Background: Breast carcinoma is the most common malignant tumor and leading cause of cancer deaths in women. While fine needle aspiration cytology is highly accurate in the diagnosis of breast ...lesions, it possesses certain drawbacks. In those circumstancesintraoperative imprint cytology assumes importance, however, imprint cytology is subjected to interpretative errors. Computer image analysis has become an important tool in the pathology laboratory for quantitative morphometric analysis. The purpose of this study was to compare the morphometric values of various breast lesions onintraoperative imprint smears with final histopathological sections.Methods: The study group comprised 30 cases of, borderline(suspicious), and malignant lesions. Intraoperative imprint smears were stained with hematoxylin and eosin, and toluidine blue. Morphometry was done on these smears and compared with morphometry on the histopathological sections, followed by statistical correlation. We studied the following five parameters: mean nuclear area, mean nuclear diameter, mean nuclear perimeter, feret circle, and nucleo-cytoplasmic ratio.Results: In the current work, all of the studied parameters with the exception of feret circle showed significantly lower values in benign ductal epithelial cells compared to malignant lesions and concentrate on the importance of morphometry as a diagnostictool that could differentiate benign from malignant lesions, especially if it can be employed on imprint smears intraoperatively. Accurate assessment of intraoperative margins by imprint smears using image analysis automation can prevent multiple reexcisionprocedures in breast conservation surgery.
Hydatid cysts usually involve the liver and lungs, but any other organ can potentially be involved and these can mimic numerous pathologies; however, primary involvement of the retroperitoneum and ...presentation as a left-sided abdominal mass is quite unusual. A 30-year-old male presented with a large cystic lump in the left side of the abdomen that was diagnosed as a primary retroperitoneal hydatid cyst by a computed tomography scan and serology. The patient was managed successfully by minimal access surgery. This report highlights that a primary retroperitoneal hydatid cyst is a rare clinical entity and should be considered as one of the differential diagnoses in patients presenting with a cystic mass in the retroperitoneum. In the present era of minimal access surgery, it can be safely managed with a laparoscopic approach.
Cystic neoplasms of the pancreatic tail are usually picked up as incidental findings during imaging studies. We report an unusual case of adrenal pseudocyst mimicking cystic tumor of pancreatic tail ...who presented with abdominal pain and weight loss. Ultrasonography and CT of the abdomen revealed a cystic mass in relation to the pancreatic tail. On exploration, a cystic mass was present in the tail of the pancreas, for which distal pancreatectomy was performed. The histopathology report surprisingly revealed an adrenal pseudocyst without a cellular lining. The normal adrenal gland was compressed in the wall. This case highlights that this rare possibility should be considered in the differential diagnosis of cystic lesions of the pancreatic tail.
Cesare Beccaria (1738-1794) offered a progressive view of punishment centered on a law-based proportionality for fair and effective crime prevention. Moderation of severity was placed in the hands of ...legislators and in the laws. Political proportionality, which eschews moderation of severity, dominates modern crime prevention. Current preferences for legal decision-making reflects generalized disproportionality applicable to all offenders. The limits of legislative and politicized proportionality necessitate modifying Beccaria's proportionality to modern contexts, and the principle and concept of specific proportionality offer a viable alternative. Contextualization, inquiry, and intra-legal engagement underpin discretion-based specific proportionality. Modernizing proportionality, while presenting some challenges, offers significant benefits to society.
Chloroma, also called granulocytic sarcoma (GS) or Myeloid Sarcoma, is a rare malignant extra-medullary neoplasm of myeloid precursor cells. It is usually associated with myeloproliferative disorders ...but its appearance may precede the onset of leukaemia. The presence of a chloroma is certainly a sign of poor prognosis. We report a case of chloroma in a middle aged female without a prior history of leukemia in the perianal skin region with clinical diagnosis of perianal abscess. When there is no concomitant leukaemia, diagnosis of chloroma may be difficult. Differential diagnoses include acute lymphoblastic leukemia, large cell NHL, lymphoblastic lymphoma, Ewing's sarcoma and cutaneous T cell lymphoma.
This case report is 10 years follow-up of a child who presented with acute abdomen at the age of 8 years. Exploration revealed acute pancreatitis with the necrosis of common bile duct and almost ...whole of the common hepatic duct with bile leaking from the junctional stump of the right and left hepatic ducts. The patient was managed successfully by Roux-en-Y hepaticojejunostomy. After 10 years, the patient again presented with a recurrent discharging sinus from the anterior abdominal wall. On exploration, it was found to be a stitch granuloma near the site of hepaticojejunostomy. However, hepaticojejunostomy was found to function normally as seen on MRCP. This rare case highlights that extra-hepatic biliary-ductal necrosis is very unusual complication of acute pancreatitis; and it can be successfully managed by Roux-en-Y hepaticojejunostomy as evident from long-term follow-up.
OBJECTIVE This prospective study was undertaken to evaluate the role of colour Doppler sonography in the assessment of prostate carcinoma. METHODS Forty consecutive patients who were suspected of ...having prostate carcinoma with either raised prostate specific antigen or abnormal digital rectal examination were included in the study. Transrectal greyscale and colour Doppler sonography of the prostate was performed using a 5–9 MHz intracavitary probe. Needle biopsies were taken from areas that showed increased flow on colour Doppler. The results were correlated with the final diagnosis established on histopathological examination. RESULTS Comparison of greyscale and colour Doppler sonography showed that the latter is more sensitive and specific in predicting the malignancy. The statistical parameters of colour Doppler versus greyscale sonography were: sensitivity 88.23 vs. 73.52, specificity 66.66 vs. 33.33, positive predictive value 93.75 vs. 85.18, and negative predictive value 50 vs. 22.22, respectively. CONCLUSION Colour Doppler and greyscale sonography should be routinely performed to improve detection of prostate carcinoma and to target the lesion.
Spontaneous Transmural Migration of Surgical Sponges Godara, Rajesh; Marwah, Sanjay; Karwasra, R.K. ...
Asian journal of surgery,
2006, 2006-Jan, 2006-01-00, 20060101, 2006-01-01, Letnik:
29, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Postoperative retained surgical sponges or other foreign bodies are usually underreported. Radio-opaque materials are usually detected on follow-up radiological investigations, but radiolucent ...materials such as sponges create diagnostic problems and clinically mimic various abdominal pathologies. Introduction of spiral computed tomography, magnetic resonance imaging and dedicated ultrasonography has enabled clinicians to find these foreign bodies at the earliest opportunity to avoid disastrous complications. Spontaneous transmural migration and expulsion per rectum of more than one sponge without sequelae is also possible. We report one such interesting case.
Acute left sided colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in acute setting. A World Society of Emergency Surgery (WSES) Consensus Conference on ...acute diverticulitis was held during the 3rd World Congress of the WSES in Jerusalem, Israel, on July 7th, 2015. During this consensus conference the guidelines for the management of acute left sided colonic diverticulitis in the emergency setting were presented and discussed. This document represents the executive summary of the final guidelines approved by the consensus conference.
Aim: Routine assessment of cell proliferation is recommended in the pathologic evaluation for all breast cancers. Considering the poor reproducibility and interobserver variability in mitotic counts, ...Ki-67 is an easily available and reliable substitute for mitotic counts and has been shown to have a significant relationship with the histologic grade of malignancy and the mitotic activity of tumors. Our study aimed at exploring Ki-67 expression and studying its correlation with other established prognostic parameters.
Materials and Methods: Seventy-five cases of primary breast cancer undergoing radical or modified radical mastectomy constituted the study group. Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2)/neu, and Ki-67 was assessed in each case. Ki-67 labeling index (Ki-67-LI) was estimated as the number of positive nuclei divided by total number of nuclei scanned counting a minimum of 1000 cells in 10 selected high power fields that displayed the highest immunoreactivity and was expressed as percentage. Ki-67 expression was correlated with various clinicopathologic prognostic parameters including age, tumor size, tumor type, axillary lymph node status, and histologic tumor grade.
Results: A statistically significant direct association was observed between Ki-67-LI and tumor size, histologic grade and Nottingham prognostic index. A statistically significant inverse association was observed between Ki-67-LI and ER and PR expression. However, no association was observed between Ki-67-LI and menopausal status, lymph node involvement and HER2/neu expression.
Conclusion: Based on our results, we concluded that modified Bloom-Richardson (MBR) grading has been recognized as a treatment related indicator. The accuracy and reliability in grading have always been a matter of concern, hence, the reproducibility of grading should be enhanced. Ki-67-a proliferation marker is easily identified and provides comparable accurate information. In contrast to poor reproducibility of mitotic counts, Ki-67 can achieve high agreement between pathologists; is more reproducible; adds complementary value to the MBR grading system and correlates well with other clinicopathologic parameters. It may act as a significant prognostic indicator for routine clinical use and be helpful for selection of adjuvant treatment. It can also add value in categorizing Grade II tumors into two prognostic subgroups with prognosis equivalent to Grades I and III, respectively.
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