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   Table of Contents - Current issue
July-September 2018
Volume 2 | Issue 3
Page Nos. 45-65

Online since Friday, September 21, 2018

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Liquid biopsy in oncology practice p. 45
Tapan Kumar Sahoo
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Diagnostic utility of touch imprint cytology in the evaluation of intraabdominal tumors p. 47
Amit Kumar Adhya, Madhabananda Kar, Ranjan Mohanty
Objectives: Touch imprint cytology (TIC) of biopsy specimen can be utilized for a rapid on-site evaluation of tumors. Its usefulness for intraoperative diagnosis is well known. We evaluated the advantages and limitations of TIC of trucut biopsies of intraabdominal tumors. Materials and Methods: TIC was obtained in 42 consecutive cases of intraabdominal masses. The sensitivity, specificity, and diagnostic accuracy of TIC were evaluated by comparing it with the final biopsy diagnosis. Results: The study included retroperitoneal tumors (13 cases, 30.95%), liver mass (11 cases, 26.19%), gall bladder mass (4 cases, 9.53%), pelvic mass (3 cases, 7.14%), iliac bone mass (2 cases, 4.76%), mesenteric nodule (4 cases, 9.53%), kidney mass (3 cases, 7.14%), and 1 case (2.38%) each of epigastric mass and loin mass. Thirty-two (76.19%) cases were diagnosed as malignant and 10 (23.81%) cases were diagnosed as benign/negative on TIC. The overall sensitivity was 87.88%, the specificity was 77.78%, the positive predictive value was 93.55%, and the negative predictive value was 63.60%. The accuracy of the test was 85.71%.Conclusions: TIC is a simple and cost-effective method that aids in the diagnostic evaluation of tumors. It is fairly accurate with high positive predictive value and hence can be used as an adjunct to the biopsy diagnosis.
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Significance of mast cells in diagnosis and grading of non-Hodgkin's lymphomas on fine-needle aspiration cytology p. 51
J Praveen, Neelaiah Siddaraju, Prita Pradhan
Background: Information regarding the diagnostic role of mast cells in non-Hodgkin's lymphomas (NHLs) on fine-needle aspiration cytology (FNAC) is negligible. Aim of the Study: To assess the role of mast cells in diagnosing and distinguishing reactive lymphoid hyperplasia (RLH) versus low-grade NHL and low- versus high-grade NHLs on FNAC. Materials and Methods: Fine-needle aspirates from 50 reactive lymph nodes and 51 NHLs were studied. Cytologic smears of NHL cases and reactive controls were evaluated in a blinded manner. A standardized mast cell count (MCC) was performed on May–Grünwald–Giemsa smears of both “NHL” and “RLH” cases. MCC was compared between RLH and NHL groups and between low- and high-grade NHLs. Mann–Whitney U-test and Wilcoxon W-test were done for statistical analysis, takingP> 0.05 as statistically significant. A receptor operator characteristic curve was plotted to calculate the cutoffs for MCC. Results: Various morphologic types of NHL were encountered with 25 high-grade and 26 low-grade NHLs. The standardized MCC in RLH ranged from 0/25 hpf to 14/25 hpf (a mean MCC of 1.54/25 hpf), while for NHL group, it ranged from 0/25 hpf to 30/25 hpf (a mean MCC of 2.39/25 hpf). The difference in the median MCC between the two groups was statistically not significant (P > 0.05). Conclusion: Performing an MCC on cytologic smears may not be of significant practical value in distinguishing RLH versus low-grade NHL, and low/intermediate grade versus high-grade NHLs. Further larger studies are required to refute or support the cytodiagnostic role of mast cells in some specific subtypes of NHL.
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Basal cell adenoma of the buccal mucosa masquerading as irritation fibroma: A rare case report p. 55
Pinali Das, Shayari Niyogi, Sanat Kumar Bhuyan, Ruchi Bhuyan
Basal cell adenoma (BCA) is an uncommon benign epithelial neoplasm of salivary gland consisting of 1%–2% of all salivary gland epithelial tumors. Frequently, these tumors occur in major salivary glands, mostly in the parotid gland. These tumors rarely occur in minor salivary gland. We report a case of BCA in a 54-year-old male patient having a growth in the left upper gingivobuccal sulcus at maxillary tuberosity region with respect to 27 and 28, which was clinically presented as irritation fibroma and was histologically diagnosed as BCA. The dilemma in diagnosis of this rare lesion, histologic paradox, and insufficient descriptive studies has directed us to present this case to serve as a guide for clinicians for proper clinicopathological and radiological analysis of such lesions.
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Epithelioid hemangioendothelioma of liver mimicking as metastasis in treated case of carcinoma of cervix: A rare clinical issue with literature review p. 58
Subhasis Mishra, Saroj Kumar Das Majumdar, Susama Patra, Dillip Kumar Parida
Epithelioid hemangioendothelioma (EH) is a rare tumor of vascular origin. Hepatic involvement of EH is a rare incidence and radiological finding may confuse with metastasis, particularly in a previously existing primary carcinoma. Biopsy from the lesion followed by immunohistochemistry (IHC) examination should be done for confirmation of the diagnosis. The clinical presentation of EH is variable, and the majority cases present with multifocal disease during the diagnosis. The therapeutic criteria of EH are still unclear since its natural history is unpredictable. We report a case of EH of the liver in a previously treated squamous cell carcinoma of the cervix. The case was found to have a solitary hepatic mass lesion in the right lobe of liver on radiological investigation. Biopsy from liver lesion was found to be EH and confirmed on IHC study.
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Leiomyoma of round ligament masquerading as an inguinal hernia p. 62
Rohini Vinayak Kulkarni, Reddy Jeevan, Bhagyalaxmi Nayak, Jayant Rath
Tumors of the round ligament of uterus are uncommon, with leiomyoma being the most common type among them with unknown exact incidence. Leiomyoma is a benign tumor and its location at inguinal area is confused with the clinical diagnosis of inguinal hernia, lymph node, or other nodal masses. Here, we report the case of a 47-year-old parous woman who presented with complaints of heavy menstrual bleeding and right groin swelling. A preoperative diagnosis of adenomyosis of uterus with inguinal hernia was made. She underwent nondescent vaginal hysterectomy, following which, on exploration of the inguinal region, a myoma was found and was confirmed as leiomyoma on histopathology. Hence, although rare, it is prudent to consider a round ligament leiomyoma as one of the differential diagnoses of the more common inguinal hernia, especially in a female patient.
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Are psychosocial problems adequately investigated in pediatric glioma? p. 65
Raju Birudu, TR Kanmani
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