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Background: Touch imprint cytology (TIC) of core needle biopsy specimen is an easy method of rapid on-site evaluation (ROSE) which aids in the rapid diagnosis of breast lumps by cytological analysis. Objective: To evaluate the efficacy of touch imprint cytology in predicting the adequacy of needle core biopsy of breast lumps and its diagnostic accuracy for malignancy. Materials and Methods: This study was done in Burdwan Medical College over a period of two years on 80 patients who had presented with breast lumps and had given consent for core needle biopsy for diagnosis. Results: Out of 80 cases, satisfactory materials on touch imprint were obtained in 79 cases. Only one case did not yield satisfactory material and hence was excluded from the analysis. A total of 43 cases were malignant, and 36 cases were either benign or inflammatory on core needle biopsy. Thirty-seven cases were accurately diagnosed as malignant by TIC, and 35 cases were accurately diagnosed as benign by TIC. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of TIC were 86.05%, 97.22%, 97.37%, and 85.36%, respectively, and the overall accuracy was 90%. Conclusion: TIC of core needle biopsy is a rapid, reliable, and accurate method for early cytological diagnosis of symptomatic breast lesions. It can be used routinely at the site of biopsy to evaluate the adequacy of materials obtained during core needle biopsy and to plan for further workup in case of malignant breast lesions.

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BACKGROUND AND AIMS: Advent of personalised treatment needs correct diagnosis of lung adenocarcinoma with its molecular subtyping. Minimal use of special stain or immunohistochemistry (IHC) in small specimens save material for molecular testing. Various histologic patterns in adenocarcinoma (ADC) subtypes have different prognostic implications and current recommendation is to describe these patterns in small specimens. Aim of this study was to diagnose adenocarcinoma from cytology specimens depending on adenocarcinoma pattern on fine needle aspiration smears and cell blocks. We also studied the additional role of cell blocks as a platform for special stain and IHC. MATERIALS AND METHODS: Conventional smears and cell block (CB) preparation were examined from transthoracic CT guided FNA samples of suspicious lung malignancy cases. Clear defining architectural pattern and cytomorphological features in favour of adenocarcinoma were evaluated and mucin stain and IHC were used as and when required. RESULTS: A total of 86 cases were included in this study, of which 83 cases were diagnosed as adenocarcinoma, 52 (62.5%) showed clear cut evidence of adenocarcinoma from smears and CBs. CB morphology alone aided the diagnosis in 12. Various ADC patterns in combination or alone were appreciated in these 64 cases. Sixteen needed mucin stain and 3 needed IHC for diagnosis. Forty one were ADC with solid pattern of which 39 showed high nuclear grade. CONCLUSION: Adequately cellular FNA smears and corresponding cell blocks of optimal quality can aid effectively in diagnosing adenocarcinoma and appreciating its pattern. Therefore, it would minimize the need for special stain and/or IHC with preservation of more material for molecular testing.

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INTRODUCTION: Guided fine-needle aspiration cytology is a popular investigative procedure in diagnosing pulmonary lesions. The Papanicolaou Society of Cytopathology (PSC) has already outlined a categorical system for reporting respiratory cytology. Though each category has a known malignancy risk, their inter observer reproducibility have not been well documented. This study was directed towards establishing the reproducibility of this categorical system in diagnosing pulmonary lesions. METHOD: One hundred and one consecutive cytology specimens obtained by CT-guided FNA from lung lesions were independently reviewed by 3 experienced cytopathologists, who allotted each case to 1 of 6 PSC categories. Statistical analysis for percent overall agreement was done using Fleiss' Kappa. RESULT: Percent overall agreement was 71.29% and free marginal kappa was 0.66. On combining categories "suspicious" and "malignant" percent overall agreement was 79.54% and free marginal kappa was 0.74. CONCLUSION: There was substantial agreement among the observers as regards reproducibility of categories which can improve if we combine certain categories, especially "suspicious" and "malignant."

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Schwannomas are slow growing, benign, nerve sheath tumours of Schwann cell origin. They predominantly involve head, neck and flexor surfaces of upper and lower extremities, while the chest wall is an uncommon location for schwannomas. Schwannomas may rarely cause erosion of adjacent bone. We are reporting a very rare case of a chest wall schwannoma with destruction of rib which occurred in a 35-year-old female patient, which initially presented as a breast mass and was radiologically misinterpreted as a malignant soft tissue tumour.

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Peeling skin syndrome (PSS) is a rare recessively inherited ichthyosiform genodermatoses characterized by superficial skin peeling. This has 2 subtypes, acral (APSS; OMIM 609796) and generalized form (OMIM 270300). The later has been subdivided into type A (non-inflammatory) and type B (inflammatory). Eight cases of peeling skin syndrome in 4 families were recorded over a period of 5 years. They were diagnosed clinically and confirmed histopathologically. Disease onset ranged from birth to childhood age (mean 5.25 ± 4.528 years) and age at presentation ranged from 7-35 years (mean 23.25 ± 10.471 years). Males outnumbered females (M:F - 5:3). All had non-inflammatory generalized disease of type-A PSS variety, except one who had type-B PSS. Two Muslim families (1 st and 2 nd family, total 5 patients) came from nearby country Bangladesh, and the 2 Hindu families were Indian. Higher severity over acral areas in generalized type, possible autosomal dominant pattern of inheritance and improvement with age as found in this series were new manifestations and possibly unreported previously. The disease was found to be poorly responsive to oral retinoids. Prevalence of the disease may be higher than expected. Importance of mutational analysis was also highlighted.

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A female child developed multiple, progressive, therapy-resistant, painful large ulcers, vesicles, and pustules since her 4 months of age. The ulcers were large, some even measured more than 8 cm; most had violaceous undermined margin with surrounding erythematous halo, raw and crusted surface and were distributed extensively over scalp, face, ear, trunk, buttocks, thigh, legs, dorsum of hands, and feet without any mucosal involvement. After detail clinical examination and investigation, it was diagnosed as a case of pyoderma gangrenosum. Extensive search did not reveal any systemic abnormality or detect any infective etiology. The case highlights the problems of diagnosis of multiple ulcers at very early age.

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A 35 years old female presented with a left inguinal swelling. Histopathological examination with routine haematoxylin and eosin, Van Gieson's and Congo red stains revealed the swelling to be intranodal palisaded myofibroblastoma. Immunohistochemistry was done and the myofibroblastic nature of the tumour cells was proved. Accurate diagnosis of intranodal palisaded myofibroblastoma is important for therapeutic and prognostic reasons. This case is reported here because of its very rare occurrence and the diagnostic dilemma that it possesses.

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Porokeratosis is a disorder of keratinization showing a well-defined lesion with a hyperkeratotic ridge on the border that contains the coronoid lamella. We report familial (autosomal dominant with reduced penetrance) disseminated plaque type (Mibelli's type) porokeratosis in a father and son. In the father, there were multiple horns and a large squamous cell carcinoma in a large lesion over the perianal region that reached up to the squamo-columnar junction of the anal mucosa and even invaded the anal sphincteric muscles. Disseminated lesions of the Mibelli's type, development of horns, and malignancy in this unusual location have not been previously reported.

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