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Background:Breast malignancies encompass various subtypes which differ in their clinical presentations, outcomes, and response to the treatment regimens. Thus, a proper histological diagnosis and a special mention of the rare histologic subtypes are required to formulate clear recommendations of their treatment protocols.Materials and Methods:This is a 1-year retrospective study highlighting the rarely encountered subtypes on the mastectomy specimens received.Results:We encountered only 11 rare cases out of the total 153 mastectomy specimens received. The rare subtypes were as follows mucinous cystadenocarcinoma (0.6%), mucinous carcinoma (0.6%), dermatofibrosarcoma protuberans (0.6%), Squamous cell carcinoma (0.6%), papillary carcinoma (2.6%), medullary carcinoma (0.6%), and malignant mesenchymal tumor (1.3%).Conclusion:Our data suggest that these variants are distinct clinicopathological entities with a unique hormonal receptor status. Scant information is available on the rare breast tumor subtypes.

Background: Autopsy has been an important tool for detection of many rare lesions as well as studyingthe course of such lesions, highlighting the cause of death and also helps in indirect collection of data formortality and forming health policies. Aim of present study was to detect the rate and type various neoplasmswhich were either clinically undiagnosed or not the direct cause of death and their system wise analysis.Material and Methods: This is a retrospective study conducted on viscera Received between year 2011-20on 810 medico legal autopsy cases coming to Department of Pathology for histopathological examination.Result: Out of 810 cases, 09 tumours were diagnosed (1.1%). In 6 cases, it was completely incidentalfinding while in 03 cases history of malignancy was present. Tumours were mostly seen in older age group(>50 years).Conclusion: The study concludes the importance of histopathologic study in autopsies in detection ofclinically undiagnosed neoplasms and evaluating the cause of death. Thus, autopsies also indirectly aid tothe true cancer incidence statistics.

Introduction: The ovaries are the primary female reproductive organs and endocrine glands. Ovarian carcinoma has often been called as the silent killer because the symptoms may develop so late that the chances of cure are very poor. According to World Health Organisation (WHO) ovarian tumours are classified based upon their most probable tissue of origin: surface epithelial (65%), germ cell (15%), sex cord-stromal (10%), metastases (5%) and miscellaneous. The malignant surface epithelial tumours are further classified by cell type into serous, mucinous, endometrioid, clear cell, brenner, seromucinous and undifferentiated carcinoma. The most widely used tumour marker in ovarian carcinoma is CA-125 which is considered as gold standard. Aim : To find the utility of serum CA-125 levels in histopathological variants of malignant surface epithelial tumours, degree of differentiation and their distribution according to clinical data pertaining to age, parity, history of use of oral contraceptive pills/ovulation inducing drugs and family history of carcinoma ovary/breast or colon. Materials and Methods: A prospective study (cohort study) was done at Guru Gobind Singh Medical College and Hospital, Faridkot over a period of 1.5 year (April 2017-oct 2018) on 50 ovarian masses which were diagnosed as ovarian carcinoma. Data was represented as frequencies and percentages for categorical variables and as means and standard deviations for continuous variables. Analysis was done using Statistical Package for Social Sciences (SPSS) v 20.0.0. Results: Serous carcinoma (80%) topped among all the histological variants. Serous high grade carcinoma was more common than serous low grade carcinoma. Maximum rise of serum CA-125 levels were seen in serous carcinoma. Among serous carcinomas, mean serum CA-125 levels were more in high grade serous carcinoma than low grade serous carcinoma and the results were statistically significant. conclusion: Serum CA-125 level is a great tool for diagnosis, follow-up and prognosis of ovarian carcinomas.

Dermatofibrosarcoma protuberans (DFSP) is best regarded as well differentiated, primary fibrosarcoma of skin. It is an uncommon, slow growing, locally aggressive, and reoccurring but rarely metastasizing tumor of the deep dermis and subcutaneous tissue. Clinically they present as firm solid nodules that arise most frequently on trunk and extremities. DFSP of the breast has been rarely reported. Here, we report a rare case of DFSP of the breast in 47-year-old woman.

Chronic lymphocytic leukemia (CLL) is characterized by the accumulation of mature-appearing lymphocytes in blood, bone marrow, lymph nodes, and spleen with a median lymphocyte count of 20-30 × 10(9)/L at the time of diagnosis. In half of the patients, the lymphocyte count doubles over a period of 1-year and cyclic rise up to 50 × 10(9)/L can occur in untreated patients while in others the count may remain stable for years. Based on the cytogenetic and molecular studies, it has been demonstrated that multiple clones may occur in CLL and clonal evolution is a frequent occurrence. The transformation of CLL to a high-grade non-Hodgkin's lymphoma such as diffuse large B cell lymphoma, Hodgkin lymphoma, and prolymphocytic leukemia is well documented. Whereas the transformation of CLL to acute leukemia occurs in

The occurrence of dual malignancies is not rare but concurrent occurrence of two malignancies with different histogenesis and different anatomical sites is not known. In the studies which have been conducted so far, none of them has shown the simultaneous occurrence of metastatic malignant melanoma and primary endometrial carcinoma. We report herein a case of a 42-year-old female diagnosed with metastatic malignant melanoma in cervical lymph node with unknown developing primary endometrial carcinoma within two months. No foci of primary malignant melanoma were found in uterus. Dual primary malignancy is being suggested by the presence of two malignancies in a patient with different morphological picture on histopathological examination, at anatomically distinct sites. Malignant melanoma and endometrial carcinoma, being a rare combination, prompted us to report the case.

Primitive neuroectodermal tumour is a malignant small round cell tumour affecting mainly the older children and adults. Palate is a very rare site for this tumour. We here report a case of 3 year male child who presented with a firm nodule of 2 x 1 cm size in the palate. Fine needle aspiration of the lump was performed and a cytodiagnosis of malignant small round cell tumour of palate was suggested. Subsequent histopathological examination supported it while Immunohistochemistry i.e. CD 99 positivity confirmed the diagnosis of PNET.

Despite of the fact that the vulva contains a high density of apocrine and anogenital mammary glands in addition to eccrine glands and folliculosebaceous units, the benign vulvar adnexal tumours are rare. Though the varied clinical presentation and diverse histopathological spectrum of vulvar neoplasms has amazed the pathologists, only few studies have been reported in literature. The present five year study consists of only five cases of benign vulvar neoplasms depicting their rarity. Hidradenoma papilliferum and syringoma were the most common entities followed by Chondroid syringoma. The aim of our study is to explore and highlight the histopathological diversity of benign vulvar adnexal tumours reflecting the relative frequency of these structures.

A 55 year old patient present with menorrhagia. Endometrial biopsy was done revealing hyperplasia of endometrium following which total abdominal hysterectomy with bilateral oophorectomy was carried out to rule out any hidden focus of endometrial malignancy. The histopathology revealed simple endometrial hyperplasia with microscopic focus of granulosa cell tumour in the right ovary. We in this case report are highlighting importance of screening of ovarian tumour in perimenopausal patients presenting with menorrhagia.

Renal cell carcinoma (RCC) has unpredictable and diverse behaviour. The classic triad of hematuria, loin pain and abdominal mass is uncommon at time of presentation. About 30%-50% of patients are found to have metastases at the time of diagnosis. Bones, lungs, liver and brain are the frequent sites of metastases. RCC with metastasis to the endometrial cavity is rarest manifestation, as seen in our patient. Patient was a 40 year old female, G3P1, known case of renal cell carcinoma, presenting in emergency with bleeding per vaginum. She had no other co-morbidity. Endometrial curettage was done and specimen sent for histopathological examination, which revealed metastasis from clear cell type of renal cell carcinoma in endometrial cavity and was confirmed on IHC.

The skin metastasis of follicular variant of papillary carcinoma thyroid (FVPTC) is a rare condition and the lesions should be differentiated from primary skin tumors. The scalp is the most frequent site which is involved in skin metastasis of FVPTC. It shows the poor outcome and aggressive nature of the disease. In this report, we aim to present a case report of a 65 year –old female with scalp metastasis of FVPTC highlighting the fact that a solitary cutaneous lesion may be the first evidence of disseminated malignancy in a patient with occult papillary thyroid carcinoma. Keywords: Cutaneous, Metastasis, Papillary thyroid carcinoma

Histopathological examination of heart autopsies is routinely done in medico-legal cases to ascertain the cause of death. Cardiovascular disease is the leading cause of deaths worldwide. Myocarditis is clinically and pathologically defined as inflammation of the myocardium. Autopsy studies have reported an incidence of 3.5% to as high as 10%. In the present study comprising of 235 heart autopsies, the diagnosis of myocarditis is made in only two cases which constituted 0.8% of the total heart autopsies. This rate of myocarditis in our autopsy study is far lower than the published studies. The aim of our study is to assess the frequency of fatal course myocarditis in a consecutive series of autopsies and to describe the histologic features of the disease.

BACKGROUND Thyroid malignancies generally present as neck masses. Occult malignancies presenting with metastasis is a rare finding. This case report highlights the rare presentation of thyroid follicular carcinoma as scalp nodule.

Ovarian carcinomas are conventionally treated with primary debulking surgery followed by chemotherapy. Nowadays neoadjuvant chemotherapy followed by surgery is an upcoming treatment modality for ovarian carcinoma. This study highlights the histopathological changes observed after neoadjuvant chemotherapy. Present study is a 40-case study stressing five histological parameters: residual tumour, fibrosis, necrosis, inflammation, and psammoma bodies. All these parameters carry prognostic significance and they are easily reproducible. Fleiss kappa statistics were used to measure intraobserver agreement between pathologists which was found to be substantial to almost perfect with κ ranging between 0.621 and 1.00. This study highlights easily reproducible parameters and their incorporation in histopathology report, thus helping in patient management.

Hysterectomy, the most common gynecological surgery, provides a definitive cure to various diseases like DUB (dysfunctional uterine bleeding), leiomyoma, adenomyosis, chronic pelvic pain, prolapse, and malignancy. However, with advent of effective medical and conservative treatment modalities for nononcological causes it is now posing question mark on justification of hysterectomy. Therefore, an audit is required to assess the correlation between preoperative diagnosis and histopathological examination of specimen for justification of the procedure. In this study over period of one year (April 2013 to March 2014) 373 hysterectomies specimens were received in the department of pathology for nononcological causes. The age of patients ranged from 22 to 85 years with mean 45±9.2 years. All cases were divided into five categories on the basis of age and audit was done. In this study the most common finding was leiomyoma (43.7%) followed by adenomyosis (19.3%). Almost 50% of hysterectomies causes were justified as preoperative diagnosis matched with histopathology. Cohen kappa statistics were used to measure agreement between preoperative and postoperative histopathological diagnosis which was found to be fair with κ value being 0.36. This study highlights that regular audit of surgeries can help improve quality of health care services and provide safe conservative option to patients.

Cutaneous metastases from internal malignancies are uncommon and occur in 0.6%–10.4% of all patients with cancer. In most cases, cutaneous metastases develop after the initial diagnosis of the primary internal malignancy and late in the course of the disease. Skin tumors are infrequent in Asian population and cutaneous metastases are quite rare. Cutaneous metastases carry a poor prognosis with average survival of few months. In the present five-year study 1924 malignant tumors were screened which included only nine cases of cutaneous metastatic deposits. A wide range of site and clinical presentations including nodules, plaques, and ulcers was noted. Histopathological findings were significant and corresponded with the primary internal malignancy. Cutaneous metastases from breast carcinoma (44.4%) were the most common finding followed by non-Hodgkin lymphoma and renal cell carcinoma (22.2% each) and carcinoma cervix (11.1%). The aim of our study is to classify the cutaneous metastases and to evaluate their clinicopathologic and immunohistochemical correlation with the primary tumor.

An autopsy case report of 70 year old male who died suddenly and post mortem examination was conducted to rule out the cause of death. Viscera consisting of parts of liver, lungs, kidney, spleen and heart were sent to Department of Pathology for histopathological examination. Gross examination of liver revealed a cyst which on microscopy was diagnosed as simple non parasitic cyst measuring 4 cms in size. This case report highlights non parasitic liver cyst an incidental rare diagnosis made on autopsy.

The lungs are one of the most vital organs of the body. They are affected by primary diseases ranging from inflammatory to neoplastic as well as are secondarily involved in almost all terminal diseases. Histopathological examination of lungs is vital in diagnostic work up of all lung diseases. The present study was conducted in year 2012–2013 in which 50 cases were analyzed. Pulmonary congestion and edema was found as the most common diagnosis followed by pneumonia and tuberculosis.