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Ectopic thyroid tissue is defined as thyroid tissue that is present at a location other than its normal anatomical location. It can have any pathological condition that could impact the orthotopic thyroid gland. However, ectopic thyroid tissue seldom becomes malignant, and the occurrence of a follicular variant of papillary carcinoma in ectopic thyroid is much more unusual. We report a rare case of ectopic follicular variant of papillary carcinoma in a 73-year-old female with a normal orthotopic thyroid gland. Despite a few reports on ectopic papillary carcinoma thyroid (PTC) in submental, thyroglossal duct cysts, and bronchial cleft cysts with normal pathologic examinations of orthotopic thyroid, only one case of PTC in the anterior neck region without any neoplastic involvement of the orthotopic thyroid gland has been reported. Ectopic thyroid carcinoma should be taken into account in the differential diagnosis of a mass lesion in the front of the neck even in the presence of a normal thyroid gland which will aid in early diagnosis and treatment of such cases. [ABSTRACT FROM AUTHOR]

Background and Aim: Blood transfusions can be a crucial, life-saving treatment in modern medical and surgical practice. The primary objective of blood transfusion services worldwide is to guarantee the availability of a sufficient and safe supply of blood and blood products. Meticulous donor screening and use of highly sensitive techniques for the detection of transfusion-transmitted infections (TTIs) may help reduce the risk of TTIs and, hence, are important steps to ensure safety for both donor and recipient. Materials and Methods: This is a retrospective record-based study done at Hamdard Institute of Medical Sciences and Research. The blood donors' data from January 2012 to December 2022 (10 years) were collected from the blood bank registry at the study site and were analyzed. Results: Males dominated the donor population (98.2%) with females comprising only (1.8%). In total, 10.9% were found unfit for donation for various reasons. Voluntary donors were (6.3%) and replacement donors were (93.7%). Out of the reasons for deferral, majority 497/1223 (40.6%) donors were deferred due to hemoglobin <12.5 g/dl, followed by 156/1223 (12.8%) deferrals due to alcohol intake within the past 72 h. Conclusion: Safe donor selection is the first step toward safe transfusion services. Identification of population groups that can be targeted to enhance the pool of willing blood donors is made easier by studying and analyzing the blood donor profile. [ABSTRACT FROM AUTHOR]

Objective: Primary Spindle cell tumors of the thyroid are very rare and comprise a myriad of differential diagnoses ranging from reactive proliferations to neoplastic processes. Differentiation amongst these rare entities is of utmost importance as it defines the prognosis and also guides future therapy. Case Report: Hereby, we present a rare case of spindle cell variant of papillary thyroid carcinoma in a sixty-four-year-old female which posed a diagnostic challenge on histology. Microscopy showed a well-circumscribed spindle cell lesion with areas of infiltration and entrapment of colloid-filled thyroid follicles. There were no characteristic features of papillary carcinoma. A panel of immunohistochemistry markers was advised which clinched the diagnosis as the spindle tumor cells were positive for thyroid papillary carcinoma markers. Although papillary carcinoma usually has an indolent course, however interestingly this patient presented with lymph node metastasis one month after surgery which cytologically showed features of malignant spindle cell neoplasm. Conclusion: Through this case report we wish to highlight the cytological, histopathological as well as immunohistochemical features of this rare variant of papillary carcinoma. [ABSTRACT FROM AUTHOR]

Objective: Primary Spindle cell tumors of the thyroid are very rare and comprise a myriad of differential diagnoses ranging from reactive proliferations to neoplastic processes. Differentiation amongst these rare entities is of utmost importance as it defines the prognosis and also guides future therapy. Case Report: Hereby, we present a rare case of spindle cell variant of papillary thyroid carcinoma in a sixty-four-year-old female which posed a diagnostic challenge on histology. Microscopy showed a well-circumscribed spindle cell lesion with areas of infiltration and entrapment of colloid-filled thyroid follicles. There were no characteristic features of papillary carcinoma. A panel of immunohistochemistry markers was advised which clinched the diagnosis as the spindle tumor cells were positive for thyroid papillary carcinoma markers. Although papillary carcinoma usually has an indolent course, however interestingly this patient presented with lymph node metastasis one month after surgery which cytologically showed features of malignant spindle cell neoplasm. Conclusion: Through this case report we wish to highlight the cytological, histopathological as well as immunohistochemical features of this rare variant of papillary carcinoma. [ABSTRACT FROM AUTHOR]

Background and Aim: Head-and-neck cancers (HNCs) are significant causes of morbidity and mortality in both the developed and developing worlds. One of the most common types of HNC is oral squamous cell carcinoma (OSCC). The rationale behind the present study is to analyze the effectiveness of nuclear proliferative markers in comparison to the various grades of OSCC. This study utilizes Anneroth's histopathological multifactorial grading system for squamous cell carcinoma and further tends to compare this histological grading with nuclear proliferative indices of p53 and argyrophilic nucleolar organizer region (AgNOR). The aim of this study was to establish and develop a correlation between the proliferative markers, AgNOR and p53, and the histologic grade of the tumor (Anneroth's grading). Materials and Methods: A total of 60 cases of oral squamous cell carcinoma were taken from October 2020 to September 2022. The histological grading was done according to Anneroth's grading, and a score was given. P53 expression was graded according to the percentage of cells showing p53-positive immunostaining, and scoring was done from 0 to 3. The AgNOR score was calculated by examining 100 nuclei and calculating the mean AgNOR score per nucleus. Results: A significant linear correlation was obtained between the histological grading of OSCC and the proliferative markers (p53 and AgNOR). Conclusion: The analysis of the NOR count provides invaluable assistance in determining tumor aggressiveness and cellular proliferation rates. They can prove to be efficient tools to procure information on the malignant potential of different premalignant lesions. Elevated p53 expression implies greater clinical severity, a higher histological grade, and a poor prognosis for oral squamous cell carcinoma. Hence, the proliferative markers can be used as adjuncts to the histological grading system of OSCC. [ABSTRACT FROM AUTHOR]

The burden of cardiovascular disease has steadily increased in India. The aim of this study was to examine the veins when they are harvested in patients undergoing CABG (coronary artery bypass grafting), prior to grafting, to look for early evidences of damage due to inflammatory processes & also for immunohistochemical evidence of inflammatory markers and to compare the findings in diabetic patients and non-diabetic patients. Materials And Methods: This study was as part of an Extramural Ad-Hoc ICMR funded project. After obtaining an informed consent, a total of 154 patients were enrolled. All patients underwent CABG & saphenous vein (SV) was harvested, sent to the lab for evaluation. The characteristic histopathological features were observed, the findings compared in both groups. Immunohistochemical evidence of inflammatory markers in the SV wall was looked for and staining for MMP-9, COX-2 and iNOS was evaluated. Florescent staining of the SV for alterations in the basement membrane was also done. Results: A predominant male population was observed with 61.68% diabetics, hypertension and hypercholestraemia were the major risk factors along with smoking. Subendothelial edema was the major histopathological finding seen. IHC staining for inflammatory markers MMP-9 and COX-2 was done and showed positive findings for both the inflammatory markers, Examination florescent staining was carried out to delineate the basement membrane. Fragmentation of the basement membrane with disruption and a fibrillary appearance was seen in patients with smoking and hypertension. A fragmented & homogenous / afibrillar basement membrane was seen in the saphenous vein of patients with diabetes. Conclusion: We inferred that quicker attrition of the vein grafts may be anticipated in individuals with significant histological findings. Studies with a larger sample size will help to further validate these conclusions. [ABSTRACT FROM AUTHOR]

Background: Pilomatrixoma (PMX) is a relatively uncommon benign cutaneous neoplasm arising from skin adnexa. It presents as a subcutaneous asymptomatic nodule mostly in the head and neck region and is frequently misdiagnosed by the clinicians. Although easily diagnosed on histopathology, the cytologic features of PMX are less distinctive, depending on the stage and evolution of disease and may mimic other benign or even malignant lesions. Aim: To study the cyto-morphological features of this uncommon neoplasm and identify its potential diagnostic pitfalls on fine needle aspiration cytology (FNAC). Material and methods: Archival records of histopathologically diagnosed Pilomatrixoma were analyzed during study period of 2.5 years. Clinical diagnosis, preoperative FNA characteristics, and histopathological details were studied in each case. Cytologic pitfalls resulting in misdiagnosis of PMX cases on FNAC were evaluated in discordant cases. Results: The series showed male preponderance, with head and neck being the commonest site. Out of 21 histopathologically proven cases of PMX, cytological correlation was available in 18 cases. A correct cytologic diagnosis of PMX/adnexal tumor was rendered in 13 cases. Erroneous diagnosis was given in 5 cases mainly because of the predominance of one component over the other or non-representative-aspirated material. Conclusion: The present study highlights the importance of careful screening of FNAC smears keeping in mind the variability in the relevant cytologic features of PMX and creates awareness about the lesions that can mimic Pilomatrixoma resulting in diagnostic dilemma. [ABSTRACT FROM AUTHOR]

Endometriosis is a prevalent benign condition arising from the female reproductive system and affects about 7%–10% of females. The association of endometriosis with serous borderline ovarian tumors has been a matter of interest in gynecology. Sampson first described the association between endometriosis and carcinoma. The endometriosis-associated ovarian malignancies are clear cell adenocarcinoma and endometrioid adenocarcinoma, whereas serous and mucinous are rare malignancies associated with endometriosis. Here, we present the case report of a 45-year-old female in which endometriosis was associated with borderline serous tumor, since there is a lack of enough confident criteria for diagnosing endometriosis-associated ovarian tumors. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to histopathologically evaluate the morphological spectrum, apoptotic index (AI), and mitotic index (MI) of endometrial lesions in patients presenting with abnormal uterine bleeding (AUB).Methods: A cross-sectional study was done over a period of 18 months where a total of 60 newly diagnosed cases of perimenopausal women presenting with AUB were included. All H and E stained pathology slides from the specimens were reviewed for initial histopathological evaluation and diagnosis. Immunohistochemistry for Bcl-2 and Bax was done. The study subjects were divided into two groups: Group 1 included 30 cases of histologically proven proliferative endometrium (PE) and endometrial polyps and Group 2 included 30 cases of hyperplasia, endometrial epithelial neoplasia (EIN)/or carcinoma. For all cases, AI and MI were calculated and compared among the two groups.Statistical Analysis: Quantitative variables were compared using the Independent t-test/Mann-Whitney test between the two groups and Kruskal-Wallis test for comparison between more than two groups. Qualitative variables were correlated using the Chi-square test. P < 0.05 was considered statistically significant.Results: In our study of 60 patients of AUB, the mean age was 45.87 years with a parity of 2 or more in most of the patients. Most of the patients in our study had heavy menstrual bleeding (66.67%) with associated complaints of weakness, pallor, and low backache. Out of 60 patients of AUB, Endometrial carcinoma was diagnosed in 13 (21.67%) patients, with the most common histopathological type being Endometrioid carcinoma. There was a significant difference in the AI, MI, and the ratio of AI/MI among various histopathological diagnoses. AI was highest for Endometrial carcinoma and lowest for hyperplasia and polyps. MI was also highest for Endometrial carcinoma and lowest for hyperplasia and polyps. However, the ratio was incongruent as it was highest for hyperplasia without atypia and lowest for PE with endometrial carcinoma being midway. The Bcl-2 expression of relatively benign conditions (Group 1) was significantly higher than Group 2 (Endometrial epithelial neoplasia/carcinoma). Bax intensity showed an almost inverse pattern, being highest in endometrial carcinoma and lower in hyperplasia and polyps with the lowest expression in PE. Even the Bcl-2:Bax ratio was also highest for PE and lowest for endometrial carcinoma with others falling in between them.Conclusion: It can be concluded that the combination of the proliferative and apoptotic markers and the ratio will help as a tool in aiding the diagnosis of endometrial lesions for patients presenting with AUB. [ABSTRACT FROM AUTHOR]

Background: The online portal has been a vital tool for both teaching as well as assessment during the COVID-19 pandemic. While being the only safe option available during this period, online assessment has its own drawbacks. Students have access to their books as well as the internet; therefore, there is no regulation over plagiarism, compromising the reliability of the examination. On the other hand, traditional offline assessment, apart from issues of safety during the pandemic, also requires a substantial infrastructure. Aims: The study was conducted to explore the possibility of using a hybrid assessment method-an online examination in an offline setting-with the aim of compensating the shortcomings of both type of assessments and evaluating its potential as a formative assessment tool. Settings and Design: The study was conducted over a period of 1 month in the Department of Pathology of a Medical College of New Delhi. A batch of 100 students belonging to the second professional MBBS were evaluated toward the end of their fifth semester. Materials and Methods: A blueprint of the online practical examination was prepared by the faculty, including the entire syllabus. The assessments were conducted 4 times for a batch of 25 students at a time. Students were called on the day of their assessment with their mobile phones, and the test was sent through Google forms. At the end of the examination, a quick evaluation of the result was done question wise and the faculty gave detailed feedback discussing the results. Following this, the students were asked to fill out an online feedback form to gather their perceptions regarding hybrid assessment. Results: Most of the students considered hybrid practical assessment to be a better mode than conventional practical assessment, and the majority thought that this mode can be useful for final exam preparation and should be conducted more frequently. Most of the students were satisfied with the time given for answering the questions as well as with the difficulty level of the questions, and felt that the syllabus was appropriately covered. However, a few students faced problems such as Internet connectivity and form reloading issues. Conclusions: A hybrid assessment method that is conducting an "on campus" online examination can be effective mode of conducting regular formative assessments. It has the advantage of requiring minimal infrastructure as well as examination faculty. [ABSTRACT FROM AUTHOR]

Background: Oral mucocele are common non neoplastic lesions of the oral cavity that develop either as a result of damage to the duct or obstruction to the duct of minor salivary gland. Histopathologically oral mucoceles are divided into two categories: Extravasation mucoceles often seen in young individuals, the lower lip being the classic location. The second category includes retention mucoceles, which occurs most often in older patients usually located in the floor of the mouth and the inside the cheek. Objectives: This study aims to describe the demographic and histological characteristics of Oral mucocele along with comparative study between Extravasation mucocele and Retention Mucocele. Method: A total of 32 cases of mucocele diagnosed in the Department of the Pathology, between 2012 and 2019 were reviewed. The clinical data were recorded and histopathologic diagnosis was made. The study variables included were age, gender, type, site, color, etiology, symptoms and dimension of the lesion. Results: A total of 32 cases of oral mucocele cases were studied corresponding to a M:Fratio of 1.13:1. Peak incidence occurred in third decade followed by equally in the first and second decades of life. Extravasation Mucocele was the clinical diagnosis in 59.4% and Retention Mucocele in 40.6%. Most lesions were located in the lower lip (59.3%). Conclusion: This study provides an important insight into demographic and histological profile of oral mucocele lesion. It was concluded that oral mucocele predominantly presented in two histological forms, Extravasation Mucocele which was more common than other lesser common form Retention Mucocele. Although these lesion are easily diagnosed on the basis of clinical presentation but sometimes these swelling can mimic other benign mucosal lesion of these region, hence histopathological examination must be done in order to rule out these lesion and also to note any variation from its normal morphological findings. [ABSTRACT FROM AUTHOR]

Background: A laboratory requisition form (LRF) is the main communication link between the laboratories and the clinicians. In a cytopathology laboratory, incomplete forms with inadequate information significantly impact the quality of the results and waste precious time of the lab. Aims: The aim of this study was to audit the LRFs for adequacy of demographic and clinical data and to analyze the reasons for the same. Settings and Design: A retrospective study was conducted in the cytopathology laboratory of a tertiary care center. Materials and Methods: All the original LRFs received for Pap smears and FNACs of 1-month duration were retrieved. The forms were scrutinized for the presence of specific parameters which were classified as patient information, clinician information and clinical information. In addition to the completeness of the form, clarity of the data was also noted. Statistical Analysis: The data were entered on excel worksheets and percentage of Pap smear and FNAC forms lacking information of various parameters was calculated. Results: A total of 431 LRFs were received in the month of January 2020. These included 274 Pap smear LRFs and 157 FNAC LRFs. Patient information was mentioned in predominantly all the forms, however, clinician and clinical information, which is indispensible for reporting, was missing in a significant proportion of the Pap smear and fine needle aspiration cytology (FNAC) forms. Conclusions: Receiving inadequately filled LRFs has been an age-old problem in all medical laboratories. Audit of inadequacy of LRFs helped in assessing the prevailing practices in the hospital and gave an insight into the quality of information available to the cytologists for reporting. Many clinicians withhold information out of ignorance about its importance or due to lack of time to fill up the details on the LRF. Also, filling out a LRF is a task usually delegated to the junior doctor in the OPD and the significance of filling the LRF correctly and comprehensively is often not emphasized upon adequately by the senior clinicians. This audit helped us taking preventive action by giving feedback to the clinicians and emphasizing to them the importance of clinical data on the LRF and in improvising the LRF using a more objective and user-friendly format. [ABSTRACT FROM AUTHOR]

Objectives: The present study focusses on cytomorphological evaluation of the scrapings and cytological appearance of a spectrum of lesions of the oral cavity, Morphometric nuclear and cytoplasmic parameters were used to distinguish between benign, premalignant and malignant lesions. Material and Methods: The samples were obtained by scraping the lesion firmly till tiny pin point bleeding points were seen to ensure adequate sampling. Adequate sampling was defined as 50 cells consisting of transepithelial cytology specimen (superficial, intermediate and basal cells). Results: A total of 80 patients were evaluated with predominance in males and mean age of presentation was 45.05± 12.8 years. Cytomorphomteric analysis revealed an increasing trend in nuclear parameters as the spectrum of oral lesion moved from benign to malignant category while a decline was observed in cellular parameters. A significant p value of <0.0001 was found between cytomorphometrical parameters and histopathological subtypes. Sensitivity and specificity of conventional exfoliative cytology in conjunction with cytomorphometry was 100% and 94.74% respectively. Negative predictive value and positive predictive value of cytology for malignant lesions was 100% and 93.75% respectively. Diagnostic accuracy of cytology in predicting malignancy taking histopathology as gold standard was 97.0. Conclusion: Grading and scoring of oral cytosmears according to morphology showed a positive correlation with histopathological diagnosis. In addition, cytomorphometry increases the diagnostic accuracy of oral conventional exfoliative cytology and hence is seen to have an impact on early detection of cellular alterations and prompt treatment. Therefore, it is a sensitive and useful adjunct to monitor the cellular transformation. [ABSTRACT FROM AUTHOR]

Background: High performance liquid chromatography (HPLC) is the most commonly used method for detection and quantitative estimation of hemoglobin variants. Hemoglobinopathies are amongst the most common genetically inherited disorders, however, the exact magnitude of different hemoglobinopathies is obscure in India. This study was done with the aim of analyzing the different findings in HPLC using D-10 analyzer and evaluating the spectrum of different hemoglobin disorders in a hospital-based population of South Delhi. Such a prevalence study would be useful to review the various strategies that can be implemented for effective control and prevention of these disorders. Methods: A hospital based descriptive observational study was conducted in which all OPD and IPD patients who were advised HPLC during their clinical workup were included. Analysis of EDTA blood samples was done by Bio Rad D10 Dual program HPLC instrument. The exact percentage of HbA, HbA2, HbF and any other variant hemoglobin was estimated. Presumptive identification of hemoglobin variants was made primarily by their percentage, retention time (RT) and peak characteristics. HPLC findings were correlated with the clinical history, family history and the CBC and peripheral smear findings in all cases. Results: On HPLC analysis, 79% of the patients had no abnormality detected and the report was within normal limits. The commonest hemoglobinopathy was Beta Thalassemia Trait followed by HbE trait. The other hemoglobinopathies detected were HbD Punjab Heterozygous (3 cases, 0.5%), Beta thalassemia homozygous (3 cases, 0.5%), Sickle cell Heterozygous (2 cases, 0.3%), HbJ Meerut Heterozygous (2 cases, 0.3%). One case each of Sickle cell Homozygous (0.15%), Compound Heterozygous HbS/beta thalassemia trait (0.15%), HbE Homozygous (0.15%), Compound Heterozygous HbE/beta thalassemia trait (0.15%), and Homozygous delta beta thalassemia (0.15%) were also diagnosed. Conclusion: This study gives an important insight to the present day scenario of hemoglobinopathies in patients in South Delhi in relation to the hematological profile. It highlights the chromatogram findings of different hemoglobinopathies on the D10 analyzer. The comprehensive data obtained by such series can help in the formulation and development of infrastructure and policies for hemoglobinopathy prevention, diagnosis and management. [ABSTRACT FROM AUTHOR]

Background: The evaluation of wastage of blood products represents an important element in the appropriate use of blood components, a critical control point in the system of blood administration. Discarding or wastage of blood can be attributed to several reasons namely time expiry, wasted import, non-usage of ordered blood, broken bags and seal with leakage, hemolytic reasons, clotted blood, returned after 30 min, and miscellaneous others. Wasting of blood and blood components are an inefficient use of resources and may be avoided. The present study was undertaken with aim of primarily to determine the frequency of blood products wasting and secondarily to determine the factors that affect blood products wastage at our institute. Methods: The present study is a retrospective cross sectional descriptive study conducted in a tertiary teaching hospital located in South Delhi catering to low socioeconomic population. Blood component wastage was defined as components that did not meet the required standards of hospitals or fractionation centres during collection, processing and storage. The main reasons included expiry date, inappropriate volume, haemolysis of red blood cells (RBCs), contamination of plasma or platelets with RBCs, blood bag leakage, reactive infectious disease tests and inappropriate temperature during storage or transportation. The required data from clinical units and blood bank were collected and analyzed for a period of 7 years. Results: A total of 13728 blood units were received during the specified period. Overall wasted factor was of 18.5% with maximum wastage of platelet concentrate units (53.7%). Analyzing the causes of blood and blood product wastage in the hospital for this study showed that blood and blood product wastage were associated with many causes of which the common causes, included the expiration of the usability period (69.2%), seroreactivity for infectious diseases (13.7%) and Quality Control units (9.2%). Conclusion: Blood is an irreplaceable precious resource which needs to be properly utilized with minimal wastage. Although present study was limited due to its retrospective nature but it still outlines the importance to emphasize that measures should be taken into account for formulating guidelines, effective policies, and training efforts for personnel. [ABSTRACT FROM AUTHOR]

It is often documented that chronic irritation could be an etiology of oral cancer; yet out of negligence little heed is paid to any sort of discomfort until it grows to a sizable mass where it is difficult to go unnoticed. Intraorally, the source of irritation could vary from a jagged tooth edge to a chronic cheek bite. Furthermore, the removable prosthesis and orthodontic appliances can lead to alteration of the oral mucosal tissue. This case report represents one such sequelae of an ill-fitting dental prosthesis. Surprisingly and unfortunately, the broken denture was still in use by the patient until the damage caused by it could no further be ignored, it is then that the patient sought medical help. A histopathological diagnosis of reparative giant cell granuloma was made, and the patient was treated by successful excision of the same. [ABSTRACT FROM AUTHOR]

Intracholecystic papillary neoplasm (ICPN) of the gallbladder is a relatively new concept and is suspected to share clinicopathologic features with intraductal papillary mucinous neoplasm (IPMN) of the pancreas and intraductal papillary neoplasm of the bile duct (IPNB). The literature on the clinicopathologic characteristics of preinvasive intraepithelial neoplasms of the gall bladder is fairly limited, partly owing to variability in its definition and terminology. We report an extremely rare case of coexistent xanthogranulomatous inflammation and intracholecystic tubulo-papillary neoplasm with low-grade dysplasia in a 48-year-old male patient. Although there are many case reports of simultaneous carcinoma gallbladder with xanthogranulomatous cholecystitis (XGC), however, the association of ICPN with XGC has not been previously described. To the best of our knowledge, this is the first case report of ICPN of gallbladder coexisting with xanthogranulomatous cholecystitis. [ABSTRACT FROM AUTHOR]

Background/Aim: Xanthogranulomatous cholecystitis (XGC) is a rare destructive inflammatory disease of the gallbladder. It is frequently misdiagnosed as gallbladder carcinoma (GBC) as it mimics latter with regard to clinical manifestations, imaging and intraoperative findings, often leading to extended surgical resection in these patients. The aim of this study was to evaluate the diagnostic dilemma of XGC cases clinico-radiologically diagnosed with GBC. Materials and Methods: From January 2017 to June 2019, a total of eight cases histopathologically diagnosed as XGC, were misdiagnosed with GBC based on preoperative and intra-operative findings. The clinical characteristics, imaging, intra-operative findings, and surgical data of these patients were collected and analyzed. Results: A total of 2154 cholecystectomy specimens were received in the histopathology section during the study period. Sixty-nine cases (3.2%) were histologically diagnosed as XGC, of which 8 cases (11.6%) were preoperatively diagnosed with GBC. These cases were predominantly seen in males in the age range of 24–62 years. The most common clinical presentation was chronic cholecystitis. Gallstones were present in all the 8 cases. Six cases presented with heterogeneous enhancement within thickened gallbladder walls on imaging. Intraoperatively, adhesions to adjacent organs were observed in seven cases. All these eight cases misdiagnosed with GBC underwent aggressive surgical treatment following which histopathology ultimately revealed XGC. Conclusion: Neither clinical manifestations nor laboratory tests/radiological methods can provide an effective means of differentiating between XGC and GBC. Preoperative diagnosis is difficult, and histopathology remains the gold standard to differentiate the two entities. [ABSTRACT FROM AUTHOR]

Background/aim: Xanthogranulomatous cholecystitis (XGC) is a rare destructive inflammatory disease of the gallbladder. It is frequently misdiagnosed as gallbladder carcinoma (GBC) as it mimics latter with regard to clinical manifestations, imaging and intraoperative findings, often leading to extended surgical resection in these patients. The aim of this study was to evaluate the diagnostic dilemma of XGC cases clinico-radiologically diagnosed with GBC.Materials and Methods: From January 2017 to June 2019, a total of eight cases histopathologically diagnosed as XGC, were misdiagnosed with GBC based on preoperative and intra-operative findings. The clinical characteristics, imaging, intra-operative findings, and surgical data of these patients were collected and analyzed.Results: A total of 2154 cholecystectomy specimens were received in the histopathology section during the study period. Sixty-nine cases (3.2%) were histologically diagnosed as XGC, of which 8 cases (11.6%) were preoperatively diagnosed with GBC. These cases were predominantly seen in males in the age range of 24-62 years. The most common clinical presentation was chronic cholecystitis. Gallstones were present in all the 8 cases. Six cases presented with heterogeneous enhancement within thickened gallbladder walls on imaging. Intraoperatively, adhesions to adjacent organs were observed in seven cases. All these eight cases misdiagnosed with GBC underwent aggressive surgical treatment following which histopathology ultimately revealed XGC.Conclusion: Neither clinical manifestations nor laboratory tests/radiological methods can provide an effective means of differentiating between XGC and GBC. Preoperative diagnosis is difficult, and histopathology remains the gold standard to differentiate the two entities. [ABSTRACT FROM AUTHOR]

Background and Objectives: Oral verrucous hyperplasia and verrucous carcinoma are two clinicopathologically distinctive oral verrucous lesions, current understanding of these lesions is perplexing hence it is important to investigate the clinicopathological features of the two verrucous lesions and estimate their relationship. The present study was undertaken with the aim of identifying the pathological features in an attempt to differentiate both lesions. Materials and Methods: Archives of the department were retrieved for verrucous lesions. 20 cases were included in the study. Each patient was reviewed for clinical details like age, sex, habits, clinical features like site of lesion, clinical diagnosis, presence of associated lesions. Pathological details including both gross and microscopic features were analyzed. Results: A total of 20 patients included in the study showed a male preponderance with a significant association with tobacco consumption and size of lesion. Majority of the lesions were localized to the buccal mucosa, histopathological features were characteristic of each lesion. Expression of Ki-67, a proliferative marker showed, a statistically significant association between the mean LI of both the lesions. Conclusions: VH and VC are closely related lesions difficult to clinically differentiate, hence histopathological evaluation plays a pivotal role in establishing a diagnosis. Differentiating the two is essential and it should be kept in mind that VH may transform into VC hence, acting as a potential precancerous lesion. [ABSTRACT FROM AUTHOR]

BACKGROUND : The histological response to chemotherapy is regarded as an independent prognostic variable in bone tumours. The surgical pathologist, thus has an important role in the management of primary malignant bone tumors like osteosarcomas and Ewing′s sarcoma subsequent to neoadjuvant chemotherapy. AIMS AND OBJECTIVES: We report a short series of fifteen cases of osteosarcoma and three cases of Ewing′s sarcoma in which the histological response of the tumor after giving neoadjuvant chemotherapy to the patient of bone tumours was assessed and graded. MATERIAL AND METHODS: Bone tumours was assessed and graded by Huvos grading. The correlation of this histopathologic tumor response with clinical outcome is a well-established routine investigation in patients with bone sarcomas and the grading of the tumor response is based on definable histopathologic criteria. RESULT: Fifteen out of eighteen cases in this study showed a response to neoadjuvant chemotherapy, which was categorized as Huvos Grade 1 (%50%) and Huvos Grade 2 (50% to 90%). One case of osteosarcoma showed a Grade 4 response with a total absence of tumor cells in all the sections. One case of osteosarcoma and Ewing′s sarcoma each were categorized as Grade 3, showing tumor foci. CONCLUSION: It was concluded that necrosis of tumor area when greater than 90%, is regarded as a powerful positive prognostic indicator for survival in patients of high grade bone sarcomas. [ABSTRACT FROM AUTHOR]

Introduction: Early detection of oral cancer is one of the most efficient ways to reduce the high mortality from this disease because of the ready accessibility of the oral cavity. We need to devise urgent diagnostic tools to detect early oral premalignant and malignant lesions. Aim: The aim of the present study was to grade the oral lesions in an attempt toward developing a novel cytological grading system. Further, morphometric analysis of cellular parameters was also performed to compare their significance in differentiating benign from malignant lesions. Materials and Methods: The present study was conducted at a tertiary care hospital catering to the low socioeconomic population. Patients presenting in the various Out Patient Departments with suspicious oral lesions were evaluated by cytology in the Department of Pathology. Results: A total of 72 patients were evaluated with a mean age of 43.54 ± 10.35 years. The involvement of the buccal mucosa was the most common site of oral lesions. Cytologically, the lesions were graded according to the oral/oro-pharyngeal cytology grading system into grades A to F. Cyto-morphometric analysis showed an increasing trend in mean nuclear diameter from benign to malignant cases while the mean cytoplasmic diameter decreased, value of P < 0.05 was observed indicating a statistically significant difference between the two groups. Conclusions: Cytological features of pleomorphism are a unique feature in oral carcinoma reflecting intracellular alterations in cells. Grading of lesions according to cytological characteristics can be helpful in standardizing the reporting of the oral lesion. However, our study was restricted by limited data; we emphasize more extensive studies to assess the usefulness and applicability of such a grading system. We also conclude that the use of cytomorphometry can improve the diagnostic reliability of exfoliative cytology. [ABSTRACT FROM AUTHOR]

Drug reaction with eosinophilia and systemic symptom (DRESS) syndrome is a rare severe drug-induced idiosyncratic hypersensitivity characterized by maculopapular and/or erythrodermic eruption, fever, peripheral lymphadenopathy, eosinophilia or atypical lymphocytosis, and visceral organ involvement. The estimated incidence of this syndrome ranges from 1/1000 to 1/10,000 drug exposures. In this report, we describe a case of DRESS syndrome in a young female with a unique presentation. The DRESS syndrome can be difficult to diagnose as its clinical findings can mimic those of other systemic diseases. This case emphasizes the importance of incorporation of the patient's clinical and medication history in the interpretation of hematological investigations. [ABSTRACT FROM AUTHOR]

Pure Primary Endometrial Squamous cell carcinoma (PESCC) is a rare entity with less than seventy cases reported till date. It is usually seen in postmenopausal females presenting with pyometra. Our patient was a 60 year old female presenting with postmenopausal bleeding since six months. Pap smear was reported as ASC-H (Atypical Squamous Cells-cannot exclude HSIL). Cervical biopsy showed features of Cervical Intraepithelial Neoplasia (C1N III). Endometrial curettings were suggestive of Squamous Cell Carcinoma, keratinizing type. Patient underwent radical hysterectomy following which a final diagnosis of Primary invasive Squamous cell carcinoma of uterus with isolated cervical dysplasia was made. Through this case report we wish to emphasize that although rare, diagnosis of PESCC endometrium should be considered in a postmenopausal elderly female presenting with pyometra. To the best of our knowledge, this is the first case report of endometrial squamous cell carcinoma coexistent with severe cervical primary dysplasia. [ABSTRACT FROM AUTHOR]

Background: Cichorium intybus has a wide range of therapeutic applications in Indian traditional systems of medicine, especially in metabolic disorders. Objective: To evaluate the toxicity profile and to investigate the antidiabetic, antihyperlipidemic, and antioxidative efficacy of C. intybus seeds in Wistar rats. Materials and Methods: The aqueous extract of seeds was prepared by decoction, and its quality control analysis was carried out by thin-layer chromatography and ultra-performance liquid chromatography-mass spectrometry (UPLC-MS) fingerprinting. Wistar rats were fed with high-fat diet for 5 weeks followed by a single dose of streptozotocin intraperitoneally to induce diabetes. The protective group of rats was given aqueous extract during and after the induction of type 2 diabetes mellitus. Further, repeated dose 28-day (subacute) and repeated dose 90-day (chronic) toxicity studies were conducted as per the OECD guidelines. Results: A total of 18 metabolites have been tentatively identified by UPLC-MS profiling in aqueous extract of C. intybus seeds. No significant changes in mortality and biochemical parameters have been observed during toxicity studies. Moreover, administration of the extract to a protective group of diabetic rats attenuated serum glucose and triglyceride levels by 52.7% and 65.3%, respectively, supported by similar results for parameters related to insulin resistance and oxidative stress. The beneficial effect of extract has also been confirmed through in silico screening. Conclusion: C. intybus can be used as a natural dietary supplement for the prevention and management of diabetes and can be explored to develop a potent phytopharmaceutical for diabetes. Abbreviations used: AECIS: Aqueous extract of Cichorium intybus seeds; HOMA-IR: Homeostatic model assessment of insulin resistance; OGTT: Oral glucose tolerance test; TLC: Thin-layer chromatography; UPLC-MS: Ultra-performance liquid chromatography-mass spectrometry. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Tuberculosis (TB) in the developing countries presents with both pulmonary and extrapulmonary manifestations. Breast TB, however, remains a rare presentation. Its importance lies in the fact that it may mimic malignancy or present as inflammatory lump/abscess. AIMS AND OBJECTIVE: The aim of the present study is to highlight the importance of breast TB and its diagnostic challenges. MATERIALS AND METHODS: It was a retrospective study conducted at a tertiary care hospital, over 2 years between 2013 and 2015 during which eight cases of breast lesions were diagnosed as of tubercular origin. RESULTS: Granulomas were seen in five cases while three cases revealed only few epithelioid cells, and necrosis was seen in all cases on fine-needle aspiration cytology. Histopathological evaluation was available in six out of the eight cases, while acid--fast bacilli were positive in three cases, the characteristic granulomas were seen in all the six cases evaluated. CONCLUSION: Significance of TB breast lies in the fact that it may masquerade as breast malignancy or pyogenic abscess. India is a developing country where TB is endemic, a high index of suspicion should be expressed in evaluating breast masses, and TB should be considered in the differential diagnosis. [ABSTRACT FROM AUTHOR]

Hibernomas are extremely rare benign tumors of adipose tissue characterized by an admixture of brown fat cells with granular, multivacuolated cytoplasm and white fat cells. Hibernomas account for 1.6% of benign adipose tissue tumors and approximately 1.1% of all adipocytic tumors. Around 10% of these cases are intramuscular. It was initially described in the early 1900s as being composed of brown fat. Hibernomas usually occur in third to fourth decades of life and the most frequent sites being thigh, trunk, shoulder, back etc. Cytological differential diagnoses of hibernoma include well differentiated liposarcoma, myxoid/round cell liposarcoma, chondroid lipoma and benign granular cell tumor. Due to its abundant vascularity evident on angiography, it can sometimes mimic a malignant lesion, from which it needs to be distinguished as complete surgical excision is the only treatment required for a hibernoma. Moreover, it has no malignant or metastatic potential. We presented a rare case of intramuscular hibernoma of the scapular region in a 34-year-old male, in which cytology was reported as pleomorphic fibrolipomatous malignant lesion. [ABSTRACT FROM AUTHOR]

Introduction: Gallbladder diseases are very common in Northern India, most common of which is Chronic Cholecystitis. Rarely, histopathological diagnosis of Eosinophilic Cholecystitis (EC) is given when transmural cellular infiltrate consists of more than 90% eosinophils. Aim: To determine the prevalence and clinicopathological profile of eosinophilic cholecystitis at a tertiary care hospital of New Delhi. Materials and Methods: This was a retrospective clinicopathological study done on twenty two cases of eosinophilic cholecystitis over a period of five years from January 2011-December 2015. In cases diagnosed histopathologically as eosinophilic cholecystitis, clinical details were obtained from hospital records and slides were retrieved. Various histologic features, pattern of the inflammatory infiltrate and association of EC with other medical diseases, drugs and allergic states were evaluated. results: Out of a total of 1370 cholecystectomy specimens received during five year period, Eosinophilic cholecystitis was diagnosed in 22 (1.6%) of the specimens. Clinically, seven of these patients had a clinical diagnosis of acute cholecystitis. Patient's age ranged from 25-64 years and male to female ratio was 1:2.7. Most common symptom reported was abdominal pain. Most of the cases showed gallstones radiologically (90%) while only two cases showed peripheral eosinophilia (9%). Histologically, mucosal and muscular eosinophilic infiltrate was seen in 72.6% of the cases. No association with drug therapy, allergies or other pre-existing medical conditions was noted. conclusion: EC is a relatively uncommon entity in which histopathology remains the main stay of diagnosis. Although the presentation may be similar to general cholecystitis, if a postoperative histopathological diagnosis of EC is made, then the patient must be investigated thoroughly to rule out other associated disease conditions, which may have a worse prognosis than cholecystitis itself. [ABSTRACT FROM AUTHOR]

Hodgkin's lymphoma has a significant presence in the Indian subcontinent. Microscopically, the hallmark of Hodgkin's lymphoma (HL) is the Hodgkin and Reed-Sternberg (HRS) cell, which is usually surrounded by a cellular infiltrate of non-malignant inflammatory cells that constitute the majority of the tumor tissue. Cells which are known to be histologic mimics of HRS cells include immunoblasts, plasmablasts and rarely dendritic cells. We report a case of a 70-year-old male who presented with fever and lymphadenopathy. In the present case, the large cells with prominent nucleoli stained positively for both CD15 and CD30 and hence the possibility of angioimmunoblastic lymphadenopathy which was considered on the H&E-stained sections was excluded. In addition, noteworthy microscopic features in this case were angiogenesis and the presence of mast cells, both associated with a poor prognosis. The clinical impression was that of disseminated tuberculosis, but on histopathology, the final opinion was 'Hodgkin's lymphoma not classifiable with an unusual histology'. The aim of reporting this case is to highlight the unusual presentation in the form of prominent angiogenesis and mast cell infiltration in a case of HL, which is indicative of a poor prognosis. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) and malignancy are among the most important current global health problems. Many authors suggest that their coexistence is a chance association owing to their high prevalence. There is, however, enough evidence that one condition may predispose the other. In our retrospective report of two cases, TB in draining lymph nodes was discovered incidentally on histopathology, following surgical resection for malignancy. The possibility of coexistent lesions, especially in regions endemic for TB, mandate a detailed histopathological examination to prevent the chances of diagnostic failure and thus therapeutic error. [ABSTRACT FROM AUTHOR]

Background: Primary nasal tuberculosis (TB) is a rare form of TB even in areas with high TB incidence. It is timely diagnosis and proper management are often delayed due to its rarity and nonspecific clinical presentation. Aim: The aim of the study was to review histopathologically diagnosed cases of nasal TB over a period of 1 year and to describe its clinical presentation, diagnostic workup, the importance of histopathological diagnosis along with a brief review of the literature. Materials and Methods: This was a retrospective study done in the Department of Pathology of a Tertiary Care Hospital of Delhi over a period of 1 year where all the cases with histopathological diagnosis of nasal TB were reviewed. Patients' clinical details, investigations and treatment details along with follow-up were obtained from the medical records section. For each case, routine hematoxylin and eosin stain were studied along with Ziehl-Neelson staining. Results: A total of four patients were diagnosed with nasal TB histopathologically. Patients' age ranged from 5 to 34 with an equal male to female ratio. All patients were immunocompetent. Primary nasal TB was seen in all of the four cases. None of the cases, it was clinically suspected, and histopathology was the mainstay of diagnosis. All the cases were treated with antituberculous treatment and showed considerable improvement. Conclusions: Although nasal TB is rare, it should be considered in the differential diagnosis of chronic nasal symptoms and granulomatous lesions of the nose. Histopathology plays an important role in the diagnosis of these clinically unsuspecting cases of nasal TB. [ABSTRACT FROM AUTHOR]

Brenner tumors of ovary are usually an incidental finding. It is an uncommon tumor which is seen affecting women of fifth to sixth decade. It is classified under transitional cell tumors of ovary, which includes benign, borderline, and malignant Brenner tumors and transitional cell carcinoma. These tumors have been associated with synchronous and metachronous neoplasia, most commonly other ovarian epithelial tumors such as mucinous cystadenoma. Occasionally, these tumors may be associated with endometrial hyperplasia or carcinomas which are due to hormones elaborated by the stromal component of Brenner tumor. The hormone produced is estrogen and less commonly androgens, which alters the estrogen and progesterone levels, causing hyperstimulation of endometrium. We present a case of 50-year-old postmenopausal women who presented with coexisting incidental Brenner tumor with leiomyoma and Endometrial adenocarcinoma. Only few authors have reported similar tumor occurrence in the past. [ABSTRACT FROM AUTHOR]

Heterotopic or ectopic tissue is a congenital anomaly, which is defined as the presence of the tissue outside its normal location, without neural, vascular, or anatomic connection with the main body of an organ in which it normally exists. This tissue is usually discovered incidentally and may be asymptomatic or may present with nonspecific gastrointestinal (GI) symptoms. Pancreatic and gastric heterotopia are the two predominantly occurring heterotopic tissues in the GI tract.[1],[2] The prevalence of ectopic pancreatic tissue in the GI tract ranges from 0.6% to 13.7% of autopsy series and it can be present anywhere in the GI tract with the most common localizations being stomach (27.5%), duodenum (25.5%), colon (15.9%), esophagus, and Meckel's diverticulum.[3],[4],[5] It is a rare finding in the gallbladder and its prevalence has not been ascertained due to lack of large-scale studies and systematic review of literature. Similarly, heterotopic gastric tissue is common throughout the GI tract from the tongue to the rectum,[6],[7] but it is extremely rare in the gallbladder with only around 34 cases reported in literature so far, while other cases of different types of heterotopic tissues in the gallbladder such as liver tissue and others such as adrenal and thyroid tissues have been described.[8] The most common presentation of ectopic tissue in the gallbladder is colicky pain in the epigastrium or right upper quadrant sometimes associated with nausea and vomiting. Here, we are presenting two incidentally detected cases, each of gastric and pancreatic heterotopias in the gallbladder. [ABSTRACT FROM AUTHOR]

Objective: Image guided fine needle aspiration cytology (FNAC) is a safe, simple, rapid, cost effective and accurate modality in evaluation of deep seated lumps (abdominal, pelvic and intrathoracic masses) which are unapproachable by blind FNAC. In this study, a critical analysis of the utility of image guided FNAC in deep seated and otherwise inacessible mass lesions was carried out. Material and Method: Fifty-four ultrasound (USG) or computed tomography (CT) guided FNACs from lumps at any location in the body, that is, thoracic, abdominal, pelvic etc over a period of 3 years (January 2012- December 2014) were included in the study. The most common site aspirated, the indications for a guided aspiration and the accuracy of aspiration cytology in comparison to the histological diagnosis were evaluated, wherever possible. Results: Fifty-four image guided FNACs were performed (46 USG guided and 8 CT guided). Inconclusive, inflammatory, benign tumors, suspicious and malignant lesion rates were 5.6%, 29.6%, 11.1%, 5.6%, and 48.1%, respectively. The most common site was the liver (25.5%), followed by the thyroid (18.5%), lung (14.8%), gallbladder (11.1%), and lymph nodes (7.4%). Cytohistological correlation could be performed in 32 cases with a diagnostic accuracy of 100%. Conclusion: FNAC coupled with a diagnostic imaging technique such as USG or CT can improve the diagnostic yield and a definite diagnosis can be reached in most of the cases. [ABSTRACT FROM AUTHOR]

Malignant thyroid tumors of follicular origin comprise a spectrum, with the indolent well-differentiated thyroid carcinoma (WDTC) at one end and lethal anaplastic thyroid carcinoma (ATC) at the other. Poorly differentiated thyroid carcinoma (PDTC) lies intermediately between WDTC and ATC in terms of morphology and prognostic standpoint. This thyroglobulin producing neoplasm accounts for 4-7% of all thyroid malignancies. PDTC has been controversial due to lack of defined diagnostic criteria. We hereby report a case of PDTC in a 42-year-old female presenting with neck swelling, pain, and dysphagia for 10 months. She was diagnosed as colloid goiter on fine-needle aspiration cytology. On imaging, a large complex thyroid with central neck nodes was seen. Total thyroidectomy and central neck node dissection were done. Based on the morphology, immunostaining, and the diagnostic criteria, a diagnosis of PDTC was made. PDTC is a diagnostic challenge due to its rarity and previous equivocal diagnostic criteria. [ABSTRACT FROM AUTHOR]

Granulomas are a rare finding on Papanicolaou (Pap) smear which if encountered are usually attributed to tuberculosis, especially in an endemic country like India. Here, we report an interesting case of a 40-year-old female presenting with blood-stained discharge and chronic pelvic pain for 8 years. She was advised Pap smear which showed granulomatous inflammation suggestive of tuberculosis. The patient was worked up for tuberculosis which was noncontributory. Dilatation and curettage was done which revealed multiple small bones and bony chips in the endometrial cavity. Following the removal of bones, the patient showed considerable symptomatic improvement. Repeat Pap smear did not reveal any evidence of granuloma. Even after extensive search of literature, we did not come across any such case report in which intrauterine retention of fetal bones evoked a granulomatous response in cervical smears though the presence of uterine granulomas in response to foreign body has been well documented. [ABSTRACT FROM AUTHOR]

Crystallizing galactocele is a very rare entity which yields a viscous, chalky material on Fine Needle Aspiration Cytology (FNAC). FNAC is used both for diagnosis as well as treatment of this condition. We present here a case of 26 years old lactating female who presented with swelling in the right breast for 8 months. The swelling was firm, discrete, non-tender and mobile involving the upper inner quadrant of right breast. A diagnosis of benign breast disease, possibly fibroadenoma was made clinically. FNAC of the lesion yielded thick, milky and chalky material. Cytological smears showed numerous semitransparent crystals of varying size and shapes with angulated borders in a background of granular and amorphous debris along with frothy appearing micelles. These crystals show positive birefringence. Based on clinical history of lactation and typical cytological findings, a diagnosis of crystallizing galactocele was made. We report this case because of rarity of this condition and to the best of our knowledge, till date only five cases of crystallizing galactocele has been reported in medical literature. [ABSTRACT FROM AUTHOR]

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Concomitant breast cancer metastasis and tubercular lymphadenitis in axillary lymph node is an extremely rare occurrence. Axillary lymph node metastasis is the most important factor in the staging of breast carcinoma and the number of axillary nodes showing metastases alters the stage. As tuberculosis also produces nodal enlargement, this can mimic or complicate the staging of malignant disease. Dual pathology in an organ can lead to difficulties in interpretation and inappropriate treatment of tuberculosis as well as carcinoma breast. Moreover, fine needle aspiration cytology (FNAC) from such cases may be misleading if only one of the diseases is picked up. Therefore, the need for multiple attempts at FNAC should be stressed upon for all palpable lumps. We report a case of infiltrating duct carcinoma breast in a 45-year-old female where tuberculosis was discovered in axillary lymph nodes in addition to metastases. As the present case led to incidental discovery of tuberculosis with tumor metastasis, it reinforces the possibility of a coexistent lesion in the pathologists' mind, especially in regions endemic for tuberculosis. [ABSTRACT FROM AUTHOR]

Uterine smooth muscle tumors and endometrial stromal tumors (ESTs) are the two major types of mesenchymal tumors of the uterus, the latter being fairly uncommon. Among these, endometrial stromal sarcoma (ESS) accounts for 0.2-1.5% of all uterine malignancies. Although routine histopathological examination is sufficient to distinguish between ESS and smooth muscle tumors in most of the cases, the distinction between ESTs and highly cellular leiomyomas (CMs), on several occasions becomes a great diagnostic challenge for the pathologist. The differentiation between EST and CM is necessary on account of the variable clinical course and slight variation in the therapy. However, this is difficult due to the tendency of endometrial stromal cells to differentiate into well-developed smooth muscle cells as well as overlapping immunohistochemical profile in some cases. We hereby report a series of cases which posed a diagnostic challenge to us as to whether they are CMs or ESTs. We therefore discuss the histological features which helped us resolve this dilemma as well as the utility of immunohistochemistry (IHC) as a diagnostic aid in arriving at a final diagnosis in such problematic cases. [ABSTRACT FROM AUTHOR]

Cutaneous ciliated cysts (CCCs) are rare, benign cysts which are also referred to as Mullerian cysts. The histological hallmark is the morphological resemblance of the lining epithelium of the cyst wall to that of the fallopian tube. These cysts clinically mimic other entities and histopathology is necessary for diagnosis. An unusual case of CCC in a young female with its differential diagnosis is discussed. [ABSTRACT FROM AUTHOR]