Pap smear screening in antenatal women: an opportunistic way to save life

Background: Cancer cervix is the most common genital tract malignancy encountered in developing countries. In India, first visit to the gynaecologist for most women is during pregnancy and it may be the only visit. Hence, prenatal care offers an excellent opportunity to implement cervical screening in patients of young age, especially in women who do not seek routine health care. Therefore, this study was conducted to know the prevalence of abnormal Pap smear among the ante-natal women and to evaluate the result in relation to various risk factors.Methods: Cross sectional observational study conducted on 425 ante-natal women attending the antenatal clinic using questioner addressing various socio-demographic variables. Measures of central tendency calculated and result was tabulated by using chi-square test.Results: Maximum number of cases in our study was NILM i.e.314 (74%) followed by 68 cases of Candida (16%), 30 cases of Bacterial vaginosis (7.1%) and 10 cases of Trichomonas vaginalis (2.4%). Only 3 cases of abnormal Pap smear was reported i.e. 2 of ASCUS and 1 of LSIL. Thus, prevalence of abnormal Pap smear was 0.7%.Conclusions: In country like India where organised screening programme are not available, as well as the awareness and uptake of available services by the target population is also poor; screening in pregnancy is worthwhile and may be a viable option to reduce the burden of cervical carcinoma.

Malignant peripheral nerve sheath tumor presenting as pathological fracture of femur in neurofibromatosis patient

Malignant peripheral nerve sheath tumors (MPNSTs) are rare soft tissue sarcomas that arise from a peripheral nerve or cells associated with the nerve sheath, such as Schwann cells, perineural cells, or fibroblasts. MPNSTs account for 5%–10% of all soft tissue sarcomas. Neurofibromas in Neurofibromatosis-1 (NF-1) may undergo malignant transformation in 2%–5% of patients. We are reporting a very rare case in NF-1 patient who, presented with pathological intertrochanteric fracture of femur and liver metastasis. X-ray from left hip joint shows lytic lesion which on histopathology turned out to be MPNST. S-100 was positive confirming its neural origin. Elbow lesion which was excised later, also showed similar features with S-100 positivity. Ultrasonography abdomen showed target lesions in liver. Fine-needle aspiration cytology from liver showed scattered malignant spindle cells. A final diagnosis of metastatic MPNST was made. Although malignant transformation in neurofibromas is extremely rare when it occurs, it is associated with NF-1 in 75% of patients. This case highlights the possibility of fracture femur as the presenting complains, in patients of NF with malignant transformation. The case is unique with regard to its presentation and rarity of metastatic sites

Atypical Proliferating Clear Cell Adenofibroma of the Ovary: A Case Report

Clear cell adenofibromas of borderline malignancy are extremely rare tumors of theovaries. They may be associated with ovarian clear cell adenocarcinomas which typically present as large adnexal masses and are generally considered highly malignant. We describe the case of a postmenopausal female with an ovarian mass diagnosed as atypical (borderline) proliferating clear cell adenofibroma. The patient is alive and wellwithout signs of recurrence three years after surgery

Utility of cytospin and cell block technology in evaluation of body fluids and urine samples: A comparative study

Background: Cytologic examination of body fluids commonly involves the use of direct or sediment smears, cytocentrifuge preparations, membrane filter preparations, or cell block sections. Cytospin and cell block techniques are extremely useful in improving cell yield of thin serous effusions and urine samples, and ensure high diagnostic efficacy. Materials and Methods: We studied cytospin preparations and cell block sections prepared from 180 samples of body fluids and urine samples to compare the relative efficiency of cell retrieval, preservation of cell morphology, ease of application of special stains, and diagnostic efficacy. Samples were collected and processed to prepare cytospin smears and cell block sections. Results: We observed that overall, cell yield and preservation of individual cell morphology were better in cytospin preparations as compared to cell blocks, while preservation of architectural pattern was better in cell block sections. The number of suspicious cases also decreased on cell block sections, with increased detection of malignancy. It was difficult to prepare cell blocks from urine samples due to low cellularity. Conclusions: Cytospin technology is a quick, efficient, and cost-effective method of increasing cell yield in hypocellular samples, with better preservation of cell morphology. Cell blocks are better prepared from high cellularity fluids; however, tissue architecture is better studied, with improved rate of diagnosis and decrease in ambiguous results. Numerous sections can be prepared from a small amount of material. Special stains and immunochemical stains can be easily applied to cell blocks. It also provides a source of archival material

Case Report Section: Pathology A lesion on lip -Hemangioma with Chronic Granuloma

ABSTRACT Infections as well as tumours and tumour-like conditions are common in the oral cavity. While hemangiomas are benign vascular tumours which may be encountered in any part of the body, granulomatous infections are unusual in the mouth. We discuss below the rare occurrence of a hemangioma on the lip which was associated with a chronic granuloma

Myopericytoma of lip: A rare lesion in an unusual location

Myopericytoma is a rare benign tumor with perivascular myoid differentiation. It shares histomorpholoic features with the so-called hemangiopericytoma, myofibroma and glomus tumor. We hereby report the case of a 14-year-old boy who presented with a slowly growing, painless, firm mass on upper lip, diagnosed as myopericytoma on the basis of histopathology and immunohistochemistry. To the best of our knowledge, this is only the second such reported case