RESUMEN
Mature teratoma is a benign germ cell tumor, histologically comprising components from mesoderm, ectoderm, and endoderm layer tissue. Here, we report a rare case of lactating adenoma arising from mature teratoma of the ovary in a pregnant female. To the best of our knowledge, only four cases of lactating adenoma arising from ovarian teratoma have been reported in the literature so far. This case is the fifth case reported worldwide, and the first case report with dual rare findings - choroidal plexus and lactating adenoma of mammary tissue in benign mature cystic teratoma. This is the second case report which uses immunohistochemical (IHC) markers to confirm the diagnosis. Grossly, the cystic structure was measuring 10x7x5cm. The cut surface revealed mixed solid and cystic areas filled with pultaceous material admixed with hair. Microscopy showed an ovarian cyst lined by stratified squamous epithelium with underlying sebaceous glands, apocrine acini, fatty tissue, smooth muscle, and glial tissues. Also noted mammary tissue composed of proliferating hyperplastic acini with central dilated ducts filled with eosinophilic secretions arranged in lobules. Immunohistochemistry with estrogen receptor (ER) and progesterone receptor (PR) showed luminal and ductal positivity. Strong expression of IHC markers such as p63 and pan-cytokeratin (pan-CK) was noted in myoepithelial cells and luminal cells respectively. Thus, confirming it as mammary tissue with hyperplastic ducts and acini.
RESUMEN
Myxoid pleomorphic liposarcoma (MPLPS) is an extremely rare entity that has been recognized and included in the literature recently. Liposarcomas are adipocytic tumors that are usually located in the extremities and retroperitoneum. Paratesticular liposarcomas are extremely rare malignant tumors originating from the adipose tissue of the paratesticular region. Myxoid pleomorphic liposarcoma (MPLPS) is an exceedingly rare variant of liposarcoma, with very few cases reported in the literature so far. Mediastinum is the most common site for MPLPS followed by the limbs, head, and neck. We report a case of a 50-year-old male patient who presented with a swelling in the right inguinal region, which came to the patient's attention in the past month. After investigations, a right-high orchidectomy was done. Histopathological examination and immunohistochemistry were performed and a diagnosis of myxoid pleomorphic liposarcoma (MPLPS) involving the spermatic cord was made. So here we report this case of myxoid pleomorphic liposarcoma involving the spermatic cord for the first time in the literature.
RESUMEN
Background Cervical carcinoma is one of the most prevalent cancers affecting women worldwide. Studies on Ki-67 expression in cervical lesions had focused mainly on the intraepithelial lesions of the cervix and not much on invasive carcinomas. The few studies published so far on Ki-67 expression in invasive cervical carcinomas have shown inconsistent results on the association of Ki-67 with various clinicopathological prognostic factors. Aims and objectives To assess Ki-67 expression in cervical carcinomas and to compare it with various clinicopathological prognostic factors. Materials and methods Fifty cases of invasive squamous cell carcinoma (SCC) were included in the study. Histological patterns and grades were identified and noted in these cases after microscopic examination of the histological sections. Immunohistochemical (IHC) staining with anti-Ki-67 was done and scored from 1+ to 3+. This score was compared with clinicopathological prognostic factors like clinical stage, histological pattern, and grade. Result Among the 50 cases of SCC, 41 showed keratinizing pattern (82%) and nine showed non-keratinizing pattern (18%). Four were in stage I, 25 were in stage II, and 21 were in stage III. Overall, 34 (68%) cases had Ki-67 score 3+, 11 (22%) had Ki-67 score 2+, and five (10%) had Ki-67 score 1+. Ki-67 score of 3+ was the most common score in keratinizing SCC (75.6%), poorly differentiated carcinomas (76.2%), and stage III cases (81%). Conclusion We observed statistically significant correlation of Ki-67 expression with higher clinical stage, keratinizing tumours, and poorly differentiated tumours (p<0.05) indirectly implying the poor prognostic significance of this marker.
RESUMEN
Introduction Determining the histological grade of breast carcinomas before mastectomy is necessary to decide about neoadjuvant chemotherapy. Core needle biopsies used for this purpose often under-grade the tumour. The grade obtained from fine needle aspiration cytology samples will help in such situations and whenever biopsy is not done, as in a resource-poor setup. Many studies are being done to find out the cytological grading system that correlates well with histological grading. Methods This study was done between 2016 and 2019 including the cases in which both modified radical mastectomy and fine needle aspiration of the tumour had been done. Robinson's cytological grading was done in Papanicolaou and haematoxylin & eosin (H&E) stained cytology smears and correlated with modified Bloom-Richardson histologic grading done in modified radical mastectomy specimens. We also studied the prognostic significance of Robinson's method by studying the association between cytological grade and lymph node metastasis. Results Sixty cases were studied. The two methods had the same grade in 49 (81.7%) cases. They showed a significant positive correlation (Spearman correlation coefficient 0.848, p-0.0001), significant association (Chi-square test, p-0.0001), and substantial agreement (kappa value 0.72). Multiple regression analysis showed chromatin score and nucleoli score as the most influential parameters. Lymph node metastasis showed significant association with cytological grade (p-0.0003), cell dissociation score (p-0.0001), nucleoli score (p-0.01), and chromatin score (p-0.04). Conclusion Robinson's cytological grading is a simple, reliable adjunct/alternative to core needle biopsies for grading breast carcinomas before mastectomy. Hence, it can be made a part of routine cytology reporting of breast carcinomas. Further long-term studies will help in confirming its prognostic significance.
RESUMEN
Introduction Chronic calculous cholecystitis is the most common and important contributing factor for cholecystectomy across the country, with a prevalence of 2-29%. Cholesterol supersaturated bile plays a major role in stone formation. It is very essential to identify the pathogenesis of stone formation in order to prevent its formation. This study is aimed to evaluate histomorphological features of chronic calculous cholecystitis and to quantitatively evaluate alteration in mucin expression using the combined Alcian blue-periodic acid Schiff (AB-PAS) stain and the combined high iron diamine Alcian blue (HID-AB) stain, to correlate with each other and also with biochemical features of gall stones. Methods A cross-sectional study of 64 chronic calculous cholecystitis were taken for histomorphological assessment and grading using Hematoxylin and Eosin (H&E) stain and Masson's trichrome stains. Expression of the type of mucins was analyzed using histochemical stains by a standardized scoring system. Results A significant positive correlation was observed between an increase in grades of inflammation and fibrosis with an increase in the quantity of sialomucin and neutral mucin in the deep layers of epithelium, and a significant negative correlation was observed between an increase in grades with a decrease in acidic mucin and sulfomucin of both superficial and deep epithelium except sulfomucin in fibrosis. No significant correlation was obtained with muscle thickness, adipose tissue deposition, and epithelial hyperplasia. A higher frequency of mixed-type stones was associated with severe inflammation. Conclusion Inflammation and fibrosis were strongly correlated with quantitative alteration and reversal of mucin composition in chronic cholecystitis; hence we conclude that these features play a significant role in the pathogenesis of stone formation. Using Combined AB(2.5pH)-PAS stain and Combined HID-AB(2.5 pH) stain to detect mucin hypersecretion and composition of altered mucin is relatively accurate and cost-effective rather than performing costly immunohistochemical (IHC) markers.
RESUMEN
OBJECTIVE: The frequency of bone marrow infiltration by Hodgkin lymphoma is low and varies from 3 to 18%. Hence there exists a dilemma whether bone marrow staging should be done only in the high risk cases. This study aims to study the clinicopathological features and the histomorphology of bone marrow infiltration by Hodgkin Lymphoma. MATERIAL AND METHOD: Bone marrow aspirates and biopsies from cases of Hodgkin lymphoma diagnosed between 2007 and 2015 were studied. Immunohistochemistry with CD15 and CD30 were done in necessary cases. Bone marrow infiltration was correlated with various clinicopathological parameters. RESULTS: Ten of the 81 cases (12.3%) studied showed infiltration by Hodgkin lymphoma in the bone marrow biopsy sections. All the aspirates were negative. Bone marrow in the involved cases showed Reed-Sternberg cells and/or mononuclear Hodgkin cells positive for CD30 in a polymorphous inflammatory background. Cases of lymphocyte depleted subtype (66%) and those with leucopenia/ thrombocytopenia (100%) were frequently associated with bone marrow infiltration. B-symptoms, anemia and mixed cellularity were the other risk factors. However none of these risk factors were noted in two out of the ten cases with bone marrow infiltration. CONCLUSION: As the role of bone marrow aspirate is minimal in the staging of Hodgkin lymphoma, bone marrow biopsy should be the method of choice. Immunohistochemistry helps in the doubtful cases. Bone marrow involvement was frequent but not confined to the high risk groups. Our findings suggest that bone marrow staging should not be restricted to the high risk cases alone.