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Introduction and Importance: Meckel's diverticulum is a congenital anomaly affecting about 2 % of the population due to incomplete omphalomesenteric duct closure during fetal development. While often asymptomatic, it can cause complications like obstruction and bleeding. Ectopic tissue within the diverticulum, such as gastric and pancreatic tissue, is reported. This report presents a unique case of ectopic pancreatic and epididymal tissue in a newborn's Meckel's diverticulum, emphasizing the significance of histopathological examination., Case Presentation: A term male newborn presented with abdominal distension and bilious vomiting shortly after birth. Physical examination revealed a palpable abdominal mass. Ultrasound showed a dilated bowel loop with a blind-ending tubular structure suggestive of Meckel's diverticulum. Surgical resection identified a diverticulum 30 cm from the ileocecal valve. Histological examination confirmed ectopic pancreatic and epididymal tissue within the diverticulum., Clinical Discussion: The coexistence of ectopic pancreatic and epididymal tissue in Meckel's diverticulum is extremely rare. The embryological mechanism remains unclear, likely involving aberrant cell differentiation. Differential diagnosis in neonates with similar symptoms includes volvulus and Hirschsprung's disease. Imaging and histopathology are crucial for diagnosis. This case underscores the diverse ectopic tissue potential in Meckel's diverticulum and the importance of thorough evaluation., Conclusion: Ectopic tissue in Meckel's diverticulum should be considered in differential diagnoses of neonatal abdominal obstruction. Awareness and timely surgical intervention are vital for management., Competing Interests: Conflict of interest statement All authors declare that there is no conflict of interest regarding the publication of this report., (Copyright © 2025. Published by Elsevier Ltd.)

Introduction and Importance: Adenosquamous carcinoma (ASC) of the colon is a rare malignancy, representing approximately 0.06 % of colorectal cancers (CRC). It is characterized by the coexistence of adenocarcinoma and squamous cell carcinoma components., Case Presentation: Here, we present a unique case of a 47-year-old male diagnosed with collision-type ASC, featuring both signet-ring adenocarcinoma and squamous cell carcinoma. The patient presented with abdominal pain and distension, and imaging revealed multiple colonic strictures and lymphadenopathy. Surgical intervention included an extended left hemicolectomy. Histopathology confirmed the presence of two distinct tumor components, with no evidence of lymph node metastasis. Immunohistochemistry was positive for p63 in the squamous cell component, while HPV DNA testing was negative., Clinical Discussion: ASC is known for its aggressive clinical course and poor prognosis compared to adenocarcinoma. Although rare, its clinical and histopathological features are important for guiding management., Conclusion: This case represents the first reported instance of a collision-type colon ASC with a signet-ring adenocarcinoma component. The patient is currently undergoing neoadjuvant chemotherapy with the modified FOLFOX6 regimen and responding well. Further research is required to elucidate the molecular mechanisms underlying ASC and improve therapeutic outcomes., Competing Interests: Declaration of competing interest All authors declare that there is no conflict of interest regarding the publication of this report., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Intranodal palisaded myofibroblastoma (IPM) arising in the axilla is an extremely rare, benign mesenchymal tumour. It is believed to originate from myofibroblast or smooth muscle cells and exhibits specific histopathological features. While there have been occasional cases of recurrence, no malignant transformation has been observed. We describe the case of a 35-year-old male presenting with an axillary mass. Histopathology revealed a tumour with a pseudo-capsule that contains compressed lymphoid tissue with spindle cells arranged in a palisade-like pattern and extravasation of red blood cells within the spindle cells. Additionally, amianthoid fibres and fuchsinophilic bodies are present. Immunohistochemical analysis typically was positive for SMA and cyclin D1, with a low proliferative index (Ki67 of <1%). The diagnosis was intranodal palisading myofibroblastoma. Only two cases of IPM in the axilla have been previously reported. Pathologists should keep this rare entity with characteristic histopathological findings in mind when reporting such tumours at an unusual site., (Copyright © 2025 Sociedad Española de Anatomía Patológica. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: The diagnosis of breast cancer necessitates a multifaceted approach integrating cytopathological and radiological assessments. The International Academy of Cytology (IAC) Yokohama system and Breast Imaging Reporting and Data System (BI-RADS) are fundamental frameworks in this context. This study aims to evaluate the diagnostic potential of a combined Yokohama-BI-RADS scoring system for breast lesions., Materials and Methods: A retrospective analysis was conducted on fine needle aspirates from January to June 2023. The cases were classified using the IAC Yokohama system and sono-mammography BI-RADS score. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated using histopathological diagnoses as the reference standard. Optimal cut-off scores for the combined scoring system were determined., Results: Among 52 patients, cytological diagnoses encompassed non-diagnostic, benign, atypical, suspicious of malignancy, and malignant categories. BI-RADS scores ranged from 1 to 5. The combined Yokohama-BI-RADS score exhibited superior diagnostic accuracy (AUC: 0.986) compared to individual systems., Conclusion: The combined Yokohama-BI-RADS scoring system represents a promising advancement in breast lesion evaluation, providing enhanced diagnostic precision by integrating cytopathological and radiological data. This approach has the potential to optimize clinical decision-making and contribute to improved patient outcomes in breast cancer management., (Copyright © 2024 Sociedad Española de Anatomía Patológica. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction and Importance: Solitary extramedullary plasmacytoma (SEP) is a rare plasma cell neoplasm, constituting around 3 % of plasma cell malignancies. SEP typically presents as a single tumor, either in bone or soft tissue, without systemic disease, and is often misdiagnosed due to its nonspecific symptoms. Diagnosis requires biopsy and extensive imaging studies to exclude multiple myeloma and other malignancies. Here, we present a case of SEP located in the hilar region, initially suspected to be a lung malignancy., Case Presentation: A 70-year-old male with a history of hepatitis C presented with hemoptysis and shortness of breath. PET-CT revealed a metabolically active mass in the left hilar region, encasing major vascular structures and obstructing the left upper lobe bronchus, suggesting a neoplastic process. Transbronchial biopsy showed lymphoproliferative disease, and immunohistochemistry revealed monoclonal plasma cells, confirming SEP. Laboratory tests indicated mild monoclonal gammopathy, and bone marrow aspirate showed minimal involvement with plasma cells. A diagnosis of SEP with minimal marrow involvement was made., Clinical Discussion: Extramedullary plasmacytomas are typically found in the head and neck, but rarer cases, like this one in the hilar region, may mimic lung cancer. A comprehensive diagnostic approach, including imaging, biopsy, and bone marrow analysis, is essential for accurate diagnosis and management., Conclusion: This case underscores the importance of a multidisciplinary approach in diagnosing SEP, which can be easily confused with lung malignancy. Early detection and treatment, including surgery and radiotherapy, lead to favorable outcomes and reduced recurrence rates., Competing Interests: Declaration of competing interest All authors declare that there is no conflict of interest regarding the publication of this report., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction and Importance: Hemangiomas are benign vascular neoplasms primarily affecting the skin and soft tissues but can also occur in visceral organs, with the liver being the most common site. Renal hemangiomas are exceedingly rare, with fewer than 300 cases reported. Various subtypes, including cavernous, capillary, and anastomosing hemangiomas, have been identified. Anastomosing hemangioma (AH), a histological subtype of capillary hemangioma, was first described in 2009. AH has a distinctive histological architecture of anastomosing sinusoidal-like vascular spaces and often mimics angiosarcoma., Case Presentation: A 28-year-old male presented with an incidentally detected left renal mass found during an evaluation for abdominal pain and dyspepsia. The patient was asymptomatic with no history of hematuria or dysuria. Physical examination was unremarkable. Contrast computed tomography revealed a heterogeneously enhancing solid mass in the left kidney, suggesting a neoplastic etiology. Laparoscopic enucleation of the tumor was performed, and histopathological examination revealed a well-circumscribed tumor composed of irregular capillary-sized vascular spaces lined by plump endothelial cells with mild atypia. Immunohistochemical analysis showed positivity for CD34, CD31, and Factor VIII, confirming the diagnosis of anastomosing hemangioma. The patient has been under follow-up with no evidence of recurrence., Clinical Discussion: Anastomosing hemangioma of the kidney, although rare, is an important benign entity that can mimic malignant vascular tumors like angiosarcoma. Accurate diagnosis relies on histopathological examination and immunohistochemistry., Conclusion: Despite its benign nature, AH often leads to overtreatment due to its diagnostic challenges. Increased awareness and reporting of AH cases are essential to improve diagnostic accuracy and management strategies., Competing Interests: Conflict of interest statement All authors declare that there is no conflict of interest regarding the publication of this report., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Cancer is a complex and heterogeneous disease characterised by uncontrolled cell growth and proliferation. One hallmark of cancer cells is their ability to undergo metabolic reprogramming, which allows them to sustain their rapid growth and survival. This metabolic reprogramming creates an immunosuppressive microenvironment that facilitates tumour progression and evasion of the immune system. In this article, we review the mechanisms underlying metabolic reprogramming in cancer cells and discuss how these metabolic alterations contribute to the establishment of an immunosuppressive microenvironment. We also explore potential therapeutic strategies targeting metabolic vulnerabilities in cancer cells to enhance immune-mediated anti-tumour responses. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02044861, NCT03163667, NCT04265534, NCT02071927, NCT02903914, NCT03314935, NCT03361228, NCT03048500, NCT03311308, NCT03800602, NCT04414540, NCT02771626, NCT03994744, NCT03229278, NCT04899921., (© 2024 John Wiley & Sons Ltd.)

This report details a rare case of a 30-year-old female presenting with neurological symptoms, including headaches, seizures, and left-sided weakness. Imaging revealed a mass in the right parafalcine region of her brain. Surgical resection identified a tumor with two distinct components. The first component exhibited characteristics of a classic solitary fibrous tumor (SFT) with typical fibroblastic cells and branching blood vessels. The second component showed high-grade sarcoma with chondrosarcomatous differentiation, a rare feature in SFT. Immunohistochemistry confirmed dedifferentiation with decreased STAT6 expression in the sarcomatous areas compared to the conventional SFT. This case highlights the challenges of managing dedifferentiated SFTs, especially in the brain, where surgical limitations increase risks. Despite the rarity of this presentation, it emphasizes the importance of recognizing this variant for appropriate diagnosis and management., (© 2024 Japanese Society of Neuropathology.)

Breast cancer remains a significant cause of mortality globally, necessitating effective treatment strategies. Neoadjuvant chemotherapy (NAC) is widely employed to minimize tumor burden and prevent local spread, with treatment efficacy varying based on molecular subtypes. Despite advancements, resistance to conventional therapies persists, prompting the exploration of alternative approaches, including immune cell therapy. Tumor-infiltrating lymphocytes (TILs) have emerged as immunological biomarkers in breast cancer, exhibiting associations with molecular subtypes and treatment response. This retrospective study assessed the clinico-pathological relationship between stromal TILs and AR expression across molecular subtypes of invasive breast carcinoma in an Indian cohort. Thirty-seven patients receiving NAC followed by modified radical mastectomy were analyzed for TILs and molecular subtyping. Immunohistochemistry was used to determine hormone receptor status and AR expression. A higher AR positivity was observed in hormone receptor-positive/Her2neu-negative and hormone receptor-positive/Her2neu-positive tumors compared to triple-negative breast cancers (TNBCs). Significant associations were observed between AR expression and tumor grade, but not with age or Her2neu status. Although no significant correlation was found between AR and complete response to NAC, a weak negative correlation between AR and TILs was noted. Notably, TNBCs with negative AR and Ki67 index exhibited poorer responses to NAC, emphasizing the need for adjuvant therapy. These findings underscore the complex interplay between AR, TILs, and treatment response in breast cancer, highlighting the potential of personalized therapeutic approaches. Further research is warranted to elucidate the prognostic significance of AR and its implications for tailored treatment strategies in breast cancer management., Competing Interests: Competing InterestsThe authors declare no competing interests., (© The Author(s), under exclusive licence to Indian Association of Surgical Oncology 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Purpose: Endometrial cancer (EC) ranks as one of the most prevalent gynecological malignancies globally. The presence and role of stromal tumor-infiltrating lymphocytes (TILs) in the tumor microenvironment have garnered interest due to their prognostic and therapeutic potential. This study aimed to evaluate the association between stromal TILs and various clinicopathological parameters in EC., Methods: A prospective study was conducted which included 30 histologically confirmed cases of endometrial carcinoma. Specimens collected from January 2023 to June 2024 were processed for routine histopathological examination and immunohistochemistry for CD3 and CD20 markers. TILs were quantified as per the International Immuno-Oncology Biomarker Working Group guidelines and categorized into low (<20%) and high (≥20%) TILs., Results: The study comprised 30 female patients, predominantly aged 51 to 60 years. Most tumors were of the endometrioid subtype (93.3%). High TILs were significantly associated with early tumor stage, lower grade, lesser myometrial invasion, and absence of nodal involvement on univariate analysis and with lower tumor stage and grade on multivariate analysis. No significant association was found between TILs and age, lymphovascular, or perineural invasion., Conclusion: The findings suggest that high TIL infiltration correlates with favorable tumor characteristics, potentially serving as a prognostic marker for early and less aggressive EC. High TILs were associated with better tumor stage, grade, and reduced nodal involvement, indicating their protective role in tumor progression. However, the lack of association with certain parameters calls for further investigation into the functional state of TILs and their interactions within the tumor microenvironment.

Purpose: Breast cancer subtypes are delineated by human epidermal growth factor receptor 2 (HER2) expression, pivotal in treatment selection. HER2-positive tumors typically respond to targeted therapies, whereas HER2-negative tumors lack HER2 overexpression. However, a subset exhibits low HER2 expression without amplification, termed HER2 low breast cancer. Despite being distinct, its clinicopathological characteristics and therapeutic implications remain less understood., Methods: A retrospective cohort study was conducted on histologically confirmed breast cancer cases from January 2022 to December 2023. Clinicopathological data including age, tumor size, nodal involvement, and hormone receptor status were collected. Immunohistochemistry categorized tumors into luminal, triple-negative, and HER2-enriched subtypes. HER2 expression was re-evaluated, classifying tumors into HER2 low and HER2-negative based on staining intensity and amplification status. Statistical analysis was performed using SPSS software., Results: Seventy female patients with breast cancer were included, exhibiting diverse clinicopathological features. HER2 low tumors (40%) were significantly associated with higher tumor stage (P=0.03), nodal involvement (P=0.01), and positive androgen receptor expression (P=0.01). Subgroup analysis revealed HER2 low hormone receptor-positive cases (78.6%) were associated with higher tumor stage (P=0.01) and nodal involvement (P=0.01), while HER2 low triple-negative cases (21.4%) demonstrated distinct characteristics such as higher histological grade (P=0.02)., Conclusion: This study underscores the complexity of HER2 low breast cancer and its implications for clinical management, emphasizing the need for personalized treatment strategies. It provides insights into the clinicopathological parameters of HER2 low breast cancers, highlighting their diverse characteristics and clinical implications.

Cancer immunotherapy uses the body's immune system to combat cancer, marking a significant advancement in treatment. This review traces its evolution from the late 19th century to its current status. It began with William Coley's pioneering work using bacterial toxins to stimulate the immune system against cancer cells, establishing the foundational concept of immunotherapy. In the mid-20th century, cytokine therapies like interferons and interleukins emerged, demonstrating that altering the immune response could reduce tumors and highlighting the complex interplay between cancer and the immune system. The discovery of immune checkpoints, regulatory pathways that prevent autoimmunity but are exploited by cancer cells to evade detection, was a pivotal development. Another major breakthrough is CAR-T cell therapy, which involves modifying a patient's T cells to target cancer-specific antigens. This personalized treatment has shown remarkable success in certain blood cancers. Additionally, cancer vaccines aim to trigger immune responses against tumor-specific or associated antigens, and while challenging, ongoing research is improving their efficacy. The historical progression of cancer immunotherapy, from Coley's toxins to modern innovations like checkpoint inhibitors and CAR-T cell therapy, underscores its transformative impact on cancer treatment. As research delves deeper into the immune system's complexities, immunotherapy is poised to become even more crucial in oncology, offering renewed hope to patients globally.

Cancer-associated fibroblasts (CAFs) are crucial component of tumor microenvironment (TME) which undergo significant phenotypic changes and metabolic reprogramming, profoundly impacting tumor growth. This review delves into CAF plasticity, diverse origins, and the molecular mechanisms driving their continuous activation. Emphasis is placed on the intricate bidirectional crosstalk between CAFs and tumor cells, promoting cancer cell survival, proliferation, invasion, and immune evasion. Metabolic reprogramming, a cancer hallmark, extends beyond cancer cells to CAFs, contributing to the complex metabolic interplay within the TME. The 'reverse Warburg effect' in CAFs mirrors the Warburg effect, involving the export of high-energy substrates to fuel cancer cells, supporting their rapid proliferation. Molecular regulations by key players like p53, Myc, and K-RAS orchestrate this metabolic adaptation. Understanding the metabolic symbiosis between CAFs and tumor cells opens avenues for targeted therapeutic strategies to disrupt this dynamic crosstalk. Unraveling CAF-mediated metabolic reprogramming provides valuable insights for developing novel anticancer therapies. This comprehensive review consolidates current knowledge, shedding light on CAFs' multifaceted roles in the TME and offering potential targets for future therapies., (© 2024 Scandinavian Societies for Pathology, Medical Microbiology and Immunology.)

Introduction and Importance: Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms, initially described in the pleura but capable of arising in various anatomical locations, including the central nervous system. Dedifferentiation, characterized by the transformation of a low-grade tumor into a high-grade sarcoma, is an uncommon phenomenon in SFTs, especially in the intracranial region., Case Presentation: A 31-year-old male visited the neurology outpatient department with complaints of frequent headaches, seizures, speech difficulties, and weakness on the left side of his body. MRI was done which showed a relatively well defined T1 isointense and T2 hypointense extra-axial mass lesion in the right frontal lobe. Histopathological analysis confirmed the diagnosis of dedifferentiated SFT, marked by distinct fibroblastic differentiation and areas of high-grade sarcomatous transformation (rhabdomyosarcoma). Immunohistochemically, areas with fibroblastic differentiation showed strong and diffuse positivity for CD99, STAT6, vimentin and focal BCL-2 High-grade sarcomatous area was positive for vimentin, desmin and Myo-D1 and was negative for GFAP, EMA, PR, S-100, SMA and CD-34. It also showed focal positivity for STAT-6. The final diagnosis of intracranial solitary fibrous tumor with rhabdomyosarcomatous differentiation was made. At 2 months of follow-up, the patient is doing well., Clinical Discussion: Given the rarity of dedifferentiation in intracranial SFTs, there is limited consensus on optimal management strategies. En bloc resection remains the primary treatment approach, though the unpredictable behaviour of dedifferentiated SFTs complicates prognosis. This case underscores the importance of integrating clinical, radiological, and pathological findings for accurate diagnosis and discusses the need for further research into effective therapeutic options for dedifferentiated SFTs, particularly in challenging intracranial cases., Conclusion: This case report presents a unique instance of an intracranial dedifferentiated SFT with rhabdomyosarcomatous dedifferentiation, highlighting the significant diagnostic challenges posed by this rare entity., Competing Interests: Conflict of interest statement All authors declare that there is no conflict of interest regarding the publication of this report., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Tuberculosis (TB) remains a global health concern with diverse clinical manifestations. Parotid tuberculosis, although rare, presents diagnostic challenges due to its atypical presentation. Cytological examination is pivotal in diagnosing parotid lesions., Case Presentation: We present three cases of parotid tuberculosis diagnosed through cytology. A 31-year-old male presented with a painless left parotid swelling. FNAC revealed granulomatous inflammation with AFB positivity. The second case, a 14-year-old female had an enlarging mass in the left parotid. FNAC showed granulomas, confirmed by GeneXpert MTB/RIF assay. The third case, a 39-year-old female presented with a painless swelling in the left parotid. FNAC demonstrated granulomatous inflammation, confirmed by mycobacterial culture., Conclusion: Cytological examination plays a crucial role in diagnosing parotid tuberculosis. These cases underscore the importance of considering TB in parotid masses. Collaboration among clinicians, radiologists, and cytopathologists is essential for accurate diagnosis and prompt management. Further research is needed to optimize diagnostic algorithms for parotid tuberculosis., Competing Interests: We state that there is no competing interest among authors, and individually. All authors whose names appear on the submission.1.made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work;2.drafted the work or revised it critically for important intellectual content;3.approved the version to be published; and4.agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved., (© 2024 Published by Elsevier Ltd.)

Context: The Modified Masood Scoring Index (MMSI) categorizes breast fine needle aspirates into four categories non-proliferative breast diseases (PBD), PBD without atypia, PBD with atypia and carcinoma in situ/carcinoma. The International Academy of Cytology Yokohama System classifies the aspirates into five categories - inadequate, benign, atypical, suspicious, and malignant. Very few studies have been conducted so far to compare the diagnostic accuracy of this system., Aims: The objectives of the study were to classify breast fine needle aspirates according to the MMSI and IAC Yokohama and assess their risk of malignancy (ROM) and performance parameters., Materials and Methods: All breast FNAs received from June 2020 to May 2023 were classified according to the MMSI and IAC Yokohama. Using histopathological diagnosis as the gold standard, ROM and performance parameters were calculated., Results: Out of the 559 breast fine needle aspirates, the histopathological correlation was available for 337 cases. The ROM for non-PBD, PBD without atypia, PBD with atypia and carcinoma in situ/carcinoma categories were 0%, 1.2%, 9.1% and 93%, respectively. The ROM for each of the categories of Yokohama system was 16.6%, 1.1%, 4.3%, 86.2% and 97.6%, respectively. The values for the sensitivity, specificity, PPV, NPV and diagnostic accuracy were slightly higher for IAC Yokohama (97.3%, 97.2%, 94.7%, 98.6% and 97.2%, respectively) than the MMSI (96.4%, 96.2%, 93%, 98.1% and 96.3%, respectively). Furthermore, another shortfall of MMSI is the inability to compare the Inadequate category of the Yokohama system., Conclusion: Overall Yokohama system proved to be a better system for categorizing breast lesions on FNAB as the scoring system provides more objective categorization and minimizes false positive and false negative cases., (© 2024 John Wiley & Sons Ltd.)

Human Papillomavirus (HPV) is a widespread infection associated with various cancers, including cervical, oropharyngeal, anal, and genital cancers. This infection contributes to 5 % of global cancer cases annually, affecting approximately 625,600 women and 69,400 men. Cervical cancer remains the most prevalent HPV-linked cancer among females, with the highest incidence seen in low and middle-income countries (LMICs). While most HPV infections are transient, factors such as HPV variants, age, gender, and socioeconomic status influence transmission risks. HPV is categorized into high-risk (HR-HPV) and low-risk types, with strains like HPV 16 and 18 displaying distinct demographic patterns. The intricate pathogenesis of HPV involves genetic and epigenetic interactions, with HPV oncogenes (E6 and E7) and integration into host DNA playing a pivotal role in driving malignancies. Early diagnostics, utilizing HPV DNA testing with surrogate markers such as p16, and advanced molecular techniques like PCR, liquid biopsy, and NGS, significantly impact the management of HPV-induced cancers. Effectively managing HPV-related cancers demands a multidisciplinary approach, including immunotherapy, integrating current therapies, ongoing trials, and evolving treatments. Prevention via HPV vaccination and the inclusion of cervical cancer screening in national immunization programs by conventional Pap smear examination and HPV DNA testing remains fundamental.Despite the preventability of HPV-related cancers, uncertainties persist in testing, vaccination, and treatment. This review article covers epidemiology, pathogenesis, diagnostics, management, prevention strategies, challenges, and future directions. Addressing issues like vaccine hesitancy, healthcare disparities, and advancing therapies requires collaboration among researchers, healthcare providers, policymakers, and the public. Advancements in understanding the disease's molecular basis and clinical progression are crucial for early detection, proper management, and improved outcomes., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Durre aden reports administrative support was provided by HIMSR. Durre aden reports a relationship with HIMSR that includes: employment. Durre aden has patent na pending to not applicable. none, (Copyright © 2024 Elsevier GmbH. All rights reserved.)

Castleman disease, a rare lymphoproliferative disorder characterized by non-neoplastic lymph node enlargement, typically presents as nodal involvement, while extranodal manifestations are uncommon. We present a unique case of unicentric Castleman disease localized to the gluteal region in a 27-year-old female. Initially mistaken for a neurogenic or vascular tumour, fine needle aspiration cytology (FNAC) revealed a polymorphous population of lymphoid cells with numerous traversing capillaries suggestive of reactive hyperplasia, possibly Castleman disease, which was later confirmed by histopathology. This case highlights the diagnostic challenges posed by rare extranodal presentations of Castleman disease and underscores the importance of interdisciplinary collaboration in accurate diagnosis and management., (Copyright © 2024 Sociedad Española de Anatomía Patológica. Publicado por Elsevier España, S.L.U. All rights reserved.)

The ongoing COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to multiple waves of infections globally. As the virus continues to evolve, new variants have emerged, some with concerning changes in transmissibility and virulence. Among these variants, the "FLiRT Variants" have recently gained attention due to their potential to alter the dynamics of transmission and disease severity. According to the Infectious Disease Society of America, the nickname 'FLiRT' is based on the technical names for their mutations. The FLiRT variants, particularly KP.2, seem to exhibit heightened transmissibility in comparison to earlier Omicron sub-variants. Additionally, they demonstrate a capacity to evade immunity conferred by prior infection and vaccines, although the full extent of this evasion is still being investigated. In this article, we review the characteristics of the FLiRT variants, including their genetic mutations, epidemiological features, potential impact on public health measures, and implications for vaccine efficacy. We also discuss strategies for surveillance, prevention, and mitigation efforts to control the spread of this variant and mitigate its impact on global health., Competing Interests: Declaration of Competing Interest No conflict of interest declared, (Copyright © 2024 Elsevier GmbH. All rights reserved.)

Introduction and Importance: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin's lymphoma (NHL), known for its aggressive nature and tendency for extranodal extension. Extranodal involvement occurs in up to 40 % of cases, with primary lymphoma in soft tissue, particularly skeletal muscle, being exceedingly rare. This report presents a rare case of primary extranodal DLBCL in the calf muscle., Case Presentation: A 35-year-old man presented with an ulceroproliferative growth in left calf muscle, initially diagnosed as squamous cell carcinoma (SCC). Imaging studies, including CECT and MRI, were inconclusive, prompting a histological examination. Biopsy revealed large malignant cells with high mitotic activity, positive for LCA, CD20, BCL-2, MUM1, and CD10, confirming a diagnosis of primary extranodal DLBCL. The patient underwent resection followed by six cycles of chemotherapy (R-CHOP) and field radiation therapy. A follow-up PET showed significant improvement, with no evidence of disease recurrence., Clinical Discussion: DLBCL often presents with rapidly growing tumors in lymph nodes or extranodal sites. Primary skeletal muscle lymphoma, particularly of the DLBCL subtype, is extremely rare, constituting about 0.5 % of extranodal lymphomas. Diagnosis typically involves imaging and biopsy, with immunohistochemistry (IHC) being crucial for accurate classification and treatment planning., Conclusion: DLBCL, while common among NHLs, rarely presents as primary extranodal lymphoma in skeletal muscle. The presented case underscores the importance of considering DLBCL in differential diagnoses for atypical soft tissue masses and the effectiveness of R-CHOP chemotherapy in managing this rare presentation. Prompt and appropriate treatment, such as R-CHOP chemotherapy, is essential for favorable outcomes., Competing Interests: Declaration of competing interest All authors declare that there is no conflict of interest regarding the publication of this report., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This study conducts the first meta-analysis to assess the aggregated risk of malignancy associated with each category of the International System for Reporting Serous Fluid Cytopathology (ISRSFC) for reporting serous effusion cytology, while also evaluating diagnostic accuracy. PubMed/MEDLINE and Embase were systematically searched using the keywords "(pleural, peritoneal, and pericardial effusions) AND (serous effusion cytology) OR (International System for Reporting Serous Fluid Cytopathology)". Articles underwent risk of bias assessment using the QUADAS-2 tool. After excluding inadequate samples, a meta-analysis determined sensitivity and specificity for different cutoff points, including "atypical considered positive," "suspicious of malignancy considered positive," and "malignant considered positive." Summary receiver operating characteristic curves assessed diagnostic accuracy, and the diagnostic odds ratio was pooled. Sixteen retrospective cross-sectional studies, totaling 19,128 cases, were included. Sensitivity and specificity for the "atypical and higher risk categories" considered positive were 77% (95% confidence interval [CI], 68%-84%) and 95% (95% CI, 93%-97%) respectively. For the "suspicious for malignancy and higher risk categories" considered positive, sensitivity and specificity were 57% (95% CI, 49%-65%) and 100% (95% CI, 99%-100%) respectively. Sensitivity and specificity for the "malignant" category considered positive for malignancy were 70% (95% CI, 60%-77%) and 99% (95% CI, 98%-99%), respectively. The pooled area under the curve ranged from 85% to 89.5% for each cutoff. This meta-analysis underscores the ISRSFC's accuracy in reporting serous fluid cytology. It emphasizes the diagnostic importance of the "suspicious" and "malignant" categories in identifying malignancy, and the role of the "benign" category in ruling out malignancy., (© 2024 American Cancer Society.)

HER2 (human epidermal growth factor receptor 2) status in breast cancer spans a spectrum from HER2-positive to ultra-low HER2, each category influencing prognosis and treatment decisions differently. Approximately 20 % of breast cancers overexpress HER2, correlating with aggressive disease and poorer outcomes without targeted therapy. HER2 status is determined through immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), guiding therapeutic strategies. HER2-positive breast cancer exhibits HER2 protein overexpression or gene amplification, benefiting from HER2-targeted therapies like trastuzumab and pertuzumab. In contrast, HER2-negative breast cancer lacks HER2 overexpression and amplification, treated based on hormone receptor status. HER2-low breast cancer represents a newly recognized category with low HER2 expression, potentially benefiting from evolving therapies. Ultra-low HER2 cancers, characterized by minimal expression without gene amplification, challenge conventional classifications and treatment paradigms. Their distinct molecular profiles and clinical behaviors suggest unique therapeutic approaches. Recent diagnostic guideline updates refine HER2 assessment, enhancing precision in identifying patients for targeted therapies. Challenges remain in accurately classifying HER2-low tumors and optimizing treatment efficacy, necessitating ongoing research and innovative diagnostic methods. Understanding the heterogeneity and evolving landscape of HER2 status in breast cancer is crucial for advancing personalized treatment strategies and improving patient outcomes., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare., (Copyright © 2024 Elsevier GmbH. All rights reserved.)

The tumor microenvironment (TME) is a critical determinant in the initiation, progression, and treatment outcomes of various cancers. Comprising of cancer-associated fibroblasts (CAF), immune cells, blood vessels, and signaling molecules, the TME is often likened to the soil supporting the seed (tumor). Among its constituents, tumor-associated macrophages (TAMs) play a pivotal role, exhibiting a dual nature as both promoters and inhibitors of tumor growth. This review explores the intricate relationship between TAMs and the TME, emphasizing their diverse functions, from phagocytosis and tissue repair to modulating immune responses. The plasticity of TAMs is highlighted, showcasing their ability to adopt either protumorigenic or anti-tumorigenic phenotypes based on environmental cues. In the context of cancer, TAMs' pro-tumorigenic activities include promoting angiogenesis, inhibiting immune responses, and fostering metastasis. The manuscript delves into therapeutic strategies targeting TAMs, emphasizing the challenges faced in depleting or inhibiting TAMs due to their multifaceted roles. The focus shifts towards reprogramming TAMs to an anti-tumorigenic M1-like phenotype, exploring interventions such as interferons, immune checkpoint inhibitors, and small molecule modulators. Noteworthy advancements include the use of CSF1R inhibitors, CD40 agonists, and CD47 blockade, demonstrating promising results in preclinical and clinical settings. A significant section is dedicated to Chimeric Antigen Receptor (CAR) technology in macrophages (CAR-M cells). While CAR-T cells have shown success in hematological malignancies, their efficacy in solid tumors has been limited. CAR-M cells, engineered to infiltrate solid tumors, are presented as a potential breakthrough, with a focus on their development, challenges, and promising outcomes. The manuscript concludes with the exploration of third-generation CAR-M technology, offering insight into in-vivo reprogramming and nonviral vector approaches. In conclusion, understanding the complex and dynamic role of TAMs in cancer is crucial for developing effective therapeutic strategies. While early-stage TAM-targeted therapies show promise, further extensive research and larger clinical trials are warranted to optimize their targeting and improve overall cancer treatment outcomes., (© 2024 International Federation of Cell Biology.)

Introduction and Importance: Incidental detection of neuroendocrine tumors (NETs) of the appendix is rare, often discovered during surgeries for other conditions. This report emphasizes the importance of thorough pathological evaluations in colorectal surgeries., Case Presentation: A 48-year-old male presented with intermittent abdominal pain, weight loss, and altered bowel habits. Colonoscopy and biopsy confirmed adenocarcinoma of the right colon. The patient underwent a right hemicolectomy. Histopathological examination revealed a moderately differentiated adenocarcinoma of the ascending colon (pT3N2b) and an incidental 0.8 cm well-differentiated NET at the tip of the appendix. The NET was low-grade (G1) with no lymphovascular invasion or metastasis. The patient received adjuvant chemotherapy with oxaliplatin and capecitabine for the colonic adenocarcinoma. The incidental NET did not alter the chemotherapy regimen due to its low-risk features., Discussion: Although, the presence of the NET did not alter the chemotherapy regimen, given its small size and low-grade nature. However, the discovery of this incidental tumor highlights the need for diligent follow-up, as patients with synchronous tumors may have an increased risk of recurrence or development of new malignancies., Conclusion: This case highlights the significance of meticulous pathological examination in colorectal surgeries, as incidental findings can significantly impact patient management and follow-up. Despite the typically indolent nature of small appendiceal NETs, their detection is crucial for accurate staging and appropriate patient care., Competing Interests: Conflict of interest statement All authors declare that there is no conflict of interest regarding the publication of this report., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Intracranial solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms, often challenging to diagnose due to their resemblance to meningiomas and other central nervous system tumors. While advancements in molecular genetics have aided in classification, diagnostic nuances and optimal management strategies remain areas of interest., Materials and Methods: This retrospective study analyzed 11 cases of intracranial SFTs treated at a neurosurgical centre in India between February 2020 and January 2024. Clinical data, radiological findings, histopathological features, and follow-up details were reviewed. Immunohistochemistry, particularly STAT6, facilitated diagnosis confirmation., Results: The median age of presentation was 32 years, with a male predominance. Headache was the most common presenting symptom, often leading to misdiagnosis as meningiomas on radiological imaging. Histologically, SFTs exhibited spindle to ovoid cells with staghorn vessels and collagenized stroma, posing challenges in differential diagnosis. WHO grading predominantly revealed grade 1 tumors, though recurrence occurred, emphasizing the importance of long-term follow-up. Immunohistochemistry, particularly STAT6, played a pivotal role in distinguishing SFTs from other entities., Conclusion: Intracranial SFTs present diagnostic challenges due to overlapping features with other tumors, warranting a comprehensive approach integrating clinical, radiological, and histopathological findings. Immunohistochemistry, particularly STAT6, emerges as a valuable diagnostic tool. Long-term follow-up is essential for monitoring recurrence and potential malignant transformation. Further research is needed to delineate optimal treatment strategies, including the role of radiotherapy in SFT management., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare., (Copyright © 2024 Elsevier GmbH. All rights reserved.)

This case report explores a rare and aggressive Malignant Peripheral Nerve Sheath Tumor (MPNST) in a 7-year-old child affecting nasal sinuses, maxilla, and orbit, an exceptionally uncommon pediatric manifestation unrelated to Neurofibromatosis 1. The child presented with alarming symptoms-nasal obstruction, snoring, epistaxis, and difficulty swallowing-underscoring the case's urgency. Non-contrast computed tomography revealed an extensive mass infiltrating nasopharynx, nasal cavity, maxillary sinus, ethmoid sinuses, and orbit, causing destructive consequences. Histopathology confirmed a high-grade MPNST, marked by rapid growth and early metastasis, highlighting management challenges. The rarity of pediatric MPNST in the nasal cavity is discussed, emphasizing the need for a broad differential diagnosis. Treatment involves surgical resection and adjuvant chemoradiation with a grim prognosis due to diagnostic complexities and morphological mimicry in young patients., Competing Interests: Conflict of InterestThe authors declare that they have no conflict of interest., (© Association of Otolaryngologists of India 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background and Aims: Breast cancer, a leading cause of female mortality, has prompted the widespread adoption of Neoadjuvant chemotherapy (NAC) for its potential to minimize metastasis risk and downstaging tumors. Tumor Infiltrating Lymphocytes (TILs) have emerged as key immunological biomarkers, particularly in breast cancer research. This study focuses on evaluating Stromal TILs (sTILs) in pre-NAC core needle biopsies of Invasive Breast Carcinoma, No Special Type (IBC, NST) and correlating it with NAC response., Materials and Methods: A retrospective study spanning three years (October 2020 to September 2023) was conducted in a tertiary care hospital, involving 73 patients meeting specific inclusion criteria. Pathological assessments, including hormone receptor status, molecular subtyping, and TILs evaluation, were performed. Logistic regression and statistical analyses were conducted to determine associations between TILs, clinicopathological parameters, and complete response., Results: The study demonstrated excellent discriminatory power of TILs (>10 %) in predicting complete response. Univariate and multivariate logistic regression underscored the independent predictive value of TILs, emphasizing their significance across diverse molecular subtypes., Conclusion: This study provides crucial insights into immune response assessment, particularly sTILs, in optimizing breast cancer treatment strategies and patient outcomes during NAC, contributing to the evolving landscape of personalized emphasising oncology., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare., (Copyright © 2024. Published by Elsevier GmbH.)

The much-hyped artificial intelligence (AI) model called ChatGPT developed by Open AI can have great benefits for physicians, especially pathologists, by saving time so that they can use their time for more significant work. Generative AI is a special class of AI model, which uses patterns and structures learned from existing data and can create new data. Utilizing ChatGPT in Pathology offers a multitude of benefits, encompassing the summarization of patient records and its promising prospects in Digital Pathology, as well as its valuable contributions to education and research in this field. However, certain roadblocks need to be dealt like integrating ChatGPT with image analysis which will act as a revolution in the field of pathology by increasing diagnostic accuracy and precision. The challenges with the use of ChatGPT encompass biases from its training data, the need for ample input data, potential risks related to bias and transparency, and the potential adverse outcomes arising from inaccurate content generation. Generation of meaningful insights from the textual information which will be efficient in processing different types of image data, such as medical images, and pathology slides. Due consideration should be given to ethical and legal issues including bias., (Copyright © 2024 Sociedad Española de Anatomía Patológica. Publicado por Elsevier España, S.L.U. All rights reserved.)

This report details a rare case of squamous cell carcinoma (SCC) in the stomach, a condition accounting for only a fraction of gastric carcinomas. A 46-year-old male patient with dysphagia, abdominal pain, and haematemesis was diagnosed with primary gastric SCC displaying aggressive metastasis, an exceptionally low-incidence condition affecting mainly males in their sixth decade of life. Primary gastric SCC, though clinically similar to adenocarcinoma, involves a bleaker prognosis, lacking standardized treatment protocols. Histopathology and imaging confirmed the diagnosis, highlighting the challenges in managing advanced cases. Palliative chemotherapy showed partial remission but led to severe neuropathy. The case underscores the urgent need for research to understand the pathogenesis, effective management, and therapeutic targets for primary gastric SCC, emphasizing its scarcity and poor prognosis in medical literature. Increased clinical awareness and ongoing research are crucial for improving outcomes in such rare presentations., (Copyright © 2024 Sociedad Española de Anatomía Patológica. Publicado por Elsevier España, S.L.U. All rights reserved.)

Isolated intraparotid neurofibromas are exceptionally rare and often associated with neurofibromatosis type 1 (NF1). Diagnosing these tumors proves challenging because of the clinical resemblance to primary salivary gland masses. This case report details an 18-year-old with a painful, enlarging parotid mass, diagnosed through fine needle aspiration biopsy (FNAB) revealing myxoid stroma and spindle cells. Magnetic resonance imaging confirmed a plexiform neurofibroma involving the parotid gland and facial nerve. Histopathology validated the diagnosis, emphasizing the importance of cytological and radiological correlation. Notably, the absent NF1 association makes this case unique. Surgical excision with facial nerve reconstruction was performed, highlighting the complexity of managing such rare intraparotid neurofibromas. Awareness of this entity is crucial for accurate diagnosis and appropriate management., (© 2024 Wiley Periodicals LLC.)

Breast cancer, a leading cause of global female mortality, demands comprehensive diagnostic and therapeutic strategies. This study delves into the nuanced realm of post-neoadjuvant chemotherapy breast cancer specimens, emphasizing the imperative need for pathologists to discern stromal and nuclear alterations adeptly. The investigation, encompassing 100 female patients with a mean age of 47.5 years, elucidates the demographic and clinicopathological parameters. Predominantly presenting as palpable lumps (85%), invasive ductal carcinoma emerged as the predominant histological type (98%). The primary focus of the study revolves around the morphological changes post-neoadjuvant chemotherapy, with a meticulous qualitative analysis encompassing stromal elements (fibrosis, elastosis, calcification) and nuclear features (pyknosis, hyperchromasia). Notably, the response to chemotherapy, classified by the International Union against Cancer criteria, delineates a substantial pathological complete response (55%), partial response (35%), and limited non-response (10%). The therapeutic landscape includes a majority of cases undergoing extensive chemotherapy cycles, primarily featuring the cyclophosphamide, doxorubicin, and paclitaxel regimen. Remarkably, this investigation unveils fibrosis (63%) and elastosis/collagenization (51%) as prevalent stromal changes, while pyknosis (58%) and hyperchromasia (48%) dominate nuclear alterations. In conclusion, this retrospective study provides a comprehensive overview of post-neoadjuvant chemotherapy breast cancer specimens, shedding light on the intricate interplay of clinical parameters, treatment responses, and histopathological changes. The findings underscore the pivotal role of pathologists in accurately diagnosing and grading tumors in the evolving landscape of breast cancer management., Competing Interests: Competing InterestsThe authors declare no competing interests., (© The Author(s), under exclusive licence to Indian Association of Surgical Oncology 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

The central nervous system tumor with BCL-6 interacting corepressor internal tandem duplication (BCOR-ITD) is a molecularly defined entity with an internal tandem duplication in exon 15 of the BCOR gene. It is histologically characterized by a solid pattern with spindle-shaped cells and a dense capillary network. Very few cases of this rare entity have been reported till date. We present a case of BCOR-positive CNS tumor in a 3-year-old child who presented with scalp swelling. A differential diagnosis of CNS tumor with BCOR expression should be considered whenever high-grade tumors with histopathological features of glial or ependymal tumors do not express the classical glial markers., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Indian Association of Surgical Oncology 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Squamous cell carcinoma of the middle ear is a very rare tumor. Early detection is uncommon as the tumor usually manifests as persistent ear discharge and otalgia, often misdiagnosed as chronic suppurative otitis media. We present a rare case of squamous cell carcinoma of the middle ear which clinically presented as chronic suppurative otitis media. Therefore, clinicians should have a high index of suspicion for clinically refractive cases of otorrhea, otalgia, excess bleeding, and non-responsiveness to treatment. All polyps and granulation tissue in EAC and middle ear should be submitted for histopathological examination especially in cases refractory to treatment., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Indian Association of Surgical Oncology 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Ovarian mature cystic teratomas comprise tissue derived from all three germ layers and constitute 10-20% of all ovarian neoplasms. Malignant transformation of mature cystic teratomas (MCT) is very rare with an incidence of 0.17-2%. The most frequently reported malignancies include squamous cell carcinoma and adenocarcinoma. Herein, we describe a case of a 56-year-old female who presented with abdominal pain and underwent total abdominal hysterectomy with bilateral oophorectomy and omentectomy for a ruptured dermoid cyst. Histological examination showed nests of pleomorphic cells with prominent nucleoli and melanin pigment in the background of a mature cystic teratoma. These cells showed immunoreactivity for Melan-A and HMB-45, thus confirming the diagnosis of malignant transformation of a mature cystic teratoma to a malignant melanoma., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Indian Association of Surgical Oncology 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Solitary Fibrous Tumor (SFT) rarely manifests within the thyroid gland, an organ predominantly associated with epithelial carcinomas. This case report explores the clinical narrative of a 70-year-old patient presenting with a sizable SFT localized in the left lobe of the thyroid, posing diagnostic challenges uncommon in thyroid nodules. The report delves into the clinical history, radiological findings, pathological assessments, and therapeutic interventions, contributing to the limited literature on thyroidal SFTs. The patient's ultrasound revealed a substantial thyroid mass causing tracheal and vascular displacement, categorized as TIRADS 3. Fine needle aspiration indicated mesenchymal origin, prompting further investigation. Contrast-enhanced computed tomography depicted a well-defined lesion with varied enhancement, compressing surrounding structures. Histopathology confirmed a spindle cell proliferation, prompting immunohistochemistry revealing CD34, STAT6, and Bcl-2 positivity, aligning with SFT characteristics. The rarity of thyroidal SFTs poses diagnostic challenges, necessitating reliance on immunohistochemistry for accurate differentiation from other spindle cell neoplasms. Radiological investigations, including ultrasound and magnetic resonance imaging, contribute to preoperative planning. The case underscores the importance of meticulous pathological examination, emphasizing the utility of immunohistochemistry in confirming SFT diagnosis. The report enhances understanding among clinicians, pathologists, and researchers, guiding improved diagnostic accuracy and tailored treatment strategies for future occurrences of thyroidal SFTs., Competing Interests: Conflict of interestThe authors have no conflicts of interest to declare., (© Association of Otolaryngologists of India 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Purpose: Gallbladder carcinoma (GBC) poses significant challenges in oncology due to its aggressive nature and limited treatment options. The lack of effective biomarkers for early detection and prognosis exacerbates the prognosis for GBC patients. Tumor budding (TB) and tumor infiltrating lymphocytes (TILs) have emerged as potential prognostic indicators in various cancers, reflecting tumor-host immune interactions and tumor aggressiveness. The study of TB and TILs in GBC is particularly important due to the limited literature available., Methods: This retrospective observational study aimed to evaluate the association of TB and TILs with clinicopathological parameters in GBC patients. Clinicopathological data were collected from patients with histologically confirmed GBC who underwent surgical resection. The sections were evaluated for TB and TILs using standardized methods. Statistical analysis was performed to assess associations between these parameters and clinicopathological variables., Results: Tumor stage and grade showed significant associations with TB and TILs, indicating their potential as prognostic markers. High TB correlated with advanced tumor stage and higher grade, while high TIL infiltration was associated with early tumor stage and lower grade. Additionally, TILs exhibited a significant association with lymphovascular invasion. Interestingly, an inverse association was observed between TB and TILs, highlighting the dynamic interplay between tumor aggressiveness and host immune response., Conclusion: TB and TILs hold prognostic significance in GBC, offering insights into its pathogenesis and potential therapeutic targets. Future research exploring the mechanistic underpinnings of tumor-host immune interactions in GBC is crucial for translating these findings into clinical applications and improving outcomes for patients.

Objective: Tuberculosis (TB) remains a major health problem, especially in the developing countries. Fine-needle aspiration cytology is the first line of investigation for tubercular lymphadenitis as it is easy to perform, less invasive, quick, and economical. The typical cytopathological features of tuberculosis TB include epithelioid cell granulomas with Langhans giant cells and caseous necrosis. The present study aimed to evaluate the cytomorphological features of newly diagnosed cases of tubercular lymphadenitis confirmed by GeneXpert., Material and Methods: This was a retrospective study in which all fine-needle aspirates from newly diagnosed cases of tubercular lymphadenitis confirmed by GeneXpert over a 1-year period from July 2022 to July 2023 were included in the study. The May-Grunwald-Giemsa stained smears from these aspirates were categorized into three patterns-epithelioid cell granulomas with necrosis, epithelioid granulomas without necrosis, and necrosis only. The granulomas were further categorized into well-formed, ill--formed, and splintered. The background of the aspirate which included a reactive lymphoid background, lymphocytes, eosinophils, and neutrophils was tabulated for all the cases., Results: Out of the three cytomorphological patterns, epithelioid granulomas with necrosis were the most predominant (67.5%), followed by necrosis only (20.8%) and granulomas without necrosis (11.6%). An acid-fast bacilli (AFB) positivity of 53.3% (64 cases) was seen on the Ziehl-Neelsen stain. Well-composed, poorly formed, and splintered granulomas were seen in 55 (57.9%), 42 (44.2%), and 21 (22.1%) cases, respectively. Neutrophils were the most common background population (42, 35%) followed by lymphocytes (36, 30%). Reactive lymphoid cells and eosinophils were seen in 12 (10%) and 3 (2.5%) cases, respectively., Conclusion: Fine-needle aspiration cytology is a rapid inexpensive minimally invasive test for tubercular lymphadenitis as epithelioid cell granulomas along with caseous necrosis are highly suggestive of TB. However, manual acid-fast AFB detection has a low sensitivity as is illustrated in the present study where only AFBwas demonstrated in only 53.3% of cases., Competing Interests: The authors declare no conflict of interest and amongst authors, the authors affiliated in Vardhman Mahavir Medical College and Safdarjung Hospital claims no conflict of interest., (© 2024 The Author(s). Published by Scientific Scholar.)

Background: Hemoglobin A1c (HbA1c) serves as a pivotal marker for long-term glycemic control. The Diabetes Control and Complications Trial (DCCT) established its relevance, yet gaps exist in understanding potential seasonal variations in HbA1c levels among diabetic patients. The study highlights the need to explore potential seasonal variations in HbA1c levels and their impact on diabetic patients., Materials and Methods: This is an observational study conducted in a tertiary care hospital from January to December 2019, the study analyzed HbA1c levels in 8138 patients. Blood samples were collected using Potassium EDTA-containing vials and processed with an automated analyzer. Seasonal variations were explored using time series analysis., Results: Mean HbA1c levels peaked during the monsoon (June to September) and were lowest in autumn (October to November). Subgroup analysis revealed differences in patients with HbA1c values below and above 6.5 %. Those with controlled blood sugar showed higher levels in winter (December to February) and monsoon (June to September), while patients with HbA1c values ≥ 6.5 % exhibited significantly lower levels in monsoon (June to September) and autumn (October to November) compared to summer (March to May)., Conclusion: In contrast to global trends, Indian patients demonstrated distinct seasonal variations in HbA1c levels. The highest levels during the monsoon (June to September) may be linked to reduced outdoor activity and dietary changes. The study emphasizes the need for tailored diabetes management considering seasonal influences. Further extensive, longitudinal studies across diverse Indian regions are recommended to comprehensively grasp the impact of seasonal changes on diabetes outcomes., Competing Interests: The authors have no conflicts of interest to declare., (© 2024 The Authors.)

Pleomorphic lipoma is an uncommon benign adipocytic tumor that arises from the subcutis. It has no risk of recurrence, metastasis or malignant transformation. The cytological findings of pleomorphic lipoma are often overdiagnosed as suspicious of malignancy owing to the pleomorphic morphology of the floret giant cells. We present a rare case of pleomorphic lipoma of the parotid gland which was misdiagnosed as a malignant tumor on fine needle aspiration cytology. Histopathological examination and positive expression for CD34 helped to arrive at the final diagnosis. Awareness about this rare entity will prevent overdiagnosis as a malignant tumor and unnecessary radical resections for this benign tumor., Competing Interests: Conflict of interestThe authors have no conflicts of interest to declare., (© Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: Sentinel lymph node (SLN) is the first lymph node to drain the lymph from a particular region involved by cancer. The commonly performed intraoperative methods for SLN evaluation are touch imprint cytology (TIC) and frozen section (FS). The present study aimed to determine the sensitivity, specificity and accuracy of TIC and FS with histopathological diagnosis as gold standard., Materials and Methods: The nodes were bissected along their long axis and wet surface was imprinted on to clean glass slides followed by toluidine blue and rapid Papanicolaou staining. Subsequently the lymph node slices were cut at three levels using the cryostat machine and stained with Hematoxylin and eosin stain. The cytological and FS findings were compared and the specificity, sensitivity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of TIC and FS was evaluated taking histopathological diagnosis as gold standard. In addition, pooled sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for touch imprint cytology and frozen section were assessed for the studies included in the meta-analysis., Results: The specificity, sensitivity, diagnostic accuracy, positive predictive value and negative predictive value of touch imprint cytology were 100%, 88.2%, 90%, 100% and 60% respectively. The specificity, sensitivity, diagnostic accuracy, PPV and NPV of frozen section were 100%, 94.1%, 95%, 100% and 75% respectively. The sensitivity of TIC and FS for detection of micrometastasis was 60% and 80% respectively. The pooled sensitivity and specificity for touch imprint cytology were 85.24% (95% CI, 83.46%-86.90%), and 98.99% (95% CI, 98.69%-99.23%) respectively. The pooled sensitivity and specificity for frozen section examination were 90.45% (95% CI, 85.15%-94.34%), and 100% (95% CI, 99.24%-100%) respectively., Conclusion: Even though the sensitivity of FS was better than imprint cytology in detection of micrometastasis, TIC is a rapid inexpensive technique which can be utilized in remote areas in absence of cryostat machine. The sensitivity of the two techniques with respect to detection of macrometastasis was comparable. This meta-analysis highlights the accuracy of the touch imprint cytology and frozen section examination in the intra-operative detection of malignancy in breast cancer.

Endosalpingiosis is a nonneoplastic lesion defined by the presence of tubal epithelium at ectopic sites such as the peritoneum, bladder, appendix, and even uterus. They may be asymptomatic and detected incidentally on ultrasonography. However, cystic endosalpingiosis is also known to be a mimicker of ovarian neoplasms. It is crucial for both the clinician and the pathologist to be aware of this benign lesion so that overdiagnosis and overtreatment can be avoided. We report a case of endosalpingiosis of the uterine serosa in a 45-year-old woman which was misdiagnosed as an adnexal cyst on radiological investigations., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Mid-life Health.)

The clinical presentation of enteric duplication cysts is dependent on the location of the cyst with symptoms varying from nausea and vomiting to abdominal distension, pain and perforation. Four patients were identified who were diagnosed with enteric duplication cysts within the period from 2019 to 2023. Three of the patients presented with signs of intestinal obstruction-abdominal distension and pain, while one had an antenatally detected abdominal mass. There were three boys and one girl with ages ranging from 4 months to 14 years. Three cases of ileal and one case of caecal duplication cyst were reported. Most of the cases showed ileal/caecal mucosa while one case demonstrated ectopic gastric mucosa. The treatment of these cysts includes surgical excision. Although radiological investigations help in arriving at a provisional diagnosis, the final diagnosis can be confirmed only after histopathological examination. Early treatment prevents complications and results in a good prognosis for the patient., (Copyright © 2024 Sociedad Española de Anatomía Patológica. Publicado por Elsevier España, S.L.U. All rights reserved.)

Metastasizing pleomorphic adenoma is recognized as a subtype of pleomorphic adenoma in WHO classification 5th edition of salivary glands. The controversy pertaining to the entity is the benign features of the disease even at a metastatic site. We present a rare case of left recurrent pre-auricular swelling in a young male reported as metastasizing pleomorphic adenoma. A nineteen-year-old male presented with left preauricular swelling seven years ago which was diagnosed as pleomorphic adenoma and underwent complete excision of tumour. The tumour recurred twice - two and five years after the surgery. At the second recurrence, the level II neck dissection showed multiple encapsulated deposits of pleomorphic adenoma having similar morphology in the cervical soft tissue with no features of high-grade transformation., (Copyright © 2023 Sociedad Española de Anatomía Patológica. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction and Importance: Neurenteric cysts (NCs) are rare congenital anomalies within the central nervous system, originating from the endodermal layer due to inappropriate embryonic notochordal plate and endoderm separation. Despite constituting a minute fraction of CNS tumors, their diverse clinical presentations and brainstem occurrence pose diagnostic challenges., Case Presentation: This study presents a series of three brainstem NCs, detailing demographics, clinical presentations, radiological features, and operative findings. Patients aged 2-40 years exhibited varied symptoms including headaches, vomiting, cranial nerve deficits, and motor/sensory deficits. Literature review of 27 cases showed a mean age of 26.8 years, predominantly in females, with diverse cystic characteristics on MRI. Surgical intervention achieved mostly complete resection, with varying outcomes including recurrence and malignant transformation., Clinical Discussion: This study sheds light on the rare entity of brainstem NCs, emphasizing their diagnostic complexity. NCs, though constituting a minute fraction of CNS tumors, present a diagnostic challenge due to their diverse clinical presentations and rarity in the brainstem., Conclusion: This study provides insights into brainstem NCs, emphasizing diagnostic complexity and the importance of MRI in accurate diagnosis and surgical intervention. Enhanced collaboration is needed to refine management strategies for these intriguing lesions., Competing Interests: Declaration of competing interest The authors report there are no competing interests to declare., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Desmoplastic melanoma is an extremely rare subtype of malignant melanoma comprising only 1% of all the cutaneous melanomas. Being amelanotic and owing to its histopathological features of spindle cells lying in a collagenized stroma, it is often misdiagnosed as a dermatofibroma or scar tissue. The present case study describes a case of desmoplastic melanoma of the chest wall where the final diagnosis could be arrived at only after an extensive immunohistochemical panel to exclude other spindle cell proliferations., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Indian Association of Surgical Oncology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Schwannomas are benign encapsulated neoplasms which arise from Schwann cells of the neural sheath. Ancient schwannoma is a rare variant of schwannoma which is often misdiagnosed as a malignant neoplasm owing to degenerative changes. They are known to show degenerative nuclear atypia, cystic degeneration, hyalinization, myxoid change and haemorrhage. We present a rare case of an intrapulmonary ancient schwannoma in a 34-year-old female patient., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Indian Association of Surgical Oncology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Mesenteric cysts, typically benign and asymptomatic, are incidental findings during abdominal investigations for nonspecific symptoms. Their origin is commonly in the mesentery of the small bowel, mesocolon, or retroperitoneum. This paper reports a rare case of a 22-year-old male with a mesenteric cyst presenting as a right lower abdominal mass. Ultrasonography revealed a heterogenous collection, leading to surgical excision. Histopathology unexpectedly revealed an extragonadal yolk sac tumor (YST) originating in the mesentery, a rarity often misdiagnosed as a cyst. YST, primarily found in gonads, is infrequently reported extragonadally. This study contributes to the limited literature on primary peritoneal YST, discussing clinicopathological parameters and presenting a detailed case. The pathogenesis of extragonadal germ cell tumors, including YST, remains debated, with migration and stagnation of germ cells during embryonic development proposed as a prevalent theory. Histopathological examination of extragonadal YST mirrors gonadal YST, featuring various patterns. Immunohistochemistry, crucial for diagnosis, reveals positive expression for SALL-4, glypican-3, PLAP, AFP, and panCK. SALL-4 emerges as the most sensitive marker for extragonadal YST. This case underscores the importance of accurate postoperative histopathology and immunohistochemistry in distinguishing mesenteric YST from cysts, as misdiagnosis can impact prognosis. The rarity of extragonadal YST emphasizes the need for comprehensive understanding and recognition in clinical practice. The study contributes valuable insights into diagnosis and management, shedding light on a challenging aspect of surgical pathology., Competing Interests: Competing InterestsThe authors declare no competing interests., (© The Author(s), under exclusive licence to Indian Association of Surgical Oncology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Epithelioid hemangioma also known as angio-lymphoid hyperplasia with eosinophilia is a rare benign vascular neoplasm of unknown etiology. It very rarely involves the nasal cavity. It always poses a diagnostic challenge for clinicians and is usually misdiagnosed as Kimura's, IgG4-related disease, or malignant vascular tumors. The present case report describes an extremely rare presentation of epithelioid hemangioma inside the left nasal cavity causing complete obstruction and nasal septal deviation towards the right side in a young male. Hematoxylin and eosin-stained sections depicted a lobular proliferation of small capillary-sized vessels lined by plump epithelioid endothelial cells surrounding central vessels and scattered around them. These cells had abundant eosinophilic to amphophilic cytoplasm and enlarged nuclei with fine chromatin and central nucleoli. On immunohistochemistry, CD34 and CD31 highlighted the vascular proliferation and epithelioid endothelial cells. Erythroblast transformation-specific (ETS)-related gene (ERG) showed strong nuclear positivity in neoplastic plump epithelioid endothelial cells. EH is a benign vascular proliferation, but a high chance of recurrence is seen if complete resection is not done. As a result, the treatment of choice is complete surgical excision with clear margins. The case highlights a non-conventional presentation of epithelioid hemangioma and the importance of histomorphological features in diagnosing this entity., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Indian Association of Surgical Oncology 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Physiological embryogenesis and adult tissue homeostasis are regulated by transforming growth factor-β (TGF-β), an evolutionarily conserved family of secreted polypeptide factors, acting in an autocrine and paracrine manner. The role of TGF-β in inflammation, fibrosis, and cancer is complex and sometimes even contradictory, exhibiting either inhibitory or promoting effects depending on the stage of the disease. Under pathological conditions, especially fibrosis and cancer, overexpressed TGF-β causes extracellular matrix deposition, epithelial-mesenchymal transition, cancer-associated fibroblast formation, and/or angiogenesis. In this review article, we have tried to dive deep into the mechanism of action of TGF-β in inflammation, fibrosis, and carcinogenesis. As TGF-β and its downstream signaling mechanism are implicated in fibrosis and carcinogenesis blocking this signaling mechanism appears to be a promising avenue. However, targeting TGF-β carries substantial risk as this pathway is implicated in multiple homeostatic processes and is also known to have tumor-suppressor functions. There is a need for careful dosing of TGF-β drugs for therapeutic use and patient selection., (© 2023 International Federation of Cell Biology.)

Introduction: Epidermoid cysts, originating from ectodermal cell remnants during embryogenesis, are rare, slow-growing tumours commonly found in the cerebellopontine angle, fourth ventricle, and sellar/parasellar regions. This retrospective study explores clinicopathological features, demographics, and radiological details of fifteen central nervous system epidermoid cyst cases over three years., Materials and Methods: Histologically confirmed cases undergoing surgical excision from July 2020 to July 2023 were retrospectively evaluated. Patient age, clinical presentations, radiological features, and histopathological findings were analyzed using descriptive statistics and aligned with the PROCESS criteria., Results: Fifteen cases, spanning various age groups and clinical presentations, were included. There were four cases each in the posterior fossa and cerebellopontine angle, three in temporal region, two in intraspinal region, and one each in the retromastoid intra-diploic and third intra-ventricular region. Lesions exhibited diverse distribution, gross findings, and microscopic features. Radiological imaging exhibited well-defined hypo-attenuated masses on computed tomography and contributed to the preoperative diagnosis in eight cases. Despite challenges in complete excision due to adherence, 13 cases underwent successful resection. Chemical meningitis, a common postoperative complication, underscores the importance of meticulous surgery., Conclusion: This study highlights clinicopathological characteristics, challenges in surgical management, and postoperative complications of central nervous system epidermoid cysts. Comparative analysis with existing literature emphasizes the uniqueness of epidermoid cysts, differentiating them from craniopharyngiomas and dermoid cysts. Despite the retrospective design, valuable insights are provided, emphasizing the need for prospective studies. Effective management involves complete excision, ensuring long-term remission and emphasizing the distinctive nature of these intriguing intracranial lesions., Competing Interests: Declaration of competing interest The authors report there are no competing interests to declare., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)