Preoperative evaluation of red blood cell distribution width as a promising biomarker for discriminating between benign and malignant breast tumors and assessing breast cancer activity.

BACKGROUND: The red cell distribution width (RDW) has been recognized as a new prognostic factor in various pathophysiological states including breast cancers. The aim of this study was to compare the RDW values between patients diagnosed with benign and malignant breast tumors and to evaluate the potential of elevated RDW as a biomarker for breast cancer activity. MATERIALS AND METHODS: A cross-sectional study compared RDW values in age-matched cohorts diagnosed with benign and malignant breast lesions and correlated them with prognostic factors for malignant breast tumors. The study excluded individuals with inflammatory disorders, pre-neoplastic disease, hematological disorders, or those taking immunosuppressive or anti-inflammatory medications. The RDW values were measured using an automated hematology analyzer. The study's statistical analysis was conducted using SPSS software at a significance level of 0.05. RESULTS: RDW demonstrated a statistically significant elevation in the cohort of patients with malignant breast tumors, those with metastatic breast tumors, a greater number of infiltrated axillary lymph nodes, larger tumor diameter, and a higher grade of the primary tumor mass. CONCLUSIONS: The findings of this study suggest that RDW has the potential to serve as a biomarker for assessing breast cancer activity and could offer substantial advantages in clinical contexts. The present study is not without limitations, and the authors suggest that a larger multicenter prospective study be conducted to further validate it's efficacy over an extended duration.

A standalone approach to utilize telomere length measurement as a surveillance tool in oral leukoplakia.

Oral squamous cell carcinoma (OSCC) is often preceded by a white patch on a surface of the mouth, called oral leukoplakia (OL). As accelerated telomere length (TL) shortening in dividing epithelial cells may lead to oncogenic transformation, telomere length measurement could serve as a predictive biomarker in OL. However, due to high variability and lack of a universal reference, there has been a limited translational application. Here, we describe an approach of evaluating TL using paired peripheral blood mononuclear cells (PBMC) as an internal reference and demonstrate its translational relevance. Oral brush biopsy and paired venous blood were collected from 50 male OL patients and 44 male healthy controls (HC). Relative TL was measured by quantitative PCR. TL of each OL or healthy sample was normalized to the paired PBMC sample (TL ratio). In OL patients, the mean TL ratio was significantly smaller not only in the patch but also in distal normal oral tissue, relative to healthy controls without a high-risk oral habit. Dysplasia was frequently associated with a subgroup that showed a normal TL ratio at the patch but significantly smaller TL ratio at a paired normal distal site. Our data suggest that evaluation of TL attrition using a paired PBMC sample eliminates the requirement of external reference DNA, makes data universally comparable and provides a useful marker to define high-risk OL groups for follow-up programs. Larger studies will further validate the approach and its broader application in other premalignant conditions.

Rare association of microfilaria with poorly differentiated mucin-secreting metastatic carcinoma in liver aspirate cytology.

Filariasis, a neglected tropical disease (NTD), is mainly caused by nematodes-Wuchereria bancrofti, Brugia malayi and B. timori Apart from profoundly disabling and disfiguring major clinical manifestations-lymphoedema, elephantiasis and hydrocoele-asymptomatic microfilaremia is common in endemic areas. Despite this, it is very rare to detect microfilariae in body fluids or aspirates. As per the literature search, this is the third case documenting incidental detection of microfilariae with metastatic deposits in the liver aspirate. Here, a 35-year-old man underwent image-guided fine-needle aspiration cytology of liver nodule. Liver aspirate cytology revealed poorly differentiated mucin-secreting metastatic carcinoma and coincidental presence of microfilariae of W. bancrofti Recently, microfilaria has frequently been found to be associated with the debilitated, immunocompromised condition and various neoplasm/cancer/malignancy. Hence, meticulous investigation should be undertaken to search for hidden pathology, whenever microfilariae are detected; and to deeply scrutinise aspirates for such parasites always, especially in endemic regions.

Retroperitoneal Tumor: A Silent Trespasser - Role of Image-Guided Fine-Needle Aspiration Cytology with Histopathological Correlation in Early Diagnosis.

OBJECTIVE: Retroperitoneal lesions present a great diagnostic challenge. Here we analyze the spectrum of retroperitoneal lesions and the utility of cytohistopathological correlation in early diagnosis. STUDY DESIGN: This 7-year study was undertaken in 338 patients with a retroperitoneal mass (kidney/adrenal/ pancreas/retroperitoneal lymph node, or soft tissue origin). In a prospective analysis, 81 patients underwent image-guided fine-needle aspiration cytology (FNAC) and 70 of the 81 underwent Tru-cut biopsy/histopathological evaluation. Clinical, radiological, and pathological details of 257 patients were retrieved from institutional records for retrospective analysis. A total of 119 patients, i.e., 70 in the prospective analysis and 49 in the retrospective analysis, had cytohistopathological correlation. RESULTS: Of the 338 cases, 88.4% were malignant (n = 274), 2.6% were benign (n = 8), 9% were nonneoplastic (n = 28), and 9% were inadequate (n = 28). Most were renal in origin (n = 106; 34.2%), followed by retroperitoneal soft tissue (n = 96; 31%). The most common nonneoplastic lesion was tubercular lymphadenitis (42.85%) and the most common benign lesion was paraganglioma (42.85%). The most common malignancy was renal cell carcinoma (21.16%), followed by Wilms' tumor (13.86%). In infancy and early childhood, Wilms' tumor, neuroblastoma, and germ cell tumor were the most common malignancies, while in middle age it was renal cell carcinoma, followed by pancreatic adenocarcinoma, and in the elderly age group it was metastatic carcinoma. Most malignancies were noted in the 5th to 6th decades. The overall sensitivity, specificity, and diagnostic accuracy of image-guided FNAC was 98.02, 72.22, and 94.12%, respectively. CONCLUSION: Image-guided FNAC is highly sensitive and specific for early diagnosis of an otherwise silent retroperitoneal mass. It saves patient from meticulous surgical procedures for diagnostic reasons and allows more rational planning of management. Knowledge of the distribution of tumors by age group helps to narrow down differential diagnoses.

Clinico-Pathological Spectrum of Ophthalmic Lesions: An Experience in Tertiary Care Hospital of Central India.

INTRODUCTION: Ophthalmic lesions show varied distribution on the basis of geographical location. Eye being a unique sensory organ needs to be studied both clinically and pathologically. AIM: This study was aimed to evaluate the histomorphological and clinico-pathlological spectrum of ophthalmic lesions at a tertiary care hospital of Central India. MATERIALS AND METHODS: We reviewed all the ophthalmic biopsies performed in the Department of Pathology of our institute between January 2008 and November 2014. Total 488 biopsies of the orbito-ocular region were obtained from patients attending the ophthalmology department. Ophthalmic biopsies were studied as per epidemiological and histomorphological data. RESULTS: The patients ranged in age from one month to 85 years with bimodal distribution. With a male to female ratio of 1:1. Ophthalmic lesions were highest (44.8%) in less than 20 years age group. Eyelid (33.6%) was the most commonly involved site. Clinical diagnosis was consistent with histopathological diagnosis in approximately 76% cases. The non-neoplastic, benign and malignant lesions were 61.1%, 7.8% and 31.1% respectively. Retinoblastoma formed 40.1% of all malignant lesions followed by sebaceous carcinoma (19.1%) and Squamous Cell Carcinoma (SCC) (10.5%). Rare lesions were primary neuroblastoma of orbit and rhabdomyosarcoma of eyelid. CONCLUSION: Findings suggest that among neoplastic lesions the most common ophthalmic malignancies were retinoblastoma in children and sebaceous carcinoma in adults. Among non-neoplastic lesions, 89% cases of infectious aetiology were of rhinosporidiosis in our study making it an important differential diagnosis among ophthalmic lesions.

Intraocular choristoma, anterior staphyloma with ipsilateral nevus sebaceus, and congenital giant hairy nevus: a case report.

A 5-year-old girl presented with choristoma of the eye along with nevus sebaceus and congenital giant hairy nevus over the face. Anterior staphyloma also was present. Although choristomas have been seen occasionally occurring with nevus sebaceus, an associated ipsilateral, regional, congenital giant hairy nevus is rare.

Pleomorphic adenoma: A diagnostic pitfall in the diagnosis of salivary gland lesions on FNAC: Case reports with review of the literature.

Fine needle aspiration cytology (FNAC) is commonly being used with increasing frequency for the pre-operative evaluation of salivary gland lesions. However, it has areas of considerable interpretational difficulties. The most frequent problems involve variations in the expected cytology of pleomorphic adenoma (PA). Salivary gland FNACs performed at Pt. JNM Medical College, Raipur, Chhattisgarh, during July 2006 to June 2007 were reviewed, and we report four cases of interesting diagnostic dilemma. As PA is the most common salivary gland neoplasm, it should always be considered and ruled out as the first differential in the diagnosis of salivary gland FNACs. In order to avoid diagnostic pitfalls, we emphasize a diagnostic approach based on the mandatory presence of all three elements of PA, i.e. 3-dimensional cohesive clusters of ductal cells, background of singly lying plasmacytoid myoepithelial cells and dense fibrillary brightly metachromatic stroma with partially obscured entrapped myoepithelial cells. To document the same, we advocate liberal use of repeat aspirations with multiple sampling performed from different parts of the tumor. Some differential diagnostic problems, e.g. carcinoma ex PA, may still however remain insolvable by cytologic means.

Rhinosporidiosis in Raipur, Chhattisgarh: a report of 462 cases.

Rhinosporidiosis is endemic in the state of Chhattisgarh. 462 cases were encountered during the period of 12 years from January 1994 to December 2005. Maximum incidence was seen in men in the age group of 21-30 years. Nose and nasopharynx were the commonest site (81.1%), followed by ocular tissue (14.2%). Many rare sites of involvement were encountered. Seven cases of generalized rhinosporidiosis were seen. Rhinosporidium seeberi could be easily identified in Haematoxylin and eosin stained sections. Sporangias and spores are better delineated by periodic Acid Schiff, Mayer's mucicarmine, Verhoff's vonGieson and Grocott Gomori methamine silver stain.