This text is a welcome addition to the field of the sampling and evaluation of histopathology specimens and is of interest to the pathologist and biomedical scientist alike. The opening few pages clearly project the importance of appropriate and adequate tissue sampling and the pivotal role of laboratory-based investigations in the overall process of histopathological tissue assessment. Emphasis is placed on the holistic significance such processes have on patient prognosis and subsequent clinical management. There are 12 chapters covering the length, breadth, depth and nature of the histopathological specimen. Each chapter deals logically and systematically with anatomical issues, clinical presentations, clinical investigations, pathological conditions and the surgical aspects involving both clinical and laboratory-based procedures. There are 129 figures throughout the text: most are perfectly adequate, some have reasonably detailed annotations, whereas others appear more schematic. There is a miscellaneous specimens chapter that deals with more selective procedures, some of which encompass cytological sampling, frozen section usage and the application of ancillary techniques such as sampling for flow cytometry, in situ hybridisation, electron microscopy, cytogenetics or molecular genetics and proteomics. There is a bibliography, which cites several reference points for each of the chapters. The majority of the content is up to date and accurately portrays the importance of thorough and precise evaluation of histopathological samples in the overall care of the patient. In addition, the text provides a useful glossary of abbreviations, covering all the chapters, which commonly appear on most histopathology clinical request forms. The text is an aide memoire rather than a reference text. It does not attempt to provide detailed information but rather gives a more generalised overview. Some chapters appear too brief and barely scratch the surface in respect of eye, muscle and nerve specimens. Arguably, such areas of histopathology have become increasingly more specialised. There is also an understating of some of the more recent laboratory-based techniques for the evaluation of the histopathology specimen. A prime example is the scant reference to the significance of sentinel lymph node biopsy for the assessment of metastatic malignant disease. The chapters dealing with breast and skin make brief reference to its value in the overall assessment of metastatic disease. The strength of this text is that it is concise, informative to a reasonable degree and offers the reader an opportunity to understand the concepts and principles before becoming more involved with detail. G.E.Orchard

Histopathology Specimens: Clinical, Pathological and Laboratory Aspects

Sarcomas of the sellar region are uncommon and unexpected tumors. Here, we review the cases reported in literature via a systematic search. Ninety-four patients, 58.5% male with mean age of 39.2 ± 17.2 years were included. Fifty-seven (62%) had soft tissue sarcomas (STS) and 35 (38%) bone sarcomas (BS). Sarcoma was a primary tumor in 66%, developed after radiotherapy in 31.9% and 7.4% were metastatic. Median time between radiotherapy and sarcoma development was 10.5 (11) years. Main presentation symptoms were visual disorders (87.9%), headache (61.5%) and III cranial nerve palsy (24.1%). After surgery, sarcoma persisted or recurred in 82.3% and overall mortality reported was 44.6% with 6.5 (14) months of median survival. Tumor appeared earlier in BS compared to STS (34.4 ± 15.1 vs. 42.6 ± 17.6 years), p = 0.034 and complete tumor resection was achieved more often (41.3% vs. 4.4%), p =  < 0.001. Condrosarcoma and rhabdomyosarcoma were more frequent subtypes among primary tumors while fibrosarcoma was among post-radiation sarcomas. Tumor size was larger in radiation associated sarcomas (mean maximum diameter 46.3 ± 9.3 vs. 29.1 ± 8.0 mm, p = 0.004) and persistency/recurrence was similar in both groups (70.1 vs. 73.3%, p = 0.259). Sarcomas appear as mass effect symptoms in the middle aged population, mainly as primary tumors, but one third is associated with radiotherapy. Surgery is commonly not curative, mortality rate is high and death ensues shortly after diagnosis.

Sarcomas of the sellar region: a systematic review.

An Extended Endoscopic Endonasal Approach for Sellar Area Chondrosarcoma: A Case Report and Literature Review.

Low-grade chondrosarcoma (LGC) is a very rare intracranial tumor, particularly in the sellar area. Herein, we describe an unusual case of LGC occurring in the sellar area. A 52-year-old man presented with diminution of vision for more than 3 months, but did not exhibit headaches reported in previous cases. MRI showed that the maximum size of the tumor was 7 cm on the left side of the saddle. We characterized the specific pathological characteristics. Histologically, the tumor had polypoid areas and a lobulated growth pattern under low-power examination. At high magnification, the tumor consisted of small cells with hyperchromatic nuclei in the cartilage matrix, with an alternating loose hypocellular zone and rich myxoid area. In our case, LGC needed to be distinguished from chordoma. Immunohistochemically, the tumor cells showed diffuse positivity for S-100 and vimentin, IDH1 was weakly cytoplasm positive. The Ki-67 labeling index was less than 5%. Additionally, AE1/3, EMA, and CK19 were negative, which could be used to exclude chordoma. This case report expands the literature on LGC and will help clinicians and pathologists better understand this entity.

/pdf/low-grade-chondrosarcoma-in-the-sellar-area-case-report-and-5c1wtyubr2.pdf

Low-Grade Chondrosarcoma In The Sellar Area: Case Report And Literature Review

Parasellar chondrosarcoma is rare slowly growing intracranial tumors. A correct diagnosis of these tumors is challenging for clinician due to overlapping location and simulation of clinical presentations with much common pituitary adenomas. We are reporting three young patients diagnosed to have parasellar chondrosarcoma highlighting the pathological features of importance required for confirm diagnosis.

/pdf/parasellar-chondrosarcoma-in-three-young-patients-a-czyty6a4iq.pdf

Parasellar Chondrosarcoma in Three Young Patients: A Diagnosis of Caution.

Chondrosarcoma is a mesenchymal tumor composed of tumor cells producing cartilage. It is more common in older age and often affects the axial skeleton. We report a rare case of chondrosarcoma mimicking a sellar and suprasellar mass with parasellar extension. A 40 yr woman presented with decreasing visual acuity and headache. Magnetic resonance (MR) image revealed a cystic sellar and suprasellar mass with parasellar extension showing mild enhancing solid component. It favored the diagnosis of craniopharyngioma. The patient underwent trans-sphenoidal partial resection of the tumor resulting in removal of the sellar mass. However, the suprasellar mass could not be excised completely due to limited surgical field. The pathologic diagnosis was chondrosarcoma. Eight months after the operation, pterional approach was performed to remove the remaining mass. Intraoperative findings confirmed that the mass originated from dorsum sellae.

https://ijp.iranpath.org/article_19279_5421e8a1bd8265e164a0e9b798ff42bc.pdf

Pituitary Chondrosarcoma presenting as a sellar and suprasellar mass with parasellar extension: An Unusual presentation

Cutaneous metastasis of underlying primary malignancies can present to dermatologist with chief complaints of cutaneous lesions. The underlying malignancy is generally diagnosed much later after a complete assessment of the concerned case. Medullary carcinoma thyroid (MCT) is a relatively uncommon primary neoplasia of the thyroid. Very few cases presenting as cutaneous metastases of MCT have been reported in the literature. Most of the cases which have been reported are of the papillary and the follicular types. We here report a case of a patient who presented in the dermatology clinic with the primary complaint of multiple subcutaneous nodules in anterior chest wall and left side of body of mandible. By systematic application of clinical and diagnostic skills these nodules were diagnosed as cutaneous metastasis of MCT bringing to the forefront a history of previously operated thyroid neoplasm. So clinically, the investigation of a flesh coloured subcutaneous nodule, presenting with a short duration, particularly in scalp, jaw, or anterior chest wall should include possibility of metastastic deposits. A dermatologist should keep a possibility of an internal organ malignancy in patients while investigating a case of flesh coloured subcutaneous nodules, presenting with short duration. A systematic application of clinical and diagnostic skills will eventually lead to such a diagnosis even when not suspected clinically at its primary presentation. A prompt and an emphatic diagnosis and treatment will have its bearing on the eventual outcome in all these patients.

/pdf/cutaneous-metastasis-of-medullary-carcinoma-thyroid-359cioco1d.pdf

Cutaneous metastasis of medullary carcinoma thyroid masquerading as subcutaneous nodules anterior chest and mandibular region.

Background: Esophageal carcinoma (EC) is an upcoming major health challenge with 4,07,000 deaths related to it reported globally in the year 2008 alone. Its risk factors apart from tobacco and alcohol vary according to various geographical areas which include ethnicity, dietary and other socio-economic factors. This can have a bearing on its various prognostic factors in which Immunohistochemistry (IHC) has emerged as a major tool for predicting the same.
p53 has proved to be a particular important molecule in development of many tumors including esophageal carcinoma as it has a role in both tumor immunity and cell cycle.
The present study was conducted in Punjabi population where tobacco usage is low because of the societal and religious taboos and where life style and developmental indicators are high in comparison to rest of India. The aim was to analyze epidemiologically the cases suffering from esophageal carcinoma, to study p53 expression in histologically proven cases of esophageal carcinoma and also to correlate p53 positive expression with the type and grade of the tumor along with other clinico-pathological parameters.
Material and Methods: The study was conducted on 50 cases of EC diagnosed in the Department of Pathology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India. The 50 cases (either endoscopic biopsies or esophagectomy specimen) were independently verified for sub classification and histopathological grading. In all the cases patient’s complains, age, gender and other important clinical parameters were recorded. All the cases were taken up for IHC study for p53 expression.
The results obtained were tabulated and statistically analyzed. A p value less than 0.05 was considered statistically significant.
Result: In the present study, maximum cases (60%) were observed in the age group of 41-60 years where female patients outnumbered male patients in a ratio of (1.3:1). Lower segment (56%) was the most common segm

https://www.ijpo.co.in/journal-article-file/2927

Immunoexpression of p53 as an indicator of invasiveness in esophageal carcinoma:- a tertiary care hospital study from Punjab, India

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Pituitary Chondrosarcoma presenting as a sellar and suprasellar mass with parasellar extension: An Unusual presentation

Cutaneous metastasis of medullary carcinoma thyroid masquerading as subcutaneous nodules anterior chest and mandibular region.

Immunoexpression of p53 as an indicator of invasiveness in esophageal carcinoma:- a tertiary care hospital study from Punjab, India