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Prostate carcinoma: correlation of histopathology with serum prostate specific antigen
Deepika Gurumurthy,
Rangaswamy Maggad,
Sapna Patel
Issue:
Volume 4, Issue 4-1, July 2015
Pages:
1-5
Received:
14 January 2015
Accepted:
19 January 2015
Published:
3 August 2015
Abstract: Prostate Specific Antigen (PSA) is the first line test in screening of prostate cancer. The increase in PSA depends on differentiation of tumour cells. Gleason grading is one of the most powerful predictors of biological behaviour and influential factors used to determine treatment. PSA, when combined with Gleason score and clinical stage, improves the prediction of pathological stage for prostate carcinoma. Aims of this study were to study the histopathological features and Gleason grading in Prostatic Carcinoma and to correlate pretreatment PSA levels with Gleason grade. The study was undertaken in a tertiary care hospital over a period of two years.Fifty one cases of prostatic carcinoma were studied. Grading done by Gleason grading system, was correlated with serum PSA levels. Software statistical package for social sciences (SPSS), version 16 was used. P value < 0.05 was considered significant. Patients were aged predominantly between 60 to 70 yrs. Majority (66.7%) had poorly differentiated adenocarcinoma. 84.3% had high values of PSA (>10ng/ml). 5.9 % had PSA value in normal range (< 4 ng/ml). Though there was a comparative increase in PSA level with increase in Gleason grade, it was not statistically significant (‘p’ value = 0.75). To conclude, a proportion of tumours with Gleason score 8-10 are so poorly differentiated that they produce relatively little PSA. Refinement in estimation and interpretation of PSA values may be considered to improve the sensitivity and specificity of PSA. Gleason grading is a better predictor of biological behaviour of prostate cancer.
Abstract: Prostate Specific Antigen (PSA) is the first line test in screening of prostate cancer. The increase in PSA depends on differentiation of tumour cells. Gleason grading is one of the most powerful predictors of biological behaviour and influential factors used to determine treatment. PSA, when combined with Gleason score and clinical stage, improves...
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Significance of Endometrial Cells in Cervical Cytology (by Conventional Pap & Manual Liquid Based Cytology) in Abnormal Uterine Bleeding Cases
Lopa Mudra kakoti,
Nandini N. Manoli,
Nandish S. Manoli
Issue:
Volume 4, Issue 4-1, July 2015
Pages:
6-10
Received:
31 January 2015
Accepted:
1 February 2015
Published:
3 August 2015
Abstract: Abnormal uterine bleeding is common gynaecologic complaint. Causes may vary with age, the most worrisome cause is malignancy of endometrium. No widely accepted screening test for endometrial carcinoma exists, but cervical cytology has been found to be of some use in detecting endometrial diseases. Guidelines from the 2001 Bethesda system, in addition to reporting of atypical glandular cells (AGC) and adenocarcinoma, requires the reporting of benign appearing endometrial cells in women aged above 40 years. Smears for cervical cytology are collected from 80 patients in the age group of 20-75 years with complaints of bleeding per vagina. Cyto-histological correlation is attempted in which D&C or hysterectomy specimen is sent. Manual Liquid Based Cytology is strongly advocated as it improves sample quality by removing obscuring factors. Out of 80 abnormal uterine bleeding cases 52 showed endometrial cells (10 atypical glandular cells & 42 benign endometrial cells) & 39 had further diagnostic evaluation of endometrium. The results indicated an association between endometrial cells in cervical cytology with carcinoma in 6 cases(15.4%), 1 case with complex hyperplasia with atypia(0.03%) ,while remaining 84.6% had benign endometrial pathology. Hence we concluded that presence of atypical endometrial cells in all women & benign endometrial cells in post menopausal women(>40yr)has considerable clinical implications & further diagnostic evaluation for endometrial sampling is of utmost importance.
Abstract: Abnormal uterine bleeding is common gynaecologic complaint. Causes may vary with age, the most worrisome cause is malignancy of endometrium. No widely accepted screening test for endometrial carcinoma exists, but cervical cytology has been found to be of some use in detecting endometrial diseases. Guidelines from the 2001 Bethesda system, in additi...
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Efficacy of Manual Liquid Based Cytology over Conventional Cytology in Oral Squamous Cell Carcinoma
Sudhir Mishra,
Jagadish Hosmani,
Nandini Manoli,
Ramakant Nayak,
Manjunath G. V.
Issue:
Volume 4, Issue 4-1, July 2015
Pages:
11-15
Received:
20 February 2015
Accepted:
23 February 2015
Published:
3 August 2015
Abstract: Context/Background: Oral cytology has come long way from its primitive Papanicolau days. Liquid Based cytology has shown significant advantages over conventional exfoliative cytology. However, LBC requires expensive automated devices and materials which might not be affordable for many cytopathological laboratories in countries with limited resources. Manual liquid Based Cytology (MLBC) is a technique that enables cells to be suspended in a monolayer and thus improves detection of lesions and improvement of adequacy. Aim: To study and evaluate the diagnostic efficiency and reliability of MLBC in comparison with conventional PAP smear (CPS) of oral squamous cell carcinoma. Materials and Methods: Two smear were prepared from 50 patients, clinically diagnosed with Oral Squamous Cell Carcinoma. Each smear was subjected to MLBC and CPS methods. The slides were evaluated by two pathologists for the staining characterstics of nucleus and cytoplasm. The diagnostic efficiency of each smear was evaluated by comparing the cytological diagnosis of each method with histopathological diagnosis. Results: Increased detection rate with MLBC was 29.41%. Identifying cellular atypia by MLBC was more sensitive (44%) compared to CPS (34%) with similar specificity (100%). The percentage agreement by the two methods was 77.28%. Conclusion: MLBC is an easy, cost effective technique comparable to CPS; however, it warrants further study in its potential application in screening of oral precancer and cancer.
Abstract: Context/Background: Oral cytology has come long way from its primitive Papanicolau days. Liquid Based cytology has shown significant advantages over conventional exfoliative cytology. However, LBC requires expensive automated devices and materials which might not be affordable for many cytopathological laboratories in countries with limited resourc...
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Idiopathic Hypereosinophilic Syndrome/Eosinophilic Leukaemia (Case Report): A Challenge to Diagnose
Sathyavathi Alva,
Angshuman Saha,
Tahera Syed,
T. M. Kariappa
Issue:
Volume 4, Issue 4-1, July 2015
Pages:
16-18
Received:
26 February 2015
Accepted:
27 February 2015
Published:
3 August 2015
Abstract: Hypereosinophilic syndrome (HES) was first described by Hardy and Anderson in 1968 . HES may result either from eosinophilic differentiation of a clone of neoplastic cells or from reactive eosinophilia. It appears lightly that in many patients idiopathic HES is actually a chronic myeloproliferative disorder. There is vaguely overlapping clinico-pathological picture of HES with (Chronic eosinophilic leukaemia) CEL which often adds to diagnostic confusion. In 2001, the World Health Organization (WHO) proposed a set of criteria that distinguish CEL from HES. An evidence of genetic clonality of eosinophils or an increase in blast cells in blood or bone marrow is mandatory for diagnosis of CEL, while no specific diagnostic tests exists for HES, making it an entity of exclusion. A 36 year old female presented with intermittent fever and dry cough since two months. Clinical examination revealed mild pallor with hepatosplenomegaly. Chest examination showed bilateral basal crepitations. The patient was subjected for hematological, biochemical and radiological assessment. The peripheral smear and bone marrow aspirates revealed presence of eosinophilic precursors with predominance of eosinophiloblasts associated with eosinophilic myelocytes, metamyelocytes, a few myeloblasts and lymphocytes, the features of which are in favour of CEL. CEL, a rare myeloproliferative entity and its presentation with pulmonary manifestations is still rare in India. Hence, we present this rare entity along with review of available literature.
Abstract: Hypereosinophilic syndrome (HES) was first described by Hardy and Anderson in 1968 . HES may result either from eosinophilic differentiation of a clone of neoplastic cells or from reactive eosinophilia. It appears lightly that in many patients idiopathic HES is actually a chronic myeloproliferative disorder. There is vaguely overlapping clinico-pat...
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Cytodiagnosis of Dimorphic Fungi with Disseminated Infection in a HIV Positive Patient – A Diagnostic Dilemma
Chitresh Yadav,
Nandini N. M.,
Shruti M. K.,
Sowmya G. S.,
M. R. Shivaprakash,
G. V. Manjunath
Issue:
Volume 4, Issue 4-1, July 2015
Pages:
19-22
Received:
15 May 2015
Accepted:
16 May 2015
Published:
3 August 2015
Abstract: Systemic mycosis caused by fungi (or dimorphic fungi) such as Histoplasma, emmonsia, candida & penicillium has emerged as an important opportunistic fungal infection in immunocompromised patient in South- East Asia. Several cases of opportunistic fungal infection has been reported but cytological diagnosis of disseminated (dimorphic) fungal infection has been reported in very few cases. Cytological diagnosis of these infections depending on the morphological characteristics has always been a challenge to practising cytologists. A case of rare disseminated fungal infection reported in a 45 year old seropositive male who is noncompliant on ART presented with ulcer over palate, fever, weight loss, occasional per rectal bleeding. On examination having bilateral cervical lymphadenopathy and hepatomegaly. On investigation- anaemia, high ESR, deranged liver function test, CD4 count 16/cumm, USG showed hepatomegaly, underwent FNAC cervical lymphnodes and guided FNAC of liver, which showed these organisms, but no pathogens were found with classical microbiological procedure. Patient was treated with itraconazole and amphotericine and showed improvement. This case illustrate the utility of FNAC in early diagnosis & management of rare infection & it also highlight the combined role of molecular technique and FNAC as an interdisciplinary approach for management of patient.
Abstract: Systemic mycosis caused by fungi (or dimorphic fungi) such as Histoplasma, emmonsia, candida & penicillium has emerged as an important opportunistic fungal infection in immunocompromised patient in South- East Asia. Several cases of opportunistic fungal infection has been reported but cytological diagnosis of disseminated (dimorphic) fungal infecti...
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FNAC Diagnosis of Soft Tissue Tumour (Proliferative Fascitis and Proliferative Myositis ): A Case Report
Sushma K. L.,
Nandini N. Manoli,
Vasudha Nassa,
Jayshree K.,
Manjunath G. V.
Issue:
Volume 4, Issue 4-1, July 2015
Pages:
23-25
Received:
19 June 2015
Accepted:
22 June 2015
Published:
3 August 2015
Abstract: Nodular fascitis is a benign fibroblastic tumour characterized by rapid growth and most of the time requires its differentiation from other tumorous lesions. Here is a case of 45 year old male who presented with a soft tissue swelling in the popliteal region. On FNAC, a differential diagnosis of proliferative myositis and proliferative fasciitis was given. Histopathological examination gave a diagnosis of nodular fascitis. Hence cytology helps to give a definite diagnosis and aid in the surgical management of soft tissue tumors.
Abstract: Nodular fascitis is a benign fibroblastic tumour characterized by rapid growth and most of the time requires its differentiation from other tumorous lesions. Here is a case of 45 year old male who presented with a soft tissue swelling in the popliteal region. On FNAC, a differential diagnosis of proliferative myositis and proliferative fasciitis wa...
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Evaluation of Breast Neoplastic Lesions by Different Cytology Grading Methods
T. S. Rekha,
N. M. Nandini
Issue:
Volume 4, Issue 4-1, July 2015
Pages:
26-30
Received:
22 June 2015
Accepted:
23 June 2015
Published:
3 August 2015
Abstract: Introduction: With the increase in the awareness of breast cancer among women, cases of lump in the breast has increased in outpatient department. Fine needle aspiration cytology (FNAC) is the easy, quick and cost effective technique of evaluating breast lump. Objective: The present study, evaluated and compared the modified Masood's cytology index (MCI) with various other cytology grading methods and histopathology. Result: Modified MCI has over all concordance rate of 86%, sensitivity of 86%, specificity of 50%, positive predictive value (PPV) of 93% and negative predictive value (NPV) of 30%. Multiple regression analysis revealed an r2 value of 60%, which was significant. The p-value of anisonucleosis, nucleoli and chromatin pattern were 0.001, 0.05 and 0.02 respectively, which was significant (p-value less than 0.05). Conclusion: Modified MCI will help the cytopathologist to accurately delineate both benign and malignant neoplastic breast lesions into respective categories. This in turn will help the treating surgeon to plan the treatment modality of the patients with lump in the breast. The study recommends that modified MCI method to be routinely incorporated for evaluation of all lump in the breast.
Abstract: Introduction: With the increase in the awareness of breast cancer among women, cases of lump in the breast has increased in outpatient department. Fine needle aspiration cytology (FNAC) is the easy, quick and cost effective technique of evaluating breast lump. Objective: The present study, evaluated and compared the modified Masood's cytology index...
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Metastasis of Adrenocortical Carcinoma to Pericardial Fluid, Cytological Diagnosis (IHC) – A Case Report
Vasudha Nassa,
Nandini N. M.,
Sushma K. L.,
Sapna Patel,
Manjunath G. V.
Issue:
Volume 4, Issue 4-1, July 2015
Pages:
31-35
Received:
1 July 2015
Accepted:
3 July 2015
Published:
3 August 2015
Abstract: A 54 years male patient presenting with multiple complaints was found to have large pericardial effusion leading to tamponade. Radiological findings were suggestive of a right adrenal mass. Cytological evaluation of the pericardial fluid revealed features of malignant effusion. Adrenocortical origin of the malignant cells was confirmed by immunostaining with A103 antibody against Melan-A. Hence, identification of primary lesion and confirmation of diagnosis was achieved by cytology with the help of immunohistochemistry performed on the cell block obtained from the drained pericardial fluid.
Abstract: A 54 years male patient presenting with multiple complaints was found to have large pericardial effusion leading to tamponade. Radiological findings were suggestive of a right adrenal mass. Cytological evaluation of the pericardial fluid revealed features of malignant effusion. Adrenocortical origin of the malignant cells was confirmed by immunosta...
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