Case of immature mesenteric teratoma.

Mesenteric teratomas are extremely rare tumor arising from totipotent primordial cells, which displays a mixture of tissues of tridermal or bidermal origin. Immature teratoma in mesentery is still rarer. Here we report a case of immature mesenteric teratoma in a two day old neonate, which is youngest such patient except for one case, which has been diagnosed prenataly with the help of ultrasonography.

Usefulness of fine needle aspiration cytology in diagnosis of neck masses.

Background: Fine needle aspiration cytology (FNAC) is a well established, simple, quick, inexpensive and minimally invasive diagnostic technique. Neck region of human body is relatively small area but houses a fairly large number of organs with a variety of lesions and consequently require from conservative to aggressive management protocols. Aims and objectives: To assess sensitivity and specificity or diagnostic value of FNAC of neck masses keeping histopathology as gold standard. Materials and Methods: Surgical biopsies or excisions from neck masses were received in fifty nine cases in which prior FNAC was done. The findings of histopathological study were correlated with the diagnosis given on FNAC. Further the sensitivity and specificity were calculated. Results: Twenty eight aspirates were from lymph nodes, fourteen were from thyroid gland, thirteen were of salivary gland origin and four were others. Out of the Fifty nine cases the diagnosis of forty four (74.57%) was corroborated by histopathology. In fifteen (25.42%) cases the histopathological diagnosis was dissimilar to that of FNAC. The overall sensitivity of FNAC in the diagnosis of neck masses was calculated to be 83.01% and specificity was 78.94%. Sensitivity was highest (82.14%) for neck lymph nodes and lowest for thyroid masses (64.28%). Specificity was the highest for other neck masses (100%) and the lowest for neck nodes (71.2%). Conclusion: FNAC of neck masses is an effective diagnostic tool but its sensitivity and specificity of diagnosis in different organs should be kept in mind while creating a management protocol for the patient.

Central neurocytoma in the vermis of the cerebellum.

In neuropathology, anatomic landmarks and topographic relationships bear particularly on issues of differential diagnosis. A case of central neurocytoma of the vermis of the cerebellum is being reported in this article. A 45-year-old male with features of hydrocephalous and a posterior fossa space-occupying lesion was diagnosed as having central neurocytoma upon a microscopy of Hematoxylene and Eosin stained sections. The diagnosis was confirmed by a positive immunohistochemical reaction for Neuron Specific Enolase (NSE) and Synaptophysin. This case report is being made to emphasize that a high index of suspicion is required even for reporting neuropathology where the site does not match the conventional location of the lesion seen and also to emphasize the importance of immunohistochemistry in proving such unusually located lesions.

Pure malignant myoepitheliomas of the breast: an immunohistochemical study.

Myoepithelioma of breast are extremely rare. We report two cases of pure malignant myoepithelioma of the breast, utilising light microscopic and immunohistochemical methods for diagnosis. Both the cases presented as breast lump. Hematoxylin and Eosin (H&E) stained microscopic sections revealed a predominantly spindle cell tumor. Immunohistochemical work up was done. Case number one expressed positivity for vimentin, Smooth Muscle Actin (SMA), S-100 and CD10. Case number two expressed positivity for Vimentin, CD10 and p63. This led to the diagnoses of malignant myoepithelioma in both of them. Documentation of such cases prospectively and from archival material, using immunohistochemistry, is of extreme importance to assess the prevalence, various phenotypic patterns, long-term biological behaviour and to establish management protocols for malignant myoepithelioma.

Prostate specific antigen ratio: for diagnosis and assessment of aggressiveness of malignancy of prostate.

The search for a perfect tumour marker, which would be able to distinguish benign from malignant enlargement of prostate accurately, is still not complete. Total Prostate Specific Antigen (TPSA), a good test, has it's own inadequacies but Free Prostate Specific Antigen (FPSA) to TPSA ratio is emerging as a better adjuvant to it. This prospective study was done to verify the utility of FPSA to TPSA ratio in diagnosis of malignancy of prostate and its relationship to Gleason grading (indicating the aggressiveness) of adenocarcinoma of prostate. 100 patients with urinary symptoms, who were above fifty years of age and had prostatic enlargement, formed the study group. TPSA and FPSA were assayed by ELISA method and FPSA to TPSA ratio was calculated. Prostatic biopsy of all the cases was obtained and diagnostic histopathology and Gleason grading (in cases where adenocarcinoma was diagnosed) was done. Sensitivity, specificity, predictive value of positive test and predictive value of negative test for TPSA and FPSA to TPSA ratio were calculated. They were found to be 100%, 76.7%, 74.1% and 100% for TPSA and 82%, 100%, 100%, 89% for FPSA/TPSA ratio. Thus making it very obvious that FPSA to TPSA ratio is an excellent adjuvant to TPSA for diagnosis of malignancy of prostate increasing the specificity and predictive value for positive test. An inverse correlation (correlation coefficient = -0.95) was also found between PSA ratio and aggressiveness of prostate cancer, pointing towards its capability to predict the histological (Gleason) grade of the tumour.

Diagnosis of malignancy of prostate.

Minimal or complete lack of symptoms hinders early diagnosis of malignancy of prostate leading to undue morbidity and mortality. Therefore early detection is imperative, making use of simple and safe technique with least of expense. Five hundred consecutive patients, who reported with urinary complaints, were assessed by digital rectal examination, transabdominal suprapubic ultrasonography for prostatic volume/weight and serum assay of prostate specific antigen (PSA). Histopathological examination of prostatic biopsy of all the cases was also done. Benign prostatic hyperplasia was found in 83.6% of cases and 16.4% of the cases were of adenocarcinoma prostate of varying severity (mild, moderate and severe). It was found that volume/weight of gland and PSA levels were very good indicators of the probable diagnosis and grade of adenocarcinoma. Statistical tests taking various levels of PSA values in account also validated the results.

Cartilagenous choristoma of palatine tonsil--a case report.

Choristoma is defined as a histologically normal tissue proliferation or nodule of a tissue type not normally found in anatomic site of proliferation. Here a case of chronic tonsillitis is being reported where mature cartilage was found embedded in the tonsil, making the surgical removal of the tonsil difficult. Cartilaginous choristoma of the tonsil appears to be a developmental anomaly in the second pharyngeal arch and could be one of the causes of recurrent tonsillitis.