Background:Diagnosis of retroperitoneal lesions is one of the most difficult areas in surgical pathology. Both primary and metastatic tumors can grow silently in retroperitoneum before the appearance of clinical signs and symptoms. Guided aspiration cytology has shown a promising role in diagnosis of lesions in this region.Aims:This study was undertaken to evaluate the reliability of guided fine-needle aspiration cytology (FNAC) in the diagnosis of retroperitoneal masses and to study the spectrum of retroperitoneal lesions in a rural tertiary care hospital.Materials and Methods:This study was done on 71 patients presenting with retroperitoneal masses over a period of 20 months in a tertiary care hospital. Ultrasound-guided FNAC was done and the smears were stained by MGG and H and E stains. Histopathological corroboration could be done on all neoplastic lesions along with some non-neoplastic lesions.Results:Out of 71 cases, 48 cases (67.6%) were found to be neoplastic. Malignant tumors (35 cases) were more common than benign ones (13 cases). Malignant lesions were predominantly composed of lesions of lymph node (17 cases i.e. 48.57%) followed by sarcomas (5 cases) and germ cell tumors. Some uncommon retroperitoneal lesions like adrenal myelolipoma, renal angiomyolipoma, Burkitt's lymphoma and adrenocortical carcinoma were found in our study. Guided FNAC could diagnose all the malignant lesions with 100% accuracy except in 2 cases of poorly differentiated carcinoma which came out to be non-Hodgkin lymphoma on subsequent biopsies.Conclusion:Guided FNAC is an inexpensive, rapid and reliable method for diagnosis of retroperitoneal masses.

Sarcoma-like mural nodule (SLMN) is a very uncommon and misleading benign entity which may be associated with benign, borderline or malignant mucinous neoplasm of the ovary. It should be distinguished from other malignant mural nodules with sarcoma, carcinosarcoma or anaplastic carcinoma for proper management. We report a rare case of SLMN in a borderline mucinous tumor of the ovary in a 30-year-old lady. In spite of having confusing histopathological features the final diagnosis was made depending on the younger age of the patient, well circumscription of the nodule, absence of vascular invasion and immunohistochemical profile.

Fine Needle AspirationCytology; Cell BlockBackground & objective: Fine needle aspiration cytology (FNAC) is an easy, rapid, and less hazardous tool to diagnose the intra-abdominal lesions with various imaging modalities adding to its sensitivity and accuracy. However, sometimes it does not yield adequate information for precise diagnosis and the risk of false-negative and indeterminate diagnosis is always present. Cellblock preparations may be particularly helpful in such problematic cases.The current study aimed atevaluating and comparing the cytological as well as histopathological features of different intra-abdominal mass lesions.Methods: Image-guided FNAC followed by cell block were performed on 167 patients from June 2012 to May 2013. Histologically correlated 111 cases were evaluated. Results of conventional smear, cell block, and combination of FNAC with cell block were compared with histopathological findings regarding diagnostic sensitivity, specificity, and accuracy of diagnosis.Results: Cell block was more specific to diagnose these lesions than FNAC (95.49% versus 90.09%). Combined application of cell block with FNAC was more specific (96.39%) than cell block alone with 100% diagnostic accuracy.Conclusion: Application of a combination of cell block with FNAC was more useful to diagnose intra-abdominal mass lesions.