1
|
Vaghasiya VL, Nasit JG, Rupavatiya B, Bambhaniya DD, Kaka R. The spectrum of cytological findings in patients with BCG lymphadenitis: A series of 13 cases. Ann Diagn Pathol 2024; 69:152260. [PMID: 38171232 DOI: 10.1016/j.anndiagpath.2023.152260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Abstract
CONTEXT Bacillus Calmette-Guérin (BCG) vaccine has been used to prevent tuberculosis and/or its severe complications for long. BCG lymphadenitis is a common complication of the vaccine, which is sometimes subjected to cytological examination. The aim of the study is to describe the cytological findings of BCG lymphadenitis. SETTINGS The study was conducted in a tertiary care hospital in the western part of India from January 2021 to December 2022. DESIGN The study was performed on archived material of all patients who were referred to the fine needle aspiration clinic for cytology examination. Clinical and pathological data of cases were retrieved, and cases of BCG lymphadenitis were selected in the study based on these data. Slides of cases were retrieved, and cytological findings were studied. MATERIALS AND METHODS Papanicolaou, Giemsa, and Hematoxylin & eosin-stained smears, as well as Ziehl-Neelson stain (Z.N. stain) smears of all BCG lymphadenitis cases, were retrieved. Cases were reviewed for individual cytological features and overall cytological diagnostic categories. Z.N. stain smears were evaluated for acid-fast bacilli. RESULTS AND CONCLUSIONS Diagnostic categories observed in BCG lymphadenitis include suppurative lymphadenitis/abscess (15 %), necrotizing lymphadenitis (23 %), necrotizing granulomatous lymphadenitis (46 %), suppurative granulomatous lymphadenitis (8 %), non-necrotizing granulomatous lymphadenitis (8 %). Acid-fast bacilli were detected by Z.N. stain in 8 cases (62 %). The cytological findings of BCG lymphadenitis closely overlap with those of tuberculous lymphadenitis. So, clinical context is very important while reporting isolated axillary lymphadenopathy, specifically in recently vaccinated infants, to avoid misdiagnosis as tuberculous lymphadenitis.
Collapse
Affiliation(s)
- Viren L Vaghasiya
- Pathology Department, Medical College Baroda, Sir Sayajirao General Hospital, The Maharaja Sayajirao University of Baroda, Vadodara, India.
| | - Jitendra G Nasit
- Pathology Department, Medical College Baroda, Sir Sayajirao General Hospital, The Maharaja Sayajirao University of Baroda, Vadodara, India
| | - Bhoomika Rupavatiya
- Pathology Department, Medical College Baroda, Sir Sayajirao General Hospital, The Maharaja Sayajirao University of Baroda, Vadodara, India
| | - Divya D Bambhaniya
- Pathology Department, Medical College Baroda, Sir Sayajirao General Hospital, The Maharaja Sayajirao University of Baroda, Vadodara, India
| | - Riya Kaka
- Pathology Department, Medical College Baroda, Sir Sayajirao General Hospital, The Maharaja Sayajirao University of Baroda, Vadodara, India
| |
Collapse
|
2
|
Nasit JG, Dhruva G. Cryptococcal lymphadenitis in a human immunodeficiency virus-infected patient: A diagnostic role of fine needle aspiration cytology and special stains. Indian J Sex Transm Dis AIDS 2016; 37:205-206. [PMID: 27890960 DOI: 10.4103/0253-7184.192129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Jitendra G Nasit
- Department of Pathology, Medical College and Sir Sayajirao General Hospital, Baroda, Gujarat, India
| | - Gauravi Dhruva
- Department of Pathology, P.D.U. Government Medical College and Hospital, Rajkot, Gujarat, India
| |
Collapse
|
3
|
Abstract
Fibroma of the tendon sheath (FTS) is an uncommon benign soft tissue tumor (STS) of the tendon sheath. Clinical and radiological features are not distinctive enough to clinch the diagnosis preoperatively. Although histological features are well described, diagnostic cytological features of FTS are still lacking. Till date only two reports describe the fine-needle aspiration cytology (FNAC) findings of FTS. The present case is a 50-year-old female who presented with a slow growing nodule on the right thigh over a period of 2 years. FNAC revealed low cell yield with loose clusters of fibrotic spindle cells and stellate cells intermingled with fibro-collagenous and myxoid matrix. Few cells showed mild degree of nuclear atypia. Necrosis and atypical mitoses were not seen. Cytology findings were suggestive of benign/low-grade fibroblastic or fibromyxoid lesion. Histology confirmed the diagnosis of FTS. This article discusses the diagnostic role of FNAC in FTS with its differential diagnosis
Collapse
Affiliation(s)
- Jitendra G Nasit
- Department of Pathology, Government Medical College, SSG Hospital, Vadodara, Gujarat, India
| | - Gauravi Dhruva
- Department of Pathology, Pandit Deendayal Upadhyay Government Medical College and Hospital, Rajkot, Gujarat, India
| |
Collapse
|
4
|
Nasit JG, Dhruva G. Cryptococcal lymphadenitis in a human immunodeficiency virus-infected patient: A diagnostic role of fine needle aspiration cytology and special stains. Indian J Sex Transm Dis AIDS 2016. [PMID: 27890960 PMCID: PMC5111311 DOI: 10.4103/2589-0557.192129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Jitendra G. Nasit
- Department of Pathology, Medical College and Sir Sayajirao General Hospital, Baroda, Gujarat, India,Address for correspondence: Dr. Jitendra G. Nasit, C/4, Suryadeep Society, Near Nutan School, Behind Chanakyapuri Society, New Sama Road, Vadodara - 390 024, Gujarat, India. E-mail:
| | - Gauravi Dhruva
- Department of Pathology, P.D.U. Government Medical College and Hospital, Rajkot, Gujarat, India
| |
Collapse
|
5
|
Abstract
Dysembryoplastic neuroepithelial tumour (DNET) is an uncommon mixed glioneuronal tumour. DNET is classified as Grade I neoplasm in revised World Health Organization classification of tumors of the nervous system. DNET is commonly seen in the temporal lobe of children and young adults with features of pharmacoresistant complex partial seizures. Tumors arising in association with DNETs are rare. Only two cases of pilocytic astrocytoma (PA) arising in DNETs are reported. Surgical excision is the only successful management with favourable prognosis. The development of recurrence and malignancy after subtotal or even after complete excision challenges the premise of stability and highlights the importance of close clinical follow up. Here, a case of DNET with area of PA is described which helps in understanding the pathogenesis and biological behavior of DNET.
Collapse
Affiliation(s)
- Jitendra G Nasit
- Department of Pathology, Government Medical College and Sir Sayajirao General Hospital, Vadodara, Gujarat, India
| | - Payal Shah
- Department of Pathology, Pandit Deendayal Upadhyay Government Medical College and Hospital, Rajkot, Gujarat, India
| | - Himanshu Zalawadia
- Department of Radiodiagnosis, Rajkot Imaging Center, Rajkot, Gujarat, India
| |
Collapse
|
6
|
Nasit JG, Patel SC. Primary Cutaneous CD8(+) CD30(+) Anaplastic Large Cell Lymphoma: An Unusual Case with a High Ki-67 index-A Short Review. Indian J Dermatol 2015; 60:373-7. [PMID: 26288406 PMCID: PMC4533536 DOI: 10.4103/0019-5154.160483] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a part of the spectrum of CD30+ cutaneous lymphoproliferative disorder, characterized by variable degrees of CD2, CD3, CD4 and CD5 expression by lymphoid cells. PCALCLs with an expression of cytotoxic phenotype (CD8+) and cytotoxic proteins are uncommon. Cutaneous CD8+ CD30+ lymphoproliferative lesions are difficult to classify, diagnose and may be the cause of misdiagnose. CD8+ PCALCL must be distinguished from CD8+ mycosis fungoides, lymphomatoid papulosis type D and primary cutaneous aggressive epidermotropic CD8+ T-cell lymphoma. Usually CD8+ PCALCL is an indolent disease with a favorable prognosis, except few cases can show poor outcomes. The high Ki-67 index points toward advanced PCALCL. Treatment modalities include surgical excision, radiotherapy and clinical monitoring. Chemotherapy is reserved for disseminated disease. We report a 59-year-old male presented with rapid development of multiple painful reddish-brown plaques and nodular ulcerative skin lesions over the left thigh region since 2 months. A diagnosis of CD8+ PCALCL with a high Ki-67 index was made on the basis of histology and immunohistochemistry, in co-relation with clinical presentation.
Collapse
Affiliation(s)
- Jitendra G Nasit
- Department of Pathology, Medical College and Sir Sayajirao General Hospital, Baroda, Gujarat, India
| | - Smita C Patel
- Department of Pathology, Medical College and Sir Sayajirao General Hospital, Baroda, Gujarat, India
| |
Collapse
|
7
|
Nasit JG, Dhruva G. Nodular hidradenoma of the scalp: a cytomorphological evaluation on fine needle aspiration cytology. Indian J Dermatol Venereol Leprol 2014; 80:569-72. [PMID: 25382530 DOI: 10.4103/0378-6323.144218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Jitendra G Nasit
- Department of Pathology, Government Medical College and Sir Sayajirao General Hospital, Baroda, Gujarat, India
| | | |
Collapse
|
8
|
Abstract
Granular cell tumor is a rare, usually benign tumor with classical histomorphology. Location of tumor varies widely within body, but spine is distinctly a rare location for this tumor. We report a rare case of granular cell tumor involving intradural extramedullary portion of lumbar region of spinal cord. Knowledge of which is important as subsequent prognosis differs from other tumor at same location.
Collapse
Affiliation(s)
- Viren L Vaghasiya
- Department of Histopathology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
| | - Jitendra G Nasit
- Department of Histopathology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
| | - Pinki A Parikh
- Department of Histopathology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
| | - Priti P Trivedi
- Department of Histopathology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
| |
Collapse
|
9
|
Nasit JG, Dhruva G. Well-differentiated papillary mesothelioma of the peritoneum: a diagnostic dilemma on fine-needle aspiration cytology. Am J Clin Pathol 2014; 142:233-42. [PMID: 25015866 DOI: 10.1309/ajcpoto9lbb4ukwc] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Well-differentiated papillary mesothelioma of the peritoneum (WDPMP) is an uncommon subtype of epithelioid mesothelioma. Usually, WDPMP has a benign course, while a few patients have multiple recurrence and malignant transformation on long-term follow-up. The histology of WDPMP has been well studied compared with the cytology. Although accurate diagnosis is based only on histology and immunohistochemical stains, knowledge of the cytologic features of WDPMP in context with clinical and radiologic features is essential to predict a preoperative diagnosis and guide proper management, after excluding reactive mesothelial hyperplasia, malignant mesothelioma, and serous neoplasms of the ovaries and peritoneum. Surgical excision gives a favorable outcome. METHODS We describe a case of 28-year-old woman who sought treatment for chronic lower abdominal pain, dysuria, and dyspareunia. RESULTS Radiologic findings suggested multiple metastatic peritoneal deposits. Ultrasound-guided fine-needle aspiration cytology showed many papillae, tubulopapillary and spheroid groups, monolayered pavement-like sheets, and many dispersed cells. Papillae showed many layers of round to ovoid cells, with minimal atypia. Atypical mitoses and necrosis were not found. A cytologic diagnosis of WDPMP was suggested. After complete resection of all the tumor nodules, histopathology and immunohistochemical findings were compatible with WDPMP. On follow-up, she developed tumor recurrence at 9 months and was managed successfully with adjuvant chemotherapy. CONCLUSIONS This article highlights the cytologic features of WDPMP with relevant review of the literature and differential diagnosis.
Collapse
Affiliation(s)
- Jitendra G. Nasit
- Department of Pathology, Pandit Deendayal Upadhyay Government Medical College and Hospital, Gujarat, India
| | - Gauravi Dhruva
- Department of Pathology, Pandit Deendayal Upadhyay Government Medical College and Hospital, Gujarat, India
| |
Collapse
|
10
|
Nasit JG, Patel M, Parikh B, Shah M, Davara K. Anterior mediastinal masses: A study of 50 cases by fine needle aspiration cytology and core needle biopsy as a diagnostic procedure. South Asian J Cancer 2014; 2:7-13. [PMID: 24455533 PMCID: PMC3876626 DOI: 10.4103/2278-330x.105872] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Mediastinal tumors are an uncommon abnormalities found in clinical practice. Anterior mediastinum is the common site and tissue diagnoses of anterior mediastinal masses (AMMs) are very important for correct therapeutic decision. Objective: We evaluate the different malignant AMMs in various age groups and the sensitivity of fine needle aspiration cytology (FNAC) and core needle biopsy (CNB). Cytology smears are reviewed with particular emphasis on pitfalls in the cytological diagnosis. Materials and Methods: This was a prospective study of 50 patients who were consulted for AMMs and underwent FNAC and CNB under guidance of ultrasound or computed tomography (CT) scan from 2006 to 2011. Cytology smears and histological sections were evaluated in all patients. Results: Among 50 cases, 36 were male and 14 were female. Most AMMs (52%) were identified in the fifth and sixth decades of life. Metastatic carcinoma and nonHodgkin's lymphoma are the common AMMs. Adequate tissue material was obtained in 49 of 50 cases by CNB. Of these 49 patients, 35 (71.42%) cases were diagnosed correctly by FNAC, whereas 14 (28.57%) cases were not diagnosed definitely by FNAC. The sensitivity of CNB for AMMs was 97.95%, significantly higher than FNAC (71.42%) (P < 0.05). CNB had statistically significant higher diagnostic rate than FNAC in the noncarcinoma group (100% versus 62.96%) (P < 0.05). There is no significant difference of CNB and FNAC in carcinoma group (P > 0.05). Diagnostic rate of FNAC was higher for carcinomatous lesions (81.81%) than for noncarcinomatous lesions (62.96%). Conclusion: Ultrasound or CT scan-guided CNB in combination with FNAC are safe, minimally invasive, and cost-effective procedure, which can provide a precise diagnosis in the AMMs, and may obviate the need for invasive surgical approach. FNAC usually suffice for carcinomatous lesions but CNB should be performed whenever the diagnosis of carcinoma is equivocal or noncarcinoma lesions are suspected.
Collapse
Affiliation(s)
- Jitendra G Nasit
- Department of Pathology, P. D. U. Government Medical College and Hospital, Rajkot, Gujarat, India
| | - Maulin Patel
- Crossworld Blood Bank and Sankalp Diagnostics, Ahmedabad, Gujarat, India
| | - Biren Parikh
- The Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
| | - Manoj Shah
- The Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
| | - Kajal Davara
- Department of Preventive and Social Medicine, M. P. Shah Medical College, Jamnagar, Gujarat, India
| |
Collapse
|
11
|
Abstract
Testicular sarcomas constitute only 1-2% of all testicular tumors and are mostly associated with germ cell tumor. Primary intratesticular rhabdomyosarcoma is rare and only 14 cases have been reported in the literature till date. It should be differentiated from germ cell tumor with sarcomatous component, other intratesticular spindle-cell sarcomas and paratesticular rhabdomyosarcoma. Accurate diagnosis and early treatment is essential as it is an aggressive tumor with high metastatic potential and poor prognosis. Orchidectomy is the treatment of choice. Chemo-radiotherapy is recommended in case of recurrence and metastasis.
Collapse
Affiliation(s)
- Jitendra G Nasit
- Department of Pathology, P.D.U. Medical College, Rajkot, Gujarat, India
| | | | | | | |
Collapse
|
12
|
Nasit JG, Chauhan S, Dhruva G. Granular cell tumor of hand presenting as subcutaneous nodule mimicking dermal adnexal tumor: A diagnosis by cytology. Indian Dermatol Online J 2013; 4:33-6. [PMID: 23439997 PMCID: PMC3573450 DOI: 10.4103/2229-5178.105467] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Granular cell tumor (GCT) is an uncommon tumor and is believed to be of schwannian origin. GCT is benign but rare malignant cases are recorded. GCT occurs in almost any part of the body. The common sites are the tongue, skin, and subcutaneous tissue. GCT of hand is an extremely rare. Till date only 17 cases are reported in the literature. Preoperative diagnosis of GCT is important, because GCT mimics dermal adnexal tumor in subcutaneous tissue, other soft tissue tumor or inflammatory lesions. GCT is composed of large polygonal cells with eosinophilic granular cytoplasm and these cells are often immunoreactive for the S-100 protein. Fine-needle aspiration cytology has been suggested to be diagnostic modality of choice and this would undoubtedly aid the correct diagnosis. Excision with wide surgical margins is curative for benign GCT. Recurrence and malignant transformation requires regular follow-up. Here, this communication documents a case of cytological diagnosis of the granular cell tumor of hand in a 21-year-old female, clinically suspected to be a dermal adnexal tumor.
Collapse
Affiliation(s)
- Jitendra G Nasit
- Department of Pathology, P. D. U. Government Medical College and Hospital, Rajkot, Gujarat, India
| | | | | |
Collapse
|
13
|
Nasit JG, Shah B, Shah M. Metastatic hepatocellular carcinoma presenting as gynecomastia in male: A diagnostic dilema in fine needle aspiration cytology. Cytojournal 2012; 9:21. [PMID: 23227100 PMCID: PMC3513934 DOI: 10.4103/1742-6413.102863] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Accepted: 08/29/2012] [Indexed: 12/27/2022] Open
Affiliation(s)
- Jitendra G Nasit
- Address: Department of Pathology, P.D.U. Government Medical College and Hospital, Rajkot
| | | | | |
Collapse
|
14
|
Affiliation(s)
- Jitendra G Nasit
- Department of Pathology, P.D.U. Medical College and Hospital, Rajkot, Gujarat, India E-mail:
| | | |
Collapse
|
15
|
|