Adnexal Tumors of Skin: An Experience at a Tertiary Care Center at Delhi.

BACKGROUND: Adnexal skin tumors are a heterogeneous group of uncommon tumors usually misdiagnosed clinically due to a huge variety of types and their variants. Histopathology usually helps in establishing the diagnosis. AIMS: The study was undertaken to analyze the morphological, clinical, and histological features of adnexal tumors (ATs) of the skin at our center over a period of 4 years. SUBJECTS AND METHODS: retrospective study was conducted over a period of 4 years (April 2010-March 2014), comprising 25 ATs of skin diagnosed in the Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi. All the consecutively reported AT cases were reviewed and reclassified as AT arising from sebaceous glands, hair follicles, or sweat glands. The concordance of clinical and histopathological diagnosis was also assessed. RESULTS: Most of the ATs were benign (24/25) with head and neck being the most common location (72%). Nearly 56% of the tumors exhibited sweat gland differentiation, 28% hair follicle differentiation, and sebaceous gland tumors accounted for 16%. The most common varieties of tumors encountered in the present study included hidradenoma papilliferum and pilomatricoma. The concordance between clinical and histopathological diagnosis was found to be 50% approximately. CONCLUSIONS: ATs of the skin are rare neoplasms with benign tumors being far more common. They are often misdiagnosed clinically, so histopathology remains the gold standard for establishing an accurate diagnosis of skin ATs.

Spindle cell lipoma masquerading as lipomatous pleomorphic adenoma: A diagnostic dilemma on fine needle aspiration cytology.

Spindle cell lipoma is a relatively uncommon benign adipocytic tumor that usually presents in subcutaneous fat of adult men. These are a rare form of lipoma, accounting for 1.5% of all lipomatous tumors, with a low rate of local recurrence and no risk of malignant behavior/dedifferentiation. Although few studies addressing the histological findings of spindle cell lipoma have been described, only a few descriptions of fine needle aspiration cytology (FNAC) findings have been documented in literature. We present a case of a 55-year-old male with a nodular swelling over left cheek (in the parotid region), which due to its location as well as prominent myxoid background prompted us to include the lipomatous salivary gland lesions in differential diagnosis. Our objective is to document and delineate the characteristic cytological features of spindle cell lipoma, which may permit a confident diagnosis on FNAC smears.

Role of Ki-67 as a proliferative marker in lesions of thyroid.

BACKGROUND: Specific criteria are used to diagnose thyroid neoplasms; however, the distinction between certain neoplasms, such as follicular adenoma and carcinoma, could be difficult. Thus, additional diagnostic features that can assist in this distinction would have great clinical usefulness. AIMS: To evaluate the role of the proliferative marker Ki-67 in nonneoplastic and neoplastic lesions of the thyroid, with a special emphasis on the distinction between follicular adenoma and follicular carcinoma. SETTINGS AND DESIGN: A retrospective study from a tertiary care center. MATERIALS AND METHODS: One hundred cases of thyroid lesions, including 50 nonneoplastic and 50 neoplastic lesions, were retrieved from the archives of the Department of Pathology, Pt. BD Sharma PGIMS, Rohtak, Ki-67 immunostaining was performed by peroxidase-antiperoxidase method and compared with mitotic counts. RESULTS: Ki-67 labeling index (LI) showed a progressive rise from multinodular goiter to benign to malignant neoplasms. A statistically significant difference was observed in Ki-67 counts between multinodular goiter vs papillary carcinoma (P < 0.05) and follicular adenoma vs follicular carcinoma (P < 0.05). The correlation between mitotic counts and Ki-67 LI was found to be significant. CONCLUSIONS: In the present study, Ki-67 was found to be useful in differentiating between follicular adenoma and follicular carcinoma, but since the sample size of our study was small, larger studies are needed to confirm this observation as well as to assign a cutoff value for differentiating benign from malignant tumors.