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Biomedical subjects

A H Deshpande

Publications and source records attributed to A H Deshpande.

10 recordsLinked to original sources

Primary malignant melanoma of the uterine cervix: report of a case diagnosed by cervical scrape cytology and review of the literature.

Cervical melanoma is a rare neoplasm and is seldom diagnosed by cervical scrape cytology. The possibility of metastatic melanoma should be excluded before making a diagnosis of primary cervical melanoma. We present a case of primary cervical melanoma diagnosed by cervical scrape cytology and a review of literature. The patient presented with vaginal bleeding of 3 mo duration and an ulcerated cervical growth. Cervical smear showed bizarre and abnormal cells containing pigment.

Female↗

Cytology of sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease).

Sinus histiocytosis with massive lymphadenopathy (SHML) is a benign, self-limiting condition of unknown etiology, which generally presents as massive bilateral cervical lymphadenopathy. It is important to distinguish SHML from other causes of histiocytosis because of the different treatment modalities. This study was carried out to assess the utility of fine-needle aspiration cytology (FNAC) findings in SHML and to distinguish if from other reactive lymphadenopathies. The lymph nodes in 4 patients (3 male and 1 female) presenting with massive bilateral cervical lymphadenopathy were aspirated. All presented with persistent bilateral cervical lymphadenopathy, polymorphnuclear leukocytosis, and raised erythrocyte sedimentation rate (ESR). Smears showed a reactive lymphoid population consisting of mature lymphocytes, plasma cells, a few polymorphs, and many histiocytes showing emperipolesis. Based on the cytologic and clinical findings, a diagnosis of SHML was made. Histopathology confirmed the diagnosis in all cases. A conclusive diagnosis of SHML can be based on cytology, provided that the cytologic findings are interpreted in the appropriate clinical context. Biopsy can be avoided in these patients. Diagn. Cytopathol. 2000;22:181-185.

Adolescent↗

Rhinocerebral mucormycosis diagnosis by aspiration cytology.

Rhinocerebral mucormycosis is a rapidly progressing, often fatal fungal infection that occurs commonly in diabetics and immunocompromised individuals. We present 2 cases of rhinocerebral mucormycosis with a paranasal mass. One patient had an intracranial extension. Nasal scrapings and fine-needle aspiration cytology (FNAC) of the paranasal masses showed fungal hyphae morphologically resembling Mucor. Surgical material showed features of mucormycosis. FNAC and scrape smears can give a conclusive diagnosis of mucormycosis, and the patient can be treated with appropriate antifungal therapy and surgical debridement. Preoperative cytology is an effective technique to establish a diagnosis of mucormycosis and obviates the need for a preoperative biopsy.

Amphotericin B↗

Aspiration cytology of extramammary tumors metastatic to the breast.

This study was carried out to examine the cytomorphologic features of metastatic breast tumors and to assess the utility of fine-needle aspiration cytology (FNAC) in diagnosing these tumors. The study group comprised five females and one male, all presenting with a breast mass. Their ages ranged between 35 and 65 years. FNAC of the breast mass was done in all cases. Three of the cases were previously diagnosed as squamous cell carcinoma (SCC) of the cervix, mucinous cystadenocarcinoma (MCA) of the ovary, and melanoma. Three cases presented initially with a breast mass. These included melanoma, non-Hodgkin's lymphoma (NHL), and plasmacytoma. The diagnosis of NHL was confirmed on histology. The patient with plasmacytoma presented primarily with a breast lump but subsequently developed multiple myeloma, and in one case of melanoma the primary tumor was detected after breast metastases. Preoperative FNAC of extramammary tumors metastatic to the breast is invaluable because the management of the patient differs entirely from that of a primary neoplasm. An accurate diagnosis can be made with the help of clinical and radiological correlation. If available, a perusal of previous history and biopsy material may prove useful.

Adult↗

Diagnostic dilemma in high intracanalar carcinoma of the cervix.

The use of colposcopy for follow up of patients with abnormal cervical smears has considerably increased the rate of detection of cervical malignancies and intraepithelial lesions in recent years. In case the lesion is situated high up in the cervical canal however, the chances of missing out the lesion are considerable. In our case the malignancy was detected only on endocervical sampling, but was missed on scrape as well as on colposcopically directed biopsy. The patient who was in perimenopausal age group, had complaints of post coital bleeding. The initial cervical scrape smear showed only squamous metaplasia. Colposcopically directed biopsy also showed the same findings. On a high index of suspicion clinically, the endocervical sampling was done with a cytobrush, which showed squamous cell carcinoma (SCC) of the cervix. Subsequent hysterectomy of the patient confirmed the diagnosis. Simultaneous endocervical sampling considerably increases the chances of finding an intracanalar lesion, particularly in older women, in whom the transitional zone (TZ) is situated high up in the cervical canal. In such a situation, even a colposcopically directed biopsy may prove inadequate. This was amply proved in our case.

Biopsy↗

Observations on oesophageal length.

The subject of oesophageal length is discussed. The great variations in the length of the oesophagus in individual patients is noted, and the practical use of its recognition in oesophageal surgery is stressed. An apprasial of the various methods available for this measurement is made; this includes the use of external chest measurement, endoscopic measurement, and the measurement of the level of the electrical mucosal potential change. Correlative studies of these various methods are made, and these show a very high degree of significance. These studies involved simultaneous measurement of external and internal oesophageal length in 26 patients without a hiatal hernia or gastro-oesophageal length in 26 patients without a hiatal hernia or gastro-oesophageal reflux symptoms, 42 patients with sliding type hiatal hernia, and 17 patients with a peptic stricture in association with hiatal hernia. The method of measuring oesophageal length by the use of the external chest measurement, that is, the distance between the lower incisor teeth and the xiphisternum, measured with the neck fully extended and the patient lying supine, is described in detail, its practical application in oesophageal surgery is illustrated, and its validity tested by internal measurements. The findings of this study demonstrate that the external chest measurement provides a mean of assessing the true static length of the oesophagus, corrected for the size of the individual.

Adult↗

A simple technique to improve recovery and morphology of cells exfoliated into fluids.

OBJECTIVE: To devise a simple, inexpensive and effective method for the cytologic study of fluids and to compare the results of the method with the conventional centrifuge smear (CS) method. STUDY DESIGN: We examined 200 fluid samples from various body sites using CS and thick and thin (TT) smears. Cellular yield, cytomorphology and background of the smears were studied and scored. The scores were compared and analyzed with the chi 2 test. RESULTS: TT smears gave a higher cellular yield, better morphologic details and cleaner background. The values of all three features were statistically significant (P < .001). In 38 cases a definitive diagnosis could be made on TT smears and not on CS smears. CONCLUSION: TT smears give significantly better results than CS smears. Simple to prepare and requiring no additional investment in terms of cost, technical skill and sophisticated instruments, this method is ideally suited to small laboratories, especially in developing countries.

Body Fluids↗

Glassy cell carcinoma of the uterine cervix a rare histology. Report of three cases with a review of the literature.

Glassy cell carcinoma is a poorly differentiated variant of adenosquamous carcinoma of the cervix associated with an aggressive course and a poor prognosis. We present three cases of glassy cell carcinoma of the cervix. Patients presented with a cervical growth which was biopsied. Histology the tumours showed nests of cells with a granular or clear cytoplasm, displaying marked pleomorphism and mitoses. Stroma showed an eosinophilic infiltrate. Two tumours showed a pure glassy cell pattern and one showed glandular differentiation with intracellular and extracellular mucin. Patients were treated with a combination of surgery, radiotherapy and chemotherapy but showed a poor response. Two patients died of the disease of pelvic or distant metastases within two years of diagnosis and one was lost to follow up. Although glassy cell carcinoma runs an aggressive clinical course, an early diagnosis may help in a more effective management and offer a better prognosis.

Adult↗