Diagnostic utility of Fine needle aspiration cytology in hepatobiliary and pancreatic mass lesions

Background: Lesions of liver, gall bladder and pancreas are quite common. After radiological assessment, FNAC under imaging guidance is an important tool in achieving early and accurate diagnosis, which is important in management of hepatobiliary and pancreatic lesions. The purpose of the study was to know the pathological spectrum of hepatobiliary and pancreatic mass lesions and usefulness of USG guided FNAC in diagnosis. Methods: A retrospective study was conducted in the Department of Pathology at Geetanjali Medical College and Hospital,Udaipur. A total of 173 FNA specimens from 171 cases over a period of three years from 1st January 2018 to 31st December 2020, with hepatic, biliary or pancreatic lesions were included in the study. Cytomorphological features were studied in detail and FNA specimens were categorized into categories including malignant, inflammatory, benign, suspicious for malignancy and inadequate. Results: FNA cytology was studied from 171 patients, aged 11 to 91 years, with mean age 54.5yrs. Out of 173 FNA specimens, most common were from liver (115,66.5%), followed by gall bladder (37,21.4%), pancreas (19,11.0%) and common bile duct (2,1.2%). Malignant lesions were the commonest (135, 78.0%). In liver metastatic tumors (64, 55.6%) were most frequent diagnoses followed by hepatocellular carcinoma (13, 11.3%). In biliary tract and pancreas, adenocarcinoma was the most commonly diagnosed lesion. Conclusion: FNA cytology is a useful tool in diagnosis of hepatobiliary and pancreatic mass lesions. It is safe, cost effective and rapid method which can be used after radiological investigation, especially in cases where biopsy cannot be performed

Neurofibromatosis type 1, pheochromocytoma with primary hyperparathyroidism: A rare association

Primary hyperparathyroidism (PHP) with pheochromocytoma and neurofibromatosis type 1 is a rare clinical association. We present a case of PHP and pheochromocytoma occurring in a 33-year-old male with familial cutaneous neurofibromatosis

Retinoblastoma in an adult

Retinoblastoma is a rare malignant tumor of the retina usually seen in children before 5 years of age. The tumor is extremely rare in adults. We report here an unusual case of retinoblastoma in a 55-year-old adult female who presented to us with an orbital mass at a late stage of the disease. Detailed laboratory investigations and imaging studies could not make a precise diagnosis. The treating ophthalmologist suspected primary intraocular tumor, metastatic carcinoma, malignant melanoma, or lymphoma and referred the patient for fine needle aspiration cytology (FNAC). Cytopathological examination of Giemsa-stained FNAC smear was consistent with that of retinoblastoma and established the diagnosis

Hepatic angiomyolipoma: A case report with diagnostic challenge

Angiomyolipomas are rare benign tumors derived from perivascular epithelioid cells that occur frequently in kidney and rarely in the liver. We present a case of hepatic angiomyolipma, with various clinical and radiological differential diagnoses. A 34-year-old male was found to have a palpable mass on the left side of the abdomen. Imaging showed heterogeneously enhancing mass lesion 15 cm Χ 7 cm, in the left lobe and segment 4 of the liver. Various benign and malignant diagnoses were entertained. The needle biopsy did not reveal any evidence of malignancy. Patient underwent resection of the lesion in view of the large size, which was diagnosed as angiomyolipoma. Angiomyolipoma is a benign tumor and accurate diagnosis is important to prevent overtreatment. Histology and immunohistochemisry may help in clinching the diagnosis, in proper clinical setting