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Introduction: Breast cancer is a diverse and heterogeneous disease affecting women in both developing and developed countries. In 2022, Global Cancer Observatory (GLOBOCAN) reported 2.3 million cases of breast carcinoma, which accounted for 11.6% of all cancer cases worldwide. The incidence of breast cancer in India has been steadily rising and has surpassed cervical cancer as the most common cancer in women. Invasive ductal carcinoma is the most common histologic type found in all age groups. Grading is done according to Elston Ellis’s modification of the Scarff Bloom Richardson Scoring system. Hormonal {Estrogen Receptor (ER), Progesterone Receptor (PR)} and Human Epidermal growth factor Receptor-2 (HER2/neu) immunohistochemical expression are used for molecular typing of breast carcinoma. Young women account for up to 25% of all breast carcinoma cases in India. Aim: To assess the clinical symptoms, histological type, grade, Immunohistochemistry (IHC) profile (ER, PR, HER2neu), and their relationships in females below 40 years of age with breast carcinoma. Materials and Methods: An ambispective cross-sectional study with a total of 99 cases of breast carcinoma in young females were included in the study, which was conducted in the Department of Pathology at Sri Aurobindo Medical College and PG Institute in Indore, Madhya Pradesh, India, between April 2022 and March 2024. Biopsies, lumpectomy, and total or modified mastectomy specimens were fixed in formalin and paraffin embedded. Sections were stained with Haematoxylin and Eosin (H&E) and IHC markers ER, PR, and HER2neu using Estrogen Receptor Alpha Antibody (EP1), EP2, and EP3 antibodies, respectively, on a fully automated workstation. Carcinomas were classified according to the World Health Organisation (WHO) classification and graded based on Elston Ellis’s modification of the Scarff Bloom Richardson System Scoring. The proportion of tumour cells and intensity were studied, and evaluation was done with appropriate controls. Results: The most common symptom was a breast lump (84.84%), while Invasive breast cancer of {No Special Type (NST)} was the most common histologic type (96.96%) and histological Grade III was predominant (53.53%) in the majority of patients. ER, PR, and HER2neu were positive in 57.57%, 51.51%, and 33.33% of cases, respectively. HER2neu expression was negative in the majority of cases (66.66%). The most common molecular subtype was Luminal A (35.35%), followed by Triple-negative Breast Cancer (TNBC) (29.29%), Luminal B (22.22%), and the least common was the HER2neu enriched subtype (13.13%). Conclusion: Invasive breast carcinoma (NST) is the most common histologic type, with higher histologic grade and a greater number of triple-negative cases seen in young females (

Introduction: A bone marrow examination involves the pathological analysis of samples from the bone marrow, which are obtained through bone marrow aspiration (BMA) and biopsy procedures. This examination is employed for the diagnosis of various hematological and nonhematological conditions. Both aspirate and biopsy samples are essential, offering a comprehensive bone marrow assessment. Objectives: In this study, we aim to compare the simultaneous evaluation of bone marrow aspirates and biopsies and to study diagnostic accuracy and concordance rate. Materials and Methods: This research was performed at the Department of Pathology, Shri Aurobindo Medical College, and Postgraduate Institute in Indore, Madhya Pradesh, India. The study was conducted from January 2019 to December 2019 and evaluated 200 patients. In 170 instances, bone marrow biopsy (BMB) and BMA procedures were conducted simultaneously, with 14 cases excluded due to issues like hemodilution or inadequate samples. Microscopic examinations were carried out on both aspirate slides and trephine biopsy sections, with the findings meticulously documented. Results: In the present research, the most prevalent clinical reason for performing a bone marrow examination was anemia (28.2%), closely followed by acute leukemias (21.9%). Among the 156 cases examined, BMA and biopsy led to a definitive diagnosis in 116 patients (74.3%), while biopsy alone diagnosed 27 cases (17.3%). Conclusion: While BMB continues to be the established benchmark for bone marrow analysis due to its heightened reliability and sensitivity, the combined use of both BMA and BMB enhances diagnostic yield significantly.

Background Prostate cancer (PCa) is the second most frequent malignancy (after lung cancer) in men worldwide .In prostate cancer, immunohistochemistry (IHC) has an important role in the diagnostic confirmation. Gleason score, tumour volume, surgical margins and Ki-67 index are the most significant prognostic factors. The value of different biomarkers like p53, Ki-67, PSMA, androgen receptor mutations, IGF, E-cadherin remains to be applied in clinical practice. In the present study we studied the expression of PSMA and Ki 67 IHC marker in prostatic carcinoma cases and its relation with Gleason score and Gleason grade group of tumour. Method A total of 52 cases of prostate carcinoma diagnosed on histopathology as adenocarcinoma in the Department of surgical pathology within 2.5 years duration were further studied immunohistochemically by PSMA and Ki 67 antibodies. Results At the time of presentation most of the cases have serum PSA level 11-50 ng/ml and with increasing Gleason score it can be ≥100ng/ml. Majority of cases have Gleason score 7 and the most common Gleason grade group is 2. PSMA and Ki 67 IHC marker is significantly correlated with Gleason score and Gleason grade group. PSMA expression is significantly correlated with perineural invasion and Ki 67 with bone metastasis. Conclusion PSMA and Ki 67 IHC marker can be used in conjunction with or as a substitute to Gleason scoring system for proper risk.

Background: Vesiculobullous disorders (VBDs) are extant with diverse clinical manifestations. Vesicles and bullae are fluid-filled cavities present within or beneath the epidermis. They are autoimmune blistering disorders in which autoantibodies are directed against target antigens present in the epidermis and dermo-epidermal junction. Objective: Evaluation of the various clinicodemographic profile of patients with a pattern of distribution (subtypes) of VBDs of the skin and assess the association between clinical aspects and histological changes in vesiculobullous lesions of the skin. Materials and Methods: The study material constituted 93 cases of VBDs out of 936 skin biopsies reported over two and a half years (January 2016 to June 2018) from the tertiary care center. A detailed history of the patients was taken, and a complete physical and dermatological examination with findings including clinical diagnosis was recorded. Histopathological examination (incisional/excisional/punch biopsy) was done in each case. The clinico-demographic evaluation was done and the results were correlated with histopathological findings. Results: Vesiculobullous lesions constituted 10.06% of all skin biopsies. The majority of cases were of pemphigus vulgaris (PV) 30 (32.25%) followed by 16 (17.2%) of bullous pemphigoid. In 83 cases (89.24%) histopathology findings were consistent with clinical diagnosis. Out of 34 cases that were diagnosed clinically as PV , the histopathological study proved 30 cases (88.23%) as PV. Conclusion: Vesiculobullous lesions of the skin are a heterogeneous group of disorders. It is essential to differentiate each pattern of subtype based on clinical examination and histopathological findings. Histopathological diagnosis with clinical correlation plays a major role in arriving at the diagnosis.

Introduction: Multiple Myeloma (MM) is a clonal expansion of B lineage plasma cells in bone marrow. MM accounts for 10-15% of haematological malignancies and 1% of all malignant diseases. Though, the aetiology of the disease is largely unknown, various factors have been found to increase the incidence of MM. The present comprehensive research work on MM in the Malwa region of central India is an attempt to establish on clinicodemographic, haematological, biochemical and radiological parameters and finally to stage them according to Durie Salmon Staging (DSS) system. Aim: To study clinicopathological profile of patients with MM. Materials and Methods: The present ambispective study was conducted on total 70 cases of MM reported in the Department of Pathology at Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India, from July 2012 to June 2020. The study design included retrospective studies from July 2012 to December 2018 (six years and five months) and prospective studies from November 2017 to April 2019 (one year and five months). The demographic data of patients’ including history and clinical findings were recorded. Complete Blood Count (CBC) was done in all cases. Biochemical investigations were also done. Urine samples of all patients were screened for the presence of Bence Jones protein. Biochemical parameters and staging of MM patients was done. Statistical analysis prepared in excels spreadsheet and quantitative data were presented as proportions. Results: The study included a total of 70 cases of MM diagnosed on peripheral smear and/or bone marrow examination. The male:female ratio was 2.1:1, with a male preponderance. The results of the present study, reported 48 (68.57%) patients were male and 22 (31.43%) patients were females. In the present investigation, the authors diagnosed serum Lactate Dehydrogenase (LDH) levels were estimated in 63, out of 70 patients. Out of which, 25 (39.69%) patients had levels 480 U/L, respectively. Conclusion: The present study, underlines the association between clinical presentation, laboratory parameters and radiological findings in establishing the diagnosis of MM. The present study emphasises not only the role of a bone marrow aspiration and biopsy in establishing a diagnosis of MM, but also, assessing the plasma cell burden in the marrow.

Background: Pancytopenia is defined as the simultaneous presence of anemia, leukopenia, and thrombocytopenia. The present study was undertaken to explore various causes and clinical manifestations of pancytopenia and to correlate them with severity of pancytopenia in adult patients of Malwa region of central India. Materials and Methods: The study was conducted in Department of Pathology of our Institute with the help of clinical departments such as medicine, surgery, oncology, and others. Two hundred and fifty-one admitted adult male and female patients from October 2015 to March 2017 (18 months) presenting with pancytopenia were included in the study. Tests for complete blood count, peripheral smear, reticulocyte count, bleeding time, clotting time, bone marrow aspiration, and trephine biopsy were done. Results: Among all the hematological disorders (202/251) causing pancytopenia, the most common was megaloblastic anemia (98/202, 48.51%) followed by dimorphic anemia (36/202, 17.8%) and aplastic anemia (18/202, 8.9%). Least common causes included hemolytic anemia (2/202) and disseminated intravascular coagulation (2/202), that is, 0.99% each. Conclusion: Thus, a comprehensive, clinical, and hematological study of patients with pancytopenia will usually help in identifying the underlying cause. The early detection of the underlying conditions would also help to enhance the prognosis of patients with pancytopenia.

Introduction: Cytological examination of serous effusions helps in staging, prognostication and management of patients with malignancy. The method has disadvantage of lower sensitivity in differentiating reactive atypical mesothelial cells from malignant cells. Aim: The aim of this study is to compare the cytological features of pleural and peritoneal exudative fluids by conventional smear (CS) method and cell block (CB) method and also to assess the utility of a combined approach for cytodiagnosis of these effusions. Materials and Methods: One hundred and fifty-three pleural and peritoneal exudative fluid samples were subjected to evaluation by both CS and CB methods over a period of 2 years. Cellularity, architecture patterns, morphological features and yield for malignancy were compared, using the two methods. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for diagnosing malignancy were calculated by both methods, using histology as a gold standard. Results: CB method provided higher cellularity, better architectural patterns and additional yield for malignancy as compared to CS method (P < 0.005). Sensitivity, specificity, PPV, NPV, and accuracy by CS method were 69.2%, 95%, 56.25%, 97.08% and 92.8%, while by CB method were 92.30%, 99.2%, 92.30%, 99.28% and 98.6%. Conclusion: The present study shows that it is advisable to routinely make CBs before discarding specimens that are suspicious for malignancy by smear examination.

Aggressive angiomyxoma (AAM) is an uncommon mesenchymal tumor that predominantly involves the pelvis and perineum of young females. It is often clinically mistaken for more common superficial lesions such as vaginal cysts, labial cysts, and lipomas. A review of the medical literature reveals very few cases of AAM reported in pregnancy. We describe a rare case of AAM in pregnancy, clinically misdiagnosed as prolapsed cervical fibroid.

Purpose: To evaluate the role of fine needle aspiration (FNAC) as a diagnostic tool in cases of orbital and ocular adnexal masses. Cytological findings were correlated with histopathological diagnosis wherever possible. Methods: FNAC was performed in 29 patients of different age groups presenting with orbital and ocular adnexal masses. Patients were evaluated clinically and investigated by non-invasive techniques before fine needle aspiration of the masses. Smears were analyzed by a cytologist in all cases. Further, results of cytology were compared with the histopathological diagnosis. Results: The age of patients ranged from 1 to 68 years (mean: 29.79±19.29). There were 14 males and 15 females with a male to female ratio of 0.93:1. Out of 29 cases, 26 aspirates were cellular. Cellularity was insufficient in three (10.34%) aspirates. Out of 26 cellular aspirates, 11 were non-neoplastic while 15 were neoplastic on cytology. Subsequent histopathologic examination was done in 21/26 cases. Concordance rate of FNAC in orbital and ocular adnexal mass lesions with respect to the precise histologic diagnosis was 90%. Conclusion: When properly used in well-indicated patients (in cases where a diagnosis cannot be made by clinical and imaging findings alone), FNAC of orbital and periorbital lesions is an invaluable and suitable adjunct diagnostic technique that necessitates close cooperation between the ophthalmologist and cytologist. However, nondiagnostic aspirates may sometimes be obtained, and an inconclusive FNAC should not always be ignored.

A rare and probably the first documented case of isolated cutaneous toxoplasmosis is being reported in a 50-year-old, vegetarian, immunocompetent man. The granulomatous nodule located on the scrotal skin was excised, and the sections and crushed material of the nodule were subjected to different staining techniques. Demonstration of crescentic structures and PAS-positive material confirmed the presence of Toxoplasma gondii. The significantly raised titer of anti-toxoplasma antibodies further supported the diagnosis. The case was successfully managed surgically. No further treatment was advised since the patient was immunocompetent and it was assumed that cell-mediated immunity would further control the proliferation of organisms.

Chondroblastoma is a rare benign cartilaginous tumor typically seen in long bones, especially femur, tibia and proximal humerus. Extracortical soft tissue invasion or metastasis is rarely seen. We report here a unique case of chondroblastoma of the fibula with extracortical soft tissue invasion. Differential diagnosis on cytology is discussed.

Xanthogranulomatous pyelonephritis (XGP) is an uncommon form of chronic pyelonephritis and a well recognized entity. It is rarely seen in children and neonates. The preoperative diagnosis is difficult and the etiology is still obscure. The condition is mostly diagnosed on nephrectomy specimen. The focal form mimicking neoplastic condition is rare. A case of XGP is reported here in an 8 month old child in which case nephrectomy was done with the clinical diagnosis of malignant renal tumor. Various modalities of preoperative diagnosis of this entity with conservative approach are also discussed.

Visceral Leishmaniasis is a well known public health problem in eastern parts of India. So far the cases have not been reported from Malwa plateu of Madhya Pradesh, to the best of our knowledge and available literature. We report here two cases of Visceral Leishmaniasis first time from the Malwa region. Both the cases are from the migratory population of Bihar. The diseases like Leishmaniasis which were previously restricted to endemic areas of the country are spreading to non endemic areas along with the large migratory population, which is seen with the development of the country.. The cases are reported to inform the National health authorities to take proper steps to curb the spread of the disease to non -endemic areas and to emphasize the need of vector surveys in these areas.