Intraoperative imprint cytology of ovarian transitional cell (Brenner) tumors: a retrospective study.

Literature on fine-needle aspiration of ovarian transitional cell tumor or Brenner tumors is sparse and mostly confined to isolated case reports of metastatic transitional cell tumors. We undertook a retrospective study of intraoperative imprint cytology of ovarian transitional cell tumors to better define the cytologic features of this uncommon ovarian tumor. Between 2005 and 2012, a total of 19 ovarian transitional cell tumors were recorded in our surgical pathology files, 10 of which had concomitant imprint cytologic material available for review. The 10 patients included in this study ranged in age between 43 and 73 years (mean age: 54 years). Nine neoplasms were histologically benign and one was borderline. Nine cases had satisfactory cytologic material for review. The cytologic features can be summarized as follows: the eight benign tumors showed abundant naked nuclei in the background, small and large clusters of tumor cells, abundant cytoplasm, smooth nuclear membranes, and lack of nuclear pleomorphism and mitoses. Single plasmacytoid cells with dense blue abundant cytoplasm, perinuclear vacuoles, nucleoli, microfollicle formation, nuclear grooves, binucleation/multinucleation, and extracellular eosinophilic material were some of the other features that were appreciated. The cytologic features of the one case of borderline transitional cell tumor were similar to those of the benign tumors except for the presence of rare mitoses, easily identifiable nuclear pleomorphism and irregular nuclear membranes. This study highlights some characteristic cytologic features of benign/borderline transitional cell tumors of the ovary which can be of help in recognizing this uncommon neoplasm.

Epidemiology of candidaemia in critically ill trauma patients: experiences of a level I trauma centre in North India.

There is a need to understand the epidemiology and risk factors associated with candidaemia in critically ill trauma patients. The rise in incidence of non-albicans candidaemia and the emergence of antifungal resistance have made such a study necessary. A prospective laboratory-based surveillance study was performed over a period of 21 months (April 2008-December 2009) at a level I trauma centre in New Delhi, India. All blood culture samples positive for Candida were processed for microbial identification by standard methods. Identification was carried out by conventional methods, using chromogenic medium (CHROMagar Candida) and by the automated Vitek 2 system. These isolates were characterized for their susceptibility to amphotericin B, fluconazole, flucytosine and voriconazole. Eighty-nine episodes of candidaemia occurred in 89 patients during the study period. The incidence was 0.71 episodes per 1000 patient days. A total of 136 Candida isolates were obtained, with non-albicans Candida species accounting for over 80 %. Candida rugosa, a rarely isolated pathogen, accounted for 25 (18.4 %) of the isolates, and 5.9 % of the isolates were resistant to fluconazole. None of the isolates showed resistance against amphotericin B, flucytosine or voriconazole. The present study revealed that non-albicans Candida species caused most of the cases of candidaemia in the trauma patients. The isolation of C. rugosa from a large number of cases highlights the ability of this rarely reported pathogen to cause bloodstream infections. The presence of azole resistance among many of the Candida isolates is a matter of concern.