Diagnostic utility of bone marrow aspiration in pancytopenia

Back ground: Pancytopenia is a common haematological finding in clinical practice. It is a striking feature of many serious and life-threatening illnesses, ranging from simple drug-induced bone marrow hypoplasia, megaloblastic anaemia to fatal bone marrow aplasias and leukaemia. The severity of Pancytopenia and the underlying pathology determine the management and prognosis. Thus, identification of the correct cause will help in implementing appropriate therapy .Pancytopenia is a common haematological finding for which bone marrow aspiration is conducted. Aim: To study the bone marrow aspiration smears in Pancytopenia cases and correlating with peripheral smear and clinical findings to arrive at a diagnosis. Materials and methods: This was a study conducted at Department of Pathology, Gandhi Medical College on 148 cases of Pancytopenia presenting over a period of 2 years. Clinical findings, complete blood counts and peripheral smear findings were recorded and Bone marrow aspiration was done. Smears were stained with Leishman stain. Perls’ stain was done in all cases. Special stains like MPO, PAS, Reticulin staining was done if needed. Results: Out of 148 cases of Pancytopenia 67 cases were males and 81 were females. Most of the cases were in the age group of 10-20 followed by 20-30. Megaloblastic Anaemia was found to be the most common cause of Pancytopenia followed by hypoplastic marrow. Conclusion: A thorough Evaluation of bone marrow smears can diagnose underlying pathology in most cases of Pancytopenia. Correlating bone marrow features with clinical and haematological findings aid in diagnosing and management of most cases of Pancytopenia.

Diagnostic accuracy of central nervous system tumors by squash cytology

Background: Squash cytology has shown to be of great value in intraoperative consultations of central nervous system lesions. Intraoperative smear cytology provide a rapid and reliable diagnosis and guidance to the neurosurgeon during surgical resection and lesion targeting. Squash smear technique saves time and amount of tissue needed. Aim: To study the validity of rapid intraoperative diagnosis of central nervous system lesions by examining the squash cytologic smears of central nervous system lesions. Materials and methods: A total of 111 cases of intracranial space occupying lesions were studied. This squash smears were prepared from the intraoperative biopsy samples and remaining tissue fixed in formalin and sent for histopathological examination. Squash smears were stained with toluidine blue and rapid haematoxylin and eosin. Squash smear cytological diagnosis was correlated with histopathological findings. Results: Out of 111 cases, in 11 (9.9%) cases showing discordance was observed between squash smear diagnosis and histological diagnosis. In 100 (90.1%) cases, squash smear diagnosis was in accordance with the final histologic diagnosis. Thus the value of squash smear technique in rapid intraoperative diagnosis of neurosurgical biopsies was corroborated by above study and the accuracy of this study match with other studies done in the past on squash smear technique. Conclusion: Squash smear cytology should be used regularly for rapid intraoperative diagnosis of central nervous system lesions, as squash smear technique is economical, reliable, feasible intraoperative rapid diagnostic method and has a place in determining the immediate management.

Carcinoma ex Pleomorphic Adenoma (CXPA)-A rare parotid malignancy

Carcinoma ex pleomorphic adenoma (CXPA) is a rare parotid malignancy and its prognosis is poorer than other parotid malignancies. Invasive tumours tend to behave in a more aggressive fashion. These tumours are seen in patients in the sixth to seventh decades of their life. We present a 38-year-old male with a right-sided parotid gland swelling, which was present for the past 3 to 4 years and gradually increasing in size, with a solitary pulmonary nodule in the left upper lobe. On Fine Needle Aspiration Cytology (FNAC) of the parotid gland, a diagnosis of CXPAwas given. This was confirmed by histopathology as CXPAwith the malignant component of mucoepidermoid carcinoma and ductal carcinoma and with comedo pattern of necrosis.