Chondroid Syringoma and Eccrine Spiradenoma

Fine needle aspiration cytology (FNAC) is a well established diagnostic tool. However, most clinicians prefer to diagnose suspected skin tumors by excisional biopsy as they are easily accessible and hence benign skin adnexal tumors are rarely encountered on FNAC. There are only a very few case reports describing the fine needle aspiration cytologic features of chondroid syringoma and eccrine spiradenoma for diagnosis. Cases: First case was a 20 year old female who presented with firm,non-tender swelling in the left little finger measuring 1 cm in diameter. Smears showed clusters of round to plasmacytoid cells with moderate to abundant cytoplasm embedded in a chondromyxoid ground substance . Hence, a diagnosis of chondroid syringoma was made. Another case was a 40 year old lady who presented with a painful swelling on the anterior chest wall measuring approximately 0.8 cms in diameter. Smears were moderately cellular with cohesive sheets and clusters of bland cells of three different cell types. Hence, a probable diagnosis of eccrine spiradenoma was made and both the cases were confirmed histologically. Conclusion: Appropriate knowledge of the cytologic features of chondroid syringoma and eccrine spiradenoma helps in providing a definitive diagnosis and correct management of the patient

Association between American College of Radiology Thyroid Imaging Reporting and Data System and Bethesda Scoring System in Assessment of Thyroid Nodule: A Prospective Cross-sectional Study

Introduction: In view of increased detection of incidental thyroid nodules on ultrasonography, there is a need for standardising the reporting system of thyroid nodules for better patient management. Aim: To assess concordance between two classification systems of thyroid nodules: American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TIRADS) 2017 criteria on sonography and Bethesda categories on cytology. Materials and Methods: A prospective, cross-sectional validation study was conducted in Department of Radiology in collaboration with the Department of Pathology at a tertiary care hospital in Dakshina Kannada district, Karnataka, India, over a period of 12 months between October 2017 to September 2018. A total of 175 thyroid nodules detected on Ultrasonography (USG) were categorised based on ACR TIRADS 2017 criteria. Ultrasound guided Fine Needle Aspiration Cytology (FNAC) was performed on the nodules and were scored on the basis of Bethesda categories. Nodules were categorized into benign and malignant under TIRADS and Bethesda and their concordance was assessed. Sensitivity, specificity, positive and negative predictive value were assessed. Pearsons Chi-square test statistical method and kappa values were used in analysis. Results: Solid composition, hypoechoic echotexture, taller than wide shape, irregular margin and microcalcification descriptors of ACR TIRADS 2017 system were features more in favour of a malignant nodule. With FNAC as gold standard, TIRADS had a sensitivity, specificity, positive and negative predictive value and diagnostic accuracy of 91.7 %, 86.3%, 63.5%, 97.6% and 87.4% respectively (p-value <0.001). Conclusion: The stratification of risk among thyroid nodules as benign or malignant using ACR TIRADS 2017 criteria yielded good result in our study. With careful examination of nodules, TIRADS can be used to select appropriate nodules for further evaluation with cytology

Original Ariticle Intraoperative consultation and smear cytology in the diagnosis of brain tumours

Background: Intraoperative smear cytology provides a rapid and reliable intraoperative diagnosis and guidance to the neurosurgeon during surgical resection and lesion targeting. It also helps the surgeon to monitor and modify the approach at surgery. Objectives: 1) To assess the utility of intraoperative smear cytology and correlate with the �nal histopathological diagnosis. 2) To describe the cytomorphological features of common brain tumours in smear preparation. Materials and methods: The material for this study was obtained from 100 consecutive biopsies of central nervous system neoplasms sent for intraoperative consultation. Smears were prepared from the biopsy samples sent in isotonic saline for immediate processing. The smears were stained by the rapid Haematoxylin and Eosin method. The cytomorphological features were noted and correlated with paraf�n section �ndings. Results: Of the total 100 cases, 86 showed accuracy when compared with histopathological diagnosis. This was comparable with other studies. Of the remaining, two cases were frank errors, 12 cases showed partial correlation, with �ve cases showed incomplete typing of the cell type and seven, discrepancy in grading of tumours. The error percentage was 14%. Correlation with clinical details and radiological �ndings were helpful in improving the accuracy rate. Conclusions: Smear technique is a fairly accurate, relatively safe, rapid, simple, easily reproducible and cost effectiv

A Rare Case of Primary Insitu Squamous Cell Carcinoma of the Endometrium with Extensive Icthyosis Uteri

Primary squamous cell carcinoma of the endometrium is exceedingly rare. We report a case of 52 years old postmenopausal woman who presented with pelvic pain of four months duration. Gynecologic examination revealed a normal cervix. A possibility of pyometra was considered through pelvic ultrasound. Total abdominal hysterectomy was performed and histopathologically, it was diagnosed as a case of primary in situ squamous cell carcinoma of the endometrium