Ovarian Steroid Cell Tumour: Correlation of Histopathology with Clinicopathologic Features

Ovarian steroid cell tumours (not otherwise specified) are rare neoplasms of the ovary and are classified under lipid cell tumours. Their diagnosis can be considered as one of exclusion. Histopathologically, the tumour should carefully be evaluated for microscopic features of malignancy, but it is essential for the clinician and the pathologist to remember that in these tumours, pathologically benign histomorphology does not exclude the possibility of clinically malignant behaviour. Our case study focuses on the comparative findings in a postmenopausal female diagnosed with an ovarian steroid tumour (not otherwise specified). A careful correlation between clinical and surgical evaluation and microscopic analysis is necessary, as is a regular followup

Cytological diagnosis of multiple myeloma presenting as a jaw swelling

Multiple myeloma is a systemic B-cell lymphoproliferative disease with varied manifestations. Its diagnosis can therefore pose difficulties for both the clinicians and pathologists. Jaw lesions, though not uncommon, rarely present as the first sign in multiple myeloma. We present here the case of a 45 year-old female who presented with a swelling of the jaw and on subsequent work-up, was diagnosed with multiple myeloma. Recent research regarding this disease has also been highlighted

A Clinicopathological Study of Fine Needle Aspirates of Lymph Nodes from Patients with Suspected Tubercular Lymphadenopathy: Analysis of 640 Cases from a Tertiary Health Care Centre in North India

Introduction: Fine needle aspiration cytology (FNAC) of lymph nodes is an out-patient, simple and, quick, cost-effective procedure that helps in the diagnosis of tubercular lymphadenopathy. This technique has high sensitivity and specificity which in addition to the establishment of cytological diagnosis, also helps to perform ancillary tests like ZN staining for AFB Bacilli and GeneXpert MTB/RIF Assay. Aims: To study the clinical and cytopathological features of fine-needle aspirates of lymph nodes from patients with suspected tubercular lymphadenopathy along with the role of ZN staining And GeneXpert assay in diagnosis. Materials and Methods: In this study 1123 patients presenting with lymphadenitis presenting to the cytopathology lab for FNAC of lymph nodes between May 2018 to May 2021 were included. Out of 1123 patients presenting with lymphadenopathies, there were 640 cases of tuberculous lymphadenitis. The clinical and cytopathological findings of these 640 cases were analyzed. Results: Most cases of tubercular lymphadenopathy were of the adult age group (20-59 years) and showed a female predominance. The most commonly involved lymph node was the cervical group. The most common clinical feature observed was cough (68.5%). Among the four cytomorphological patterns observed, maximum cases showed epithelioid cell granuloma with necrosis. Ziehl- Neelsen staining showed overall AFB positivity of 40.3%. Smear showing necrosis without epithelioid cell granuloma showed maximum AFB positivity among the four patterns.GeneXpert MTB/RIF Assay showed an overall detection rate of 84%. Conclusion: FNAC is a simple, cost-effective, outpatient technique with high diagnostic accuracy in cases of tubercular lymphadenopathy which can be coupled by Ziehl Staining for Acid-fast bacilli and GeneXpert MTB/RIF Assay. However, in smear-negative cases, it poses a diagnostic dilemma, thus in a developing country like India with a high prevalence rate of tuberculosis, FNAC coupled with Z.N. staining and new molecular tests like GeneXpert MTB/RIF assay should be included in the first-line investigation in cases with tubercular lymphadenopathy. Key words: Tuberculosis, Fine Needle Aspirate Cytology(FNAC), Necrosis, Epithelioid cells, Cytopathological pattern, Ziehl–Neelsen Staining, GeneXpert Mycobacterium/Rifampicin(MTB/RIF) Assay</jats:p

Epithelial myoepithelial carcinoma in an ectopic salivary gland: A diagnostic dilemma

The ectopic Salivary Gland is the presence of salivary tissue in unusual locations which do not normally host it. Moreover, neoplasms arising from these ectopic tissues are very rare, however, tumourigenic changes in these inclusions have been observed in a few cases.We present a clinically unsuspected case of an ectopic salivary gland tissue present on the mid-neck, which was diagnosed as Small lymphocytic leukaemia outside Jawaharlal Nehru Medical College, Aligarh. On further evaluation, a definitive diagnosis of epithelial myoepithelial carcinoma arising in ectopic salivary gland tissue within the cervical lymph node was made. Therefore, these tumours need to be included in the differential diagnosis of neck masses, for a prompt diagnosis and adequate treatment.</jats:p

A comparative study of the role of cytopathology, staining for acid-fast bacilli and genexpert MTB/RIF assay in the diagnosis of tubercular lymphadenopathy

The diagnosis of tubercular lymphadenopathy can be made by FNAC combined with staining for AFB along with newer methods like GeneXpert assay. India carries one of the largest burdens of TB accounting for twenty-seven per cent of worldwide cases. To evaluate the role of cytopathology, AFB staining and GeneXpert assay in the rapid diagnosis of tubercular lymphadenopathy along with the usefulness of GeneXpert assay in the diagnosis of indeterminate aspirates. A total of 372 patients presenting with lymphadenopathy and clinical suspicion of a tubercular aetiology were included in the analysis.183 patients (56%) were adults (20-59 years) followed by 66 patients (20%)in the paediatric age group. 189 were females(57.3%) and 141 were males (42.7%). The cervical group of lymph nodes were most commonly involved (66%).69.1% were AFB positive in 201 smears with features favouring tubercular infection (positive cytology) which increased to 183 (91%) when GeneXpert Analysis was done, while 72 cases (55.8%) were AFB positive on cases with indeterminate cytology which showed an increment to 108 cases (83.7%) on the application of GeneXpert. FNAC combined with ZN staining and GeneXpert has a much higher diagnostic accuracy, GeneXpert further prevents underdiagnosis and enables rapid and accurate diagnosis in cases with indeterminate/inconclusive FNAC and ZN staining.</jats:p

Disseminated cryptococcosis in an immunocompetent child

Cryptococcus is a ubiquitous fungus and is known for causing meningitis and cutaneous infections in immunocompromised individuals. Disseminated cryptococcal infection is very rare and almost always found to occur in immunocompromised individuals especially in persons infected with HIV. This is particularly attributed to its capsulated spores. But there are few reported cases in which it has been found to cause disseminated infections even in immunocompetent individuals. We report a similar case of disseminated cryptococcal infection in an immunocompetent host. Early detection and treatment of disseminated cryptococcosis is essential to reduce morbidity and for better outcome

Use of GaAlAs Diode Laser for Excisional Biopsy of Gingival Giant Cell Fibroma: A Case Report of a Rare Lesion

Giant cell fibroma (GCF) is a relatively rare lesion in the oral cavity. Despite having unique microscopic features, it can be easily misdiagnosed clinically as any common hyperplastic lesion. This report presents a case of a 21-year old male with a lesion involving the papilla between the mandibular central incisors. The lesion was excised completely under topical anesthesia using a 980 nm diode laser. On histopathological examination of the excised tissue, no thermal damage or any other alteration was observed, while the features were suggestive of GCF. Healing of the gingiva was uneventful and without any signs of recurrence. Apart from the widely known advantages of the diode laser, it also appears to maintain the integrity of biopsy specimens, if used with appropriate settings. This advantage may play a vital role in the biopsy of rare lesions where the diagnosis is entirely based on accurate histopathological examination.</jats:p

Retiform hemangioendothelioma of the gluteal region: A case report

Retiform hemangioendothelioma is a locally aggressive, rarely metastasizing, low-grade angiosarcoma characterized by intercommunicating vascular channels lined by hobnail or cuboidal endothelial cells, flanked by lymphocyte and hyaline sclerosis. Neoplastic endothelial cells usually express von Willebrand factor, CD31 and CD34, while the lymphocytic infiltrate shows a mixture of CD3+, T and CD20+ B cells. The authors describe a case of a 76-year-old female who presented with a soft, painless, ill-defined mass measuring 9 cm in her right gluteal region for the past 15 years, clinically suggestive of a lipoma. There was no regional lymphadenopathy. The mass was resected and sent for histopathological examination. The slow-growing lesion and the typical histomorphology led to the diagnosis of retiform hemangioendothelioma. The diagnosis was confirmed by immunohistochemistry using CD34 antibody, which strongly stained the endothelial cells. The patient was followed up for 6 months after the surgery and no recurrence was noted

Spindle-cell ameloblastic carcinoma of the maxilla with adenoid cystic carcinoma-like areas: A new variant?

Ameloblastic carcinoma is a rare aggressive malignancy of odontogenic epithelial origin. The disease has been reported to afflict people over a wide range of age group without any sex predilection. It is characterized by rapid growth and destruction of overlying bones along with involvement of adjacent soft tissues. The overall prognosis of this cancer is poor despite radical surgery and radiotherapy. Owing to the rarity of this lesion, complete data on the biological behavior and response to different treatment modalities are still lacking. The authors hereby report a case of this uncommon tumor arising from left maxilla in a 60-year-old Indian male. Histopathological examination of the tumor showed foci of spindling intermixed with large areas of tumor cells arranged in cribriform pattern and having luminal eosinophilic material which was reminiscent of adenoid cystic carcinoma. A final diagnosis was achieved after immunohistochemical study. These unusual findings prompted this case report