Non-neoplastic Lesions among Lateral Neck Mass Specimens in a Tertiary Care Center: A Descriptive Cross-sectional Study.

INTRODUCTION: Lateral neck masses present clinically as neoplastic or non-neoplastic lesions of lymph nodes, salivary glands, and thyroid. Non-neoplastic lesions, if evaluated timely, may not transform into malignancy thus reducing clinical burden. A cytomorphological study using fine needle aspiration is a reliable method for the diagnosis of such masses. The aim of this study was to find out the prevalence of non-neoplastic lesions of lateral neck mass specimens received in the Department of Pathology in a tertiary care center. METHODS: This descriptive cross-sectional study was carried out in the Department of Pathology among lateral neck mass specimens of a tertiary care center from January 2019 to December 2020 after obtaining ethical approval from the Institutional Review Committee (Reference no: 155/19). A convenience sampling method was used and data analysis was done in Microsoft Excel 2019. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Out of 300 lateral neck mass specimens, non-neoplastic lesions were found in 246 (82%) (77.7-86.3 at 95% Confidence Interval). The involvement of lymph nodes in 117 (47.6%) was the most common finding followed by thyroid 112 (45.5%). Among non-neoplastic lesions, the cytomorphological features of benign nodular goiter 93 (37.8%) was the most common lesion followed by reactive lymphoid hyperplasia 73 (29.7%). CONCLUSIONS: The study showed that the prevalence of non-neoplastic lesions was similar to that of other national and international studies.

The histone methyltransferase G9a: a new therapeutic target in biliary tract cancer.

The histone methyltransferase G9a (EHMT2) is a key enzyme for dimethylation of lysine 9 at histone 3 (H3K9me2), a suppressive epigenetic mark. G9a is over-expressed in tumor cells and contributes to cancer aggressiveness. Biliary tract cancer (BTC) is a rare cancer with dismal prognosis due to a lack of effective therapies. Currently, there are no data on the role of G9a in BTC carcinogenesis. We analyzed G9a expression in n=68 BTC patient specimens and correlated the data with clinicopathological and survival data. Moreover, we measured G9a expression in a panel of BTC cell lines and evaluated the cytotoxic effect of G9a inhibition in BTC cells using established small-molecule G9a inhibitors. G9a was considerably expressed in about half of BTC cases and was significantly associated with grading and tumor size. Additionally, we observed significant differences of G9a expression between growth type and tumor localization groups. G9a expression diametrically correlated with Vimentin (positive) and E-Cadherin (negative) expression. Importantly, survival analysis revealed G9a as a significant prognostic factor of poor survival in patients with BTC. In BTC cells, G9a and H3K9me2 were detectable in a cell line-dependent manner on mRNA and/or protein level, respectively. Treatment of BTC cells with established small-molecule G9a inhibitors resulted in reduction of cell viability as well as reduced G9a and H3K9me2 protein levels. The present study strongly suggests that G9a contributes to BTC carcinogenesis and may represent a potential prognostic factor as well as a therapeutic target.

Comparative study on a homemade rapid urease test with gastric biopsy for diagnosis of Helicobacter pylori infection.

The main objective of this study was to determine whether a homemade rapid urease test was reliable when compared to histology in the diagnosis of Helicobacter pylori infection. Endoscopic antral biopsies from 15th August 2004 to 15th July 2005 were studied prospectively. Rapid urease test and histological examination were done on all specimens. Among 160 biopsies, 56 cases showed H. pylori in histological section and 59 cases were rapid urease test positive. Among 56 H. pylori infected patients, the sensitivity, specificity, positive and negative predictive values, percentage of false positive, and percentage of false negative values of rapid urease test were 96.4%, 95.2%, 91.5%, 98.0%, 4.8% and 3.5% respectively. Rapid urease test is positive in significantly higher number (p < 0.001) in histological positive cases. In conclusion our homemade rapid urease test is a test with good sensitivity and specificity for detection of H. pylori infection.

Cancer: determinants and progression.

Cancer is the combination of uncontrolled cellular proliferation and immortality. It is a multi-step disease with a multi-factorial etiology. The determinants of cancer are many and varied including genetic predisposition, environmental influences, infectious agents, nutritional factors, hormonal and reproductive factors, radiation etc. However, the extent of the genetic involvement and their interaction with environment in tumorigenesis is still elusive. The six essential alterations in cell are proposed which determines the transition from normal cell to malignant. It includes--self-sufficiency in growth signals, insensitivity to growth-inhibitory (antigrowth) signals, evasion of programmed cell death (apoptosis), limitless replicative potential, sustained angiogenesis, and tissue invasion and metastasis. Nevertheless, the last two decades have seen rapid improvements in understanding the complex molecular mechanisms underlying tumorigenesis, yet the quest for unraveling the mystery is not over. Further study in this area is indispensable that could hold the promise of increasing our understanding of cancer etiology and possible preventive strategy.

Harlequin baby--a rare case of keratinization disorder.

Harlequin icthyosis is a very rare inborn error of epidermal keratinization with autosomal recessive inheritance. Abnormal lipid metabolism in mitochondria with defective lamellar body formation is the main defect leading to hyperkeratosis. Prenatal diagnosis can be done by invasive procedures such as fetal skin biopsy and also by ultrasonography.