To study the expression of estrogen, progesterone receptor and p53 immunohistochemistry markers in subtyping endometrial carcinoma.

Background: Endometrial cancer is one of the most commonly diagnosed cancers in women worldwide. Aim and Objectives: To study the expression of estrogen receptor (ER), progesterone receptor (PR) and p53 immunohistochemistry (IHC) markers in subtyping endometrial carcinoma. Materials and Methods: A total of 100 cases of carcinoma endometrium submitted during January 2016 to October 2018 were included in our study. The ER, PR and p53 expressions were scored as per the adopted scoring system. Agreement between ER, PR and p53 IHC expression and the consensus HE diagnosis, FIGO grading and tumour staging were assessed using Chi square tests. Results: There was a statistical association between ER, PR and p53 status and tumour histologic type with a P value < 0.01. There was no statistical significance observed between ER and PR expressions and different FIGO grades. Statistical significance (P = 0.036) between p53 and different FIGO grades seen. No statistical significance was observed between ER, PR and p53 expressions and different tumour stages and tumour invasiveness. There was a statistical association between ER and PR status and lymph node metastasis. p53 did not show a statistical significance. Conclusion: Combination of ER, PR and p53 IHC markers can be used to distinguish type 1 and type 2 endometrial cancers. PR expression is more specific than ER in endometrioid carcinomas. p53 expression is more specific in serous carcinoma, however, p53 IHC alone cannot be used to distinguish different grades of endometrioid carcinomas as there is variability of staining in endometrioid carcinomas.

A Study of Focal and Segmental Glomerulosclerosis according to the Columbia Classification and Its Correlation with the Clinical Outcome.

Introduction Focal and segmental glomerulosclerosis (FSGS) is a leading cause of nephrotic syndrome in both adults and children. The "Columbia classification of FSGS" includes five variants; not otherwise specified (NOS), tip, perihilar, cellular, and collapsing variants that may have different prognostic and therapeutic implications. Materials and Methods This is a retrospective study and was carried out in the Department of Histopathology, Apollo Hospitals, Hyderabad. Of a total of 11,691 kidney biopsies over a 7-year period, from 2006 to 2012, 824 cases were diagnosed as FSGS, of which 610 cases in which detailed clinical findings were available were included in this study. FSGS was then categorized according to the Columbia classification. Results FSGS, NOS was the predominant histomorphological variant. Serum creatinine was significantly high in the collapsing variant, followed by NOS. Follow-up data was available for 103 cases,72.8% had complete remission, 10.6% had partial remission, and in 16.5 % there was no remission. Relapses were observed in 6.7% cases, two patients (1.9%) succumbed, and 4.8% cases progressed to chronic kidney disease. Conclusion This study showed that perihilar variant was less prevalent, with tip and cellular variants being more prevalent in Indian subcontinent compared to Western literature. Collapsing variant was also less common.

Renal Lymphoma Diagnosed on Kidney Biopsy Presenting as Acute Kidney Injury.

Introduction: Renal manifestations associated with hematolymphoid malignancies are known. Primary or secondary involvement of the kidney by lymphomatous infiltration has various clinical presentations. Acute kidney injury is not an uncommon finding in relation to lymphomatous interstitial infiltration proven on kidney biopsy. However, diagnosing it solely on renal biopsy remains a challenge and needs expertise and aid of immunohistochemistry as the prognosis is dismal. Methods: This is a retrospective study of kidney biopsy-proven cases of renal lymphoma presenting with acute kidney injury. Results: The study included 12 patients with ages ranging from 4 to 50 years who presented with serum creatinine ranging 2.1-9.6 mg%. Renal biopsy findings showed interstitial lymphomatous infiltrate. Two cases were diagnosed as primary lymphoma and the other 10 as secondary lymphomas. Among the 12 cases, nine were B-cell non-Hodgkin lymphoma, of which diffuse large B-cell lymphoma was diagnosed in six (50%), low-grade B-cell type in two (16.6%), chronic lymphocytic leukemia in one (8.3%), and three were T-cell-type. Two were acute T-cell lymphoblastic lymphoma and one other was a high-grade T-cell lymphoma. Four patients succumbed. The other four patients are alive; one is on chemotherapy, while two of them are on hemodialysis. Conclusion: Acute kidney injury as a presenting feature with lymphomatous infiltration of renal parenchyma is not uncommon. The patchy involvement makes it challenging on kidney biopsy with definitive diagnosis being made with the help of immunohistochemistry. Appropriate multidisciplinary involvement improves patient outcome.

Rosette-forming glioneuronal tumors: a report of two cases.

Rosette-forming glioneuronal tumor, a mixed glial and neuronal tumor, is a relatively new entity in tumors of the central nervous system, included in 2007 classification published by World Health Organization (WHO). It was initially described to occur in and around the fourth ventricle; however, recent case series have reported other locations also. Their occurrence in supratentorial and spinal locations has recently been reported. We report two cases of rosette-forming glioneuronal tumors, one in the midbrain and one in a suprasellar location, and review the literature.

Rosai-Dorfman disease mimicking a sphenoid wing meningioma.

A 40-year-old male presented with a single generalized tonic-clonic seizure. MRI revealed an enhancing, dural-based, left lateral sphenoid wing lesion suggestive of a meningioma. At microsurgical excision, the lesion was firm and relatively avascular. The histopathological report revealed S-100 positive histiocytic proliferation with lymphophagocytosis (emperipolesis) characteristic of the Rosai-Dorfman disease. The case and its management are discussed.

Children with visual impairments may have altered joint movement: an observational case-control study / Niños con deficiencia visual pueden tener la amplitud de movimiento articular alterada: un estudio observacional tipo caso-control / Crianças com deficiência visual podem ter a amplitude de movimento articular alterada: um estudo observacional tipo caso-controle

To assess the articular range of motion in children with congenital visual impairment. Were evaluated 75 children between five and twelve years old, 49 with normal visual acuity and 26 visually impaired. Two evaluators performed the measure of active and passive range of motion by goniometry of shoulder and hip in all axes of motion. All examiners made a test of correlation between data obtained, to determine the inter-rater reliability, using the intraclass correlation coefficient (ICC). In individuals with visual impairments was statistically significant difference, with higher range of motion in individuals with visual impairments to medial and lateral rotation of shoulder and hip lateral rotation. Were found: high correlation in the inter-rater reliability (ICC>0.70) for 9 (22.5%) groups of articular range of motion, moderate correlation (0.7>ICC>0.5) for 25 (62.5%) groups and low correlation to 6 (15%) groups ranges of motion. Sampled children with congenital visual impairment showed greater joint mobility for rotational range of motion of the shoulder and hip than children with normal visual acuity, although they have also shown lower values for articular range of motion in abduction and extension in shoulders.

Se evaluó la amplitud de movimiento articular en niños con deficiencias visuales congénitas. Se evaluaron a 75 niños con edades entre 5 y 12 años, siendo 49 con acuidad visual normal y 26 con deficiencia visual. Dos evaluadores realizaron la medición de la amplitud de movimiento articular activa y pasiva mediante goniometría del hombro y de la cadera, en todos los ejes de movimiento. Todos los evaluadores realizaron un test de correlación entre los datos obtenidos para la determinación de la fiabilidad interevaluador, por medio del coeficiente de correlación intraclase (ICC). En los individuos con deficiencia visual hubo diferencia estadísticamente significativa, con mayores valores de amplitud de movimiento para la rotación medial y lateral del hombro y rotación lateral de la cadera. Fueron encontradas: alta correlación de fiabilidad interevaluadores (ICC>0,70) para 9 (22,5%) grupos de amplitud de movimiento articular, correlación moderada (0,7>ICC>0,5) para 25 (62,5%) grupos y baja correlación para 6 (15%) grupos de amplitudes de movimiento. Los niños incluidos en la muestra con deficiencia visual congénita presentaron mayor movilidad articular para las amplitudes de movimiento de rotación del hombro y de la cadera que los niños sin deficiencias visuales, aunque también presentaron valores más bajos para la amplitud de movimiento articular de abducción y extensión de hombros.

Avaliou-se a amplitude de movimento articular em crianças com deficiências visuais congênitas. Foram avaliadas 75 crianças entre 5 e 12 anos de idade, sendo 49 com acuidade visual normal e 26 portadoras de deficiência visual. Dois avaliadores realizaram a medida da amplitude de movimento articular ativa e passiva, pela goniometria do ombro e quadril, em todos os eixos de movimento. Todos os avaliadores realizaram um teste de correlação entre os dados obtidos, para determinação da confiabilidade interavaliador, por meio do coeficiente de correlação intraclasse (ICC). Nos indivíduos com deficiência visual houve diferença estatisticamente significativa, com maiores valores de amplitude de movimento para rotação medial e lateral de ombro e rotação lateral de quadril. Foram encontradas: alta correlação na confiabilidade interexaminador (ICC>0,70) para 9 (22,5%) grupos de amplitude de movimento articular, correlação moderada (0,7>ICC>0,5) para 25 (62,5%) grupos e baixa correlação para 6 (15%) grupos de amplitudes de movimento. As crianças amostradas com deficiência visual congênita apresentaram maior mobilidade articular para as amplitudes de movimento rotacional do ombro e quadril que as crianças sem comprometimentos visuais, embora tenham apresentado também menores valores para amplitude de movimento articular de abdução e extensão de ombros.

Confiabilidade intra e interexaminadores da fotogrametria na classificação do grau de lipodistrofia ginóide em mulheres assintomáticas / Intra and inter-examiner reliability of photogrammetry in the classification of the degree of gynoid lypodystrophy in asymptomatic women

A lipodistrofia ginóide (celulite) é uma afecção dermatológica comum entre as mulheres. Uma das suas formas de avaliação é a inspeção visual por meio da fotogrametria. Entretanto, não foram encontrados estudos que verifiquem a repetibilidade e reprodutibilidade dessa avaliação. O objetivo deste estudo foi verificar a confiabilidade intra e interexaminadores da avaliação da celulite por meio da fotogrametria. Foram fotografadas e avaliadas as regiões glúteas de 50 mulheres (25,14+-4,45anos). A reprodutibilidade foi testada pela avaliação da mesma fotografia por dois examinadores em duas ocasiões diferentes, com intervalo de um ano;...

Gynoid lypodystrophy (cellulitis) is a common condition among women. One of its forms of evaluation is the visual inspection by photogrammetry. However, no studies could be found in literature on the repeatability and reproducibility of such evaluation. The purpose of this study was to assess reliability intra and interexaminer of cellulitis evaluation by photogrammetry. The gluteal regions of 50 women (mean age 26.14±4.45 years) were photographed and evaluated. Reproducibility was tested by evaluation of the same photograph by two examiners on two one-year interval occasions; repeatability was assessed by a single examiner on two occasions one week apart. The Kappa index was applied. Results showed substantial correlation (ê=0.70) between examiners for cellulite degrees in upperbuttock, and moderate correlation (ê=0.50) for cellulite degrees in lower buttock. As to repeatability, analyses showed excellent correlation (ê=0.81) for cellulitis degree in upper buttock and substantial correlation (ê=0.75) in lower buttock. The method proposed for classification of different gynoid lypodystrophy degrees byphotogrammetry hence showed acceptable reliability intra and inter-examiner for the majority of evaluated regions, with the exception of the lower buttock...