ABSTRACT
Background: Fine needle aspiration cytology has become an established tool in the diagnostic armamentarium of many clinical practices. The initial diagnosis of many mass lesions, both superficial and deep-seated, can often be readily and safely assessed by fine needle aspiration cytology. In our study, we assessed 361 cases of soft tissue tumors by fine needle aspiration cytology during a period of three years. We tried to follow up as many cases as possible to obtain corresponding excision biopsies for histopathological examination. Immunohistochemical studies were also performed on biopsy sections in some cases for confirmation of diagnoses. Aims and objectives: 1) To study the age, sex and site-wise distribution of soft tissue tumors. 2) To assess the utility of fine needle aspiration cytology in diagnosing various types of soft tissue tumors. 3) To assess the sensitivity, specificity, positive and negative predictive values, and overall histological correlation percentage of fine needle aspiration cytology in diagnosing soft tissue tumors. Methods: Aspirations were carried out using a 22 gauge disposable needle and a 10c.c disposable syringe for suction. Wet-fixed smears were stained with hematoxylin and eosin and pap stain. Dry-fixed smears were stained with May-Grunwald Giemsa stain. Periodic Acid Schiff stain was used in some cases of extraskeletal Ewing’s sarcoma. Corresponding biopsy sections were stained with hematoxylin and eosin. Immunohistochemical stains were also used in some of the cases for confirmation of diagnosis. Results: Of the 361 cases recorded in our study, 320 patients could be successfully followed up and excision biopsies were obtained. The remaining 41 patients were excluded from the study due to inability to obtain biopsy. Of the 320 cases, 200 were diagnosed as benign soft tissue tumors, while 120 were diagnosed as malignant on cytological examination. The median age of occurrence of benign soft tissue tumors was 34.23years, while that of malignant soft tissue tumors was 48.33years. Prevalence was highest in the age group of 20-49years, during which majority were benign lesions. Soft tissue tumors were more common in the lower extremities with predominant benign tumors, while malignant tumors were more common in the trunk. Sexwise distribution showed a male:female ratio of 1.76:1. Various patterns were observed in cytology. The commonest tumors were lipomas (55%), followed by benign peripheral nerve sheath tumors (37%). Malignant soft tissue tumors constituted 37.5% cases, among which malignant fibrous histiocytoma was the most frequent tumor. Soft tissue sarcomas were classified into 5 general categories on the basis of predominant appearance in aspiration smears: I. Myxoid II. Spindle cell III. Pleomorphic IV. Polygonal V. Round cell. Immunohistochemical studies were done for some tumors with vimentin, desmin, S-100 protein and Neuron Specific Enolase (NSE), Leucocyte Common Antigen (LCA), cytokeratin (CK) and Epithelial Membrane Antigen (EMA). A comparative analysis was done between the cytology report and histopathology. Conclusion: Final evaluation of the results showed that the diagnostic accuracy of fine needle aspiration cytology in soft tissue tumors was 96.88%, sensitivity was 95.08% and specificity was 97.98%.Thus our study proves the efficacy of fine needle aspiration cytology in the diagnosis of soft tissue tumors as a useful cost-effective procedure.
ABSTRACT
Background: Ovarian tumours account for 3% of all cancers amongst women, being the second most common cancer of the female genital tract. The ovarian tumours are highly heterogenous with a wide range of histological patterns. Aim of current study was to study the histological patterns and the age incidence of the ovarian tumours in our institute. Methods: The present study is a prospective study conducted in the department of pathology, Andhra Medical College, from August 2011 to July 2013. Results: We received a total of 267 specimens of ovarian tumours during this period, out of which, 263 were primary and 4 were secondary tumours. Benign tumours were 209 (78.3%), borderline were 10 (3.7%) and malignant were 48 (18%) in numbers. Overall surface epithelial tumours constituted the majority of tumours accounting for 214 (80.2%) cases, followed by germ cell tumours 38 (14.2%) and sexcord stromal tumours 11 (4.1%). The single most common tumour diagnosed was serous cystadenoma. The most common malignant tumour was serous cystadenocarcinoma. The age groups affected ranged from 11-70 years. The peak age incidences for different histological types were as follows: surface epithelial tumours: 21-50 years, germ cell tumours: 21-30 years, sexcord stromal tumours: 51-60years. Benign tumours were more common in 21-40 years of age, borderline in 31-50 years and malignant tumours in 41-50 years age group. Conclusion: The results from our study were comparable with those reported in literature; however malignant serous and mucinous tumours showed a lower peak age incidence in our study. Krukenberg tumours also occurred in younger age group in our study.