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Ovarian pathology ranges from innocuous non-neoplastic lesions to malignant neoplastic entities. The incidence, clinical appearance and the behaviour of the different types of ovarian tumour is extremely variable. In order to have a better understanding of frequency and histomorphological patterns of different ovarian lesions study was encountered in our tertiary care hospital.To study the histopathology of ovarian non-neoplastic and neoplastic lesions and to study the distribution of ovarian lesions with respect to various parameters like age, bilaterality, gross and microscopic features.This is a prospective study of 125 ovarian specimens received in department of pathology, G.K. General Hospital, Bhuj during August 1, 2018 to July 31, 2020. Total 125 cases of ovarian specimens were studied, amongst them 58 were non-neoplastic and remaining 67 were neoplastic. The most common non-neoplastic lesion seen was follicular cysts 12 cases (21%), followed by endometriosis 9 cases (16%). Among 67 neoplastic ovarian lesions 58(87%) cases were benign, 3(4%) cases were borderline and 6 (9%) cases were malignant. In benign ovarian neoplasm, most commonly seen lesions were serous cystadenoma 24 cases (36%) followed by 13 cases (20%) of mature cystic teratoma. In malignant cases, maximum was of high-grade serous cystadenocarcinoma.Ovarian epithelial tumours are the most common type, while serous cystadenocarcinoma was the most common malignancy. Histological examination is gold standard and in certain difficult cases require immunohistochemistry.Ovary is an important reproductive organ with involvement in production of progeny.Ovarian pathology ranges from innocuous non-neoplastic lesions to malignant neoplastic entities. Ovarian neoplasms have become increasingly important not only because of the wide range of neoplasms, but also because they have gradually increased the mortality rate. The incidence, clinical appearance and the behaviour of the different types of ovarian tumour is extremely variable.

Context: Non-granulomatous necrotizing lymphadenopathy (NGNL) is not a specific entity. It is seen in various conditions like Kikuchi-Fujimoto disease (KFD), Systemic Lupus Erythematosus (SLE), tuberculosis, lymphoma/metastasis and lymph node infarction. These conditions mimic each other histologically but it is necessary to identify the correct pathology as the treatment differs significantly. Aim of the study: To highlight the subtle morphological features which lead to the etiological diagnosis in NGNL. Materials and Methods: The lymphnode biopsies (N=198), reported in our institute as NGNL, over 4½ year study period, were retrieved. Of these, the benign cases were 64 in total, with 40 cases of KFD and 8 cases of SLE. H&E, special stains and immunohistochemistry slides were reviewed by two pathologists. Histomorphological features like amount of necrosis, apoptotic debris, vasculitis, presence of neutrophils, eosinophils, histiocytes, plasma cells, hematoxylin bodies, Azzopardi phenomenon and thrombus formation were studied. Statistics: Logistic regression analysis was performed to identify the most significant histopathological parameter with each disease. Kendall’s Tau matrix plot analysis was used to measure the correlation between the disease and the histopathologic variables. Results: Features like vasculitis, hematoxylin bodies and Azzopardi phenomenon showed strong correlation with SLE and inverse correlation with KFD. Apoptotic debris, paucity of neutrophils and eosinophils had a strong positive association with KFD. Conclusion: The histological features help in differentiating the various entities associated with NGNL. It is necessary to correlate with clinical details and various laboratory parameters to reach a conclusive diagnosis because these conditions have varied treatment modalities. Keywords: Kikuchi­Fujimoto disease, necrosis, paucity of neutrophils, SLE

Introduction: FNAC plays an important role in the early diagnosis of the axillary swelling. This study was conducted to document the spectrum of lesions on the patients that came for FNAC with the complain of axillary swelling. Materials and methods: Present study was carried out at the Department of Pathology. A total of 30 cases of axillary swelling which were referred for FNAC in the department of Pathology, over the period of 3 months were retrospectively evaluated. All the stained slides of the cases were also reviewed. Results : From 30 cases there were 13 males and 17 females. On examining the stained slides maximum number of cases presented with chronic granulomatous lymphadenitis followed by Reactive lymphadenitis , Lipoma, Ductal carcinoma metastasis of breast in axillary lymphnode, chronic non-specific lymphadenitis, One unusual case of Hydatid cyst who presenting with axillary swelling was also diagnosed. Conclusion : FNAC is an important tool in differentiating benign and malignant lesions thus, helps in the proper management of the disease. Keywords: Axillary swelling, FNAC, Benign and Malignant

Rhabdomyosarcoma is a malignant neoplasm of mesenchymal cells, which shows varying degrees of striated muscle cell differentiation. It predominantly occurs in children while rarely found in adults. Involvement of the oral cavity accounts for only 10-12% of all head and neck cases. Herewith, we report a rare case of oral spindle cell / sclerosing rhabdomyosarcoma in a 47-year-old male presented with a small mass involving the gingiva of right upper incisor. The mass was excised with a preoperative diagnosis of gingival epulis and subjected to histopathological and immunohistochemical examination which confirmed it to be spindle cell / sclerosing rhabdomyosarcoma. Data regarding its clinical course, genetic abnormalities and prognosis as a combined subtype is scant. Keywords: Adult spindle cell/sclerosingrhabdomyosarcoma (S­ScRMS) Oral Cavity, Rhabdomyosarcoma, Maxillary Gingiva, Immunohistochemistry

Aims: 1) To detect Cyclophilin, APC and SFRP5 genes associated with Epithelial ovarian cancer by PCR. 2) To study and compare the prognostic and diagnostic efficacy of serological markers like Ca 125 and HE4 and their correlation with epithelial/ non epithelial ovarian neoplasms. Settings and Design: Comparative observational study, Prospective study Methods and Materials: 64 cases fulfilling the inclusion criteria and giving their consent for inclusion in the study were enrolled as subjects of the present study over a period of one year. After DNA extraction (Invitrogen mini kit, USA) conventional PCR to amplify the extracted DNA and further subjected them to agarose gel electrophoresis for the identification(expression) of 3 genes i.e Cyclophillin, APC and SFRP5, was done; However, none expressed. Methods and Materials: ELISA was used to assess CA125 and HE4 pre and post surgical intervention. Results: The serum markers were raised more in malignant epithelial ovarian cancer cases and levels plummeted after surgical intervention, as compared to benign masses. Results: We could not establish correlation of the genes’ expression with the serum markers and histopathology. Conclusions: Combining HE4 and CA125 both might be more helpful than either of them using alone, in diagnosing as well as prognosticating ovarian diseases. Conclusions: A panel of multiple genes on a larger sample size may be needed for CTC detection. Key Messages: Early detection of ovarian tumors leads to early diagnosis and hence early institution of intervention and hence decreased morbidity and mortality. Keywords : Ovarian lesion, Circulating tumor cells, Serum CA125, Serum HE4

Context: Cytology of body fluid is one of the oldest methods that is widely accepted. Though the pleural fluid cytology is well documented, data on peritoneal fluid cytology is sparse. It has a distinct value in confirming or disapproving malignant lesion. Most of the laboratories use cytospin smears for cytological study. While cytospin smears without doubt is a good method for cytodiagnosis, it can be complemented with cellblock for a more accurate diagnosis. Cellblock is a diagnostic modality which can help in pointing the cause for effusion and also in staging, prognosis and therapy of many malignant conditions. Aims: The aim of this study is to (1) analyse the cytomorphology of peritoneal fluid using cytospin and cellblock technique and (2) to assess the utility of cellblock method in identifying malignant cells in peritoneal effusion and wash samples. Materials and Methods: A total of 53 ascitic fluid and peritoneal wash samples that were clinically suspected of malignancy were studied. Each of the samples were processed by cytospin smear and cell block method. Statistical analysis used: The results were interpreted by descriptive analysis. Results: Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of the cytological test was 96.15%, 100%, 100%, 96.42% and 98.11% respectively. Cellular yield for malignancy was 3.85% more by the cellblock method. Conclusions: Cellblock can provide an additional information which can aid in increasing the sensitivity of cellblock. It can complement cytospin smears, especially to detect malignant cells in peritoneal fluid. A combined approach of cytospin and cellblock can help in a more accurate diagnosis. Keywords: Cell block, Cytodiagnosis, Cytology, Sensitivity

Introduction: Primary CNS lymphoma (PCNSL) is a rare form of extra nodal Non-Hodgkin Lymphoma that is typically con?ned to the brain, spinal cord, lepto meninges and eyes. We studied the clinico pathological features of PCNSLs, immuno histochemical (IHC) markers expressed and the association of morphological features & IHC markers with clinical outcome. Materials and Methods: 30 cases of primary CNS lymphomas were studied. 25 cases were diffuse large B cell lymphomas, which were sub classified using Hans algorithm into GCB and non-GCB. The IHC markers done were CD20, CD3, BCL2, BCL6, MUM-1, CD10 and c-myc. Mean proliferation index Ki was 80%. Follow up and survival data was collected and the association of each IHC marker and subtype with prognosis was assessed. Conclusion: PCNSL forms around 2% of all lymphomas as well as primary CNS tumours. Non GCB type is more common (72%). Mean overall survival was 9.7 months. Ki-67 index of 80% or more is the only independent variable of prognostic significance. None of the other IHC markers or sub typing had any influence on the outcome. Keywords: Primary CNS lymphoma, IHC, Prognosis, GCBsubtype, Ki 67 index

Introduction: A wide spectrum of normal, benign, premalignant, and malignant lesions may occur on the vulva. Symptoms of vulvar disorders may be non-specific. Empiric treatment of vulvovaginal symptoms is common but usually not helpful. Though the varied clinical presentation and diverse histopathological spectrum of vulvar lesions have amazed Pathologists, only a few studies have been reported in the literature. The present study consists of a histopathological spectrum of vulvar lesions. Objectives of the Study: 1.To evaluate the histopathological spectrum of vulvar lesions. 2. To compare the incidences of non-neoplastic and neoplastic lesions of the vulva. Materials and Methods: Present study includes all types of vulvar lesion specimens received in the Department of pathology over a period of four years. Result: All thirty-nine vulvar biopsies received in the Department of Pathology were studied for histomorphologic features. The lesions were categorized as non-neoplastic, neoplastic. The neoplastic ones were further divided into benign, malignant, and premalignant. The age of the women ranged from 15 to 69 years (mean 36.18±12.71) with the maximum number of patients between 30 to 40 years of age. Non neoplastic lesions were more common (22; 56.4%) than the (17; 43.6%) neoplastic lesions. There were 15(38.5%) benign lesions while 2 cases (5.13%) were malignant. Among the non-neoplastic lesions, Bartholin's duct cyst was the most common histopathologic diagnosis (35.9%). The fibroepithelial polyp was the most common benign neoplastic lesion constituting 15.3%. Conclusion: In the present study nonneoplastic lesions were more common than neoplastic lesions. Among the neoplastic lesions, benign neoplasms were more frequent than malignant lesions. Keywords: Vulvar lesion, Histopathological

Objective: To study ten cases of toxoplasmic lymphadenitis (TL) in which the diagnosis was made by fine needle aspiration cytology and confirmed by subsequent serology. Study design: Retrospective study done over a period of five years. We retrieved ten cases of Toxoplasma lymphadenitis in which fine-needle aspiration cytology (FNAC) of lymph node was done after clinical examination. Serology with electrochemiluminescense was done in all the cases. Results: The cytological features were characterised by microgranulomas, abundance of tingible body macrophages and absence of necrosis. Serologic testing for toxoplasma in all the cases revealed elevated titres. Conclusion: Lymphadenitis due to Toxoplasma infection should be considered in the diagnosis of unexplained lymphadenopathy at all sites, especially the cervical region. Serologic confirmation should be recommended for all suspected cases. FNAC diagnosis can eliminate the need for hospitalization and surgery. To the best of authors’ knowledge, this is 5th case series of cytodiagnosis of TL in the English literature and 2nd in the Indian literature. This is the largest case series of cytodiagnosis of TL in the Indian literature and 2nd largest in the world literature next to the one done by Haque et al. Keywords: Toxoplasma lymphadenitis, Toxoplasma lymphadenitis FNAC, Toxoplasma serology, Posterior cervical lymphadenitis.

COVID-19 is an infection caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Now there are increased cases with super infections by mucormycosis, which were rarely reported in the beginning of the current pandemic of COVID 19. Herewith a case of 47 year-old male patient of post COVID-19 infection having severe hypoxia and was on ventilator, received steroid treatment and also known case of HIV/AIDS. Now admitted to our hospital having fever, facial pain, and swelling midface region. His RT-PCR test was positive. On clinical, radio imaging and on histopathological findings diagnosed as maxillary mucormycosis. We are presenting this rare case for its clinical, radio imaging, and on histopathological findings. Keywords: COVID19, Mucormycosis, SARSCoV2, maxillary fungal infection.

Juvenile xanthogranuloma(JXG) is an uncommon benign histiocytic cutaneous lesion which is seen primarily in first two decades of life. There is not much literature available on its cytology. We present a case of solitary juvenile xanthogranuloma in a 43 years old female located above left nasal ala which was diagnosed on Fine needle aspiration cytology and subsequently confirmed on histology. Characteristic cytological features favored a diagnosis of juvenile xanthogranuloma. Keywords: Juvenile Xanthogranuloma, Cytology, Adult.

Introduction: Swellings in the Head and Neck region are very common and are evaluated with the help of a detailed clinical history, physical examination and investigations like FNAC, USG, CT scan or excisional biopsy. Fine Needle Aspiration Cytology (FNAC) is a simple, quick, inexpensive and minimally invasive OPD procedure used in the diagnosis of different swellings of Lymph nodes, thyroid, salivary gland and soft tissues in the Head and Neck region. Aim: We did this study with the purpose of identifying the frequency and distribution of different pathologies found in FNAC done in patients presenting with a swelling in the Head and Neck region as per the site, age, sex and type of the lesion. Materials and Methods: A retrospective study was conducted on the patients presenting with swelling in the Head and Neck region at the Pathology department of a tertiary care hospital between the duration of 1st August 2019 to 30th April 2021. FNAC was performed on total 260 patients. Results: Out of 260 cases, 157 cases (60.4%) were from Lymph nodes, 50 cases (19.2%) from thyroid gland, 27 cases (10.3%) from skin and subcutaneous tissue, 23 cases (8.84%) from salivary gland and 3 cases (1.1%) were inconclusive due to inadequate material aspiration. 149 cases (57.98%) were inflammatory, 70 cases (27.24%) benign and 38 cases (14.78%) were found to be malignant. Conclusion: FNAC is a simple, quick, inexpensive, minimally invasive OPD procedure and used as first line of investigation in the diagnosis of swellings in the Head and Neck region. Keywords: Fine needle aspiration cytology, Head and Neck, Inexpensive, Simple.

Background: The cytological examination of serous effusions has been universally accepted and a positive diagnosis is considered as a definitive diagnosis. It helps in staging, prognosis and management of the patients in malignancies and also helps to differentiate inflammatory and non – inflammatory lesions. The main diagnostic dilemma is to differentiate between reactive mesothelial cells from that of malignant cells in our routine practice. Aims: To compare the morphological features of the conventional cytology with that of the cell block technique. Materials and Methods: The study was conducted in the cytology section of the department of Pathology. Seventy five fluid samples were subjected to diagnostic evaluation for over a period of two years (August 2019 to February 2021). Along with the conventional smears, cell blocks were prepared using 10% alcohol – formalin as a fixative agent. Results: Cellularity and yield for malignancy was more by the cell block technique. Conclusion: The cell block technique provides high cellularity, better architectural patterns, morphological features and an additional yield of malignant cells when compared with that of conventional smear cytology. Keywords: Cell block, Conventional smear, Pleural effusion.

Aims and Objectives: To study the expression of immunomarker CD 44 and evaluate its diagnostic and prognostic significance and its correlation with clinicopathological variables in Breast Carcinoma. Materials and Methods: 50 diagnosed cases of breast carcinoma, presenting clinically with breast lumps were processed routinely for histopathological diagnosis of breast cancer and immunoexpression of CD 44 was performed. The immunoexpression of CD44 was detected mainly at the membrane of tumour cells and the scoring was performed. Results: 217 (98.2%) were females and 4(1.8%) males. Most common subtype involved was invasive carcinoma (NST) in 205(92.8%) cases. Out of 29 cases of grade 2 tumor, 07 (14.0%) showed 1+ score, 10(20.0 %) showed 2+ score and 12 (24.0%) cases showed 3+ immunoexpression. Out of 25 cases of T2 (2-5cm) size, 07(14.0%) showed 1+ score, 09(18.0%) case each showed 2+ score and 3+ immunoexpression. Out of 26 cases of stage III, 04(8.0%) showed 1+ score, 09(18.0%) showed 2+ score and 13(26.0%) cases showed 3+ immunoexpression. Out of 05 cases of N3, 02(4.0%) showed 2+ score and 03(6.0%) showed 3+ immunoexpression. Out of 21 cases of basal cell type, 03(6.0%) showed 1+ score, 07(14.0 %) showed 2+ score and 11(22.0%) cases showed 3+ immunoexpression. Out of 11 (50.0%) cases with weak to moderate expression of CD44, 7(31.8%) cases were stable and alive while 4(18.2%) died due to distant metastasis to various sites. Conclusions: CD 44 is associated with disease progression, recurrence, advanced metastasis and reduced disease free survival and can be used in future to predict early diagnosis of advanced disease. Keywords: Breast carcinoma, CD 44, Immunohistochemistry, Prognosis.

Introduction: Anaplastic thyroid carcinoma (ATC) presenting with cutaneous metastasis is rare and only few cases have been reported so far. Commonly involved sites are the cervical region and the thorax. Anaplastic thyroid carcinoma has poor prognosis and no standard treatment has been documented however extensive surgery with curative treatment often with adjuvant radiation and chemotherapy are effective. Most common genetic mutation in ATC is P53 (20-83% cases), RAS mutation (up to 50%), BRAFV600E mutation (25%) p13KCA mutation (12-23%) and copy gain leading to Akt activation (38-61%). Case Presentation: In our study, we have reported a case of a 66 years old male patient who presented with thyroid, back and the ribs (right side) swelling with a radiological diagnosis of malignant thyroid lesion, FNAC was done from all of the above mentioned sites. FNAC smears from all sites showed pleomorphic atypical cells. A diagnosis suggestive of High Grade Epithelial Neoplastic lesion was given with a possibility of Anaplastic thyroid carcinoma with cutaneous metastasis. Conclusion: Anaplastic thyroid carcinomas (ATC) with cutaneous metastasis often present with solitary or multiple swellings as seen in many studies. Very few cases has been reported which has been diagnosed on FNAC. The case reported highlights multiple nodular swelling in neck, right side back and ribs. Cytomorphologically it was suggestive of anaplastic thyroid carcinoma with cutaneous metastasis, which is rare and only few cases documented. Keywords: Anaplastic Thyroid Carcinoma, Bethesda Thyroid cytopathology, Cutaneous metastasis, Squamoid differentiation, Thyroid Fine Needle Aspiration.

Dr. Albert Coons et al in 1941 first initiated immunohistochemistry to identify cellular or tissue constituents by means of antigen and antibody interactions. The site of antibody binding can be identified either by direct labeling of antibody or by use of secondary labeling method. Immunohistochemistry (IHC) involves the use of labeled antibodies to localize the antigens in the tissues through antigen-antibody interactions and are visualized either by fluorescent dye, enzyme, radioactive element or colloidal gold. IHC usage has an obvious advantage over the traditional one, which uses special enzyme staining technique that identify only limited number of proteins, enzymes and certain tissue structure. IHC can be commonly employed to distinguish the tissue of epithelial and mesenchymal differentiation, cellular changes which are normally not visible in regular staining techniques, and earliest changes in transformed tissues. IHC is relatively rapid and simple method to better determine the specific neoplastic tissue origin, the behavior or progression of neoplasm. Hence IHC have gained importance in the medical research and has been considered as a crucial & widely used technique in research laboratories as well as in clinical diagnostics. In present review IHC markers for epithelial origin that can be utilized to diagnose the tumor or to determine the prognosis of the tumor.. Keywords: Immunohistochemistry, Antigen, Antibody labeling, Epithelial origin markers.

Introduction: Thyroid lesions usually present as mass lesions or in association with hypo or hyper thyroidism. FNAC has certain limitations like adequacy of specimen and interpretation of cytology, as the sampling of the lesion can be variable and not always representative. Hence, specific diagnosis can be arrived at only after a histopathological examination. Objectives: The present study was undertaken to describe histopathology patterns, frequency, age and sex distribution of non-neoplastic thyroid gland lesions in the southwest region of Maharashtra to aid clinicians in appropriate treatment and prognosis. Materials and Methods: This was a cross-sectional study of 110 non-neoplastic thyroid specimens received at the department of Pathology, D.Y. Patil Medical College, Kolhapur, between October 2018 to September 2020. Results: The frequency of non-neoplastic thyroid lesions was found to be 2% of all surgical specimens. Most commonly encountered specimens were of Hemithyroidectomy (31.8%) Female predominance with F:M ratio of 2.5:1 was seen. Most of the lesions occurred in the 4t h decade. Out of the 110 cases, most common lesions were hyperplastic (74.5%), followed by inflammatory lesions (21.8%) and congenital lesions (3.7%). Evaluation of any thyroid specimen should be thorough through complete histopathological examination. Conclusion: Histopathological evaluation of any enlarged thyroid should be thorough to arrive at a definite diagnosis. Keywords: Thyroid, Nonneoplastic lesions, Histopathology, Goitre.

Genitourinary tuberculosis is uncommon and mostly involves kidneys, seminal vesicles and epididymis. Isolated prostatic tuberculosis is rarely reported and is an under recognized entity. Here, we report such a case which clinically mimicked prostatic carcinoma and was subsequently diagnosed on image guided needle biopsy. Keywords Prostate, Tuberculosis, Prostatic carcinoma

Fibrocartilaginous dysplasia (FCD) or massive cartilaginous differentiation in fibrous dysplasia are interchangeably used terms. It is a rare variant of fibrous dysplasia (FD) which is benign, lytic, and expansile bone lesion and causes progressive deformity in the bones and may lead to pathological fracture. Radiologically, FCD may confused with cartilaginous benign and malignant bone tumours. FCD usually shows calcification in imaging. Surgical curettage or corrective osteotomy and histopathological examination of these lesions is necessary to differentiate it from other cartilaginous tumours. Here we report case of fibrocartilaginous dysplasia of distal femur in a 4-year-old male child. Keywords: Fibrocartilaginous Dysplasia, Fibrous Dysplasia.

Introduction: The neck swellings, specially of cystic nature, may be of thyroid origin, thymic cysts, thyroglossal duct cysts, branchial cleft cysts, bronchogenic cysts or lymphangiomas depending upon the site of origin. Parathyroid cysts constitute 0.5-1% of all neck cysts and are a rare entity. A strong index of suspicion is required for its correct diagnosis. Here, we report a case of parathyroid cyst in a 40 year old female and the clinicopathological findings which posed a diagnostic challenge, thus highlighting the importance of including parathyroid cysts in the differential diagnosis of neck cysts. Case Report: Fine needle aspiration was performed on the swelling and approximately 20 ml of watery, crystal clear fluid was aspirated from the cyst. Cytological examination was acellular. The fluid PTH level was 23.6 pg/ml, serum calcium was 8.6 mg/dl (normal reference range 8.5-10.1 mg/dl) and serum PTH level was 65.88 pg/ml (normal reference range 15-65 pg/ml. Conclusion: Parathyroid cysts are uncommon benign cystic lesions and may be functional or non functional in nature. FNA is a valuable diagnostic tool along with fluid PTH level. The parathyroid cysts should be included in the differential diagnosis of all anterior cystic neck swellings so that they are not missed or misdiagnosed as thyroid lesions. Keywords: Parathyroid cysts, PTH, FNAC, USG.

Effusions are extremely common and constitute a significant proportion of all cytologic specimens being examined in any laboratory of a general hospital.1 Fluid analysis plays an important role in clinical medicine. The major purpose of examination is for the presence of malignant cells and also to identify the effusion is of inflammatory, non specific and or neoplastic origin. Objectives: 1. To study the age and sex wise incidence of pleural effusions. 2. To study the incidence of non- neoplastic and neoplastic effusions. 3. To study the gross and microscopic features of effusions. Materials and Methods: Two years prospective study was done on 360 specimens of pleural effusions and were analysed. Centrifuged smears were stained and studied with clinical correlation. Results: Out of 360, 342(95%) were non neoplastic and 18(5%) were neoplastic effusions. Commonest malignancy was Adenocarcinoma. Conclusion: Non-neoplastic lesions were common in the study. Exudates were common in infections Tuberculosis), Pneumonia and Malignancy. Keywords: Pleural effusion, Exudate, Malignancy.

Pediatric malignancies especially sarcomas are the most common and predominant cause of mortality in children. Such ongoing efforts are crucial to better understand the etiology of childhood cancers, get better the survival rate for malignancies with a poor prognosis, and maximize the quality of life for survivors. In this review article we authors aim to discuss relatively common benign and malignant connective tissue tumors (soft tissue tumor), focusing on current management strategies and new developments, as they relate to the role of the otolaryngologist– head and neck surgeon. Other rarer paediatric head and neck tumors beyond the scope of this review. Keywords: Pediatric, Sarcoma, Soft tissue, Tumor.

Introduction: Lymphadenopathy is one of the common clinical presentations in patients of all age group. Lymphadenopathy can be due to reactive or infective cause, but malignancy including metastastic deposits in are not uncommon in elderly. Fine needle aspiration cytology (FNAC) is a useful diagnostic rapider in many mass lesions like lymphadenopathy. Aims and Objectives: Three years study was conducted to know the spectrum of diseases causing enlargement of lymph nodes in elderly patients with age 60 years and above. Materials and Methods: We have collected all the clinical data from the registers from June 2014 to June 2017 in Medical records section, KIMS, Koppal and reviewed FNAC slides of lymph node aspirates of elderly. Results: A total of 60 elderly patients of age 60 years and above with lymphadenopathy were included in this study. Cervical group of lymph nodes were the predominant site for lymphadenopathy. The commonest cause of lymphadenopathy was reactive, seen in 29 patients, followed by 23 patients with metastatic deposits and squamous cell differentiation was commonest type. Tubercular and suppurative lymphadenitis were observed in four cases each. CBNNAT is an useful diagnostic modality in microbiological confirmation of tuberculosis. Males showed preponderance of reactive as well as in metastatic lymphadenopathy. Conclusion: Though reactive lymphadenitis is the commonest cause for enlargement of lymph nodes but metastatic deposits are not uncommon in elderly. FNAC as a diagnostic rapider useful screening tool for all elderly patients presenting with lymphadenopathy. Keywords: Lymphadenopathy, Reactive, Metastatic, FNAC, Tubercular, CBNAAT.

Aims & Objectives: 1. To evaluate various causes of postmenopausal bleeding in terms of functional and organic endometrial lesions on histopathological basis, 2. To confirm or to rule out the diagnosis of atypical or malignant endometrial lesions. 3. To help the gynecologists in diagnosis of endometrial cancer as early as possible. Materials and Methods: The study was carried out in the Department of Pathology, GMERS Medical College-Junagadh from January 2015 to September 2018 and includes 200 cases of postmenopausal women who presented with bleeding problems at our institute. Histopathological evaluation of endometrium was done in all these cases after clinical evaluation and final diagnosis was given in terms of organic or functional lesions. Results: Out of 200 cases, 36 cases (18%) showed organic lesions & 164 cases (82%) showed functional lesions. Among organic lesions, Simple & Typical Hyperplasia was the commonest one (12 cases), while among functional lesions, Atrophic Endometrium was the commonest one (88 cases). Atypical and Malignant lesions were commonly seen after 60 years of age. Conclusion: The role of histopathology remains always important in the evaluation of postmenopausal bleeding. Careful histopathological evaluation of endometrium is always necessary in order to confirm or to rule out premalignant or malignant lesions in order to save the patient’s life. Keywords: Postmenopausal Bleeding, Organic Lesions, Functional Lesions.

Introduction: Skin is the largest sensory organ of the body and acts as a barrier against various harmful environmental agents. Thus it is involved in wide spectrum of disorders ranging from inflammatory conditions to neoplastic lesions. Skin biopsy followed by histopathological study is needed for accurate diagnosis, identifying etiological agent with special stains wherever feasible, and to help clinicians to decide the appropriate management. But for instance, only few statistical studies have been carried out in southern India. Thus, the present study was carried out with an aim of describing the histopathological spectrum of all the skin lesions in a tertiary care hospital. Materials and Methods: The present study is a retrospective study carried out in the Department of Pathology, BLDE. (Deemed to be) University, Shri B.M. Patil Medical College, Hospital and Research Centre, Vijayapura, Karnataka. All the skin biopsies received in histopathology section from October 2015 to September 2017 were reviewed from the archives of the department. Results: Out of 286 skin biopsies with histopathological diagnosis, majority of the cases were belonging to group V- granulomatous lesions (154 cases), followed by group III (46 cases), group IV (27 cases) and group VI (27 cases), group VII (16 cases), group II (12 cases) and group VIII (4 cases). Conclusion: Dermatological lesions are heterogeneous with wide age distribution, clinical and histopathological spectrum. Histopathological examination of the skin biopsy remains the gold standard for diagnosis which can be supported with the other techniques to confirm the diagnosis. Keywords: Histopathology, Dermatology and Leprosy.

Background: Fine needle aspiration cytology (FNAC) is a cost-effective diagnostic technique for evaluation of salivary gland lesions. But, then, cytological evaluation of salivary gland lesions also has lot of challenges. To overcome the difficulties, “The Milan system for reporting salivary gland cytopathology” (MSRSGC) was introduced for diagnosis and management and establishing the risk of malignancy (ROM) in different categories. The present study was conducted to grade the salivary gland lesions according to Milan system of reporting and to correlate with their histopathological findings. Material and Methods: The current study was conducted in the department of Pathology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry for a period of 5 years. Around 153 salivary gland lesions were aspirated. Salivary gland swellings were examined clinically, correlated with the details on the request forms and ultrasound findings, palpated and aspirated. The cytological features were evaluated and categorized according to Milan System for Reporting Salivary Gland Cytopathology”: Category 1: Nondiagnostic (ND); Category 2: Non-neoplastic (NN); Category 3:Atypia of undetermined significance (AUS); Category 4a: Neoplasm: benign (NB), Category 4b: Neoplasm:salivary gland neoplasm of uncertain malignant potential (SUMP); Category 5: suspicious of malignancy(SM); and Category 6: Malignant (M). They were further correlated with histopathological findings. All data were entered in MS excel sheet. Results: Total 153 cases were evaluated cytologically, and histological followup was available in 134 cases. The distribution of cases into different categories were as follows Non-Diagnsotic (2.6%), Non-Neoplastic (20.9%), Atypia of Undetermined Significance (1.9%), Neoplastic-Benign (41.1%),Salivary gland neoplasm of Uncertain Malignant Potential (0%), Suspicious of Maligancy (0%) and Malignancy (33.3 %). Risk of malignancy were

Objective: To study histopathological and clinicopathological findings in a case series of Extra Nodal Non Hodgkin Lymphomas (EN NHL). Materials and Methods: 17 cases of primary ENNHLs, collected during a period of November 2019 to November 2020 (one year), wherein the clinical data included age, gender, site, clinical presentation and radiological findings were collected. Haematoxylin and eosin staining was done along with Immunohistochemistry (IHC) using a panel of antibodies depending on the morphology. Result: 17 cases of primary ENNHLs taken. Majority of our patients were from higher age group, presenting in sixth decade, though the age range was wide between 5-92 years. Our study included 12 males and 5 females, with a male: female ratio of 2.4:1. We found retroperitoneal masses and GIT as the most common site for ENNHLs.Weight loss followed by fever was the most common clinical presentation in our study presentation. Ann Arbor Staging was done in 16/17 cases where 35% (6/17) belonged to stage I, 35% (6/17) cases belonged to stage II, 17.6 (3/17) belonged to stage III and 1.5% (1/17) belonged to stageIV. Eastern cooperative oncology group performance scale (ECOG) was also calculated and documented. Conclusion: This study highlights importance of diagnosing Extranodal NonHodgkin’s lymphomas as a separate entity since its clinical presentation, prognosis, staging and management differs from Nodal NonHodgkins lymphoma. Keywords: Immunohistochemistry, Extranodal, NonHodgkin lymphoma.

Introduction: A focal mass or a nodule in the liver has become easily accessible to the needle of a pathologist, courtesy the rising numbers of guided FNAC. Precise localisation of lesions helps in studying the cytological features in greater detail, of the area in question. A targeted needle aspiration achieves high rates of sensitivity and specificity with regard to the varied spectrum of the pathologies encountered in liver especially when correlated with serological tests. Thus present study was carried out with aim to assess the role of guided FNAC in the diagnosis of nodular lesions of liver and to study their cytomorphology. Materials and Methods: It is an observational, prospective study of 130 adequate aspirates from liver nodules done at tertiary care hospital over two year period. All patients presenting with nodular liver mass detected on imaging techniques were selected for FNAC under USG or CT guidance. Another pass was taken from the surrounding liver to ascertain the presence of parenchymal changes like fatty change, cirrhosis and dysplasia. Results: Adequate aspirates from 130 cases were studied. Lesions were categorised into non neoplastic (11) and neoplastic which were further classified benign (1), primary malignancies (31HCC, 4 cholangiocarcinoma) metastasis (72) and undifferentiated malignancies (11) respectively on cytology. Conclusion: Guided FNAC of the liver is a rapid simple and precise method of identifying the pathology in liver nodules. It can be a useful modality to triage the patients and decide further line of management. Keyword: FNAC, Guided, Nodular lesions, Liver, Cirrhosis.

Malignant melanoma (MM) of gynaecological tract represents about 2% cases of all melanomas. Most of the gynaecologic tract melanomas are reported in vulva and vagina. Malignant melanoma of uterine cervix is extremely rare and about 78 cases are mentioned in literature. Primary Malignant melanoma of cervix usually occurs in sixth decade of life and has poor prognosis. We report a case of primary malignant melanoma diagnosed in a young woman of 28 years. Initial diagnosis of malignant melanoma was made on the basis of morphological features revealed in the cervical biopsy obtained from a polypoidal cervical growth. Cervix as the primary site of occurrence of malignant melanoma was confirmed after extensive clinical and radiological evaluation. Radical hysterectomy was the initial treatment. Histopathogical diagnosis was substantiated in this patient with the help of immunohistochemical markers. Keywords: Primary malignant melanoma, Cervix, Diagnosis, Histopathological features.

Extramedullary haematopoiesis (EMH) is usually pathological in adults and has varied causes. In adults, it occurs due to insufficient bone marrow function, ineffective erythropoiesis or stromal disorders of bone. Literature review supports that it can occur at any site. Only very few cases of EMH with leukemic infiltrates in lymph nodes have been reported so far. Here we present a similar case, which was confirmed by histomorphology and immunohistochemistry. Keywords: Extramedullary haematopoiesis (EMH).

Context: Fineneedle aspiration cytology (FNAC) is an important tool in the diagnosis of soft tissue tumours. The method is widely tested in recent years as it is easy, quick, safe and fast compared to histopathology. Aims: Present study is being conducted to study the cytomorphological patterns of soft tissue tumours and find out the efficacy of FNACwhen compared with histopathology aided with immunostains. Settings and Design: Fifty six cases presented with soft tissue swellings were subjected to FNAC. The results were compared with histopathology aided with immunohistochemistry. Materials and Methods: Present study was a prospective study conducted between July 2007 and December 2008 for a period of one and a half year in the department of Pathology of a tertiary care institute. Patients who presented with soft tissue tumours were included in the study. Patients with inflammatory swellings and those in which histopathology was not available were excluded. Fifty six cases presented with soft tissue swelling were subjected to fine needle aspiration (FNA). Findings were compared with histopathology. Immunohistochemistry was used in some cases for exact diagnosis.| Statistical analysis used: sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy. Results: In the primary diagnosis of soft tissue tumours by FNAC, the study showed sensitivity and specificity of 93.75% and 94.4% for malignancy. Overall diagnostic accuracy was 94.4% for both benign and malignant neoplasms. Positive predictive value and negative predictive value was 88.24% and 97.3% for malignancy. Conclusions: FNA of soft tissue tumours yields specific architechtectural patterns and cytological details. FNAC helps in the initial management of soft tissue tumours as it is rapid and fairly accurate. Keywords: Soft issue tumours, Cytology, Patterns, Histopathology.

Primary cutaneous mucinous carcinoma is a rare adnexal neoplasm of eccrine origin. Most of the cutaneous mucinous carcinomas are metastatic, commonly from gastrointestinal tract and breast. Primary cutaneous mucinous carcinoma was first described in 1952. Only about 200 cases are reported in literature till date. Only a couple of case reports describing the cytological features are available. We report a case of a 70 years old male presenting with nodular lesion on cheek, which was cytologically diagnosed as mucinous neoplasm and later on confirmed on histology and histochemistry to be primary cutaneous mucinous carcinoma. A thorough radiological and clinical workup to rule out the possibility of metastatic deposit of mucinous carcinoma was done. Keywords: Primary cutaneous mucinous carcinoma, Eccrine, Metastatic.

Squamous cell carcinoma of kidney is the extremely rare entity of upper urinary tract neoplasm. The most common type of kidney cancer is clear cell renal cell carcinoma followed by papillary and chromophobe renal cell carcinoma. We report a case of renal cell carcinoma who presented with complaints of pain abdomen and hematuria. Radiologic investigation showed a renal mass and calculi in the left kidney. The patient subsequently underwent left radical nephrectomy. Pathological diagnosis of SCC of idney was made.We report a rare case of primary renal squamous cell carcinoma involving whole of the kidney. With the best of our knowledge, only few cases of primary renal squamous cell carcinoma are reported. Keywords: Squamous, Nephrolithiasis, Hydronephrosis, Pelvicalyceal System, Chromophobe.

Renal replacement lipomatosis (RRL) is a rare condition that occurs as an end result of renal atrophy or replacement of renal parenchyma by excessive lipomatous tissue in renal sinus and perinephric space. We reported a case of RRL presented in our tertiary health centre. Left Nephrectomy was performed kidney sent to our department for histopathology examination and after extensive literature search, a diagnosis of RRL was given. In majority of cases, RRL is associated with renal calculi. Idiopathic variety of RRL is not common. It is a rare entity and due to lack of experience the diagnosis may be missed. It has to be differentiated from other fat-containing tumors such as xanthogranulomatous pyelonephritis, renal lipomas, liposarcoma and angiomyolipoma. Keywords: RRL (Renal Replacement Lipomatosis), Idiopathic, Nephrectomy, Adipose tissue.

Background: Skin adnexal tumours are heterogenous group of uncommon tumours having distinct histological features. They have varied clinical presentation and morphological differentiation towards one or more types of adnexal structures found in normal skin. The aim of this study was to study the different histomorphological patterns of appendageal tumours and correlate them with clinical presentations. Materials and Methods: This was a retrospective study of three year duration of all cases clinically diagnosed to be appendageal tumours and confirmed by histopathology in our department. The tumours were classified according to their differentiation after a detailed histopathological examination in haematoxylin and eosin sections. Results: The total number of cases in the study were 43,in which 28 were males and 15 females. Most of the tumours (97.7 %)were benign and there was only one case sebaceous carcinoma. The majority of the tumours had an eccrine differentiation (30.9%), nodular hidradenoma among them being the most common lesion (20.9%). Trichilemmal cyst (30.2%) constituted the maximum cases of pilar origin. Conclusion: Skin adnexal tumours are relatively rare with benign ones being more common than the malignant tumours. Proper clinical correlation and histopathological study helps in reaching a correct diagnosis. Keywords: Appendageal, Skin tumour, Eccrine, Nodular hidradenoma, Sebaceous carcinoma.

Gastrointestinal Basidiobolomycosis (GIB) is an unusual fungal disease caused by Basidiobolus ranarum, seen in the stomach, small intestine, colon, and liver. It has been rarely reported in the literature and most of the reported cases have been from US, Saudi Arabia, Kuwait, and Iran. Basidiobolus ranarum is an environmental saprophyte found worldwide. It is a member of the order Entomophthorales of the class zygomycete. The infection is generally restricted to subcutaneous tissues but the disease can also involve visceral organs.GIB usually has nonspecific clinical manifestations and its diagnosis is more challenging. Delayed diagnosis of GIB increases the risk of morbidity and mortality, especially in pediatric patient. The plan of our case report is to illustrate the wide range of clinical presentations, clinico-radiological and histopathological diagnosis, management and outcomes. Keywords: Basidiobolomycosis, Gastrointestinal, Pediatrics, Malignancy, Entomophthorales, Immunocompetent.

Background: Intra-operative cytology (IOC) is a method of intra-operative pathological evaluation of cytology smears. The most important indication for IOC is to establish or confirm diagnosis rapidly. Other advantages of IOC are its simple, inexpensive, excellent preservation of cellular details, with no loss of tissues as occurs with cryostat sections and adequacy of surgical margins. Frozen sections are well established method for providing rapid and accurate intra-operative diagnosis. Objective: To evaluate the diagnostic utility of imprint cytology and assess the accuracy of imprint cytology with histopathological diagnosis obtained from ovarian neoplasm. Materials and Methods: Imprint smears were prepared immediately from all the ovariotomy specimens. The specimens were sent for histopathology along with prepared smears to categorize as benign, borderline and malignant. Sensitivity, specificity and accuracy were assessed. Results : Among the 99 specimens studied, 80 were benign, 9 borderline and 10 malignancy according to histopathology. We found that sensitivity, specificity, for benign lesions were 100%, 42.1% and for malignant lesions were 80%, 91.9% respectively. The overall accuracy was 89%. Conclusion : Imprint smear of ovarian neoplasm gives a rapid diagnosis with 89% accuracy against histopathology with added advantages. Imprint cytology is an adjunct to frozen section for providing an intra-operative diagnosis; however, in resource poor settings, it can be used as a stand-alone method for aiding intra-operative decision making. Keywords: Imprint smear, Histopathology, Ovarian neoplasm, Intraoperative cytology.

Backgraound: Lymphadenopathy is a common clinical problem and biopsies done to know the cause of nodal enlargement may be neoplastic or non-neoplastic. Neoplastic lesions are mainly lymphohematogenous malignancies and metastases while non-neoplastic lymphadenopathies are varied. This study was undertaken to determine the histopathological spectrum of lymphadenectomies. Materials and Methods: This was a descriptive study wherein 516 cases of histologically diagnosed peripheral lymph node biopsies from Aug 2016 to July 2019 were reviewed. Surgical resection specimens with lymph node dissection were excluded from the study. Results: Neoplastic lesions were 47.68% (246 cases) consist of 21.5% (111 cases) of non-Hodgkin lymphoma, 17.6% (91 cases) of Hodgkin lymphoma and 8.5% (44 cases) of metastatic lesions. The nonneoplastic lesions were 52.32% (270 cases), which included 21.1% (109 cases) of tuberculosis followed by follicular hyperplasia, 9.5% (49 cases), chronic lymphadenitis 8.9% (46 cases). Conclusions: Lymphoma was the most common cause of biopsied lymphadenopathy in our study (NHL comprising 21.5% and HL comprising 17.6%) followed by tubercular lymphadenitis (21.1%). Keywords: Lymph Node, Non-neoplastic diseases, Hodgkin lymphoma, Non Hodgkin lymphoma.

Growing teratoma syndrome (GTS) is a rare entity which presents as metastasizing large masses of mature teratoma during or after the course of chemotherapy of non seminomatous germ cell tumours of testis or ovary. Somatic malignancy arising in growing teratoma syndrome is much rarer. Patients with growing teratoma syndrome require close follow up as there is a risk for somatic malignancy. We report a case of squamous cell carcinoma arising in growing teratoma syndrome in her second recurrence. There is no documented such cases in the literature until now. Keywords: Growing teratoma syndrome, Somatic malignancy, Squamous cell carcinoma.

Background: Non-infectious granulomatous dermatitis is a distinctive reactive inflammatory condition. They are relatively difficult to diagnosis and distinguish both clinically and histologically and most of them are associated with systemic diseases that impact on the overall prognosis. Present study aims at classifying the non-infectious granulomatous dermatitis based on morphology of granulomas, for making an accurate diagnosis. The definitive diagnosis of the granulomatous lesions of skin with identification of etiological agent is very essential for specific treatment and an appropriate desirable outcome. Aims and Objectives: To study the histomorphology of various non- infectious granulomatous dermatitis of skin and classify them, accordingly into different categories. Materials and Methods: A total of 2,690 skin biopsies received to the department of pathology over a period of five year (Jan 2011-Jan 2016) were objectively reviewed using different staining technique. Noninfectious granulomatous dermatitis were identified and classified into different types based on morphology, etiology and also compared among different age groups and genders. Results: Out of total 2,690 skin biopsies received, 314 cases exhibited granulomatous reaction pattern. Among the granulomatous lesions of skin, non-infectious granulomas were seen in 77 cases (2.8%). Among the non-infectious granulomas majority of the cases were mixed cell granuloma seen in 45 cases (58.44%), palisading granuloma in 19 cases (24.67 %), non-specific granulomas/miscellaneous in 10 cases (13 %) and epithelioid cell granuloma without necrosis granulomas in 3 cases (3.9 %). Conclusions: Knowledge of histomorphology of non-infectious granulomatous dermatitis is very important to understand and detect the early and old lesions of dermatitis. This helps in guiding and planning the therapeutic approaches of the dermatitis. Keywords: Histomorphology, Skin, Foreign body, Rheumatoid nodule.

Skin adnexal tumours are a heterogeneous group of uncommon and rare tumours usually misdiagnosed clinically due to different types and similar presentation. They include a diverse group of benign and malignant neoplasms. They may present as single or multiple lesions and can be sporadic or familial in inheritance. They might be a superficial manifestation of an internal malignancy. Benign lesions are more common but malignant tumours are rare and locally aggressive, with potential nodal and distant metastasis with a poor clinical outcome. Histopathology is the basis of critical diagnosis, which has therapeutic and prognostic implications. Here we report a case series of skin adnexal tumours with aggressive behaviour on histopathology which appeared benign clinically. This case series emphasises the need for early detection and proper follow up of skin adnexal tumours to reduce the morbidity and mortality. Keywords: Adnexal Tumours, Benign, Histopathology, Malignant, Skin.

Introduction: Breast lesions are leading cause of morbidity and mortality in women worldwide. Fine Needle Aspiration (FNA) is an affordable, minimally invasive and rapid method. It is gaining importance as a preoperative procedure to distinguish benign and malignant breast lesions. Thus unnecessary invasive procedures can be avoided. This study is undertaken to explore utility and accuracy of FNA in various breast pathologies. Objectives: 1) To study cytology of various breast lesions, 2) To correlate cytological diagnosis with histopathological diagnosis wherever possible, 3) To study sensitivity, specificity and accuracy of FNA in breast lesions Materials and Methods: A two year prospective study was carried out from November 2017 to November 2019 at Department of Pathology, JJM Medical College – Davangere. This study included patients with breast lesions referred for FNA. FNA was done. Cytomorphological features were studied. Cytomorphological diagnosis was correlated with histopathological diagnosis wherever possible. Results: Out of 425 patients with suspected breast lesions, cyto-histo morphological correlation was possible in 331 cases. Cytology histology concordance was 94.4%. This study has sensitivity of 90.1%, specificity of 96.5% and accuracy of 94.1%. Conclusion: FNA is highly simple, safe and effective technique. It should be an essential component in preoperative diagnosis of breast lesions. Keywords: Breast, Fine Needle Aspiration Cytology, Classification.

Introduction: Effusion cytology have gained acceptance worldwide in analysing body fluids, and a positive diagnosis renderedon cytomorphologyis often considered as a definitive diagnosis for further work up. However due to the known limitations, diagno stic problems arise in routine practice to differentiate reactive versus atypical mesothelial cells and malignant cells by the routine conventional smear (CS) method, thereby warranting adjunct studies like cell block techniques to enhance its efficacy Aims: To compare and analyse the cytomorphological features of the conventional cytosmears with those of the cell block sections and also to assess the utility and sensitivity of the cell block method in picking up the definitive diagnosis of pleural effusions. Materials and Methods: The study was conducted in the cytology section of the Department of Pathology, MGMCRI, SBV, Puducherry. Overall 50 pleural fluid samples were subjected to diagnostic evaluation for over a period of 18 months. Along with the conventional smears, cell blocks were prepared from the remnant fluid using Thromboplastin- pooled plasma method. Histopathology samples were obtained in feasible cases Results: Cellularity yield was low in cytosmears and was enhanced when combined with cell block method especially in non diagnostic /hemorrhagic samples, suspicious cases for malignancy, the efficacy was increased by a margin of 20 % more by the cell block method. Also pattern analysis was possible in Cell block and to categorize primary versus metastatic. Conclusions: The cell block method provides high cellular yield, architectural patterns analysis, morphological features and aids in categorizing primary and metastatic effusions thereby, increases the efficacy of effusion cytology serving as a bridge between cytology and histopathology. Keywords: Cell block conventional smear pleural effusions sensitivity.

Sinonasal papilloma is a benign surface mucosal neoplasm with variable growth pattern and cytological features. It is a rare benign tumor with tendency to recur and also malignant transformation. The most common sites of inverting papillomata are lateral nasal wall and middle meatus and are usually unilateral. Rarely Bilateral disease can occur, which may be due to direct extension of the tumour, but can also occur as two distinct lesions. The etiology still remains unclear, eventhough the morphology and clinical behavior of this lesion has been well described. Here we report a case of recurrent bilateral nasal polyposis, histologically diagnosed as Inverted sinonasal papilloma, which is a rare entity. Keywords: Sinonasal papilloma, Bilateral, Pathology.

Placental mesenchymal dysplasia (PMD) is a rare clinicopathologic entity characterized by placentomegaly and USG features of grape like vesicles resembling partial mole. The gross findings of abnormally enlarged placenta with dilated or aneurysmal blood vessels with histologic evidence of edema of the stem villi with thick walled blood vessels and characteristic absence of trophoblastic proliferation is suggestive of PMD. PMD usually involves a normal fetus, but can be associated with intrauterine growth restriction, still birth and Beckwith Weidmann syndrome in a significant number of cases. Although rare in combination with PMD, it is known to have a poor prognosis than foetuses without structural abnormalities.We report a case of 28 year old second gravida with PMD who delivered a preterm baby with mesenchymal hamartoma, with a favourable outcome in the fetus. Keywords: Placental mesenchymal dysplasia (PMD)

Introduction: Lymph nodes are important components of peripheral or secondary lymphoid organs which play a huge role in immune response. Aim: To study cytomorphological features and incidence of various lymph node lesions in patients ?18 years. Materials and Methods: The data has taken from 100 patients of ?18 years having lymph node lesion presented at central clinical laboratory for Fine Needle Aspiration cytology examination. FNAC was done in all cases & correlated with their clinical data. Results: Interpretation of their cytology examination is showing that in our tertiary care centre most common lymph node lesion in patient ?18 year is granulomatous lymphadenitis(44%) followed by reactive lymphadenitis (37%), Acute inflammation(06%), Abscess formation (05%), Cystic lesion (03%), and Leukemic infiltration (02%). Most affected age is 6 to 10 years. Conclusion: Granulomatous & Reactive lymphadenitis are common causes of lymphadenitisin ?18 years age group. Among this study 6-10 years are more affected age group. These result can be obtain by Fine Needle Aspiration cytology examination. Keywords: Fineneedle aspiration cytology, lymph node, lymphadenitis.

Chronic Myelogenous Leukemia (CML) is a chronic myeloproliferative neoplasm characterised by uncontrolled proliferation of mature and maturating granulocytes. In our case 42 year male over a period of 13 months showed blastic transformation with severe thrombocytopenia, disseminated intravascular coagulation and bleeding. Herewith we present this case for its clinical behaviour, hematological findings and disease course. Keyword: Myeloproliferative Neoplasms, Blast crisis, Leukemia.

Choriocarcinoma is a uncommon malignant genital neoplasm, which is classified as either gestational choriocarcinoma or nongestational choriocarcinoma. Gestational trophoblastic diseases were first described in 400 BC by Hippocrates. It is a rare and aggressive neoplasm. Choriocarcinoma have very different biological behavior, prognosis and metastasis. The aim of this case reports was to examine the clinical characteristics, Radiological and histopathological features of gestational choriocarcinoma patients with treatment of this rare disease. Keywords: Choriocarcinoma, Syncytiotrophoblasts.

Background: Angiolymphoid hyperplasia with eosinophilia, a benign vascular tumor is a rare entity. It is characterized by abnormal proliferation of blood vessels with mixed inflammatory infiltrate in the background. Case: We present a case report of Angiolymphoid hyperplasia with eosinophilia in a women of age 47 years. She presented with multiple nodules in the temporal region of scalp. Her IgE levels were normal. Chest X-ray and Skull X-ray was unmarkable and histologically proven to be angiolymphoid hyperplasia with eosinophilia. Result: Multiple nodular lesion in the scalp was diagnosed as Angiolymphoid hyperplasia with eosinophilia. Conclusion: Angiolymphoid hyperplasia with eosinophilia, though a rare entity should be kept in mind for early intervention. Keywords: Angiolymphoid hyperplasia with eosinophilia, Nodule, Vascular neoplasm.