Cytomorphological Spectrum of Malignant Melanoma: A 3-Year Study in a Tertiary Care Centre in India.

Background: Melanoma is an aggressive malignant tumor with high metastatic potential. FNAC provides a quick and effective tool to diagnose primary and metastatic melanoma cases. Aims and Objectives: To document the epidemiological features of malignant melanoma cases attending in a tertiary care centre in India, with special reference to different cytomorphological parameters. Materials and Methods: This was a retrospective hospital based study done in the Department of Pathology. 39 cases of malignant melanoma diagnosed on cytology during a period of 3 years were retrieved, reviewed and studied. Results: Out of the 39 cases,21 were males(1.16 male:female ratio). The mean age was 53 years. Metastatic cases were more common than primary melanoma cases. Most common site for metastasis was liver followed by inguinal lymph node. Epitheloid was the most common pattern. Conclusion: Characterstic melanin pigment although common, is not always present. Thus, cytopathologists must know the various cytomorphological spectrum of features of melanoma.

Renal Involvement in Primary Sjogren's Syndrome: A Case Series of Three Cases with Various Clinicopathological Presentations.

Sjogren's syndrome is a prevalent and underdiagnosed systemic disease that primarily affects epithelial tissue. It may affect renal function, either as an epithelial disease causing tubulointerstitial nephritis (TIN) or as an immune complex-mediated glomerulopathy. These lesions may cause a variety of clinical features, both overt and occult. The epithelial disease is mediated by B and T cells. The prevalence of renal involvement in primary Sjogren's syndrome has been reported to range approximately from 10% to 30%. Patients with renal involvement in primary Sjogren's syndrome may have renal manifestations, such as renal tubular acidosis (RTA) Type I, TIN, diabetes insipidus, nephrolithiasis, and Fanconi syndrome. Distal RTA was reported more commonly than proximal RTA, which can present as acute hypokalemic paralysis. We present three cases of primary Sjogren's syndrome with significant renal involvement and various clinicopathological presentations.

Rosai-Dorfman disease presenting as internal jugular vein thrombosis and middle lobe collapse-consolidation.

Rosai-Dorfman disease, also known as sinus histiocytosis with massive lymphadenopathy, is a rare and benign disease that usually presents as massive and painless cervical lymphadenopathy. We are reporting this rare disease with systemic manifestations and causing internal jugular vein thrombosis and middle lobe collapse-consolidation.

Symptomatic Primary Ovarian Leiomyoma in a Postmenopausal Woman: A Rare Entity.

Leiomyomas are benign mesenchymal neoplasms mostly seen in the uterus and are one of the most common pelvic masses seen in women, but primary ovarian leiomyomas are rare among all the benign ovarian tumors, which account only for 0.5%-1%. The definitive diagnosis of such lesions is difficult prior to surgical excision, as there are no pathognomonic symptoms or characteristic imaging findings. Here, we report a case of primary ovarian leiomyoma with brief review of literature, highlighting the differential diagnosis of ovarian spindle cell lesions. The correct diagnosis of an ovarian leiomyoma requires identification of the nature of tumor as smooth muscle. An immunohistochemistry marker analysis is recommended for definitive diagnosis.

A study of detection and comparison of immunofluorescence on formalin-fixed paraffin-embedded tissue with fresh frozen renal biopsy specimen.

Direct immunofluorescence on the fresh frozen tissue is established way of demonstrating of immunoglobulins and complement deposition in renal biopsies. IF studies can be done on paraffin-fixed tissue (IF-P) and give comparable results to those obtained on frozen tissue for most pathogenic immunoglobulins and immunoglobulin fragments; although, the detection of C3c may be more problematic. In our study, we used proteinase-K method for antigen retrieval. We aimed to detect immunoglobulins and complements in formalin-fixed paraffin-embedded (FFPE) tissue sections from renal biopsies and have comparison of IF staining intensity on FFPE sections with conventional IF on fresh frozen tissue. Based on our results, we conclude that IF-P can serve as salvage technique and has significant diagnostic utility.

Histopathological Analysis of Skin Adnexal Tumors: A Three Year Study of 110 Cases at A Tertiary Care Center.

BACKGROUND: Skin adnexal tumors (SAT) encompass wide spectrum of benign and malignant tumors that differentiate toward one or more adnexal structures found in normal skin. Overall incidence of SATs is low yet they can be challenging to diagnose. AIMS: The aim of this study is to study the spectrum and microscopic features of SATs. MATERIALS AND METHODS: It was a retrospective cross-sectional, descriptive study conducted over a period of 3 years. Formalin fixed, paraffin-embedded sections were stained with hematoxylin and eosin for histopathological analysis. RESULTS: Out of the total 34,400 biopsies, 110 cases were diagnosed as SATs comprising 39.09% of tumors with follicular differentiation followed by tumors showing sweat gland differentiation (37.27%), and sebaceous differentiation (23.63%). The age ranged from 5 years to 85 years and male:female ratio was 1.03:1. Most of the tumors were benign (82.73%) while only 17.27% were malignant. Pilomatricoma (28.2%) was the most common benign tumor while sebaceous carcinoma (11.8%) was the most common malignant tumor. CONCLUSION: Architectural features are of great importance in differentiating benign tumors from malignant.

'Hot cross bun' sign in a case of cerebrotendinous xanthomatosis: a rare neuroimaging observation.

We report a 25-year-old young man presenting with cognitive decline, pancerebellar features, spastic quadriparesis, bilateral cataract (operated) and tendo-Achilles swelling (xanthoma). The CT of the head showed bilateral cerebellar hypodensities. There were bilateral cerebellar hypointensities involving dentate nuclei on T1-weighted images with corresponding hyperintensities on T2-weighted MRI. Additionally, an interesting MRI finding-'hot cross bun' appearance was seen in pons which has not been reported in the literature so far. Biopsy from tendo-Achilles confirmed xanthoma. He was treated with chenodeoxycholic acid following which he showed improvement in cognition and weakness.

A comparative and evaluative study of cytological and histological grading system profile in malignant neoplasm of breast--an important prognostic factor.

Breast carcinoma is one of the leading causes of malignancy in females. Diagnosis of breast carcinoma is often made by fine needle aspiration biopsy. Nuclear grading is the most important prognostic factor. It is important to grade the breast carcinoma which will provide valuable information to the treating oncologist to plan the management. The purpose of the study is to compare the cytological grading with histological grading and to assess the prognosis according to the grade. 100 cases of breast carcinoma were graded cytologically by Robinson Grading system and 71 cases were graded histologically by modified Bloom-Richardson system and results of both were compared and statistical correlation was done. In the present study sensitivity and specificity of cytological grading system were 90.77% and 84.42% respectively.