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Background: Ovarian cancer is one of the most common malignancies in female patients. In recent years, immunohistochemistry (IHC) has emerged as an important tool in the diagnosis of ovarian tumors. The study aimed to assess estrogen receptors (ERs), progesterone receptors (PRs), Her-2-neu, and Ki-67 by IHC in surface epithelial ovarian tumors and to correlate the findings with different variables. Materials and Methods: It was a cross-sectional study. Oophorectomy/salpingo-oophorectomy/cystectomy specimens were included in this study. IHC was done on 10% neutral buffer formalin-fixed paraffin-embedded tissue sections by using Dako FLEX Ready to use mouse monoclonal antibodies and DakoEnvisionTM FLEX/ HRP detection reagent. Results: The study includes 81 cases of surface epithelial ovarian tumors (a benign serous tumor [20], a benign mucinous tumor [18], a borderline mucinous tumor [5], low-grade serous carcinoma [8], high-grade serous carcinoma [19], mucinous carcinoma [7], endometrioid carcinoma [2], borderline Brenner tumor [1], and malignant Brenner tumor [1]. ER had higher expression in malignant cases (51.33%) than in benign cases (15.8%). PR had higher expression in malignant tumors (54.05%) incomparable to benign (18.42%) and borderline tumors (16.66%). PR had higher expression in high grade. Expression of Her-2-neu positivity was found to be 29.7% out of the total 81 cases. Her-2-neu was found in 11 high-grade tumors among 31 malignant cases. CA-125 levels were significantly higher in malignant ovarian tumors (P = 0.0143). Proliferation activity was considered low if proliferation index (PI) <10% and high if PI >10%. The study showed high PI in malignant tumors. Conclusion: Expression of these marks in adjunct to H&E diagnosis may prove beneficial in differentiating benign, borderline, and malignant cases, in which a diagnosis of borderline cases based on sole H & E is doubtful.
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Background: Breast cancer is a heterogeneous disease that encompasses several distinct entities with remarkably different characteristics . Histological type is the most important aspect of breast carcinoma characteristics. Histological type is associated with differences in epidemiology , diagnostic issues , clinical course & prognosis . Histological special types account for about 25% of breast cancer. Aim-The aim of this study is to identify the incidence and morphology of special types of breast cancers prevalent in our locality along with assessment of IHC status(ER,PR,Her2/neu)for better understanding of rare malignant tumors. Methods: This was aretrospective analysis of all special subtypes of breast cancers over a period of six years (July 2011-June 2017) in the department of Pathology ,VSSIMSAR,Burla,Odisha.Clinicopathological parameters and IHC status were reviewed in all cases. Results: All patients were females with median age of 51 years and undergone modified radical mastectomy. Out of total 448 cases of all breast carcinomas22 cases are of special histologic types.Medullary carcinoma was the most common type ( 7cases )( 13.8%) followed by metaplastic carcinoma(5cases)(22.7%), lobular carcinoma 3(cases )(13.6%),apocrine carcinoma 3(13.6%)cases, papillary carcinoma2(9%)cases, one(4.5%)case each of mucinous carcinoma and sebaceous carcinoma. Conclusion: The identification of the special types has a significant utility in luminal breast cancers and should be considered in therapeutic algorithm.
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Background: Pleural effusion may be due to benign or malignant causes. Patient with known malignancy raises the possibility of pleural involvement. In majority of cases, malignant pleural effusion is associated with high morbidity and mortality.Confirmation of malignancy by cytological or histological examination of pleural fluid is currently important modality in establishing the diagnosis. Aim And Objective -To diagnose malignant pleural effusion by cytological and histological examination of pleural fluid at our centre. Methods: Cross-sectional study including all the patients with pleural effusion done on 101 cases. Results: Most of the effusions are benign. Initial pleural fluid cytology was positive for malignancy in 40% of patients. Thoracoscopic pleural biopsy confirmed 75% positive cases for malignancy.Malignancy causing pleural effusion are mostly due to carcinoma of lungs and breast. Conclusion: Cytological and histopathological examination of pleural fluid are useful diagnostic tools in patients with pleural effusion.
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Background: Salivary gland tumour accounts for less than 5 % of all head and neck tumours. Fine needle aspiration cytology (FNAC) is a useful method for evaluating suspicious salivary gland lesions due to its low cost, minimum morbidity, rapid turnaround time, high specificity, and high sensitivity. On the basis of cytological examination, lesions can be divided into inflammatory, benign, or malignant. If possible, specific diagnosis is given which helps the clinicians in planning the management of the lesion. The objective of the present study is to evaluate spectrum of salivary gland lesions in our set up and to access the diagnostic accuracy and efficacy of FNAC with correlation to histomorphology in spectrum salivary gland lesions. Methods: Present study being both prospective and retrospective, was carried out in department of pathology, VIMSAR, Burla, Odisha. The patients who came to cytology -preoperatively were subjected to FNAC to establish preoperative diagnosis. Postoperatively, the histomorphology was correlated with cytological diagnosis. The study was conducted over 3-year period (December 2014 to November 2017) in which 100 patients were observed. In the present study, 100 cases of salivary gland swelling are included . Salivary gland lesions were studied under the three groups, including non-neoplastic lesions, benign and malignant tumours. Results: In the present study, non-neoplastic lesions accounted for 56%(56/100), followed by benign tumour 29%(29/100) and malignant 15%(15/100). The most common gland involved was parotid (72%), followed by submandibular gland (25%) and minor salivary glands (03%), whereas no case of sublingual salivary gland lesion was observed in the present study. Chronic sialadenitis was the most common lesion (71.4%, 40/56). In benign tumours, pleomorphic adenoma accounted for maximum number of cases (86.21%, 25/29). In malignant lesions, mucoepidermoid carcinoma was the most common malignant tumour (66.67%, 10/15). In the present study, both cytology and histology were carried out in 73 cases out of 100 in which correlation was done for sensitivity, specificity, and diagnostic accuracy. The diagnostic accuracy of FNAC for the non-neoplastic lesions, benign tumours, and malignant tumours was 97.5%, 84.2%, and 85.71%, respectively, and overall diagnostic accuracy was 91.78%. Conclusion: The FNAC technique is accurate, technique sensitive, and specific especially when used as screening method. Preoperative cytology is a useful, quick and reliable diagnostic technique for rapid diagnosis which helps in early diagnosis and can prevent unnecessary surgeries on patient.
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Background: Breast cancer is the second most common cancer in the world and,by far,the most frequent cancer among women with an estimated 1.67 million new cancer cases diagnosed in 2012. It is well established that there are at least 4 main molecular subtypes of breast cancer based on different patterns of gene expression, and they have a considerable impact on outcome. Objective of this study is to establish a comparative analysis of breast cancer by IHC assay in western Odisha and to correlate with reference to tumor sizes, histological grade and lymph node involvement. Methods: This study was conducted in VIMSAR, Burla, Odisha from July 2014 to August 2017 where 66 Cases of radical mastectomy received for routine histopathological evaluation from Dept of Surgery for histological typing and evaluation of IHC status by Dako EnvisionTM FLEX/HRP detection reagent. ER, PR, Her2neu and Ki67 were evaluated as per ASCO/CAP guidelines. The molecular subtypes were correlated with known prognostic markers as tumor size,histologic grade and lymph node status. Results: Triple negative and Her2neu 20.9% of cases were more aggressive and correlated with increased tumor size,higher grade and majority showed lymph node involvement at an early stage. Conclusion: After overall assessment it was seen that majority of cases were Luminal A type followed by triple negative and Her2neu positive cases indicating not only the latter are related to poor outcome but also showed its increased prevalence in this part of odisha possibly because of late presentation. Molecular typing help categorize and plan targeted therapy to patients.