Gouty Tophi-Diagnosis Clinched on Cytology with Review of Literature

Periarticular and articular nodules represent as one of the most common manifestations of a wide variety of non-neoplastic and neoplastic lesions. These nodules tend to create diagnostic dilemmas, as most of them present with variable signs/ symptoms and have nonspecific laboratory findings. Amongst these, gouty tophus is an important differential, the diagnosis of which can be difficult in cases of unusual presentations, i.e., in the absence of arthritis and/ or hyperuricemia. The authors hereby present a clinically unsuspected case of gouty tophi in a 37-year-old male with a soft tissue swelling at 1st metatarsophalangeal joint of the left foot. Fine needle aspiration cytology played a pivotal role in clinching the diagnosis, thus highlighting its substantial role in diagnosis of periarticular nodules

5-year experience with vulval lesions in a tertiary care hospital: series of 115 cases

Background: Wide range of vulval lesions have been described with similar modes of presentation. Benign and inflammatory lesions form the major chunk. Squamous cell carcinoma is the most reported malignant entity. Aim was to review the vulval lesions received in our departmentMethods: We studied the data from the archives of the Department of Pathology for a period of 5 years from January 2014 to December 2018 for vulval biopsies and specimens sent for histopathological examination. The final diagnoses were divided into non-neoplastic, neoplastic and non- specific.Results: Age of women ranged from 22 to 86 years (mean 54.3±3.6) with the maximum number of patients between 50 to 60 years of age. Most common form of clinical presentation was an itchy white elevated lesion on the vulva (72 cases, 62.6%). The most common site for the lesions was labia minora (90 cases, 78.2%). Non neoplastic lesions were seen in 53 cases and neoplastic lesions were seen in 52 cases. There were 28 (53.8%) benign lesions while 24 cases (46.1%) were malignant. Squamous cell carcinoma was the most frequently diagnosed form accounting for 20 cases (83.3%). Rare tumours like Malignant melanoma, Merkel cell carcinoma and Neuroendocrine carcinoma formed 16.6% (n=4). Seven cases were premalignant. Two cases had non-specific histologic diagnosis showing mild chronic inflammation.Conclusions: Previous studies have reported that non-neoplastic lesions form around 70% of cases. However, in our study we found that the non-neoplastic and neoplastic lesions form equal number of cases (46%) which may be attributed to increased awareness or geographical variation

Follicular Carcinoma Metastasized to Scalp Diagnosed by Fine Needle Aspiration Cytology

Follicular carcinoma is the second-most common thyroid cancer after papillary carcinoma but it is known to cause distant metastases to bones, lungs and central nervous system. Distant metastases at the time of diagnosis may be the reason for initial presentation in many patients. The incidence of cutaneous metastases is very rare and only 30 cases have been reported in the literature.The authors present a case of follicular carcinoma arising in multinodular goiter and metastasizing to the scalp diagnosed on fine needle aspiration cytology. The case is presented here to highlight the role of FNAC in preoperative diagnosis of such tumors so that an effective therapy/ surgery is planned

Spindle Cell Variant of Medullary Carcinoma Thyroid- A Case Report

A 14-year-old girl presented with a solitary thyroid nodule since 1 year. Fine needle aspiration cytology (FNAC) from the thyroid swelling revealed discretely arranged spindle cells with scant cytoplasm. Because of diagnostic dilemma, a provisional diagnosis of spindle cell lesion of thyroid was given as distinction of amyloid from collagen and basement-like material was difficult on cytology smears. Also, spindle cell might be seen in anaplastic carcinoma, melanoma, soft tissue sarcomas, etc. Tumor cells were positive for cytokeratin and chromogranin in cell block preparation. Thus, the diagnosis of spindle cell variant of medullary carcinoma thyroid was given

Cytomorphological Analysis of Skin Adnexal Tumors

Objectives: To study the cytomorphological features and pitfalls in the cytological diagnosis of various skin adnexal tumors (AT).Methods: This is a two-year cross sectional descriptive study. Cases diagnosed as skin AT on cytology were included in the study. Histological correlation was done on the biopsies which were available. Pitfalls on cytology were evaluated keeping histopathology as the gold standard for diagnosis.Results: A total of 46 cases of skin AT were included in the study. Upper limb was the most common site involved by them (36.96%). Young adults were the most commonly affected age group. Of the 46 aspirates, 26 cases (56.50%) which were typed include pilomatricoma (14 cases), chondroid syringoma (6 cases), skin AT of eccrine origin (5 cases) and sebaceous origin (1 case). Specific typing was not possible in 20 cases in this study. The authors did not diagnose any primary malignant tumor of skin in this study. 21 cases had histopathological correlation. Two cases of pilomatricoma showed discordance on histopathology. Out of the five cases diagnosed as skin AT of eccrine origin, one case was confirmed as eccrine poroma and the other as eccrine spiradenoma on histopathology. Out of the 20 cases, which could not be specified on cytology, five were diagnosed as nodular hidradenoma.Conclusion: FNAC is a useful investigation for diagnosing skin AT but all cases of skin adnexal tumors cannot be typed on cytology

Fallopian tube prolapse after hysterectomy: A rare entity.

Prolapse of fallopian tube into the vaginal vault following hysterectomy is a rare complication and an underreported clinical entity as well. Cumulative incidence of fallopian tube prolapse is 0.5% and 0.06% with vaginal hysterectomy and abdominal hysterectomy respectively. Histopathology along with good clinical correlation is the only definite way to confirm its diagnosis

Gliosarcoma in a Paediatric Patient: A Rare Entity and Review of Literature

Primary Gliosarcoma is a rare malignant tumour of central nervous system in adults. It is usually a variant of Isocitrate Dehydrogenase (IDH) wild type glioblastoma. Its incidence is approximately 2% of glioblastomas and has a dismal prognosis. Most common age group is between 40-60 years of age is commonly seen in males. Paediatric gliosarcoma is even rarer than adults ones. Most common location is temporal and frontal lobes (cerebral hemisphere). Histologically, it shows biphasic pattern and is composed of both glial and mesenchymal components. Both these components has monoclonal proliferations. Here, a 20-month-old boy resident of Gorakhpur, presented with persistent crying for short duration in neurosurgery emergency. On magnetic resonance studies a frontotemporal lesion was found, for which he underwent tumour excision. The tumour proved to be a primary gliosarcoma. Due to malignant nature of tumour patient did not survive. Gliosacrcoma is rare adult tumour, but can rarely occur in children. A differential diagnosis of gliosarcoma should be kept in mind, while dealing with congenital tumours in children, due its aggressive nature with poor survival outcome

Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016