Background: Cytological examination of exfoliated cells is very challenging and of paramount importance for diagnosis, staging and prognosis as the finding of cancer cells in such a specimen denotes that the patient has advanced and incurable cancer. Aims & Objective: To study serous effusion for various pathological conditions. Material and Methods: The study was performed on serous effusions. Serous effusions from pleural, pericardial and peritoneal fluid were included and all other fluids were excluded. Their clinical history and other relevant parameters were noted. Collection was performed with 18-gauge needle under local anaesthesia and sterile conditions. When delay, samples were stored at 2-6 ͦ C. Conventional smear and or Cytospin method were performed. Ether alcohol (wet fixed) and air dried smears were used. H & E stain, papanicolaou stain and MGG stain were done. Results: Out of total 355 cases, 186 were of pleural fluid, 164 of peritoneal fluid and 5 were of pericardial fluid. 288 cases were benign, 24 cases were malignant effusion, 17 cases were suspicious of malignancy and 26 cases were degenerated. Transudate, haemorrhagic and straw coloured fluid were more common. Conclusion: Benign effusions are common in younger whereas malignant effusions are common in older people. A combined approach to morphology by may-grunwald giemsa, papanicolaou with haematoxylin and eosin stain was better than individual method. Recurrent hemorrhagic effusions are more common in malignant effusions. Conventional smear method can yield good result. Scattered cells are indicative of benign effusions and clusters, 3 D balls, papillary patterns indicate malignant effusions.
Background: Fine needle aspiration cytology (FNAC) is a reliable as well as an inexpensive diagnostic method. It is suitable for the developing countries for the diagnosis of lymphadenopathy at any approachable site. Fine needle aspiration cytology not only confirms the presence of metastatic disease but also, in most cases, gives the clue regarding the origin of the primary tumor, prognosis as well in the management of patient for staging purposes. The aim of the study was to detect and diagnose metastasis in lymph nodes. Methods: A study was done of all metastatic lymph node lesions reported in Department of Pathology, Govt. Medical College, Surat from May 2011 to April 2012. Results: A total of 2355 cases of fine needle aspiration cytology were carried out of which 580 cases were of lymph node. Cytology results were positive for metastasis in 157 specimens (27.06%). The most common site was cervical lymph nodes. Maximum numbers of cases of metastatic tumors were in 41-50 yrs age group. There were 115 males and 42 females with a male predominance (Male:Female= 2.8:1). The most common malignancy was squamous cells carcinoma, seen in 118 cases (75.15%), followed by metastatic mammary carcinoma (13 cases, 8.29%). In 26 cases out of 580 cases, histopathological confirmation was done and diagnostic accuracy of FNAC was 100%. Conclusions: Fine needle aspiration cytology of lymphadenopathy is a useful tool in diagnosing metastatic lesions with good certainty. [Int J Res Med Sci 2013; 1(4.000): 451-454
Background: Bone tumours are comparatively uncommon among wide array of lesions and pose a diagnostic problem as they constitute a small portion of diagnostic experience among pathologist. Aims & Objective: To study the histopathological features of bone lesions and their correlation with age of presentation, site and type of lesion. Material and Methods: The present study was carried out at a tertiary care center from October 2003 to January 2006. A total of 79 bone lesions were analyzed. A detail clinical and radiological history was taken. Bone biopsy was performed by either percutaneous method with needle/drill or Open surgical biopsy. If attached soft tissue was also received, bony tissues were put for decalcification (10% nitric acid) and soft tissue was immediately fixed into 10 % formalin and processed by paraffin embedding. Sections were stained by haematoxylin and eosin stain. Results: Incidence of non-neoplatic and benign neoplastic lesions was 68.40% while that of malignant lesion was only 20.22%.Younger patients (58.24%) and males (59.49%) were more commonly affected. Amongst non-neoplastic lesions, tuberculous lesions (17.72%) were commonest while exostosis (15.19%) and osteosarcoma and chondrosarcoma were common benign and malignant neoplastic lesions respectively. Overall most common bone involved was femur. In tuberculous lesions, vertebrae were commonly involved. Osteolytic lesions were more common. Metaphysis was the commonest site. Conclusion: Though bone tumours are less common lesions and pose a diagnostic problem, if viewed in perspective of clinico-radiology and histopathology, a correct diagnosis can be reached.
Background: Soft tissue sarcomas, compared with carcinomas and other neoplasms, are relatively rare and constitute less than 1% of all cancers. Immunohistochemistry (IHC) especially a panel approach is an important adjunct to histopathological morphology and plays an important role in Soft tissue sarcoma diagnosis and accurate typing. Aims & Objective: Current study is to evaluate the utility of histopathology and immunohistochemistry in soft tissue sarcoma diagnosis and accurate typing. Material and Methods: Total of 50 cases of soft tissue sarcoma studied from January 2010 to October 2012. All cases were reported using routine (H&E) Hematoxylin-eosin stain and other ancillary techniques including panel approach of immunohistochemistry. Results: Histomorphology confirmed diagnosis in 22 % cases. In 78 % cases it was contributory to IHC. IHC provide confirmative diagnosis (Single diagnosis) in 45 cases (90%), definitive diagnosis (with two possibilities) in 4 cases (8%) and noncontributory in 1case (2%). Conclusion: Despite the rapid development of molecular genetic techniques, IHC still remains the most important diagnostic tool in the diagnosis of soft tissue tumours aside from recognition of morphologic features and clinical correlation. One of its major utilities is to correctly identify a tumour as mesenchymal or nonmesenchymal origin and then accurate typing done according to specific cell lineage. IHC is specifically useful in tumours of uncertain cell lineage and primitive round cell tumours. Indeed IHC has brought Brown revolution in sarcoma diagnosis and accurate typing. But important not to forget histopathology which provide the basic platform for the panel approach of IHC.
Background: Biopsy method of choice is a controversy issue for diagnosis of soft tissue sarcoma which are traditionally been managed by wide excision surgery and radiotherapy. Chemotherapy is reserved for advanced cases. Aims & Objective: The objective of study was to evaluate diagnostic accuracy of various modes of biopsy focusing on image guided core needle biopsy (CNB). Material and Methods: Current study includes 50 cases of soft tissue sarcoma from January 2010 to October 2012. The Mode of biopsies included image guided CNB, open and excision biopsy. Effective accuracy of each was determined by accuracy of biopsy to provide adequate tissue for histopathological and other special examinations like immunohistochemistry to reach final diagnosis. Results: Out of total 50 cases CNB was done in 13 cases, open biopsy in 2 cases and in 35 cases excision biopsy was done. CNB was adequate in 92.31 % cases and 7.69 % cases it was inadequate. Open and excision biopsy were 100 % adequate. Conclusion: Image guided CNB is very helpful in early diagnosis and shows high accuracy especially for high-grade sarcoma. It is less invasive compared to others and differentiate benign from malignant. It is handful when preoperative diagnosis is essential for planning pre-operative chemotherapy especially in patients with primarily inoperable, advanced tumour with compromised performance status or recurrent tumour. But it should be properly directed and representative of whole tumour and require full radiological correlation by experienced hands. Tumours with myxoid pattern, lipomatous tumours and low grade sarcomas encounters lower diagnostic accuracy on CNB.
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