A comparison of cytological and histopathological findings and role of immunostains in the diagnosis of soft tissue tumors.

BACKGROUND: Fine needle aspiration cytology (FNAC) has been employed as a useful technique for the initial diagnosis of soft tissue tumors (STT) as well for the identification of recurrent and metastatic cases. AIM: We conducted this study on soft tissue tumors to find the efficacy of FNAC and to finalize the histological diagnosis with immunostains. MATERIALS AND METHODS: The present study was conducted on 126 patients of soft tissue tumors. FNAC and histopathology was performed in all the cases. RESULTS: Hundred and five cases (83.3%) were diagnosed as benign and 21 cases (16.7%) as malignant. On FNAC, tumors were divided into six cytomorphological categories i.e. lipomatous, spindle cell, round cell, myxoid, pleomorphic and vascular tumors. Seventeen cases were inconclusive on cytology. In five cases, the type of malignancy was changed on histological examination. There were three false positive and two false negative cases giving a positive predictive value of 97.2 % in terms of malignancy, a sensitivity of 98.1% and a specificity of 96.7%. CONCLUSIONS: FNAC has a definite role in forming the initial diagnosis of STT, while histopathology with the aid of immunomarkers provides the final diagnosis.

Dysgerminoma with pregnancy and viable baby: a case report.

Dysgerminomas are the most common of primitive germ cell tumors of the ovary, accounting for 1-5% of all ovarian malignancies. The reproductive age group females are most commonly affected, thereby causing problems in conception and if pregnancy occurs, it leads to feto-maternal compromise. It is extremely rare to have a successful natural pregnancy, with viable child birth with a coexisting dysgerminoma, without any assisted reproductive interventions. We hereby report a case of successful spontaneous natural pregnancy in a primi gravida, associated with dysgerminoma, with no feto-maternal compromise.

Primary neuroendocrine carcinoma of the breast.

Primary neuroendocrine carcinoma of the breast is rare-only about 30 cases have been reported in literature. Immunohistochemical examination showing expression of chromogranin and/or synaptophysin confirms evidence of neuroendocrine differentiation. Usually foci of neuroendocrine differentiation can be seen in breast carcinoma and are reported to be present in about 2-5% of breast cancer cases. Here, we report a case of breast carcinoma in which most of the areas studied on the tissue section showed neuroendocrine differentiation.

Mammography-guided stereotactic fine needle aspiration cytology of breast lesions.

The purpose of the present study was to evaluate the efficacy of mammographic guided stereotactic fine needle aspiration cytology in 136 patients with breast lesions including mammographic features, cytomorphological findings and nuclear grading in malignant cases. Majority of the cases were predictable correctly by combination of the three modalities of diagnosis viz, clinical examination, mammography and cytology.

Cytology in the otorhinolaryngologist's domain - a study of 150 cases, emphasizing diagnostic utility and pitfalls.

150 patients with mass lesions in the head and neck area, excluding the CNS and thyroid gland were subjected to FNA cytodiagnosis. II out of 150 smears were considered unsatisfactory for diagnostic evaluation. Out of the 139 patients who yielded satisfactory smears, cytodiagnosis led to the following broad categories - inflammatory and non- neoplastic (24/139, 17.3%), benign neoplasm (60/139, 43.2%), suspicious for malignancy (14/139. 10%) and malignant neoplasms (41/139, 29.5%). Histopathologic follow- up was available in 120 cases. 15/24 with inflammatory lesions were not subjected to biopsy, rest 4 were lost to follow up (I had a suspicious smear and 3 the diagnosis of benign neoplasm). Correlation of cytodiagnoses with histopathology yielded the following results - 52 out of 57 patients with the cytodiagnosis of benign neoplasm and having, histologic follow up had concordance, while 39 out of 41 cytologic diagnoses of malignancy, correlated with histopathology.Out of surgically sampled 9 patients, with inflammatory smears, 8 were benign and 1 malignant. In the suspicious category 2 out of 13 surgically sampled patients had malignancy. Thus, excluding the suspicious smears the accuracy of diagnosis by FNAC in this study came to 93% and a sensitivity for cancer detection of 95%. We encountered a false negative rate of 9.0% and a false positive rate of 4.9%.The results are discussed, especially in the light of the misdiagnoses and ways at avoiding diagnostic : error.