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Abstract Background Ewing sarcoma (ES) is a highly aggressive malignant tumor most commonly affecting long bones. Extraskeletal Ewing sarcoma (EES) is a malignant tumor with aggressive behavior carrying bad prognosis with pancreas being an extremely rare primary site. We present a case of histopathologically proven EES of the pancreas in a young female who presented with abdominal pain. 18F-fluorodeoxyglucose positron emission tomography (18F FDG PET/CT) is a useful modality for detecting distant metastases in EES. It helps in diagnosis, localizing the primary, its extension, optimal treatment planning and evaluation of response to standard treatments available. Case presentation An 18-year-old female presented with complaints of progressive abdominal pain and distention since 6 weeks. Physical examination was suggestive of a solid large mass in the upper left abdomen and decreased breath sounds with dullness in the left lower lung fields. On Contrast enhanced computed tomography (CECT) imaging, a large heterogeneously enhancing mass was seen arising from pancreas along with retroperitoneal lymphadenopathy. A moderate sized left sided pleural effusion with atelectasis of lower lobe of left lung was also noted. Histopathological analysis was suggestive of pancreatic ES following which the patient underwent five cycles of chemotherapy. Following this, she underwent 18F FDG PET/CT which showed hypermetabolic large mass arising from body and tail of pancreas with areas of internal necrosis along with left adrenal metastasis, retroperitoneal lymphadenopathy, a massive left pleural effusion and compressive atelectasis of left lower lobe. The patient expired within a week following PET/CT. Conclusions EES most often presents in the late stage of the disease with vague symptoms. Timely diagnosis and initiation of treatment is of utmost importance considering the aggressiveness of the tumor. Establishing a diagnosis of Ewing sarcoma is especially difficult when the mass is arising from the pancreas. Imaging, histopathology and immunohistochemistry (IHC) play a key role in accurate diagnosis of such masses. 18F FDG PET/CT can be useful for detecting local and distant spread, operability, treatment planning and evaluation of response to chemotherapy.

Introduction: Carcinoma of gallbladder is an aggressive disease with poor outcome. The Epidermal Growth Factor Receptor (EGFR) is a transmembrane receptor that regulate growth, proliferation and differentiation in cells. Increased EGFR receptor expression has been studied in various cancers like lung, colorectal, breast and pancreatic tumours and anti-EGFR antibody has been used successfully for therapeutic and diagnostic purposes. Aim: To evaluate EGFR expression in gallbladder carcinoma and its association with clinicopathological factors to reveal its relation to prognosis. Materials and Methods: This cross-sectional retrospective observational study in which 64 samples were collected of resected specimen of Gallbladder Carcinoma (GBC), from the Department of Pathology, King George’s Medical University, Lucknow, Uttar Pradesh, India, between March 2017 to September 2018. Haematoxylin and Eosin (H&E) stained sections were evaluated for tumour type and histopathological grading and TNM staging was done. Immunohistochemistry (IHC) was performed and analysed prospectively using ready to use anti-EGFR as per manufacturer’s protocols. Association between EGFR expression and clinicopathological factors were statistically analysed using Statistical Package for the Social Sciences (SPSS) software version 21.0. Results: The EGFR expression was positive in 52 (81.25%) cases of GBC which showed a highly significant association between tumour grade and stage. About 60% of poorly differentiated GBC displayed strong (3+) staining intensity as compared to 30% of moderately differentiated (3+) and 10% of well differentiated tumours (3+). It suggests that with decreasing differentiation of tumour EGFR staining intensity increases (p

Introduction Oral Submucous fibrosis (OSMF) occurs in young adults, who are in the habit of chewing tobacco mixed with areca nut and its various commercially available preparations. The disease results in progressive inability to open the mouth due to the submucosal fibrosis initiated by chronic inflammation affecting mainly oral mucosa. Authors undertook the present study to correlate the clinical features of OSMF to histopathological features and to find out aetiopathological factors of this condition. Materials and Methods A total of 123 clinically diagnosed OSMF patients, in the age range of 17 to 70 years were studied. Mouth opening was measured using a scale and was recorded in millimeters. Incisional biopsy was taken from the representative areas in the oral cavity. The patients were graded clinically and histopathologically and results were analyzed and discussed. Result Most of the patients were in the age group of 20-30 years (37.4%) with male predominance. The duration of either tobacco or areca nut chewing ranged from 1 to 35 yrs. Most patients had these habits for 6-19 yrs. Majority (55.3% & 54.5%) of the patients belonged to grade-2 (clinical grading) and intermediate grade (HPE grading) respectively. The HPE grading showed significant and direct association with duration of ill habits. The HPE grading showed significant and direct association with clinical grading (χ2=204.08, p

Introduction Oral Submucous fibrosis (OSMF) occurs in young adults, who are in the habit of chewing tobacco mixed with areca nut and its various commercially available preparations. The disease results in progressive inability to open the mouth due to the submucosal fibrosis initiated by chronic inflammation affecting mainly oral mucosa. Authors undertook the present study to correlate the clinical features of OSMF to histopathological features and to find out aetiopathological factors of this condition. Materials and Methods A total of 123 clinically diagnosed OSMF patients, in the age range of 17 to 70 years were studied. Mouth opening was measured using a scale and was recorded in millimeters. Incisional biopsy was taken from the representative areas in the oral cavity. The patients were graded clinically and histopathologically and results were analyzed and discussed. Result Most of the patients were in the age group of 20-30 years (37.4%) with male predominance. The duration of either tobacco or areca nut chewing ranged from 1 to 35 yrs. Most patients had these habits for 6-19 yrs. Majority (55.3% & 54.5%) of the patients belonged to grade-2 (clinical grading) and intermediate grade (HPE grading) respectively. The HPE grading showed significant and direct association with duration of ill habits. The HPE grading showed significant and direct association with clinical grading (χ2=204.08, p

Introduction: CDX2 is a caudal type homeobox gene encoding a transcription factor that play important role in regulating proliferation and differentiation of the intestinal epithelium. Recent studies demonstrated CDX2 expression in metaplasia and carcinoma of oesophagus, stomach, ampulla of Vater, gallbladder and cholangiocarcinoma. Clinical and pathological significance of CDX2 in gallbladder carcinoma is not well established. Aim: To evaluate CDX2 expression in premalignant and malignant lesions of gallbladder and its correlation with histological grades and clinicopathological features. Materials and Methods: A total 93 cases of gallbladder lesions including 57 cases of adenocarcinoma, 27 cases of premalignant condition and 9 cases of chronic cholecystitis were selected both prospectively and retrospectively. Histological grading and typing was done. Immunohistochemical staining was performed using mouse monoclonal anti-human CDX2 as per manufacturer’s protocol. Statistical analysis was done using SPSS software (version 21.0). Results: CDX2 expression was strongly associated with well and moderately differentiated adenocarcinoma as compared to poorly differentiated (100% 77.3% and 35.3% respectively, p

Background: GLUTs are a family of proteins that mediate glucose transport through the membrane, expressed in head and neck squamous cell carcinoma. GLUT-1 positivity in malignant cells indicates increased proliferative activity, energy requirements, aggressive behaviour and poor radiation response. Aim: To observe the expression of GLUT-1 protein in oral squamous cell carcinoma in tobacco and non-tobacco users and to correlate the expression with histopathological grading and pathological staging. Methods: 50 cases (25 tobacco and 25 non-tobacco) of oral squamous cell carcinoma, selected during period of August 2014 to July 2015. Histopathological grading, TNM and staging were done. Immunohistochemical staining was performed using standard protocol for paraffin embedded sections. Analysis was performed on SPSS software (Windows version 17.0). Results: Significant association of GLUT-1 expression was found with history of tobacco (p

Dermoid cysts account for approximately 25% of all ovarian tumors. Presence of pure squamous cell carcinoma is very rare findings (1-2%), which is attributable to malignant transformations into a pre-existing dermoid cyst. As there are no specific signs and symptoms to suggest malignancy in dermoid cyst, therefore it is difficult to predict, and most cases are diagnosed post-operatively. We hereby report a case of dermoid cyst ovary with malignant transformation into squamous cell carcinoma in 50 years post-menopausal women. Who presented with complaint of abdominal pain and increased frequency of micturation. Hysterectomy with Bilateral-salpingo-oophorectomy (BSO) with omentectomy was done. Right ovary showed huge cyst with hair shaft, sebaceous materials and a small solid area. Histopathological examination revealed squamous cell carcinoma was arising within the dermoid cyst.

Introduction: E-cadherin is a glycoprotein cell adhesion molecule, which is important for maintenance of epithelial integrity and its loss is a useful biomarker for diagnosis and prognosis of preneoplastic and neoplastic squamous cell lesions. Aim: To evaluate and compare the expression of E-cadherin in oral and cervical premalignant and malignant squamous cell lesions. Materials and Methods: A total of 66 specimens (nine normal, 32 premalignant and 25 malignant) were obtained from oral cavity and cervix including 41 female and 25 male patients, which were divided into Group-I (control), Group-II (premalignant) and Group-III (malignant). Tumour grading and staging was performed. Immunohistochemical staining was done using monoclonal mouse antibody, E-cadherin as per manufacturer’s instruction. Analysis was performed using SPSS software version 17.0. Results: E-cadherin expression showed significantly (p=0.006) higher grades of expression in Group-I as compared to Group II and group III. Expression of E-cadherin was homogenous with membranous pattern in 100% cases of group I and was found in basal and parabasal layers of epithelium. Among group III, welldifferentiated squamous cell carcinoma showed strong staining (++) in 92.3% of cases as compared to moderately/poorly differentiated tumours (16.7% of cases). As tumour become poorly differentiated, cytoplasmic staining was predominant pattern in 50% of cases of moderately/poorly differentiated tumour. Overall comparison of E-cadherin expression between oral and cervix lesions showed insignificant difference (p>0.05). Conclusion: E-cadherin expression was found to inversely correlate with the loss of cell differentiation. It can be used as prognostic marker for both oral and cervical premalignant and malignant squamous cell lesions.

Cysticercosis is a well known parasitic infestation occurring at multiple sites including brain, muscles, liver, lungs, heart and peritoneum. Clinical presentation may be misleading most of the times. We herewith report two cases of oral cysticercosis which we encountered in our setup within a week. Both patients were young, urban vegetarian females presenting with cheek swelling. One had a diffuse swelling while other developed a cystic lesion. We found dead worm in the haematoxylin and eosin stained sections, but one may not always find it. Therefore, a high index of suspicion is needed in endemic areas. In cases of nonspecific inflammation serial sectioning and processing of the whole specimen is recommended before signing off a case as non specific inflammation even more, if we have calcific deposits. The correct diagnosis is of huge importance as involvement of other organs may give rise to serious complications. We report two cases of oral cysticercosis which reveal the importance of the histopathologic examination, emphasizing the need to include cysticercosis in the differential diagnosis of oral nodular lesions in endemic areas. Informed consent was taken from both the patients prior to the examination.