Journal of Cytology & Histology

Background: The liver is the site of numerous neoplastic and non-neoplastic lesions, with neoplastic lesions accounting for a prominent cause of morbidity and mortality. Being a common site for metastatic tumors, it becomes imperative to differentiate the same from hepatocellular carcinoma, owing to varied management modalities involved. Diagnosis by fine needle aspiration cytology (FNAC), is considered a prominent investigative procedure in this regard. However, it is not without its limitations and disadvantages.

Aim and Objectives: This retrospective research analyzes the cytological features of hepatic masses, with particular reference to pattern assessment, cellular and nuclear details along with background characteristics of note which could define differentiating characteristics of hepatocellular carcinoma from metastatic malignancy. Accompanying clinico-radiological and biochemical parameters that could be helpful in this regard were also studied. An attempt was also made to distinguish the features characteristic to different grades of hepatocellular carcinoma (HCC).

Method: FNAC of 114 hepatic neoplastic lesions received during a two years period in the pathology department of a tertiary care hospital were retrospectively analyzed. Clinico-radiological and biochemical parameters were correlated, and data thus retrieved was analyzed statistically for relevance. Results: Males were predominantly affected both by primary and metastatic malignancy with primary over 60 years of age. Jaundice, history of prior alcohol consumption, pre-existing liver disease, elevated LFT along with AFP levels >400 ng/ml was seen in significant cases of hepatocellular carcinoma. Radiologically, metastasis showed multiple lesions with most cases less than 5cms in diameter with invasion of adjacent structures. Analysis of three characteristic cytological features including presence of cytoplasmic bile, intranuclear inclusions and traversing blood vessel was carried out and it was observed that the highest chance of tumor being HCC was when all three were seen. After analyzing features to differentiate between the different grades of HCC it was observed that as the grades progressed the cells became undifferentiated and similarities increased. Cytohistological correlation was seen in 91.3% of cases of primary and 86.9% of metastatic malignancies.

Conclusion: Close attention to cytological features like cell clusters, intranuclear inclusions, endothelial rimming in conjunction with radiological images and biochemical markers provide valuable pointers in distinguishing between primary HCC and hepatic metastatic carcinomas thus obviating the need of invasive procedures.

Purpose: Oncocytic cell tumors, due to historical and clinical reasons, tend to be put in a higher risk category compared with other cell type tumors. We tried to define the malignancy risk for this entity.

Methods: At our institution, we studied the risk of malignancy associated with a cohort of 107 thyroid nodules aspirates containing oncocytic cells in the cytology report and we have further analyzed other clinical factors.

Results: A tendency for higher risk of malignancy in male sex was found (31.3% vs. 15.4% in women), the difference, however, was not statistically significant (P = 0.291). Total thyroidectomy was the preferred surgical approach and only 10.3% of patients were submitted to lobectomy. Histopathology reports documented 46.7% hyperplastic/adenomatoid nodules, 31.8% adenomas, 12.1% papillary carcinoma, 3.7% oncocytic cell carcinoma, 2.8% lymphocytic thyroiditis and 1.9% poorly differentiated carcinoma. Benign nodules (Bethesda Class II) exhibited a 9.7% malignancy risk; Class III exhibited a 20% malignancy risk; Class IV exhibited a 18.4% malignancy; Class V exhibited a 16% malignancy risk and Class VI exhibited a 100% malignancy risk. Overall histologic data from the aspirated nodules showed a risk of malignancy of 17.8%.

Conclusion: Our study seems to suggest that in the presence of oncocytic cells there may be a tendency for a higher than expected malignancy rate. Clinical factors appear to be insufficient to base our management decisions with confidence and molecular markers are still under development. Therefore, surgery may stand as the favored option in this setting.

Thyroid nodules (TNs) consider alarming problem among women. Although benign nodules far outnumber cancerous one. The risk of malignancy can be evaluated preoperatively using fine needle aspiration cytology (FNAC) under ultrasonographic guidance is widely used. The Bethesda system for Reporting Thyroid Cytopathology (TBSRTC) was worldwide accepted as standardized approach for cytological interpretation of these nodules. The purposes of this study are to apply and determine the risk of malignancy (ROM) of each standard cytological category of TBSRTC correlating with histopathological examinations and other publications. This study was performed on 1500 patients were complaining of thyroid nodules. All patients underwent for FNAC under ultrasonographic guidance. The obtained materials were diagnosed and categorized according the standard cytological categories of TBSRTC 2017. The cases which were diagnosed C4,C5, and C6 underwent to thyroid surgery, then all the taken specimens were examined and evaluated microscopically. The ROM in FNAC and a correlation with the histopathological findings were done.

Conclusion: Cytological interpretation of thyroid nodules applying the standard categories of the Bethesda system can minimize the risk of over surgical treatment and yielding more accurate approach for patient's management.

Tissues acquired from the bodies of human or animals are transpicuous after tissue processing. Without tissue staining, the individual components of these tissues cannot be seen and appreciated. Haematoxylin extracted from the heartwood of a small tree, Haematoxylin campechlanum (Logwood) alongside synthetic eosin, constitutes the most commonly used Hematoxylin and Eosin staining method in histopathology laboratories. In view of the hazards associated with the use of synthetic stains and the escalating cost of foreign dyes, it has become essential to seek for natural, economic, easy to use, biodegradable, safe (to both human and environmental health) and more eco-friendly alternatives or supplements to the routine Haematoxylin and eosin stains. Thus, the present study is aimed at evaluating the staining potentials of indigenous Hibiscus sabdariffa calyx, Lawsonia inermis leaves and Vitec doniana stem barks on liver and kidney tissue slides. Ethanolic, aqueous, mordant and non mordant sohext extracts of the plant products were substituted for haematoxylin (as primary stains) in the modified haematoxylin and eosin methods. Results revealed that the three plant products imparted various intensities of pink or pale pink colouration on the cytoplasm of the constituent cells without any form of nuclear staining at a concentration of 100mg/ml.Observed acidic nature of all the three plant extracts was probably responsible for their failure to stain the nucleus in keeping with the general staining principle that only basic stains do clour the acidic nucleus. It is recommended that more studies be carried out to provide methods for increasing the pH of the extracts to the alkaline (basic) side of neutrality for effective nuclear staining.

Current studyaimed to evaluate the antiviral activities of free silver nanoparticles (AgNPs) and hydrogen peroxide combined silver nanoparticles(AgNP-H₂O₂) compared to standard IFN-α2a against Herpes simplex virus type-1 (HSV-1), Vesicular stomatitis virus (VSV) and Middle East respiratory syndrome-coronavirus (MERS-CoV). The related biochemical and pathological changes as well asthe expression levels of antiviral biomarkers, namely Mx-A and 2'-5'-oligoadenylate synthetase (2'-5'-OAS)were investigated. Cytotoxicity of AgNPs and AgNP-H₂O₂ was monitored against Vero cellsusing MTT assay. Data revealed that the toxicity was concentration dependent and AgNP-H₂O₂was significantly (P<0.05)toxicthan AgNPs recording an IC₅₀value of 0.864 and7μM/ml, respectively. Oxidative stress markers showed elevated reactive oxygen species and decreased lactate dehydrogenase post treatment with AgNPs and AgNP-H₂O₂ compared to untreated cellcontrol. Assessment of the antiviral activity of tested particles prior to infection showed thatAgNP-H₂O₂exhibited higher reduction in the viralinfectivity titer in the order of 76.21% and 57.89% compared to that recorded post infection (34.11% and 36.84%) against HSV-1 and VSV, respectively. Similar pattern was observed in case of AgNPs but with lower depletion rate while, the highest depletion was in case of IFN-α2a. The percentage reduction in the plaque forming units against MERS-CoV were 33.3%, 66.6% and 87.5% post treatment with AgNPs, AgNP-H₂O₂ and IFN-α2a, respectively.MxA and2'-5'-OAS genes exhibited a signifinat (P<0.05) up-regrulationin. Pathological changes post treatment with tested particles showed signs of apoptosis indicating that although these particles exhibited promising antiviralpotentials, buttheir toxicity profile should be considered.