Cytohistopathological correlation of Papanicolaou smears: a hospital based study

Background: Carcinoma of cervix is the second most common cancer in women worldwide and the leading cause of death from cancer in several developing countries including India. The use of the cervical smear (Papanicolaou/Pap) as a screening tool has significantly reduced the incidence of cervical cancer. Cytohistopathological correlation of Pap smear is a widely accepted method of internal quality assurance and helps in the analysis of various factors leading to discrepant diagnosis. With the above view, the present study has been carried out to evaluate the cytohistopathological correlation of the various cervical lesions.Methods: The study was prospective cross-sectional hospital based study carried out over a period of eight months in which out of 500 pap smears screened, cytohistopathological correlation of 70 cases were obtained.Results: Specificity in the present study was 84.2% and the sensitivity was 77.7%. The accuracy of Pap smears was 82.1%. The overall correlation between cytology and histopathology was found to be 57% with the highest correlation in the high grade squamous intraepithelial lesion (HSIL) category (87.5%).Conclusions: The study provides good cytohistopathological correlation especially for high grade lesions. So we believe that the success of screening for cervical cancer is based on collection of adequate materials and correct interpretation of abnormal cells

Metanephric adenoma of kidney: a rare and distinct entity

Metanephric adenoma (MA) is an unusual renal neoplasm with benign behaviour most of the times. Clinically MA mimics malignant renal neoplasms due to nonspecific signs and symptoms such as polycythaemia, haematuria and abdominal pain. MA usually presents as a mass lesion on radiographic studies and can be found incidentally. The treatment of choice is surgical excision. Though MA is usually a benign tumour, increase in the knowledge of MA pathology may lead to less invasive treatments in the future. Less than 200 cases of metanephric adenoma are reported till date in the literature

Clinicopathological Study of Meningioma

Background: Meningiomas are tumours originating from meningothelial cells. They are commonly located at intracranial, intraspinal or occasionally ectopic site. They show histological diversity and are categorized into three grades by WHO 2007 Classification .This grading helps in predicting their behaviour and deciding treatment strategy. Objective: To study the frequency, clinical details, topographic distribution, histological typing and grading of 87 cases of meningioma. Diagnostic accuracy of radio-imaging and utility of squash cytology for their intraoperative diagnosis was also assessed. Methods: Total 87 histopathologically confirmed cases of meningioma were studied with above mentioned aims and objectives. Analysis of histological features, typing and grading of all cases was done according to WHO 2007 classification of meningioma. Result: Meningioma constituted 15.60% of all CNS neoplasms. It was the most common extra-axial tumour and contributed to 37.09% all extra- axial intracranial neoplasms. 90.8% of the meningiomas were intracranial where convexity was the most favored location. 6 out of 8 spinal meningiomas were located at thoracic level. Headache was the most frequent presentation. Obvious female predominance was observed. The most common histological subtype was meningothelial followed by transitional. Majority 87.36% were benign grade I tumours .3.45% cases showed recurrence.In 74.41% cases radiological diagnosis matched exactly with histopathological diagnosis while squash cytology provided exact diagnosis in 91.15% cases. Conclusion: Meningiomas are slow growing extra-axial tumoursmajority being intracranial, benign grade I neoplasms occurring commonly in elderly females and squash cytology plays a great role in their intraoperative diagnosis

Extra-axial central nervous system lesions- a clinicopathological overview

Background: Extra-axial Central Nervous System (CNS) lesions simply abut the CNS from meningeal or juxtameningeal site and include lesions arising from extra-parenchymal elements in CNS including meninges, nerve sheath or midline neur-axial structures confining to sellar region, pineal region and ventricles. Objective: To study extra-axial CNS lesions in terms of frequency, demography, topography and to assess utility of squash cytology to for their rapid diagnosis. Material and Methods: Total 383 cases of all clinically and radiologically suspected and/or histopathologically confirmed cases of extra-axial CNS lesions were studied with above mentioned objectives and resuls were tabulated and analysed. Result: Extra-axial lesions contributed 49.10% cases of all CNS lesions. Of these extra-axial lesions 68% were neoplastic (benign & malignant) and most of these (86.9%) neoplasms were benign. Neoplastic lesions were most commonly seen in 4th -5th decade while non-neoplastic in 1st-3rd decade with equal sex distribution. They were commonly located intracranially (73.36%) than at spinal location. Meninges were most common affected site. Intracranially meningioma (37.09%) and epidermoid cyst (46.38%) were most common neoplastic and non-neoplastic lesions respectively. While schwannoma (39.59%) and tuberculosis (45.28%) were most common neoplastic and non-neoplastic lesion at spinal location respectively. Extra-axial metastatic neoplasms contributed 2.08% of extra-axial CNS lesions. Developmental anomalies were seen in 19.5% cases. 7.28% neoplastic lesions were recurrent of which maximum were pituitary adenomas. In 74.41% cases radiological diagnosis matched exactly with histopathological diagnosis while squash cytology provided exact diagnosis in 89.84% cases. Conclusion: Extra-axial CNS lesions are common, constituting nearly half of the cases of CNS lesions; most of which are intracranial, slow growing, benign neoplasms and squash cytology plays a great role in intra-operative consultation

A Post-Mortem Diagnosis of Idiopathic Giant Cell Myocarditis Presenting as Sudden Death: A Report of Two Cases

Giant cell myocarditis is also known as ‘Granulomatous myocarditis’, of which Idiopathic giant cell myocarditis (IGCM) is a rare clinicopathological entity. IGCM is known to cause sudden death in healthy adults in the absence of any symptomatic heart disease. While performing autopsies if there is no apparent cause of death the autopsy surgeon must keep in mind IGCM, especially in healthy adults with an unexplained sudden death. We report here series of two cases of unexpected sudden death in an undiagnosed heart disease and the utility of histopathological diagnosis after autopsy when other ancillary techniques are unavailable

Meningioma with the unique coexistence of secretory and lipomatous components: A case report with immunohistochemical study

Meningioma is the most common extra-axial neoplasm which accounts for 30% of all intracranial tumors with a female predilection. These tumors exhibit a broad spectrum of differentiation potency corresponding to different histological subtypes. Meningothelial cells can rarely show separate secretory or lipomatous (metaplastic) transformation. The coexistence of these two different histological subtypes in a single meningeal tumor is extremely rare with only two reported cases. We report an uncommon case of meningioma in a 40-year-old female showing histological admixture of both secretory and lipomatous (metaplastic) meningioma, which to our knowledge is only the third reported case in the world. It highlights the multipotency of phenotypic transformation of primary meningothelial cells. This rare tumor behaves in a fashion similar to benign meningioma of WHO Grade I type