An Observational Study on Cutaneous Appendageal Tumours with Pilar Differentiation

Background: Cutaneous appendageal tumours belong to a diverse group of tumours with specific histo pathology.The aim of this study is to determine the pattern, age,gender and site distribution of Pilar differentiation tumours. Material & Methods: The study was conducted in the department of Pathology,Government Medical College Srinagar for a period of 18 months. It was an observational cross sectional study.Formalin fixed,paraffin embedded tissue sections were stained with hematoxylin and eosin stain for histopathological analysis. Results: A total of 112 cases of Pilar tumours were studied.108 were benign and 4 were malignant with male to female ratio of 1.07:1. The maximum number of benign cases were observed in 11 -20 years of age group and the malignant tumours age ranges from 35-45 years and the tumour usually presented in the eighth decade.Head and Neck was the most common site. Conclusion: Histopathological examination of Pilar Tumours is the gold standard to differentiate between benign and malignant tumours. It is also useful for exact categorization of cutaneous appendageal tumours.

Rizwan Hamid, Altaf Chalkoo, Saima Tariq, Sheikh Bilal, Suhail Wani

The leiomyoma is a benign smooth-muscle neoplasm commonly found in the female genital tract, gastrointestinal tract, or skin. Leiomyomas of the oral cavity are unusual. Oral leiomyomas are uncommon due to the paucity of the smooth muscle in the mouth (except in blood vessels) and thus the involvement of jaw bones is extremely rare. Leiomyomas have been classified as solid angiomyoma, angioleiomyoma (vascular leiomyoma), and epithelioid variants. Angioleiomyomas are benign mesenchymal tumors derived from smooth muscle, which rarely occur in the oral cavity. Malignant transformation probably does not occur but careful histopathologic examination is still necessary to differentiate these benign lesions from their malignant counterparts due to different prognosis. Although uncommon in the maxilla and mandible, they should be included in the differential diagnosis of radiolucent lesions of jaw bones. An extensive search of literature was carried out on the Medline-PubMed and Google Scholar database using the keywords such as leiomyoma, angioleiomyoma, jaw bones, maxilla, mandible, intra-osseous to thoroughly search and collect all the reported cases of intraosseous leiomyoma (but our search was not limited to these terms only). To the best of our knowledge, only 23 cases of intraosseous leiomyomas have been reported so far in the jaw bones, among which only 8 belonged to angioleiomyomas. Herein, we report the 9th case of intraosseous angioleiomyoma, one of the variants of leiomyoma and overall 24th intraosseous leiomyoma in a 6-year-old female child, together with conventional histopathologic and immunohistochemical findings

Invasive tumor front in oral squamous cell carcinoma: an independent prognostic factor

Background:Head and neck squamous cell carcinoma (HNSCC) is one of the most aggressive and invasive cancer types. Squamous cell carcinomas of the oral cavity are among the ten most common cancers in the world, and accounts for almost 3-5% of all malignancies. The invasive edges of head and neck squamous cell carcinomas often display different morphological and molecular characteristics than more superficial parts of the same tumor. Methods:In our 2 year retrospective study, carried at a tertiary care centre of north India, main aim was to evaluate the prognostic significance of several parameters of the modified Bryne’s grading system along with probability of survival in OSCC patients.Results:Out of 60 cases 40 were males and 20 were females. Tumor differentiation was assessed which showed that 90% of the tumors were well differentiated, 6.6% of the tumors were moderately differentiated and 3.4% of the tumors were poorly differentiated. The predominant POI in the primary OSCC was pattern 2 (63.4% in 38 cases) followed by pattern 3, pattern 1and pattern 4 (28.4% in17 cases, 6.6% in 4 cases and 1.6% in 1 case) respectively.Conclusions:Distributing all the cases according to the Bryne’s prognostic groups we found that 13 (21.7%) cases belonged to group with a score of <9, and 47 cases (78.3%) had a score of >9.The 5-year tumour-specificsurvival in OSCC patients with invasive front score of <9 was 95% compared to 46.25% in patients with high invasive front score >9.

The Spectrum of Histopathological Patterns Observed in Prostate Specimens in a Tertiary Care Hospital in Kashmir

Introduction: Prostate gland involved by a no. of benignand malignant diseases is a common cause of morbidity andmortality in the elderly men. The present study was an attemptto understand the histopathological spectrum of prostaticlesions in the specimens received by a tertiary care hospital.Material and Methods: 433 cases of prostatic specimensincluding TURP chips, TRUS guided biopsies and Prostaticspecimens received in the Department of Pathology,Government Medical College Srinagar were included in thepresent study. There were 344 needle biopsies and 82 TURPchips. All the specimens were fixed in 10% neutral bufferedformalin and thin sections were stained with Hematoxylinand Eosin stain (H&E stain). Relevant clinical data includingage, the presenting complaints and S.PSA values in suspectedcases of carcinoma prostate were recorded.Results: A total of 433 prostate specimens were receivedduring the period of three years. The specimens included 344TURP chips and 82 TRUS guided biopsies. 7 prostectomyspecimens were also included. The age of the patients variedfrom 42 years to 89 years. There were 380 benign cases and53 malignant cases. The most common presenting featurewas increased frequency of micturition followed by difficultyin starting and stopping the stream of urine. Among benignlesions the most frequent histopathological entity observedwas benign nodular hyperplasia. The most common age ofpresentation was the sixth to seventh decade of life. Almostall neoplasms of the prostate were prostatic adenocarcinomaswith most of the cases seen in the sixth to seventh decade oflife with another peak in the seventh to eight decade of life.Conclusion: A variety of benign and malignant lesions areseen in prostatic specimens. These need to be differentiatedand classified. Benign nodular hyperplasia is the mostcommon benign lesion and prostatic adenocarcinoma isthe most common malignant lesion of Prostate. Perineuralinvasion is a significant finding and guide. Serum PSA is auseful adjunct in cases where the values are higher.

Isolated angiokeratomas of the tongue: A rare entity

Angiokeratomas consist of ectasias of dermal capillaries associated with an acanthotic and hyperkeratotic overlying epidermis. These dark red-to-purple, papular vascular anomalies can vary considerably in size, depth, and location. It is a skin disorder that rarely involves oral cavity. It can occur in localized or generalized form and is often associated with underlying metabolic disorder such as Fabry's disease and fucosidosis. It has many clinical variants with the same underlying histopathology. Mucosal involvement, including the oral cavity, is occasionally found either as a component of the systemic variety, called angiokeratoma corporis diffusum, or associated with cutaneous lesions in more locations. Isolated oral involvement seems to be rather infrequent, and only eighteen cases have been described in the world literature thus far. Isolated multiple angiokeratomas of tongue without plaque formation have been reported only four times before this. Here, we report a fifth case of isolated multiple angiokeratomas of tongue in a 16-year-old female which was confirmed by immunohistochemical pattern in consonance with a blood vessel origin, with expression of CD31, CD34, and von Willebrand factor. The lesion did not express D2-40 and CD45. No other malformation or metabolic disorder was found in the patient.

Pilomatrixoma: A Clinico - Pathological Study

Introduction: Pilomatrixoma (calcifying epithelioma ofMalherbe) is a benign skin tumor with differentiation towardshair follicles. Pilomatrixoma may be mistaken for many otherconditions like epidermoid cyst, dermoid cyst, calcified lymphnode or a hemiangioma. The aim of this study was to describethe clinical and histopathological characteristics of patientspresenting with pilomatrixoma.Material and Methods: The present study was conductedin the Post Graduate department of pathology, govt. medicalcollege Srinagar. 51 cases of pilomatrixoma were included inthe study. The final diagnosis was arrived by histopathologicalexamination of the specimens. The clinical features andphysical examination including age, sex, site of lesion andsize were noted and analyzed.Results: 51 cases of pilomatrixoma, comprising about 37%cases of all skin adnexal tumors were considered. The mostcommon age group involved was 11-20 years comprising of33.34% of all cases. 23 (45.10%) were males and 28 (54.90%)were females. There was a slight female predominance. Themost common anatomical location for the tumor was foundto be head and neck followed by trunk, upper limbs and lowerlimbs. The histopathological findings observed were: a benignwell demarcated lesion surrounded by a capsule in almost allof the cases. The lesions were found to be composed of islandsof epithelial cells embedded in a stroma. Two types of cellswere identified in these epithelial islands basaloid cells andshadow cells.Conclusions: Pilomatrixoma should be considered in thedifferential diagnosis of nodules, especially those on the headand neck. Careful clinical examination and familiarity withthe condition may lead to accurate diagnosis and appropriatetreatment.