The study was undertaken to evaluate the reliability of ultrasound guided fine needle aspiration biopsy (FNAB) in distinguishing benign and malignant lesions in the retroperitoneum and correlate the diagnosis by cytology of retroperitoneal masses with the results obtained by histology. The clinicopathological study was carried out in 50 patients presenting with retroperitoneal masses on ultrasonography. Fine needle aspiration under ultrasound guidance of these masses was performed by 20-22G needle after thorough clinical examination. Malignant lesion constituted the maximum number of cases-31 (62%) followed by benign and inflammatory lesion-16 cases (32%). Eleven cases out of 23 renal masses were Wilm's tumour, 4 were renal cell carcinoma and there was a single case of angiomyolipoma of kidney. Out of 20 cases with retroperitoneal lymphadenopathy 12 cases (60%) were inflammatory, mainly tuberculosis and 8 (40%) had malignancy. Out of the 7 cases of miscellaneous retroperitoneal masses, 3 were fibrohistiocytic tumour and 2 were myxoid liposarcoma. Ultrasound guided FNAB is an inexpensive, rapid, safe and accurate procedure for the diagnosis of retroperitoneal masses.

The study was undertaken to evaluate the role of ultrasound guided fine needle aspiration cytology (FNAC) of gastrointestinal masses in providing higher diagnostic yield and assess its reliability in distinguishing between benign and malignant gastrointestinal lesions. 86 patients with gastrointestinal masses after thorough clinical examination underwent ultrasonographic examination. Those found to have a mass were subjected to FNAC. Smears prepared were fixed in 95% ethyl alcohol and stained with Haematoxylin and Eosin and Papanicolaou stains. Forty (46.5%) were males and 46 (53.5%) females with majority of patients in the third decade in both sexes. Malignant lesions constituted the maximum number of 42 (48.8%) cases, followed by 36 (41.8%) cases of benign and inflammatory lesions. Adenocarcinoma was the most common malignancy accounting for 36 (85.7%) cases; out of which 16 (44.4%) cases were adenocarcinoma stomach and 20 (55.6%) cases were adenocarcinoma intestine. Among the inflammatory and benign lesions, 30 (83.3%) cases were tuberculous followed by 4 (11.1%) cases appendicitis, The mean age of malignancy was 39.2 years and the average age of tuberculous patients in our study was 25.5 years. On cytohistological correlation, 30 were found to be true positive for malignancy, 5 true negative and 1 false negative. There were no false positive cases. We obtained a sensitivity of 93.8%, specificity of 100% and diagnostic accuracy of 94.4% in our study. Ultrasound guided FNAC is an effective and useful method which eliminates the need for surgical biopsy and provides sufficient information for the initiation of therapy.

Delayed villous maturation (DVM) has been associated with an increased risk of adverse pregnancy outcome, including stillbirth, in the late third trimester, but there are limited published data. Moreover, it is recognized that the assessment of villous maturation is subjective and hampered by both intraobserver and interobserver variability. This audit aims to assess concordance in the reporting of DVM among pediatric pathologists at a single specialist center to improve reproducibility of this potentially important diagnosis. This is a retrospective review of singleton placentas from pregnancies at 35 weeks gestation or greater submitted for histopathologic examination between June 2013 and December 2013. Placental slides were reviewed independently by 4 pediatric pathologists, blinded to the original report, apart from gestational age; villous maturation was assessed as appropriate, accelerated, or delayed for the stated gestational age. A total of 464 placental histopathology reports were reviewed, of which 164 were greater than 35 weeks gestation; of those, 42 (26%) were originally reported as DVM. Following the audit slide review, 38 cases (23%) were assessed to show DVM by at least 1 pathologist. Consensus, with at least 3 pathologists agreeing to a diagnosis of DVM, was achieved in only 14 cases (9% of all cases reviewed; 37% of all cases called DVM). However, the proportion of overall agreement between 2 of the pathologists was 0.92. Concordance for DVM is poor among pathologists and subject to much interobserver variability. Consistency may be improved by consensus histologic review of all the placentas in which the diagnosis of DVM is being considered and stringent application of the published diagnostic criteria.