Endometriotic nodules need to be differentiated from other benign/malignant masses and evaluated for possible malignant transformation. FNAC provides a safe and effective tool for diagnosis thereby obviating the need for other procedures.
It is commonly believed that cytodiagnosis of Hodgkin's lymphoma (HL) is much easier than that of non-Hodgkin lymphoma (NHL). However, recognition of certain NHL subtypes with Reed-Sternberg (R-S)-like cells and results of immunohistochemical studies point to the contrary. To study the limitations of cytology in diagnosis of HL, fine-needle aspiration (FNA) smears of 130 lymphoma or suspected lymphoma cases were reviewed. Initial and reviewed cytodiagnoses were compared with histopathology in 89 cases. Immunocytochemical and immunohistochemical studies were performed in 56 and 59 cases, respectively. Among histologically diagnosed HL cases, definitive cytodiagnosis of HL (initial as well as reviewed) was significantly less frequent than cytodiagnosis of NHL among histologically diagnosed NHL cases (P = 0.0328 and = 0.0001, respectively). On the other hand, cytologically diagnosed HL/NHL cases were significantly more frequent in the former group (P = 0.0001 and = 0.0018, respectively). ALCL and TCRBCL were the two NHL subtypes which created confusion with HL in FNA smears. Twenty-one cytohistological concordant HL cases and equal number of discordant cases were compared. When compared with discordant group, the patients in concordant group were significantly younger (P = 0.045). Hodgkin/Hodgkin-like cells and typical R-S cells were significantly more frequent in FNA smears of the concordant group (P = 0.0478 and = 0.0431, respectively). Immunocytochemical and immunohistochemical studies showed good correlation with histological diagnosis of HL. It is suggested that proper interpretation of cytologic features, together with use of immunocytochemical parameters can help in reducing the margin of error in cytodiagnosis of HL.
Cytological examination of pleural effusion and ascitic fluid samples, supported by immunocytochemical studies, may be useful for the classification of lymphomas under the WHO system.
Psammoma bodies (PBs) form an important diagnostic criterion of papillary thyroid carcinoma (PTC), but their mechanism of formation is not clear. Following our observation in a case of PTC that laminated hyaline globules may be the precursor form of PBs, the present study was undertaken to find out their relation to PBs in PTC cases. Fifty-four cases of PTC and 14 follicular neoplasms, diagnosed by fine-needle aspiration (FNA) cytology, were studied by one of the investigators (DKD) to find out the PBs, irregular calcifications, hyaline globules, and other forms made of similar material. PBs along with irregular calcification were present in five PTC cases, PB alone was present in 1 case, and irregular calcification alone was present in 4 cases. Large hyaline globules (LHGs), small hyaline globules (SHGs), branching hyaline cylinders (BHCs), and irregular hyaline deposits (IHDs) were identified in 10, 14, 6, and 9 cases, respectively. One or more of these four forms were present altogether in 18 (33.3%) of PTC cases and none of the follicular neoplasms (P=0.0142). These forms were present in 80.0% of cases with PB/irregular calcifications as opposed to 22.7% in cases without them (P=0.0012). Our observations suggest that LHGs, SHGs, and BHCs are precursors of PBs and IHDs serve as a nidus for irregular calcification.
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