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ABSTRACT: The breast can be affected by a variety of specific and unique disorders during pregnancy and lactation. One of these disorders is spontaneous infarction of the breast which is a rare condition seen in physiologically hyperplastic mammary tissue associated with pregnancy and lactation. The causes and mechanism of the development of breast infarct remain largely unknown. Only 25 cases of breast infarct have been reported in the English literature. Phyllodes tumor is uncommon in pregnant women, and to date, only one report of spontaneous infarction of the phyllodes tumor has been reported in a postpartum woman. In this report, we describe the first case of coexistent infarction of the hyperplastic breast parenchyma with infarction of phyllodes tumor in a 25-year-old female.
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Objectives: Going back to the basics of urinary bladder neoplasms and correlation of histopathological diagnosis with age, sex, clinical features, smoking in tribal population of India in today's day and age. Along with that we are also determining the role of p53 and Ki67 immunomarkers in grading and staging of Urinary Bladder Neoplasms and their correlation with history of smoking. Materials and Methods: This retrospective study was done in a tertiary care hospital affiliated with medical college in tribal region of India. Total 72 cases of transurethral resection of bladder tumors and bladder biopsies were studied over a period of 2 years. The histopathological grading and staging was done according to the WHO/ISUP 2016 classification. The histopathological diagnosis was further correlated with age, sex, clinical features, and history of active smoking. Along with that immunomarkers p53 and Ki-67 were done and correlated with grading and staging of tumors and with history of smoking. The cut-off used was more than 20% positivity for high expression and < 20% for low expression. For descriptive, data median (Interquartile Range) and ratio were used. For categorical variables percentage (%), Fisher exact test and Chi-square test were used. Results were evaluated with SPSS software program. P < 0.05 was considered statistically significant. Results: Out of 72 cases studied, 66 cases were neoplastic. Out of them, bladder neoplasms were common in age group of 41-60 years and there was a male preponderance. Most common clinical feature was hematuria. Smoking was not a risk factor for the development of bladder neoplasms but bladder neoplasms in smokers were associated with higher grading and staging. The most common neoplasm was High Grade Papillary Carcinoma (43.05%). Stage T1 and Stage T2 were seen in 3.03% and 27.8% of cases. P53 and Ki-67 immunomarkers showed higher expression in tumors of higher grade and stage. Conclusion: The take away from this study is bladder neoplasms that are quite versatile and histopathology is the gold standard to confirm these. However, p53and ki-67 gives important information regarding prognosis of tumors and helps in stratification of patients in high risk and low risk groups. Development of bladder carcinoma was independent of history of smoking; however, smoking is associated with higher grading and staging of bladder neoplasms and is also associated with higher expression of p53 and Ki-67 immunomarkers.
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INTRODUCTION: In October 2007, "The National Cancer Institute (NCI), Thyroid Fine Needle Aspiration State of the Science Conference" was held in Bethesda, Maryland hosted by the NCI with the intention of formulating internationally acceptable guidelines for reporting of thyroid cytopathology. This was because, thyroid FNAC have a reporting confusion due to multiplicity of category terminologies. To overcome this, The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was introduced for unifying the terminology and morphologic criteria along with the corresponding risk of malignancy. The Bethesda system for reporting thyroid cytopathology represents a major step towards standardization, reproducibility, improved clinical significance, and greater predictive value of thyroid fine needle aspirates (FNAs). AIM: The aim of this study was to elucidate the diagnostic utility of the Bethesda system in reporting thyroid FNAs and to assess the effectiveness of FNAC in the evaluation of thyroid nodules by comparing the results with histopathological evaluation. MATERIALS AND METHODS: The present study was carried out in our institute during the July 2012 to September 2014. In this study, 100 FNACs done which were classified according to the Bethesda system and out of them, 60 histopathological evaluations obtained from this group were evaluated. The sensitivity, specificity, positive and negative predictive values were evaluated. RESULTS: Out of 100 FNACs, 06% were Non-diagnostic, 78% were Benign, 04% were Atypical follicular lesion of undetermined significance (AFLUS), 04% were suspicious for Follicular neoplasm (SFN), 01% were suspicious for Follicular neoplasm Hurthle cell type, 03% were suspicious for malignancy (SM), and 04% malignant. In 60 cases, data of follow-up histopathologic examination (HPE) were available. The sensitivity was 88.89% and specificity was 84.31%. The positive and negative predictive value were 50% and 97.7%, respectively. CONCLUSION: The Bethesda system is very useful for a standardized system of reporting thyroid cytopathology, improving communication between cytopathologists and clinicians, and inter-laboratory agreement, leading to more consistent management approaches. An additional point which is in favor of the implementation of this system is that the classification is directly related to the risk of malignancy in each category, which in turn, prompts the recommended clinical management of that category, thus truly embodying the clinico-pathological correlation in its true spirit. The correlation of FNAC with histopathology is necessary before starting treatment.
