Utility of FNAC in conjunction with cell block for diagnosing space-occupying lesion [SOL] of liver with emphasis on differentiating hepatocellular carcinoma from metastatic SOL: analysis of 61 cases

Objectives: To study the cytological patterns of fine-needle aspiration cytology [FNAC] obtained from space-occupying lesions [SOLs] of the liver with an aim to differentiate primary hepatocellular carcinoma from metastatic deposits and to evaluate the added advantage and efficacy of studying cell blocks in conjunction with smears for enhancing diagnostic accuracy

Methods: This prospective study took place over two years [September 2007 to 2009] and included 61 patients with cases of liver SOLs that were clinically or radiologically suspicious for malignancy and who were referred for computed tomography or ultrasonography-guided FNAC. Smears were prepared from the aspirated material, and any remainder was used to make the cell block [n = 55]. A final diagnosis was made after evaluating the smears and cell block sections

Results: On cytomorphology, a diagnosis of moderately differentiated hepatocellular carcinoma [HCC] and metastatic carcinoma was made in 10 [18.2%] and 25 [45.5%] cases, respectively, and were confirmed using cell block sections. In cases where it was difficult to differentiate between welldifferentiated HCC and regenerative nodules, and between poorly differentiated HCC and poorly differentiated metastatic carcinoma, a final diagnosis was made with the help of cell blocks sections. Cell blocks assisted in reaching a final diagnosis in 16 [29.1%] cases. Cases that were diagnosed using cytomorphology were confirmed by the cell block method. In these 39 [70.9%] cases we were able to render a diagnosis with much more confidence

Conclusion: In our experience, difficulties in diagnosing SOL liver are attributed to differentiation of the tumor. Cell block preparation gives an additional advantage as architectural details can be studied that help to reach an accurate diagnosis in problematic and challenging cases. Thus, we strongly recommend the use of the cell block technique in conjunction with cytosmears for the purpose of diagnosis

Histopathological study of neoplastic lesions of large intestine in Kashmir Valley, India.

Background: Aim of current study was to study the histopathological spectrum of neoplastic lesions of large intestine and histopathological pattern of colorectal carcinoma in young adults. Methods: We took a combined retrospective & prospective study in the department of pathology. The specimens were collected from subjects diagnosed as colorectal carcinomas in histopathology department and clinical details were sought from the medical records. Variables like age, sex, dietary habit, relevant history, tumor size, location, type of lesion, histological pattern of patients were checked. Results: In the series of 446 patients of colorectal neoplasm, maximum number of patients presented in 4th to 6th decade of life (47.30%), while as (15.46%) were between 20-40 years. The youngest patient with an adenocarcinoma was 18 years (male) of age and the oldest one was 80 years (male) of age. Average age of patients was 50.50 years. The male to female ratio was 1.3:1. The study revealed that the carcinoma of ascending colon was much more prevalent, constituting 107 (40.07%) cases. The proportion of well differentiated carcinoma was highest in left side colon and rectum. The incidence of moderately differentiated and poorly differentiated carcinoma was greater on right side colon. Conclusion: Adenocarcinoma is the most common histological variant of colon carcinomas.