The acronym WCAFTI (cafti)-(Worrisome cytologic alterations following tissue infarction) is introduced here for the first time for the entity which describes the spectrum of cytologic changes seen in spontaneous infarction of an epithelial lesion. The pathology may be responsible for abnormal cytologic findings such as cellular dyshesiveness, nuclear enlargement with cytoplasmic blurring and irregular nuclei. Although, it is a rare event, it is essential for a cytologist to be aware of this new acronym WCAFTI to avoid misinterpretation of atypical cells and necrosis as indicators of malignancy. It is typically described here in a fibroadenoma from a 49-year-old female who sought medical help for pain in left breast mass.

Histopathology is a dependable tool in identifying the underlying cause in SA. Even in cases that show a complete loss of follicles, it is possible to suggest the etiology based on epidermal and connective tissue changes.

Background:Alopecia Areata (AA) is a “non-scarring” alopecia that has an autoimmune basis. Though clinically distinctive, problems arise in diagnosis depending on the temporal stage of the disease at presentation; some of them progress to scarring alopecia and predicting its prognosis is difficult. Histological changes depend on the disease stage and site of the biopsy.Objectives:To describe the spectrum of histologic features in AA.Materials and Methods:A prospective and retrospective study of H and E sections of all biopsies signed out as AA between 2001 and 2009 (20 cases) was undertaken.Results:The diagnosis was made on vertical sections in all cases. The total number of hair follicles ranged from 1 to 24 with an average of 7 and comprised mainly terminal follicles. Vellus follicles were scanty. Anagen to non-anagen ratio was 1:1.62. Miniaturization of follicles was noted in five (25%) cases. Peribulbar inflammation was seen in all the cases with a dominance of lymphocytes. Perifollicular fibrosis was noted in 12 (60%) and pigment casts in 5 (25%) cases. Scarring was seen in two cases. In these cases, a diagnosis of AA was rendered on the basis of even spacing of the fibrotic units and remnants of the catagenic basement membrane within the scars. The epidermis and interfollicular dermis were normal in all the cases.Conclusion:The most consistent features of AA are an increase in non-anagen terminal follicles and peribulbar lymphocytic infiltrate. The etiology can be determined even in cases that have progressed to scarring.

Objective:To assess the efficacy of a peripheral smear examination as a screening tool for β-thalassemia trait.Materials and Methods:17 623 Leishman-stained peripheral smears were evaluated during the period from July 2006 to September 2007. The following parameters were studied: hemoglobin, red blood cell count, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and red cell distribution width. All the cases that showed microcytosis, hypochromia, erythrocytosis and absence of anisopoikilocytosis were suspected of having the thalassemia trait (TT), and all these cases were further evaluated with Alkaline Hemoglobin Electrophoresis for confirmation.Results:Of the 17 623 smears examined, 60 cases were considered suspicious of having TT. Alkaline hemoglobin electrophoresis carried out on all these cases revealed an elevated HbA2 (Mean = 7.5%). Five cases evaluated were found to have other hemoglobinopathies (1 Sickle cell trait, 3 Hb-E, 1 thalassemia intermedia).Conclusion:Careful screening of peripheral smear is an invaluable screening tool for thalassemia trait (PPV - 95%). There must be awareness among the peripheral centers about the importance of peripheral smear screening and the affected persons should be counseled.