Abstract: Background: Brain tumors are heterogeneous group of neoplasms, affecting different age groups. Although some studies have been published regarding pathological pattern of brain tumors from different countries of the world and also from India, comprehensive clinicopathological studies from Eastern India is lacking. Aims: The aim of this study was to observe recent incidence of different brain tumors and to study clinical and histopathological spectrum of brain tumors in Eastern India. Materials and Methods: The present study was a cross-sectional observational study involving 130 cases of brain tumors which were diagnosed during the 3-year study period (January 2010–December 2012). Data regarding clinical presentation and radiological features of all cases were collected from all patients. Histopathological diagnosis was correlated with clinical and radiological diagnosis. Results: We found 130 cases of brain tumor with a male preponderance. The cases were distributed in a wide age range from 4 years to 78 years with the mean age of 42.38 years. Most common tumor type in our study was neuroepithelial tumor (92 cases, 70.76%). Among the neuroepithelial tumors, most frequent subtype was astrocytic tumor (54 cases, 41.5%). The second most frequent brain tumor was meningioma (20 cases, 15.3%). We found higher incidence of oligodendroglial tumor (8.46%) and medulloblastoma (7.69%) in our series. Conclusion: Males are more predispose to brain tumors in comparison to females. Astrocytic tumors are most common subtype in Eastern India. However, the WHO Grade I neoplasms are more frequent brain tumors.

Abstract: Background: Bone marrow metastasis by a nonhematologic malignancy signifies advanced stage of disease and confers a poor prognosis. The aim of this study was to analyze clinical presentation, hematological profile, biochemical profile, radiological presentation, and patterns of bone marrow involvement in patients with metastatic nonhematologic malignancies retrospectively. Materials and Methods: Ninety bone marrow procedures were done in cases of nonhematologic malignancies for suspected involvement or as a part of staging procedure. Results: Sixteen out of 90 patients showed metastasis by nonhematologic malignancies. The most common malignancy to metastasize was malignant small round cell tumor (Ewing's sarcoma and rhabdomyosarcoma) followed by carcinoma breast and prostate. The most common clinical presentation was backache, fever anorexia, and abdominal pain. The biochemical findings included raised serum calcium and lactate dehydrogenase. 62.5% had anemia and 37.5% had thrombocytopenia. Leukocytosis was seen in 37.5% of patients. Leukoerythroblastic picture was seen in 43.75% cases. Of the eleven cases where both bone marrow aspirate and biopsies were done, 10 cases showed malignant cells in both. Immunohistochemistry was conclusive in four cases. The combined procedure of aspiration and biopsy gives a higher yield and are essential in patients with suspected bone marrow metastasis in nonhematologic malignancies.

Abstract: Background: Cancer of the cervix is the second most common cancer among women in the world. It accounts for 12% of all cancers in females. This study aims to evaluate the pattern of cervical cytology and its correlation with clinical and histopathological findings. Materials and Methods: This is 10 years retrospective and prospective study, in which all the Papanicolaou (Pap) smears were reported as per the 2001 Bethesda system. Clinical and histopathological correlation was done in cases where cervical biopsy or total hysterectomy specimens were available. Results: A total of 3791 Pap smears were studied with respect to age group, clinical signs and symptoms, and cytology findings. Cervical biopsy correlation was done in 200 cases. Most of the patients were in age group of 31–40 (35.61%) years. The Pap smear findings revealed 88.02% as negative for intraepithelial lesion or malignancy (NILM), 5.99% epithelial cell abnormality (ECA), and 5.99% were unsatisfactory. ECA comprised atypical squamous cells of undetermined significance (ASCUS) with 2.98%, low-grade squamous intraepithelial lesion with 1.19%, and high-grade squamous intraepithelial lesion with 0.66%. There were 36 cases (0.95%) of malignancy. Sensitivity, specificity, and positive predictive value of Pap smear in diagnosing ECA and malignancy were 89.47%, 88.70%, and 82.92%, respectively. Conclusion: Pap smear test is ideal screening method for cervical carcinoma. Nonspecific inflammation and ASCUS were most common finding among NILM and ECA group, respectively. Biopsy is considered to be the gold standard for carcinoma cervix provided that it is taken from representative areas.

Abstract: Background: Different molecular classes of breast cancer (BRCA) correlate with prognosis and response to therapy. Triple-negative breast cancer (TNBC) is a newer concept and very limited studies were carried out in India. The aim of this study was to profile the molecular types with a particular emphasis on TNBCs. Materials and Methods: Prospectively evaluated descriptive study for 2 years from June 2014 to March 2016, was carried out in the Department of Pathology and Surgery in a tertiary care institute. Cases included were of invasive breast carcinoma in females, confirmed by histopathology. Ethical clearance was received. Data were analyzed using Statistical SAS software. Results: A total of 123 cases of invasive BRCA were studied and mean age was 44.64 years. The peak age group was 36–45 years (43.9%). Tumor sizes ≥2 cm was 30%, between 2 and 5 cm was 50.40%, over 5 cm was 19.51%. Invasive duct carcinoma was 82.11% and invasive lobular carcinoma 8.13%. Only 21% of subjects presented as early breast carcinoma. Cases of 1–3 nodes were 22.8%, 4–5 nodes 21.1%, more than five nodes were 34%. Histologic Grade 3 was 50.4%, Grade 2 was 41%, and Grade 1 was only 8.1. The American Joint Committee on Cancer, Stage 1 (17.9%) in Stage 2 (29.3%) Stage 3 was 46.3%, Stage 4 was 6.5%. Estrogen receptor was in 40.62%, progesterone receptor 35.77%, Her2/Neu 18.69% luminal A (19.51%), luminal B (21.13%), Her2/Neu type (17.88%), and triple negatives (38.21). Conclusion: The present study showed significantly higher TNBC with poor prognostic factors in younger women in a background of peculiar ethic spectrum in this geographical region.

Abstract: Background: Fine needle aspiration cytology (FNAC) is often considered as the initial mode of investigation in the evaluation of the soft tissue tumors (STTs). This study was undertaken to explore the utility and accuracy of FNAC in STT by correlating their histopathological diagnoses. Materials and Methods: A total of 220 FNAC of STT was retrieved and evaluated retrospectively between January 2012 and June 2015 and correlated with their subsequent histopathological diagnoses. Results: On FNAC, 175 (79.6%) were benign, 26 (11.8%) were malignant and 19 (8.6%) were inconclusive. On the correlation of subsequent histopathology, 173 cases were confirmed as benign (true negative) and 22 cases were confirmed as malignant (true positive). There were four false positive and two false negative results. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive values of FNAC for diagnosing malignant STT were 91.7%, 97.7%, 97%, 84.6%, and 98.9%, respectively. Conclusion: The present study concluded that FNAC can be used as a reliable diagnostic tool for preoperative triaging of benign and malignant STT with fair sensitivity, specificity, and accuracy, even though a specific diagnosis may not be possible in all cases. In addition, we have found a considerable proportion of difficulties in the diagnosis of certain STT; hence, care should be taken while interpreting these challenging FNAC cases.

Abstract: Germ cell tumors (GCTs) are common tumors of gonads. Their occurrence at extragonadal sites, either as primary tumors or as metastatic foci, is rare. Extragonadal GCTs have a prevalence of 1–2.5% of all GCTs with mediastinum being the most common site of involvement, followed by retroperitoneum, pineal gland, and sacrococcygeal region. Involvement of other extragonadal sites, including lymph nodes, is usually associated with metastatic disease. We report a case of a young female with an atypical presentation of a swelling in the left neck region creating a clinical and pathological dilemma.

Abstract: Background: Breast carcinoma is the leading cause of cancer deaths in women. Molecular classification of breast carcinoma along with Ki-67 index is considered a better predictive factor for prognosis and treatment than routine histopathology. Aims: To classify breast carcinoma into the four molecular subtypes defined by immunohistochemical expression of triple markers: Luminal A (estrogen receptor/progesterone receptor-positive [ER/PR+] and human epidermal growth factor receptor 2 HER2/neu), luminal B (ER/PR + and HER2/neu+), triple negative (ER/PR − and HER2/neu−), and HER2 positive (ER/PR−, HER2/neu+), and to correlate the expression of ER, PR, HER2/neu, and classification with Ki-67. Materials and Methods: The present study includes sixty breast carcinoma cases studied over a 3-year period. The expression patterns of ER, PR, HER2/neu, and Ki-67 were studied. Clinical features, pathologic features such as size, grade, and lymph node status, and correlation with Ki-67 of the four subtypes were compared. Results: Out of sixty cases, most common molecular subtype was triple negative (40.00%) followed by luminal B (23.33%). Most of the tumors showed low proliferative index (low Ki-67); however, triple negative and HER2 positive subtype showed high proliferative index. Most common histological subtype was ductal carcinoma which was mainly triple negative. All medullary carcinoma cases were triple negative. One case of lobular carcinoma and mucinous carcinoma each was HER2 positive and luminal B, respectively. Single case of carcinoma of male breast was luminal B subtype. Conclusion: Correlation of molecular classification with age, histological grade, and Ki-67 was statistically significant (P < 0.05). ER/PR also correlated with histological grade and Ki-67 (P < 0.01). These results emphasize the fact that molecular subtypes correlate with prognosis and aid in targeted therapy.

Abstract: Carcinoma cervix is the most common malignancy in Indian women. Squamous cell carcinoma (SCC) of cervix with metastasis to duodenum is a rare occurrence. Until now, we could find only six cases in the literature. We found such rare case and hence report here a case of a 67-year-old female patient with carcinoma cervix with duodenal metastasis diagnosed after 4 years of cervical carcinoma. On gastroduodenoscopy thickened mucosal folds were seen in the second and third part of the duodenum. Histopathology confirmed it as metastatic SCC. She was started on palliative chemotherapy but succumbed to the disease. This case is being reported due to its rare occurrence.

Abstract: Background: Among the cancers, oral cancer occupies tenth position, and the incidence is rising alarmingly with more than 300,000 new cases being detected every year. The expression of myofibroblast (MF) has been demonstrated in various malignant lesions and is considered an important participant in the invasive process. We have attempted to analyze the distribution and possible association of MF in epithelial dysplasia and squamous cell carcinoma by immunohistochemistry. Materials and Methods: Histopathologically confirmed twenty cases each of epithelial dysplasia and oral squamous cell carcinoma and ten cases of normal mucosa comprised the study group. MFs were detected by immunostaining with alpha-smooth muscle actin (α-SMA). Blood vessels and normal oral mucosa acted as an internal and external control respectively. Results: Of twenty cases of epithelial dysplasia, six (30%) were positive, all cases of squamous cell carcinoma and normal mucosa were positive and negative for α-SMA expression respectively. No statistical significance was observed between the patterns of MF distribution. Statistically significant results of α-SMA expression were noted in severe grades of dysplasia ( P = 0.000) and between epithelial dysplasia and squamous cell carcinoma ( P = 0.000). Conclusion: Analysis of α-SMA expression for MF proliferation can be used as a stromal marker for predicting behavior in oral precancer and cancer.

Abstract: Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor which occurs mostly in the mandible. It is primarily seen in fifth to seventh decades with a female predilection. We report a case of CCOC in the maxillary arch of a 66-year-old woman. Morphologic examination along with histochemical and immunohistochemical markers led to the establishment of the diagnosis. It is important to diagnose this entity and differentiate it from other clear cell tumors in the head and neck region as it is a locally aggressive tumor with a propensity for regional, nodal, and distant metastasis.

Abstract: Primary intracranial malignant melanoma is a very rare tumor, and most of the central nervous system melanomas are metastatic diseases. Diagnosis needs extensive dermatological, opthalmological, and radiological workup to exclude metastatic melanoma. Histologically, it should be differentiate from benign melanocytic lesions, pigmented choroid plexus carcinoma, and pigmented papillary medulloblastoma. Here, we are reporting a case of primary malignant melanoma of posterior fossa in an adolescent girl diagnosed in squash cytology as well as in histology and confirmed by immunohistochemistry and by excluding metastatic melanoma.

Abstract: Background: Fine-needle aspiration cytology (FNAC) gives the necessary information of various breast lesions for surgical management of patients and can be extremely useful for establishing the best neoadjuvant therapy in patients where surgical removal of tumor is not the best option. The National Cancer Institute, Bethesda sponsored conference recommended that the tumor grading on FNAC should be incorporated in reports for prognostication. Objective: The purpose of this study is to determine the correlation between cytomorphologic and histomorphological features and to evaluate the utility of different cytological grading systems and to determine which cytology grade corresponds best to the histology grade. Materials and Methods: The present prospective study included fifty cases of breast carcinoma diagnosed on FNAC and confirmed on histopathology. Detailed cytomorphological features were studied. Cytology grading was done using six grading systems. Detailed histological features were studied, and carcinomas were graded as per modified Scarff-Bloom-Richardson's histopathological grading system. Cytology grading was correlated with histology grading. Results: Out of fifty cases of breast carcinomas, the 29 (58%) cases of each Robinson's cytological grading and Fisher's modification of Black grading correlated with histological grading. The cytological features, namely, nuclear chromatin, nuclear pleomorphism, cell size, nuclear margins, and naked tumor nuclei used in grading correlated well with histological grade. Conclusion: Cytology grading adds to objectivity, reproducibility, and authenticity to the report. The cytology features such as nuclear chromatin, nuclear pleomorphism, cell size, nuclear margins, and naked tumor nuclei had influential role in predicting the final cytology grade. Among the six cytology grading systems, Robinson's system is simple to interpret, more objective, takes less time, and is reproducible and correlates precisely with histological grade as evident from our study. It should be used for routine evaluation of aspirates of breast carcinoma.

Abstract: Background: Uterine prolapse is a common complaint in gynecology. It is defined as an abnormal downward displacement or protrusion of the pelvic structures in the vaginal canal. Aim: The aim of this study was to know the gross and microscopic cervical changes in uterine prolapse and their association with clinical findings. Materials and Methods: The present study was conducted in the histopathology section of the Department of Pathology in Rural Institute of Medical Science and Research, Saifai, Etawah, Uttar Pradesh, on hysterectomy specimens with prolapse uterus from January 2012 to May 2015. Results: The minimum age of patients with prolapse was 25 years and maximum age was 70 years, maximum number of patients belonged to 41–50 years age group (38.72%). Common clinical complaint was something coming out per vagina (53.61%). On gross examination, hypertrophy of cervix was a common pathology (46.38%). Histopathology examination of prolapse uterus showed chronic cervicitis (87.65%), cervical intraepithelial neoplasia I (21.70%), and others, but carcinoma cervix was not present. Conclusion: Prolapse uterus was a common gynecological complaint among rural women, usually clinically presenting with something coming out per vagina. Grossly, the cervix appeared hypertrophied in the majority. Histopathological examination showed chronic cervicitis in bulk. Chronic cervicitis paves the way for premalignant and malignant lesions of cervix, though cervical carcinoma is rare in prolapse uterus. Prolapse uterus must be diagnosed early so as to provide early treatment before the complications arise.

Abstract: Background: Blood vessel counts using CD105 staining are more informative marker of prognosis as compared with staining by other endothelial markers. We conducted a study to compare intratumoral (IT) and peritumoral (PT) microvessel density (MVD) in head and neck squamous cell carcinoma (HNSCC) using endothelial marker CD105 and its correlation with lymph node metastasis, histological grading, and other clinicopathological parameters. Materials and Methods: Fifty cases of HNSCC with modified radical neck dissection specimens were included in the study group. Representative blocks were prepared from tumor, PT tissue, tumor margins, and all the lymph nodes. Histopathological diagnosis and other parameters were established on the routine hematoxylin and eosin stain. Immunohistochemical profile of blood vessels in IT and PT tissues was assessed by subjecting one section each from a representative block of the tumor and PT tissue to CD105 immunostain. To determine MVD, four fields with the highest MVD (hotspots) were identified. The mean values were calculated by taking an average of all the measurements. Results: No significant association was seen between MVD, IT-MVD, and PT-MVD and different age groups, male/female patients, risk factors, site of tumor, size of tumor, presence/absence of inflammation, pushing/infiltrating margin, and different stages of tumors. When compared in node positive and negative groups, a significantly higher MVD, IT-MVD, and PT-MVD was seen in association with lymph node metastasis. The comparison of MVD between PT and IT area revealed significantly higher IT-MVD (P = 0.001). Conclusion: In the study, we found a significant association of IT-MVD with lymph node metastasis and also observed CD105 as a highly specific marker for IT microvessels while PT vessels were not stained or weakly stained.

Abstract: Background: Dendritic cell (DC)-based vaccination has shown promising application in tumor immunotherapy. However, it is not clear whether the presence of tumor impacts the efficacy of generation and functionality of DCs. Aim : To compare the phenotype of DCs generated from naive or tumor bearing mice and their capability to restore leukopenia-associated chemotherapy. Materials and Methods: DCs were generated from bone marrow (BM) of naive or Ehrlich ascites carcinoma (EAC) bearing mice. EAC is an undifferentiated breast cancer cell line with the high transplantable capability and rapid proliferation. BM cells were cultured in vitro for 7 days with granulocyte macrophage colony-stimulating factor and interleukin-4 (20 ng/ml each), loaded with different concentrations of EAC cell lysate (0.5, 1, 3 and 5 mg/10 6 ) DCs followed by activation with the toll-like receptor 3 ligand poly(I:C). For DC-based vaccination, CD1 mice ( n = 5/group) were inoculated with an intraperitoneal (i.p.) injection of 0.25 × 10 6 EAC cells to form ascites, treated on day 14 with an i.p. injection of cyclophosphamide (4 mg/mouse) and on day 15 with subcutaneous injection of 2 × 10 6 DCs from control or EAC bearing mice. Injected DCs were loaded with or without EAC lysate followed by i.p. injection of 50 μg/mouse poly(I:C). On day 21, mice were bled and sacrificed for peripheral blood count and spleen and BM cellularity. Results : Yield of DCs generated from naIve or EAC bearing mice, as well as their phenotype (CD11c + CD11b + ) and activation (CD40 and CD80) with poly(I:C) were similar. Loading DCs with 1 mg EAC lysate induced better viability and activation phenotype as compared with the other concentrations. Regardless the source of DCs, DCs vaccination restored the total numbers of leukocytes in blood but not in the spleen and BM. The effect on peripheral blood leukocytes was coincided with the restoration of the relative numbers of lymphocytes, monocytes, and granulocytes. Conclusion: These data support the use of allogenic DCs from healthy donors in anticancer DC-based vaccination.

Abstract: Background: Primary lymphoma of the salivary gland is not often encountered in routine practice. About 5–10% of Non-Hodgkin's lymphomas (NHLs) are found in the salivary gland, most frequently involving parotid gland. Henceforth, it is necessary to understand the distinct clinical presentations and course of primary salivary gland lymphomas as this may help guide the proper diagnosis and management of patients with these tumors. Materials and Methods: We retrospectively reviewed primary NHL diagnosed at our medical institute over a period of 2 years. Results: Five cases of primary salivary gland lymphoma were found, two involving parotid gland while other three affecting submandibular gland. None of the cases had a clinical suspicion of lymphoma. However, they were diagnosed as having NHL B-cell type on histopathology. Conclusion: Since primary salivary gland NHL is an uncommon finding, it is often overlooked as the differential diagnosis. Methods of diagnosing and treating lymphoma are different from those of other benign pathologies of the salivary gland. Therefore, a high index of suspicion is warranted to provide a quick and efficient diagnosis and treatment without subjecting the patient to unnecessary tests and procedures.

Abstract: Ancient schwannomas are rare benign encapsulated tumors of long standing duration. These tumors are usually solitary and may grow to a large size before detection of notable degenerative changes. The term “ancient schwannoma” is used to describe a schwannoma that has undergone changes such as relative loss of Antoni Type A tissue, perivascular hyalinization, calcification, cystic necrosis, hemorrhage and the presence of degenerative nuclear changes that may be misinterpreted as sarcomatous change. We report a case of ancient schwannoma in the left side neck.

Abstract: Ocular surface squamous neoplasia is a term that describes neoplastic changes of the cornea and conjunctiva ranging from squamous dysplasia to invasive squamous cell carcinoma (SCC). SCC of the conjunctiva is a rare tumor mainly affecting the elderly age group. Resemblance to common conditions such as pterygium and pinguecula may result in a wrong diagnosis on the part of an ophthalmologist. We present a rare case of SCC of the conjunctiva in a 41-year-old female.

Abstract: Background: Carcinoma of uterine cervix is the commonest cancer affecting females in developing countries. Concurrent chemoradiation has remained the sole definitive treatment available in the advanced stages. The study was planned to take the advantage of radiosensitisation accruing due to chemotherapy at the time of brachytherapy, when approximately 40% of total tumor dose is applied. Subjects and Methods: Sixty-four patients were enrolled who had locally advanced uterine cervix carcinoma (Federation of Gynecology and Obstetrics Stage IIB–IVA) from July 2011 to May 2013 for concurrent chemotherapy and intracavitory brachytherapy after completion of concurrent chemotherapy and external beam radiotherapy followed by three insertion of brachytherapy separated by a week by flexitron brachytherapy unit to Point A, for each application was 6 Gy by high dose rate. Cisplatin was given (35 mg/m 2 ) 1 day before brachytherapy in each application. Results: At medium follow-up of 19 months (range 8–30 months) clinical complete response rate was found to be 89% at 3 months of follow-up. Acute side effect as nausea and vomiting Grades I and II were recorded as 55% and 28% respectively, no renal dysfunction and no thrombocytopenia were encountered. No patients had Grade IV or life threatening toxicity. Overall survival and disease free survival after 30 months of follow-up is 88% and 75% respectively. Conclusion: Use of concurrent chemotherapy with brachytherapy is effective and feasible with acceptable toxicity for locally advanced carcinoma of the uterine cervix.

Abstract: Leukemic involvement of the breast is very rare and more commonly seen in acute myeloid leukemia. Involvement of the breast in acute lymphoblastic leukemia (ALL) at diagnosis is very rarely reported and is often confused with primary breast tumors. We present a case of young female presenting with breast mass and axillary lymphadenopathy, thus masquerading as breast carcinoma. Breast biopsy and bone marrow examination revealed leukemic infiltration of pre-B cell ALL. Cerebrospinal fluid showed involvement with leukemic cells. The patient was treated with MCP-841 protocol and therapeutic cranial irradiation, followed by maintenance oral chemotherapy leading to complete resolution of breast mass. Thus, ALL should be considered in the list of differential diagnosis of breast masses, especially in young females.

Abstract: The role of tobacco smoking as a causative factor in the development of the periodontal disease has long been debated and recently a large number of papers have been published in the literature regarding this symbiosis. Smoking also gives an encouraging environment for microbes in the mouth such as Porphyromonas gingivalis , Prevotella intermedia , and Aggregatibacter actinomycetemcomitans because the by-products of smoking prevent the mechanisms that limit the growth of harmful bacteria in the oral cavity. Thus, smoking promotes early stages of periodontal disease. Smoking in the form of cigars and pipes have similar deleterious effects that cigarettes do on oral health. Much of the literature has also showed that smokers affected with periodontitis respond less favorably to periodontal treatment be it nonsurgical and surgical. In this paper, we have reviewed the effects of smoking on various aspects of the periodontal disease process.

Abstract: Giant cell carcinoma of uterus is an aggressive form of endometrial carcinoma. It can be confused on histopathology with other giant cell containing lesions including trophoblastic tumors, certain primary sarcomas, and malignant mixed mullerian tumors. Due to the paucity of cases of this rare subtype, the prognostic parameters are difficult to assess. We describe here one such case in a 60-year-old female who presented with postmenopausal bleeding. To the best of our knowledge, this is the 13th case being reported in world literature. We intend to describe this case due to its rarity, failure to recognize this tumor as a subtype, and lack of definition and guidelines in the literature for accurate classification.

Abstract: Pulmonary hamartoma are benign, well-circumscribed single nodule in the lung parenchyma. They are composed of an abnormal mixture of epithelial and mesenchymal elements. Patients are usually asymptomatic and discovered by chance. We report a case of 65-year-old male patient who presented with cough with hemoptysis, dyspnea, and chest pain. Lumpectomy was done, which revealed histological features of chondroid hamartoma.

Abstract: Background: Cervical Lymphadenopathy is one of the commonest and sometimes only clinical finding for a benign and malignant lesion. Fine needle aspiration cytology (FNAC) is a simple, safe, rapid and inexpensive method for establishing the diagnosis of lesions. Metastasis is more common in cervical lymph node and enlarged cervical nodes in an elderly patient must be considered as metastatic until proved otherwise. Methods: Retrospectively, 320 cases of left cervical lymph node FNAC were collected from five years record (May 2010 - June 2014) at Sri Devaraj Urs Medical College, Tamaka, Kolar. Review of all cytological reports were done according to standard guidelines and the morphological features of all non-neoplastic and neoplastic lesions were analysed. Results: Out of 320 cases 33% showed reactive lymphadenitis, 29% showed metastatic deposits, 14% showed features of granulomatous and necrotizing lymphadenitis, 9% were tuberculous lymphadenitis. In the present study, reactive lymphadenitis was the most common cause of enlarged lymph nodes followed by metastatic deposits. Squamous cell carcinoma is the most common metastatic lesions of lymphnode and comprise of 65% of the cases. Out of 62 cases of SCC 74% were keratinized, 16% were non keratinized, 29% cases showed granulomas. Non keratinization, presence of granuloma, plasma cells and eosinophils favours metastasis from nasopharyngeal carcinoma. Keratinization favours squamous cell carcinoma and absence of eosinophils and plasma cells in the background favors SCC metastasis from other sites. Conclusion: The present study highlight the usefulness of FNAC in left cervical lymphadenopathy where metastasis is common. Thus the knowledge about the cytological features and patterns will help the clinician to detect the respective cases early for investigations and treatment.

Abstract: Acute leukemia generally present with nonspecific symptoms such as fatigue, weakness, malaise, anorexia, weight loss, fever, bone pains, bruising, or bleeding that begin gradually and are the consequence of associated cytopenias. Polyserositis with predominant pericardial effusion clinically manifested as heart failure as the presenting feature of acute myeloid leukemias (AMLs) has been rarely described. In this report, we describe a case of a 21-year-old male, who presented with symptomatic serositis and leukemia cutis and was subsequently diagnosed as AML-myelomonocytic type (AML-M4).

Abstract: Invasive ductal carcinoma is the most common histological pattern of breast cancer. Breast cancer metastasis has been observed at various sites but solitary metastasis to parotid gland is rare. Around 15 cases have been reported so far. We report a case of 61-year-old lady with early breast carcinoma metastasizing to ipsilateral parotid gland. She underwent breast conservation surgery with axillary dissection. Pathological stage was pT2(m) N0. Immunohistochemistry revealed hormone receptor positive, HER2-neu negative. She received adjuvant chemotherapy, radiotherapy, and hormonal therapy. Seven months later, she had parotid gland metastasis. She underwent superficial parotidectomy and right neck dissection. Hormonal therapy was changed to 2 nd line.

Abstract: Mucinous carcinoma (MC) (colloid carcinoma) is a particular, rare type of breast carcinoma. It is characterized by the presence of extracellular mucin. MC of the breast generally presents as a lobulated, moderately well-circumscribed mass on mammography, sonography, and magnetic resonance imaging. It has a favorable prognosis due to the low incidence of axillary lymph node metastasis and poor adherence to bottom fascia and poor infiltration of overlying skin. It has high incidence of estrogen receptor and progesterone receptor positivity. The incidence of MC in females under 35 years of age is only 1%. Here, we report a case of MC of right breast in a 30-year-old female.

Abstract: Background: (1) To study and correlate the mast cell numbers in benign prostatic hyperplasia (BPH) and prostate carcinoma lesions. (2) To compare mast cell numbers of intratumoral and peritumoral regions in prostate adenocarcinomas. (3) To ascertain a relationship between the number of mast cells and age, prostate-specific antigen (PSA) levels, and Gleason Grade. Subjects and Methods: One-hundred cases of prostate lesions, consisting of 75 cases of BPH and 25 cases of prostatic adenocarcinoma, received in the form of transurethral resection of prostate chips in the Department of Pathology, were included in the study. After histopathological diagnosis, the paraffin sections were stained with toluidine blue. Results: The mean value of mast cell count per mm 2 in benign and malignant lesion was 37.05 and 92.20, respectively. The difference in mean mast cell count in BPH and prostatic adenocarcinoma was found to be statistically significant ( P = 0.001). The correlation between mast cell count and Gleason Grade was found to be statistically significant ( P : Grades I–III - 0.043; 0.002; 0.012). However, no correlation was found between mast cell count with age and PSA levels. Conclusion: In this study, an increase in the number of mast cells was observed in patients with prostate cancer than in benign lesions. This suggests a stimulating role of mast cells in the progression of cancer.

Abstract: Background: Hepcidin is the master regulator of iron homeostasis but until now, data about its expression in acute lymphoblastic leukemia (ALL) is scarce. Objectives: To evaluate hepcidin level in a group of ALL children in different treatment phases, investigating its relation to serum ferritin and erythroid activity. Materials and Methods: Forty ALL children were included and categorized into; Group I: Included 20 newly diagnosed ALL children who were evaluated at diagnosis and after remission. Group II: Included 20 ALL children in the maintenance phase of therapy. Twenty age and gender matched healthy children were enrolled as a control group. Complete blood count including reticulocytes %, liver functions, renal functions, and C-reactive protein were assayed. Serum hepcidin and ferritin were measured by enzyme-linked immunosorbent assay. Results: Serum hepcidin and ferritin levels were significantly higher among both ALL groups compared to the controls. These values were higher before therapy than after remission in the newly diagnosed group as well as than the maintenance group. Before therapy, both serum hepcidin and ferritin levels had significant negative correlation with hemoglobin and reticulocytes % while directly correlated with each other. Conclusion: Hepcidin level increased in ALL children at diagnosis and in different treatment phases. The highest rise was at diagnosis. These results indicate that hepcidin level among ALL patients is under the opposing effects of the iron stores and erythroid activity with the net level is determined by the strength of each stimulus.