Fine needle aspiration cytology aided categorisation of neuroblastic tumours: a report of two cases

Background: Cytology of the adrenal gland is a less performed technique even in tertiary care centres; yet cytological evaluation is an important diagnostic tool for assessment of adrenal lesions. Our objective was to evaluate the diagnostic utility of FNAC smears and cellblock with immunohistochemistry (IHC) in lesions of the adrenal. Material and methods: We had a total of 50 cases over a period of 2 years where both FNAC smears and cellblocks were taken. The smears and cellblocks were examined for adequacy. They were subsequently categorised into four groups: unsatisfactory, benign, suspicious of malignancy and malignant. The diagnostic accuracy of FNAC smears and cellblock with IHC were evaluated and compared, taking histopathology, wherever available, as the gold standard, Result: We had 50 cases with age ranging from 6 to 53 years with a median of 7.5 years. Of these, 54% were cytologically malignant and neuroblastoma was the commonest lesion. Histopathology was available in 23 cases only, where the diagnostic accuracy was evaluated. The sensitivity and specificity of FNAC smear was 100% and 85.71%, respectively whereas the sensitivity and specificity of cellblock with IHC was 100% and 92.86%, respectively. Conclusion: Cellblock together with IHC provides a higher degree of specificity, reduces the unsatisfactory rate and improves the diagnostic accuracy in lesions of the adrenal gland. Immunohistochemistry is an important adjunctive tool.

Section: Discussionmentioning

confidence: 86%

“…There was also presence of lymphocytes. Stromal elements were scanty 10 . One case of adrenal schwannoma was cytologically diagnosed as benign nerve sheath tumour.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Diagnostic utility of cytology smears and cell block in adrenal lesions

Mukherjee

Sengupta

Das

et al. 2020

“…In this scenario again LCA and synaptophysin performed on CB are the only reliable differentiating tools. We encountered three cases of GNB as well which has a more favourable outcome than NB 12 . NBs are the mostly immature and aggressive compared to GNBs.…”

Section: Discussionmentioning

confidence: 93%

Utility of cell block preparation in diagnosis of paediatric abdominal neoplasms

Kanjilal

Das²,

Chatterjee

et al. 2020

Background Paediatric abdominal neoplasms are fairly common. Fine needle aspiration cytology (FNAC) is used for the initial evaluation of paediatric abdominal neoplasms. However, sometimes FNA interpretation can be difficult on limited material, owing to tumour heterogeneity and overlapping features. Therefore, we attempted to obtain additional information using cell block (CB) preparation from residual aspiration material along with immunohistochemistry (IHC) to enhance the diagnostic accuracy. Aim To evaluate the correlation between CB preparation and FNAC in diagnosis of paediatric abdominal tumours with the help of an extended panel of IHC markers and to highlight some of the diagnostic difficulties. Materials and methods A total of 113 cases of paediatric abdominal masses were studied. In addition to routine FNA smears, CBs were prepared from the residual material for IHC analysis as considered appropriate. Results This study included a total of 113 children with abdominal masses. Histopathology following surgical resection was available in 53 cases. Histology was taken as gold standard to measure the diagnostic accuracy with reference to sensitivity (Sn), specificity (Sp), positive predictive value and negative predictive value. The Sn of FNA alone was 87.5% and Sp was 97.78%. The Sn and Sp increased with use of CB alone and were 100% and 97.78% respectively. The highest Sn and Sp were observed when CB was combined with IHC where both the values were 100%. Conclusion CB with IHC is a useful adjunct to the routine FNA smears that further contributes to enhance the accuracy of the cytopathological diagnosis and is useful for choosing pre‐operative chemotherapeutic regimen.

“…2 Just as FNAC-based prechemotherapy categorization of neuroblastic tumours is important as they are well known to undergo spontaneous and induced maturation, likewise, HBs have also been seen to undergo a range of chemotherapyinduced changes including mature hepatocyte like area. 4,5 The surgically resected specimen after administration of neoadjuvant chemotherapy can never represent the original tumour morphology. Therefore pretreatment diagnosis and categorization of HB is important with regard to prognosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

FNAC Aided Diagnosis and Categorization of Hepatoblastoma:

Bera

Das

Islam

et al. 2016

Hepatoblastoma is the most common primary malignant hepatic tumour of infancy and early childhood. Histologically hepatoblastomas are categorized into pure epithelial and mixed epithelial-mesenchymal types and epithelial type is further subcategorized into pure fetal type, fetal and embryonal type, pure embryonal, and small cell types. This categorization has been shown to have prognostic and therapeutic implication. Fine needle aspiration cytology (FNAC) is useful in pre-operative diagnosis and categorization in most cases of hepatoblastomas. Periodic acid-Schiff (PAS) stain can be helpful to differentiate fetal subtype from embryonal subtype of hepatoblastoma. Here we describe three cases of hepatoblastomas diagnosed and categorized on cytology with subsequent confirmation on histological examination. Diagn. Cytopathol. 2017;45:77-82. © 2016 Wiley Periodicals, Inc.