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Cytology of serous effusions is an indispensable diagnostic tool for the diagnosis of non-neoplastic as well as neoplastic effusions, aiding in the categorisation, staging, and prognostication of the patient. This study focuses on reclassifying the reported cases of peritoneal fluid cytology by employing the TIS, highlighting various challenges encountered and adding to the body of data regarding the ROM, focussing on peritoneal effusions due to gynaecological causes.Peritoneal effusion samples were retrieved from the archives of our department and reclassified according to the TIS. The ROM for each category was calculated based on available surgical follow-up.A total of 818 peritoneal effusions were studied. Following the definitions and guidelines for reporting in the TIS, the cases were reclassified into five categories. 125(15.2%) were put into the category of non-diagnostic (ND), 595(72.7%) as negative for malignancy (NFM), 26( 3.2%) as atypia of undetermined significance (AUS), SFM included 12 cases (1.5%) and 60 cases (7.3%) as malignant. The respective ROM values for each category were 16.9%, 12.1%, 50%, 80%, and 100% respectively. By considering MAL group and SFM group as positive groups, ND, NFM, and AUS as negative groups, the diagnostic accuracy, sensitivity, specificity, positive and negative predictive values were determined to be, 85.2%, 36.7%, 99.1%, 91.7%, and 84.5% respectively.Peritoneal cytology categorisation as per the proposed TIS offered a practical approach for categorisation of the fluids received. The ROMs reported in our study were mostly concordant with those published according to the TIS.

Fine-needle aspiration cytology (FNAC) forms one of the first-line investigations in the evaluation of tumors in modern era. Its role in diagnosing soft tissue tumors (STT) has been well established. However, the morphological overlap and biological heterogeneity of STT pose a morphological diagnostic challenge.To evaluate the scope of FNAC in diagnosis and categorization of STT and to correlate the cytological features with histological findings wherever available, and to analyze the reasons for discordance, if any.All FNAs of cytologically diagnosed STT during 5-year period were retrospectively analyzed. FNAC smears stained using May-Grünwald Giemsa, Pap- and hematoxylin and eosin, were evaluated and interpreted inconjunction with clinical details. Cellblock and immunocytochemistry (ICC) was done, wherever required to render the final diagnosis.Of the total 15,844 FNAC done in 5 years, 1319 (8.3%) cases were diagnosed as STT. Benign tumors comprised the majority (94.2%), whereas 5.8% were diagnosed to be malignant. These were further grouped according to the cytomorphological features into adipocytic (82.2%), benign spindle cell lesions (10.8%), vascular (1.4%), spindle cell sarcoma/sarcoma NOS (2.2%), myxoid (0.3%), round cell tumors (0.9%), metastatic tumors (1.9%), and others (0.3%). The cytological findings were corelated with histopathological findings, which were available in 316 cases. The specificity and sensitivity calculated for detecting malignancy was 99.2% and 95.4%, respectively. The overall diagnostic accuracy for diagnosing malignancy was 98.7%. Among the group of non-adipocytic tumors, the sensitivity, specificity, PPV, NPV calculated for diagnosing a malignant tumor (irrespective of exact sub-categorization) is 95.2%, 100%, 100%, and 96.4%, respectively. The overall diagnostic accuracy in non-adipocytic tumors is 97.92%.FNAC is a simple, cost effective, and minimally invasive method in diagnosing STT with good sensitivity and specificity. It is of utility not only in primary lesions, but also for metastatic tumors, and for the documentation of locally recurrent soft tissue neoplasms.

Amyloidosis is a well-recognized entity, that can present as a systemic disease, or, uncommonly, as a localized mass. We report here, a rare presentation of amyloidosis presenting as a supraclavicular swelling, diagnosed on fine-needle aspiration cytology. Subsequent bone marrow examination led to the diagnosis of multiple myeloma. This case highlights the need to be aware of cytological characteristics of amyloidosis, which can have unusual presentation posing a diagnostic dilemma.