We present a multi center breast fine needle aspiration cytology (FNAC) dataset designed for patch wise classification using C1 to C5 reporting labels. The prospective dataset includes 321 patients and 470 whole-slide images (WSIs) collected from participating tertiary medical centers in India between May 2023 and March 2026. Slides were stained using Papanicolaou (190 WSIs) or MayGrunwald Giemsa (280 WSIs), scanned on a Hamamatsu NanoZoomer S360 at 40X magnification and 0.25 microns per pixel, and stored directly in NDPI format. Across the 470 WSIs, 446 WSIs contain annotated patch regions, yielding 7,398 PNG image patches with expert-verified C1 to C5 labels. The release includes NDPI WSIs, WSI-level GeoJSON annotation files, extracted patch images, deidentified metadata, a data dictionary, a validation summary, a manifest linking WSIs to Zenodo records, and code for dataset inspection and reuse. The complete dataset is approximately 950 GB and is available through Zenodo.

Background: Peritoneal washing (PW) cytology has become a widely accepted procedure for staging of gynecological malignancies. Aims: To compare conventional cytology, liquid-based cytology (LBC) and cell block in the evaluation of PWs. Materials and Methods: A total of 50 clinically suspected cases of gynecological malignancies were enrolled, which included 41 ovarian neoplasms, eight uterine, and one case of cervical malignancy. The age of the women ranged from 13 to 74 years. The PW samples obtained in all cases were subjected to conventional cytology, LBC, and cell block preparations. Immunohistochemistry (IHC) was applied on cell blocks and analyzed. A comparative evaluation and statistical correlation between the three techniques was performed. Results: The number of cases reported as positive for malignancy on conventional smear and LBC were 9 (18%) and 11 (22%), respectively. Fifteen (30%) cases were reported as positive for malignancy on cell block after IHC analysis. All three cytological techniques showed a good correlation in diagnosing peritoneal metastasis on evaluation by Cohen’s kappa score (≤ 1.00). However, the overall sensitivity, specificity, and diagnostic accuracy of PW cytology was 43.8%, 94.4%, and 62%, respectively, taking histopathology as the gold standard. The most common malignancy which led to peritoneal fluid involvement was high-grade serous carcinoma of the ovary. Conclusion: The study demonstrates the usefulness of combining the three cytological techniques to diagnose peritoneal metastasis in gynecological malignancies. Cell block with IHC can help in reducing the false-negative cases and further adds to objectivity in ambiguous cases.

Oral squamous cell carcinoma is a major public health burden, particularly in regions with limited access to specialist pathology services. Oral brush cytology provides a minimally invasive approach for screening and early assessment, but the development of automated analysis methods requires well-annotated, multi-source datasets. We present a multicenter oral cytology dataset collected from tertiary medical centers in India. The dataset includes Papanicolaou- and May-Grünwald-Giemsa-stained whole-slide images, associated patient- and slide-level metadata, high-resolution image patches, and expert-verified nucleus-level annotations in QuPath-compatible GeoJSON format. The annotations support computational tasks including nucleus segmentation, instance segmentation, and cytological category classification. Dataset-level validation checks are provided to document file completeness, metadata consistency, annotation integrity, patch-to-slide linkage, and reuse readiness. The dataset is intended to facilitate development and benchmarking of computational pathology methods for oral cytology analysis.

ObjectivesTo determine the efficacy of quantitative shear wave elastography in differentiating benign and malignant axillary lymph nodes (ALN).MethodsExactly 127 lymph nodes from 127 patients with clinically palpable axillary swelling were examined by both B‐mode sonography and elastography from November 2022 to March 2024. Gray‐scale sonograms were evaluated based on: the short‐axis diameter, shape, hilum, maximum cortical thickness, and border of the ALN. Shear wave elastography determined the mean elasticity modulus (E‐mean) and elasticity ratio (E‐ratio). Fine needle aspiration cytology or histopathological examination was kept as the gold standard and diagnostic performance shear wave elastography was compared.ResultsThe data showed that out of 127 lymph nodes, 77 (60.6%) were benign and 50 (39.4%) were malignant based on pathological results. The E‐mean for malignant lymph nodes (mean, 73.15 kPa) was higher than that for benign lymph nodes (mean, 21.47 kPa; P < .001). The area under the receiver operating characteristic curve for E‐ratio in predicting malignant and benign lymph nodes was 0.897 (95% CI: 0.839–0.955). The E‐ratio for malignant lymph nodes was also higher (mean, 10.2) than for benign nodes (mean, 2.95; P < .001). The area under the receiver operating characteristic curve for E‐ratio in predicting malignant and benign lymph nodes was 0.816 (95% CI: 0.733–0.899).ConclusionOur results showed a significant association between tissue elasticity and pathological correlation.

Oral squamous cell carcinoma OSCC is a major global health burden, particularly in several regions across Asia, Africa, and South America, where it accounts for a significant proportion of cancer cases. Early detection dramatically improves outcomes, with stage I cancers achieving up to 90 percent survival. However, traditional diagnosis based on histopathology has limited accessibility in low-resource settings because it is invasive, resource-intensive, and reliant on expert pathologists. On the other hand, oral cytology of brush biopsy offers a minimally invasive and lower cost alternative, provided that the remaining challenges, inter observer variability and unavailability of expert pathologists can be addressed using artificial intelligence. Development and validation of robust AI solutions requires access to large, labeled, and multi-source datasets to train high capacity models that generalize across domain shifts. We introduce the first large and multicenter oral cytology dataset, comprising annotated slides stained with Papanicolaou(PAP) and May-Grunwald-Giemsa(MGG) protocols, collected from ten tertiary medical centers in India. The dataset is labeled and annotated by expert pathologists for cellular anomaly classification and detection, is designed to advance AI driven diagnostic methods. By filling the gap in publicly available oral cytology datasets, this resource aims to enhance automated detection, reduce diagnostic errors, and improve early OSCC diagnosis in resource-constrained settings, ultimately contributing to reduced mortality and better patient outcomes worldwide.

INTRODUCTION:Extra-pulmonary tuberculosis occurring in the breast is a rarity. The clinical presentation is multifaceted, often mimicking malignancy and pyogenic breast abscess. Fine needle aspiration cytology (FNAC) is an essential component of the triple test in evaluating breast lumps. METHODS:The present study is a retrospective analysis of 18 cases of tubercular mastitis (TM) over two years who underwent FNAC and were found to respond to anti-tubercular therapy on follow-up. Air-dried and alcohol-fixed smears were made and stained with May Grünwald Giemsa and hematoxylin and eosin stains. Special stains: Ziehl Neelsen (ZN), Gram, and periodic-acid Schiff (PAS) were done. In cases where pus was aspirated, material was sent for microbiological culture. For the Mycobacterium culture, Lowenstein-Jensen medium slants were employed. RESULTS:All 18 cases were female in the age range of 13-59 years (mean 29.5 years). The majority were in the age bracket of 21-30 years. Frank pus was aspirated in 9 cases. Based on FNAC characteristics, cases were divided into three groups. Group I included 10, 55.6 % cases with epithelioid cell granulomas without necrosis. Group II had 6, 33.3 % cases showing epithelioid cell granulomas and necrosis, while Group III had 2, 11.1 % cases revealing caseous necrosis without any evidence of granulomas. The correlation of these groups to acid-fast bacilli (AFB) status showed AFB positivity of 100 % in group III, followed by 66.7 % in group II and 20 % in group I. Culture was positive for Mycobacterium tuberculosis in 5 cases. CONCLUSION:FNAC is a preliminary diagnostic modality which avoids unnecessary surgical intervention for tubercular mastitis. Demonstration of epithelioid cell granulomas in breast aspirates, even without AFB positivity in endemic regions for tuberculosis, calls for a therapeutic trial of anti-tubercular therapy.

BACKGROUND:Breast cancer is the most common cancer among women worldwide, with no biomarker validated for reliable early diagnosis. miRNAs have emerged as potential circulating biomarkers for several diseases. miR-27a has shown a multifaceted role in the pathogenesis of breast cancer and may be explored for its diagnostic potential. Similarly, soluble HER-2/neu may reflect the presence of tissue HER2 receptors in breast cancer. METHODS:Ninety-four patients with breast lumps (BIRADS III or above) were enrolled. Diagnosis and grading were confirmed by biopsy. Serum miRNA was extracted, and miR-27a expression was measured via RT-PCR using RNU6 as a control. sHER-2 levels were assessed using ELISA. Statistical analyses included chi-square, Mann-Whitney U, Kruskal-Wallis, and ROC curve analysis. RESULTS:MiR-27a expression was significantly higher in breast cancer patients than those with benign tumours (p < 0.0001), correlating with tumour size, grade, lymph node involvement, and metastasis (p < 0.05). ROC analysis revealed a cut-off >10.31 (AUC 0.971, sensitivity 93.0%, specificity 89.2%). sHER-2 levels were significantly elevated in tissue HER-2 positive breast cancer cases (p < 0.0001). CONCLUSION:MiR27a shows strong potential to be used as a biomarker for breast cancer diagnosis and prognosis. sHER-2 effectively differentiated between the HER-2 status of breast cancer. Larger studies with follow-up are needed for clinical validation.

Rosai Dorfman Destombes disease, also known as sinus histiocytosis with massive lymphadenopathy, is a rare non-neoplastic idiopathic disorder characterised by histiocytic proliferation with evidence of emperipolesis. They present with a varied spectrum of clinical manifestations and cytomorphological features, posing diagnostic challenges and therapeutic dilemmas.

ABSTRACT:The abuse of illicit drugs causes a myriad of systemic complications. Intravenous (IV) injection of such drugs poses various additional threats, primarily due to the use of excipient materials in them. Pulmonary artery embolism with foreign material and granulomatosis may be encountered in the lungs on histopathological examination in such cases. In this study, we aimed to analyze the histopathological findings in lungs in postmortem specimens with suspected IV drug abuse. This was a retrospective study of 5 years in which 15 cases of known or suspected history of drug abuse were assessed. The clinical details were compiled, and the hematoxylin and eosin (H and E)-stained microscopic slides were retrieved from the archives for reviewing the histopathological features in lungs submitted for postmortem analysis. All the cases were male, aged 21 to 36 years (median: 27 years). Gross examination revealed edematous lungs in four cases (26.6%). On microscopic examination of the lungs, all the cases (100%) showed the presence of basophilic irregular structures to rod-like pale crystalline refractile material, which was accompanied by a granulomatous reaction in the lumen of the pulmonary arteries. Four of these cases (26.6%) showed birefringence on polarizing microscopy. The use of illicit drugs is becoming widespread, especially among young individuals. IV drug abuse increases the rate of morbidity and mortality by affecting primarily the pulmonary vasculature, particularly pulmonary arteries. An acquaintance with the various patterns of pulmonary involvement in IV drug abuse is essential to arrive at an accurate pathological diagnosis and provide a possible cause of death in such cases.

AIM:To evaluate thyroid nodules with sonoelastography and magnetic resonance imaging (MRI). MATERIALS AND METHODS:The study included 28 patients with 40 thyroid nodules. Clearance was obtained from the institute's ethical clearance committee. Patients with pure cystic nodules or nodules with eggshell calcification, diffuse thyroid pathology (such as Graves' disease, Hashimoto's thyroiditis, De Quervain thyroiditis, and Riedel's thyroiditis), inaccessible nodules via fine needle aspiration cytology (FNAC), or patients with a history of thyroid gland surgery were excluded from the study. Strain elastography was performed on a Phillips iU22 machine, producing qualitative color-coded strain maps (graded using the Rago 5-point system) and semiquantitative strain ratios. MRI was performed on a Phillips ACHIEVA 1.5T magnet with a head and neck coil. RESULTS:Rago scores statistically correlated (χ2 = 18.052, p < 0.001) with malignant nodules, and using the receiver operating characteristic (ROC) curve, the area under the ROC curve (AUROC) for the mean strain ratio predicting malignant outcomes was 0.88 [95% confidence interval (CI): 0.767-0.992], which was also statistically significant (p < 0.001). A cutoff of mean strain ratio ≥2.48 predicted malignant outcomes with 100% specificity. T2 signal intensity ratio (SIR) and apparent diffusion coefficient (ADC) values were not statistically significant in predicting malignant outcomes. Kinetic curves were statistically significant for Rago scores (χ2 = 11.356, p = 0.045); however, no significant difference was found in predicting malignant outcomes. CONCLUSION AND CLINICAL SIGNIFICANCE:We concluded that sonoelastography, along with grayscale ultrasound, is a useful noninvasive technique for predicting histological outcomes. However, MRI should largely be reserved as a problem-solving tool rather than a standalone imaging modality. The kinetic curves show some degree of overlap between histologically distinct diseases, and thus large-scale multicenter trials are needed for further standardization.

Background:Skin malignancies are the most common form of malignant disease in the western world, predominantly affecting older age groups. The majority of skin cancers are basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma, which account for more than 95% of total skin malignancies. However, in India, these constitute only 1-2% of all cancers. There is an increase in incidence in India over 10 years of period. There is scarcity of data on the clinico-pathological profile of these tumours from this geographical region. Materials and Methods:This was a retrospective study conducted in a tertiary care teaching hospital in which archival records and histopathology sections of all patients of skin carcinomas diagnosed over a period of 5 years (January 2016 to December 2020) were analysed. The clinical parameters and histopathological features of the cases were analysed and correlated for any possible association. Results:Out of the 230 skin malignancies studied, SCC constituted the most common type (n = 148), followed by BCC (n = 70) and malignant melanoma (n = 12). The tumour commonly presented in the 6th decade of life with slightly higher male preponderance (M: F =1.6:1). Sun-exposed areas were the most common sites, and the common presentations included non-healing ulcer, fungating/cauliflower/polypoidal growth, and hyperpigmented or nodular plaque. In SCC, previous history of diabetes and burns was noted in 10% and 3.4% of the patients, respectively. Conclusion:SCC is likely the most common histological type of skin malignancies in India. The clinico-pathological profile of skin malignancies of patients depends on multiple factors, notably the skin colour and the geographical location.

BACKGROUND:Hodgkin lymphoma (HL) is a hematopoietic neoplasm characterized by malignant Reed-Sternberg (RS) cells in an inflammatory background. Although the cytological features of HL are well elucidated in literature, yet many postulated factors cause its misdiagnosis. This study aims to assess the diagnostic reliability of fine needle aspiration cytology (FNAC) in HL and evaluate the factors contributing to a false-negative and false-positive diagnosis, taking histopathology as the gold standard. METHODS:This was a retrospective study in which 47 cases of HL diagnosed on histopathology were compared with their prior cytological diagnosis. RESULTS:The patient's age ranged from 3 to 80 years (median: 36 years) with a M:F ratio of 2.9:1. Lymph node aspirations were performed from multiple anatomical sites, out of which the cervical was the most common (57.8%). FNAC was inconclusive in two cases due to unsatisfactory smears. The false-negative diagnosis of reactive lymphadenitis was given in four cases, and false-positive in four cases, which included three cases of non-HL, and one case of malignant small round blue cell tumor. The overall diagnostic accuracy of FNAC in the diagnosis of HL was 82.2%. CONCLUSIONS:The cytological diagnosis of HL can be challenging when classic RS cells are absent. Contributing factors for a false-negative diagnosis include obscuring reactive inflammatory cells, fibrosis of the involved lymph nodes, partial involvement of the lymph node, and misinterpretation. A thorough clinical examination with evaluation of FNAC smears from multiple areas, and ancillary tests help improve the diagnostic accuracy of cytological diagnosis.

Fibromatosis colli of infancy, a benign spindle cell lesion originating from sternocleidomastoid muscle, can be diagnosed under appropriate clinical settings, aided by radiological and cytological findings. If diagnosed early, unnecessary surgical interventions could be avoided.

Cribriform adenocarcinoma of the salivary gland is a rare infiltrative tumour with a dearth of literature explaining the cytomorphology. There is no case reported in the tonsil on fine needle aspiration cytology. It can be differentiated from other salivary gland malignancies on the basis of pattern recognition and molecular analysis of cell blocks.

Background: Malignancy of the breast is one of the most common cancers among females worldwide. Magnetic resonance mammography (MRM) is a valuable complement to conventional methods for the early diagnosis of disease, thereby providing patients with a better prognosis. The number of unnecessary biopsies and repeated excisions in cases of indeterminate breast lesions detected on conventional imaging is high. Aims: The purpose of this study was to evaluate the role of MRM in the evaluation of indeterminate breast lesions [Breast Imaging Reporting and Data System (BIRADS) 3/4] found in conventional mammography and ultrasonography (USG), taking the histopathological examination (HPE) as the gold standard. Materials and methods: A total of 38 patients with conventional radiological imaging diagnosis of indeterminate breast lesions (BIRADS 3/4) were included in this study and evaluated using contrast-enhanced MRM according to the MR-BIRADS lexicon (5th edition). Morphological characteristics of lesions were evaluated to determine the probability of malignancy. Histopathology was kept as the gold standard for comparing all the statistical parameters. Results: There were a total of 40 lesions, 35 masses, and five nonmass enhancement (NME) available for evaluation out of the 38 patients. The sensitivity of margins to detect malignancy approached 100%; however, it had a slightly lower specificity of 66.67%. Magnetic resonance imaging (MRI) showed good diagnostic performance with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 85, 90, 89.47, 85.71, and 87.50%, respectively. Conclusion: The MRI has been shown to be useful as a problem-solving tool in breast cancer screening, clarifying indeterminate findings and avoiding unnecessary short follow-ups and percutaneous biopsies. How to cite this article: Mishra E, Kaur N, Kaur R, et al. Role of Magnetic Resonance Mammography in the Evaluation of Indeterminate Breast Lesions. J Assoc Physicians India 2023;71(11):76-84.

BACKGROUND:Malignancy in pleural effusion is an indication of poor prognosis. The distinction between malignant cells and reactive mesothelial cells in effusion cytology is sometimes difficult and requires ancillary techniques. Evaluation of morphological indicators of chromosomal instability (CI) like micronuclei (MN), chromatin bridging (CB), nuclear budding (NB), and multipolar mitosis (MM) on routine cytology smears is a promising tool to distinguish malignant from benign ascitic fluids. However, it has been scarcely evaluated in pleural effusions. The present study was conducted to evaluate the diagnostic value of these markers in differentiating between malignant and benign pleural fluids.METHODS:It is a cross sectional study in which a total of 72 pleural fluid samples over a period of 2 years received in the cytology department of the hospital were evaluated. The cytological analysis was done by two independent cytopathologists and interpreted as either malignant or benign. Four morphological markers of CI were counted in the May-Grünwald Giemsa (MGG) stained smears of all the cases and the score was compared with the conventional cyto-morphological diagnosis.RESULTS:Out of 72 cases, there were 42 malignant and 30 benign effusions on cytological examination. The mean score of micronuclei count, nuclear budding, chromatin bridging and multipolar mitosis in malignant effusions were 7.26 ± 2.74, 9.55 ± 5.53, 1.83 ± 1.17, and 2.21 ± 1.62 respectively that was significantly higher than the benign effusions (1 ± 0.71, 1.1 ± 0.86, 0.38 ± 0.50, and 0.15 ± 0.37 respectively) (p < .05). On Receiver operating characteristic (ROC) curve analysis, a cut-off of 5 for the MN count had a sensitivity of 88% and specificity of 100% in detecting malignant pleural effusion [Area under curve (AUC) 95.8%, p < .001].CONCLUSION:Evaluation of morphological indicators of CI on routine MGG stained smears is a simple and cost-effective method to differentiate between benign and malignant pleural fluids.

PURPOSE:Brachytherapy is the gold-standard treatment for choroidal melanoma. This study evaluated iodine-125 brachytherapy by using Ocuprosta seeds with indigenous non-collimated plaques in Asian patients. METHODS:Retrospective single-center study in a tertiary care hospital of 12 eyes with choroidal melanoma in 12 Asian patients who underwent brachytherapy with Ocuprosta seeds fixed on non-collimated plaques and had a follow-up of at least 32 months (mean: 42.4 ± 9.5 months; median: 40 months). Radiotherapy was planned after developing the digital 3D model of the tumor within the eye by using radiological images and clinical pictures. Ocuprosta iodine-125 seeds were used on indigenous non-collimated gold plaques to deliver the radiation for precalculated time. "Successful outcome" was taken as a decrease in the volume of the tumor, and "unsuccessful outcome" was defined as no change in the tumor volume or increase in the tumor volume at 24 months after brachytherapy. RESULTS:The mean decrease in tumor volume was 21% (914.5 ± 912.2 mm3 to 495.7 ± 633.6 mm3) after brachytherapy, which correlated with the baseline volume of the tumor. Ten eyes (83.3%) showed a reduction in tumor volume, whereas two eyes showed an increase in the volume of the tumor after brachytherapy. One of the cases with a reduction in tumor size developed neovascular glaucoma. Enucleation was done in three eyes. A globe salvage rate of 75% and tumor regression rate of 83% were seen in the present study using Ocuprosta seeds. CONCLUSIONS:Iodine-125 brachytherapy with uncollimated indigenous gold plaques is an effective treatment modality for choroidal melanomas in Asian patients.

Context: The conventional smears (CS) and Liquid based cytology (LBC) are important tools to detect carcinoma cervix and its precursor lesions. Aims: The present study was done to compare the cytomorphological features of cervical lesions using both techniques and compare with the histopathological diagnosis. Settings and Design: This was a prospective observational study over a period of 1.5 years at a tertiary care hospital. Methods and Material: A total of 969 women in the age group of 21–65 years presenting with either routine screening or complaints of vaginal bleeding, discharge, or pelvic pain were enrolled for the study. Both the CS and LBC smears were analyzed and compared with the corresponding histopathology diagnosis. The data was analyzed using Statistical Package for the Social Sciences (SPSS) software and P values <0.05 were considered significant. Results: There were 8.57% unsatisfactory smears in CS as compared to 0.5% in LBC smears. Liquid-based cytology was superior to conventional preparations in terms of smear adequacy, lesser hemorrhagic and inflammatory background, and presence of more endocervical cells. Liquid-based cytology showed a better yield in detecting all the types of epithelial cell lesions with a concordance rate of 73.9% between the two techniques. On histopathology correlation of these lesions, LBC had a higher sensitivity (96.67%) and diagnostic accuracy (99.08%) as compared to CS (73.33% and 92.66%, respectively). Conclusions: Liquid-based cytology is superior to conventional cytology for the detection of epithelial cell lesions. Reduction in the unsatisfactory smears, a cleaner background, and better representation of the sample are more significantly appreciated on LBC in contrast to CS.