The fine-needle aspiration cytology (FNAC) of four cases of chordoma that were diagnosed preoperatively is presented. One of the cases showed anaplastic components along with the classical features of chordoma; this is probably the second case diagnosed with these features on FNAC. The cytologic features of classical chordoma include conspicuous extracellular matrix in the background. Polygonal cells, dissociated and in small groups, were identified in all cases. Physaliphorous cells were also prominently found in these cases. In addition, the case with anaplastic features showed very bizarre cells with profound multinucleation and the presence of intranuclear cytoplasmic inclusions. The diagnosis of chordoma was possible because of a high index of suspicion on clinical grounds and the use of special staining for confirmation.
Aim:To compare the efficacy of fine-needle non-aspiration cytology (FNNAC) with that of fine-needle aspiration cytology (FNAC) of thyroid lesions.Materials and Methods:FNAC and FNNAC techniques were studied in 50 cases of thyroid lesions. All the needle-sampling procedures were done by a single operator. The samples were assessed cytologically and evaluated using five parameters, that is, background blood or clot, amount of cellular material, degree of cellular degeneration, and degree of cellular trauma and retention of appropriate architecture.Statistical Analysis:Wilcoxon signed rank test was performed using SPSS14 software. Differences between all the individual parameters as observed in FNAC and FNNAC smears were insignificant.Results and Conclusion:After evaluation of FNAC and FNNAC on the basis of these scores, greater numbers of diagnostically superior samples were obtained by FNNAC; however, by FNAC more number of diagnostically adequate smears were observed. The numbers of unsuitable smears were also more by FNNAC technique.
During the last 4 yr, fine-needle aspiration cytology (FNAC) has been employed in 1,474 patients in 0-15-yr age group at our institute. Of these, 245 patients were found to have malignant disease, including primitive neuroectodermal tumors, hepatoblastoma, nephroblastoma, sarcoma, and epithelial malignancies. Four metastases from medulloblastoma and two each from astrocytoma and meningioma were confirmed without open biopsy. FNAC interpretation was easy when cytologic findings were correlated with relevant clinical and radiologic data.
Individual parameters of B Mode when used alone were not found to be very effective in differentiating benign and malignant lymph nodes. However features of B-Mode combined together as well as color Doppler ultrasound, help in the detection of reactive lymph nodes and can be used as a diagnostic tool with good accuracy. However, they cannot be used as a diagnostic method for metastatic or tubercular nodes and cytopathology/histopathology remains the gold standard in such situations.
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