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Bansal C.,Eras Medical College and Hospital | Handa U.,Government Medical College and Hospital | Mohan H.,Government Medical College and Hospital
Journal of Cytology | Year: 2011

Aim: To delineate and characterize the cytomorphologic features of pilomatrixoma (PMX) helpful in correct diagnosis of the lesion on fine needle aspiration cytology (FNAC). Materials and Methods: Archival records of clinical findings, FNAC and histopathological reports of PMX cases were analyzed. Aspirate findings in 14 cases of PMX were correlated with detailed clinical data and subsequent histopathology on excisional biopsy. Different morphological findings were graded semiquantitatively from 0 to 3+. Results: The series showed female preponderance, with head and neck being the commonest site. Majority patients had a single tumor with mean size of 1.6 cm. Out of 14 biopsy proven cases of PMX, cytology findings revealed PMX in 7 cases on the basis of ghost cells, groups of basaloid cells, squamous cells in combination with multinucleated giant cells and calcium deposits in a background of debris. The main reasons for erroneous diagnosis were predominance of one component over the others and non-representative aspirated material. Conclusions: The cytological features of PMX are characteristic and allow a conclusive diagnosis provided the smears are examined keenly bearing in mind the diagnostic traps that can mislead a cytopathologist.

Bansal C.,University of Lucknow | Pujani M.,Hamdard Institute of Medical science and Research | Sharma K.,University of Lucknow | Srivastava A.,Eras Medical College and Hospital | Singh U.,University of Lucknow
Journal of Cancer Research and Therapeutics | Year: 2014

In developing countries, diagnosis of breast carcinoma is still made on fine-needle aspiration cytology (FNAC). For the resource-poor settings, FNAC is cheaper, less invasive and can sample different areas of the lesion compared with core needle biopsy. The role of breast FNA is usually limited to just categorize the lesion as benign or malignant. Prognostic information from cytomorphology, conveyed to the clinician depends upon the cytopathologist's way of formatting the report. PubMed-based literature search collated the information from articles describing the architectural and cytological features studied on breast aspiration smears. This review focuses on cytomorphological features and the different grading systems with their strengths, short-comings, and practical applicability. Eight worldwide articles proposing new methods of grading the cytological smears from breast cancers were published between 1980 and 2006. All the grading methods were developed for the most common type of breast cancer, that is, infiltrating duct carcinoma (not otherwise specified) type, and most of the workers used Papanicolaou-stained smears for the purpose of grading. Moreover, if interpreted carefully FNAC smears can convey information on most of the histological features. Hence, in developing countries, the focus should be on extracting the maximum information from cytological smears, so that a more precise «surgical pathology» type diagnosis can be given, instead of merely reporting as benign or malignant. Among all the discussed grading systems, we suggest grading system by Howell would be most appropriate and closest to the accepted histologic grading system as it applies Scarff-Bloom-Richardson histological grading system with modifications on FNA smears. We recommend it to be followed by all cytopathologists, in order to bring uniformity in the reporting of breast FNAs for grading the malignant lesions.

Bansal C.,Eras Medical College and Hospital | Gupta A.,Eras Medical College and Hospital | Kumar A.,University of Lucknow | Srivastava A.,Eras Medical College and Hospital
Indian Journal of Medical and Paediatric Oncology | Year: 2014

Aims: Nuclear size increases in malignant tumors and reflects DNA content, ploidy and proliferation index. Present study investigated if the nuclear morphometry could differentiate histomorphologically similar paediatric malignant small round cell tumors on hematoxylin and eosin stained sections for diagnostics in a resource poor setting. Settings and Design: All the consecutive malignant pediatric tumors received in Pathology Department from other faculties of King George's Medical University and also those referred directly to Pathology Department from other hospitals of city/other cities during 3 years period were recorded. Materials and Methods: Morphometric analysis was done in 22 confirmed (by higher ancillary techniques) but histomorphologically difficult to differentiate round cell tumors. All sections were analyzed by cell images from six different areas, using Leica Q win 500 images software. Results: Nuclear measurements were obtained for retinoblastoma (RB) (nine cases), neuroblastoma (five cases), Wilms tumor (WT) (three cases), rhabdomyosarcoma (three cases), malignant hemangiopericytoma (one case) and non-Hodgkin lymphoma (one case). Among the RBs, maximum mean nuclear area percent (24.93) was seen in a case with nerve involvement and metastasis, followed by cases with only nerve involvement (21.60) and smallest area (16.57) was in non-nerve involving, nonmetastatic cases. All five cases of neuroblastoma had almost similar mean nuclear area percent (18.05-18.29). WT case with metastasis had higher nuclear area (21.25) than nonmetastatic (19.47). Amongst all the tumors, minimum value (14.93) was seen in malignant hemangiopericytoma. Conclusion: Morphometric evaluation in paediatric malignant round cell tumors have generated useful data, and needs further multicentric confirmation for implementation.

Srivastava A.N.,Eras Medical College and Hospital | Srivastava S.,Sanjay Ghandi Postgraduate Institute of Medical science SGPGIMS | Bansal C.,Eras Medical College and Hospital | Misra J.S.,Eras Medical College and Hospital
ecancermedicalscience | Year: 2013

Objective: Nucleolar organizer region (NOR) associated proteins are argyrophilic and visualized by silver stains. AgNOR pleomorphic dots increase in cancer and most researchers have done a common count of single dots. Pleomorphic dots are few and perhaps indicate a more severe prognosis. The present study was aimed at investigating the relative preponderance and diagnostic value of both pleomorphic and single AgNOR dots in cervical carcinogenesis. Study design: Silver nitrate staining was performed in 50 cervical smears each of cytologically diagnosed normal, inflammatory, low grade squamous intraepithelial lesion (LSIL), High-grade squamous intraepithelial lesion (HSIL), and squamous cell carcinoma cases registered at C.S.M. Medical University, Lucknow, India. Results: The accumulated data revealed a positive and significant correlation of cell counts of both pleomorphic (r = 0.94; p < 0.01) and single dots (r = 0.95; p < 0.01) with disease severity. The rate of increase in cell counts of pleomorphic dots (b = 2.61) was 1.1 times higher than the rate of increase in cell counts of single dots (b = 2.29). Conclusion: This study indicates the diagnostic potential of pleomorphic dots in the process of cervical carcinogenesis. The number of pleomorphic dots also varies significantly in different types of SIL, which may help in discriminating precancerous lesions of the cervix. Copyright: © the authors.

Bansal C.,Eras Medical College and Hospital | Singh U.S.,Chhatrapati Shahuji Maharaj Medical University | Misra S.,Chhatrapati Shahuji Maharaj Medical University | Sharma K.L.,Chhatrapati Shahuji Maharaj Medical University | And 2 more authors.
CytoJournal | Year: 2012

Background: Fine needle aspiration (FNA) is a quick, minimally invasive procedure for evaluation of breast tumors. The Scarff-Bloom-Richardson (SBR) grade on histological sections is a well-established tool to guide selection of adjuvant systemic therapy. Grade evaluation is possible on cytology smears to avoid and minimize the morbidity associated with overtreatment of lower grade tumors. Aim : The aim was to test the hypothesis whether breast FNA from the peripheral portion of the lesion is representative of Scarff-Bloom-Richardson grade on histopathology as compared to FNA from the central portion. Materials and Methods : Fine-needle aspirates and subsequent tissue specimens from 45 women with ductal carcinoma (not otherwise specified) were studied. FNAs were performed under ultrasound guidance from the central as well as the peripheral third of the lesion for each case avoiding areas of necrosis/calcification. The SBR grading was compared on alcohol fixed aspirates and tissue sections for each case. Results : Comparative analysis of SBR grade on aspirates from the peripheral portion and histopathology by the Pearson chi-square test (χ2 =78.00) showed that it was statistically significant (P<0.001) with 93% concordance. Lower mitotic score on aspirates from the peripheral portion was observed in only 4 out of 45 (9%) cases. The results of the Pearson chi-square test (χ2 = 75.824) with statistically significant (P=0.000). Conclusion : This prospective study shows that FNA smears from the peripheral portion of the lesion are representative of the grading performed on the corresponding histopathological sections. It is possible to score and grade by SBR system on FNA smears. © 2012 Shidham VB, et al.; licensee Cytopathology Foundation Inc.

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