Indian journal of pathology & microbiology最新文献

Introduction: Recent advances in the field of head and neck cancer have identified depth of invasion (DOI) and worst pattern of invasion (WPOI) as important prognostic/predictive factors in oral cancers. Muscle invasion, which has a better reproducibility, can be a suitable alternative as a predictor of biological behavior, especially if combined with WPOI. There is sparse literature available regarding its prognostic significance.

Materials and methods: We analyzed 35 cases of oral-squamous-carcinomas, where the presence or absence of muscle invasion was correlated with other prognostic factors, with respect to nodal positivity and advanced stage.

Result: The positive predictive values (PPV) of DOI, WPOI, and muscle invasion in relation to lymph node metastasis were 42.3%, 64.7%, and 47.8%, respectively. The PPVs of DOI, WPOI, and muscle invasion in relation to stage were 57.7%, 70.6%, and 65.22%, respectively. The negative predictive values (NPV) of DOI, WPOI, and muscle invasion in relation to nodal metastasis were 88.89%, 94.44%, and 91.66%, respectively. The NPVs of DOI, WPOI, and muscle invasion in relation to tumor stage were 66.67%, 66.67%, and 75%, respectively. PPV of muscle invasion was higher than that of DOI. WPOI and muscle invasion were combined and correlated with nodal positivity/high clinical staging. The PPV (71.42% and 85.71%) was significantly greater than these parameters alone and was more significant than DOI. The NPVs (90.47% and 76.19%) were also significantly higher.

Conclusion: WPOI along with muscle invasion in squamous cell carcinoma could be a supplement to DOI in predicting lymph nodal metastasis and tumor stage.

Abstract: Myositis ossificans (MO) is a reactive, localized, benign lesion that typically affects the extremities in younger people. It is a unique and uncommon condition that has been difficult to fully understand regarding its causes, development, and effective treatment. Commonly seen in muscles of arms, and thighs, it seldom includes the masticatory muscles. Severe trismus results if it affects the masticatory muscles. Magnetic resonance imaging and computed tomography scans are useful methods for identifying the calcified mass. Histopathology is essential for achieving an accurate diagnosis and planning subsequent treatment strategies. This report describes the case of a 30-year-old male patient who came with a complaint of pain during mouth opening for 1 month.

Abstract: Extraskeletal chondromas are rare slow growing benign neoplasms predominantly formed by the hyaline cartilage. These tumors arise from the tenosynovial sheath or the soft tissue adjacent to the tendon sheath. Hands and feet are the most frequently involved sites. Other less frequent sites such as the knee, trunk, oral cavity, pharynx, and the base of the skull have also been reported in the literature. The histomorphology closely resembles a chondroblastoma of the bone. It is extremely important that these benign tumors be differentiated from its other similar looking benign mimcs. To the best of our knowledge, only 12 cases of chondroblastoma like soft tissue chondroma (CLC) have been reported, 11 of which were located in the hand. In this case report, we present a 54-year-old female with a soft tissue swelling over the right hand index finger diagnosed as CLC on core needle biopsy followed by excision.

Abstract: Amyloid fibrils aggregate and deposit in many tissues and multiple organs, leading to systemic amyloidosis. One of the main forms of systemic amyloidosis is called amyloid A (AA) amyloidosis, where chronic inflammation causes the serum amyloid A (SAA) protein to transform into a precursor protein. Regarding the etiology of AA amyloidosis, it was noted that inflammatory arthritis, such as rheumatoid arthritis, was the most common underlying pathology and that malignant disease was one of the uncommon causes. Amongst the malignant causes, the common carcinomatous etiology of amyloidosis has been identified as renal cell carcinoma (RCC). We report a case of incidental detection of ipsilateral renal and adrenal gland AA amyloidosis with RCC in a patient who died 10 days after surgery due to sepsis and multiorgan failure. A 65-year-old female who presented with weight loss, haematuria, left loin pain, severe fatigue, anemia, and facial puffiness for 4 weeks before admission. An ultrasonography (USG) of the abdomen and pelvis revealed a well-encapsulated mass lesion involving the anteromedial aspect of the upper pole of the left kidney, with the possibility of a malignant mass lesion. On histopathology, it was a clear cell RCC with adjacent renal parenchyma and adrenal gland showing amyloid deposits, which showed apple green birefringence on the polariser. These deposits were positive for serum amyloid A on immunohistochemistry (IHC). Thus, renal cell carcinoma, amongst solid organ malignancies, can be the most common cause of systemic amyloidosis.

Introduction: Disorders of sexual development (DSD) comprise a group of congenital conditions, occurring in approximately 1 in 4,500 to 5,500 newborns.

Materials and methods: Over a 3-year period, seven cases presented with ambiguous genitalia, primary amenorrhea, and abdominal masses and were admitted to our hospital's General Surgery and Gynaecology wards. Radiological, cytogenetics, and hormonal evaluation was done, followed by surgical excision and histopathological examination of the gonads. The study was conducted with proper written informed consent from parents and received approval from the Institutional Ethics Committee.

Results: Out of four cases diagnosed with mixed gonadal dysgenesis (MGD), one had dysgerminoma, one had both dysgerminoma and gonadoblastoma, and another had bilateral gonadoblastoma. Three other cases were diagnosed as ovo-testicular DSD. We experienced varied presentations of dysgenetic gonads in DSD - ovotestis to streak gonad and dysgenetic testis.

Conclusion: Early diagnosis and categorization of disorders of sex development (DSD) are crucial to prevent adverse outcomes and ensure optimal management.

Aim: The study aims to investigate the prognostic significance of programmed death-ligand 1 (PD-L1) and tumor-infiltrating lymphocytes (TILs) expression in glottic laryngeal carcinoma (LC) and assess the correlation of their expression.

Materials and methods: For this study, 40 patients who underwent complete resection of the glottic laryngeal tumor as primary treatment were selected. PD-L1 and TIL expression levels were determined by immunohistochemistry.

Results: Disease-free survival (DFS) was statistically significantly longer in patients with the combined positive score (CPS). CPS ≥1 than those with CPS <1. The concentration of TILs in tumor specimens was not significantly related to gender, age, T status, N status, tumor, node, metastasis (TNM) stage, pathological grade, or locoregional recurrence. Multivariate Cox regression analysis showed that low CPS and positive nodal status are statistically significant and independent predictors of malignancy recurrence.

Conclusions: The findings of our study suggest that PD-L1 could be a valuable indicator for predicting recurrence and reduced survival following definitive therapy. Consequently, further comprehensive studies involving larger groups of patients are imperative to ascertain the predictive significance of PD-L1 and TIL as biomarkers in LC.

Abstract: Ganglioglioma is a glioneuronal tumor comprised of a combination of neoplastic ganglion and glial cells and associated with mutations in the MAPK signaling pathway. It is considered a central nervous system (CNS) World Health Organisation grade 1 tumor and is usually seen in a younger age group, particularly in the first two decades of life. The most common location is the temporal lobe, although they can occur anywhere in the central nervous system. They usually have an excellent prognosis, but around 5% of gangliogliomas are associated with aggressive behavior. Recurrence or malignant transformation in gangliogliomas is rare. We report an unusual case of recurrent aggressive ganglioglioma in a 12-year-old child with unexpected novel genotypic expression along with a brief review of literature.

Abstract: Sclerosing polycystic adenoma is a recently described, rare sclerosing tumor of salivary gland with fibrocystic changes. It was previously called sclerosing polycystic adenosis. This benign tumor closely resembles other salivary gland neoplasms. Less than 50 cases of this entity have been reported so far. Here we present three cases of sclerosing polycystic adenomas, in a 52-year-old male, a 27-year-old female and a 30-year-old female respectively. All the three cases radiologically and cytologically resembled other salivary gland neoplasms. It is important to be aware of this entity so as not to confuse with other more common salivary neoplasms.

Abstract: Mixed phenotype acute leukemia (MPAL) with BCR: ABL1 rearrangement constitutes around 0.5% of all leukemias and rarely shows B-monocytic immunophenotype. We describe here a peculiar and intriguing case of a 40-year-old female who presented with anemia, leukocytosis, thrombocytopenia, and a peripheral smear showing 70% blasts of dual morphology resembling lymphoblasts and promonocytes. In cytochemistry, the promonocytes-like cells were strongly positive for non-specific esterase (NSE). Flow cytometry delineated two separate populations-the major one (57%) expressing strong CD19, CD10, CD22, cytoplasmic CD79a, CD34, CD13, CD33, CD14, and HLA-DR corresponding to the B-lineage and a minor population (10%) positive for CD14, CD64, CD11c, CD117, and dim myeloperoxidase suggestive of monocytic lineage. RT-PCR for BCR: ABL1 was positive for p210 transcript. A diagnosis of MPAL with BCR: ABL1 of B/monocytic immunophenotype was made, and the patient was managed with acute lymphoblastic leukemia (ALL) based induction chemotherapy and tyrosine kinase inhibitor. The uniqueness of the case is the presence of an additional population of bonafide promonocytes in an otherwise typical case of Philadelphia-positive B-ALL expressing CD13 and CD33. This case underscores the importance of morphology and cytochemistry in detecting and confirming minor blast populations, which may manifest as the dominant or the only clone at relapse.