Clinicopathological Profile of Nodular Hidradenoma: A ten year Study in a Tertiary Care Center.

Nodular hidradenoma is a rare skin adnexal tumor of eccrine differentiation with predominant site being scalp and axillae. Due to its variable locations and unusual clinical presentation and no definite radiological criteria, histopathology seems to be the mainstay in diagnosing these tumors. Most of the lesions present as a cystic swelling and was clinically thought to be a sebaceous cyst/metastasis/carcinoma/sarcoma. In our study, we have included 37 cases and compared its varied clinical and radiological presentation.

Overexpression of EGFR in esophageal squamous cell carcinomas - A new biological target in cancer therapy.

BACKGROUND: Esophageal squamous cell carcinoma (ESCC) is the predominant type of esophageal cancer in the Asian belt. These cancers show poor prognosis with an overall 5-year survival rate less than 19%. Exploring new molecular therapeutic targets such as epidermal growth factor receptor (EGFR) could be the corner stone of new curative treatment. The present study was done to analyze the overexpression of EGFR in different grades of ESCC and explore its role as a diagnostic and theranostic marker in ESCC. METHODS: In this retrospective study, 50 formalin-fixed paraffin-embedded blocks of ESCCs diagnosed from 2014 to 2019 were retrieved. The biopsies were subjected to immunohistochemistry staining of EGFR. The intensity of the membrane staining was reviewed and scored. Compared with various intrinsic and extrinsic factors using Chi-square test, scores more than 2+ were considered as overexpression. RESULTS: Majority (84%) specimens demonstrated overexpression of EGFR where high-grade ESCCs had greater overexpression rates compared to low-grade ESCC (P < 0.05). CONCLUSION: By targeting the EGFR molecules, anti-EGFR drugs could block their signals and stop the growth and spread of ESCCs especially high-grade tumors while harming the normal cells as little as possible. A clinical trial using anti-EGFR monoclonal antibodies will help in the long run to develop immunotherapy drugs.

Precocious puberty in a child: A rare cause and review of literature.

Precocious puberty (PP) in pediatric office practice is challenging as the cause varies from benign to malignant conditions. Adrenocortical tumors are rare in childhood and pseudo-precocious puberty is the most common clinical presentation in children. We report a case of a 5-year-old boy who presented with features of abdominal distention and virilization, and his abdominal magnetic resonance imaging (MRI) revealed an adrenal tumor which was confirmed as adrenocortical carcinoma by biopsy. This case report highlights the importance of the awareness among general practioners and pediatricians to rule out adrenocortical tumors while evaluating a child with PP.

The Significance of Topoisomerase II Alpha in Invasive Breast Carcinoma.

Background Topoisomerase II alpha (Top 2 A) protein has been shown to be a proliferation marker associated with tumour grade. The current study evaluated the prognostic impact of Top 2 A protein on luminal breast cancer and its utility as an independent prognostic marker. Immunohistochemical expression of Top 2 A in breast cancer and its correlation with the tumour type, size, lymph node metastases, grade and ER/PR positivity. Methodology Ethics committee approval was taken and 65 cases of Invasive breast carcinoma presenting to the Department of Pathology at a tertiary care centre in South India were studied. Patient details including age, tumour type, tumour size, tumour grading, estrogen receptor (ER)/progesterone receptor (PR)/human epidermal growth factor receptor 2 (HER2/neu) status and pathologic stage was studied. Immunohistochemistry (IHC) work-up for Top 2 A expression was done and evaluated. Results Of the 65 histological sections of breast cancers, 29/65 showed nuclear positivity for Top 2 A. Node positive tumours 17/65 stained positive for Top 2 A. Stage I tumours 2/65, stage II tumours 12/65 and stage III 14/65 stained positive for Top 2 A. Among the HER2/neu-positive tumours, 22/65 stained for Top 2 A and among ER/PR-positive 9/65 cases were positive for Top 2 A. Triple-negative tumours 5/65 stained for Top 2 A. Conclusion Higher Top 2 A expression was seen in higher stage tumours. HER2/neu-positive tumours significantly showed a correlation with Top 2 A positivity. Therefore, Top 2 A expression can be considered an individual prognostic factor in breast carcinoma.

Lung Parenchymal and Endobronchial Metastases From Ovarian Carcinoma.

Ovarian cancer is the seventh most common cancer in women and the eighth most common cause of cancer death in the world with an overall 5-year survival rate of <50%. (1) The most common age of presentation is at the perimenopausal age group and two-thirds of them present with advanced stage of disease. (2) Thoracic metastases occur in up to 50% of patients. Pleural effusion is the most common presentation of thoracic metastases in these patients, whereas pulmonary parenchymal metastases, lymphangitis, and nodal involvement are less commonly reported. (3) Tracheobronchial involvement is rare with few cases reported in literature. Herewith, we are presenting a case of ovarian cancer in a young female with both lung parenchymal and endobronchial metastases. Bronchoscopy revealed endobronchial tumor in right lower lobe bronchus part of which was covered by yellowish necrotic material. Biopsy showed metastatic ovarian malignancy complicated by aspergillosis. She was started on oral itraconazole along with supportive management following which hemoptysis stopped.

Histological reclassification, histochemical characterization and c-kit immunoexpression in renal cell carcinoma.

OBJECTIVES: Renal cell carcinoma is the most lethal of all urologic malignancies. Several parameters such as histological subtype, nuclear grade and TNM staging help in determining the prognosis and treatment options. A newer therapeutic modality has been suggested based on expression of c-kit antigen by the tumor cells. This study was designed to evaluate various histological parameters and correlate them with c-kit expression. MATERIALS AND METHODS: The study was done on 40 consecutive cases of renal epithelial tumors. Histological sections were reviewed and reclassified according to WHO (2004) classification and nuclear grade assessed. Hale's colloidal iron stain was done to identify the chromophobe variant. Immunostaining with c-kit was done and its expression was studied. The results were correlated and statistical significance was assessed. RESULTS: The age range was 31-81 years, with a male to female ratio of 2:1. Seventy per cent of the cases were clear cell RCC (ClRCC), 17.5% were chromophobe type, 7.5% were papillary RCCs and 5% cases were oncocytomas. Fuhrman nuclear grading revealed 60.5% cases to be of low grade and 39.5% high grade. Hale's colloidal iron staining was positive in chromophobe RCC and oncocytomas, while it was negative in ClRCC. Immunostaining with c-kit was positive only in oncocytomas. CONCLUSIONS: Clear cell RCC was the most common histological subtype of RCC. Clear cell RCC known to have a poor prognosis, showed a statistically significant higher nuclear grade than chromophobe and papillary RCCs which have a better prognosis. Hale's colloidal iron staining was extremely useful in distinguishing chromophobe RCC and oncocytoma from the granular cell variant of clear RCC. Our study revealed c-kit negativity in all RCC. As Imatinib could be ineffective in such tumors, its clinical activity has to be carefully assessed in such tumors through further studies.

Squamous cell carcinoma arising from primary retroperitoneal mature teratoma.

A 65 year old postmenopausal female presented with left sided abdominal pain. Sonogram revealed an intra-abdominal 7.4 x 5.7 cm heterogenous mass. On laparotomy, approximately 10 X 10 cm mesenteric mass was seen adherent to the descending colon. Multiple omental tumor deposits were also noted. Gross examination showed solid and cystic tumor with sebaceous material admixed with hair. Histopathology showed mature cystic teratoma with a spectrum of well to poorly differentiated squamous cell carcinoma with omental metastasis.

Subcutaneous panniculitis-like T cell lymphoma in a HIV positive patient.

Immunocompromised patients are at increased risk for developing certain malignant tumors, particularly aggressive B cell lymphomas and extranodal lymphomas like primary central nervous system lymphoma and primary effusion lymphoma. T cell lymphomas are uncommon in these patients. We report a rare case of subcutaneous panniculitis-like T cell lymphoma in a HIV positive patient who presented with multiple subcutaneous nodules.