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V Kannan

Publications and source records attributed to V Kannan.

64 records · Page 4Linked to original sources

Prostatic aspirates. A cytomorphologic analysis with emphasis on well-differentiated carcinoma.

In this retrospective evaluation of 72 cases of fine needle aspiration biopsy of the prostate, 25 aspirates from well-differentiated carcinoma were compared with 27 aspirates from benign prostatic enlargement and 20 aspirates from moderately to poorly differentiated carcinoma. Each case was examined by a single observer (V.K.) for multiple parameters including cellularity, dyshesion, nuclear membrane irregularity, anisonucleosis, macronucleoli (major criteria of malignancy), cell and nuclear enlargement, and altered nuclear/cytoplasmic ratio. Cellularity was the most significant indicator, but all major and minor criteria of malignancy were consistently important for distinguishing well-differentiated carcinoma from benign lesions. Systematic use of these meaningful standards enhances diagnostic sensitivity.

Biopsy, Needle↗

Appraisal and cytomorphologic analysis of common carcinomas of the breast.

This work is based on 15 years experience with more than 9000 needle aspiration biopsies from the breast performed by a number of clinicians without syringe guns. From 1981 through 1983, 329 carcinomas were detected with a sensitivity of 90%. A positive or suspicious report was issued in 17 of the 32 minimal carcinomas. There were no false-positive diagnoses. A retrospective comparative study was made on the aspiration biopsy cytology specimens from 65 histologically verified carcinomas: 30 infiltrating ductal, 16 infiltrating lobular, 10 medullary, and 10 colloid carcinomas. Parameters included the pattern, major malignant criteria, and cell measurements by calibrated ocular micrometry. The classic features of each carcinoma and the differential cytomorphology are described.

Adenocarcinoma, Mucinous↗

ASCUS, mature metaplastic type. Cytologic diagnosis and follow-up.

OBJECTIVE: To study the cytologic criteria for follow-up of mature metaplastic cells within the atypical squamous cells of undetermined significance (ASCUS) category. STUDY DESIGN: Squamous epithelial abnormalities between January 1994 and June 1997 at our institution totaled 2,632 and included squamous carcinoma (1), high grade squamous intraepithelial lesions (278), low grade squamous intraepithelial lesions (875) and ASCUS (1,478). From the ASCUS group, 134 (9.06%) were metaplastic; 89 were selected for review. Criteria for case selection were follow-up with tissue biopsy or at least two Pap smears and no previous epithelial abnormality. Patients ranged from 27 to 70 years of age. Parameters tabulated included number of abnormal cells per slide, their architecture, cell size, shape, cytoplasmic hue and texture, nuclear size and contour, chromatin pattern and nucleoli. Additionally, specimens were reviewed for hormonal status and inflammation. The findings were correlated with follow-up data. RESULTS: Cells generally appeared single or in loose, monolayered sheets of three to seven cells per group. The cells were well demarcated, polygonal or oval and ranged from 11 to 30 microns with cyanophilic or eosinophilic thickened cytoplasm. The round to oval nuclei with slight irregularity showed a minimally increased nuclear/cytoplasmic ratio with stippled chromatin. Upon review, 69 smears were confirmed as ASCUS-M. Follow-up revealed 42 with benign findings, 9 with persistent ASCUS/ASCUS-M and 18 with low grade squamous intraepithelial lesions. CONCLUSION: In mature metaplastic cells with minimal atypia in patients with no previous or concurrent dysplasia, the follow-up details were similar to those described for ASCUS-superficial/immediate squamous cells. These patients could be followed conservatively.

Adult↗

Diagnostic pitfalls in fine needle aspiration cytology of pleomorphic lipoma. A case report.

BACKGROUND: Pleomorphic lipoma is an unusual pseudosarcomatous condition with characteristic morphology. Despite its pleomorphic appearance, it follows a benign course and does not recur or metastasize if completely excised. CASE: A 66-year-old man presented with swelling in the back of the neck of approximately six months' duration. The focally cellular aspirate revealed round to oval, hyperchromatic cells, rare multinucleated cells and fragments of mature adipose tissue. On initial evaluation, the smear pattern suggested a malignant neoplasm. However, upon review of the cytologic material along with histology, the characteristic pattern, including floret cells, was recognized. CONCLUSION: The rarity of pleomorphic lipoma and the atypical cellular features of the aspirate can cause difficulty in diagnosing this entity. Awareness of this rare but not-uncommon entity, along with clinical correlation, is crucial in arriving at the correct diagnosis.

Aged↗

Calculus artifact. A challenge in urinary cytology.

OBJECTIVE: To retrospectively review calculus artifact and compare it with instrument artifact and papillary transitional cell carcinoma (TCC). STUDY DESIGN: Voided urine specimens from patients with calculi (65), TCC (low grade, 10, high grade, 34) and history of prior instrumentation (12) were studied. RESULTS: Nineteen specimens of calculus artifact had unremarkable cytology. Forty-six specimens had abnormal single cells or papillary clusters and cell balls or a mixture of both. The papillary groups had smooth as well as irregular borders, a cytoplasmic collar and cells with occasional cytoplasmic vacuoles, slightly increased nuclear/cytoplasmic (N/C) ratio and inconspicuous nucleoli. Squamous preponderance and birefringent crystals were seen. In instrumentation artifact, papillary clusters or three-dimensional cell balls had smooth borders, cytoplasmic collars, an occasional cytoplasmic vacuole, normal N/C ratio, regular nuclear membrane and finely granular nuclear chromatin. In TCC, papillary clusters with loss of polarity and irregular borders were present in both grades but were predominant in low grade TCC. No cytoplasmic collar was noted. In high grade TCC, single cells and nuclear alterations were more pronounced, with increased N/C ratio, hyperchromasia, coarse chromatin, irregular nuclear envelopes, prominent nucleoli and rare mitosis. CONCLUSION: Calculus artifact can produce papillary clusters masquerading as papillary TCC. Unlike instrument artifact, there may be significant nuclear atypia, which could be reversible. To avoid diagnostic pitfalls, further investigation is suggested after removal of calculus.

Artifacts↗

Low grade transitional cell carcinoma and instrument artifact. A challenge in urinary cytology.

This was a retrospective study of 46 cases of urine specimens to distinguish low grade transitional cell carcinoma (TCC) and instrument artifact. The cytomorphologic features of 46 urinary specimens showing papillary fragments were studied. Urine from TCC showed papillary and irregular groups of cells with ragged borders and subtle nuclear changes. Urine after instrumentation showed cellular specimens with cohesive, ball-shaped and papillary clusters with smooth borders lined with a denser-staining cytoplasmic collar. The evenness of the border and presence of the cytoplasmic collar were distinguishing features of instrument artifact.

Artifacts↗