ABSTRACT
Acute leukemia often presents with symptoms due to bone marrow failure. But with atypical presentations, the diagnosis may not be straight forward and requires thorough clinical examination followed by carefully selected and interpreted investigations. We present a case of acute leukemia in a child who was admitted with pain and swelling of foot. In absence of classical features, leukemia was not initially suspected and even on subsequent biopsy, the diagnosis could not be picked up, requiring thorough re evaluation. We have hereby made an effort to analyse the pitfalls in this case to help practising clinicians and pathologists who might encounter similar scenarios.
ABSTRACT
Hepatoblastoma (HBL) is the most common primary malignant hepatic tumor in children. The aim of the present study is to describe cytological findings of HBL, to subclassify it, and to discuss differential diagnoses. Twenty cases were taken from records of Cytopathology department, Gujarat Cancer and Research Institute, Ahmedabad. The aspiration smears were stained with Papanicolaou stain andlor Giemsa stain. Cytological and architectural criteria were applied to aspiration smears. Fifteen cases (75%) of HBL were diagnosed in the patients below the age of two years. The commonest presentation was found to be lump in abdomen. On the basis of cytoarchitectural features, HBL was classified in two groups undifferentiated and differentiated. Morphologically, the tumor cells were commonly arranged in acinar pattern, papillary pattern, or in sheets. FNA cytology alone had some limitations in the diagnosis of HBL. Hence, cytoarchitecture in combination with clinicalfeatures, imaging techniques and serum a-fetoprotein levels were helpful for specific diagnosis of HBL and to rule out various others differential diagnosis of small round cell tumor. The cytological differential diagnosis between differentiated HBL and Hepatocellular carcinoma (HCC) was found to be very difficult.