Abstract : Sacrococcygeal teratoma (SCT) is a congenital neoplasm that develop embryologically from totipotent cells and enlarge as a mass in sacrococcygeal region. SCT is usually benign but in a significant number of patients it presents with metastatic disease. A 1-year-old female child presented to our hospital with a history of a sacrococcygeal swelling since birth. Investigations revealed the lump to be a sacrococcygeal teratoma. The size of swelling increased gradually over time to a size of 12 cm × 9 cm at presentation. On further work up the patient was found to have metastasis in cerebrospinal fluid (CSF). We present a very rare case of CNS metastasis in a girl with sacrococcygeal teratoma reported on cytology.

Keyword : Cerebrospinal fluid, CNS metastasis, Cytology, Sacrococcygeal teratoma.

Abstract : Granulomatous dermal lesions pose a diagnostic challenge, since several causes can produce an identical histologic picture and, conversely, a single cause may produce varied histologic pattern. The aim of this study is to analyze the spectrum of various etiologies involved in granulomatous skin diseases and their clinicopathological correlation. Cases of granulomatous lesions reported over last one year on histopathological and cytological examination were reviewed along with special stains. A total of 20 cases of different etiologies were taken for study including infectious and non-infectious underlying causes. Out of the 20 dermal granulomatous lesions studied, 12 cases (60.0%) were bacterial, 1 case (5%) each of fungal and associated with malignancy and 6 cases (30%) due to non-infectious etiology like granuloma annulare and foreign body associated were recorded. Amongst the bacterial granulomatous lesions, predominance of Mycobacterium leprae was seen, 6 cases (40%). The varied presentation of Hansen’s disease in our study included 4 cases (20%) of tuberculoid leprosy and 2 cases (10%) each of lepromatous leprosy and borderline tuberculoid leprosy. Three cases (15%) of cutaneous tuberculosis seen in our study and were typified as lupus vulgaris, 2 cases (10%) and a single case (5%) of tuberculosa verrucosa cutis. One case, (5%) of Klebsiella rhinoscleromatis was also seen. Skin biopsies help in arriving at a conclusive diagnosis, if aided by a proper clinical history and examination and assisted by special stains, culture of organisms, PCR and immunoflourescence.

Keyword : Skin, Granulomatous lesions, Biopsy.

Abstract : To study the clinical and radiological presentation of lung cancer and diagnose the type of lung cancers using cytohistopathology and immunohistochemistry where-ever required. The study was carried out on 200 patients of lung cancer. Cytological investigations included sputum cytology, pleural fluid examination, percutaneous needle aspiration, trans-bronchial needle aspiration and FNAC lymph-node. Histopathology of paraffin embedded sections of lung biopsies was done. Immunohistochemical staining was done where ever required. Out of 200 cases, cytology was helpful in typing malignancy in 165 cases (82.5%).In the remaining 35 cases, 21 cases (10.5%) were suggestive of malignancy and 14 cases (7.0%) were inconclusive. On histological evaluation of 64 cases, typing was possible in 48 cases (71.8%) and 18 cases (28%) were reported as poorly differentiated carcinoma. After applying immunohistochemistry in 18 cases of poorly differentiated malignancies, 13 cases(72.2%) were positive only for CK5/6 as squamous cell carcinoma, 4 cases were positive for TTF1, out of which 3 were positive for CK7 making it as 4 cases(22.2%) of adenocarcinoma. One case (5.5% was positive for CK5/6, CK7 and TTF1 and was diagnosed as adeno-squamous carcinoma. Combination of various cytological techniques following additional use of histological evaluation of lung biopsies where ever required has raised the sensitivity of diagnosing lung cancer from 82.5% to 91.0% and immunohistochemistry clinched the diagnosis in poorly differentiated lung cancers.

Keyword : Lung cancer, Cytohistopathology, Immunohistochemistry

Abstract : Anaplastic carcinomas are the lethal thyroid neoplasms and have poor survival rate and prognosis. Pre existing well differentiated thyroid neoplasms can give rise to anaplastic carcinoma. Here, we report a case of anaplastic carcinoma in a young female in a colloid goitre as an incidental finding diagnosed by histopathological examination. Thyroid function tests showed suppressed TSH and elevated FT4 and FT3. Anti-thyroid hormone drugs were started. Thyrotropin receptor antibody was negative. USG neck showed single hypoechoic lesion in the periphery of the right lobe. A thyroid scan revealed focal hot and cold nodules and fine needle aspiration biopsy (FNAB) of the thyroid gland showed colloid nodule. Patient underwent right side lobectomy and final histopathology showed anaplastic thyroid carcinoma. Our case is interesting from a pathophysiologic perspective, since it suggests that nodular goiter can be associated with an aggressive form of thyroid carcinoma. We would like to emphasize that there should be a high index of suspicion in patients with nodular goiter for careful evaluation to detect any associated cancer.

Keyword : Anaplastic carcinoma, Colloid goitre, Incidental, Thyroid