Histomorphological and Immunohistochemical Analysis of Pleural Neoplasms.

BACKGROUND & OBJECTIVE: Primary pleural neoplasms are rare entities compared with the pleural involvement by metastatic carcinoma.The current study aimed at investigating the complete spectrum of pleural neoplasms and differentiating between them with the aid of immunohistochemistry (IHC). METHODS: Consecutive pleural biopsy specimens positive for a neoplasm, both primary and metastatic, were included in the study. Diagnosis or a differential diagnosis was suggested on histopathology confirmed by a panel of IHC markers such ascytokeratin(AE1/AE3), epithelial membrane antigen (EMA),vimentin, calretinin, CD34, CD99, SMA,bcl2, S100, CK7,CK20,TTF1,GCDFP, HMB45, LCA, synapto-physin, chromogranin, and naspsin. RESULTS: A total of 35 cases of pleural neoplasms included 15 (42.9%) primary pleural neoplasms and 20 (57.1%) metastatic carcinoma. Synovial sarcoma, malignant mesothelioma (MM), and solitary fibrous tumor (SFT) accounted for 14.2%,11.4%, and 8.5% of metastatic cases, respectively. Epithelioid sarcoma(ES), neuroendocrine carcinoma, and inflammatory myofibroblastic tumor were less common, each contributing to 2.9% of pleural neoplasms. Among the 20 cases of metastatic carcinoma, 13 were from the lung and 7 from the breast. Lung neoplasms metastasizing to the pleura were adenocarcinoma (n=12) and atypical carcinoid (n=1). CONCLUSION: Analysis of histopathological pattern along with a panel of appropriate IHC markers distinguished the rare entities of pleural neoplasms essential to determine the prognosis and treatment modality.

Correlation of COX- 2 Expression in Colorectal Carcinoma with Clinicopathological Features.

OBJECTIVE: Colorectal carcinoma is the most common neoplasm of the gastrointestinal tract. COX-2 expression is upregulated in colorectal carcinoma. Therefore its assessment would identify patients amenable to adjuvant anticyclooxygenase therapy. We studied COX-2 immunoexpression in colorectal adenocarcinoma and correlated it with clinicopathological features as age, gender, tumor location, tumor size, degree of differentiation, and TNM stage. MATERIAL AND METHOD: Sixty-five consecutive cases of colorectal adenocarcinoma were retrieved from the records of the Pathology Department of a tertiary care hospital. The tumors were categorized as low positive and high positive based on their total COX-2 scores, which is the sum of proportion and intensity scores of immunostaining, and were correlated with clinicopathological features. Statistical analysis was done using the Chi-square test and Kendall's Tau-b correlation method. RESULTS: COX-2 was expressed in 86.2% of cases including 90% of left colonic carcinomas and 77.3% of right colonic carcinomas. Lymph node metastasis was present in 22.2%, 25% and 47.75% of COX-2 negative, low positive and high positive tumors respectively. High positive COX-2 cases constituted 33.3% of stage I, 58.8% of stage II, 80% of stage III and 100% of stage IV tumors. About 56.6% of well differentiated, 66.6% of moderately differentiated and 100% of poorly differentiated carcinomas showed high COX-2 expression. The COX-2 overexpression was associated with advancing depth of invasion (p=0.021), stage of tumor (p=0.05), more frequent lymph node metastasis and decreasing degree of differentiation. CONCLUSION: The association of COX-2 overexpression with increasing stage and depth of invasion may justify the use of COX-2 inhibitors as an adjuvant to chemo and radiotherapy.

Soft palate schwannoma.

Schwannomas are relatively uncommon, slow-growing benign neoplasms that can arise from any cranial, peripheral or autonomic nerves. These neoplasms are derived from Schwann cells. The involvement of the palate is a rare presentation although there have been a few reported cases of schwannomas arising in the tongue. This is a case report of one such rare presentation-a case of Schwannoma in a 43-year-old man at a rare site, soft palate. At this location, the clinical diagnosis is confounded by other tumours such as minor salivary gland tumour, pyogenic granuloma and lipoma.

Meckel syndrome with Caroli disease and choledochal cysts.

Meckel syndrome is a lethal autosomal recessive disorder characterized by the triad of cystic renal dysplasia, occipital encephalocele, or other anomaly of the central nervous system and post-axial polydactyly. Malformation of the ductal plate is an integral component of Meckel syndrome. Ductal plate malformations include congenital hepatic fibrosis, biliary hamartoma, autosomal dominant polycystic liver disease, Caroli disease, and choledochal cyst. The occurrence of cystic hepatic disease, Caroli disease, and choledochal cyst have not been highlighted. This is a report of a 26-week fetus with features of Meckel syndrome, Caroli disease, and choledochal cyst.

Testicular biopsies--histomorphologic patterns in male infertility.

The objective of the present study is to observe the spectrum of histopathological changes in the testicular biopsies of infertile men and to assess if a bilateral biopsy is required to reveal the pathology of infertility in every case or a unilateral biopsy would suffice. Thirty testicular biopsies (21 bilateral and 9 unilateral) were studied from 30 infertile men. The patterns of testicular damage seen in the present study were maturation arrest followed by hypospermatogenesis, Sertoli-cell only syndrome, tubular hyalinisation and one case was associated with normal histology. Comparing the histopathological findings in bilateral biopsies, it was seen that a unilateral biopsy would suffice to reveal the pathology in most instances and a bilateral biopsy is needed only when there is appreciable difference in the size of the testes.