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Byline: Siddhi. Sinai Khandeparkar, Priya. Bagale, Smita. Pathade, Bageshri. Gogate, Shivani. Battin We report a case of anaplastic lymphoma kinase-positive anaplastic large T-cell lymphoma (ALK+ALCL) presenting primarily as a sinonasal [...]

Byline: Siddhi. Sinai Khandeparkar, Lokesh. Fegade, Bageshri. Gogate, Nikhil. Talathi About 6-10% of all intracranial tumors arise in or involve the cerebellopontine angle (CPA) of which most are schwannoma (80%) [...]

Byline: Tejal. Khande, Avinash. Joshi, Siddhi. Khandeparkar, Maithili. Kulkarni, Bageshri. Gogate, Aniket. Kakade, Piyush. Sahu, Chaitnya. Khillare Background: Breast cancer (BCA) is the second most common cancer among women in [...]

Introduction: Mediastinum is the central portion of the thoracic cavity, compartmentalization of which into anterior, middle, and posterior compartments is useful in understanding the vast diversity of pathological lesions in this space. Cysts, inflammatory lesions, various primary, and metastatic tumors are found in this region, which tend to have a predilection for specific area of mediastinum depending on histopathological type. Objective: The objective was to study the clinicoradiological features and histopathological findings in patients presenting with mediastinal masses in a tertiary care hospital over a period of 10 years. Materials and Methods: This is a retrospective cross-sectional study of cases presenting as mediastinal lesions. Detailed clinical history and radiological findings were noted wherever available. Histopathology and immunohistochemical slides were reviewed. The data were analyzed using mean and percentage. Results: Twenty-four cases of mediastinal lesions were found in this study. It included 4 nonneoplastic lesions, 12 benign, and 8 malignant neoplastic cases. The age ranged from 3 months to 79 years. About 18 cases (64%) were located in the anterior mediastinum, and thymoma (8/18) was the most common lesion. One case each of pericardial cyst, bronchial cyst, and Hodgkin's lymphoma were seen in the middle mediastinum. Three cases of schwannoma and one case of neuroendocrine carcinoma were seen in the posterior mediastinum. Pan-cytokeratin, lymphoma panel, neuroendocrine markers, and placental alkaline phosphatase were done in neoplastic lesions to confirm the diagnosis. Conclusion: This study reflects the varied mediastinal lesions and importance of triad of clinical, radiological, and meticulous immunohistopathological examination for arriving at an appropriate diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Oral squamous cell carcinoma (OSCC) is the most common malignant tumor occurring in the oral cavity. Aim: The present study was conducted to evaluate the biomarkers such as epidermal growth factor receptor (EGFR), human epidermal growth factor receptor 2 (HER2/neu), p53 and Ki67 expression in OSCC cases, and its correlation with other well-established clinicopathological parameters. Materials and Methods: Seventy cases of OSCC cases diagnosed between 2015 and 2019 were included in the study. A technique of manual tissue microarray was employed for the analysis of expression of IHC markers such as EGFR, HER2/neu, p53, and Ki67 in all cases. Results were subjected to the statistical analysis. Results: A statistically significant positive association was noted between EGFR expression and tumor grade, tumor stage, and p53 immunoexpression in OSCC cases. Increased EGFR expression was noted insignificantly in OSCC cases with lymph node (LN) metastasis and Ki67 positive cases. Statistically significant positive association was noted between HER2/neu expression and tumor grade and stage of oral SCC cases. Increased HER2/neu expression was noted insignificantly in OSCC cases with LN metastasis, p53 and Ki67 positive OSCC cases. A statistically significant positive association was noted between percent of tumor cells expressing EGFR, HER2/neu, p53 and Ki67, and grade of OSCC. Conclusion: This study intends to document prognostic utility of EGFR and HER2/neu expression in OSCC cases in the Indian setting and contribute to the data pool which could aid in formulating individual tailored therapy that includes targeted therapy in oral SCC cases. [ABSTRACT FROM AUTHOR]

Introduction: Breast carcinoma (BCa) is one of the most common cancers among women globally. Increased vimentin expression has been reported in various epithelial cancers. Aim: This study examines the expression of vimentin in BCa and its correlation with various prognostic factors such as tumor size, histological grade, lymph node status, estrogen receptor (ER), progesterone receptor (PR), HER2/neu, and Ki67 status. Materials and Methods: Seventy cases of BCa diagnosed between 2014 and 2015 were included in the study. A technique of manual tissue microarray was employed for the analysis of expression of immunohistochemical (IHC) markers such as vimentin, ER, PR, HER2/neu, and Ki67. Results were subjected to statistical analysis. Results: Vimentin was found positive in 53 (75.7%) cases of BCa, of which 18 cases (25.7%) were triple-negative BCa (TNBC). Positivity for ER, PR, Her2, and Ki67 was 32.8%, 31.4%, 60%, and 99%, respectively. Vimentin expression was significantly associated with ER negativity. All 53 cases expressing vimentin showed positive Ki67 labeling index; however, this was not statistically significant. Maximum vimentin expression was observed in the age group >50 years, postmenopausal women, BCa cases showing lymphovascular invasion (LVI), axillary lymph node metastasis, higher stage and higher grade of tumor, negative PR expression, and positive HER2/neu expression. However, this was not statistically significant. In TNBC, vimentin expression was significantly associated with histological grade and LVI. Conclusion: Vimentin expression was associated with well-established poor prognostic factors of BCa. Vimentin expression if routinely included in histopathology report would aid in better understanding of tumor behavior. [ABSTRACT FROM AUTHOR]

Synchronous malignancies of breast and thyroid have been rarely documented in literature. The reports of secondary malignancies after thyroid cancer and treated breast cancer are relatively not uncommon. We encountered a case of thyroid tumor coexisting with carcinoma of breast. On histopathological and immunohistochemical (IHC) studies, the thyroid was involved by medullary carcinoma and the breast revealed invasive ductal adenocarcinoma. The rarity of this association has prompted us to report this case [ABSTRACT FROM AUTHOR]

Malignant peripheral nerve sheath tumor (MPNST) is very uncommon tumor of parotid gland and it is an uncommon spindle cell sarcoma accounting for approximately 5% of all soft-tissue sarcoma. There is strong association between MPNSTs and neurofibromatosis (NF-1) and previous irradiation. Structural abnormality of chromosome 17 is associated with NF-1 and so MPNST. We present a case of a 78-year-old male presenting with slowly growing parotid mass who underwent tumor resection. [ABSTRACT FROM AUTHOR]

Introduction: Papillary squamotransitional cell carcinoma (PSTCC) arising from the uterine cervix is a distinctive histomorphological subtype of squamous cell carcinoma (SCC) not otherwise specified (NOS) of cervical epithelial tumors., Aim: The present study was undertaken to study the histopathological features and immunoexpression of CK7, CK20, p53 and Ki-67 in PSTCC of the cervix., Materials and Methods: This study included 43 cases of PSTCC of cervix. A technique of manual tissue array was employed along with IHC staining of entire section in some cases. The expression pattern of CK7, CK 20, p53 and Ki67 in PSTCC was studied and clinico-pathological correlation of various parameters with IHC expression of CK7 and CK20 was observed. Results were subjected to statistical analysis and were considered significant when the p-value was less than 0.05., Results: Out of 43 PSTCC cases, there were 38 squamotransitional type and 5 papillary type. Histomorphologically, all the cases studied were having fused papillae with rounded contours and fibrovascular cores with highest number of cases having intermediate cell type morphology (86%). Stromal invasion was seen in 74.4% of cases. Koilocytosis were seen in 39.3% of cases. Thirty-two cases showed CK7 immunopositivity (+) and CK20 immunonegativity (-), nine cases were both CK7 and CK20 - and two cases were CK7- and CK20+. Among them 90.7% cases were p53 positive and all cases were positive for Ki67 immunostaining with highest number of cases showing moderate proliferative activity (74.4%); followed by nine cases showing high (20.93%) and two cases showing low proliferative activity (4.65%)., Conclusion: The distinct histomorphology and CK7/CK20 immnunoprofile of PSTCC along with Ki67 and p53 could help in arriving at an accurate diagnosis as well predicting its biological behavior.

Background: Cervical intraepithelial neoplasia (CIN) II and CIN III have a high progression rate to invasive squamous cell carcinoma (SCC). Histopathological assessment is known to have intra and inter-observer diagnostic discrepancies even among two panels of pathologist. Subsequently, to improve on the accuracy of histopathological examination, various IHC biomarkers have been evaluated in the biopsy of cervix., Aim: The present study was undertaken to evaluate the immunoexpression and interrelationship of p16INK4A, MIB-1 and CK17 in histopathologically diagnosed cases of CIN and invasive cervical carcinoma (ICC) which could aid in differentiating CIN and ICC from benign cervical lesions., Materials and Methods: This study included 120 cases of cervical lesions; out of which 20 cases were each of negative for malignancy/dysplasia (NED), CIN I and CIN III, 10 cases of CIN II and 50 cases of ICC. A technique of manual tissue microarray was employed for the study of immunohistochemical markers such as p16INK4A, CK17 and MIB-1 in all cases. Results were subjected to statistical analysis., Results: The difference in p16 immunoexpression between NED (0/20, 0%) and CIN+ICC (97/100, 97%) cases was statistically highly significant. (p<0.01) The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy of p16 immunoexpression in comparison to histopathological diagnosis was 97%, 100%, 100%, 86.96% and 97.5% respectively. The overall agreement of p16 staining with histopathological diagnosis was 97.5% (?=0.9151 i.e. very good) The difference in MIB-1 immunoexpression between CIN-I (6/20, 30%) and CIN II+III (30/30, 100%), CIN (36/50,72%) and ICC (50/50, 100%) cases was statistically highly significant. (p<0.01) The difference in MIB-1 immunoexpression between NED (0/20, 0%) and CIN+IC (86/100, 86%) cases was statistically highly significant. (p<0.01) The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy of MIB-1 immunoexpression in comparison to histopathological diagnosis was 86%, 100%, 100%, 58.82% and 88.33% respectively. The overall agreement of MIB-1 staining with H&E diagnosis was 88.33%. (?=0.6719 i.e. good) The difference in CK17 immunoexpression between CIN-I (11/20, 55%) and CIN-II+III (26/30, 86.67%) cases was statistically significant. (p=0.030) The difference in CK17 immunoexpression between CIN (37/50, 74%) and ICC (46/50, 92%) cases was statistically significant. (p=0.033) The difference in CK17 immunoexpression between NED (0/20, 0%) and CIN+ICC (83/100, 83%) cases was statistically highly significant. (p<0.01) The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy of CK 17 immunoexpression in comparison to histopathological diagnosis was 82%, 100%, 100%, 52.63% and 85% respectively. The overall agreement of CK 17 staining with histopathological diagnosis was 85% (?=0.6029 i.e. moderate) The agreement between p16 and MIB-1 immunostaining was 89.16%. (?= 0.7 i.e., good) The agreement between CK17 and MIB-1 immunostaining was 86.6%. (?= 0.683 i.e., good) The agreement between p16 and CK17 immunostaining was 84.16%. (?= 0.5908 i.e., moderate) Conclusion: The findings of the present study indicate that the IHC report of p16, MIB-1 and CK-17 in CIN and ICC cases if included in each histopathology report could aid in accurate diagnosis which could facilitate in better patient management.

Introduction: Immunohistochemical (IHC) markers of mucin family are associated with various Gallbladder Lesions (GBLs)., Aim: To study the distribution of GBL with respect to age and sex as well as to analyse the IHC profile of MUC1 and MUC5AC in GBLs and attempt correlation with clinical and histopathological findings., Materials and Methods: The present study was conducted over a period of six years. A technique of manual tissue array was employed for cases subjected to IHC using MUC1 and MUC5AC. Results were statistically analysed using software program "The Primer of Biostatistics 5.0"., Results: A total of 629 GBL were encountered. Out of 605 of non-neoplastic lesions, 32 (5.29%) expressed MUC1 while 515 (85.12%) cases expressed MUC5AC. Out of 24 cases of neoplastic GBL, 20 cases (83.33%) showed positivity for MUC1 and 9 cases (37.5%) were positive for MUC5AC. The rate of MUC1 expression was significantly higher in Gall Bladder Cancer (GBC) {18GB carcinoma (ca) +3 Carcinoma In Situ (CIS)} (85.71%) than chronic cholecystitis (4.71%). The positive rate of MUC5AC expression was significantly lower in GBC (28.57%) than chronic cholecystitis (87.19%). The percentage of cases showing MUC1 expression increased as the severity of disease progressed from hyperplasia to CIS. The percentage of cases showing MUC5AC expression decreased as the severity of disease progressed from hyperplasia to CIS., Conclusion: In this study, 96.18% cases were non neoplastic GBL of which chronic cholecystitis (87.77%) was predominant. 3.81% of the GBL constituted for neoplastic lesions of which 75% were GBC. MUC1 showed higher rates of expression in neoplastic GBL. MUC5AC showed higher rates of expression in non neoplastic GBL. Expression of MUC1 and MUC5AC might be closely related to pathogenesis of neoplastic and non neoplastic GBL.