Oligodendroglioma metastasizing to cervical lymph node: Rare entity diagnosed on fine-needle aspiration cytology.

Extra neural metastasis of central nervous system oligodendroglioma is very rare. Oligodendroglioma is the seventh most frequently occurring neoplasm of central nervous system (CNS) with metastasis outside the CNS. According to literature, presence of metastasis in CNS was most frequently detected in patients of glioblastoma (41.4%), medulloblastoma (26.7%), ependymomas (16.4%), astrocytoma (10.3%) and oligodendroglioma (5.27%). A 38-year-old male patient presented with loss of vision and swelling on left side of neck since last 1 week measuring 3 x 2 cm. He was operated for brain tumor 7 years back, which was diagnosed as oligodendroglioma. Ultrasound sonography revealed multiple hypoechoic lymph nodes in bilateral cervical region largest measuring 4.5 x 1.9 cm in left submandibular region. FNA of left submandibular lymph node was done, which revealed deposits of poorly differentiated malignancy. Cell block was prepared for carrying out ancillary studies which showed positivity for glial fibrillary acidic protein (GFAP), S-100 and negativity for cytokeratin (CK), epithelial membrane antigen (EMA), LCA and progesterone receptor (PR). Based on previous history of oligodendroglioma, cytological and immunohistochemistry (IHC) findings a diagnosis of metastatic oligodendroglioma was made. Metastasis of oligodendroglioma to cervical lymph node should also be considered as one of the differential diagnoses. Diagnosing metastatic CNS tumor is extremely challenging for pathologists. It is essential to have the clinical information of a previous CNS tumor, including the histologic type and immunophenotype. Besides common malignancies of cervical lymph node, we should also think of CNS metastasis so that patient management will be early and proper.

Cyclin-dependent kinase inhibitor p21 and proliferative marker ki67 in colonic carcinoma.

Objective: Tumor grade employed for colorectal cancer has long been based on the degree of differentiation, which is difficult to judge objectively. The aim of this study was to assess the immunohistochemical expression of p21 and ki67 and their correlation with the histological grading of colorectal carcinoma. Materials and Methods: A total of 45 biopsy specimens of colorectal cancer were pathologically reviewed and correlation of grade and differentiation of tumor was performed with immunostaining. Results: Ki 67 and p21 markers showed inverse relationship. An inverse relationship of p21 was found with tumor grade, differentiation, Dukes staging and lymph node status, whereas no correlation could be found between these parameters and ki67 expression. Conclusion: We found that p21 can be used to assess the grading and metastatic potential of colorectal carcinoma whereas increased Ki67 expression can help us in the diagnosis of malignancy.

Histomorphological and Morphometric Evaluation of Microvessel Density in Nodal Non-Hodgkin Lymphoma Using CD34 and CD105.

Background Expression of angiogenic markers determined by microvessel density (MVD) could be used as a reliable predictor of prognosis and as a potential target for antiangiogenic therapy in different categories of non-Hodgkin lymphoma (NHL). Aims The aim of this study was to evaluate MVD using immunohistochemical methods and computer-assisted quantitative image analysis in nodal NHL patients and compare CD34 and CD105 expression in lymph nodes of NHL patients. Materials and Methods The present study was conducted on 60 lymph node biopsies received in the Department of Pathology at our tertiary care center for histopathological examination. Representative paraffin-embedded tissue sections were stained with hematoxylin and eosin along with immunohistochemical stains for CD34 and CD105. MVDs were analyzed at 400× using automated image analyzer by two investigators independently. Statistical Analysis Data were calculated, tabulated, and statistically analyzed using SPSS (Statistical Package for Social Studies) statistical program version 18. The values entered were mean of morphometric parameters. In all tests, p -values below 0.05 were regarded as significant. Results MVD was determined by CD34 and CD105 antibody highly correlated with different categories of NHL. Higher MVD was observed in cases of aggressive NHL as compared with indolent NHL and the difference was statistically significantly. MVD using CD105 was correlated more strongly as compared to CD34 with different categories of NHL. Conclusion The present study concluded that NHL exhibits potent angiogenic activity that increased significantly with increasing aggressiveness. The study also demonstrated that CD105 is more specific than CD34 as a marker of neoangiogenesis in NHL.

Fine needle aspiration cytology of cervical lymph nodes: Comparison of liquid based cytology (SurePath) and conventional preparation.

BACKGROUND: Fine needle aspiration cytology (FNAC) is the first diagnostic step in patient with cervical lymphadenopathy because of its simplicity, safety and early availability of the results. Liquid-based cytology (LBC) is an alternative processing method which is used for both gynecological and nongynecological samples. Literature reviewed show few studies comparing LBC with conventional preparation (CP). AIM: The present study was undertaken to evaluate the efficacy of LBC and comparison of LBC and CP in cervical lymphadenopathy. MATERIALS AND METHODS: In this prospective study, a total of 75 cases of FNAC with cervical lymphadenopathy were included. The first pass was used for CP followed by LBC with the use of SurePath (SP) technique. Both the smears were compared for cellularity, background containing blood, cell debris, lymphoglandular bodies, stromal fragments, cytoarchitectural pattern, etc., by semiquantitative scoring system. RESULTS: There was no statistical difference in the cellularity, cell architecture, and monolayer cells (P > .05). On the basis of background containing blood, cell debris, lympho-glandular bodies, stromal fragments (P < .001), nuclear, and cytoplasmic details (P < .05), LBC was found to be superior to CP. CONCLUSION: LBC is a relatively simple technique and superior to CP in respect of better nuclear and cytoplasmic details with loss of background blood and debris. It has a diagnostic accuracy equivalent to that of CP. However, use of both LBC and CP can result in better diagnostic accuracy.

Solitary fibrous tumor of central nervous system masquerading as meninigioma: Report of a rare case.

INTRODUCTION: Solitary fibrous tumor (SFT) is a rare neoplasm of mesenchymal origin that occurs most often in the visceral pleura. It rarely occurs in the central nervous system (CNS). If they occur intracranially, they are extra-axially located and develop from the meninges. CASE REPORT: Herein, we present a case of SFT in a 45 years old female. MR imaging showed isointense to hypointense signal intensity, and marked enhancement. Microscopically, the tumors showed characteristic "patternless-pattern" architecture. Elongated tumor cells formed fascicles alternating with hypocellular densely collagenous stroma. Immunohistochemistry for STAT6, CD34, BCL2 and CD99 favours the definitive diagnosis of SFT. CONCLUSION: In general, complete surgical resection may offer the best chance of a favourable clinical outcome. Their biological features remain largely unknown. Hence, the clinical management and prognosis is often challenging due to the lack of comprehensive data.

Aseptic and Alopecic Nodules of Scalp: A Rare and Underdiagnosed Entity.

Aseptic and alopecic nodules of the scalp (AANS) are a rare and emerging entity in literature, etiology of which is presently unknown. It is characterized by multiple skin-colored dome-shaped nodules associated with nonscarring alopecia. It is usually located in the upper part of occiput and is surrounded by normal scalp. AANS have a good prognosis and can even resolve spontaneously. Only few cases have been reported in the literature so far. We are reporting a rare case of AANS in a 26-year-old female.

Significance of vascular endothelial growth factor and CD31 and morphometric analysis of microvessel density by CD31 receptor expression as an adjuvant tool in diagnosis of psoriatic lesions of skin.

BACKGROUND: Pathogenesis of psoriasis is a debated issue. Several mechanisms have been proposed to identify the etiology and pathogenesis so that specific treatments can be given to patients with psoriasis. AIMS: (1) To compare pattern and distribution of vascular endothelial growth factor (VEGF) and CD31 in patients with psoriasis and other psoriasiform lesions of skin. (2) To study the correlation between VEGF and CD31 expression, clinical severity, and histopathology of psoriasiform lesions of skin. (3) Evaluation of microvessel density (MVD) by using computer-assisted quantitative image analysis in psoriatic skin lesions. MATERIALS AND METHODS: This study was conducted on eighty cases, out of which forty were diagnosed cases of psoriasis and forty cases of clinically suspected psoriasiform lesions, submitted in the Department of Pathology, Pt. B.D. Sharma, University of Health Sciences, Rohtak, for histopathological examination. Histopathological sections were stained by routine hematoxylin and eosin staining, and these biopsies were further subjected to immunohistochemical staining with VEGF and CD31 as per standard technique. RESULTS: Assessment of various histopathological features revealed strong correlation between epidermal hyperplasia, suprapapillary thinning, and elongation of rete ridges. Suprabasilar keratinocytes in psoriatic lesions stained intensely for VEGF. The difference for number of microvessels and MVD in psoriasis and psoriasiform lesions was statistically significant. Correlation between intensity of VEGF staining by suprabasilar keratinocytes and MVD was found to be highly significant in psoriatic lesions. CONCLUSION: The present study concluded that psoriatic lesions exhibit potent angiogenic activity. Early lesions show increased MVD along with other histomorphological parameters such as hypogranulosis, parakeratosis and Munro's microabscesses. Overexpression of VEGF by suprabasilar keratinocytes correlated with increased MVD in papillary dermis.

Disseminated invasive aspergillosis in a prolonged stay in the intensive care unit.

Aspergillus is a common cause of invasive mycosis, especially in immunocompromised individuals. We report the case of a 62-year-old male who was hospitalized after suffering severe physical injuries and died after few weeks of hospitalization. A medicolegal autopsy was conducted, and various organs were sent for histopathological examination of which heart, lungs, and kidneys showed extensive involvement by aspergillus. Thus, a diagnosis of disseminated invasive aspergillosis was made on autopsy, which itself is a rare entity. This case report illustrates a prolonged stay in the intensive care unit as a possible risk factor for the development of disseminated aspergillosis.

Disseminated invasive aspergillosis in a prolonged stay in the intensive care unit

Aspergillus is a common cause of invasive mycosis, especially in immunocompromised individuals. We report the case of a 62-year-old male who was hospitalized after suffering severe physical injuries and died after few weeks of hospitalization. A medicolegal autopsy was conducted, and various organs were sent for histopathological examination of which heart, lungs, and kidneys showed extensive involvement by aspergillus. Thus, a diagnosis of disseminated invasive aspergillosis was made on autopsy, which itself is a rare entity. This case report illustrates a prolonged stay in the intensive care unit as a possible risk factor for the development of disseminated aspergillosis.

Primary breast mucormycosis: FNAC diagnosis of a rare entity.

Mucormycosis is the common name given to several different diseases caused by fungi in the order of mucorales. The clinical hallmark of these opportunistic pathogens in invasive mucormycosis is tissue necrosis resulting from angioinvasion and subsequent thrombosis. Rarely the disease may affect immunocompetent individuals. In addition, the breast involvement in this disease is very rare. Herein, we describe a case of primary breast mucormycosis diagnosed on fine needle aspiration cytology (FNAC), in an immunocompetent young female, which is extremely rare. Diagn. Cytopathol. 2016;44:761-763. © 2016 Wiley Periodicals, Inc.

Sialoblastoma. diagnosis by FNAC: A case report.

Tumors of salivary gland are very uncommon in children and comprise of <5% of all salivary gland tumors. Most of these neoplasms originate in the parotid gland with 10-15% arising from the submandibular, sublingual, and minor salivary glands. We report a case of sialoblastoma in an 8-year-old male child who presented with a history of slowly progressive swelling of the parotid gland since birth, which was soft to firm in consistency and mobile in all directions. Magnetic resonance imaging showed a well encapsulated tumor located in the superficial lobe of the left parotid gland. Fine needle aspiration was performed, which revealed a parotid tumor with closest resemblance to sialoblastoma. Superficial parotidectomy was performed. The histopathology confirmed the diagnosis of sialoblastoma. Sialoblastoma should always be considered when the lesion is known or suspected to be congenital.

Cytological findings of an extragonadal yolk sac tumor presenting at an unusual site.

Yolk sac tumor (YST) is a rare neoplasm that affects children and adolescents. Fine needle aspiration biopsy is an extremely useful procedure for the diagnosis of YST. Main objective is to describe the characteristic cytological features of fine needle aspirates of YST. We report a case of YST in a 4-year-old male child occurring at paravertebral region showing cytomorphological details.

Chordoma of skull base presenting as nasopharyngeal mass.

While the nasopharynx is most commonly regarded by the otolaryngologist as a primary site of neoplastic involvement, it is also an avenue of spread of base-of-the-skull tumors presenting as bulging nasopharyngeal masses. Chordoma is a relatively rare tumor of the skull base and sacrum thought to originate from embryonic remnants of the notochord. Chordomas arising from the skull base/clivus are typically locally aggressive with lytic bone destruction. The optimal treatment may be photon/proton radiotherapy alone or combined with a gross total resection, when feasible. We report a case of intracranial chordoma presenting as nasopharyngeal mass.

Ectopic parapharyngeal meningioma: diagnosis of a rare entity on FNAC.

Meningioma is a tumour most commonly located intracranially that may rarely extend extracranially. Ectopic meningioma presenting as parapharyngeal mass is a rare entity. We report a case of an 18-year-old female who presented with a complaint of swelling below the right angle of mandible associated with difficulty in swallowing for the last 3 months. The swelling measured 1.5 × 1 cm and was firm, fixed, non-pulsatile, non-transilluminant and non-tender. Computer tomography revealed a heterogenous enhancing mass with foci of calcification in parapharyngeal space without any intracranial component. Intraoral fine needle aspiration cytology was performed. A cytological diagnosis of spindle cell lesion of neural origin with the closest possibility of meningioma was rendered. Excision biopsy confirmed the diagnosis of ectopic parapharyngeal meningioma. It is important for clinicians and pathologists to be aware of this entity at the unusual site.

Siringoma condroide con matriz rica en hialina: una lesión infrecuente en el canal auditivo externo / Hyaline matrix rich chondroid syringoma: a rare lesion of the external auditory canal

El siringoma condroide, o tumor mixto cutáneo, es un tumor benigno infrecuente de las glándulas sudoríparas. Es el homólogo cutáneo del adenoma pleomórfico de las glándulas salivares. La presentación clínica es inespecífica y su diagnóstico histopatológico resulta difícil. Característicamente, el tumor se compone de una proliferación de células epiteliales en una matriz condromixoide. Presentamos un caso de siringoma condroide originado en un pólipo del canal auditivo externo en un varón de 25 años, con un cuadro clínico de sensación de obstrucción del oído e hipoacusia. El propósito de esta presentación es ayudar tanto al clínico como al patólogo a reconocer este tumor benigno infrecuente(AU)

Chondroid syringoma, or mixed tumour of the skin, is an uncommon benign sweat gland tumour. It is the cutaneous counterpart of pleomorphic adenoma of the salivary glands. The clinical presentation of chondroid syringoma is non-specific and its histological diagnosis can prove difficult. Characteristically, it is composed of a proliferation of epithelial cells set in a chondromyxoid matrix. We report a case of chondroid syringoma arising from a polyp in the external auditory canal in a 25 year old male who presented with a sensation of blockage of the ear and impaired hearing. The aim of this report is to help both the clinician and the pathologist recognize this uncommon benign neoplasm(AU)

Sertoli-Leydig cell tumor of ovary with heterologous element: a case report.

Sertoli-Leydig cell tumors are uncommon tumors of ovary accounting for about 1% of sex cord stromal tumors. They constitute between 0.1% to 0.5% of all the primary ovarian neoplasms. The majority of reported cases are moderately or poorly differentiated combined Sertoli-Leydig cell tumors. A rare case of Sertoli-Leydig cell tumor with heterologous element in a 14 year girl is described. The heterologous component comprised smooth muscle, an uncommon element, that was seen in 60 to 70% of the tumor area. The epithelial element of the tumor consisted of solid, tubular and foci of retiform pattern. Both these features imply a poor prognosis.

Infectious markers in blood donors of East Delhi: prevalence and trends.

All blood donors Voluntary and Replacement who have donated blood in the centre or in the voluntary blood donation camps, were analyzed for the prevalence of infectious markers over a period of 3 years from 1997 to 1999. A total of 52500 blood units were collected and screened for hepatitis B surface antigen (HBsAg), antibodies to HIV I and II and VDRL reactivity. Seropositivity was 471 (0.8%) for HIV I and II, 963 (1.8%) for HbsAg, 1449 (2.76%) for VDRL and 64 (0.5%) for anti HCV. Voluntary donors were comparatively safe. The seropositivity for HIV showed increasing trend between 1997 to 1999.