Evaluation of Estrogen and Progesterone Receptors and Her-2 Expression with Grading in the Fine-needle Aspirates of Patients with Breast Carcinoma.

BACKGROUND: There has been a limited literature with regards to comparison between the pre-operative hormonal/Her-2 neu assessment by immunostaining on fine-needle aspiration (FNA) versus core needle biopsies (CNBs) and their correlation with grading of breast carcinoma. MATERIALS AND METHODS: Two hundred fifty FNAs and 201 CNBs from 252 patients with breast carcinoma were subjected immunocytochemical/histochemical (ICC/IHC) staining along with the grading by the Robinson cytologic and modified Scarff-Bloom-Richardson scoring systems, respectively. Depending on the material adequacy, IHC was also performed on cell blocks. Sensitivity, specificity, and predictive values of ICC were calculated. The kappa statistics was performed to see the power of the study. Cytologic versus histologic gradings were compared and analysed by percentage analysis. RESULTS: Sensitivity of ICC on FNAs for ER, PR, and Her-2neu was 49%, 28.8%, and 46%, respectively, while specificity was 84.5%, 90.6%, and 86.6%, respectively, with a fair agreement on kappa statistics. Her-2neu positivity on CNB versus FNA had a moderate agreement. Her-2neu staining of 3+ was seen in most of the Grade-2 tumours on FNA. CONCLUSIONS: Fairly reliable results on grading and hormonal/Her-2neu status are possible when ICC is performed on qualitatively superior FNA material. This is particularly useful in the management of patients in certain settings like inoperable cases.

Subcutaneous Phaeohyphomycosis: A Clinical Mimic of Skin and Soft Tissue Neoplasms-A Descriptive Study from India.

BACKGROUND: Phaeohyphomycosis is a fungal infection caused by heterogenous group of fungi known as phaeoid or dematiaceous fungi. It manifests in four clinical forms-cutaneous, subcutaneous, systemic and cerebral phaeohyphomycosis. The subcutaneous form is the most common presentation. Clinically these subcutaneous swellings resemble benign skin and soft tissue neoplasms like lipoma, sebaceous cyst or neurofibroma. Histopathology serves as a very useful tool in diagnosing these cysts by identifying the fungal elements. METHODS: A retrospective review of all cases diagnosed as phaeohyphomycosis in the department of Pathology at a tertiary care centre in South India over 9 years (January 2009-December 2017) was done. The clinical, histopathological findings of these cases were reviewed and analysed. RESULTS: Sixty-six cases of subcutaneous phaeohyphomycosis were reported during the 9 year period. Sixty-two per cent of these patients were diagnosed as skin and soft tissue neoplasms. In 94% cases, the extremities were affected. Multiple cysts were seen in 11% of patients. Fine needle aspiration cytology was done in 29 cases with fungal hyphae identified in all cases on cytology. CONCLUSION: Subcutaneous phaeohyphomycosis mimics benign skin and soft tissue neoplasms clinically. Histopathological examination along with cytology plays a major role in diagnosis of phaeohyphomycosis and thus helps in appropriate patient management.