Isolated pleural effusion is a rare manifestation of filariasis that mimics tuberculosis, especially in endemic regions. We describe a case of lymphocytic and exudative pleural effusion showing microfilaria on pleural fluid cytology. A retrospective review of all cases of filarial pleural effusion reported after 2000 was conducted to evaluate the association between filariasis and pleural effusion as well as to screen the features that can help in accurate detection of these patients. The analysis suggested a causal association between the parasite and the development of pleural effusion with a high sensitivity of pleural fluid cytology for diagnosis.
Presence of granuloma in Hodgkin lymphoma is a common finding which is often a source of diagnostic confusion.There is no clearly defined strategy to approach this dual pathology. The present case describes a diagnostic approach using modalities like immunohistochemistry and Catridge based nucleic acid amplification test that helped reach to most likely cause of granuloma with underlying Hodgkin lymphoma.
Gastro-inestinal stromal tumours (GISTs) comprise 1–2% of all gastrointestinal (GI) tumours. The mesentery, retroperitoneum and omentum are common sites of extra-gastrointestinal stromal tumours (E-GISTs). Isolated involvement of the mesentery by tuberculosis (TB) without any evidence of pulmonary disease is quite unusual. Here we report a case of an E-GIST arising from the small bowel mesentery in a 60-year old female where an incidental concurrent mesenteric tuberculosis was diagnosed following surgical resection.
Context:
The conventional smears (CS) and Liquid based cytology (LBC) are important tools to detect carcinoma cervix and its precursor lesions.
Aims:
The present study was done to compare the cytomorphological features of cervical lesions using both techniques and compare with the histopathological diagnosis.
Settings and Design:
This was a prospective observational study over a period of 1.5 years at a tertiary care hospital.
Methods and Material:
A total of 969 women in the age group of 21–65 years presenting with either routine screening or complaints of vaginal bleeding, discharge, or pelvic pain were enrolled for the study. Both the CS and LBC smears were analyzed and compared with the corresponding histopathology diagnosis. The data was analyzed using Statistical Package for the Social Sciences (SPSS) software and P values <0.05 were considered significant.
Results:
There were 8.57% unsatisfactory smears in CS as compared to 0.5% in LBC smears. Liquid-based cytology was superior to conventional preparations in terms of smear adequacy, lesser hemorrhagic and inflammatory background, and presence of more endocervical cells. Liquid-based cytology showed a better yield in detecting all the types of epithelial cell lesions with a concordance rate of 73.9% between the two techniques. On histopathology correlation of these lesions, LBC had a higher sensitivity (96.67%) and diagnostic accuracy (99.08%) as compared to CS (73.33% and 92.66%, respectively).
Conclusions:
Liquid-based cytology is superior to conventional cytology for the detection of epithelial cell lesions. Reduction in the unsatisfactory smears, a cleaner background, and better representation of the sample are more significantly appreciated on LBC in contrast to CS.
Background: Histoplasmosis is a mycotic infection commonly affecting patients with impaired immunity. It mainly manifests as pulmonary or disseminated infection. The diagnosis is often missed in non-endemic regions due to lack of suspicion especially when it involves unusual sites in healthy individuals.Case: An elderly male presented with solitary left shoulder swelling for the last 2 months. Clinical and radiological findings were suggestive of malignant etiology. Fine needle aspiration cytology from the lesion demonstrated yeast like fungi within the histiocytes. The cytomorphological features were suggestive of Histoplasma which was later confirmed on culture. Patients had an uneventful recovery with anti-fungal treatment.Conclusion: Histoplasma can present in elderly with indolent involvement of uncommon sites. High index of suspicion accompanied by active search using special stains is the key to diagnosis
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