Cytology
Fatemeh Samiee Rad; mehdi Ghaebi; Simin Zarabadipour; Arezoo Bajelan; fatemeh Pashazade; Mehri Kalhor; Amane Barikani
Abstract
Background & Objective: Premalignant lesions of cervix have increased dramatically in recent years. Early diagnosis and management of abnormalities have an effective role in preventing the invasion of the disease and also in timely treatment. This study aimed to compare diagnostic methods in the ...
Read More
Background & Objective: Premalignant lesions of cervix have increased dramatically in recent years. Early diagnosis and management of abnormalities have an effective role in preventing the invasion of the disease and also in timely treatment. This study aimed to compare diagnostic methods in the detection of squamous cell abnormalities with abnormal Pap smear test. Methods: This cross-sectional study was performed on 1000 women with abnormal Pap smears in 2007-2018. Sampling was performed with simple method. All samples were subjected to an immediate assessment of colposcopy and histopathology if suspected. The checklist included demographic information as well as symptoms, cytopathology, colposcopy and histopathology findings. Data analysis was performed using descriptive and statistical analysis (P<0.05). Result: A significant relationship between histopathology and Pap smear findings was found (P=0.009), also there was a significant correlation between histopathology and colposcopy findings (P=0.001). However, there was no significant relationship between clinical symptoms and histopathology findings (p=0.8). Sensitivity , specificity , positive and negative predictive value of Pap smear were 43%, 65.9%, 75.4%, 32.2% and of colposcopy were 74.7%, 39.5%, 75%, 39.1%, and of clinical symptoms were 72.6%, 28.1%, 71.1%, 29.7%, respectively. Conclusion: Pap smear findings have the appropriate diagnostic accuracy in comparison with colposcopy and histopathology findings for screening and diagnosis of squamous intra-epithelial lesions. Also, there was higher sensitivity of colposcopy compared with Pap smear to detect cervical lesions. Therefore, it is advisable to use these methods simultaneously.
Indranil Chakrabarti; Priyanka Agarwala; Pranati Bera; Sankarshan Bhaduri
Abstract
Background: Phyllodes tumors (PTs) are uncommon biphasic fibroepithelial neoplasms of the breast occurring in elderly females with a peak incidence between 45 and 49 years. Depending on various histological criteria, they are subdivided into benign, borderline, and malignant forms. Metaplastic changes ...
Read More
Background: Phyllodes tumors (PTs) are uncommon biphasic fibroepithelial neoplasms of the breast occurring in elderly females with a peak incidence between 45 and 49 years. Depending on various histological criteria, they are subdivided into benign, borderline, and malignant forms. Metaplastic changes occur, but are quite infrequent and cystic squamous metaplasia is very rare among the observed metaplastic changes in PT. Case: The current paper presents the case of a 41-year-old female with a progressively enlarging swelling in the left breast. Subsequent histopathological examination revealed benign PT with cystic squamous metaplasia. The previously done fine needle aspiration smears were also reviewed, which showed important diagnostic clues to this rare entity, but were ignored due to the rarity of the lesion. Conclusion: The case was presented because of its unique cytological and histopathological morphology and also to determine the role of aspiration cytology to diagnose such a rare occurrence.
Arijit Majumdar; Angshuman Jana; Soumali Biswas; Swagata Bhattacharyya; Anirban Jana
Volume 9, Issue 3 , July 2014, , Pages 193-198
Abstract
Background and Objective: Fine needle aspiration cytology (FNAC) is well accepted as a useful diagnostic technique in the management of adult patients with head and neck lumps. But, until recently, very few reports have been obtained regarding the role of FNAC in nonthyroidal neck masses in children. ...
Read More
Background and Objective: Fine needle aspiration cytology (FNAC) is well accepted as a useful diagnostic technique in the management of adult patients with head and neck lumps. But, until recently, very few reports have been obtained regarding the role of FNAC in nonthyroidal neck masses in children. Hence, the objective of our study was to determine the diagnostic value of fine needle aspiration cytology in the diagnosis of paediatric nonthyroidalneck masses.
Methods: This descriptive study was conducted at the Department of Pathology,Dr.BCRoyPGIPSKolkata from January2012 to December 2012. Hundred patients with non-thyroidal neck masses fulfilling theinclusion criteria were included in the study. Fine needle aspirations were performed by Leishman-Giemsa staining.
Results: The most common nonneoplastic neck swelling seen in children were an enlarged lymph node due to inflammation 38(42.2%),i.e., reactive lymphadenitis. Others were TB lymphadenitis25(27.8%), nonTB granulomatous lymphadenitis 2(2.22%), chr.sialadenitis 2(2.22%), branchial cyst 4(4.44%) and epidermal cyst 3(3.33%) cases.
Overall sensitivity, specificity, positive predictive value and negative predictive value of FNAC in our cases are 93.06%, 72.22%, 93.06% and 72.22%.
Conclusion:FNA is a valuable diagnostic tool in the management of children with the clinical presentation of a suspicious neck mass. The technique reduces the need for more invasive and costly procedures like open biopsy.
Mitra Mustaphi Ruplekha; Gon Sonia; Bhattacharyya Roop Narayan
Volume 9, Issue 1 , January 2014, , Pages 1-8
Abstract
Background & Objective: Chronic non healing ulcers or scar undergoing malignant transformation is a rare phenomenon with an estimated incidence of 2%. Though, numerous predisposing factors have been identified, still it is rarely diagnosed and commonly mistaken for a benign condition. The ...
Read More
Background & Objective: Chronic non healing ulcers or scar undergoing malignant transformation is a rare phenomenon with an estimated incidence of 2%. Though, numerous predisposing factors have been identified, still it is rarely diagnosed and commonly mistaken for a benign condition. The objective of this study was to verify the efficacy of the Fine Needle Aspiration Cytology/ Scrape cytology of chronic non healing ulcers, and its use in the early detection of the malignant transformation, thereby facilitating early management. Methods: A total of 10 cases of chronic non healing ulcer with malignant transformation were included in the study where the initial diagnosis was made on Fine Needle Aspiration Cytology/Scrape cytology and later on confirmed on histopathology. Results: Squamous cell carcinoma (7 cases), acantholytic variant of Squamous Cell Carcinoma (1 case), malignant fibrous histiocytoma (1 case) and carcinosarcoma (1 case) was seen. A 100% concordance with histopathology was seen in Squamous cell carcinoma cases. Because of the rarity of the case and unusual transformation, high grade pleomorphic spindle cell carcinoma was the cytological diagnosis in case of Malignant Fibrous Histiocytoma. Conclusion: Marjolin ulcer arising out of chronic non healing ulcers can prove to be a precursor of any different kind of malignancies. Fine Needle Aspiration Cytology/scrape cytology can be used as a first line diagnostic modality for the early diagnosis as it is a fast and safe method with high rate of accuracy, sensitivity and specificity
Nayereh Ghomian; Sakineh Amouian; Fatemeh Tavassoli; Taraneh Arbabzadeh
Volume 9, Issue 1 , January 2014, , Pages 9-16
Abstract
Background & Objective: Chronic non healing ulcers or scar undergoing malignant transformation is a rare phenomenon with an estimated incidence of 2%. Though, numerous predisposing factors have been identified, still it is rarely diagnosed and commonly mistaken for a benign condition. The objective ...
Read More
Background & Objective: Chronic non healing ulcers or scar undergoing malignant transformation is a rare phenomenon with an estimated incidence of 2%. Though, numerous predisposing factors have been identified, still it is rarely diagnosed and commonly mistaken for a benign condition. The objective of this study was to verify the efficacy of the Fine Needle Aspiration Cytology/ Scrape cytology of chronic non healing ulcers, and its use in the early detection of the malignant transformation, thereby facilitating early management. Methods: A total of 10 cases of chronic non healing ulcer with malignant transformation were included in the study where the initial diagnosis was made on Fine Needle Aspiration Cytology/Scrape cytology and later on confirmed on histopathology. Results: Squamous cell carcinoma (7 cases), acantholytic variant of Squamous Cell Carcinoma (1 case), malignant fibrous histiocytoma (1 case) and carcinosarcoma (1 case) was seen. A 100% concordance with histopathology was seen in Squamous cell carcinoma cases. Because of the rarity of the case and unusual transformation, high grade pleomorphic spindle cell carcinoma was the cytological diagnosis in case of Malignant Fibrous Histiocytoma. Conclusion: Marjolin ulcer arising out of chronic non healing ulcers can prove to be a precursor of any different kind of malignancies. Fine Needle Aspiration Cytology/scrape cytology can be used as a first line diagnostic modality for the early diagnosis as it is a fast and safe method with high rate of accuracy, sensitivity and specificity.
Mahesh Kumar; Ratnakar Potekar; Balasaheb Ramling Yelikar; Vijayalaxmi Patil; Mahesh Karigoudar; Pankaj Pande
Volume 8, Issue 4 , October 2013, , Pages 219-226
Abstract
Background and Objectives: Thyroid gland because of its superficial location is amenable to direct physical examination. Clinical assessment of thyroid lesions by means of physical examination, thyroid scans and ultrasonography is not completely reliable. Fine needle aspiration cytology (FNAC) is the ...
Read More
Background and Objectives: Thyroid gland because of its superficial location is amenable to direct physical examination. Clinical assessment of thyroid lesions by means of physical examination, thyroid scans and ultrasonography is not completely reliable. Fine needle aspiration cytology (FNAC) is the most cost-effective, safe and an initial diagnostic test in the pre-operative evaluation of thyroid lesions. Many surgeons use intraoperative frozen section biopsies to confirm the diagnosis of FNAC and guide the extent of thyroidectomy. Therefore, the objective of the present study was to assess the diagnostic accuracy of frozen section in comparison with fine needle aspiration cytology and histopathology in thyroid lesions.
Materials & Methods: Fine needle aspiration cytology and frozen section (FS) were evaluated in 59 patients. FNAC was classified as benign, malignant and suspicious, and FS was classified as benign, deferred and malignant. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated for both FS and FNAC.
Results: Out of 59 patients, 3 were positive for malignancy, 51 were benign, and five were suspicious on FNAC. Over all accuracy of fine needle aspiration cytology was 93%. Five were positive for malignancy, 50 were benign and 4 were “deferred” in frozen section. Over all accuracy of frozen section was 96%.
Discussion: Fine needle aspiration cytology can be used primarily to select patient for surgery and frozen section can be employed to plan the extent of surgery. Frozen section had a good accuracy, sensitivity and negative predictive value compared to fine needle aspiration cytology.
Surendra Kumar Verma; Roopesh Kumar; Jonathan Srivani; Jonathan Jonathan
Volume 8, Issue 4 , October 2013, , Pages 227-234
Abstract
Background & Objectives: The accurate assessment of the diseased tissue is fundamental to the diagnosis and management of disorders of the central nervous system (CNS). The ‛squash’ or ‛crush’ technique has been universally employed in the intraoperative diagnosis of CNS tumors. The ...
Read More
Background & Objectives: The accurate assessment of the diseased tissue is fundamental to the diagnosis and management of disorders of the central nervous system (CNS). The ‛squash’ or ‛crush’ technique has been universally employed in the intraoperative diagnosis of CNS tumors. The aim of our study was to evaluate the accuracy of squash preparation in diagnosing CNS tumors by comparing with histopathology.
Methods: This was a descriptive study which included 63 patients with CNS tumors from whom most of the samples were collected by craniotomy. Squash smears were made and stained with H&E, Papanicolaou & May-Grunwald Giemsa stains. Paraffin sections were made from formalin fixed tissue sent separately.
Results: Of 63 cases, squash cytology diagnosis correlated with histopathology in 56 cases with a diagnostic accuracy of 88.9%. A 100% accuracy was seen in pilocytic astrocytoma, anaplastic astrocytoma, glioblastoma, ependymoma, anaplastic ependymoma, choroid plexus papilloma, schwannoma, hemangioblastoma, craniopharyngioma, prolactinoma and metastases. Of the 7 cases which did not correlate with histopathology, one was a sampling error, 4 were diagnostic errors and 2 were instances of grading discrepancy.
Conclusion: Squash preparations are a highly effective tool in the rapid intraoperative diagnosis of CNS tumors. It is a simple, reliable, cost effective procedure which in most cases can help the operating surgeon to come to a correct decision regarding the further management of the patients.
Anuradha Sinha; Jyoti Prakash Phukan; Gautam Bandyopadhyay; Sanjay Sengupta; Rinki Saha
Volume 8, Issue 1 , January 2013, , Pages 59-63
Abstract
Superficial acral fibromyxoma are rare soft tissue tumors predominantly involving hands and feet of adults. There are only a few reported cases of this benign neoplasm, but no FNAC diagnosis of this tumor is reported in the literature. A Forty-eight year old female presented with a 5 x 3.5 cm globular, ...
Read More
Superficial acral fibromyxoma are rare soft tissue tumors predominantly involving hands and feet of adults. There are only a few reported cases of this benign neoplasm, but no FNAC diagnosis of this tumor is reported in the literature. A Forty-eight year old female presented with a 5 x 3.5 cm globular, firm swelling over the right fifth toe. Fine needle aspiration cytology (FNAC) of the lesion was interpretated as superficial acral fibromyxoma, and Subsequent histopathology confirmed the diagnosis and demonstrated cytohistological correlation for the first reported time in the literature. SAFM may recur if not adequately excised. Preoperative FNAC diagnosis will help the surgeons to plan for wider excision to prevent recurrence.
Rajesh Laishram
Volume 5, Issue 4 , September 2010, , Pages 212-215
Abstract
Background: Spontaneous infarction is an uncommon complication of fibroadenoma of the breast. Although infarction following fine needle aspiration (FNA) has been reported in the literature, infarction encountering on first time aspiration is very rare. Lack of knowledge of this entity may lead to an ...
Read More
Background: Spontaneous infarction is an uncommon complication of fibroadenoma of the breast. Although infarction following fine needle aspiration (FNA) has been reported in the literature, infarction encountering on first time aspiration is very rare. Lack of knowledge of this entity may lead to an erroneous diagnosis of inflammatory lesion like mastitis and carcinoma on cytology smears.
Case: We report the cytological and histological findings in partial spontaneous infarction of fibroadenoma in an 18-year-old female and literature reviewed.
Conclusion: In young patients with breast lumps, if the aspirated material is necrotic, the probable diagnosis of spontaneous infarction should always be kept in mind. Viable fibroadenomatous tissue should be searched for in the FNA smears.
Mohammad Rakhshan; Azadeh Rakhshan
Volume 4, Issue 4 , September 2009, , Pages 147-150
Abstract
Background and Objective: Fine needle aspiration cytology (FNAC) is a well-established method of diagnosis in palpable masses of various sites. This study was conducted to evaluate the usefulness of FNAC as a diagnostic tool in the management of patients with cervical lymphadenopathy. Patients and Methods: ...
Read More
Background and Objective: Fine needle aspiration cytology (FNAC) is a well-established method of diagnosis in palpable masses of various sites. This study was conducted to evaluate the usefulness of FNAC as a diagnostic tool in the management of patients with cervical lymphadenopathy. Patients and Methods: Totally 178 patients admitted to Loghman-Hakim Hospital , Tehran, Iran, with cervical masses, were included in this study. They had undergone FNA and subsequently excisional biopsy of the same neck mass in which a lymphoid tissue lesion had been established. Results: Reactive lymphadenitis, metastatic neoplasm, Hodgkin’s lymphoma, and non-Hodgkin’s lymphoma constituted 59.6%, 17.9%, 14.6% and 7.8% of total cases, respectively. In 27 cases (15.2%), the FNA findings were nondiagnostic. Diagnostic accuracy of FNAC was about 88%. Sensitivity, specificity, positive and negative predictive values were 75.8%, 96.6%, 94% and 85.1%, respectively. Conclusion: FNAC has a high accuracy in the diagnosis of malignancies of cervical lymph nodes, but due to the existance of false negative cases, the benign results should be further evaluated if high clinical suspicion of malignancy exists.
Farid Kosari; Hedieh Moradi Tabriz; Sanaz Saniee
Volume 4, Issue 4 , September 2009, , Pages 186-189
Abstract
In Riedel’s thyroiditis, a rare chronic inflammatory disease of thyroid gland, fine needle aspiration is usually non-diagnostic because most often only follicular cells are obtained and not the fibrous material characteristic of this type of thyroiditis. Therefore the diagnosis is often only established ...
Read More
In Riedel’s thyroiditis, a rare chronic inflammatory disease of thyroid gland, fine needle aspiration is usually non-diagnostic because most often only follicular cells are obtained and not the fibrous material characteristic of this type of thyroiditis. Therefore the diagnosis is often only established by histopathologic study of the surgically obtained biopsy. The illustrated case is a 46-year-old female who presented with a firm, non-mobile thyroid nodule of the left lobe. Fine needle aspiration was performed, demonstrating fragments of fibrous tissue and few inflammatory cells including neutrophils and lymphocytes, findings that could be representative of Riedel’s thyroiditis. Frozen section examination during subsequent surgery and later histopathologic study confirmed the diagnosis. Fine needle aspiration of the thyroid, if successfully done, could be highly suggestive for Riedel’s thyroiditis.
Mahmood Khaniki; Zeynab Nazary; Kazem Zendehdel; Fereshte Fakur
Volume 4, Issue 2 , April 2009, , Pages 59-64
Abstract
Background and Objective: The aim of this study was to compare the screening performance of a new modified liquid-based cytology method (Liquiprep™) with conventional PAP smear (CP) in a low risk population, using colposcopy followed by histology as “gold standard”. Patients ...
Read More
Background and Objective: The aim of this study was to compare the screening performance of a new modified liquid-based cytology method (Liquiprep™) with conventional PAP smear (CP) in a low risk population, using colposcopy followed by histology as “gold standard”. Patients and Methods: This cross-sectional study was performed on random referred specimens to a general gynecological clinic in Tehran, during 20 months by a split-sample method. In both CP and Liquiprep™ group, all positive and 10% of negative results of smears were followed by colposcopy. A biopsy was taken whenever any atypical transformation zone seen. Sensitivity, specificity, negative and positive predictive values (PV), and overall accuracy of both methods were analyzed in relation to histology. Results: A total of 1265 patients were analyzed by two methods. In 158 (12.5%) of cases histological diagnosis was made. Liquiprep™ samples (94.7%) were more adequate than CP (92.1%). There was not any low or high-grade squamous intraepithelial lesion (SIL). Atypical squamous cell of undetermined significance (ASC_US) was diagnosed more with CP than with Liquiprep™ (1.43% vs. 0.79%) while pathologically 60% of ASC_US in Liquiprep™ and 16.6% in CP had degrees of SIL. The Liquiprep™ had a significantly higher sensitivity (83% vs. 66%) and positive PV (83% vs. 33%) than the CP to detect SIL at histology but the difference in specificity was non significant (98% vs. 86%). Conclusions: This study confirms the superiority of the Liquiprep™ method to detect cervical lesions in a low risk population.
Nourieh Sharifi; Mohammad Javad Yazdanpanah
Volume 2, Issue 3 , June 2007, , Pages 97-99
Abstract
Background and Objective: Cutaneous cytology is the study of scraping or smears obtained from skin lesions. Although not commonly employed, cutaneous cytology has been a useful tool for clinicians due to simplified procedures and high sensitivity and specificity of presurgical clinical diagnosis of common ...
Read More
Background and Objective: Cutaneous cytology is the study of scraping or smears obtained from skin lesions. Although not commonly employed, cutaneous cytology has been a useful tool for clinicians due to simplified procedures and high sensitivity and specificity of presurgical clinical diagnosis of common types of skin tumors. This investigation was conducted to study usefulness of cutaneous cytology in diagnosis of basal and squamous cell carcinoma. Methods: We collected 42 skin tumors in total, clinically presumed to be either BCC (n = 31) or SCC (n = 10). Samples were taken by the scraping technique. After smearing the cells onto several glass slides, they were fixed with 96% alcohol. The specimens were stained with Papanicolaou stain. Punch biopsies were taken to confirm the clinical and cytologic impression. Results: Cytodiagnosis and histopathologic examination of 42 cases of BCC (n = 32) and SCC (n = 10) showed a significant concordance between histopathology of skin specimen and cytologic diagnosis with a sensitivity rate of 96.8% and specificity rate of 90% and with a high positive predictive value of 96.8%. Conclusion: Cytologic examination is easy to perform, saves time, and provides a rapid and reliable procedure in diagnosis and confirmation of non-melanoma malignant skin tumors (BCC and SCC).