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Presence of additional copies of Philadelphia chromosome (Ph) is characteristic of chronic myeloid leukemia in blast crisis, very rarely observed in de novo acute lymphoblastic leukemia (ALL). Ph positive (Ph+ve) ALL and CML in lymphoid blast crisis (CML-LBC) are biologically different with divergent clinical course. Double Ph+ve ALL has little data available as to its incidence and prognostic significance. We studied five cases of Ph+ve precursor B-cell ALL having an extra copy of Ph chromosome with regard to their clinical and laboratory features. An extensive review of literature was done on prognostic significance and molecular aspects of double Ph in ALL. The study confirms that double Ph was a rare phenomenon in precursor B-cell ALL. It is observed that molecular basis of double Ph positive ALL is less understood compared to CML in blast crisis. The study highlights fundamental role of cytogenetic and molecular studies in diagnosis and management of these patients. Long-term follow-up studies on a larger group of patients are required to understand the prognostic impact of extra Ph in Ph+ve ALL, which is usually resistant to standard chemotherapeutic regimen and often requiring bone marrow transplantation., Supplementary Information: The online version contains supplementary material available at 10.1007/s12288-022-01525-1., Competing Interests: Conflict of interestThe authors have no conflicts of interest to declare that are relevant to the content of this article., (© Indian Society of Hematology and Blood Transfusion 2022.)

Introduction: Neuroblastoma (NB), Wilms tumor (WT), hepatoblastoma (HBL), germ cell tumors (GCT), rhabdomyosarcoma (RMS), and so forth are the commonly identified solid tumors in infants. Invasive diagnostic techniques are more challenging in infants than older children. fine needle aspiration cytology (FNAC) is a safe, minimally invasive and outpatient procedure which is time and cost-effective for solid tumor diagnosis. This study aims to evaluate the role of FNAC in the diagnosis of various infantile solid tumors., Methods: In this retrospective study, 61 cases of FNA of infant solid tumors were retrieved from the cytology archives over a period of 5 years from January 2013 to December 2017. Cytomorphology was studied and immunohistochemistry on cell block was performed wherever feasible. Histopathological correlation was done in 19 cases., Results: Of the 61 cases studied, 60 cases were included in the study of which 35 were male and 25 were female. Infantile solid tumors constituted 7.3% of all pediatric solid tumors reported in cytopathology division of our Institute. The most common final diagnosis was NB (15, 25%) followed by HBL (13, 21.6%), WT (10, 16.6%), RMS (nine, 15%) and GCT (nine, 15%). The commonest site was abdominal-pelvic (42, 70%). A definitive independent diagnosis could be made on FNA in 48 cases (80%). Follow-up was done for 1.5 to 4 years (mean 26 months). The highest and lowest mortality was noted in NB (64.3%) and WT (12.5%) respectively., Conclusion: This study concludes that FNAC can be adopted as a diagnostic modality in infant solid tumors., (© 2021 Wiley Periodicals LLC.)

Synovial sarcoma is a mesenchymal neoplasm that shows a specific t(X;18) translocation that leads to the formation of SS18-SSX gene fusions and is most commonly seen in soft tissues of the extremity. The gastrointestinal tract is a very rare site of involvement. We report a case of primary gastric synovial sarcoma in a 13-year-old male child. Synovial sarcoma should be included in the differential diagnosis when spindle cell neoplasms are encountered in the stomach. A high degree of suspicion, followed by the necessary immunohistochemistry and molecular studies, is required to make an accurate diagnosis.

Background: Variety of substances such as tobacco, UV radiation, infrared rays, X-radiations, and chemicals on oral induction results in chromosomal aberrations and production of micronucleus (MN). Among them, tobacco-specific nitrosamines are potent mutagenic agents causing oral cancer., Objective: The objective of the study is to compare the genotoxicity in buccal mucosal cells, i.e. the MN count of all groups and to find the incidence of micronucleated cells (MNCs) in accordance to duration and frequency of tobacco usage and timing of contact of tobacco in the oral mucosa., Materials and Methods: Individuals without any oral diseases were divided into 3 groups having 25 in each group: smoking, chewing, and control. Smears were made from buccal exfoliated cells and stained with DNA-specific Feulgen stain. Frequency on MNC per 500 cells was assessed with one-way ANOVA and Tukey HSD multiple comparisons test and mean rank with Kruskal-Wallis test., Results: The mean micronucleus MN revealed that chewers had 8.00, smokers had 7.20 and controls had 0.4. The ANOVA test for mean frequency of micronucleated cell MNC revealed High significance (<0.001) for between groups comparison. The mean rank by Kruskal Wallis test revealed the MNC increases as the duration and frequency of habit increases. An increase in MNC in accordance to time of contact with buccal mucosa increases as the duration and time increases., Conclusion: Estimation of MN serve as an indicator of genetic damage and points that tobacco in chewing form induce genotoxic effect. This is studied in an easily accessible tissue- buccal mucosa in a non invasive manner., Competing Interests: None

Competing Interests: There are no conflicts of interest.

Tumors arising from urachus in children are exceedingly rare and sporadically reported in literature. Being a midline structure, the urachus may harbor neoplastic germ cell elements and can occasionally present as a case of acute abdomen. A 20-month-old toddler presented with spontaneous rupture of an urachal yolk sac tumor causing hemoperitoneum. He underwent resection, received platinum-based chemotherapy and presently remains well on follow-up. Despite its rarity, urachal germ cell tumors must be considered in a child with acute abdomen and tumor markers must be measured preemptively in such cases.

Background: Of the overall 9.5 million deaths annually in India, nearly 100,000 are due to organ failure. To save and extend lives, organ donation and organ transplantation have become the only hope. Health care professionals (HCPs) are a key element in facilitating cadaveric organ donation process., Objective: To assess and compare the knowledge, attitude, and practice regarding organ donation among undergraduate dental students., Methods: A cross-sectional study was conducted among 298 undergraduate dental students of the Panineeya Institute of Dental Sciences and Hospital, Hyderabad, India. A 27-item self-administered questionnaire, which assessed the levels of knowledge (Q1-13), positive attitude (Q14-24) and practice habits (Q25-27) regarding organ donation with dichotomous scale (Yes/No)., Results: As compared to males, females reported better mean±SD scores in knowledge (8.22±1.51) and practice (0.91±0.8); higher mean±SD attitude scores (8.55±1.56) were reported among males (p<0.001). While second year dental students had higher scores for their knowledge (8.55±1.56) and practice (1.02±0.44) compared to other year of training, third year students showed a significant higher mean attitude score (1.73±1.17) (p=0.02). Hindus and Muslims scored significantly lower mean knowledge, attitude and practice habits compared to others (Christians, Jains and Athesists) (p<0.001). There was a positive correlation between mean knowledge, attitude, and practice habits., Conclusion: There are an average level of knowledge and low levels of positive attitude and practice habits among studied dental students towards organ donation and transplantation.

Background: The Ewing sarcoma family of tumors (ESFT) are aggressive malignant tumors with small round cell morphology affecting mainly children and adolescents. The aim of this study is to classify the histological diversity and clinical characteristics of ESFT in children from a Tertiary Care Center in South India., Materials and Methods: This retrospective descriptive study includes 51 cases of ES in children aged below 15 years. Clinical details were collected from case files. Histomorphological features were reviewed and tumors were subtyped into classic, primitive neuroectodermal tumor (PNET) and atypical variants along with immunohistochemical markers, cytogenetics, and fluorescence in situ hybridization (FISH)., Results: Fifty-three percent were female and 47% were male with mean age of 10 years. The most common site of involvement was skeletal involvement in 71%, followed by soft tissue involvement in 23%, and visceral involvement in 6%. Localized disease at presentation was seen in 44%, locally advanced disease in 28%, and metastatic disease in 28%. Recurrence was documented during follow-up in 18% of the cases. Histomorphologically, classic type was the most common (72%) followed by PNET (20%) category and atypical variant (8%). All cases were immunoreactive for CD99. Cytogenetic study in 12 cases showed translocation t(11;22) (q24;12) in 80% and variant translocations such as t(3;16), t(3;11) with nonspecific numerical abnormalities in 20%. FISH was carried out for documentation of four cases with atypical histomorphology., Conclusion: ESFT had wide histological variation which required confirmation by ancillary studies.