Diagnostic utility of special stains in defining the spectrum of maxillofacial pathologies

Background: The Fine needle aspiration cytology (FNAC) is considered as a valuable and distinguished diagnostic test in the initial assessment of the patients presenting with a mass in the head and neck region or when a recurrence is suspected after previous treatment. Aims: This study was therefore designed to elucidate the efficacy of FNAC as an alternate diagnostic tool to histopathology in head and neck swellings and evaluation of staining efficacy of PAP and MGG stain over Haematoxylin and eosin (H and E) in routine cytopathological smears. Settings and Design: The study was conducted in the Department of Oral and Maxillofacial Pathology, where FNAC samples were collected from 150 patients with head and neck swellings. Materials and Methods: All the slides were stained with H and E, Papanicolaou (PAP), and May Grunewald Giemsa (MGG) stains. The cytopathological diagnosis was compared with histopathological diagnosis based on H and E stained sections obtained from paraffin-embedded formalin-fixed biopsy specimen of benign and malignant neoplasms. Statistical Analysis Used: The resulting data were analyzed using SPSS software version 19. Differences between the variables were analyzed using Pearson Chi-square test and Kruskal–Wallis test wherever applicable. Results: The FNAC as a diagnostic tool has sensitivity of 84.8%, 72.72%, and 78.78%, specificity of 62.5%, 75%, and 75%, and accuracy of 80.48%, 73.14%, and 78.04% in H and E, MGG, and PAP stain, respectively. PAP stain was the most efficient stain when all qualitative parameters are taken into consideration with maximum sensitivity and specificity for achieving definitive cytodiagnosis. Conclusions: The FNAC is an inexpensive and minimally invasive technique to diagnose different types of head and neck swellings and complement histopathological diagnosis.

Evaluation of immunocytochemistry on destained giemsa stained smears as an alternative to conventional technique

Introduction: Protocol for immunocytochemical (ICC) staining in May-Grünwald Giemsa (MGG)–stained smears has been difficult to establish. It is the need of the hour to be able to use prestained slides for ICC in specific cases to deliver timely diagnoses and reduce inconvenience to patients. Aims and Objectives: To evaluate and compare the use of MGG-stained smears for the purpose of ICC, after de-staining and saline rehydration to that of routine standard ICC. Materials and Methods: A prospective study was conducted on 40 FNAC samples: 25 cases of breast disease and 15 cases of reactive lymphoid hyperplasia known to express pancytokeratin and leukocyte common antigen (LCA)/CD45, respectively. Air-dried smears of each case were stained by standard MGG stain and after the report was dispatched, one smear was selected and sent for ICC. The smears were analyzed to determine the overall result and grade each smear semi-quantitatively with respect to staining-intensity, stain-localization, staining-uniformity, counter-staining, and background-staining. Observations and Results: The proposed protocol was inferior to conventional ICC in all the parameters, more pronounced in pancytokeratin than LCA/CD45. Only 8% of air-dried smears stained for pancytokeratin showed optimal stain intensity (as opposed to 44% of wet-fixed smears), whereas only 14.3% of air-dried smears were optimally stained for LCA (as opposed to 85.7% of wet-fixed smears). Conclusion: The proposed protocol of de-stained Giemsa smears as an alternative to conventional technique for ICC was unsuccessful in giving satisfactory results.

Efficacy of FNAC in early diagnosis of prostatic carcinoma

Background: Prostatic carcinoma is one of the most important causes of mortality in elderly men mainly because of the late detection despite of the fact that it is a potentially curable disease. Fine needle aspiration cytology (FNAC) is an easy to perform outpatient procedure requiring no expensive equipment or anesthesia. Objectives: The present study was carried out in an attempt to evaluate the fine needle aspiration cytology in the diagnosis of carcinoma prostate. Materials and methods: The present study was performed on 27 patients admitted in the surgical wards, with complaints suggestive of prostatic disease, in whom there was found to be a suspicion of malignancy of the prostate gland. Results: Among 27 patients, 14 patients were diagnosed as prostatic malignancy on per rectal FNAC whereas, 19 patients were confirmed with prostatic cancer histologically. Out of 19 histologically confirmed cancer cases, 16 were also positive on FNAC i.e. 84.21% accuracy of FNAC in detecting prostatic malignancy. Conclusion: Fine needle aspiration cytology is easily available and inexpensive procedure. It is a reliable method in the diagnosis of prostatic cancer. Its positive results are relatively more reliable than the negative ones. It is an effective method in follow up of the cancer cases.