Biomedical subjects

P V Kumar

Publications and source records attributed to P V Kumar.

At least 55 records · Page 3Linked to original sources

PubMedDate not supplied

Bull's eye (target) inclusions in neoplastic cells in malignant serous effusions. A study of 289 cases.

OBJECTIVE: To study the prevalence and significance of bull's eye (target) inclusions in neoplastic cells in malignant serous effusions. STUDY DESIGN: We reviewed malignant pleural, peritoneal and pericardial effusions from 289 patients who had proven cancer at known primary sites. The ages of the patients ranged from 5 to 72 years; 166 were male and 123 female. RESULTS: Bull's eye inclusions are an uncommon finding and appeared in only 13 cases of metastatic adenocarcinoma of the breast, stomach, colon, lung, ovary, pancreas and urinary bladder. They were positively stained with periodic acid-Schiff stain with diastase. The inclusions were not seen in cells of nonadenocarcinomatous neoplasms, such as squamous cell carcinoma, oat cell (small cell) carcinoma, neuroblastoma, lymphoma and germ cell tumors. CONCLUSION: Bull's eye inclusions are found in about 5% of malignant serous effusions containing cells of metastatic adenocarcinoma. The primary site of an adenocarcinoma cannot be deduced on the basis of the presence of inclusions.

Adenocarcinoma↗

PubMedDate not supplied

Subcutaneous metastasis from transitional cell carcinoma of the bladder diagnosed by fine needle aspiration biopsy. A case report.

BACKGROUND: Metastasis of transitional cell carcinoma (TCC) of the bladder to the skin and subcutaneous tissue is an uncommon finding. CASE: A 58-year-old man with a known case of high grade TCC of the bladder, presented with a right paraspinal mass. Clinically an abscess was suspected. Fine needle aspiration (FNA) showed many clusters and isolated malignant cells in an inflammatory background. The smears were diagnosed as positive for malignancy. CONCLUSION: It is essential to differentiate tumors metastatic to the skin and subcutaneous tissue from inflammatory lesions. FNA helped with the diagnosis in this case and prevented unnecessary biopsy.

Biopsy, Needle↗

PubMedDate not supplied

Follicular variant of papillary carcinoma of the thyroid. A cytologic study of 15 cases.

OBJECTIVE: To study the cytologic findings of follicular variant of papillary thyroid carcinoma (FVPTC) and to compare them with the cytologic findings on other thyroid lesions. STUDY DESIGN: The study group consisted of aspirate smears from 15 cases of histologically proven FVPTC. The control group consisted of 152 cases, including adenomatous colloid goiter (70), usual papillary carcinoma (40), follicular adenoma (30), Hürthle cell neoplasm (7) and medullary carcinoma (5). RESULTS: The smears of FVPTC revealed numerous colloid balls in the background, multilayered microfollicles (rosettes), numerous nuclear grooves and inclusions in the monolayer sheets of follicular cells, very rare giant cells, absence of calcification and papillary clusters. Rosettelike microfollicles and numerous colloid balls were not seen in the control group. CONCLUSION: The combination of numerous colloid balls and rosettelike microfollicles was frequently seen in FVPTC. This combination was not observed in the control group.

Adenoma↗

PubMedDate not supplied

Primary squamous cell carcinoma of the thyroid diagnosed by fine needle aspiration cytology. A report of two cases.

BACKGROUND: Primary squamous cell carcinoma of the thyroid is a rare malignant tumor that needs to be distinguished from other neoplasms. CASES: Two males aged 65 and 68 years presented with an enlarged right lobe of the thyroid. Thyroid scintigraphy revealed a cold nodule. Clinically malignancy was suspected. Fine needle aspiration (FNA) revealed numerous clusters and isolated malignant cells, dyskeratotic cells and deposits of eosinophilic granular keratin material. Subtotal thyroidectomy was performed. Histologic findings confirmed the cytologic diagnosis of squamous cell carcinoma. CONCLUSION: Primary squamous cell carcinoma of the thyroid is a rare tumor. FNA findings of this tumor were not reported before. FNA study cannot help to differentiate primary from metastatic squamous cell carcinoma of the thyroid.

Aged↗

PubMedDate not supplied

Papillary carcinoma of the breast. Cytologic study of nine cases.

OBJECTIVE: To study the cytologic findings of papillary breast carcinoma by fine needle aspiration. STUDY DESIGN: The study group consisted of fine needle aspiration (FNA) specimens of breast tumors from nine patients performed during the period 1988-1997. Eight were female, and one was male. The FNA results were compared with the final histologic diagnosis. RESULTS: The tumor sizes were 4-6.5 cm. The aspirations yielded a good amount of bloody material. The smears revealed high cellularity, papillary clusters, isolated low-to-tall columnar cells, mild to moderate atypia, hemorrhagic background, foam and hemosiderin-laden macrophages, calcification, rare mitoses, palisading row of cells and bipolar cytoplasmic eosinophilic granules. The smears were diagnosed as either suspicious or suggestive of papillary carcinoma. The histologic examination revealed invasive papillary carcinoma. CONCLUSION: Papillary carcinoma of the breast can be diagnosed by using a panel of cytologic findings that includes hypercellularity, papillary clusters, hemorrhagic background, palisading rows of tall columnar cells, cellular atypia and calcification. The interesting finding in this study was the presence of eosinophilic bipolar cytoplasmic granules, which has not been reported before.

Aged↗

PubMedDate not supplied

Testicular leukemia relapse. Fine needle aspiration findings.

OBJECTIVE: To study the role of testicular fine needle aspiration (FNA) in the diagnosis of leukemia relapse. STUDY DESIGN: The study group consisted of 32 leukemia patients in complete remission for one to five years. Their ages ranged from 8 to 63 years. Twenty-five of them had bilateral testicular enlargement, and seven had unilateral enlargement. Hematologic workup and bone marrow studies of all of the patients showed no evidence of leukemia (full remission). FNA smears were obtained by using 22-gauge needles fitted to 20-mL syringes. RESULTS: The smears revealed 13 cases of acute lymphoblastic leukemia L2 (ALL-L2), 8 of ALL-L3, 5 of acute monoblastic leukemia M5 (AML-M5), 1 of acute promyelocytic leukemia (APL-M3), 1 of AML-M1; 1 of erythroleukemia, AML-M6, 1 of chronic lymphocytic leukemia, 1 of chronic myelogenous leukemia and 1 of plasma cell leukemia. CONCLUSION: FNA study of the testis is safe, time saving, rapid and easy to perform for the diagnosis of testicular leukemia relapse, obviating the need for biopsy.

Adolescent↗

PubMedDate not supplied

Papillary Hürthle cell carcinoma (Warthin-like tumor) of the thyroid. Report of a case with fine needle aspiration findings.

BACKGROUND: Papillary Hürthle cell carcinoma with lymphoplasmacytic stroma is a newly recognized variant of papillary carcinoma of the thyroid gland. Fine needle aspiration findings reveal some points that have not been reported previously. CASE: A 50-year-old female presented with a left lobe thyroid mass. Fine needle aspiration of the nodule yielded cellular smears, mostly in large and small papillary clusters of Hürthle cells, with nuclear grooves and rare nuclear inclusions in a lymphoplasmacytic background. Isolated Hürthle cell and multinucleated giant cells were also seen. Histopathologic examination of the 3-cm-diameter nodule showed papillary Hürthle cell carcinoma with lymphocytic stroma, or "Warthin-like tumor" of the thyroid, with capsular invasion. CONCLUSION: The presence of papillary clusters with nuclear features of papillary carcinoma and oxyphilic cytoplasm in a lymphoplasmacytic background should raise the diagnosis of Warthin-like tumor of the thyroid.

Adenolymphoma↗

PubMedDate not supplied

Extramedullary plasmacytoma. Fine needle aspiration findings.

OBJECTIVE: To determine the role of fine needle aspiration cytology in the diagnosis of extramedullary plasmacytoma. STUDY DESIGN: The study group consisted of 13 patients with palpable masses at various sites. The tumors were aspirated for cytologic study. RESULTS: The smears revealed groups of mature and immature plasma cells at various stages of maturation. Mature plasma cells showed an eccentric nucleus and abundant, deep, basophilic cytoplasm with a paranuclear halo. Plasmablasts (immature plasma cells) showed a prominent, eccentric nucleus with single, large nucleolus and abundant, deep, basophilic cytoplasm with no paranuclear halo. Binucleate and multinucleate forms were also seen quite often. The tumors were excised, and the histologic sections confirmed the cytologic diagnosis. All the patients received radiotherapy. One patient (18 years old) developed recurrence and died due to extensive infiltration into the maxilla and mandible. Two patients (57 and 62 years) developed multiple myeloma one to two years after the excision of tumors, and both died two to three months later. The remaining 10 patients were alive and well at this writing. CONCLUSION: The smears from all 13 patients were diagnosed as extramedullary plasmacytomas by fine needle aspiration cytology.

Adolescent↗

PubMedDate not supplied

Leukemia cutis. Fine needle aspiration findings.

OBJECTIVE: To aspirate, for cytologic study, skin nodules from known cases of leukemia during full remission. STUDY DESIGN: The study group consisted of nine leukemia patients in full remission who developed skin nodules on the head, face, chest and upper extremities. RESULTS: The size of the nodules ranged between 1 and 3.5 cm. The nodules were aspirated with 21-gauge needle. Four were diagnosed as acute lymphoblastic leukemia, 1 as chronic lymphocytic leukemia, 1 as acute myeloblastic leukemia, 2 as acute monocytic leukemia and 1 as acute promyelocytic leukemia. Histologic sections were diagnosed as lymphoma-leukemia. The patients developed leukemia again three to four months after excision of the skin nodules. CONCLUSION: Fine needle aspiration cytology is useful in the diagnosis of leukemia cutis.

Adult↗

PubMedDate not supplied

Nuclear grooves in ependymoma. Cytologic study of 21 cases.

OBJECTIVE: To study the efficacy of crush preparation smears in the diagnosis of ependymomas. STUDY DESIGN: The study group consisted of 21 patients aged 7-61 years. All were admitted to Shiraz University hospitals (Nemazi and Beheshti) with intramedullary tumors. Fourteen were ventricular (fourth ventricle), 1 was in the parietal lobe, 5 were in the lumbosacral region and 1 was in the cauda equina. Intraoperative crush preparation smears were obtained from tissue, which was sent for frozen section and diagnosed cytologically. The control group consisted of 123 intracranial tumors (meningiomas, schwannomas, astrocytomas, oligodendrogliomas, medulloblastomas, pituitary adenomas, choroid plexus papilloma, craniopharyngioma and metastatic tumors). RESULTS: The smears in 11 cases revealed perivascular pseudorosettes, and the smears in 21 cases revealed ependymal rosettes. Papillary clusters, calcification and intranuclear inclusions were seen in two cases. Acinar structures were seen in seven cases. Myxomatous material was seen in one case. Nuclear grooves were seen in 15 cases. All cases were diagnosed as ependymomas. Biopsy specimens confirmed the cytologic diagnosis. The tumors in the control group showed no evidence of nuclear grooves. CONCLUSION: Fifteen cases of ependymoma showed a substantial number of nuclear grooves. Intraoperative crush preparation smears were very useful in the diagnosis of ependymomas and helped with the rapid interpretation of frozen sections.

Adolescent↗

PubMedDate not supplied

Osteoclastomalike anaplastic carcinoma of the thyroid gland diagnosed by fine needle aspiration cytology. Report of two cases.

BACKGROUND: Thyroid diseases are common among the female population in Iran; the main one is endemic colloid goiter. Thyromegaly can be due to neoplastic and nonneoplastic disorders. The clinical distinction between benign and malignant tumors of the thyroid gland is sometimes difficult. Fine needle aspiration (FNA) study can be used as a preliminary step for identifying such lesions. CASES: Two female patients aged 54 and 62 years were admitted to Nemazi Hospital, Shiraz, Iran, with the chief complaint of weight loss, rapid enlargement of the thyroid gland for the last few months and pressure symptoms in the neck. Clinically these cases were diagnosed as malignant thyroid lesions. However, for further diagnosis the tumors were aspirated. The smears revealed numerous osteoclastlike giant cells with intranuclear inclusions and numerous, isolated oval to spindle-shaped malignant cells. The smears were diagnosed as osteoclastlike anaplastic carcinoma of the thyroid. CONCLUSION: FNA is useful in the diagnosis of osteoclastomalike anaplastic carcinoma of the thyroid.

Biopsy, Needle↗

PubMedDate not supplied

Kala-azar: liver fine needle aspiration findings in 23 cases presenting with a fever of unknown origin.

OBJECTIVE: To study the role of liver fine needle aspiration (FNA) in the diagnosis of kala-azar with an atypical presentation. STUDY DESIGN: The study group consisted of 23 patients (aged 18-37). All were admitted to Shiraz University Hospitals for the investigation of fever of unknown origin. The immunofluorescent antibody titer for kala-azar was positive (> 1:256 dilution). However, routine abdominal sonography revealed multiple small, hypoechoic lesions in the liver, more suggestive of metastatic tumor or miliary tuberculosis. The lesions were aspirated for cytologic diagnosis. RESULTS: The smears revealed many atypical hepatocytes, groups of epithelioid histiocytes and, in 15 patients, macrophages containing few to many Leishman bodies, allowing a diagnosis of kala-azar. The liver needle biopsy specimens confirmed the cytologic diagnosis of kala-azar and liver cell atypia. The patients were given glucantime therapy, and 21 recovered; 1 patient was lost to follow-up, and 1 died during treatment. CONCLUSION: Liver FNA is a useful procedure for the diagnosis of kala-azar, particularly in cases with atypical clinical presentations.

Adolescent↗

PubMedDate not supplied

Tuberculous orchitis diagnosed by fine needle aspiration cytology.

OBJECTIVE: To study the role of the fine needle aspiration cytology (FNAC) in the diagnosis of testicular lesions. STUDY DESIGN: Seven adult males (55-68 years) presented to the clinic with unilateral enlargement of the testis for the previous few months. Clinically, a malignant tumor was suspected. Fine needle aspiration was performed for rapid diagnosis. RESULTS: The smears revealed many groups of epithelioid histiocytes, giant cells, a few plasma cells and occasional spindle-shaped fibroblasts. Acid-fast stain revealed a few acid-fast bacilli. The cases were diagnosed as tuberculosis and treated with orchiectomy and antituberculous drugs. The patients did well. Histologic sections confirmed the cytologic diagnosis. CONCLUSION: FNAC is useful in the diagnosis of tuberculous orchitis.

Biopsy, Needle↗

PubMedDate not supplied