ABSTRACT
Tailgut cysts (TGCs) are rare congenital lesions derived from the remnants of primitive hindgut and are usually lined by squamous, transitional, or glandular epithelium. Malignant transformation in TGC may occur which is still rarer. Most common malignancies that arise from these cysts are adenocarcinomas. Preoperative diagnosis is difficult as high degree of suspicion is required for the diagnosis. We report here a case of adenocarcinoma arising in a tale gut cyst diagnosed preoperatively and till date very few cases have been reported in literature.
Subject(s)
Adenocarcinoma/diagnosis , Cysts/diagnosis , Neoplasms, Germ Cell and Embryonal/diagnosis , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Adult , Cysts/pathology , Cysts/surgery , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Male , Neoplasms, Germ Cell and Embryonal/pathology , Neoplasms, Germ Cell and Embryonal/surgery , Sacrococcygeal Region/diagnostic imaging , Sacrococcygeal Region/pathology , Sacrococcygeal Region/surgery , Treatment OutcomeABSTRACT
CONTEXT: Intraoperative consultation frozen section (FS) provides a surgeon background and management plan for surgery. Surgeons' and pathologists' coordination between each other including their departments' cooperation for FS management is very important. The role of FS in the intraoperative consultation is important. It is always advisable to consult an experienced histopathologist specially trained for CNS lesions for intraoperative consultation. AIMS: Frozen section (FS) diagnosis provides surgeons, physicians, and pathologists a provisional diagnosis to plan out their management plan. By this study, we intended to evaluate the importance of intraoperative consultation-FS diagnosis in central nervous system (CNS) lesions. In this study, the diagnostic accuracy and the various limitations of using FS of CNS tumors were determined. SUBJECTS AND METHODS: In this study, we analyzed retrospectively, the results of FS and final diagnoses of all CNS tumors were made at our institute for the duration of 1 year from July 2014 to June 2015. ETHICAL STANDARDS: We all authors state that all human studies have been approved by the Institutional Ethics Committee. We all authors also gave our informed consent before their inclusion in the study. Details that might disclose the identity of the subjects under study have been omitted. RESULTS: We studied 252 cases of age group from 1 to 76 years. Out of which, 155 (61.50%) cases had complete concordance between FS and final diagnosis, 77 (30.5%) cases had a partial concordance, and 20 cases (8.0%) were discordant. Considering the concordant and partially concordant cases, the accuracy rate was 92.0%, sensitivity was 93.42%, specificity was 91.66%, and positive and negative predictive values were 94.66% and 59.45%, respectively. CONCLUSIONS: A Kappa agreement score of 0.75 (substantial agreement score) showed high concordance for FS results with the permanent section. We came to the final conclusion that high sensitivity and specificity were seen with FS diagnosis in the CNS tumors.
Subject(s)
Central Nervous System Neoplasms/diagnosis , Interprofessional Relations , Neurosurgical Procedures/methods , Pathology, Surgical/methods , Referral and Consultation , Adolescent , Adult , Aged , Central Nervous System Neoplasms/surgery , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Intraoperative Period , Male , Middle Aged , Prognosis , Retrospective Studies , Young AdultABSTRACT
Brown tumor (BT) is caused by altered metabolism of calcium resulting from hyperparathyroidism (primary or secondary). The most common cause of hyperparathyroidism is isolated parathyroid adenoma (PA), and the most common symptoms are hypercalcemia related. BT is considered as a late manifestation of PA and usually diagnosed after surgical treatment of the bony lesion. Fine-needle aspiration cytology (FNAC) is a cheap, easy, and less traumatic procedure and should be performed in all lesions wherever possible as unnecessary surgeries may be avoided. We here report a rare case of PA presenting primarily as BT and diagnosed on FNAC.
ABSTRACT
BACKGROUND: Follicular dendritic cell sarcoma (FDCS) is a rare neoplasm arising from follicular dendritic cells of germinal centers. The most common site of origin is lymph nodes and it may mimic a variety of tumors at that location, including carcinomas and sarcomas. Diagnosis is frequently missed on cytology as there are very few case reports describing the cytological characteristics of the lesion. Even on histology, a high degree of suspicion is required for an appropriate diagnosis. CASE: A 60-year-old male presented with a gradually increasing left submandibular mass that had been present for 3 months. Fine-needle aspiration cytology (FNAC) was performed, showing many clusters as well as scattered epithelioid cells with spindled to oval nuclei, nuclear pleomorphism, grooves, inclusions, and uniformly dispersed mature lymphocytes throughout the smears. The diagnosis of FDCS was suspected and was confirmed on histopathology and immunohistochemistry. CONCLUSION: FNAC can be a cheap, easy, and helpful tool in obtaining a diagnosis of FDCS as there are few characteristic cytological features that are better recognized than histology.
