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The metaplastic breast carcinoma is a rare malignancy with an incidence of 5% of all breast tumors. Metaplastic carcinoma of the breast with mesenchymal differentiation (MCMD), previously known as carcinosarcoma, is a very rare and aggressive tumor that has been recently classified as a subtype of metaplastic breast carcinoma. It accounts for 0.08%–0.2% of all breast cancers, with only a few cases reported in the literature. Metaplastic breast carcinoma most often affects women over 50 years of age, with an average age between 55 and 60 years. We report three cases of metaplastic breast carcinoma with mesenchymal differentiation presented at our hospital. Patients were in their 4th decade. All patients presented with a fast-growing large mass and were treated surgically (mastectomy), with the final histopathological diagnosis of MCMD. [ABSTRACT FROM AUTHOR]

Introduction: In India, prostate carcinoma is the fifth most common cause of carcinoma in men, and the fourth in cancer mortality. Incidence of prostate malignancy is increasing in India by one percent every year. Prostate carcinoma is graded using the Gleason scoring system. The Gleason score is very useful for predicting the prognosis of prostate carcinoma. The collaborative use of clinical features, combined with the size of the prostate, prostate-specific antigen levels, and histopathological features helps in making an accurate and early diagnosis of the patients. Material and Method: This present prospective study included all histologically proven cases of prostate carcinoma in the Department of Pathology, Guru Gobind Singh Medical Hospital over a period of one year. A detailed histopathological examination of the H and E stained sections is carried out under light microscope including histological typing, Gleason scoring and grading. The Gleason grade was correlated with serum PSA levels. Results: Out of 80 cases, 28 (35%) were reported as Gleason grade group 3 with a Gleason score of 7 (4 + 3). 12 cases (15%) showed a Gleason grade group 2 with a Gleason score of 7 (3 + 4). Grade group 4 (Gleason score 8) and grade group 5 were observed in 22 cases (27.5%) and 18 cases (22.5%), respectively. Whereas, no case of Gleason grade group 1 with Gleason score of 6 (3 + 3) was seen. Conclusion: Gleason's Group Grade 3 outnumbered all the group grades, contributing 35% (28 cases) of the total cases of prostatic adenocarcinoma. Serum PSA levels were raised (>10 ng/ml) in 100% of cases. Henceforth, it signifies the importance of serum PSA levels in prostate carcinoma. Lymphovascular invasion was associated with higher group grade of prostatic adenocarcinoma. [ABSTRACT FROM AUTHOR]

Objective: The causes of pancytopenia vary in different populations depending on age, gender, nutrition, geographic location, standard of living, and exposure to certain infections and drugs. As the severity of pancytopenia and its underlying etiology determine the management and prognosis, identifying the correct etiology in a given case is crucial and helps in implementing timely and appropriate treatment. The objectives of this study were to study the clinical profile and hematological parameters of pancytopenic adults and to identify different etiologies of pancytopenia. This observational study was conducted in the Medicine department of a tertiary care teaching hospital. Materials and Methods: The study was conducted on 100 adult patients aged 18–65 years presenting with pancytopenia. All the participants were subjected to detailed clinical examination and relevant investigations including bone marrow (BM) examination. Categorical variables were presented in number and percentage (%). Qualitative variables were correlated using the Chi-square test. A P <0.05 was considered statistically significant. Results: A female preponderance was observed, and the majority of patients were aged between 18 and 40 years. The most common clinical features were generalized weakness, fever, and pallor. Seventy-four percent of patients were vegetarians; 58% had vitamin B12 deficiency, 25% had folic acid deficiency and 19% had a deficiency of both. The most common cause of pancytopenia was megaloblastic anemia (MA) (37%), followed by dimorphic anemia (DA) (26%), aplastic anemia (AA) (20%), and hematological malignancies (11%). Conclusion: MA, DA, and AA are the most prevalent etiologies of pancytopenia. BM examination is of utmost importance in the definitive diagnosis of pancytopenia and is useful in initiating timely treatment as a significant number of causes of pancytopenia are potentially curable. [ABSTRACT FROM AUTHOR]

Introduction: The male genital system consists of the prostate, seminal vesicle, testes, epididymis, vas deferens, bulbourethral gland, ejaculatory duct, penis and scrotum. Male genital cancers are histologically diverse. They are difficult to detect and treat because of their anatomic locations, biological characters and complications. Aim: To study the histopathological spectrum of tumours of the male genital system according to World Health Organization (WHO) classification. Materials and Methods: The present study is a hospital based descriptive study conducted in the Department of Pathology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India, during February 2019 to August 2020 which included 128 cases. All biopsies, specimens and review blocks and slides of male genital tract tumours were processed and slides were stained with Haematoxylin and Eosin (H & E) stain. Serum tumour markers and immunohistochemical stains were used. The clinical information including symptoms related to the male genital system, histopathological findings and diagnosis were recorded on the pre-designed proforma. Other necessary information was collected from the requisition form received along with the biopsy material. The association between categorical variables was explored using Pearson's Chi-square test. A p-value <0.05 was considered statistically significant for this study. Results: The present study included 128 cases, of which the majority of the cases 82 cases (64%) were that of prostate, 28 cases (21.9%) of the penis, 15 cases (11.7%) of testes, two cases (1.6%) were that of the scrotum and one case (0.8%) was of the epididymis. The histopathological spectrum showed Adenocarcinoma was present in 80 (62.5%), leiomyosarcoma in 01 (0.8%), lymphoma in 01 (0.8%), mixed germ cell tumour in 9 (7.0%), seminoma in 5 (3.9%), postpubertal teratoma in 1 (0.8%), basaloid in 1 (0.8%), papillary-basaloid in 2 (1.6%). Conclusion: Prostate tumours outnumbered all other tumours of the male genital tract with adenocarcinoma of prostate followed by squamous cell carcinoma of the penis and mixed Germ Cell Tumour (GCT) of testes. The present study provides updated information regarding the histopathological spectrum of male genital system tumours. [ABSTRACT FROM AUTHOR]

Introduction: The ovaries are the primary female reproductive organs and endocrine glands. Ovarian carcinoma has often been called as the silent killer because the symptoms may develop so late that the chances of cure are very poor. According to World Health Organisation (WHO) ovarian tumours are classified based upon their most probable tissue of origin: surface epithelial (65%), germ cell (15%), sex cord-stromal (10%), metastases (5%) and miscellaneous. The malignant surface epithelial tumours are further classified by cell type into serous, mucinous, endometrioid, clear cell, brenner, seromucinous and undifferentiated carcinoma. The most widely used tumour marker in ovarian carcinoma is CA- 125 which is considered as gold standard. Aim : To find the utility of serum CA-125 levels in histopathological variants of malignant surface epithelial tumours, degree of differentiation and their distribution according to clinical data pertaining to age, parity, history of use of oral contraceptive pills/ovulation inducing drugs and family history of carcinoma ovary/breast or colon. Materials and Methods: A prospective study (cohort study) was done at Guru Gobind Singh Medical College and Hospital, Faridkot over a period of 1.5 year (April 2017-oct 2018) on 50 ovarian masses which were diagnosed as ovarian carcinoma. Data was represented as frequencies and percentages for categorical variables and as means and standard deviations for continuous variables. Analysis was done using Statistical Package for Social Sciences (SPSS) v 20.0.0. results: Serous carcinoma (80%) topped among all the histological variants. Serous high grade carcinoma was more common than serous low grade carcinoma. Maximum rise of serum CA-125 levels were seen in serous carcinoma. Among serous carcinomas, mean serum CA-125 levels were more in high grade serous carcinoma than low grade serous carcinoma and the results were statistically significant. conclusion: Serum CA-125 level is a great tool for diagnosis, follow-up and prognosis of ovarian carcinomas. [ABSTRACT FROM AUTHOR]

Background: Liver is the site of many diseases, many become symptomatic while few are diagnosed only on autopsy. The cause of chronic liver disease varies in different geographic areas and influenced by socioeconomic status, diet, life style and regional diseases. Method: This retrospective study was carried out in a tertiary care hospital in the department of pathology over a period of one year. A total of 40 cases of liver specimens, received as part of liver, constituted the material for the study. All were autopsy cases and the organs were received in 10% formalin. Routine grossing and staining with H&E stain were performed. Slides were analysed and the findings were noted in percentages. Results: A total of 40 specimens were studied. Age ranges from new born to 70 years, with 92.5 % male cases. 32.5% of cases were autolysed. 25% were showing chronic venous congestion followed by fatty change (22.5%), hepatitis (12.5%). 2.5% each of cirrhosis, steatohepatitis and normal liver. Conclusion: 1. Autopsy has an important role in identifying the cause of death. 2. To overcome the autolysis of the specimen, the medical practitioner performing the autopsies should be trained about how to carry post mortem and to preserve the viscera for histopathological examination so that cause of death could be noted. [ABSTRACT FROM AUTHOR]

Histopathological examination of heart autopsies is routinely done in medico-legal cases to ascertain the cause of death. Cardiovascular disease is the leading cause of deaths worldwide. Myocarditis is clinically and pathologically defined as inflammation of the myocardium. Autopsy studies have reported an incidence of 3.5% to as high as 10%. In the present study comprising of 235 heart autopsies, the diagnosis of myocarditis is made in only two cases which constituted 0.8% of the total heart autopsies. This rate of myocarditis in our autopsy study is far lower than the published studies. The aim of our study is to assess the frequency of fatal course myocarditis in a consecutive series of autopsies and to describe the histologic features of the disease. [ABSTRACT FROM AUTHOR]

Plexiform Fibrohistiocytic Tumour (PFHT) is an intermediate malignant tumour of soft tissue. It is a rarely metastasising dermal subcutaneous neoplasm. It affects children and young adults. The age range of presentation is from birth to age 77 years. The tumour is most commonly located on the upper extremities, whereas the involvement of the frontal region is rare. The differential diagnosis includes benign fibrous histiocytoma, fibromatosis, giant cell tumour and neurofibroma. Plexiform fibrohistiocytic tumour is a slow-growing mass and which is considered a low grade malignant tumour. Treatment is simple excision. It can exhibit aggressive behaviour and rate of local recurrence is 12-38%. A 45-year-old female was presented with a solid mass on the frontal region of the head which was diagnosed as a plexiform fibrohistiocytic tumour with underlying frontal bone invasion on histopathological examination of an excised mass in the Pathology Department. Plexiform Fibrohistiocytic Tumour (PFHT) is a mesenchymal neoplasm that shows a multinodular growth pattern and which is composed of fibroblasts, histiocyte-like cells and multinucleated osteoclast like giant cells. Clinically, it is usually a slow-growing mass with frequent local recurrence and rare regional lymphatic and systemic metastasis. [ABSTRACT FROM AUTHOR]

There is an upward trend in the incidence of various mycotic infections. Deaths from HIV-associated opportunistic mycoses and other immuno-compromised patients (malignancies like leukemia, solid cancers, organ transplants, bone marrow transplant associated nosocomial infections) are becoming one of the major cause of mortality. However, the definitive diagnosis of invasive mycotic diseases is can be made on routine histopathology biopsy of the lung and post-mortem histopathological examination of the viscera for the cause of death. We conducted the present study on 271 medicolegal cases in which viscera was received in the department of Pathology at GGS medical college, Faridkot in last 5 years (2010-2016). Of the total, 143 cases having both the lungs as the part of viscera we encountered only two cases (1.3%) of pulmonary candidiasis. This study highlights the utility and indispensability of histopathological autopsies for complete and accurate diagnosis at demonstration of rare diagnosis. [ABSTRACT FROM AUTHOR]

Mature cystic teratoma is the most common type of ovarian germ cell tumor. The presentation ranges from its asymptomatic nature to various complications such as torsion, rupture, and malignant change. The present case summarizes the rarest complication in the form of superinfection in a young girl without preexisting risk factors. [ABSTRACT FROM AUTHOR]

Ovarian carcinomas are conventionally treated with primary debulking surgery followed by chemotherapy. Nowadays neoadjuvant chemotherapy followed by surgery is an upcoming treatment modality for ovarian carcinoma. This study highlights the histopathological changes observed after neoadjuvant chemotherapy. Present study is a 40-case study stressing five histological parameters: residual tumour, fibrosis, necrosis, inflammation, and psammoma bodies. All these parameters carry prognostic significance and they are easily reproducible. Fleiss kappa statistics were used to measure intraobserver agreement between pathologists which was found to be substantial to almost perfect with κ ranging between 0.621 and 1.00. This study highlights easily reproducible parameters and their incorporation in histopathology report, thus helping in patient management. [ABSTRACT FROM AUTHOR]

The lungs are one of the most vital organs of the body. They are affected by primary diseases ranging from inflammatory to neoplastic as well as are secondarily involved in almost all terminal diseases. Histopathological examination of lungs is vital in diagnostic work up of all lung diseases. The present study was conducted in year 2012-2013 in which 50 cases were analyzed. Pulmonary congestion and edema was found as the most common diagnosis followed by pneumonia and tuberculosis. [ABSTRACT FROM AUTHOR]

Hysterectomy, the most common gynecological surgery, provides a definitive cure to various diseases like DUB (dysfunctional uterine bleeding), leiomyoma, adenomyosis, chronic pelvic pain, prolapse, and malignancy. However, with advent of effective medical and conservative treatment modalities for nononcological causes it is now posing question mark on justification of hysterectomy. Therefore, an audit is required to assess the correlation between preoperative diagnosis and histopathological examination of specimen for justification of the procedure. In this study over period of one year (April 2013 to March 2014) 373 hysterectomies specimens were received in the department of pathology for nononcological causes. The age of patients ranged from 22 to 85 years with mean 45 ± 9.2 years. All cases were divided into five categories on the basis of age and audit was done. In this study the most common finding was leiomyoma (43.7%) followed by adenomyosis (19.3%). Almost 50% of hysterectomies causes were justified as preoperative diagnosis matched with histopathology. Cohen kappa statistics were used to measure agreement between preoperative and postoperative histopathological diagnosis which was found to be fair with κ value being 0.36. This study highlights that regular audit of surgeries can help improve quality of health care services and provide safe conservative option to patients. [ABSTRACT FROM AUTHOR]

Hysterectomy, the most common gynecological surgery, provides a definitive cure to various diseases like DUB (dysfunctional uterine bleeding), leiomyoma, adenomyosis, chronic pelvic pain, prolapse, and malignancy. However, with advent of effective medical and conservative treatment modalities for nononcological causes it is now posing question mark on justification of hysterectomy. Therefore, an audit is required to assess the correlation between preoperative diagnosis and histopathological examination of specimen for justification of the procedure. In this study over period of one year (April 2013 to March 2014) 373 hysterectomies specimens were received in the department of pathology for nononcological causes. The age of patients ranged from 22 to 85 years with mean 45 ± 9.2 years. All cases were divided into five categories on the basis of age and audit was done. In this study the most common finding was leiomyoma (43.7%) followed by adenomyosis (19.3%). Almost 50% of hysterectomies causes were justified as preoperative diagnosis matched with histopathology. Cohen kappa statistics were used to measure agreement between preoperative and postoperative histopathological diagnosis which was found to be fair with κ value being 0.36. This study highlights that regular audit of surgeries can help improve quality of health care services and provide safe conservative option to patients. [ABSTRACT FROM AUTHOR]

Cutaneous metastases from internal malignancies are uncommon and occur in 0.6%-10.4% of all patients with cancer. In most cases, cutaneous metastases develop after the initial diagnosis of the primary internal malignancy and late in the course of the disease. Skin tumors are infrequent in Asian population and cutaneous metastases are quite rare. Cutaneous metastases carry a poor prognosis with average survival of few months. In the present five-year study 1924 malignant tumors were screened which included only nine cases of cutaneous metastatic deposits. A wide range of site and clinical presentations including nodules, plaques, and ulcers was noted. Histopathological findings were significant and corresponded with the primary internal malignancy. Cutaneous metastases from breast carcinoma (44.4%) were the most common finding followed by non-Hodgkin lymphoma and renal cell carcinoma (22.2% each) and carcinoma cervix (11.1%). The aim of our study is to classify the cutaneous metastases and to evaluate their clinicopathologic and immunohistochemical correlation with the primary tumor. [ABSTRACT FROM AUTHOR]

A wide spectrum of Primary as well as secondary diseases can affect liver. With the rare exception of fulminant hepatic failure, liver disease is an insidious process in which clinical detection and symptoms of hepatic decompensation may occur weeks, months or many years after the onset of injury .Liver injury and healing may also occur without even clinical detection. Liver histopathology remains a mainstay in the diagnostic workup of most liver diseases. Liver autopsies are a wonderful learning tool for clinicians as well as pathologists. They help in formulating exact liver disease burden in the population .Present study was conducted between the period of 2008 - 2012 consisting of 154 cases. Fatty change liver (Steatosis) was found to be the most common disease entity followed by hepatitis. [ABSTRACT FROM AUTHOR]

Histopathological examination of medicolegal autopsies is done to establish the cause of death when autopsy surgeon recognizes any morbid anatomical changes in tissue and suspects that it may be reason of death. But many incidental findings have been highlighted on histopathological examinations which have proven to be great learning tools for the pathologists as well as the forensic expert. Present study was done between the period of 2008-2011 consisting of 100 cases expressing the importance of histopathological examination of viscera not only to ascertain the cause of death but also a great learning tools and highlighting various rare diagnosis which can be made only on histopathology. Histopathological examination is important for accumulation of mortality statistics which are essential for public health and health service planning. [ABSTRACT FROM AUTHOR]

Histopathological examination of heart autopsies is routinely done in medicolegal cases to ascertain the cause of death. Cardiovascular disease is a class of diseases that involves the heart or blood vessels (arteries and veins). They remain the leading cause of deaths worldwide. It is also a major cause of disability. Heart autopsies are a great learning tool for clinicians, pathologists as well as forensic experts. The cardiac autopsies may have changed very little during the last 50 years, the pathologists role on cardiac team has changed dramatically . Present study was done between the period of 2009 - 2011 consisting of 50 cases highlighting the importance of heart autopsies to establish the cause and mode of death as well as a magnificent learning tool. Cardiomegaly was found to be the most common disease entity followed by myocardial infarction in the present study. [ABSTRACT FROM AUTHOR]

Neurofibromas commonly involve peripheral nervous system. Isolated neurofibroma of vagina is very rare tumor and usually associated with Von Recklinghausen's disease. Vulva is the most frequent location of neurofibroma of genital tract followed by clitoris and labia. We present a rare case of neurofibroma of vaginal wall presented as vaginal cyst in a 52 year old female with no history of any other symptoms related to Recklinghausen's disease. Excision biopsy was done and on the histopathological examination non-encapsulated, well circumscribed mass composed of spindle shaped cells with wavy nuclei and bland nuclear chromatin was noted. Immunohistochemistry revealed strong positivity with S-100. [ABSTRACT FROM AUTHOR]

Despite of the fact that the vulva contains a high density of apocrine and anogenital mammary glands in addition to eccrine glands and folliculosebaceous units, the benign vulvar adnexal tumours are rare. Though the varied clinical presentation and diverse histopathological spectrum of vulvar neoplasms has amazed the pathologists, only few studies have been reported in literature. The present five year study consists of only five cases of benign vulvar neoplasms depicting their rarity. Hidradenoma papilliferum and syringoma were the most common entities followed by Chondroid syringoma. The aim of our study is to explore and highlight the histopathological diversity of benign vulvar adnexal tumours reflecting the relative frequency of these structures. [ABSTRACT FROM AUTHOR]

An autopsy case report of 30 year old female patient having widespread bed sores, dyspnea and high grade fever who died within an hour of admission to the hospital. An autopsy was conducted and viscera consisting of parts of lungs, kidneys, liver, spleen and heart were sent for histopathological examination. Histopathological examination of lungs revealed presence of chronic inflammatory infiltrate along with numerous colonies of round to ovoid fungal spores. Differential diagnosis of Candida and Cryptococcus was kept and using PAS and mucicarmine stains pulmonary candidiasis was confirmed. The present case highlights pulmonary candidiasis comes under category of severe mycoses and is an incidental diagnosis made on autopsy. [ABSTRACT FROM AUTHOR]

The occurrence of dual malignancies is not rare but concurrent occurrence of two malignancies with different histogenesis and different anatomical sites is not known. In the studies which have been conducted so far, none of them has shown the simultaneous occurrence of metastatic malignant melanoma and primary endometrial carcinoma. We report herein a case of a 42-year-old female diagnosed with metastatic malignant melanoma in cervical lymph node with unknown developing primary endometrial carcinoma within two months. No foci of primary malignant melanoma were found in uterus. Dual primary malignancy is being suggested by the presence of two malignancies in a patient with different morphological picture on histopathological examination, at anatomically distinct sites. Malignant melanoma and endometrial carcinoma, being a rare combination, prompted us to report the case. [ABSTRACT FROM AUTHOR]

An autopsy case report of 70 year old male who died suddenly and post mortem examination was conducted to rule out the cause of death. Viscera consisting of parts of liver, lungs, kidney, spleen and heart were sent to Department of Pathology for histopathological examination. Gross examination of liver revealed a cyst which on microscopy was diagnosed as simple non parasitic cyst measuring 4 cms in size. This case report highlights non parasitic liver cyst an incidental rare diagnosis made on autopsy. [ABSTRACT FROM AUTHOR]

Syringoma is a benign eccrine sweat gland tumour affecting mostly females at puberty as multiple soft papules usually 1-2 mm in diameter. The sites of predilection are lower eyelids, cheeks. Syringoma of the vulva is a rare disorder. Only few cases have been reported in the literature. We report here a case of 46-year-old female who presented to gynecology department with vulvar papules associated with vulvar itching and burning since two years. Microscopic examination of the punch biopsy revealed numerous small ducts lined by two layers of epithelial cells embedded in a fibrous stroma. Some of the ducts showed small comma like tails of epithelial cells imparting them a tadpole shape. Despite being a rare diagnosis, vulvar syringoma should be kept in differential diagnosis with vulvar pruritus [ABSTRACT FROM AUTHOR]