Gynecologic Pathology
Maryam Entezarian; Fereshteh Ameli; Noraidah Masir; Tan Geok Chin
Abstract
Background & Objective: Ovarian cancer is associated with the highest mortality rate among gynecologic malignancies. Despite new therapeutic strategies, ovarian cancer still has a high risk of metastasis and mortality. Endocan is a newly identified endothelial cell activation marker, which is responsible ...
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Background & Objective: Ovarian cancer is associated with the highest mortality rate among gynecologic malignancies. Despite new therapeutic strategies, ovarian cancer still has a high risk of metastasis and mortality. Endocan is a newly identified endothelial cell activation marker, which is responsible for angiogenesis, tumor invasion, and aggressive behavior of tumors. The aim of this study was to assess Endocan expression in different types of ovarian tumors and to identify its relationship with clinicopathologic characteristics of ovarian tumors.Methods: This cross-sectional study was conducted on 183 tissue samples, including benign, borderline, and malignant ovarian tumors collected from the University Kebangsaan Malaysia Medical Center archive of Pathology during 2005-2015. Mouse monoclonal anti-human Endocan/ESM-1 Clone MEP08 was used at a dilution of 1:400 for immunohistochemical (IHC) staining. All the information was collected by a checklist, and the association between clinicopathological features and high or low levels of Endocan -MVD was evaluated using Pearson chi-square, Fischer's exact, or Monte Carlo tests.Results: The prevalence of Endocan positivity was significantly higher in malignant compared to borderline and benign ovarian tumors (P<0.001). There was also a significant association between type of tumor and Endocan status in malignant ovarian tumors (P=0.02), indicating that Endocan positivity was more likely in serous malignant ovarian tumors compared to other ovarian tumor types. However, the tumor stage was not significantly associated with Endocan status (P=0.31).Conclusion: This study showed that Endocan positivity may show the highest prevalence among malignant tumors suggesting that high Endocan expression would be negatively associated with ovarian tumor behavior.
Neuropathology
Arezoo Eftekhar Javadi; Elham Nazar; Hedieh Moradi Tabriz
Abstract
Introduction: Chondroma is a benign cartilaginous tumor. It is found very rarely in the head and neck. Case presentation: This report describes a 25-year-old woman who presented with generalized headache from 4 months ago. The patient underwent excisional surgery. The histological examinations revealed ...
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Introduction: Chondroma is a benign cartilaginous tumor. It is found very rarely in the head and neck. Case presentation: This report describes a 25-year-old woman who presented with generalized headache from 4 months ago. The patient underwent excisional surgery. The histological examinations revealed benign cartilage forming tumor, compatible with chondroma. The radiologic and histologic correlation confirmed the diagnosis. Based on the diagnosis, the patient received no more treatment. Conclusion: We concluded that intracranial chondroma should be included in the differential diagnosis of a calcified mass on skull imaging. Proper diagnosis is necessary for further patient management.
Alireza Sadeghipour; Navid Abdi; Pegah Babaheidarian
Abstract
Background: Tuberous sclerosis (TSC) is inherited as an autosomal dominant disease, characterized by skin lesion and tubers in vital organs, especially brain in three categories including subependymal nodules, cortical tubers and subependymal giant cell astrocytoma. Subependymal giant cell astrocytoma ...
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Background: Tuberous sclerosis (TSC) is inherited as an autosomal dominant disease, characterized by skin lesion and tubers in vital organs, especially brain in three categories including subependymal nodules, cortical tubers and subependymal giant cell astrocytoma. Subependymal giant cell astrocytoma (SEGA) is an indolent neoplasm which usually arises at the cauda thalamic groove near foramen monro, although it occurs usually in the clinical settings of TSC, a few number of SEGA has been reported without such history. Its morphology with special cytoarchitecture could be mistaken with other glial brain tumors with similar morphology. Therefore, investigating new markers for differentiating SEGA from other mimickers seems logical rather than other glioneural immunohistochemical markers introduced before. Case: We investigated CD99 expression in SEGA as an adjunctive marker for diagnostic purposes. Five reported cases of SEGA were studied and all of them showed CD99 expression besides usual glioneural markers. Conclusion: CD99 may be a useful adjunctive marker in differentiating SEGA from other mimickers
Birgul Ciftci; Enver Vardar; Funda Tasli; Savas Yakan; Erdinc Top; Mehmet Yildirim
Abstract
Although the majority of mesenchymal lesions of the gastrointestinal tract are neoplastic in nature, but nonneoplastic reactive processes may also involve the gastrointestinal tract and mesentery. Some more aggressive neoplasms located in same area, such as fibromatosis or gastrointestinal stromal ...
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Although the majority of mesenchymal lesions of the gastrointestinal tract are neoplastic in nature, but nonneoplastic reactive processes may also involve the gastrointestinal tract and mesentery. Some more aggressive neoplasms located in same area, such as fibromatosis or gastrointestinal stromal tumors may be cause of diagnostic confusion. Reactive nodular fibrous pseudo tumor (RNFP) of the gastrointestinal tract and mesentery is a recently recognized entity. Here we present one such lesion in 71 years-old- man with a history of abdominal surgery. The tumor was firm, tan–white colored, ranged in size 19.5 cm in greatest dimension, and was grossly well circumscribed. Histologically it is composed of spindle-shaped cells resembling fibroblasts arranged haphazardly or in intersecting fascicles, embedded in a collagen-rich stroma with sparse intralesional lymphoid cells frequently arranged in aggregates. We present a case of this entity have largest tumor and also due to the rarity.
Deepti Gupta; Veena Gupta; Nisha Marwah; Meenu Gill; Sumiti Gupta; Gopal Gupta; Promil Jain; Rajeev Sen
Abstract
Background and Objective: Breast cancer is the commonest cancer of Indian women. Estrogen and Progesterone expression is seen in benign breast lesions and in breast carcinoma associated with good prognostic parameters and it correlates well with response to hormone therapy. Although a lot of studies ...
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Background and Objective: Breast cancer is the commonest cancer of Indian women. Estrogen and Progesterone expression is seen in benign breast lesions and in breast carcinoma associated with good prognostic parameters and it correlates well with response to hormone therapy. Although a lot of studies have been conducted in the past on hormone receptor expression in breast cancer and few have correlated them with other prognostic parameters of breast cancer, the present study was intended to document the prevalence of hormone receptor positive breast carcinomas in our population; their importance in benign breast diseases; to document a reliable scoring system of hormone receptors expression by Quick scoring; to correlate them with most of the proven prognostic parameters of breast carcinoma. Methods: Tissue specimens from 25 patients with benign breast disease and 50 patients with breast carcinoma were assayed for estrogen (ER) and progesterone (PR) receptors using Quick scoring. ER/PR expression in breast carcinomas was correlated with various prognostic parameters including patients’ age, menopausal status, tumor size, type, MBR grade, NPI, lymphatic vessel invasion, lymph node stage, lymphomononuclear invasion, elastosis and HER2/neu status. Result: Scoring of steroid receptors paralleled intensity of hyperplasia in benign breast diseases but in breast carcinoma, it was inversely correlated with grade of tumor, NPI, HER2/neu status, tumor necrosis, lymphomononuclear infiltrate and elastosis. We found no relationship with tumor size, lymph node status or age. Conclusion: Assessment of hormone receptors for clinical management of breast cancer patients is strongly advocated to provide prognostic information and best therapeutic options
Arijit Majumdar; Angshuman Jana; Soumali Biswas; Swagata Bhattacharyya; Anirban Jana
Volume 9, Issue 3 , July 2014, , Pages 193-198
Abstract
Background and Objective: Fine needle aspiration cytology (FNAC) is well accepted as a useful diagnostic technique in the management of adult patients with head and neck lumps. But, until recently, very few reports have been obtained regarding the role of FNAC in nonthyroidal neck masses in children. ...
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Background and Objective: Fine needle aspiration cytology (FNAC) is well accepted as a useful diagnostic technique in the management of adult patients with head and neck lumps. But, until recently, very few reports have been obtained regarding the role of FNAC in nonthyroidal neck masses in children. Hence, the objective of our study was to determine the diagnostic value of fine needle aspiration cytology in the diagnosis of paediatric nonthyroidalneck masses.
Methods: This descriptive study was conducted at the Department of Pathology,Dr.BCRoyPGIPSKolkata from January2012 to December 2012. Hundred patients with non-thyroidal neck masses fulfilling theinclusion criteria were included in the study. Fine needle aspirations were performed by Leishman-Giemsa staining.
Results: The most common nonneoplastic neck swelling seen in children were an enlarged lymph node due to inflammation 38(42.2%),i.e., reactive lymphadenitis. Others were TB lymphadenitis25(27.8%), nonTB granulomatous lymphadenitis 2(2.22%), chr.sialadenitis 2(2.22%), branchial cyst 4(4.44%) and epidermal cyst 3(3.33%) cases.
Overall sensitivity, specificity, positive predictive value and negative predictive value of FNAC in our cases are 93.06%, 72.22%, 93.06% and 72.22%.
Conclusion:FNA is a valuable diagnostic tool in the management of children with the clinical presentation of a suspicious neck mass. The technique reduces the need for more invasive and costly procedures like open biopsy.
Srinivas Ghante Nagaraj; Anitha Chalageri; Anjana Gupta; Manjula Vijayanand
Volume 9, Issue 1 , January 2014, , Pages 71-76
Abstract
We report a case of florid polypoid endometriosis presenting with advanced bulky disease in pelvis with serum CA – 125 levels of 7844U/ml. The extent of tumor, CT scan findings, elevated serum CA – 125 levels were suggestive of ovarian malignancy. Histopathology demonstrated endometrial glands ...
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We report a case of florid polypoid endometriosis presenting with advanced bulky disease in pelvis with serum CA – 125 levels of 7844U/ml. The extent of tumor, CT scan findings, elevated serum CA – 125 levels were suggestive of ovarian malignancy. Histopathology demonstrated endometrial glands and stroma. Glands were neither crowded nor complex and were separated by a fibromatous stroma that contained endometrial stromal cells. These features were consistent with diagnosis of polypoid endometriosis, a recently described entity with a clinical presentation completely different from conventional endometriosis. Our case emphasizes the association of high levels of CA – 125 with benign gynaecologic conditions.
Surendra Kumar Verma; Roopesh Kumar; Jonathan Srivani; Jonathan Jonathan
Volume 8, Issue 4 , October 2013, , Pages 227-234
Abstract
Background & Objectives: The accurate assessment of the diseased tissue is fundamental to the diagnosis and management of disorders of the central nervous system (CNS). The ‛squash’ or ‛crush’ technique has been universally employed in the intraoperative diagnosis of CNS tumors. The ...
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Background & Objectives: The accurate assessment of the diseased tissue is fundamental to the diagnosis and management of disorders of the central nervous system (CNS). The ‛squash’ or ‛crush’ technique has been universally employed in the intraoperative diagnosis of CNS tumors. The aim of our study was to evaluate the accuracy of squash preparation in diagnosing CNS tumors by comparing with histopathology.
Methods: This was a descriptive study which included 63 patients with CNS tumors from whom most of the samples were collected by craniotomy. Squash smears were made and stained with H&E, Papanicolaou & May-Grunwald Giemsa stains. Paraffin sections were made from formalin fixed tissue sent separately.
Results: Of 63 cases, squash cytology diagnosis correlated with histopathology in 56 cases with a diagnostic accuracy of 88.9%. A 100% accuracy was seen in pilocytic astrocytoma, anaplastic astrocytoma, glioblastoma, ependymoma, anaplastic ependymoma, choroid plexus papilloma, schwannoma, hemangioblastoma, craniopharyngioma, prolactinoma and metastases. Of the 7 cases which did not correlate with histopathology, one was a sampling error, 4 were diagnostic errors and 2 were instances of grading discrepancy.
Conclusion: Squash preparations are a highly effective tool in the rapid intraoperative diagnosis of CNS tumors. It is a simple, reliable, cost effective procedure which in most cases can help the operating surgeon to come to a correct decision regarding the further management of the patients.
Maliheh Khoddami; Maryam Barangi
Volume 7, Issue 2 , April 2012, , Pages 121-124
Abstract
Ovarian borderline serous tumors are uncommon. Combination of borderline serous adenofibromatous tumor and prominent micro papillary architecture is not previously reported. We report a case of borderline papillary serous adenofibromatous tumor (also called serous adenocarcinofibroma) with extensive ...
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Ovarian borderline serous tumors are uncommon. Combination of borderline serous adenofibromatous tumor and prominent micro papillary architecture is not previously reported. We report a case of borderline papillary serous adenofibromatous tumor (also called serous adenocarcinofibroma) with extensive micropapillary pattern in a 27 year-old married woman. She was infertile and presented with diffuse abdominal pain and dysparonia. Bilateral 5.3 and 4.5 cm solid ovarian masses were detected by sonography. Both masses were ovoid with tan-pink bosselated smooth external surfaces, and solid tan lobular cut surfaces. Microscopically, both tumors showed many papillary structures in a fibrotic stroma and contained multiple psammoma bodies. The papillae had broad hyalinized fibrotic stroma with many micropapillary projections arising from the main papilla, lined by mildly pleomorphic cuboidal cells. Mitotic activity was low with no marked nuclear atypia or stromal invasion. No extraovarian implants or metastases were identified.
Fahimeh Asadi Amoli; Masoumeh Mohebbi; Amir Hossein Sina
Volume 6, Issue 4 , September 2011, , Pages 224-228
Abstract
Chloroma or granulocytic sarcoma (GS) is a malignant neoplasm of myeloid lineage that occur in a variety of anatomic sites other than the bone marrow including soft tissue, bone, lymph node, nasal fossa, skin and sometime in the orbit. In the subconjunctiva it is rarely reported. A 4-year-old ...
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Chloroma or granulocytic sarcoma (GS) is a malignant neoplasm of myeloid lineage that occur in a variety of anatomic sites other than the bone marrow including soft tissue, bone, lymph node, nasal fossa, skin and sometime in the orbit. In the subconjunctiva it is rarely reported. A 4-year-old girl with a history of treated acute myelogenous leukemia was referred to Farabi Eye Hospital, Tehran, Iran for the evaluation of subconjunctival mass that was appeared since one month ago. Cell blood count (CBC) of the patient was normal except for Hb=7gm/dl. General physical examination was normal except for the signs of anemia. Histopathological evaluation of subconjunctival mass showed a malignant large round cell neoplasm. Immunohistochemical studies confirmed granulocytic sarcoma. When confronting a large cell or undifferentiated round cell neoplasm, the possibility of myeloid sarcoma should be investigated. Myeloperoxidase (MPO), cluster designation (CD) molecules such as CD34, CD45, CD15, CD68 and lysozyme positivity or Leder staining are useful in this regard.
Fahimeh Asadi Amoli; Ali Sadeghi Tarri; Khalil Hamzeh Doost; Naser Kamalian; Hedieh Moradi Tabriz
Volume 6, Issue 3 , June 2011, , Pages 124-132
Abstract
Background and Objectives: We aimed at evaluating the efficacy of fine needle aspiration biopsy (FNA) in comparison with histopathology and demonstrating whether cytological study could be a proper diagnostic tool in orbital mass lesions. Materials and Methods: In a cross sectional study during 36 months, ...
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Background and Objectives: We aimed at evaluating the efficacy of fine needle aspiration biopsy (FNA) in comparison with histopathology and demonstrating whether cytological study could be a proper diagnostic tool in orbital mass lesions. Materials and Methods: In a cross sectional study during 36 months, patients referred to our ophthalmologic center affiliated to Tehran University of Medical Sciences, for evaluation of orbital masses, were selected for FNA. After the surgery, the results of FNA were compared against histopathologic diagnoses as our gold standard method. Finally, the frequencies of specimen adequacy, the accuracy of FNA in distinguishing benign and malignant lesions and in the exact definitive diagnosis of the disorders were reported. Results: In 27.4% of the total 62 cases, the specimens were inadequate for cytologic evaluations. The rate of specimen adequacy in malignant and benign lesions was 82.6 % and 66.66%, respectively. From the morphologic point of view, the rate of the exact definitive diagnosis of malignant and benign disorders in the total 62 cases was 78.2% and 38.46% and; in the adequate specimens, it was 94.73% and 57.69%, respectively. There was no false positive FNA result for malignant cells and only in one malignant case, the FNA report was falsely negative. All data wee analyzed by SPSS software and p value Conclusion: FNA was considered more beneficial in the diagnosis of malignant lesions. FNA is a relatively noninvasive, rapid, specific, and accurate method for the preoperative primary diagnosis of orbital mass lesions and especially in malignant lesions and in some conditions, specific diagnoses can be achieved.
