Intraoperative pathology consultation is often required for guiding immediate surgical decisions so as to limit the extent of surgery. Accurate intraoperative diagnosis is crucial. The present study evaluates the accuracy of imprint cytology and frozen section in intraoperative consultation for tumor and tumor margins. A total of 157 tissue specimens for type of lesion, tumor margins and lymphnode metastasis were included. Imprint was taken by holding the tissue bit with forceps and touching it onto a clean glass slide without undue pressure or lateral movements. They were stained with Papanicolaou, May-Grunwald Giemsa and Hematoxylin and Eosin [H&E] stains. The tissue bits taken were then embedded and frozen. Section cutting was done using cryostat and were stained using rapid Haematoxylin and Eosin stain, and examined under a light microscope. Later, the tissue was fixed in 10% neutral buffered formalin for routine histopathological processing then stained with H&E stain. Based on the histological diagnosis, the accuracy of intraoperative imprint cytology and frozen section were evaluated. A total of 157 tissue specimens were received during the study period, which were classified into specimens for type of tumor [145 specimens], tumor margins [54 specimens] and lymph node metastasis [7 specimens] for analysis. The overall diagnostic accuracy of imprint cytology in detection of type of tumor was 97.9% and that of frozen section was 98.6%. It can be concluded that imprint cytology typically provides the accurate diagnosis without the need for a sophisticated machine such as cryostat which is required for frozen section analysis.

Uterine leiomyosarcoma is a rare uterine malignancy that arises from the smooth muscle of uterine wall. Presenting symptoms may be vague and mimic other benign uterine conditions. They are notoriously aggressive with poor prognosis. We report a case of a 35-year-old female, who presented with abdominal distension with pain and vomiting. A non-tender mass measuring 14X12 cms was felt on palpation in the same region. CT scan revealed a large, relatively well defined, hypodense pelvic mass in retro-uterine pouch. Patient underwent exploratory laparotomy with primary resection of tumour with pan-hysterectomy with pelvic lymph node resection. Histopathologically, it was diagnosed as pleomorphic sarcoma probably leiomyosarcoma of uterus which showed immunostain Smooth Muscle Antigen (SMA) positive and Epithelial Membrane Antigen (EMA) negative. It was Estrogen Receptor(ER) negative. The rarity as well as pathological diversity makes this study beneficial and this definitive reporting will be helpful in diagnosis of smooth muscle tumours with challenging histologic features.

Primary adenoid cystic carcinoma of cervix is a rare entity. Co-existence of adenoid cystic carcinoma with squamous cell carcinoma is even more rare. Here we present the case of an 85 year old postmenopausal lady who presented with on and off vaginal bleeding and was found to have a hard cervical mass. Hysterectomy with bilateral salpingo-oophorectomy was done and histopathological evaluation revealed coexisting solid variant of adenoid cystic carcinoma and squamous cell carcinoma. High grade squamous intraepithelial lesion was seen adjacent to invasive squamous cell carcinoma. Adenoid cystic carcinoma was positive for CD117 and squamous cell carcinoma was positive for p63. Both the components were also immunoreactive for p16.

Atypical meningioma is often treated adequately by complete surgical resection and subsequent radiation therapy. Nevertheless, radiation therapy should be reassessed in the management of younger patients and particularly in individuals harboring NF2 genetic mutation. To the best of our knowledge this is the third case of post radiation transformation of atypical meningioma in an adolescent male after reviewing the available English literature. Kew wards: Post radiation, atypical meningioma, transformation, sarcomatous meningioma, NF2 mutation.