Expression of CD117 and platelet-derived growth factor receptor α in patients with alopecia areata.

BACKGROUND: Alopecia areata is a disease of uncertain, probably autoimmune etiology. The role of growth factors like platelet-derived growth factor and C-kit (CD117) in alopecia areata is unknown. AIMS: To compare the expression of CD117 and platelet-derived growth factor receptor α in tissue samples of alopecia areata and normal controls. METHODS: Thirty biopsy samples of alopecia areata and eighteen normal control samples were included in this cross-sectional study. Immunohistochemistry was done to detect the expression of CD117 and platelet-derived growth factor receptor α in cases and controls. The mean percentage of follicles expressing CD117 and platelet-derived growth factor receptor α was compared among cases and controls. RESULTS: The mean number of follicles expressing CD117 in anagen and catagen hairs differed significantly among cases and controls. The extent and intensity of staining with platelet-derived growth factor receptor α correlated significantly with the severity of alopecia areata based on the severity of alopecia tool score. LIMITATIONS: Confirmation of the expression pattern of molecules observed in immunohistochemistry with western blot or polymerase chain reaction would have strengthened the report. CONCLUSIONS: The expression of CD117 varied in cases and controls. The expression of platelet-derived growth factor receptor α correlated with the severity of the disease. This could explain how platelet-rich plasma works in the treatment of alopecia areata. Further studies are required to explore the role of these molecules in autoimmune pathogenesis.

Follicular Lymphoma: A Clinicopathological Analysis from a Tertiary Care Institute in Southern India.

INTRODUCTION: Follicular lymphoma (FL) is an indolent lymphoproliferative disorder of B-cells with variable clinical behavior. It is the second most common subtype of Non-Hodgkin lymphoma in western countries but reported to have a lower incidence in Asia. MATERIALS AND METHODS: Cases of FL diagnosed in the Department of Pathology of our Institute from January 2009 to June 2015 were included in the study. The clinicopathological parameters including staging, histological details, and immunohistochemical markers CD20, CD10 and BCL-2 were recorded in all the cases. RESULTS: Of the 497 cases of Non-Hodgkin Lymphoma reported during the study period, 36 (7.2%) cases were follicular lymphoma. The mean age was 50 years with male to female ratio of 3.2:1. Grade 1/2 was seen in 70% cases. 22 % cases had low grade with high proliferation index (Ki67 > 40%). Granulomatous response was seen in two cases. Diffuse large cell lymphoma component was present in four cases. Bone marrow involvement and peripheral blood spill were seen in 12 (37.5%) and six cases (18.8%) respectively. 72% cases were in stage 3 or 4. CONCLUSION: The incidence of FL was lower in our study than other Indian studies. FL presented in the elderly, with male predominance and disseminated stage. The study highlights features of low grade with high proliferation index, granulomatous response, leukemic involvement, and transformation to high grade lymphoma.

Concurrent Presentation of Therapy Related Acute Myeloid Leukemia in a Case of Neuroblastoma.

Therapy related Acute Myeloid Leukemia/Myelodysplastic syndrome (t-AML/MDS) occur due to the direct mutational events of the chemotherapeutic agents and radiotherapy. The disease latency, mutational events and prognosis vary with the type of chemotherapeutic agent. Therapy related Acute Myeloid Leukemia occurring with DNA topoisomerase II inhibitors have a shorter latency period and poor prognosis than anthracyclin based regimens. We report a case of a 9 year old boy who developed t-AML with mixed-lineage-leukemia gene translocation within a year of high dose chemotherapy for stage 4 neuroblastoma. He had residual mass of neuroblastoma in the abdomen and bone marrow. The patient expired within 2 weeks of induction chemotherapy.

CD56 Negative Aggressive T Cell Large Granular Lymphocytic Leukemia.

T cell large granular lymphocytic leukemia is a clonal proliferation of cytotoxic large granular T cells positive for CD3 and CD8. It is a chronic lymphoproliferative disorder with an indolent course. Therapeutic options include observation and low dose chemotherapy. Rarely, they have an aggressive course. Such cases have expression of NK cell associated antigens like CD56 in the T cells. These cases require more aggressive therapy with acute lymphoblastic leukemia regimens. We report a case of fatal CD56 negative T cell large granular lymphocytic leukemia in a 38 year old lady.

Reactive Eccrine Syringofibroadenomatosis Presenting as Bilateral Plantar Hyperkeratosis.

Eccrine syringofibroadenoma (ESFA) is a rare cutaneous tumor with eccrine differentiation with varied clinical manifestations. We report a case of reactive eccrine syringofibroadenomatosis associated with chronic bilateral plantar ulcers in a patient with diabetes mellitus presenting as plantar hyperkeratosis and verrucous growth at margins.

Neurotized congenital melanocytic nevus resembling a pigmented neurofibroma.

Neurotized congenital melanocytic nevus and pigmented neurofibroma (PNF) are close mimics and pose a clinicopathological challenge. We present a case of pigmented hypertrichotic plaque over lumbosacral region and discuss the differential diagnosis and its clinical, histopathological and immunohistochemistry features which may aid in differentiation. We highlight the difficulties faced in differentiating neurotized congenital melanocytic nevus from pigmented neurofibroma.