sumiti gupta

Follicular dendritic cell neoplasms are extremely rare. Information regarding the accurate treatment and prognosis is limited owing to their rarity; thus, this tumor encompasses a domain to be brought into focus. Clinical and pathological diagnoses warrant a high index of suspicion as this entity is not considered in routine clinical practice. Histopathologically it mimics various other neoplasms which lead to higher chances of misdiagnosis at initial evaluation. Use of follicular dendritic cell immunohistochemical markers CD 21 and CD 35 helps in rendering a definitive diagnosis.

Follicular dendritic cells or dendritic reticulum cells are important components of the immune system essential for antigen presentation. Malignancies arising from these cells are uncommon and the first case was reported in 1986. The most common sites of follicular dendritic cell sarcomas are lymph nodes, especially cervical, axillary and mediastinal regions, but extranodal sites including head and neck and gastrointestinal tract may be affected in one-third of patients. Immunohistochemistry plays an important role in its diagnosis to differentiate it from morphologically similar malignancies The present report describes a case of follicular dendritic cell sarcoma in a patient with chronic myeloid leukemia (CML) treated with imatininb mesylate for 6 years. This case deserves reporting due to rarity of the disease and hitherto unreported association with CML. Furthermore, the pathological diagnosis is challenging and requires a close-knit effort between the pathologist and haematologist.

Breast cancer is the commonest cancer of Indian women. Estrogen and Progesterone expression is seen in benign breast lesions and in breast carcinoma associated with good prognostic parameters and it correlates well with response to hormone therapy. Although a lot of studies have been conducted in the past on hormone receptor expression in breast cancer and few have correlated them with other prognostic parameters of breast cancer, the present study was intended to document the prevalence of hormone receptor positive breast carcinomas in our population; their importance in benign breast diseases; to document a reliable scoring system of hormone receptors expression by Quick scoring; to correlate them with most of the proven prognostic parameters of breast carcinoma. Tissue specimens from 25 patients with benign breast disease and 50 patients with breast carcinoma were assayed for estrogen (ER) and progesterone (PR) receptors using Quick scoring. ER/PR expression in breast carcinomas was correlated with various prognostic parameters including patients’ age, menopausal status, tumor size, type, MBR grade, NPI, lymphatic vessel invasion, lymph node stage, lymphomononuclear invasion, elastosis and HER2/neu status. Scoring of steroid receptors paralleled intensity of hyperplasia in benign breast diseases but in breast carcinoma, it was inversely correlated with grade of tumor, NPI, HER2/neu status, tumor necrosis, lymphomononuclear infiltrate and elastosis. We found no relationship with tumor size, lymph node status or age. Assessment of hormone receptors for clinical management of breast cancer patients is strongly advocated to provide prognostic information and best therapeutic options.

This study evaluates estrogen and progesterone expressions in patients with ovarian tumors (both benign and malignant) and their correlation with various clinicopathological prognostic parameters. Receptors for estrogen and progesterone are predictive and prognostic markers of endometrial and breast cancers. However, their clinical significance in epithelial ovarian cancer is not clear due to conflicting data from only a few immunohistochemical studies available in the literature. The present study was conducted on 60 cases of ovarian tumors, 20 benign and 40 malignant. Estrogen and progesterone expressions were studied by immuno- histochemistry and correlated with various clinicopathological parameters such as, menopausal status, histological type, WHO grade and FIGO stage. Out of 20 benign tumors the estrogen receptor was positive in 10 (50%) and progesterone receptor was positive in 14 (70%) tumors. In 40 malignant tumors, the estrogen receptor was positive in 13 (32.5%) and progesterone receptor was positive in 11 (27.5%) cases. There was statistically significant estrogen receptor expression observed in serous tumors (P=0.001). When compared with other clinico- pathological parameters, we noted a significant association between progesterone receptor expression and favorable prognostic parameters such as young age, benign tumors and early FIGO stage. There were variable expressions of the estrogen and progesterone receptors in ovarian tumors. Progesterone receptor expression was associated with favorable prognostic factors that included younger age, benign tumor and low FIGO stage. No such association was observed with estrogen receptor expression.

Abdominal cutaneous and subcutaneous nodules are uncommon lesions which may be benign or malignant. Majority of the malignant nodules are metastatic in origin and may be the initial presentation of primary malignancy, hence an early diagnosis is important. Our aim was to find out the spectrum of lesions (both non-neoplastic and neoplastic) that present as cutaneous and subcutaneous abdominal wall nodules and to assess the efficacy of fine needle aspiration cytology (FNAC) in early diagnosis of all such lesions so that need for histopathology can be minimized. The study was conducted on 46 patients of all age groups, presenting with various palpable cutaneous and subcutaneous abdominal wall nodules. FNAC was performed, smears stained with May Grunwald- Giemsa stain and Pap stains. Special stains were applied wherever required. Cytological diagnosis was subsequently correlated with histopathological diagnosis. Out of 46 FNAC cases; there were 13 non-neoplastic lesions, 15 benign neoplasms and 17 malignant lesions. One case was inadequate for opinion that on histopathology turned out to be metastatic deposits from renal cell carcinoma. The rate of unsatisfactory FNAC was 2.2% and the sensitivity was 89.47%. The specificity and positive predictive value was 100%. FNAC is a simple, minimally invasive, highly accurate and cost effective technique for quick diagnosis of malignant metastatic abdominal wall nodules, thus minimising the need for histopathology and for deciding mode of treatment

Pilomatricoma is a benign skin adnexal tumour usually seen in the head and neck region of children and young adults. It is underrecognized on cytology، resulting in the overdiagnosis of malignancy. We bring forth a case report of a slow growing nodular swelling in a 10-year-old female child، which was misdiagnosed on Fine Needle Aspiration Cytology (FNAC) as a malignant neoplasm and found to be pilomatricoma histopathologically. Nodular lesions of pilomatricoma، which are predominantly composed of basaloid cells and devoid of other diagnostic features، lead to a false diagnosis of malignancy. To avoid misdiagnosis، pilomatricoma should be considered in differential diagnosis when primitive appearing cells are aspirated in slow growing subcutaneous nodules. Cytomorphological features of pilomatricoma and major pitfalls in diagnosis are also being discussed.

Abdominal cutaneous and subcutaneous nodules are uncommon benign or malignant lesions. The majority of the malignant nodules are metastatic in origin and may be the initial presentation of a primary malignancy; hence، an early diagnosis is important. Our aim of this study was to find out the spectrum of lesions (both non-neoplastic and neoplastic) that present as cutaneous and subcutaneous nodules on the abdominal wall and to find out the efficacy of fine needle aspiration cytology in the early diagnosis of such lesions so that the need for histopathology can be minimized. The study was conducted on 46 patients of all age groups who presented with various palpable cutaneous and subcutaneous abdominal nodules. These nodules were assessed by fine needle aspiration cytology. The diagnosis was made cytopathologically and subsequently correlated with the histopathological diagnosis when possible. Out of 46 cases aspirated; there were 13 non-neoplastic cases، 15 benign neoplasms، 17 malignant cases and one case whose tissue sample was inadequate for opinion but turned out to be metastatic deposits from renal cell carcinoma on histopathology. The rate of unsatisfactory fine needle aspiration cytology was 2. 2% and the sensitivity was 89. 47%. The specificity and positive predictive value were 100%. Fine needle aspiration cytology is a simple، minimally invasive، highly accurate and cost effective technique for early diagnosis of malignant metastatic nodules on the abdominal wall and therefore minimizes the need for histopathology and facilitates decision-making regarding the mode of treatment.