asymptomatic nodule mostly in the head and neck region and is frequently misdiagnosed by the clinicians. Although easily diagnosed on histopathology, the cytologic features of PMX are less distinctive, depending on the stage and evolution of disease and may mimic other benign or even malignant lesions.</p><p><strong>Aim: </strong>To study the cyto-morphological features of this uncommon neoplasm and identify its potential diagnostic pitfalls on fine needle aspiration cytology (FNAC).</p><p><strong>Material and methods: </strong>Archival records of histopathologically diagnosed Pilomatrixoma were analyzed during study period of 2.5 years. Clinical diagnosis, preoperative FNA characteristics, and histopathological details were studied in each case. Cytologic pitfalls resulting in misdiagnosis of PMX cases on FNAC were evaluated in discordant cases.</p><p><strong>Results: </strong>The series showed male preponderance, with head and neck being the commonest site. Out of 21 histopathologically proven cases of PMX, cytological correlation was available in 18 cases. A correct cytologic diagnosis of PMX/adnexal tumor was rendered in 13 cases. Erroneous diagnosis was given in 5 cases mainly because of the predominance of one component over the other or non-representative-aspirated material.</p><p><strong>Conclusion: </strong>The present study highlights the importance of careful screening of FNAC smears keeping in mind the variability in the relevant cytologic features of PMX and creates awareness about the lesions that can mimic Pilomatrixoma resulting in diagnostic dilemma.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"40 2","pages":"88-94"},"PeriodicalIF":1.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10305896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9729612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01Epub Date: 2023-05-22DOI: 10.4103/joc.joc_1_22
Suneet Singh, Jayashri P Chaudhari, Kanchan Kothari
{"title":"Castleman Disease: Diagnosis on Cytology.","authors":"Suneet Singh, Jayashri P Chaudhari, Kanchan Kothari","doi":"10.4103/joc.joc_1_22","DOIUrl":"10.4103/joc.joc_1_22","url":null,"abstract":"","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"40 2","pages":"105-106"},"PeriodicalIF":1.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10305901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9737530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Senay Erdogan-Durmus, Cansu Yol, Lebriz Uslu-Besli, Nesrin Uygun
Follicular variant of papillary thyroid carcinoma (FV-PTC) is the second most common subtype of PTC after the classic PTC. FV-PTC is characterized by nuclear features of classic PTC with a follicular architecture that lacks classic papillary morphology. Unlike follicular thyroid carcinoma (FTC), which is more often manifested by hematogenous metastases to lung and bone, PTC tends to metastasize to cervical lymph nodes. Distant metastases of PTC are very rare, whereas renal metastasis is extremely rare.[1] Renal fine-needle aspiration (FNA) is not commonly used due to concerns about safety and diagnostic accuracy. However, it can be used for diagnosis in poor surgical candidates or patients with unresectable tumors and for excluding metastasis, hematologic malignancy, and benign or reactive processes.[2] Here, we report the cytomorphological and clinical features of a 74-year-old female patient with renal mass diagnosed as FV-PTC metastasis with FNA. We report this case because of the rarity of renal metastasis of FV-PTC, which can be a diagnostic pitfall in the evaluation of renal FNA. A 74-year-old woman presented for evaluation of a right renal mass, and she did not have any urinary symptoms such as hematuria or pain. Computerized tomography (CT) of abdomen revealed a 29 × 28 mm homogeneous solid mass arising from the upper pole of the right kidney. The medical history of the patient indicated a total thyroidectomy performed at our hospital 7 years ago. The histologic type of tumor was identified as FV-PTC (with focal insular pattern and extrathyroidal extension). A recent fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scan of the patient revealed multiple hypermetabolic pulmonary and bone metastasis as well as an additional new hypermetabolic lesion with an SUVmax value of 7.5 on right upper renal pole [Figure 1].Figure 1: FDG-PET/CT scan maximum intensity projection (MIP) image revealing intense FDG uptake on upper pole of right kidney, which was proven to be thyroid cancer metastasis on histopathology (black arrow). She also had multiple bone metastases and pulmonary metastases with increased FDG uptakeCT-guided FNA was performed on renal mass for diagnosis. Very few cells were found on slides by rapid on-site evaluation; however, a second FNA could not be performed because the patient was unable to tolerate the procedure. In cytological evaluation, the slides were hypocellular, but the hematoxylin and eosin slides of cell block were rich in tumoral cells. The small- to medium-sized tumor cells with a follicular architecture with slightly monomorphic atypia were seen [Figure 2]. An immunohistochemical study was carried out in cell block to support the diagnosis. Tumor cells were positive for CK7, thyroid transcription factor-1 (TTF-1), thyroglobulin, and focal positive for CD56. No staining was observed with PAX2 [Figure 3]. The case was assessed with previous slides of thyroid resection. The s
{"title":"Cytomorphological and clinical features of follicular variant papillary thyroid carcinoma (with focal insular pattern) metastasis to kidney","authors":"Senay Erdogan-Durmus, Cansu Yol, Lebriz Uslu-Besli, Nesrin Uygun","doi":"10.4103/joc.joc_30_23","DOIUrl":"https://doi.org/10.4103/joc.joc_30_23","url":null,"abstract":"Follicular variant of papillary thyroid carcinoma (FV-PTC) is the second most common subtype of PTC after the classic PTC. FV-PTC is characterized by nuclear features of classic PTC with a follicular architecture that lacks classic papillary morphology. Unlike follicular thyroid carcinoma (FTC), which is more often manifested by hematogenous metastases to lung and bone, PTC tends to metastasize to cervical lymph nodes. Distant metastases of PTC are very rare, whereas renal metastasis is extremely rare.[1] Renal fine-needle aspiration (FNA) is not commonly used due to concerns about safety and diagnostic accuracy. However, it can be used for diagnosis in poor surgical candidates or patients with unresectable tumors and for excluding metastasis, hematologic malignancy, and benign or reactive processes.[2] Here, we report the cytomorphological and clinical features of a 74-year-old female patient with renal mass diagnosed as FV-PTC metastasis with FNA. We report this case because of the rarity of renal metastasis of FV-PTC, which can be a diagnostic pitfall in the evaluation of renal FNA. A 74-year-old woman presented for evaluation of a right renal mass, and she did not have any urinary symptoms such as hematuria or pain. Computerized tomography (CT) of abdomen revealed a 29 × 28 mm homogeneous solid mass arising from the upper pole of the right kidney. The medical history of the patient indicated a total thyroidectomy performed at our hospital 7 years ago. The histologic type of tumor was identified as FV-PTC (with focal insular pattern and extrathyroidal extension). A recent fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scan of the patient revealed multiple hypermetabolic pulmonary and bone metastasis as well as an additional new hypermetabolic lesion with an SUVmax value of 7.5 on right upper renal pole [Figure 1].Figure 1: FDG-PET/CT scan maximum intensity projection (MIP) image revealing intense FDG uptake on upper pole of right kidney, which was proven to be thyroid cancer metastasis on histopathology (black arrow). She also had multiple bone metastases and pulmonary metastases with increased FDG uptakeCT-guided FNA was performed on renal mass for diagnosis. Very few cells were found on slides by rapid on-site evaluation; however, a second FNA could not be performed because the patient was unable to tolerate the procedure. In cytological evaluation, the slides were hypocellular, but the hematoxylin and eosin slides of cell block were rich in tumoral cells. The small- to medium-sized tumor cells with a follicular architecture with slightly monomorphic atypia were seen [Figure 2]. An immunohistochemical study was carried out in cell block to support the diagnosis. Tumor cells were positive for CK7, thyroid transcription factor-1 (TTF-1), thyroglobulin, and focal positive for CD56. No staining was observed with PAX2 [Figure 3]. The case was assessed with previous slides of thyroid resection. The s","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"114 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136367014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Context: The performance parameters of cervical cytology in any accredited cytology laboratory requires implementation of quality control exercise, which ensures acceptable performance by a laboratory. This study aims to assess the analytical aspect of quality control measures by evaluating the frequency and accuracy of epithelial abnormalities as detected in cervical Pap smears using histopathologic diagnosis as the gold standard. Methods: A retrospective diagnostic test study from 2018 to 2020 was conducted. Out of the total 6000 Pap smears, histopathologic correlation was available in 150 cases in the form of colposcopic-directed biopsy (CDB) and loop electrosurgical excision procedure (LEEP) tissue in 105 cases. The quality control measures analyzed were Atypical Squamous Cell: Squamous Intraepithelial Lesion (ASC: SIL) ratio, cyto-histo correlation, and study parameters like sensitivity, specificity, positive predictive value, and negative predictive value of Pap smears as against CDB and LEEP. Results: 4.5% smears were reported as inadequate, 92.3% as Negative for intraepithelial lesion or malignancy (NILM), followed by epithelial abnormality found in 3.21%. The ASC: SIL ratio was 1.3:1. Concordance rate against CDB was 100% in Squamous cell carcinoma (SCC), 82.35% in high-grade squamous intraepithelial lesion (HSIL), 82% in atypical squamous cells of undetermined significance (ASCUS), 65.6% in low-grade squamous intraepithelial lesion (LSIL), and 50% in Atypical Squamous Cell ,High grade Squamous Intraepithelial Lesion can not be ruled out (ASC-H). Total concordance rate was 84.15%. Sensitivity of Pap smear was 65% for LSIL and 82% for HSIL. Specificity, positive predictive value, and negative predictive value were 63.63%, 90%, and 75%, respectively. Concordance rate was 96% with LEEP. Conclusion: Quality control measures give an insight of performance of any accredited cytology laboratory. This exercise needs to be conducted on a regular basis, so that relevant steps can be taken in case of major discrepancy.
{"title":"Cervical cytology and histology correlation as an analytic quality assurance exercise: Experience from an accredited cytology laboratory","authors":"ShubhangiV Belekar, Meherbano Kamal, AishwaryaS Warke","doi":"10.4103/joc.joc_174_22","DOIUrl":"https://doi.org/10.4103/joc.joc_174_22","url":null,"abstract":"Context: The performance parameters of cervical cytology in any accredited cytology laboratory requires implementation of quality control exercise, which ensures acceptable performance by a laboratory. This study aims to assess the analytical aspect of quality control measures by evaluating the frequency and accuracy of epithelial abnormalities as detected in cervical Pap smears using histopathologic diagnosis as the gold standard. Methods: A retrospective diagnostic test study from 2018 to 2020 was conducted. Out of the total 6000 Pap smears, histopathologic correlation was available in 150 cases in the form of colposcopic-directed biopsy (CDB) and loop electrosurgical excision procedure (LEEP) tissue in 105 cases. The quality control measures analyzed were Atypical Squamous Cell: Squamous Intraepithelial Lesion (ASC: SIL) ratio, cyto-histo correlation, and study parameters like sensitivity, specificity, positive predictive value, and negative predictive value of Pap smears as against CDB and LEEP. Results: 4.5% smears were reported as inadequate, 92.3% as Negative for intraepithelial lesion or malignancy (NILM), followed by epithelial abnormality found in 3.21%. The ASC: SIL ratio was 1.3:1. Concordance rate against CDB was 100% in Squamous cell carcinoma (SCC), 82.35% in high-grade squamous intraepithelial lesion (HSIL), 82% in atypical squamous cells of undetermined significance (ASCUS), 65.6% in low-grade squamous intraepithelial lesion (LSIL), and 50% in Atypical Squamous Cell ,High grade Squamous Intraepithelial Lesion can not be ruled out (ASC-H). Total concordance rate was 84.15%. Sensitivity of Pap smear was 65% for LSIL and 82% for HSIL. Specificity, positive predictive value, and negative predictive value were 63.63%, 90%, and 75%, respectively. Concordance rate was 96% with LEEP. Conclusion: Quality control measures give an insight of performance of any accredited cytology laboratory. This exercise needs to be conducted on a regular basis, so that relevant steps can be taken in case of major discrepancy.","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136371720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2023-02-15DOI: 10.4103/joc.joc_28_22
Sukhpreet Kaur, Rahul Karode, Hanni V Gulwani
Background: Meningiomas are generally slow-growing, benign, and non-infiltrating in nature. They are usually easy to diagnose cytologically if they are of the meningothelial type; however, they may cause diagnostic challenges when they manifest as unusual morphological variants, like the microcystic type. Because of the rarity of microcystic meningioma (MM), information on its cytological features is rarely available in the literature.
Objectives: The goal of this study is to review the cytological features of MM in crush preparations prepared at the time of intra-op consultation and to identify the more common features which are helpful in rendering a correct diagnosis.
Material and methods: Cytological features of five cases of MM were reviewed and noted from the records.
Results: There were five patients of MM with a male: female ratio of 1.5:1 and a mean age of 52 years. All tumors were supratentorial and dura-based. Magnetic resonance imaging (MRI) showed low signal intensity on T1 and high signal intensity on T2 weighted images in four cases. Cytosmears were moderate-to-highly cellular. There were variable-sized cystic spaces within the meningothelial cell clusters. In four cases, nuclear pleomorphism was frequently observed. Nuclear pseudoinclusions, atypical mitoses, vascular proliferation, and necrosis were absent in all cases. Whorling and psammoma bodies were seen in only one case.
Conclusion: Cytological features identified would be helpful in the diagnosis of microcystic meningiomas, especially in unusual radiological findings. Their unusual cytological features might lead to problems in differential diagnosis from other intracranial tumors, including glioblastoma, metastatic tumor, etc.
{"title":"Microcystic Meningioma - A Diagnostic Dilemma During Intraoperative Squash Smear Study.","authors":"Sukhpreet Kaur, Rahul Karode, Hanni V Gulwani","doi":"10.4103/joc.joc_28_22","DOIUrl":"10.4103/joc.joc_28_22","url":null,"abstract":"<p><strong>Background: </strong>Meningiomas are generally slow-growing, benign, and non-infiltrating in nature. They are usually easy to diagnose cytologically if they are of the meningothelial type; however, they may cause diagnostic challenges when they manifest as unusual morphological variants, like the microcystic type. Because of the rarity of microcystic meningioma (MM), information on its cytological features is rarely available in the literature.</p><p><strong>Objectives: </strong>The goal of this study is to review the cytological features of MM in crush preparations prepared at the time of intra-op consultation and to identify the more common features which are helpful in rendering a correct diagnosis.</p><p><strong>Material and methods: </strong>Cytological features of five cases of MM were reviewed and noted from the records.</p><p><strong>Results: </strong>There were five patients of MM with a male: female ratio of 1.5:1 and a mean age of 52 years. All tumors were supratentorial and dura-based. Magnetic resonance imaging (MRI) showed low signal intensity on T1 and high signal intensity on T2 weighted images in four cases. Cytosmears were moderate-to-highly cellular. There were variable-sized cystic spaces within the meningothelial cell clusters. In four cases, nuclear pleomorphism was frequently observed. Nuclear pseudoinclusions, atypical mitoses, vascular proliferation, and necrosis were absent in all cases. Whorling and psammoma bodies were seen in only one case.</p><p><strong>Conclusion: </strong>Cytological features identified would be helpful in the diagnosis of microcystic meningiomas, especially in unusual radiological findings. Their unusual cytological features might lead to problems in differential diagnosis from other intracranial tumors, including glioblastoma, metastatic tumor, etc.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"40 1","pages":"19-23"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9522643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Immunotherapy currently stands as a novel treatment option, specifically in cases of advanced non-small cell lung carcinoma (NSCLC). Expression of programmed death ligand-1 (PD-L1) in tumor cells forms the mainstay for the use of anti-PD-L1 monoclonal antibodies in the treatment of NSCLC. Aims: The objectives of the study were to assess utility of cell blocks for testing of PD-L1 in adenocarcinoma lung and to compare the expression of PD-L1 in cell blocks and the corresponding biopsy specimens. Materials and Methods: The current study was a prospective case series that included 20 cases of NSCLC–adenocarcinoma lung. Cases included in the study had biopsies performed from lung masses, along with which cell blocks were prepared from fine needle aspiration cytology (FNAC) samples. Testing for PD-L1 was done using the monoclonal PD-L1 antibody, SP-263 clone on the Ventana Benchmark XT system. PD-L1 expression was assessed only in the tumor cells, and cases with >1% expression, cytoplasmic or membranous, in tumor cells were categorized as positive. Results: PD-L1 expression was identified in the biopsy samples of tumor cells of 20% of cases (n = 4/20). In the corresponding cell blocks, PD-L1 expression was identified in the tumor cells of 15% of cases (n = 3/20). Sensitivity and specificity of cell blocks were 75% and 100%, respectively. Positive and negative predictive values were 100% and 94.12%, respectively. Conclusion: PD-L1 testing has both predictive and prognostic implications. PD-L1 testing in cell block samples is a potential alternative, specifically in cases where biopsy tissue is minimal or unavailable.
{"title":"Programmed death ligand-1 testing in adenocarcinoma lung: A comparative study of cell block versus biopsy","authors":"Nuzhat Husain, Saumya Shukla, RahulK Pandey, Vani Gupta, Anurag Gupta, Surya Kant","doi":"10.4103/joc.joc_33_22","DOIUrl":"https://doi.org/10.4103/joc.joc_33_22","url":null,"abstract":"Background: Immunotherapy currently stands as a novel treatment option, specifically in cases of advanced non-small cell lung carcinoma (NSCLC). Expression of programmed death ligand-1 (PD-L1) in tumor cells forms the mainstay for the use of anti-PD-L1 monoclonal antibodies in the treatment of NSCLC. Aims: The objectives of the study were to assess utility of cell blocks for testing of PD-L1 in adenocarcinoma lung and to compare the expression of PD-L1 in cell blocks and the corresponding biopsy specimens. Materials and Methods: The current study was a prospective case series that included 20 cases of NSCLC–adenocarcinoma lung. Cases included in the study had biopsies performed from lung masses, along with which cell blocks were prepared from fine needle aspiration cytology (FNAC) samples. Testing for PD-L1 was done using the monoclonal PD-L1 antibody, SP-263 clone on the Ventana Benchmark XT system. PD-L1 expression was assessed only in the tumor cells, and cases with >1% expression, cytoplasmic or membranous, in tumor cells were categorized as positive. Results: PD-L1 expression was identified in the biopsy samples of tumor cells of 20% of cases (n = 4/20). In the corresponding cell blocks, PD-L1 expression was identified in the tumor cells of 15% of cases (n = 3/20). Sensitivity and specificity of cell blocks were 75% and 100%, respectively. Positive and negative predictive values were 100% and 94.12%, respectively. Conclusion: PD-L1 testing has both predictive and prognostic implications. PD-L1 testing in cell block samples is a potential alternative, specifically in cases where biopsy tissue is minimal or unavailable.","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136367000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: A majority of the patients with gall bladder cancer (GBCa) present at an advanced stage and have poor survival. The aim is to retrospectively study the role of guided FNA in the diagnosis of GBCa in a superspecialty institute and to describe the cytomorphologic spectrum of gall bladder (GB) lesions in the North Indian population.
Materials and methods: All suspected cases of GBCa who underwent guided FNA from the primary GB mass or metastatic liver space-occupying lesion from 2017 to 2019 were included. The aspirate smears were retrieved and analyzed for cytomorphological features independently by two cytopathologists. The neoplastic lesions were classified according to the WHO 2019 classification.
Results: Of 489 cases, fine needle aspiration cytology (FNAC) was diagnostic in 463 cases (94.6%), of which 417 (90.1%) were positive for malignancy, 35 (7.5%) were inflammatory, and 11 (2.4%) were inconclusive for malignancy. Adenocarcinoma not otherwise specified (NOS) was the most common type seen in 330 cases (79.1%) and 87 (20.9%) were unusual variants. These included papillary adenocarcinoma (22, 5.2%), mucinous adenocarcinoma (12, 2.8%), signet ring carcinoma (2,0.4%), adenosquamous carcinoma (8, 1.9%), squamous cell carcinoma (10, 2.4%), neuroendocrine neoplasms (7, 1.7%), undifferentiated carcinoma (24, 5.7%) and non-Hodgkin lymphoma (2,0.4%), respectively. Immunohistochemistry on the cell block confirmed the diagnosis wherever possible. Histopathology was discordant in 5 out of 33 cases.
Conclusion: Guided FNAC is a sensitive investigation that plays a crucial role in confirming the diagnosis and deciding the further treatment options in advanced-stage GBCa patients. The uncommon variants of GBCa can be reliably categorized on cytology.
{"title":"Role of Guided FNA in Gallbladder Cancer: A Retrospective 3-Year Study.","authors":"Surbhi Goyal, Garima Prasad, Dimple Chaudhary, Puja Sakhuja, Siddhartha Srivastava, Anil K Aggarwal","doi":"10.4103/joc.joc_224_21","DOIUrl":"10.4103/joc.joc_224_21","url":null,"abstract":"<p><strong>Background: </strong>A majority of the patients with gall bladder cancer (GBCa) present at an advanced stage and have poor survival. The aim is to retrospectively study the role of guided FNA in the diagnosis of GBCa in a superspecialty institute and to describe the cytomorphologic spectrum of gall bladder (GB) lesions in the North Indian population.</p><p><strong>Materials and methods: </strong>All suspected cases of GBCa who underwent guided FNA from the primary GB mass or metastatic liver space-occupying lesion from 2017 to 2019 were included. The aspirate smears were retrieved and analyzed for cytomorphological features independently by two cytopathologists. The neoplastic lesions were classified according to the WHO 2019 classification.</p><p><strong>Results: </strong>Of 489 cases, fine needle aspiration cytology (FNAC) was diagnostic in 463 cases (94.6%), of which 417 (90.1%) were positive for malignancy, 35 (7.5%) were inflammatory, and 11 (2.4%) were inconclusive for malignancy. Adenocarcinoma not otherwise specified (NOS) was the most common type seen in 330 cases (79.1%) and 87 (20.9%) were unusual variants. These included papillary adenocarcinoma (22, 5.2%), mucinous adenocarcinoma (12, 2.8%), signet ring carcinoma (2,0.4%), adenosquamous carcinoma (8, 1.9%), squamous cell carcinoma (10, 2.4%), neuroendocrine neoplasms (7, 1.7%), undifferentiated carcinoma (24, 5.7%) and non-Hodgkin lymphoma (2,0.4%), respectively. Immunohistochemistry on the cell block confirmed the diagnosis wherever possible. Histopathology was discordant in 5 out of 33 cases.</p><p><strong>Conclusion: </strong>Guided FNAC is a sensitive investigation that plays a crucial role in confirming the diagnosis and deciding the further treatment options in advanced-stage GBCa patients. The uncommon variants of GBCa can be reliably categorized on cytology.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"40 1","pages":"12-18"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9469365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Fine Needle Aspiration Cytology of Maxillary Ameloblastoma: A Cytological Eye-Opener.","authors":"Akriti Jindal, Gargi Kapatia, Manjit K Rana, Nikhil Rajan, Utkarshni Khera","doi":"10.4103/joc.joc_106_22","DOIUrl":"10.4103/joc.joc_106_22","url":null,"abstract":"","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"40 1","pages":"49-50"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9472453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The deposition of calcium in the skin is known as calcinosis cutis. It can affect any part of the body and can mimic soft tissue or bony lesions clinically.
Aim: To describe the clinical and cytomorphologic features of calcinosis cutis on fine needle aspiration cytology smears.
Materials and methods: A total of 17 cases reported as calcinosis cutis on fine needle aspiration cytology were reviewed for the available clinical and cytological details.
Results: The cohort included both adult and pediatric patients. Clinically, the lesions appeared as painless swellings of variable sizes. The common sites affected were the scrotum, iliac region, scalp, pinna, neck, axilla, elbow, arm, thigh, and gluteal region. Aspirate was chalky white, paste-like in all the cases. The cytologic evaluation revealed amorphous crystalline deposits of calcium along with histiocytes, lymphocytes, and multinucleated giant cells.
Conclusions: Calcinosis cutis has a wide spectrum of clinical presentations. Fine needle aspiration cytology is a minimally invasive approach for diagnosing calcinosis cutis, thus eliminating the need for more extensive biopsy procedures.
{"title":"Clinico-cytomorphological Spectrum of Calcinosis Cutis.","authors":"Malvika Shastri, Pratibha Gautam, Preeti Diwaker, Priyanka Gogoi, Vinod K Arora","doi":"10.4103/joc.joc_75_22","DOIUrl":"10.4103/joc.joc_75_22","url":null,"abstract":"<p><strong>Introduction: </strong>The deposition of calcium in the skin is known as calcinosis cutis. It can affect any part of the body and can mimic soft tissue or bony lesions clinically.</p><p><strong>Aim: </strong>To describe the clinical and cytomorphologic features of calcinosis cutis on fine needle aspiration cytology smears.</p><p><strong>Materials and methods: </strong>A total of 17 cases reported as calcinosis cutis on fine needle aspiration cytology were reviewed for the available clinical and cytological details.</p><p><strong>Results: </strong>The cohort included both adult and pediatric patients. Clinically, the lesions appeared as painless swellings of variable sizes. The common sites affected were the scrotum, iliac region, scalp, pinna, neck, axilla, elbow, arm, thigh, and gluteal region. Aspirate was chalky white, paste-like in all the cases. The cytologic evaluation revealed amorphous crystalline deposits of calcium along with histiocytes, lymphocytes, and multinucleated giant cells.</p><p><strong>Conclusions: </strong>Calcinosis cutis has a wide spectrum of clinical presentations. Fine needle aspiration cytology is a minimally invasive approach for diagnosing calcinosis cutis, thus eliminating the need for more extensive biopsy procedures.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"40 1","pages":"24-27"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9522640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dear Editor, Fibroadenomas are the most common solid benign breast lesions in women having epithelial and stromal components. It may occur at any age, with the peak incidence being in adolescent girls around their 20s and 30s, except for complex fibroadenoma occurring in older women.[1,2] Hormonal stimulations have an etiological role, particularly an increase in estrogen and progesterone activity, pregnancy, and lactation. Being hormone-dependent, tumor dimensions increase during these hormonally active periods and decrease during the perimenopausal period.[2,3] The size of the lump in complex fibroadenoma is relatively smaller (average 1.3 cm in diameter) compared to simple fibroadenoma (average diameter: 3 cm). Fibroadenoma is termed complex fibroadenoma when it possesses either of the histological features, cyst >3 mm in diameter, sclerosing adenosis, epithelial calcification, and papillary apocrine metaplasia.[1,3,4] We report a case of a 48-year-old postmenopausal woman who presented with a history of a painless, mobile lump in the right breast for 1 month. The lump was single, nonprogressive in size, and was not associated with pain or nipple discharge. The patient did not give any history of hormonal therapy or surgery. On examination, a solitary, round to oval hard, nontender mass was felt in the right breast’s upper outer and central quadrant measuring 6 × 5 cm. No significant ipsilateral axillary lymph node was palpable. She had no family history of any breast lumps. At our center, mammography of the right breast revealed an irregular-shaped high-density lesion with a microlobulated margin in the upper outer quadrant extending into the upper-central and lower-outer quadrant measuring 64 × 58 × 40 mm and a focus of macrocalcification within it (Breast Imaging Reporting and Data System: BIRADS 4b). The possibility of benign phyllodes tumor was rendered [Figure 1a]. Similarly, ultrasonography of the right breast exhibited an irregular-shaped heterogeneously hypoechoic lesion with a few cystic areas measuring 63 × 54 mm (BIRADS 4b), the possibility of phyllodes tumor. Subsequently, ultrasound-guided fine-needle aspiration cytology was performed from the lesion. The smear from the representative site was cellular, comprising sheets of benign ductal epithelial cells and a few mildly cellular stromal fragments [Figure 1b]. Few epithelial cell clusters show discohesiveness at the periphery with nuclear pleomorphism in the form of enlarged nuclei, prominent nucleoli, and occasional mitosis. The background showed bare bipolar nuclei and blood [Figure 1c-e]. Based on these findings, the fine-needle aspiration cytology was reported as an atypical breast lesion according to The International Academy of Cytology Yokohama system, and the patient was advised to excision biopsy for a definitive diagnosis.Figure 1: (a) Mammography of the right breast shows an irregularly shaped (microlobulated margin) high density, heterogeneously hypoechoic lesion with
{"title":"Cytomorphological features of complex fibroadenoma breast","authors":"RaviH Phulware, Samikshya Thapa, Arvind Kumar, Sanjeev Kishore","doi":"10.4103/joc.joc_58_23","DOIUrl":"https://doi.org/10.4103/joc.joc_58_23","url":null,"abstract":"Dear Editor, Fibroadenomas are the most common solid benign breast lesions in women having epithelial and stromal components. It may occur at any age, with the peak incidence being in adolescent girls around their 20s and 30s, except for complex fibroadenoma occurring in older women.[1,2] Hormonal stimulations have an etiological role, particularly an increase in estrogen and progesterone activity, pregnancy, and lactation. Being hormone-dependent, tumor dimensions increase during these hormonally active periods and decrease during the perimenopausal period.[2,3] The size of the lump in complex fibroadenoma is relatively smaller (average 1.3 cm in diameter) compared to simple fibroadenoma (average diameter: 3 cm). Fibroadenoma is termed complex fibroadenoma when it possesses either of the histological features, cyst >3 mm in diameter, sclerosing adenosis, epithelial calcification, and papillary apocrine metaplasia.[1,3,4] We report a case of a 48-year-old postmenopausal woman who presented with a history of a painless, mobile lump in the right breast for 1 month. The lump was single, nonprogressive in size, and was not associated with pain or nipple discharge. The patient did not give any history of hormonal therapy or surgery. On examination, a solitary, round to oval hard, nontender mass was felt in the right breast’s upper outer and central quadrant measuring 6 × 5 cm. No significant ipsilateral axillary lymph node was palpable. She had no family history of any breast lumps. At our center, mammography of the right breast revealed an irregular-shaped high-density lesion with a microlobulated margin in the upper outer quadrant extending into the upper-central and lower-outer quadrant measuring 64 × 58 × 40 mm and a focus of macrocalcification within it (Breast Imaging Reporting and Data System: BIRADS 4b). The possibility of benign phyllodes tumor was rendered [Figure 1a]. Similarly, ultrasonography of the right breast exhibited an irregular-shaped heterogeneously hypoechoic lesion with a few cystic areas measuring 63 × 54 mm (BIRADS 4b), the possibility of phyllodes tumor. Subsequently, ultrasound-guided fine-needle aspiration cytology was performed from the lesion. The smear from the representative site was cellular, comprising sheets of benign ductal epithelial cells and a few mildly cellular stromal fragments [Figure 1b]. Few epithelial cell clusters show discohesiveness at the periphery with nuclear pleomorphism in the form of enlarged nuclei, prominent nucleoli, and occasional mitosis. The background showed bare bipolar nuclei and blood [Figure 1c-e]. Based on these findings, the fine-needle aspiration cytology was reported as an atypical breast lesion according to The International Academy of Cytology Yokohama system, and the patient was advised to excision biopsy for a definitive diagnosis.Figure 1: (a) Mammography of the right breast shows an irregularly shaped (microlobulated margin) high density, heterogeneously hypoechoic lesion with","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136371415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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