Pneumatosis cystoides intestinalis- a morphological curio or a pitfall for surgeons: report of two cases and literature review

Pneumatosis Cystoides Intestinalis (PCI) is an uncommon but well recognised clinical entity in which gas-filled cysts appear in the intestinal wall.PCI can be an incidental finding or it may be detected during radiography or laparotomy. We came across two cases of PCI with characteristic morphological features associated with perforation peritonitis in and sigmoid volvulus respectively. In both cases PCI was not suspected pre-operatively.Both patients underwent urgent surgical exploration for the abdominal emergencies and were discharged in good general condition. It is imperative that the imaging finding of PCI is carefully correlated with the findings of physical examination, clinical history, and laboratory test results to determine which patients can be managed medically by treating the underlying disease and which will require emergency surgery. This decision can be difficult because the origin of the gas is often unclear and the patient's symptoms can be volatile, presenting a major dilemma for the surgeon

Preoperative cytological diagnosis of papillary cystic variant of acinic cell carcinoma: A key consideration in patient management

Preoperative diagnosis of malignant salivary gland tumors is difficult as radiological imaging procedures have low sensitivity rate for detecting malignancy in parotid gland tumors. With careful and detailed analysis of cytological features, guided fine needle aspiration cytology can prove to be a reliable diagnostic modality that can help in differential diagnosis of cystic parotid malignancies from cystic benign tumors and non-neoplastic lesions. Papillary cystic variant of acinic cell carcinoma is a rare, cystic, primary neoplasm of salivary gland that occurs commonly in parotid .The tumor shows high local recurrence rate and has poorer prognosis compared to classic acinic cell carcinoma. Preoperative cytological diagnosis of papillary cystic variant of acinic cell carcinoma of parotid, in the case described here was the basis for adequate and timely surgical management with good results

Leishmaniasis in a patient with HIV co-infection: Diagnosis on fine needle aspiration cytology

Leishmaniasis is a vector borne parasitic disease caused by obligate intracellular protozoa Leishmania and is transmitted by the bite of sand fly. The disease typically presents in visceral, cutaneous and mucocutaneous forms and is endemic in some states of India. Cases with atypical presentation are seen when patient has co- infection with HIV. We report a case of Leishmaniasis occurring in a HIV seropositive expectant mother diagnosed initially on fine needle aspiration cytology. The patient was resident of non endemic area and had presented with isolated cervical lymphadenopathy and fever without spleenomegaly. Characteristic morphological features of Leishmania seen in the fine needle aspiration smears from the neck nodes were identified and definitive diagnosis of Leishmaniasis could be given. Cytological features were not suggestive of any other disease. Timely diagnosis of the disease facilitated proper management in our patient

Cytology of lesions arising in and around operative scars: short series of four cases

Fine needle aspiration cytology (FNAC) is an established and valuable method for morphological diagnosis of soft tissue masses and confirmation of their local recurrence or metastasis. This study aims to highlight role of FNAC in confirmation of soft tissue recurrences that occurred in and around operative scars. Wet fixed & air dried smears were made from the material aspirated from four representative cases and stained routinely. Preoperative cytodiagnosis could be given in all cases. In two cases arising in previous scars of benign nerve sheath tumors, FNAC confirmed recurrence in one case and could suggest increased grade of lesion in the other. In the third case, in which initial nature of the lesion was not known, FNAC diagnosed scar endometriosis on two occasions. In fourth case local recurrence of extra abdominal fibromatosis was confirmed. Histopathological correlation was available in all cases. FNAC confirmed recurrence and could suggest diagnosis on scanty material