Background:Intraoperative cytology (IOC) is a simple and quick technique with excellent preservation of cellular details. In the present study, we have evaluated the role of IOC by various methods of smear preparation and compared it with frozen section diagnosis. A scoring system was followed for epithelial tumors for characterization and grading on the basis of cellularity, pattern, nuclear, cytoplasmic features, and background details.Materials and Methods:The study was conducted during a time span of 2 years in total 48 cases of ovarian tumors. Fine-needle aspiration cytology, touch/imprint, scrape, and crush techniques were used. The smears so prepared were processed for toluidine blue and Giemsa and Papanicolaou staining. Cases were cytomorphologically categorized into four groups: Indeterminate; unequivocally benign; borderline tumor with equivocal morphology; and unequivocally malignant (graded into well, moderately, and poorly differentiated).Results:In our study, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 88.88, 96, 96, 88.88, and 92.31%, respectively, were recorded. This was comparable to frozen section diagnosis with a sensitivity, specificity, PPV, NPV, and accuracy of 85.18, 96.15, 95.83, 86.21, and 90.56%, respectively. In epithelial tumors, cytological grading correlated with histopathological grading in 85.29% cases of epithelial tumors.Conclusion:IOC gives comparable results to frozen section and can be used for intraoperative assessment of ovarian tumors. Grading of epithelial tumors on IOC can be performed and may become an important step in intraoperative decision-making for better management and outcome of the patient.

A 38-year-old lady presented with a left shoulder swelling. The swelling had been present for the last 5 years and showed gradual enlargement since the last 1 year. On examination a firm swelling was noted in the left shoulder measuring 2x1.5x1cm. The swelling was not fixed to overlying skin. She had no other significant history. No significant haematological findings or systemic disease. With a clinical suspision of calcified parasitic cyst the patient was operated upon.We received a single globular grey white mass that measured 1x0.5x0.5cm. It was firm to hard in consistency. On cut section it was gritty. On microscopic examination a well circumscribed lesion was present with extensive areas of calcification and ossification. DISCUSSIoNPilomatricoma, also known as "calcifying epithelioma of Malherbe" is a tumour which shows differentiation towards hair cells, particularly hair cortex cells [1]. Four clinical variants have been described. They are: 1) eruptive type; 2) perforating type; 3) familial type (associated with myotonic dystrophy); and 4) recurrent invasive, non-metastatic pilomatrix carcinoma [2].In a study by M. Valluvan et al., on skin adnexal tumours over a span of 10 years only a single case of pilomatricoma with myeloid metaplasia was reported [2]. Also, in another study by Steven Kaddu et al., seven cases of pilomatricomas with EMH were found in a span of 16 years. Two out of these seven showed myeloid erythroid and megakaryocytes while rest were with myeloid and or erythroid precursor cells [3]. They found that this phenomenon is not uncommon in pilomatricoma with an overall incidence of 5.8%. Ackerman et al. in 1993 studied 120 cases of pilomatricomas and had noted EMH in seven cases [4]. Only two lesions showed osseous metaplasia. The variable incidence of this entity can thus be ascertained from the incidences quoted by different authors.Cutaneous EMH has rarely been docu mented. ABStRACtPilomatricoma is a benign follicular skin appendage tumour. It usually occurs as solitary lesion and is most commonly seen in the face and upper extremeties. Here we report a rare case of extramedullary haematopoiesis (EMH) in pilomatricoma in a 38-year-old lady.

Histiocytic sarcoma (HS) is a rare hematolymphoid malignant neoplasm with an aggressive clinical course. It can arise de novo or from low-grade B-cell lymphoma. We describe the case of a 16-year-old boy referred to our hospital with generalized lymphadenopathy, weight loss, and decreased appetite for one month. The patient died undiagnosed on the 7 th day of hospitalization. Lymph node and bone marrow biopsies were performed one day before the patient died. The lymph node biopsy revealed an architectural effacement with a diffuse proliferation of large pleomorphic neoplastic cells containing large, multilobulated nuclei, coarse vesicular chromatin, prominent nucleoli, and a moderate amount of eosinophilic cytoplasm. The bone marrow aspiration smears and biopsy also showed evidence of infiltration by these above-mentioned cells. Based on the morphology, along with the exclusion of many differential diagnoses by an extensive panel of immunohistochemical markers, a diagnosis of HS was made. This case report aims at evaluating all the clinical and immunophenotypic features of a case of HS with multifocal presentation and an aggressive clinical course in order to give a correct and definite diagnosis at the proper time.

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Granular cell tumor (GCT) is a rare soft tissue neoplasm of Schwann cell origin. Most cases occur in adults; however, the precise incidence is unknown in children. GCT is usually a slow-growing, painless tumor involving the skin and soft tissues that is mostly located in the head and neck region, especially the tongue. The breast is one of the least common sites involved by GCT. This paper presents a 3-year-old girl who presented with a soft to firm, ill-defined swelling on the right breast with painful ulceration of the overlying skin. Fine needle aspiration rendered an initial diagnosis of fibrocystic change accompanied by apocrine metaplasia. Histologic evaluation of the excised breast mass revealed a benign granular cell tumor. Although rare, GCT of the breast should be included in the differential diagnosis for breast masses in pediatric patients. Proper diagnosis and timely management of this tumor are essential because of its malignant potential (<2% of cases) and high rate of local recurrence if not properly excised.