Evaluation of enzyme-linked immunosorbent assay plasma p16INK4a protein in squamous cell carcinoma in uterine cervix: A case-control study.

Background: Cervical cancer is one of the common cancers in females. The common method of screening is Pap test which has low sensitivity. Hence, better methods are explored with different biomarkers, of which estimation of P16 protein can be opted in early detection of cervical cancer. Materials and Methods: Seventy cases and seventy controls were considered for the study. Cases were invasive squamous cell carcinoma (SCC) of cervix confirmed by histopathology. Controls were healthy age-matched females. The blood sample of cases and controls was collected in K2 Ethylenediaminetetraacetic acid vacutainer, and the separated plasma was subjected to estimation of P16 protein by quantitative sandwich Enzyme-Linked ImmunoSorbent Assay method. The data were analyzed for the association between p16 protein in plasma in cases and controls. Results: The age among cases and controls ranged from 30 to 80 years. The P16 levels among cases ranged from 3.4 to 19.6 ng/ml with a mean of 7.24 ± 2.35 ng/ml. The plasma P16 level in controls ranged between 0.9 and 9.7 ng/ml with mean of 4.1 ± 2.22 ng/ml. At cutoff more than 4.8 ng/ml in cases, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 92.86%, 72.86%, 77.4%, 91.1%, and 82.86%, respectively. The specificity increased with increase in plasma p16 levels. The P16 levels were maximum in stage IV disease. Conclusion: This was a pilot study to detect the plasma p16INK4a levels in SCC of cervix. The levels of plasma p16 protein between 3.9 and 5 ng/ml can be considered as the range for the test to be positive. In clinically suspected cases of cervical cancer, levels more than 4.8 ng/ml can be considered for the diagnosis as point of care test.

Protective effect of ascorbic acid and Ginkgo biloba against learning and memory deficits caused by fluoride.

Fluoride is present in the ground water, World Health Organization permitted level of fluoride in the ground water is 0.5 ppm. Tooth pastes, mouth washes, tea and sea fish are the sources of fluoride. Exposure to these multiple sources results in several adverse effects in addition to the fluorosis. The present study aimed to test the effect of vitamin C and Ginkgo biloba against the behavioural deficits caused by fluoride. Rats were divided into five groups with six animals in each group (n = 6). Control group received ordinary tap water with 0.5 ppm of fluoride, the remaining groups received 100 ppm of fluoride for 30 days prior to fluoride exposure. Two groups of animals received 100 mg/kg body weight of vitamin C and G. biloba for 15 days prior to fluoride exposure. After 45 days, behavioural studies (T-Maze, passive avoidance) were conducted on the experimental animals. The results of the present study showed no behavioural deficits in the control group of animals however, the rats that received fluoride water exhibited impairment in their spatial learning and memory deficits. The deficits are not marked in the vitamin C and G. biloba groups. To conclude chronic exposure to high levels of fluoride causes severe impairment in the spatial learning and memory, these deficits can be ameliorated with the vitamin C and G. biloba.

A rare case of ALK negative CD30+ primary cutaneous anaplastic large cell lymphoma in a young adult.

Cutaneous anaplastic large cell lymphoma can present either as a primary disease or as secondary to a pre-existing systemic anaplastic lymphoma. Distinguishing primary cutaneous anaplastic lymphoma (PC-ALCL) from its systemic counterpart requires a complete clinical and laboratory workup. We hereby report a case of PC-ALCL in a young adult, who presented with unusual rapidly progressive ulcerated mass in the neck. Biopsy showed anaplastic large cells, which were strongly positive for CD30 and CD25 but ALK1 gene product was negative. Clinical examination and computed tomography (CT) scan ruled out extracutaneous involvement. Chemotherapy with 6 cycles of CHOP regimen was planned and on follow-up, a complete remission of the lesion was attained.

Comparison of microalbuminuria with hs-CRP and low density lipoprotein levels in nondiabetic, nonhypertensive myocardial infarction patients.

INTRODUCTION: Microalbuminuria (MA), defined as urine albumin to urine creatinine ratio (UACR) of 30 to 300 mg/G of creatinine, is an established risk factor for cardiovascular morbidity and mortality and for end-stage renal disease in individuals with an adverse cardiovascular risk profile such as those with hypertension or/and diabetes mellitus. MATERIALS AND METHODS: Thirty five patients were included in the study and equal number of age- and sex-matched controls were also included. 2 ml of venous blood was collected for hs-CRP determination and early morning mid stream urine sample was collected under strict aseptic precautions. The lipid profile was estimated in cobas autoanalyzer. RESULTS: There was significant increase in levels of Low density lipoprotein (LDL) cholesterol, microalbumin, and hs-CRP (P< 0.001) in patients with myocardial infarction compared to healthy controls. CONCLUSION: Therefore, MA and hsCRP evaluation may have potential role in improving cardiovascular risk prediction, when used along with traditional lipid profiles.

Endometrial aspiration cytology by various techniques.

The demand for testing endometrium for detecting pathological as well as hormonal status is increasing and cytodiagnosis is extended very rapidly in malignant and non-malignant conditions. The gynaecologists have responded to this trend by providing cost effective care without compromising the quality. With this in mind, uterine aspiration curettage, ambulatory procedure, for endometrial sampling was studied. Dilatation and curettage (D&C) is probably most commonly performed gynaecological surgery. It accounts for large proportion of hospital bed use and operating room time, the cost is significant and patient also risks the complication of anaesthesia. Consequently various alternative procedures for endometrial sampling like endometrial brush, uterine lavage, jet wash vabra aspiration and endometrial biopsy have been reported.

Comparative study of peripheral blood smear, quantitative buffy coat and modified centrifuged blood smear in malaria diagnosis.

The present study was aimed at modifying the centrifuged blood smear (modified centrifuged blood smear or MCBS), to make it a feasible and standardized procedure. The results obtained were compared with the current diagnostic methods - peripheral blood smear (PBS) and quantitative buffy coat (QBC). Blood samples collected from 100 suspected malaria patients were subjected to all three tests. It was found that PBS had 86.79% sensitivity and was absolutely specific. QBC was 96.22% sensitive and 93.61% specific. The majority of variations occurred in PBS negative cases; cases with parasite count Plasmodium falciparum. It was seen that by the addition of centrifugation to the conventional smear technique (MCBS) improved its sensitivity from 86.79% to near 100%. QBC and MCBS were found superior to PBS. Since MCBS combines principles of both QBC and PBS, it is as sensitive as QBC, as specific as PBS, and above all, easily performed and affordable.

Placental pathology in pregnancy-induced hypertension (PIH) with or without intrauterine growth retardation.

The foetus, placenta and mother form a composite triad of dynamic equilibrium, and dysfunction of any one of them can affect the others. The aim of the present study was to appreciate qualitatively and to assess quantitatively the pathological features of placentas associated with pregnancy induced hypertension (PIH) with and without intrauterine growth retardation (IUGR) & also IUGR placentas without PIH and to compare them with the normal placentas and to evolve plausible explanation for the outcomes of PIH and IUGR. The study evaluated 40, 51, 58 placentas of PIH with IUGR (category I), PIH without IUGR (category II), IUGR without PIH (category III) respectively and compared them with 118 normal placentas. The basic conclusions of the study were that PIH is common among primigravida and probably the main factor in the genesis of IUGR and reduced placental weight. There was a high prevalence of inflammation, infarction, ischemia, intervillous hemorrhage, and syncytial knots in PIH with IUGR placentas as also in PIH without IUGR (category II) and IUGR without PIH (category III) placentas. Acute atherosis was a characteristic finding of PIH placentas (both category I & II).

Endometrial aspiration cytology in dysfunctional uterine bleeding.

Aspiration cytology is a safe simple and reliable technique without any complication This can be used as a safe and reliable out patient procedure with minimum discomfort to the patient. The use of a cannula as a device for endometrial aspiration provides adequate material for cytological examination. So the present study was undertaken, to assess the ease of collection of endometrial material and to assess the relative compatibility of aspiration cytology and histopathology.

Primary pulmonary Hodgkin's disease: a distinct entity.

A 30-year-old lady presented with fever, dry cough and weight loss for the preceding five months. Radiological investigations revealed a solitary nodular lesion in the lingula of the left lung. Guided fine needle aspiration cytology failed to yield any diagnostic material. Bronchoscopic cytology was also not contributory. As a last resort open lung biopsy was done and a diagnosis of Hodgkin's disease was made. Hilar and pre aortic lymph node biopsies showed only reactive change. The final diagnosis was primary pulmonary Hodgkin's disease.

Fibrosarcomatous Bednar tumor with distant metastases--a case report.

In July 1994, a 27 year-old man presented with a twice recurrent, pigmented tumor on his left wrist. Wide excision and histological examination showed a pigmented dermatofibrosarcoma protuberans (PDFSP) or Bednar tumor with foci of fibrosarcomatous (FS) change. Immunohistochemistry helped to distinguish it from cellular blue nevus and malignant melanoma. In January 1997, he presented with 3 swellings on his thighs which showed features of fibrosarcoma. In March 1998, he developed multiple tumors on his thighs, chest wall, supraclavicular region, parapharyngeal region and two lung nodules. To the best of our knowledge, there are only 3 previously published reports of metastases in patients with Bednar tumor. We present the fourth such case.

Metastatic lobular mammary carcinoma diagnosed in cervicovaginal smears: a case report.

Lobular carcinoma of the breast uncommonly metastasizes to the cervix. We report a case of lobular carcinoma of the breast with an abnormal cervicovaginal smear caused by metastasis in the cervix. We also discuss the differential diagnosis of primary genital and secondary adenocarcinomas in abnormal cervicovaginal smears.

Reed-Sternberg-like cells in T-cell rich B-cell lymphoma: a diagnostic dilemma.

T-cell-rich B-cell lymphoma (TCRBCL) is a recently described variant of diffuse Non-Hodgkin's lymphoma (NHL) which requires immunohistochemical analysis for its recognition. Striking similarities exist between TCRBCL and lymphocyte predominant Hodgkin's Disease (LPHD) due to the presence of Reed-Sternberg (R-S) like cells. Hence, the need for distinction between the two is of utmost importance from a prognostic and therapeutic stand point. The present study describes a case of TCRBCL, misdiagnosed as Hodgkin's Disease (HD) on fine needle aspiration (FNA) cytology. However, immunostaining of paraffin embedded sections corrected the cytological diagnosis.

Leukoerythrophagocytosis by sinus histiocytes: case report.

Leukoerythrophagocytosis by sinus histiocytes in the lymph nodes is a rare cytological observation. Though often seen in lymph nodes draining malignancies, one may occasionally encounter them in vascular lesions. We report a case of leukoerythrophagocytosis by sinus histiocytes of the right supraclavicular lymph nodes in a 35-yr-old male. He presented with a painful soft tissue mass in the right anterior region of the chest wall extending into the axilla of 6 mo duration. Bilateral radial pulsations were absent. The patient had received treatment for pulmonary tuberculosis 1 yr ago. FNAC of the soft tissue mass revealed only blood. Radiological evaluation revealed a vascular lesion, with smooth borders, extending into the upper zone of right lung and displacing the second rib inferiorly. Doppler evaluation confirmed it to be a right subclavian aneurysm with arteritis.

Fine Needle Aspiration cytology versus Fine Needle Sampling without aspiration. A prospective study of 200 cases.

In the present prospective study of 200 patients with superficial swelling of various sites, FNS followed by FNA were performed. Fifteen cases were excluded due to inadequate material. In the 80 lymph node cases, FNS was diagnostic in 85% cases as compared to FNA in 87.5%. The diagnostic accuracy was higher for FNA (87.5%) than for FNS (81.25%). However FNS smears were much superior qualitatively than FNA smears and for the diagnosis of malignant conditions FNS was found to be much better. Regarding the 68 thyroid swellings, FNS obtained a diagnosis in 82.4% cases while FNA got it in 77.9%. The diagnostic accuracy with FNS (89%) was much better compared to FNA (75%). Of the 27 breast cases FNS yielded diagnostic material in 70.38% cases while FNA was diagnostic in 85.19%, thus establishing definite superiority. However FNS seemed to be better for diagnosing malignant lesions while FNA appeared better for diagnosing benign ones. In the 5 salivary gland lesions and 5 miscellaneous lesions both FNS and FNA fared equally well. On the whole FNS technique was much more patient friendly and gave high class "text book" quality smears while FNA smears gave quantitatively more adequate material. Both the techniques therefore would be complementary to each other.

Eruptive collagenoma.

A case of eruptive collagenoma in a male is being reported. He presented with asymptomatic nodules and plaques over the trunk, upper extremity and face of 15 years duration. Family history was negative. Histopathology with H & E stain followed by Verhoeff van Gieson's staining revealed increased collagen in dermis confirming the diagnosis of eruptive collagenoma. Patient also had Beckers naevus.

Aspiration cytology of metastatic chordoma to the orbit.

PURPOSE: To report a case of metastatic tumor to the left orbit from a sacrococcygeal chordoma. METHODS: A 48-year-old man with a sacrococcygeal chordoma developed left orbit swelling, left eye proptosis with deteriorating vision, and the inability to walk. Fine needle aspiration cytology (FNAC) of the orbital tumor and sacrococcygeal tumor was performed. RESULTS: Fine needle aspiration cytology (FNAC) showed features of sacrococcygeal chordoma with metastatic tumor to the left orbit. CONCLUSION: Although chordoma rarely metastasizes, this case demonstrates chordoma metastatic to the orbit.

FNAC diagnosis of mucinous carcinoma of male breast--a case report.

Mucinous carcinoma of the male breast is a very rare tumour. So far only about 8 cases have been reported in the literature most of which were diagnosed after surgical resection. Fine-needles aspiration biopsy even though a well established procedure for the evaluation of breast masses in female there are only occasional reports of aspirates form male breast masses. We herein-present one case of mucinous carcinoma of breast in a 65 year old male diagnosed by fine needle and confirmed by histopathology.