Subdural haematoma secondary to carcinoma of the uterine cervix.
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Brain Neoplasms↗
Biomedical subjects
R Nijhawan
Publications and source records attributed to R Nijhawan.
Pathology of supraclavicular lymphadenopathy in Chandigarh, north India: an audit of 200 cases diagnosed by needle aspiration.
OBJECTIVE: Fine needle aspiration cytology (FNAC) of lymph nodes can be used routinely as a first-line diagnostic test. The majority of studies reveal a malignant cause for palpable supraclavicular lymph nodes. The present audit further emphasizes the use of FNAC as a first-line investigation for the evaluation of enlarged supraclavicular lymph nodes. METHODS: A total of 200 cases of palpable supraclavicular lymph node(s) were included in the present study. RESULTS: Left supraclavicular lymph nodes were found to be more commonly involved (59.5% cases). Sixty-four per cent cases showed metastatic deposits and 13.5% cases were diagnosed as tuberculosis. Ten per cent cases showed reactive lymphoid hyperplasia; 0.5% (one) case showed only necrosis and on autopsy, a microscopic focus of choriocarcinoma was found in the testis. In 7.5% cases, diagnostic material could not be aspirated despite repeated attempts. Common metastatic tumours were from lung (22% cases), breast (16.4% cases), cervix (11% cases) and oesophagus (8.6% cases). In 13.3% cases the primary site was unknown and the diagnosis of malignancy first came from FNAC. CONCLUSION: The present study further highlights the importance of FNAC as a first-line diagnostic modality in the evaluation of supraclavicular lymphadenopathy. A full history, radiological findings and immunochemistry in difficult cases can help to arrive at a definitive diagnosis.
Adolescent↗
Fine needle aspiration of epididymal nodules in Chandigarh, north India: an audit of 228 cases.
BACKGROUND: Epididymal nodules are not infrequently encountered in surgical practice. These are generally small and slippery and fine needle aspiration cytology (FNAC) is not easy. But as it is rapid and less traumatic than a biopsy, this is a favoured technique in the assessment of epididymal nodules. PATIENTS AND METHODS: In the present study, all the cases of epididymal nodules aspirated from January 1998 to August 2004 were retrieved from the cytology files of the Department of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. RESULTS: A total of 228 cases were retrieved and divided as follows: tuberculous epididymitis 70 (30.7%), non-specific inflammation 10 (4.4%), microfilaria 2 (0.9%), hydrocele 26 (11.4%), spermatocele 42 (18.4%), spermatic granulomas 12 (5.3%), adenomatoid tumour 3 (1.3%), leiomyosarcoma 1 (0.4%) and lipoma 1 (0.4%). Thirty-six (15.8%) cases were labelled as benign aspirate not otherwise specified. FNAC material was inadequate for opinion in 22 (9.65%) cases and three (1.3%) cases revealed evidence of a haematoma. CONCLUSIONS: FNAC was useful in the diagnosis of 90.3% of cases, thereby avoiding surgical biopsy and other investigations. Therefore, FNAC has an important role in the differential diagnosis of epididymal nodules as it can detect malignancy and benign conditions such as tuberculosis and acute and chronic epididymo-orchitis.
Biopsy, Fine-Needle↗
Fine needle aspiration of subcutaneous cysticercosis.
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Adult↗
Fine-needle aspiration cytology of extramammary neoplasms metastatic to the breast.
Fine-needle aspiration (FNA) biopsy is the first-line investigation in any breast lump and hence cytomorphological recognition of nonmammary metastatic tumors to the breast and their distinction from primary tumors is important. Metastatic breast neoplasms diagnosed over a 6-yr period from 1997 to 2002 were retrieved from the database of the Department of Cytopathology and the clinical, cytopathological, histochemical, and immunohistochemical findings were correlated with the histopathology of the primary tumor. Fifteen cases of metastatic breast neoplasms were encountered constituting 1.47% of all malignant tumors of the breast diagnosed on FNA. There were 14 female patients and one male patient aged 13-80 yr. The preaspiration clinical diagnosis was either a benign breast lump or a malignancy (primary vs. metastatic). The breast lump was the initial presentation in four cases and the cytodiagnosis of a metastatic malignancy lead to the subsequent detection of the primary malignancy. These included one case each of melanoma, myeloma, rhabdomyosarcoma, and small-cell carcinoma of the lung. There were five pediatric cases that included four cases of rhabdomyosarcoma and one case of leukemic deposit. The adult cases included two cases each of melanoma, small-cell carcinoma, and myeloma; one case of choriocarcinoma; and three cases of soft-tissue sarcomas. These included two cases of malignant fibrous histiocytoma (MFH) and one case of leiomyosarcoma. The presence of unusual cytomorphological patterns on breast FNA should alert the cytopathologist to the possibility of a metastatic breast neoplasm, even if not suspected clinically. A detailed history of the patient, clinical correlation, and immunocytochemistry helps in establishing an accurate diagnosis, which avoids unnecessary surgery and ensures appropriate treatment.
Adolescent↗
A study of unusual metastasis in fine needle aspirate of the liver.
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Adolescent↗
Rosai-Dorfman disease: unusual cause of diffuse and massive retroperitoneal lymphadenopathy.
Rosai-Dorfman disease (RDD), originally described as sinus histiocytosis with massive lymphadenopathy, is a rare histiocytic proliferative disorder with a distinctive microscopic appearance. Patients usually present with massive cervical lymphadenopathy. However other nodal sites (mediastinal and inguinal) are also frequently involved. The retro-peritoneum is an infrequent site of involvement. This uncommon entity should also be included in the list of differential diagnoses of diffuse and massive lymphadenopathy, which includes includes infectious/granulomatous conditions, lymphomatous and metastatic disease.
Adult↗
Development of an ophthalmic formulation containing ciprofloxacin-hydroxypropyl-b-cyclodextrin complex.
Ophthalmic formulations of ciprofloxacin were formulated using inclusion complexes of ciprofloxacin HCl (CFLX HCl) and hydroxypropyl-beta-cyclodextrin (HP-beta-CD). The complexes were prepared by the method of freeze drying and evaluated by phase solubility studies, differential scanning calorimetry, powder X-ray diffractiometry, fourier transform infrared spectroscopy and scanning electron microscopy. The ophthalmic solutions formulated using the complexed drug exhibited better stability, biological activity and ocular tolerance in comparison to another ophthalmic solution formulated using uncomplexed drug and also in comparison to a marketed preparation.
2-Hydroxypropyl-beta-cyclodextrin↗
Melanotic neuroectodermal tumour in an infant.
Most jaw swellings in infancy are benign odontogenic cysts or tumours. The encounter with an unusual melanotic neuroectodermal tumour of the jaw in a young infant is described in this report. There has been no recurrence, after complete surgical excision, in a follow-up period of six months.
Female↗
Leukemic infiltration of psoas muscle: an unusual cause of ureteral obstruction.
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Biopsy↗
Cytologic spectrum of 227 fine-needle aspiration cases of chest-wall lesions.
This study was carried out with the objective of studying the cytomorphology of the wide variety of chest-wall lesions. Two hundred twenty-seven chest-wall lesions were studied over a period of 4 yr. Routine May-Grünwald-Giemsa (MGG) and hematoxylin-eosin (H&E) slides were studied along with special stains, whenever required. The malignant lesions comprised 36.13% of all cases (81/227). Of the 126 benign lesions, the majority were inflammatory in nature (68/126), the next commonest lesion being lipoma (38/126). Rare cases of tuberculosis involving the sternum, epithelioid leiomyosarcoma, and neuroendocrine tumors involving ribs, malignant nerve sheath tumors involving the chest wall, metastatic carcinoma of the stomach and prostate, and papillary carcinoma thyroid are reported in this series. Histopathology was available in 24 cases, and hematological correlation in one case. A 100% cytohistological and cytohematological correlation was found, with no false positives or false negatives. In conclusion, fine-needle aspiration cytology is a rapid, diagnostic tool, eliciting many interesting lesions in the chest wall. It is useful not only in detecting primary and metastatic lesions, but also in follow-up of tumor recurrence.
Adolescent↗
The flash-lag phenomenon: object motion and eye movements.
An object flashed briefly in a given location, the moment another moving object arrives in the same location, is perceived by observers as lagging behind the moving object (flash-lag effect). Does the flash-lag effect occur if the retinal image of the moving object is rendered stationary by smooth pursuit of the moving object? Does the flash-lag effect occur if the retinal image of a stationary object is caused to move by smooth-pursuit eye movements? A disk was briefly flashed in the center of a moving ring such that the ring center was completely 'filled' by the disk. In this display, observers perceived the flashed disk to lag such that it appeared only to partially 'fill' the ring center. The 'unfilled' portion (perceived void) of the moving ring was seen in the color of the background. With smooth pursuit of the ring, the flash-lag effect was eliminated, and observers saw the flashed disk centered on the moving ring. A strong flash-lag effect was observed when observers smoothly pursued a moving point target past a continuously visible stationary ring. Once again, the flashed disk appeared to only partially fill the center of the continuously visible stationary ring, yielding a vivid 'perceived void'. These results are discussed in terms of neural delays and their compensation.
Eye Movements↗
Metastatic placental site trophoblastic tumor: a case report.
Placental site trophoblastic tumor (PSTT) is very rare. It is an unusual variant of gestational trophoblastic neoplasia usually confined to the uterus, although 10% of patients have metastases. The clinical behaviour of PSTT varies and despite knowledge of its histology, diagnosis of this rare form of trophoblastic disease and prediction of its biological behaviour remains difficult due to only a few cases reported in literature.
Adult↗
Role of DNA flow cytometry and image cytometry on effusion fluid.
The objective of the study was to assess the value of DNA flow cytometry (FCM) and image cytometry (ICM) as an adjunct to routine diagnostic cytology. In this prospective study, 100 consecutive effusion fluids were studied for routine cytology, DNA FCM, and in selected cases, ICM. One half of the centrifuged fluid sample was used for routine cytology and the remaining portion was used for DNA FCM. Nuclear area, nuclear diameter, nuclear perimeter, nuclear convex perimeter, nuclear roundess, and nuclear convex area were measured on at least 100 cells by ICM in cytologically malignant or DNA aneuploid cases along with control cases. Clinical follow-up was done in all cases. There were 22 cytologically malignant cases and 78 cytologically benign cases. Among the 22 cytologically malignant cases, there were 11 aneuploid and diploid cases each by DNA FCM. Out of 78 cytologically benign cases, six (7.7%) were aneuploid by DNA FCM. Smears of these cases showed predominantly reactive mesothelial cells, but the DNA histograms showed hypodiploid (one), hyperdiploid (three), tetraploid (one), and hypertetraploid (one) aneuploidy. Follow-up of these cases showed clinical or histologic features of malignancy except in one case of tetraploid aneuploidy, which did not show any features of malignancy and responded well to antitubercular therapy. Therefore, out of 27 malignant effusions, DNA FCM picked up 16 cases and routine cytology detected 22 cases. Sensitivity and specificity of DNA FCM were thus 59.25% and 98.63%, respectively. There was a statistically significant difference (Student's unpaired t-test, P < 0.05) between cytologically malignant cases and control benign cases in all the nuclear morphometric parameters except for nuclear roundness. There was, however, no statistically significant difference of nuclear morphometric parameters between cytologically benign vs. DNA aneuploid cases and control benign cases. DNA FCM is a useful adjunct for routine diagnostic cytology. Visual diagnostic cytology and morphometric digital microscopy miss some cases of malignancy which can be detected by DNA flow cytometry. Diagn. Cytopathol. 2000;22:81-85.
Adult↗
Desmoplastic ameloblastoma: a case report with fine-needle aspiration cytologic findings.
A case of desmoplastic ameloblastoma of the maxilla in a 25-yr-old woman is presented. Smears prepared from fine-needle aspiration cytology showed two populations of cellular elements: cohesive epithelial clusters with basaloid morphology present, mostly in bidimensional, irregularly outlined clusters with ill-formed palisading of nuclei at the periphery in some, and a mesenchymal component represented by 1) a sparse chunk of moderate-sized tissue fragments made up of spindle- or ovoid-shaped nuclei entrapped in mesenchymal matrix, and 2) many dissociated naked oval-to-spindle-shaped nuclei. The presence of epithelial and mesenchymal components and their benign nature lead us to consider the possibility of benign odontogenic tumors 1) of epithelial origin, such as ameloblastma with a stromal component, e.g., desmoplastic ameloblastoma; 2) of mesenchymal origin, such as odontogenic fibroma; and 3) of mixed epithelial and mesenchymal origin, such as ameloblastic fibroma. Excision and histopathological examination of this lesion confirmed the diagnosis of desmoplastic ameloblastoma. In the given clinical setting and radiological examination, the above cytological features suggest a benign odontogenic tumor, rather than precisely diagnosing any of the entities mentioned above. However, it is important to distinguish between these, since the treatment varies accordingly. The differential diagnosis is discussed.
Adult↗
Changing objects lead briefly flashed ones.
Continuous, predictable events and spontaneous events may coincide in the visual environment. For a continuously moving object, the brain compensates for delays in transmission between a retinal event and neural responses in higher visual areas. Here we show that it similarly compensated for other smoothly changing features. A disk was flashed briefly during the presentation of another disk of continuously changing color, and observers compared the colors of the disks at the moment of flash. We also tested luminance, spatial frequency and pattern entropy; for all features, the continuously changing item led the flashed item in feature space. Thus the visual system's ability to compensate for delays in information about a continuously changing stimulus may extend to all features. We propose a model based on backward masking and priming to explain the phenomenon.
Adaptation, Physiological↗
The role of attention in motion extrapolation: are moving objects 'corrected' or flashed objects attentionally delayed?
Objects flashed in alignment with moving objects appear to lag behind [Nijhawan, 1994 Nature (London) 370 256-257]. Could this 'flash-lag' effect be due to attentional delays in bringing flashed items to perceptual awareness [Titchener, 1908/1973 Lectures on the Elementary Psychology of Feeling and Attention first published 1908 (New York: Macmillan); reprinted 1973 (New York: Arno Press)]? We overtly manipulated attentional allocation in three experiments to address the following questions: Is the flash-lag effect affected when attention is (a) focused on a single event in the presence of multiple events, (b) distributed over multiple events, and (c) diverted from the flashed object? To address the first two questions, five rings, moving along a circular path, were presented while observers attentively tracked one or multiple rings under four conditions: the ring in which the disk was flashed was (i) known or (ii) unknown (randomly selected from the set of five); location of the flashed disk was (i) known or (ii) unknown (randomly selected from ten locations). The third question was investigated by using two moving objects in a cost-benefit cueing paradigm. An arrow cued, with 70% or 80% validity, the position of the flashed object. Observers performed two tasks: (a) reacted as quickly as possible to flash onset; (b) reported the flash-lag effect. We obtained a significant and unaltered flash-lag effect under all the attentional conditions we employed. Furthermore, though reaction times were significantly shorter for validly cued flashes, the flash-lag effect remained uninfluenced by cue validity, indicating that quicker responses to validly cued locations may be due to the shortening of post-perceptual delays in motor responses rather than the perceptual facilitation. We conclude that the computations that give rise to the flash-lag effect are independent of attentional deployment.
Attention↗
Grading of ductal breast carcinoma by cytomorphology and image morphometry with histologic correlation.
OBJECTIVE: To investigate the relevance of image analysis for grading breast carcinoma. STUDY DESIGN: Twenty-five ductal breast carcinoma cases were chosen randomly from routine fine needle aspiration clinics. The results of cytomorphologic grading and image morphometry were correlated with those of histologic grading. The five image morphometric parameters studied were nuclear diameter, nuclear area, nuclear roundness, nuclear perimeter and grey level to compare with chromatin texture. RESULTS: Cytologic grading alone had a high correlation with histologic grading. The lowest correlation was found in grade 2 tumors. When cytologic grading was supplemented with image morphometric parameters, the correlation was higher than that of cytologic grading alone. CONCLUSION: Cytologic grading has a high correlation with histologic grading. The correlation improves further on supplementation with image morphometric parameters.
Biopsy, Needle↗