Buccal Mucosa Exfoliative Cell Prussian Blue Stain Co-Relates with Iron Overload in ß-Thalassemia Major Patients.

Thalassemics require regular blood transfusion therapy leading to iron overload in the body tissues, which is a major cause of morbidity and mortality in these patients. We hereby attempted to measure this iron overload by means of exfoliative cytology, a non-invasive and inexpensive technique. The aims and objectives of our study were: 1. To detect iron overload by oral exfoliative cytology using Perl's Prussian blue stain in ß-thalassemia major patients. 2. To correlate staining positivity with serum ferritin levels. Smears were obtained from buccal mucosa of 50 ß-thalassemia major patients (who had taken more than 12 transfusions) and 25 healthy subjects of the same age group as controls. Smears were stained with Perl's Prussian blue. Blood samples were taken from the study group for estimation of serum ferritin levels. Grading criteria were defined for assessing the Prussian blue positivity. Perl's positivity was observed in 49 out of 50 of thalassemic patients (98%). 1 patient had Grade 0, 7 patients had Grade I, 5 had Grade II, 12 had Grade III, 14 had Grade IV while 11 patients had Grade V positivity. Spearman Rank's Correlation Co-efficient was 0.38, signifying a weak positive correlation between positivity of buccal smears for Perl's Prussian blue staining and respective serum ferritin levels. Perl's Prussian blue staining of exfoliated cells from buccal mucosa can be used to assess iron overload in ß-thalassemia major patients, as a screening as well as diagnostic tool. With the grading system we can give a semi-quantitative assessment of the same.

Extra-venous use of autologous platelet concentrate: beginning of a new era of therapy of transfusion medicine?

Autologous infusion of blood platelets to induce healing of injured tissue is reported in several recent journals. The presence of many 'platelet-derived-factors' forms the basis of these studies. These studies have demonstrated improvement in 70-80% patients over a period of up to several months. We have identified the lapses in their techniques. We decided to undertake a small pilot study to test our use of "platelet concentrate" (U. S. P.) in patients of tendon injuries and also to establish a protocol for the extra-venous use of autologous blood platelets. We present, here, an improved technique of autologous platelet therapy in three groups of patients. Our results are compared with four earlier studies. Enhancement in clinical recovery of patients was achieved in shorter interval of time. We have concluded that use of "Platelet Concentrate" with its quality control tests, seems to be better in place of PRP and/or 'uncontrolled' platelet injection. Further, selection of patients for this therapy is crucial. Patients with acute bursitis do not appear ideal for this kind of therapy. However, chronic tendon injuries that are likely to worsen on corticosteroid injections can be treated with autologous platelets with excellent results. This appears to pave a new path for mesodermal regeneration and healing by extra venous use of platelet concentrate.

Fine needle aspiration cytology in mediastinal myxoid liposarcoma: a case report.

BACKGROUND: The mediastinum is an uncommon site for liposarcoma, with <1 % of all tumors occurring in this site. CASE: A 40-year-old woman presented with superior vena caval syndrome. Radiologic investigations revealed the presence of a large soft tissue mass occupying the anterior and middle mediastinum. A computed tomography (CT)-guided fine needle aspiration cytology (FNAC) sample showed the presence of fibrillary myxoid material with arborizing blood vessels and atypical lipoblasts. A diagnosis of myxold liposarcoma was made, which was later confirmed on bistopathology. CONCLUSION: The mediastinum is a challenging area for FNAC, which is a useful tool for accurate diagnosis. Awareness of the presence of liposarcoma is important for its recognition.

Preoperative diagnosis of renal angiomyolipoma with fine needle aspiration cytology: a report of 3 cases.

BACKGROUND: Angiomyolipoma is a rare benign neoplasm, commonly involving the kidney. Preoperative diagnosis on fine needle aspiration cytology can confirm the diagnosis, reducing the chances of unnecessary surgery. CASES: We studied cases of renal angiomyolipoma (AML) presenting within 1 year with palpable renal masses confirmed on ultrasound to be of renal origin. Fine needle aspiration cytology (FNAC) smears showed a few cohesive syncytial fragments with adipocytes, spindle cells and isolated single cells with foamy cytoplasm; a diagnosis of AML was made. The diagnosis was confirmed on histopathology, which showed mature adipose tissue, tortuous and thick-walled blood vessels lacking elastic tissue lamina and bundles of smooth muscles that seemed to emanate from the blood vessels. CONCLUSION: A preoperative diagnosis of renal AML is of great importance for correct management. In fact, when the lesion is small and asymptomatic, a conservative approach may be considered. Partial nephrectomy is possible with masses < 5 cm. Preoperative FNAC along with computed tomographic findings and immunocytochemical analysis of FNAC smears with HNB-45 can confirm the diagnosis of AML, thus preventing unindicated nephrectomy.