Reporting Pancreatic FNAC using the Papanicolaou System: Still a Diagnostic Challenge.

Introduction: The Papanicolaou Society of Cytopathology System for reporting Pancreaticobiliary Cytology (PSCPC) is a reliable method to classify pancreatic fine needle aspiration cytology (FNAC) smears. However, it is not without practical problems which can diminish the diagnostic accuracy of the cytological diagnosis.

Aims And Objectives: To determine the diagnostic pitfalls while reporting cytomorphology of pancreatic lesions according to PSCPC on correlating FNAC findings with histopathology.

Role of Fine Needle Aspiration Cytology in the Rapid Diagnosis of Pulmonary Infections in Renal Allograft Recipients with Respiratory Failure.

Background: Renal transplantation is the treatment of choice in patients with end-stage renal disease. However, allograft recipients are at a higher risk of infection due to immunosuppressive therapies. This study aimed to analyze the utility of fine needle aspiration cytology (FNAC) lung in the etiological diagnosis of pulmonary infections in renal allograft recipients with respiratory failure.

Red Cell Distribution Width and Ratio of Red Cell Distribution Width-to-Total Serum Calcium as Predictors of Outcome of Acute Pancreatitis.

Background: Current severity assessment scores of acute pancreatitis (AP) include multiple variables, the results of which are available only after 48 h of admission. Red cell distribution width (RDW) and total serum calcium (TSC) are simple routine parameters related to inflammatory status and results of which are readily available.

Aim: The aim of this study was to evaluate RDW and RDW: TSC within 24 h of hospital admission as predictors of outcome (severity and mortality) and intervention (medical/percutaneous drainage/surgical) required by patients of AP.

Peritoneal malignant mesothelioma: Slippery like an eel to diagnose on cytology-case series of 3 cases.

Introduction: Peritoneal malignant mesothelioma is an extremely rare tumor and is a difficult diagnosis to be made on cytology alone. We report 3 cases where the cytologic features were misdiagnosed as carcinoma/lymphoma but histopathology and immunohistochemistry (IHC) established the diagnosis of malignant mesothelioma.

Clinical Details: Case 1 was a 60-year-old man with multiloculated ascites and omental caking.

Diagnostic role of fine needle aspiration cytology (FNAC) in the evaluation of gall bladder lesions: an institutional experience.

Background: Carcinoma of the gall bladder is the most common malignancy of the biliary tract. Ultrasonography guided Fine Needle Aspiration Cytology (FNAC) plays a crucial role in early detection of gall bladder (GB) lesions. Early diagnosis of GB lesions is a necessity in view of rising trend in GB carcinoma related mortality in India.

Synchronous high-grade bladder carcinoma associated with chronic lymphocytic leukemia: A rare entity in Indian literature.

B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) is one of the common lymphoproliferative disorders with an increased risk of developing subsequent neoplasms of epithelial and mesenchymal origin. The decreased immunity and B-cell dysfunction in CLL probably accounts for this emergence of secondary malignancy. Breast, brain, skin and prostate tumors have been reported as usual coincident malignancies of CLL, while in occasional cases CLL may occur with malignancies of other solid organs, such as skin, lung, heart, and prostate.

Cerebrospinal fluid pleocytosis in immunocompromised patients: Can it be Cryptococcus.

Cryptococcal meningitis commonly affects immunocompromised cases and can have varied presentation. In some instances, the presence of a plethora of inflammatory cells on cerebrospinal fluid (CSF) in an immunosuppressed patient can lead to further investigations, which unravel the presence of cryptococcal meningitis. The aim of this retrospective study was to analyze the spectrum of CSF findings of immunosuppressed patients who were diagnosed to have cryptococcal meningitis.

Feasibility of Masood's cytological index for screening breast lesions in low resource setting.

Fine needle aspiration cytology has long been an accepted diagnostic modality in combination with physical examination and mammography to investigate breast lesions. In the present era, more proficient methods such as stereotactic mammographically guided breast biopsy is the preferred choice, however, in low resource setting, FNAC still remains the most cost effective and sampling modality to diagnose breast cancer. With the intention to evaluate the efficacy and limitations of FNAC in evaluation of breast lesions in low resource setting, we employed the Masood's cytological staging system to stratify the breast lesions and correlate them with histopathology wherever possible.

Hepatic fine-needle aspiration cytology: The role of rapid on-site evaluation in the assessment of hepatic lesions.

Background/aims: Radiologically guided fine-needle aspiration cytology (FNAC) of internal organs is not cost-effective. Rapid on-site evaluation (ROSE) of smears by a cytopathologist can improve the diagnostic yield of FNACs and save time and money by reducing the need for repeat procedure/biopsy. To determine the role of ROSE in the diagnostic outcome of hepatic lesions by comparative analysis of FNAC with and without ROSE by a cytopathologist.

Coinfection of Sarcina ventriculi and Candida in a patient of gastric outlet obstruction: An overloaded pyloric antrum.

Sarcina ventriculi is a rare gram-positive, anaerobic bacteria, associated with delayed gastric emptying. We report a case of a 45-year-old lady, who presented with features of gastric outlet obstruction, and coinfection of S. ventriculi and Candida was detected on examining gastric brushings and biopsy.

: A surprising coexistence with adenocarcinoma - Never brush aside brushings for biopsy.

has been rarely reported as superadded infection over carcinomatous growth on rectal brushings. We present a case of 68-year-old male who presented with abdominal pain and bleeding per rectum who was found to have an ulceroproliferative growth on sigmoidoscopy. Rectal brushings revealed coexistence of with malignant cells of adenocarcinoma.

Role of FNA and Special Stains in Rapid Cytopathological Diagnosis of Pulmonary Nocardiosis.

Background: Nocardia, a gram-positive aerobic bacillus of the Actinomycetales family, is a significant opportunistic pathogen in immunocompromised individuals. Clinical and radiological features of pulmonary nocardiosis are nonspecific and can be misdiagnosed as tuberculosis, pneumocystis, staphylococcal or fungal infections, or as malignancy. Aspiration cytology with special stains is a quick and effective approach for accurate diagnosis.

"Polka Dot Macrophages" on cytology of bilateral adrenal masses-Nailing disseminated histoplasmosis.

Histoplasma capsulatum is a saprophytic fungus that in immunocompetent individuals causes self-limited pulmonary infection; however, in immunosuppressed patients involvement of the reticuloendothelial system, alimentary tract, urinary tract, and central nervous system is fairly common. Rarely patients present with bilateral adrenal masses which mimic tuberculosis and metastasis on radiology because of associated central necrosis. Ultrasound guided FNAC aided by special stains like Periodic Acid Schiff (PAS) and Gomori Methenamine Silver (GMS) may help in early diagnosis in such dubious cases.

Melanotic neuroectodermal tumor of infancy: Cytology and histopathology of a rare lesion at an uncommon site.

Melanotic neuroectodermal tumour of infancy is a rare, pigmented neoplasm generally arising in infants during the first year of life. The cytological features are rarely described in the literature. This case due to its rarity and unusual site emphasising the cytopathological features and the necessity of histology for differentiating it from other round cell tumours has been presented.

Intraoperative diagnosis of hydatid cyst of the ovary masquerading as tumor.

Hydatid disease, caused by the larval stage of Echinococcus granulosus, is found most commonly in the liver and lungs, but no organ is immune. The ovarian involvement is often secondary to a cyst's dissemination localized in a different site. Occasionally, the cyst enlarges, thus mimicking an ovarian tumor.

Cytohistological discordance on gastrointestinal brushings: Facts unfolded.

Introduction: Brush cytology is a rapid, cost-effective, and reliable tool to diagnose gastrointestinal tract (GIT) lesions in low-resource settings. Most of the studies on GIT brushings have focused on upper GI lesions. We have studied the diagnostic accuracy of brush cytology in the entire length of GIT and correlated the cytological diagnosis with histopathology.

Non-Secretory Myeloma, Diagnosed on Renal Biopsy as Cast Nephropathy.

Multiple myeloma is a disorder of plasma cells which can involve kidneys in the form of cast nephropathy. Neoplastic plasma cells produce either complete immunoglobulins or fragments of immunoglobulins leading to a monoclonal spike in the serum and/or Bence Jones proteinuria. Very few patients present as non-secretory myeloma when no immunoglobulins (M spike) are produced or only light chains are secreted which can only be detected in urine.

Preanalytical Errors in Hematology Laboratory- an Avoidable Incompetence.

Background: Quality assurance in the hematology laboratory is a must to ensure laboratory users of reliable test results with high degree of precision and accuracy. Even after so many advances in hematology laboratory practice, pre-analytical errors remain a challenge for practicing pathologists. This study was undertaken with an objective to evaluate the types and frequency of preanalytical errors in hematology laboratory of our center.

Disseminated Histoplasmosis: A Fatal Opportunistic Infection in Disguise.

Histoplasma capsulatum is no longer confined to certain geographic areas and should always be considered in the differential diagnosis of lymphadenopathy and organomegaly in HIV-positive patients. We present an unusual case of a 20-year-old immunocompromised male of African origin presenting with fever, jaundice, hepatosplenomegaly, and retroperitoneal and cervical lymphadenopathy. Fine needle aspiration (FNA) smears from the cervical lymph node revealed numerous yeast forms of histoplasma in macrophages.