Background:Mediastinal tumors are an uncommon abnormalities found in clinical practice. Anterior mediastinum is the common site and tissue diagnoses of anterior mediastinal masses (AMMs) are very important for correct therapeutic decision.Objective:We evaluate the different malignant AMMs in various age groups and the sensitivity of fine needle aspiration cytology (FNAC) and core needle biopsy (CNB). Cytology smears are reviewed with particular emphasis on pitfalls in the cytological diagnosis.Materials and Methods:This was a prospective study of 50 patients who were consulted for AMMs and underwent FNAC and CNB under guidance of ultrasound or computed tomography (CT) scan from 2006 to 2011. Cytology smears and histological sections were evaluated in all patients.Results:Among 50 cases, 36 were male and 14 were female. Most AMMs (52%) were identified in the fifth and sixth decades of life. Metastatic carcinoma and nonHodgkin's lymphoma are the common AMMs. Adequate tissue material was obtained in 49 of 50 cases by CNB. Of these 49 patients, 35 (71.42%) cases were diagnosed correctly by FNAC, whereas 14 (28.57%) cases were not diagnosed definitely by FNAC. The sensitivity of CNB for AMMs was 97.95%, significantly higher than FNAC (71.42%) (P < 0.05). CNB had statistically significant higher diagnostic rate than FNAC in the noncarcinoma group (100% versus 62.96%) (P < 0.05). There is no significant difference of CNB and FNAC in carcinoma group (P > 0.05). Diagnostic rate of FNAC was higher for carcinomatous lesions (81.81%) than for noncarcinomatous lesions (62.96%).Conclusion:Ultrasound or CT scan-guided CNB in combination with FNAC are safe, minimally invasive, and cost-effective procedure, which can provide a precise diagnosis in the AMMs, and may obviate the need for invasive surgical approach. FNAC usually suffice for carcinomatous lesions but CNB should be performed whenever the diagnosis of carcinoma is equivocal or noncarcinoma lesions are suspected.
Testicular sarcomas constitute only 1–2% of all testicular tumors and are mostly associated with germ cell tumor. Primary intratesticular rhabdomyosarcoma is rare and only 14 cases have been reported in the literature till date. It should be differentiated from germ cell tumor with sarcomatous component, other intratesticular spindle-cell sarcomas and paratesticular rhabdomyosarcoma. Accurate diagnosis and early treatment is essential as it is an aggressive tumor with high metastatic potential and poor prognosis. Orchidectomy is the treatment of choice. Chemo-radiotherapy is recommended in case of recurrence and metastasis.
Granular cell tumor is a rare, usually benign tumor with classical histomorphology. Location of tumor varies widely within body, but spine is distinctly a rare location for this tumor. We report a rare case of granular cell tumor involving intradural extramedullary portion of lumbar region of spinal cord. Knowledge of which is important as subsequent prognosis differs from other tumor at same location.
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