Frequency of Translocation t(11;22)(q24;q12) Using Fluorescence In Situ Hybridization (FISH) in Histologically and Immunohistochemically Diagnosed Cases of Ewing's Sarcoma.

Introduction Ewing sarcoma (ES) family of tumors is one of the most common groups of malignancies arising in children, adolescents, and young adults. Although characteristic histology with immunohistochemical expression of CD99 and FLI1 after exclusion of other small round blue cell tumors is considered diagnostic of ES, frequency of typical ES translocation, i.e., t(11;22)(q24;q12) is not known in our population. Therefore, in this study, we aimed to evaluate the frequency of this translocation in histologically and immunohistochemically diagnosed cases of ES along with its association with other pathological parameters. Methods A total of 43 morphologically and immunohistochemically diagnosed cases of ES were included in the study. Fluorescence in situ hybridization (FISH) was performed on representative paraffin blocks to identify t(11;22)(q24;q12) translocation. Association with various clinicopathological characteristics was determined. Results Mean age of the patients was 18.23±9.57 years. Bone was the most commonly involved site (22; 51.2%) followed by soft tissue (17; 39.5%) and parenchymal organs (4; 9.3%). A total of 88.4% of cases were found to be FISH-positive for t(11;22)(q24;q12). No significant association of translocation positive cases was noted with tumor size or disease-free survival. Similarly, no significant association of tumor size with disease-free survival was found. Conclusions A significant proportion of cases of histologically diagnosed cases of ES exhibited characteristic t(11;22)(q24;q12). This signifies that histology along with immunohistochemistry is reliable for the diagnosis of this tumor; however, in difficult cases, FISH can be performed to detect characteristic translocation. Moreover, we did not find tumor size to be a significant prognostic indicator of survival in ES.

An Unusual Case of Inflammatory Myofibroblastic Tumor of the Appendix Masquerading as Acute Appendicitis.

Inflammatory myofibroblastic tumor (IMT) is reported virtually in every anatomic location of the body, but most cases are commonly identified in the mesentery and omentum. The etiology of this tumor is unclear with many suggestions of viral, inflammatory, or oncogenic mutational factors that establish it as a clonal neoplasm. Clinical and laboratory workup, including roentgenography, is not usually helpful to reach a pre- or intraoperative diagnosis. Histopathology and immunohistochemistry of the resected specimen provides a definitive answer by the exclusion of a close clinical differential diagnosis of gastrointestinal stromal tumor and many lookalikes. Complete surgical excision with clear margins is the mainstay of treatment. Rare cases have been seen involving the appendix. To the best of our knowledge, only 11 confirmed cases of purely appendiceal IMT have been published in the literature to date.

Expression analysis of cyclooxygenase-2 in patients suffering from esophageal squamous cell carcinoma.

Esophageal squamous cell carcinoma (ESCC) is one of the aggressive malignancies and mechanisms underlying its pathogenesis remain unclear. Cyclooxygenase-2 (COX-2) enzyme system plays a crucial role in many gastrointestinal malignancies and is an important regulator of cell growth, proliferation, apoptosis, differentiation and transformation. More precise outcome of COX-2 in ESCC is less investigated. In this study we investigated the risk factors of ESCC and expression of COX-2 in Carcinoma in situ (CIS) and ESCC compared to normal esophageal mucosa. ESCC relationship to clinico-pathological parameters using immunohistochemistry was also part of this investigation. Current study was conducted in the Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan. A total of 69 diagnosed patients of ESCC, both Pakistanis and Afghans were enrolled. Various risk factors associated with ESCC were recorded. Mean age at the time of diagnosis was 55 years. Out of 69 patients of ESCC 46 (67%) were users of dipping tobacco (Naswar). Expression of COX-2 was determined in normal esophageal mucosa, CIS and invasive ESCC using Immunohistochemistry (IHC). Differences of mean were computed using ANOVA followed by applying Post Hoc test. Patients were categorized as positive with high expression or negative with low to nil expression. ANOVA showed large differences in expression of COX-2 in normal healthy mucosa compared with CIS and ESCC with the mean difference of -9.529 and -7.370 respectively, p-value being <.05 at 95% confidence interval (CI). No significant difference was noticed in the expression of COX-2 in CIS compared with ESCC with p-value >.05 at 95% CI. Our complete cohort (23-85 years) showed statistically significant difference in the expression of COX-2 gene in ESCC and CIS tissue samples compared with normal healthy mucosa. Results of this study indicate that over-expression of COX-2 is positively associated with ESCC.

Antifungal exploitation of fungicides against Fusarium oxysporum f. sp. capsici causing Fusarium wilt of chilli pepper in Pakistan.

The research was conducted to evaluate in-vitro efficacy of numerous fungicides against Fusarium oxysporum f. sp. capsici. In present research, six treatments (T) viz. Carbendazim, Benomyl, Topsin-M, Difenoconazole, Nativo, and Alliete along with control, various concentrations (C), days (D), and their interactions, i.e., (T × C), (T × D), (C × D), and (T × C × D) were exploited in a laboratory through food poison technique. Alliete expressed maximum colony growth (1.93 cm) as compared to all other fungicides with respect to control. Interaction between treatments and concentration (T × C) exhibited maximum colony growth of all treatments (Carbendazim, Benomyl, Topsin-M, Difenoconazole, Nativo, and Alliete), i.e., 0.87, 1.23, 1.73, 2.20, 2.53, and 2.93 cm at 300 ppm as compared to 500 and 700 ppm concentrations, respectively. Similar trend was also observed concerning interaction between (fungicides × days) and (tested concentrations × days). Results of the present study revealed that among tested fungicides, Carbendazim at 700 ppm expressed significant reduction in fungal growth.

Hairy polyp, a clinicopathologic study of four cases.

Hairy polyps (HPs), dermoids or teratoid tumors are rare tumors of naso-oropharyngeal region which commonly present at or shortly after birth. The etiology and classification of these tumors is still debatable and categorized by different authors differently. HPs have female predominance and usually present with respiratory and feeding problems. Microscopically, the polyp is covered by skin with underlying mesenchymal core. The aim of this study is to describe the clinicopathological features of Hairy polyps on a cohort of cases. We reviewed the surgical pathology database of our institution for last 10 years and retrieved four cases of hairy polyps. The age of patients ranged from 1 month to 18 years (mean = 12 years), with a female to male ratio of 1:3. Two of our cases presented at birth and two cases in late teens. Two of the HPs were located in nasopharynx, one on soft and hard palate and one on lower lip. One case was associated with bifurcation of tongue. Size of the polyps ranged from 2.3 to 4.5 cm (mean = 3 cm). Histologically, all HPs were lined by skin and the underlying core consisted of adnexal structures, adipocytes, skeletal muscle, smooth muscle and seromucinous glands. Lymphoid aggregates, cartilage and bone were seen in one case each. Our series highlights the diverse nature of this entity in terms of age of presentation and location. HP at lower lip and associated bifurcation of tongue has not been previously reported. We observed a male predominance in contrast to the published literature. However, number of cases is too few to read a definite conclusion on this point. The etiology is still controversial and includes congenital malformation and activation of pluripotent stem cells.

Tuberculosis verrucosa cutis in a patient with keloid over ear lobule.

Tuberculosis (TB) is a global health problem with predominance in resource-poor countries. Extrapulmonary TB constitutes approximately 10% of the cases and can present as different forms depending on the route of entry. Cutaneous TB is a small subset of the extrapulmonary TB. Cutaneous TB can either be of primary origin or secondary origin or it can be a part of a systemic infection. TB verrucosa cutis (TBVC) is the exogenous reinfection of TB in a previously sensitised patient. Routine cultures do not have a high yield in TBVC due to the paucibacillary nature of the organism. Here we are presenting a rare case of a patient who developed in a keloid over the right ear lobule following ear piercing. This has only been presented once in the previous literature and for the first time in the head and neck region.