A Comparative Study of Sodium Alginate and Plasma Thrombin Cell Block in Diagnostic Cytopathology.

Background: Cell block is an indispensable supplement in the practice of cytopathology. The diagnostic utility of cytology specimens is significantly impacted by the capacity to generate sufficient cell blocks obtained from concentrated fluid samples or fine-needle aspiration specimens after routine processing. This routine processing involves getting directed passes to produce a cell block, especially if the cytopathologist believes additional immunocytochemical stains and/or molecular studies would be required. Objective: This study compared two methods of cell block preparation: the sodium alginate (SA) method and the plasma thrombin (PT) method. A comparison was made regarding overall cellularity, morphological preservation, and concealed artifacts. Methodology: This cross-sectional study evaluated 104 serous fluid samples and fine-needle aspirates. Cell blocks were prepared for each sample using the plasma thrombin and sodium alginate technique. The formalin-fixed, paraffin-embedded cell blocks were subjected to histochemical staining with hematoxylin and eosin, and slides were assessed for cellularity, artifacts, and morphological preservation. Results: The study utilized chi-square tests to analyze cellularity, morphology, and artifact presence, demonstrating significant differences in cellularity and artifacts between the two methods, with the sodium alginate method showing more cellularity and more artifacts, while morphologically, there was no significant difference between the two methods. Conclusion: Our study's findings have practical implications for cytopathologists. We conclude that, compared to plasma thrombin methodology, the sodium alginate cell block technique yields higher cellularity, while there was no difference in morphology. Even though artifacts were more prevalent in sodium alginate cell blocks than in plasma thrombin cell blocks, our study suggests that the former can be a better alternative for cell block examination.

CD10 Immunohistochemical Expression in Breast Carcinoma and Its Correlation With Clinicopathological Parameters.

BACKGROUND:  Interaction between the stromal and tumor cells is of crucial importance in breast cancer progression and response to therapy. A literature search has shown that stromal CD10 expression signifies the biological aggressiveness of various epithelial malignancies. Stromal markers are now becoming apparent as novel markers in evaluating the prognosis of invasive breast cancer and have not been studied substantially to date. OBJECTIVES: To study the immunohistochemical expression of CD10 in stromal cells of breast carcinoma and to correlate the expression of CD10 with various clinicopathological prognostic factors such as the size of the tumor, histological grade, lymph node status, and estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2/neu protooncogene (HER2-neu) status. METHODOLOGY:  In the present study, a hospital-based cross-sectional study was conducted on 50 mastectomy specimens diagnosed with invasive breast carcinoma. The specimens of patients who had received neoadjuvant therapy or chemotherapy were excluded. Size of the tumor, grade of tumor on histopathology, lymph node involvement, and IHC status of ER, PR, and HER2-neu were noted. IHC staining for the CD10 marker was performed, and expression of stromal CD10 was correlated with these clinical-pathological prognostic factors. RESULTS:  CD10 expression in stromal cells of breast carcinoma was seen in 40 (80%) cases, and it showed a statistically significant association with histological grade (χ2 = 17.262; p-value < 0.0001), ER negativity (χ2 = 3.668; p-value < 0.045), and PR negativity (χ2 = 3.926; p-value < 0.048). CONCLUSION: A strong association of stromal CD10 expression with a well-established negative prognostic marker such as a higher tumor grade, ER-negative status, and PR-negative status was noted and thus, stromal CD10 expression can be used as an independent prognostic marker in breast carcinoma.

Arthroscopic Excision of a Solitary Intra-articular Osteochondroma Manifesting as a Loose Body: A Presentation of an Extremely Rare Medical Condition.

Osteochondroma typically has extra-articular growths at the metaphysis. Intra-articular osteochondroma is extremely uncommon. We report a case of a 55-year-old woman who had been experiencing right knee pain for the past 12 months. An arthroscopy revealed a medial meniscus tear with a loose body in the right knee. It was removed arthroscopically. Histopathology identified it as an osteochondroma. Therefore, intra-articular osteochondroma can be regarded as an uncommon cause of loose bodies in adult patients.

Incidental Hemangioma in Tubectomy and Hemorrhoidectomy Specimens: A Report of Two Cases.

Benign vascular neoplasms, or hemangiomas, can develop anywhere in the body.As they are usually asymptomatic, they are discovered incidentally while evaluating other coexisting diseases or conditions. We herein report two cases of capillary hemangioma at two extremely rare sites. A woman in her early 30s with a history of nine months of amenorrhea came for safe confinement and underwent an elective lower segment cesarean section (LSCS) with bilateral concurrent tubectomy. Another case involved a man in his 40s who presented with bleeding per rectum for three months. Per rectal examination, two purplish red masses were noted at the 3 and 11 o'clock positions, which were noncompressible and did not bleed on touch. Subsequently, a hemorrhoidectomy was performed. A well-defined vascular lesion in the fallopian tube and hemorrhoidal tissue were seen during the histopathological examination, which was compatible with a capillary hemangioma. The vascular endothelium was emphasized by immunostaining with CD34.Due to the potential for these lesions to manifest as surgical emergencies, it is imperative for surgeons to recognize and appropriately manage such presentations.

The Expression of Cyclooxygenase-2 in Cervical Intraepithelial Neoplasia and Cervical Cancer.

Aim To examine the relationship between tumor differentiation, parametrial, and lymphovascular invasion, as well as the differential expression pattern of cyclooxygenase-2 (COX-2) in cervical intraepithelial neoplasia and various forms of cervical cancer. Methods Histologically diagnosed cases of in-situ and malignant lesions of the cervix were included in the study. Two sections were cut from paraffin blocks. One section was stained with Haematoxylin and Eosin (H&E) for morphologic diagnosis, and the other sections were subjected to COX-2 immunohistochemical staining. Cases of colon carcinoma were taken as positive controls. Cytoplasmic and membrane staining of tumor cells were considered as positive staining, and grading was done. Results Out of the 62 patients, 40 cases (64.5%) showed positive expression of COX-2 in squamous cell carcinoma when compared to in-situ cervical intraepithelial neoplasia and adenocarcinoma. The results were statistically significant, with a p-value of 0.003. Conclusion COX-2 expression is directly proportional to the level of grading of the tumor. The higher the grading, the higher the expression of COX-2. Selective COX-2 inhibitors increase the efficacy of chemotherapy or radiotherapy.

Safety and efficacy of the new CryoPop® cryotherapy device for cervical dysplasia in low- and middle-income countries: study protocol for a multicenter open-label non-inferiority clinical trial with historical controls.

BACKGROUND: Cervical cancer is the fourth most common cancer in the world, affecting mainly women residing in low- and middle-income countries. Progression from a pre-invasive phase to that of an invasive phase generally takes years and provides a window of opportunity to screen for and treat precancerous lesions. METHODS: This study is being conducted at four sites in north Karnataka, India. Community sensitization activities have been organized in the study areas to create awareness among stakeholders, including elected representatives, physicians, health care workers, and potential participants. Organized community based as well as hospital-based screening is being conducted using visual inspection with acetic acid (VIA). Screen positive women are referred to respective study hospitals for colposcopy and directed biopsy. Participants with confirmed high-grade cervical dysplasia (high-grade squamous intraepithelial lesions or HSIL) who fit all other eligibility criteria will be recruited to the study and will receive cryotherapy using CryoPop®, an innovative new cryotherapy device. DISCUSSION: There is a need to develop an inexpensive, simple, and effective cryotherapy device for use by frontline health care providers at locations where screening and timely treatment can be given, accelerating access to cervical cancer prevention services and minimizing loss to follow-up of women with precancerous lesions who need treatment. TRIAL REGISTRATION: Clinical Trial Registry - India CTRI/2019/01/017289 ClinicalTrials.Gov number NCT04154644 . Registered on November 6, 2019.

Quantitative mast cell analysis and hormone receptor study (ER, PR and HER2/neu) in invasive carcinoma of breast.

CONTEXT: Breast cancer constitutes nearly one third of cancers among women. Immune responses caused by neoplastic cells lead to the accumulation of inflammatory cells like mast cells (MCs), macrophages, lymphocytes, and plasma cells around the tumor tissue forming the tumor microenvironment. AIM: The study aims at quantifying the role of MCs in different grades of invasive carcinoma of breast with respect to estrogen receptor (ER), progesterone receptor (PR), and Human Epidermal growth factor Receptor 2 (HER2/neu). MATERIALS AND METHODS: This study included 60 cases of invasive carcinoma of breast. Toluidine blue staining was used for quantitative MC analysis and correlated with immunohistochemistry analysis for hormonal markers' positivity-ER, PR and HER2/neu. RESULTS: The mean age was 52 years (range: 25-75 years). The average number of MCs in Grade I, II, and III were 24.05, 18.4, and 7.9, respectively, with a significant P value. ER, PR, and HER2/neu positivity was found in 60%, 55%, and 32% of the cases, respectively. ER positivity with mean MC count of 23.55 was found in 36 cases, and 33 cases were positive for PR with a mean MC count of 24.18 and a significant P value. HER2 positive cases were 28 with a mean MC count of 20.82. CONCLUSION: The presence of MCs in breast cancer is inversely proportional to the grade of tumor, i.e., a maximum number of MCs were seen in low grade tumors. In addition, there is a positive correlation between ER and PR receptor positivity with the presence of MCs in the stroma of breast cancer.

Steroid Cell Tumor of the Ovary - A Rare Case Report and Review of Literature.

Steroid cell tumors of the ovary are extremely rare, accounting for only 0.1% of all ovarian tumors. Most steroid cell tumors secrete steroid hormones, and only about 10%-15% of patients are asymptomatic. The clinical presentation may take many forms, including abdominal pain, distention, irregular menstrual cycles, and hirsutism. Here, we present a case of a 60-year-old postmenopausal patient who presented with complaints of bleeding per vagina and abdominal pain for 4 months. Ultrasonography (USG) revealed a hypoechoic left adnexal mass measuring 65 mm × 40 mm × 30 mm. Based on these USG findings, the diagnosis of cystic lesion of the left ovary was made. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was done, and the specimen was sent for histopathological analysis. On histopathology, diagnosis of steroid cell tumor-not otherwise specified was offered. This case is reported due to its rarity and its unusual presentation, together with a brief review of the literature of the same.

Symmetric Peripheral Gangrene Associated with H1N1 Infection.

More and more cases of H1N1 influenza are being detected in India and so also the variety of complications this virus can cause. Here, we report a case of symmetric peripheral gangrene following H1N1 infection.