This pilot study aimed to establish the interrelationship between collagen and mast cells in periapical granulomas and periapical cysts.
An observational cross-sectional study was conducted on the ...paraffin-embedded tissue sections of 68 specimens (34 periapical granulomas and 34 periapical cysts). The specimens were stained with picrosirius to observe collagen fiber birefringence and anti-tryptase antibody to evaluate the mast cell count immunohistochemically. The mean number and birefringence of collagen fibers, as well as the mean number of mast cells (total, granulated, and degranulated), and the mean inflammatory cell density were calculated. The data obtained were analyzed using the Kruskal Wallis test, Mann Whitney
test, and Spearman correlation test (
< 0.05).
The mean number of thick collagen fibers was higher in periapical cysts, while that of thin fibers was higher in granulomas (
= 0.00). Cysts emitted orange-yellow to red birefringence, whereas periapical granulomas had predominantly green fibers (
= 0.00). The mean inflammatory cell density was comparable in all groups (
= 0.129). The number of total, degranulated, and granulated mast cells exhibited significant results (
= 0.00) in both groups. Thick cyst fibers showed significant inverse correlations with inflammation and degranulated mast cells (
= 0.041, 0.04 respectively).
Mast cells and inflammatory cells influenced the nature of collagen fiber formation and its birefringence. This finding may assist in the prediction of the nature, pathogenesis, and biological behavior of periapical lesions.
Morphological diagnosis of non-Hodgkin lymphoma (NHL) is usually based on lymph node biopsy. Bone marrow biopsy (BMB) is important for staging, and morphology alone can be challenging for subtyping. ...Immunohistochemistry (IHC) allows a more precise diagnosis and characterization of NHL using monoclonal antibodies. However, there is a need for a minimal panel that can provide maximum information at an affordable cost.
All newly diagnosed cases of B-cell NHL with bone marrow infiltration between 2017 and 2019 were included. BMB was the primary procedure for diagnosing B-cell NHL. Subtyping of lymphomas was performed by immunophenotyping using a panel of monoclonal antibodies on IHC. The primary diagnostic panel of antibodies for B-cell NHL included CD19, CD20, CD79, CD5, CD23, CD10, Kappa, and Lambda. The extended panel of antibodies for further subtyping included CD30, CD45, CD56, Cyclin D1, BCL2, and BCL6.
All cases of B-cell NHL were classified into the chronic lymphocytic leukemia (CLL) and non-CLL groups based on morphology and primary IHC panel. In the CLL group, the most significant findings were CD5 expression, CD23 expression, dim CD79 expression, and weak surface immunoglobulin (Ig) positivity. In the non-CLL group, they were CD5 expression, positive or negative CD23 expression, strong CD79 expression, and strong surface Ig expression. An extended panel was used for further subtyping of non-CLL cases, which comprised CD10, Cyclin D1, BCL2, and BCL6.
We propose a two-tier approach for immunophenotypic analysis of newly diagnosed B-cell NHL cases with a minimum primary panel including CD5, CD23, CD79, Kappa, and Lambda for differentiation into CLL/non-CLL group and Kappa and Lambda for clonality assessment. An extended panel may be used wherever required for further subtyping of non-CLL.
CONTEXT: Fetal hemoglobin (HbF) reduces to <1% few months after birth. However, it can persist beyond infancy into adult life in rare conditions such as delta-beta (δβ) thalassemia and hereditary ...persistence of HbF. δβ thalassemia is a relatively rare type of thalassemia due to decrease in both beta and delta globin chain production. AIMS: This study aims to assess the hematological and high-performance liquid chromatography (HPLC) findings in δβ thalassemia. SETTINGS AND DESIGN: Cross-sectional observational study. SUBJECTS AND METHODS: The study was conducted in department of Clinical Pathology, PGIMS, Rohtak. On screening of 1197 patients over a period of around 1 year, a total of 13 cases of δβ thalassemia were detected by HPLC. STATISTICAL ANALYSIS USED: Not done. RESULTS: The age of presentation ranged from 1 to 42 years with a mean age of 22.8 years. Eleven cases were diagnosed as heterozygous δβ thalassemia and two as homozygous δβ thalassemia. CONCLUSIONS: δβ thalassemia is an uncommon cause of elevated HbF. Clinical and hematological parameters should be carefully analyzed for accurate diagnosis.
Accessory spleen within the scrotum Marwah, Nisha; Bhutani, Namita; Kalra, Rajnish ...
Journal of pediatric surgery case reports,
03/2019, Letnik:
42
Journal Article
Recenzirano
Odprti dostop
Abstract Presence of accessory spleen in scrotal sac is an extremely rare condition. It is attributed to splenogonadal fusion which is a rare congenital anomaly. It can be an incidental finding on ...ultrasonography and during orchiopexy or inguinal hernioplasty or less frequently can present as a scrotal swelling usually in adult life mimicking as testicular tumor. In view of the rarity of this condition, we present two cases highlighting the clinical characteristics of the condition, with a special focus on the signs and findings which might help prevent unnecessary orchiectomies.
Expression of COX-2 in Carcinoma Breast Sharma, Ashish; Marwah, Nisha; Parmar, Padam ...
Journal of clinical and diagnostic research,
03/2018, Letnik:
12, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Introduction: Early detection of breast cancer with chemoprevention is needed to decrease cancer related mortality at an early stage. The role of Cyclooxygenase-2 (COX-2) in carcinogenesis and tumour ...progression has been a subject of interest in breast cancer. Aim: To study the spectrum of COX-2 expression in normal breast tissue, Ductal Carcinoma In Situ (DCIS) and invasive breast cancer. Materials and Methods: Fifty cases of primary breast cancer undergoing radical or modified radical mastectomy constituted the study group. Histopathological diagnosis was established on routine Haematoxylin and Eosin (H&E) stain and various histologic prognostic parameters were assessed. Immunohistochemical profile of the tumour was assessed by subjecting one section each from a representative block of tumour to ER, PR, HER2/ neu and COX-2. Immunohistochemical Score (IHS) of COX-2 was calculated by combining an estimate of the percentage of immunoreactive cells (quantity score) with an estimate of the staining intensity (staining intensity score). The results obtained were interpreted and correlated statistically. When the data was qualitative, a chi-square test was used to assess the association. Correlation of COX-2 IHS with clinicopathological parameters and different areas was calculated by Spearman rank correlation (rs). The significance of correlation was evaluated by using critical values table for Spearman’s coefficient of correlation. Results: COX-2 IHS was negative in (n=17, 34%) and moderately positive in (n=33, 66%) of the tumour cases examined. Among normal breast tissues, negative and moderate positivity was seen in (n=14, 28%) and (n=36, 72%) of the cases respectively. Amongst the 23 cases with DCIS component, (n=20, 86%) of the cases revealed moderately positive COX-2 IHS. COX-2 expression was correlated within normal breast tissue, DCIS component and invasive areas, as paired samples. Paired areas examined for COX-2 expression with group of normal-invasive, normal-DCIS and tumour-DCIS and all the three components together. Correlation of COX-2 expression among the paired areas examined was statistically significant. Conclusion: Based on present results, COX-2 exerts autocrine and paracrine effects and is involved in early breast cancer carcinogenesis. Inhibition of COX-2 may represent a potential target for preventing breast cancer oncogenesis.
Background: Wilms’ tumor is the most common malignant renal tumor in the pediatric age group. This tumor is classically managed by multimodal treatment which involves surgery, radiotherapy and ...chemotherapy. While there is plenty of data in world literature on the outcome of Wilms’ tumor, there is a paucity of data from India. Methods: All patients with proven diagnosis of Wilms’ tumor between 2008 to 2012 were noted from the hospital’s cancer registry. We performed detailed analyses of all patients’ clinical case records for demographic profiles, clinical features, imaging studies, treatment, and outcome. Histopathological classification of the tumor determined the patient’s post-operative management. All patients were followed for a period of 3 years and we analyzed the eventual outcome in the form of disease-free survival, complications, tumor recurrence, and mortality. Results: There were 31 cases of Wilms’ tumor included in this study. The median age of presentation was 3-4 years (range: 5 months-6 years) with a female: male ratio of 1.2:1. Abdominal mass was the chief presenting feature in 20 (64.5%) patients followed by abdominal pain in 6 (19.3%). All children had unilateral disease, 25 (80.6%) had right-sided and 6 (19.3%) had left-sided disease. Bilateral disease was seen in only one case. Of the 31 cases of Wilms’ tumor, 36% cases presented with stages I and II disease, 55% had stage III, and 9% of the cases were stage IV. Most cases of Wilms’ tumor were stage III. The majority had classical Wilms’ tumor with a favourable histology. The estimated 5-year event free survival was 87.3% Conclusion: A multidisciplinary approach can approach similar survival rates compared to the National Wilms’ Tumor Study Group, even in the Indian scenario. Further improvement in survival of these children can only be achieved by increasing awareness, early recognition, appropriate referral, and a multidisciplinary approach.
Adenocarcinoma of the prostate is the second most common cause of cancer. The loss of CD10 is a common early event in human prostate cancer and is seen in lower Gleason Score malignancies while ...increased and altered expression is seen in high Gleason Score tumors, lymph nodes and bone metastasis.
This was a prospective observational study conducted on 75 patients suspected to have prostate cancer. Immunohistochemical profile was assessed for PSA, AMACR and CD10 immunostaining. The intensity of CD10 expression and pattern of CD10 staining of tumor cells was evaluated.
The patients were in age group of 50-90 years with a mean age of 70.97 ± 9.51 years. As the Grade Group/Gleason Score increased, the number of cases showing negative expression decreased and the pattern of expression changed from membranous to cytoplasmic to both types of expression. As the serum PSA levels increased the intensity of expression changed from focally positive to diffusely positive. The pattern of expression also changed from membranous to cytoplasmic to both (membranous + cytoplasmic) types of expression with an increase in PSA levels.
By immunohistochemical analysis we can identify CD10 positive tumors, which may warrant more aggressive initial therapy. A number of drugs against CD10 are available based on which potential targeted therapies could be formulated.
Solitary fibrous tumor is a rare tumor of the salivary gland. To date, 27 cases have been reported. The clinical and radiological features are the same as other lesions of the parotid gland. Hence, ...light microscopy and immunostaining is important to confirm the diagnosis. Fine needle aspiration cytology yield depends on the area sampled and can be inconclusive in many cases. Treatment of choice is complete surgical excision with regular long-term follow up. Most cases are benign, however three malignant cases have been reported. Here, we report a case of solitary fibrous tumor in the parotid gland seen in a 14-year old female diagnosed by histopathological examination and immunohistochemistry analysis.
We report a very rare case of Meckel’s diverticulitis with ileal stricture at the base of the diverticulum in a young adult as a cause of recurrent small bowel obstruction lasting for 7 years. None ...of the pre-operative investigations were able to diagnose the cause of obstruction. The patient had undergone appendicectomy 3 years ago but without any relief. Thereafter he was given a therapeutic trial of anti-tubercular drugs, but his symptoms rather worsened with this treatment. Finally, the diagnosis of Meckel’s diverticulitis with ileal stricture was made on exploratory laparotomy. The patient recovered well following segmental ileal resection including the stricture and inflamed Meckel’s diverticulum. This unusual case highlights that such a rare clinical entity should be considered as a differential diagnosis while dealing with cases of recurrent distal ileal obstruction so as to avoid misdiagnosis and mismanagement as happened in the present case.
Follicular dendritic cells or dendritic reticulum cells are important components of the immune system essential for antigen presentation. Malignancies arising from these cells are uncommon and the ...first case was reported in 1986. The most common sites of follicular dendritic cell sarcomas are lymph nodes, especially cervical, axillary and mediastinal regions, but extranodal sites including head and neck and gastrointestinal tract may be affected in one-third of patients. Immunohistochemistry plays an important role in its diagnosis to differentiate it from morphologically similar malignancies The present report describes a case of follicular dendritic cell sarcoma in a patient with chronic myeloid leukemia (CML) treated with imatininb mesylate for 6 years. This case deserves reporting due to rarity of the disease and hitherto unreported association with CML. Furthermore, the pathological diagnosis is challenging and requires a close-knit effort between the pathologist and haematologist.
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