Immunohistochemical Staining With Neuroendocrine Markers is Essential in the Diagnosis of Neuroendocrine Neoplasms of the Esophagogastric Junction.

Neuroendocrine neoplasms (NENs) of the esophagogastric junction (EGJ) are uncommon and the classification of these tumors has been revised several times. Since 2016, at the Department of Pathology, Rigshospitalet, Denmark, all adenocarcinomas and poorly differentiated carcinomas of the EGJ have been stained routinely with the neuroendocrine markers, synaptophysin and chromogranin A, to detect a possible neuroendocrine component. This study aimed to determine if routine immunohistochemical staining is necessary to detect neuroendocrine differentiation of the EGJ tumors by evaluating how often a neuroendocrine component of the tumors was correctly identified or missed on routine hematoxylin and eosin-stained slides, and by evaluating the interobserver agreement among several pathologists. Of 262 cases a NEN was identified in 24 (9.2%). Up to 22.7% of all EGJ NENs would have been missed without routinely performed neuroendocrine staining in all EGJ tumors. The interobserver agreement between 3 pathologists was slight to moderate. In conclusion, immunohistochemical staining with neuroendocrine markers is essential for the diagnosis of NENs, and to detect all NENs, we recommend to perform this routinely on all resected tumors of the EGJ.

Sessile serrated lesion and its borderline variant - Variables with impact on recorded data.

Sessile serrated lesion (SSL), belonging to non-dysplastic serrated polyps (SP), has lately received much focus. Its role in the serrated neoplasia pathway(s) seems well established. Data on prevalence rate, demography, and some polyp characteristics remain, however, to be firmly established. Nor has its relation to SPs with subtle aberrant features, falling short of definite SSL-histology, been sufficiently addressed. The aim of this study was to highlight variables that may influence recorded data on SSL and to further discuss the appropriate place of SPs that possess histological attributes intermediate between traditional hyperplastic polyp (HP) and SSL, termed borderline SSL (BSSL). Upon review of 8.324 consecutive colorectal polyps signed-out as HP, 219 SSLs and 206 BSSLs were segregated, using strict predetermined criteria. Predominant left-sidedness and equal gender distribution characterized the present series, though right-sided SSLs occurred significantly more often in older subjects with a trend toward more females. The lower age of patients with SSL/BSSL in the last part of the study reflects the increased focus on hereditary neoplasm. BSSL differed from SSL only by a smaller polyp size. Discordant SSL-data can be ascribed primarily to diversities in endoscopic procedure, though tissue handling, the criteria used, and study design may contribute. A precursor status of BSSL to SSL is an attractive, though still unsubstantiated thesis.

MWCNTs as reinforcing agent to the hap-gel nanocomposite for artificial bone grafting.

The essence of this investigation is to explore MWCNTs as reinforcing agents to strengthen Hap-Gel nanocomposites for artificial bone grafting applications without significantly compromising their biocompatibility. Hap-Gelatin composites, reinforced with various proportions of MWCNTs, were synthesized to optimize the MWCNT content in the composites which yield commendable improvement in the strength. The morphological studies reveal that the MWCNTs act as templates for nucleation of Hap crystals. The biocompatibility of MWCNT reinforced Hap-Gelatin composites were evaluated in animal model through the histopathological investigation of tissues from skin, kidney, and liver. On histopathological examination, no noticeable alteration due to toxicity was found for lower concentration of MWCNTs. Mild reversible changes in the liver and tubular damage in kidney have been observed for higher concentration (4 wt % of MWCNTs). It can be inferred from the findings that MWCNTs, in proportions less than 4%, can successfully be used to reinforce the Hap-Gel nanocomposite to improve its mechanical properties. However, how safe would these CNT reinforced bone implants would be when used for prolonged period in actual physiological conditions needs to be investigated further.

Cleft palate associated with hamartomatous bifid tongue. Report of two cases.

Congenital tumours of the tongue may have a detrimental effect on the simultaneously developing adjacent structures. Palate formation may be affected as it develops in the same period of organogenesis as the tongue. We present two such rare cases of cleft palate with tumour of the dorsal tongue as the probable causative factor. To analyse such an entity, it is necessary to understand the embryogenesis of the palate and tongue. The management and possible elucidation of the occurrence with respect to the developmental phases of tongue and palate are detailed in brief.

An unusual presentation of filariasis: a case report.

BACKGROUND: Filariasis and its consequences are a major health problem in tropical countries, including the Indian subcontinent. Despite its high incidence, it is unusual to find microfilaria in fine needle aspiration cytology (FNAC) smears. We present a case of subcutaneous firm to cystic swelling, aspiration of which revealed a large number of microfilaria. CASE: A 30-year-old man presented with a chain of intermittent, firm swellings in both arms. FNAC of the swellings revealed a large number of 4 microfilariae with associated giant cell reaction and inflammatory cell-like eosinophils. CONCLUSION: Besides the documented usual mode of presentation of filarial infection, it can present in an atypical manner, so careful examination of aspirates from the subcutaneous swellings, especially in filariasis endemic zones, is very important.

A cytologic perspective on meibomian gland carcinoma.

OBJECTIVE: To reevaluate and reestablish the reproducible diagnostic cytomorphologic features of meibomian gland carcinoma (MGCA), demonstrating the importance of fine needle aspiration cytology (FNAC) in eyelid lesions and leading to better management of the tumor. STUDY DESIGN: Cytologic smears ofpreviously diagnosed cases of MGCA over a 3-year period were collected, along with their histopathology reports. The cytomorphology of the histopathologically proven cases were reevaluated in greater detail. The cytologic smears were stained with Leishman-Giemsa cocktail and Papanicolaou stain, and the histopathologic sections were stained with hematoxylin-eosin. Special stains and immunohistochemical stains were applied as required. RESULTS: Of the 19 cases, 3 diagnosed as MGCA on cytologic examination were reported as basal cell carcinoma on histopathology. On reevaluation of the cytologic smears, in addition to the regular characteristic features of MGCA, interesting findings such as an isolated dispersed cell population in a bubbly background, signet ring cells, pseudo-mucin cell balls, giant cell reaction and hyaline-like round bodies were observed. CONCLUSION: This study emphasizes the cytomorphologic features of MGCA in addition to those described in the literature, which could be of a great help in its diagnosis. Further, it emphasizes the importance of FNAC in the diagnosis of MGCA.

Adenoid cystic carcinoma of ceruminous gland: a case report.

Adenoid cystic carcinoma of the external auditory canal (EAC) is a very rare malignant tumor and its diagnosis is frequently missed because of the superficial nature of biopsies. A 30 year old male presented with 6 months history of recurrent painful right ear discharge. On examination there was a nodule of 2 cms in diameter. The microscopic examination of the punch biopsy specimen of tumor revealed typical features of an adenoid cystic carcinoma. While reporting the biopsies of external auditory canal one should keep the adenoid cystic carcinoma as one of the possible differentials, especially if the biopsy is superficial, problem is recurrent and histopathological features suggest the granulation tissue.

Leishman-Giemsa cocktail: an effective Romanowsky stain for air-dried cytologic smears.

OBJECTIVE: To develop an economical, quick, readily available and simple alternative to May-Grünwald-Giemsa (MGG) stain and so to explore the combination of Leishman and Giemsa stain (LG cocktail). STUDY DESIGN: One wet-fixed and 2 air-dried smears were prepared from 720 cases during the period January 2003-November 2004. The LG cocktail and MGG stain were used on the air-dried smears and Papanicolaou stain in wet-fixed smears. Diagnoses of the cases were made using the LG cocktail-stained smears, and then its diagnostic efficacy was cross-checked with the MGG- and Papanicolaou-stained smears by the same cytopathologist. A comparative study of the LG cocktail and MGG-stained smears was done. RESULTS: The results achieved with the LG cocktail-stained smears were comparable to or even better than those with the MGG-stained smears, with excellent diagnostic efficacy. CONCLUSION: As compared to MGG stain, the 1-step LG cocktail is cheaper, easier to standardize and quicker.

Cryptococcal lymphadenitis: report of a case with fine needle aspiration cytology.

BACKGROUND: Cryptococcosis is one of the opportunistic infections in AIDS, and therefore an expeditious diagnosis is of the utmost importance since once a cryptococcal infection disseminates, it becomes life threatening. CASE: A 40-year-old woman presented with epistaxis, fever and cervical lymphadenopathy for 20 days. Fine needle aspiration showed reactive lymphoid hyperplasia with plump, histiocytoid cells resembling metastatic deposits. The second aspirate showed ovoid to spherical, thick-walled structures that stained positive for periodic acid-Schiff stain and mucicarmine. CONCLUSION: Lymph node fine needle aspiration cytology provides an economical and rather quickly accomplished cytodiagnostic result.

Cystic atypical mesoblastic nephroma.

Cystic variants of atypical mesoblastic nephromas are very rare. The present communication deals with two such cases encountered in 3- and 6-month-old patients. The literature is briefly reviewed. The need for proper diagnosis of this tumor to distinguish it from cystic nephroma and Wilms' tumor is highlighted.