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Article ; Online: The Milan system for reporting salivary gland cytopathology - Assessment of utility and the risk of malignancy.

Prakash, Annu E / Sukumaran, Renu / Nayak, Nileena / Lakshmi, K / Mathews, Anitha / Kattoor, Jayasree

2023

Abstract: Background: Cytological diagnosis of salivary gland lesions furnishes several challenges to pathologists and clinicians owing to their diverse morphology and varying reporting terminology. The Milan system for reporting salivary gland cytopathology was ... ...

Abstract	Background: Cytological diagnosis of salivary gland lesions furnishes several challenges to pathologists and clinicians owing to their diverse morphology and varying reporting terminology. The Milan system for reporting salivary gland cytopathology was proposed to overcome these defects. The aim of this study was to grade histopathologically diagnosed cases of salivary gland pathology using Milan system and to correlate Milan system with histopathological diagnosis. The study aims to assess the utility of the Milan system and the risk of malignancy in each category. Materials and methods: This is a retrospective study of 4 years duration. All the cases of salivary gland pathology with fine-needle aspiration cytology findings from January 2015 to December 2018 were retrieved and classified according to the Milan system. Histopathology follow-up of these cases were reviewed from the archives, and risk of malignancy was calculated. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated using histopathological diagnosis as the gold standard. Results: Cytology slides of 151 cases were reviewed, and the Milan system was applied. Histopathology follow-up was obtained in 94 cases (attrition rate = 37.74%). The percentage of cases in each category were as follows: nondiagnostic = 9.27%, nonneoplastic = 4.64%, atypia of undetermined significance = 3.97%, benign neoplasm = 23.84%, neoplasm of uncertain malignant potential = 8.61%, suspicious for malignancy = 11.92%, and malignant = 37.75%. Sensitivity, specificity, positive predictive value, and negative predictive value of the Milan system were 94.20%, 96.00%, 98.48%, and 85.71%, respectively. Conclusion: The Milan system has high sensitivity and specificity in comparison with histopathology. This system proves helpful to the pathologist as well as the clinician in achieving uniformity of reporting terminology by classifying salivary gland lesions into subcategories with prognostic relevance.
Language	English
Publishing date	2023-12-29
Publishing country	India
Document type	Journal Article
ZDB-ID	410194-7
ISSN	1998-4774 ; 0019-509X
ISSN (online)	1998-4774
ISSN	0019-509X
DOI	10.4103/ijc.IJC_158_21
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Article: Cytomorphologic Spectrum of Hurthle Cell Lesions of Thyroid: A Study of 54 Cases.

Anila, K R / Nayak, Nileena / George, Preethi Sara / Jayasree, K

The Gulf journal of oncology

2018 Volume 1, Issue 26, Page(s) 6–10

Abstract: Introduction: Lesions of the thyroid gland composed of Hurthle cells constitute a wide spectrum of pathological entities ranging from benign hyperplastic nodules with Hurthle cell metaplasia at one end to malignancies like Hurthle cell carcinomas. The ... ...

Abstract	Introduction: Lesions of the thyroid gland composed of Hurthle cells constitute a wide spectrum of pathological entities ranging from benign hyperplastic nodules with Hurthle cell metaplasia at one end to malignancies like Hurthle cell carcinomas. The cytological distinction of these entities is not only diagnostically challenging but are also critical since they influence treatment decisions. Aim: To critically analyze the cytomorphology of cases of Hurthle cell lesions in FNACs and to characterize cytological features shown to be statistically signific ant in predicting Hurthle cell neoplasm (HCN). Methods: During the period from January 2014 to August 2015, 1667 cases of thyroid FNAs were done at our centre, of which 54cases,showed a predominance of hurthle cells, i.e. more than or equal to 50% hurthle cells (≥=50%).These cases were included in the study and were critically reviewed for 9 cytomorphologic features which included cellularity, architecture, and percentage of Hurthle cells, background colloid, chronic inflammation, nucleoli, intranuclear cytoplasmic inclusions (INCI), nuclear grooves and transgressing blood vessels (TBV). The results were evaluated by using univariate and stepwise logistic regression (SLR) analysis; statistical significance was achieved at P-value < 0.05. Results: Out of the 9 parameters studied, the cytological features shown to be statistically significant in predicting HCN and distinguishing them from benign hurthle cell lesions(BHCLs) were increased cellularity, non-macro follicular architecture, >90% Hurthle cells, absence of background colloid and absence of chronic inflammation.
MeSH term(s)	Adenoma, Oxyphilic/pathology ; Cytodiagnosis/methods ; Humans ; Thyroid Neoplasms/pathology
Language	English
Publishing date	2018-04-02
Publishing country	Kuwait
Document type	Journal Article
ISSN	2078-2101
ISSN	2078-2101
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Article: Role of Rapid On-site Evaluation in CT-guided Fine Needle Aspiration Cytology of Lung Nodules.

Anila, K R / Nayak, Nileena / Venugopal, M / Jayasree, K

Journal of cytology

2018 Volume 35, Issue 4, Page(s) 229–232

Abstract: Objective: To prospectively investigate the value of rapid on-site evaluation (ROSE) in transthoracic fine needle aspiration cytology (FNAC) of patients with pulmonary nodules. Computed tomography (CT)-guided FNA is commonly employed for the diagnosis ... ...

Abstract	Objective: To prospectively investigate the value of rapid on-site evaluation (ROSE) in transthoracic fine needle aspiration cytology (FNAC) of patients with pulmonary nodules. Computed tomography (CT)-guided FNA is commonly employed for the diagnosis of lung lesions and the most common reason for not being able to provide a diagnosis in FNA is inadequacy of samples. Materials and methods: This was a prospective study conducted in the departments of pathology and radiology of our cancer centre. This study had approval from the institutional review board and ethical committee of our institute. Fifty consecutive cases undergoing CT-guided transthoracic FNAC in our centre were included in the study. The smear submitted for ROSE was stained using toluidine blue stain. The specimen adequacy and diagnosis in ROSE was compared with that of the final cytology report, and the concordance regarding adequacy and diagnosis were noted. Results: Smears were adequate in 34 cases (68%) and inadequate in 16 cases (32%) Out of the 16 inadequate cases, 5 (31%) were converted to adequate due to the application of ROSE, thus increasing the adequate number of cases to 39 (78%). A diagnosis of malignancy was made in all 39 adequate cases. Sensitivity of ROSE in determining adequacy was 92% and specificity was 100%. The most common malignancy was adenocarcinoma in 26 cases. Pnemothorax occurred in 2 cases. No significant complications occurred in other cases. Conclusion: CT-guided FNA with ROSE is a safe and useful tool in the diagnostic work-up of lung cancer patients. A multidisciplinary approach along with onsite evaluation of adequacy will increase the diagnostic utility of cytology in lung lesions.
Language	English
Publishing date	2018-10-24
Publishing country	India
Document type	Journal Article
ZDB-ID	645018-0
ISSN	0970-9371
ISSN	0970-9371
DOI	10.4103/JOC.JOC_134_17
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Article: Meningioma presenting as temporal region swelling: Diagnosis by cytopathology and immunohistochemical confirmation on cell block preparation.

Nair, Anila Kunjulekshmi Amma Raveendran / Nayak, Nileena / Kattoor, Jayasree

Journal of cytology

2016 Volume 32, Issue 3, Page(s) 204–206

Abstract: Meningiomas are common intracranial neoplasms. Meningomas are rarely subjected to fine-needle aspiration (FNA) studies. However, intraoperative squash preparations are commonly done. FNA of meningiomas are usually performed incidentally for cases with a ... ...

Abstract	Meningiomas are common intracranial neoplasms. Meningomas are rarely subjected to fine-needle aspiration (FNA) studies. However, intraoperative squash preparations are commonly done. FNA of meningiomas are usually performed incidentally for cases with a clinical suspicion of some other disease such as metastatic carcinoma. We are reporting two cases, which were referred to our center with a diagnosis of metastatic carcinoma on FNA from swelling of the temporal region. We are discussing the characteristic cytomorphological features, which help in diagnosing meningiomas, the common cytological differentials, and the utility of immunohistochemistry (IHC) on cell block preparations in confirming the diagnosis, especially when there is a clinical differential diagnosis.
Language	English
Publishing date	2016-01-05
Publishing country	India
Document type	Case Reports
ZDB-ID	645018-0
ISSN	0970-9371
ISSN	0970-9371
DOI	10.4103/0970-9371.168905
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Article: Cytomorphologic spectrum of lymphocytic thyroiditis and correlation between cytological grading and biochemical parameters.

Anila, K R / Nayak, Nileena / Jayasree, K

Journal of cytology

2016 Volume 33, Issue 3, Page(s) 145–149

Abstract: Introduction: Chronic lymphocytic thyroiditis [Hashimoto thyroiditis (HT)] is a common thyroid lesion diagnosed on fine-needle aspiration cytology (FNAC). Apart from FNAC, various other parameters, such as clinical features, ultrasonographic findings, ... ...

Abstract	Introduction: Chronic lymphocytic thyroiditis [Hashimoto thyroiditis (HT)] is a common thyroid lesion diagnosed on fine-needle aspiration cytology (FNAC). Apart from FNAC, various other parameters, such as clinical features, ultrasonographic findings, antithyroid antibody levels, hormone profiles, and radionuclide thyroid scan, are also taken into consideration in making a diagnosis of HT. Aims: To grade lymphocytic thyroiditis based on the cytomorphology and to correlate the cytological grades with the levels of antithyroid peroxidase antibody (ATPO), antithyroglobulin antibody (ATG), and thyroid stimulating hormone (TSH). Materials and methods: During a period of one and half years, 1,667 cases underwent FNAC of thyroid at our tertiary care center. Of these, 128 cases had cytological evidence of lymphocytic thyroiditis. Out of these, in 60 cases the levels of ATPO, ATG, and TSH were known. The cytological grades of lymphocytic thyroiditis in these cases were correlated with these parameters. Results: Out of the 60 cases, 55 were females. Age ranged from 5 years to 70 years, with majority of patients in third decade. Diffuse enlargement of thyroid was the commonest presentation. However, 14 cases presented with nodular disease. Majority of the patients had grade 1 thyroiditis (27 cases), followed by grade 2 thyroiditis (22 cases). Cytomorphology was diagnostic of thyroiditis in all 60 cases. ATPO was elevated in 57 cases and ATG was elevated in 40 cases. Elevated level of TSH was seen in only 18 cases. In 39 cases, TSH value was normal. There was no correlation between the cytological grades of thyroiditis and the levels of antithyroid antibodies and TSH. Conclusion: Lymphocytic infiltration of thyroid follicles is pathognomonic of lymphocytic thyroiditis. Positivity for antithyroid antibodies is strongly associated with HT but no correlation was observed between the grades of thyroiditis and the levels of ATPO, ATG, and TSH.
Language	English
Publishing date	2016-05-20
Publishing country	India
Document type	Journal Article
ZDB-ID	645018-0
ISSN	0970-9371
ISSN	0970-9371
DOI	10.4103/0970-9371.188055
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Article: Hematolymphoid Neoplasms in Serous Effusions: Morphological Spectrum, Distribution, and Role of Ancillary Techniques—A Retrospective Analysis of 75 cases

Sukumaran, Renu / Nayak, Nileena / Nair, Rekha A. / Kattoor, Jayasree / Jacob, Priya Mary / Narayanan, Geetha / Thankamony, Priyakumari

Indian Journal of Medical and Paediatric Oncology

2021 Volume 42, Issue 05, Page(s) 451–456

Abstract: Introduction: Involvement of body fluids can occur at the time of diagnosis or during the disease course of hematolymphoid neoplasms. Cytodiagnosis of malignant effusion is important in effective clinical management.: Objectives: 1) The aims of the ... ...

Abstract	Introduction: Involvement of body fluids can occur at the time of diagnosis or during the disease course of hematolymphoid neoplasms. Cytodiagnosis of malignant effusion is important in effective clinical management. Objectives: 1) The aims of the study were to determine the frequency of distribution of various hematolymphoid neoplasms involving body fluids, (2) to study the morphology of hematolymphoid neoplasms in fluids, and (3) to assess the role of ancillary techniques in the diagnosis. Materials and Methods: In this retrospective study, all cases of hematolymphoid neoplasms involving body fluids diagnosed from January 2016 to December 2018 were evaluated. Results: During the 3-year period, there were 75 cases of hematological malignancies involving body fluids. These included 48 male patients and 27 female patients. Pleural fluid was involved in majority of cases (56 cases; 74.67%), followed by ascitic fluid (17 cases; 22.67%), and pericardial fluid (2 cases; 2.67%). High cellularity, monotonous population of cells, high nuclear-cytoplasmic (N/C) ratio, indentation/irregularity of nuclear membrane, immature chromatin/irregular clumping of chromatin, increased mitosis, and karyorrhexis were the key features which helped to differentiate between reactive and neoplastic processes. There were 35 cases of B-cell neoplasms, 33 cases of T-cell neoplasms, and seven cases of myeloid neoplasms involving body cavity fluids. T-lymphoblastic lymphoma was the most common subtype (29 cases; 38.7%), followed by diffuse large B-cell lymphoma (DLBCL) (12 cases; 16%). In 53 cases, effusion was present in the initial presentation itself. Initial diagnosis was made in effusion cytology in 25 cases (33.33% of the total), with the help of flow cytometry in 20 cases, and immunohistochemistry (IHC) in cell blocks in five cases. Conclusion: Diagnosis of hematolymphoid neoplasms in body fluids based on correlation with clinical details, critical evaluation of cytology findings, and comparison with previous diagnosis along with the judicious use of ancillary techniques helps in deciding an early treatment plan.
Keywords	Effusion cytology ; hematolymphoid neoplasm ; peritoneal fluid ; pleural fluid
Language	English
Publishing date	2021-10-01
Publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2181724-8
ISSN	0975-2129 ; 0971-5851 ; 0975-2129
ISSN (online)	0975-2129
ISSN	0971-5851 ; 0975-2129
DOI	10.1055/s-0041-1731844
Database	Thieme publisher's database

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Article ; Online: Subcutaneous panniculitis-like T-cell lymphoma: A report of five cases with review of literature.

Nair, Rekha A / Arunkumar, N / Jacob, Priya Mary / Nayak, Nileena

Indian journal of cancer

2015 Volume 52, Issue 4, Page(s) 675–676

MeSH term(s)	Adolescent ; Adult ; Aged ; Female ; Humans ; Lymphoma, T-Cell/diagnosis ; Lymphoma, T-Cell/pathology ; Male ; Middle Aged ; Panniculitis/diagnosis ; Panniculitis/pathology ; Young Adult
Language	English
Publishing date	2015-10
Publishing country	India
Document type	Case Reports ; Letter ; Review
ZDB-ID	410194-7
ISSN	1998-4774 ; 0019-509X
ISSN (online)	1998-4774
ISSN	0019-509X
DOI	10.4103/0019-509X.178416
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Article: Mediastinal hamartoma - A rare presentation.

Balakrishnan, Jayaprakash / Maniyan, Deepu / Nayak, Nileena / Nair, Anila Kunjulekshmi Amma Raveendran

Lung India : official organ of Indian Chest Society

2015 Volume 32, Issue 6, Page(s) 665–666

Language	English
Publishing date	2015-11-30
Publishing country	India
Document type	Journal Article
ZDB-ID	2410801-7
ISSN	0974-598X ; 0970-2113
ISSN (online)	0974-598X
ISSN	0970-2113
DOI	10.4103/0970-2113.168111
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Article ; Online: Solid-pseudopapillary neoplasm of the pancreas: A classical presentation with unique paranuclear dot like immunostaining with CD 99.

Nair Anila, Kunjulekshmi Amma Raveendran / Nayak, Nileena / Muralee, Madhu / Venugopal, Bhaskaran Pillai / Mony, Rari P

Indian journal of pathology & microbiology

2015 Volume 58, Issue 3, Page(s) 365–367

Abstract: A 32-year-old lady presented with a history of abdominal pain and upper abdominal discomfort of 3 months duration. Her imaging studies done at a local hospital showed a solid-cystic mass involving head of the pancreas. The patient was referred to our ... ...

Abstract	A 32-year-old lady presented with a history of abdominal pain and upper abdominal discomfort of 3 months duration. Her imaging studies done at a local hospital showed a solid-cystic mass involving head of the pancreas. The patient was referred to our surgical oncology department. On examination, there was a nontender mass in the epigastrium. An ultrasound scan guided fine-needle aspiration (FNA) was done which was showing classical features of solid-pseudo papillary neoplasm of the pancreas. With this preoperative diagnosis patient was taken up for surgery. Per operatively, there was a solid-cystic mass in the head of the pancreas. Pancreaticoduodenectomy was done. Histopathology and immunohistochemistry (IHC) confirmed the diagnosis of solid-pseudo papillary neoplasm of the pancreas. Apart from the routine IHC panel, CD 99 immunostain was also done which demonstrated the characteristic paranuclear dot-like staining observed in previous studies in the literature.
MeSH term(s)	12E7 Antigen ; Adult ; Antigens, CD/analysis ; Biomarkers, Tumor/analysis ; Biopsy, Fine-Needle ; Carcinoma, Papillary/diagnosis ; Carcinoma, Papillary/pathology ; Carcinoma, Papillary/surgery ; Cell Adhesion Molecules/analysis ; Cytoplasm/chemistry ; Female ; Histocytochemistry ; Humans ; Immunohistochemistry ; Microscopy ; Pancreas/pathology ; Pancreas/surgery ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery ; Vimentin/analysis
Chemical Substances	12E7 Antigen ; Antigens, CD ; Biomarkers, Tumor ; CD99 protein, human ; Cell Adhesion Molecules ; Vimentin
Language	English
Publishing date	2015-07
Publishing country	India
Document type	Case Reports ; Journal Article
ZDB-ID	197621-7
ISSN	0974-5130 ; 0377-4929
ISSN (online)	0974-5130
ISSN	0377-4929
DOI	10.4103/0377-4929.162902
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Article: Pulmonary histoplasmosis mimicking carcinoma lung.

George, Paul / Nayak, Nileena / Anoop, T M / Gopi, Nikhil / Vikram, H P / Sankar, Arun

Lung India : official organ of Indian Chest Society

2015 Volume 32, Issue 6, Page(s) 663–665

Language	English
Publishing date	2015-11-30
Publishing country	India
Document type	Journal Article
ZDB-ID	2410801-7
ISSN	0974-598X ; 0970-2113
ISSN (online)	0974-598X
ISSN	0970-2113
DOI	10.4103/0970-2113.168133
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