Objectives:Fine-needle aspiration cytology (FNAC) is a first-line investigation in the evaluation of neck nodules. In an attempt to search for reliable cytomorphological criteria for parathyroid lesions, we systematically evaluated cytomorphology of FNAC of parathyroid lesions.Study Design:FNAC of 15 parathyroid and 15 hyperplastic thyroid nodules with histological confirmation were reviewed for following features: Cellularity, follicles, bare nuclei, cohesiveness, vascular profiles, cytoplasmic granularity, intracytoplasmic vacuolation, mitosis, macrophages, and colloid.Results:Vascular proliferation, bare nuclei, intracytoplasmic fat vacuolation, absence of colloid, and high cellularity showed significant association with parathyroid lesions (P ≤ 0.05). Intracytoplasmic fat vacuolation was 53.3% sensitive and 100% specific for parathyroid. Follicular pattern and papillaroid clusters were also important; however, they achieved nearly significant statistical difference (P = 0.05 and P = 0.06, respectively). The combination of vascular proliferation and intracytoplasmic fat vacuolation were significantly associated with parathyroid (P = 0.006) whereas the absence of bare nuclei and the presence of background colloid were associated with thyroid cytomorphology (P = 0.03).Conclusion:No single cytological feature is helpful in differentiating parathyroid from thyroid lesion. Vascular proliferation, bare nuclei, intracytoplasmic fat vacuolation, high cellularity, and the absence of colloid were significantly associated with the parathyroid origin. The combination of at least two features — vascular proliferation and intracytoplasmic fat vacuoles — were highly suggestive of parathyroid origin.

Figure 4: Post-operative kidney, ureter and bladder X-ray shows the wound drain (black arrow) and the distal end of the shunt catheter (white arrow) within the ureter Figure 3: Post ventriculoureteric shunt -10 days post-operative: Complete resolution of hydrocephalus with multiple shunt tubes within the ventricular system. This was consistent with improved sensoriumthe ureter at the insertion site, which gradually sealed off. Possibly we should have applied fibrin glue and fat around the insertion site to prevent leakage; and (6) urine routine analysis, urine culture, ultrasound of the KUB may be performed in the pre-operative state to assess the renal system. This may alter the decision making.

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Background: Solid pseudopapillary tumours (SPT) of pancreas is an unusual neoplasm with uncertain malignant potential. It is seen predominantly in adolescent girls and young women. We present the clinical, ultrasound-guided fine needle aspiration (US-FNA) cytologic features, differential diagnosis and immunohistochemical findings in SPT. Methods: A retrospective 4-year (2007-2010) fine needle aspiration samples of 8 solid pseudopapillary tumours of pancreas were reviewed. Results: The entire cases were cured with exploratory laparotomy. This study includes 8 cases (1 male, 7 female) of solid pseudopapillary tumours of pancreas. All these cases showed characteristic cytomorphological features displaying hypercellular smears with presence of several papillary fragments lined by multilayered anisomorphic atypical cells having fine chromatin with delicate nuclear groove, myxoid stroma and foamy macrophages in a haemorrhagic background. Conclusions: Correct preoperative cytological diagnosis of solid pseudopapillary tumours of pancreas may be accurately possible by US-FNA technique and also aids in treatment of the surgically curable cancer in the patients.

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Breast cancer is the first in the incidence of malignancies among women. The documented frequency of osseous metastasis from breast cancer is about 12.8 %. Although breast cancer cells have been documented in the bone marrow in autopsy, haematological manifestations due to metastatic disease to the marrow is rare. The prognosis of these cases is dismal and improper management worsen the condition further. IHC for ER, PR & Her 2/neu status plays a vital role in ascertaining the treatment protocol both in primary tumors as well as metastatic or recurrent tumors. Receptor conversion has been documented in metastatic and recurrent cases. We report a case of 65 year female with a history of ER, PR positive and Her 2/neu negative carcinoma breast 3½ years back, presented with anemia and low back ache diagnosed as metastatic breast carcinoma to bone marrow with receptor conversion.

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