Clinicopathological correlation of tumor-stroma ratio and inflammatory cell infiltrate with tumor grade and lymph node metastasis in squamous cell carcinoma of buccal mucosa and tongue in 41 cases with review of literature

Introduction: Several studies regarding tumor-stroma ratio (TSR) in colorectal, esophageal, breast, endometrial, and cervical carcinomas have been done in the past with significant results. Objectives: The objectives of this study were to (1) study and grade TSR in buccal mucosa and tongue squamous cell carcinoma (SCC), (2) grade inflammatory cell infiltrate surrounding the tumor, and (3) correlate the above two parameters with tumor grade, lymph node metastasis, lymphovascular invasion (LVI), and perineural invasion (PNI). Materials and Methods: Totally, 25 patients of buccal SCC and 16 cases of tongue SCC were included in the study. TSR was assessed visually on the hematoxylin and eosin-stained tissue sections by two independent observers. Cases were categorized into two groups: One with high TSR >50% (stroma poor) and the other with low TSR <50% as the stroma-rich group. TSR was correlated with tumor size, lymph node metastasis, inflammatory cell infiltrate, LVI, and PNI. Data were analyzed by the Statistical Package for the Social Sciences version 16.0 (Chicago, IL, USA) for Windows. The Chi-square and Fischer's exact tests were applied in the analysis of categorical variable. Results and Conclusion: SCC of buccal mucosa showed a significant correlation between TSR and size of the tumor (P = 0.001). We found that smaller the tumor size ≤2 cm (Stage T1), lesser the TSR, and size >2 cm was found to be associated with higher TSR. Hence, higher TSR (stroma poor) was associated with an adverse pathological characteristic, i.e., advanced T significantly. There was no significant correlation between TSR and inflammatory infiltrate with grade of the tumor, lymph node metastasis, LVI, and PNI. In 16 cases of SCC of the tongue; no correlation was observed between TSR and inflammatory infiltrate with tumor size, grade of the tumor, lymph node metastasis, LVI, and PNI. TSR has been studied in various malignancies (mostly adenocarcinomas) including laryngeal SCCs; however, it has never been studied on oral SCCs

The Clinical Significance Of Rassf1a And Cdh1 Hypermethylation In Breast Cancer Patients

Introduction:Aberrant DNAmethylation patterns in serum DNAmight be used as a biomarker for the early diagnosis and management of cancer patients. The aim of present study was to evaluate DNAmethylation of RASSF1Aand CDH1 in circulating cell free DNA(cfDNA) from serum and paired tissue DNAsamples of breast cancer patients. Material and methods: Methylation-specific PCR was used to assess the methylation status of the two genes in serum and paired tissue sample DNAof 50 breast cancer patients. Biochemical parameters were assessed using an electrochemiluminescence analyzer. Results: Significant correlation found between methylation status of RASSF1A and CDH1 in serum and paired tissue samples of patients. Among clinicopathological findings, CDH1 methylation showed significant association with advance staging and tumor and methylation of RASSF1A exhibited significant association with progesterone receptor and estrogen receptor status in both serum and paired tissue. Vitamins levels were significantly high in cases compared to control group. High folic acid levels were significantly associated with the RASSF1Amethylation. Conclusions: These findings suggest that methylation of cfDNAmay be important in the early detection of breast cancer.

Primary intraosseous atypical inflammatory meningioma presenting as a lytic skull lesion: Case report with review of literature.

Primary extradural meningiomas of the skull comprise 1% of all meningiomas, and lytic skull meningiomas are still rarer and are said to be more aggressive. We present a case of 38‑year‑old male with an extradural tumor which on histopathological examination showed features of inflammatory atypical meningioma (WHO Grade II). The intense inflammatory nature of osteolytic primary intraosseous meningioma has not been reported before. This entity deserves special mention because of the need for adjuvant therapy and proper follow‑up.

High-risk histomorphological features in retinoblastoma and their association with p53 expression: An Indian experience.

Introduction: Histopathological features in retinoblastoma are considered high‑risk factors (HRF) for tumor progression and metastasis, thus their presence becomes an indication for adjuvant chemotherapy. Present study was undertaken to evaluate the incidence of HRF in retinoblastoma and to correlate them with p53 expression. Materials and Methods: This was a retrospective study where 17 diagnosed cases of retinoblastoma were included. Cases were re‑evaluated for various histomorphological parameters. Immuno‑histochemical analysis was done with p53 antibody by Streptavidin biotin method. Results: The patients were in the age range of 1.5-50 years. Common histological features included necrosis (70.5%), calcification (64.7%), and retinal detachment (58.8%). Incidence of various morphological parameters was anterior chamber seeding (47.2%), ciliary body involvement (29.4%), iris involvement (29.4%), choroid involvement (58.8%), scleral invasion (29.4%), extrascleral invasion (11.8%), and optic nerve infiltration (23.5%). p53 expression was present in four cases out of 13 cases (30.7%) and showed a significant association with choroid invasion (P = 0.02). Discussion: The presence of HRF should alert the physician for a possible metastasis, and such patients should be kept on regular follow‑up to detect an early recurrence. p53 expression, a known poor prognostic indicator, showed significant association with choroid invasion, however, no association was seen with other HRF. Conclusion: Histopathological HRF have significant therapeutic and prognostic implications. The incidence of HRF is higher in developing countries as patients present with a more advanced stage of disease. p53 expression is significantly associated with choroid invasion out of all HRF.

Fatal nitrobenzene poisoning: Some case reports and medicolegal aspects.

Nitrobenzene is a synthetic organic compound, pale yellow in colour, freely soluble in alcohol, with a pleasant odour like that of bitter almonds or shoe polish. It is widely used in chemical industry, and is present in commercial products such as shoe and metal polish, ink, paint remover and soap. Poisoning due to nitrobenzene is usually chronic in nature, mainly due to occupational exposure, except for a few acute cases of industrial accidents or suicides. We report three cases of fatal nitrobenzene poisoning through oral ingestion. All persons consumed alcohol prior to, or along with nitrobenzene. The alleged manner of poisoning was different in every case (one case each of homicide, suicide and accident). Clinical features, autopsy findings and medicolegal aspects of nitrobenzene poisoning are discussed.

Primary tuberculosis of nose with intracranial extension: A rare presentation.

Tuberculosis continues to be a major public health problem. This disease has varying presenting features. We here present a case of primary tuberculosis of the nose with intracranial extension, a very rare presenting feature of tuberculosis

Morphological findings in bone marrow biopsy and aspirate smears of visceral kala azar: A review.

Context: Visceral leishmaniasis (VL) is endemic in India and may simulate and cause many hematological disorders like pancytopenia, myelofibrosis, myelodysplasia and hemophagocytosis. Aims: The study aims to investigate the hematological manifestation of Visceral Leishmaniasis and associated changes that may be observed in bone marrow aspirate smears and biopsy which may warn a pathologist of possible infections. Settings and Design: This is a retrospective study of 18 VL cases on B (b) one marrow aspirate and biopsy in the department of Pathology in a tertiary care teaching hospital in New Delhi. Methods and Material: Giemsa stained slides of bone marrow aspirates and hematoxylin and Eosin stained biopsy slides were reviewed in detail by two competent pathologists. All the findings were tabulated and discussed and comparisons made with the previous similar studies. Results: Hyper cellular marrow, increased lymphocytes and plasma cells, marrow granulomas, hemophagocytosis, myelofibrosis, myelodysplasia and gelatinous transformation of the marrow were notable features the presence of which together or individually should caution a pathologist to search for Leishman Donovan (LD) bodies in patients especially in a non-endemic zone in a tropical country.