Ovarian tumors – Incidence and histopathological spectrum in tertiary care center, Valsad

Introduction: Ovarian tumors are now the one of the leading cause of death involving a wide spectrum of clinical, morphological and histopathological diagnosis. It frequently does not result in symptoms until the tumor has spread extensively and pose difficulties to clinicians. Objectives: The aim was to study the incidence and histopathological spectrum of ovarian tumors according to WHO classification in different age group and its clinical correlation. Materials and methods: A study was undertaken during a period of May 2011 to December 2017. The tumors were classified according to WHO classification after thorough examination of H&E slides. Data of clinical presentation of patient was also recorded in each case. Results: There were total 162 cases were studied, amongst which surface epithelial tumors were the commonest variety accounting for 126(77.7%) cases, followed by Germ cell tumors 30(18.5%) cases and Sex-cord stromal tumors 6(3.8%) cases. Benign tumors (93.2%) were more common than malignant (6.2%) and borderline (0.6%). Among benign tumors, serous cystadenoma (57.4%) were the most common followed by mucinous cystadenoma (16%) and mature teratoma (16%). Most of the ovarian tumors were unilateral (89.5%) with left sided predominance (49.4%). Majority of benign tumors presented with cystic consistency (67.9%) and mixed consistency (4.3%) in malignant tumors. The age range was 4 year to 70 years. Abdominal pain (48.8%) was the commonest clinical presentation. Conclusion: Ovarian tumors were found to occur in wide range of age with bimodal peak for malignant tumors. Benign tumors were more common across the all age group. An accurate histopathological diagnosis and staging is important for therapeutic and prognostic purpose.

Adjunctive role of immunohistochemistry to traditional histomorphology in diagnosis and accurate typing of soft tissue sarcoma.

Background: Soft tissue sarcomas, compared with carcinomas and other neoplasms, are relatively rare and constitute less than 1% of all cancers. Immunohistochemistry (IHC) especially a panel approach is an important adjunct to histopathological morphology and plays an important role in Soft tissue sarcoma diagnosis and accurate typing. Aims & Objective: Current study is to evaluate the utility of histopathology and immunohistochemistry in soft tissue sarcoma diagnosis and accurate typing. Material and Methods: Total of 50 cases of soft tissue sarcoma studied from January 2010 to October 2012. All cases were reported using routine (H&E) Hematoxylin- eosin stain and other ancillary techniques including panel approach of immunohistochemistry. Results: Histomorphology confirmed diagnosis in 22 % cases. In 78 % cases it was contributory to IHC. IHC provide confirmative diagnosis (Single diagnosis) in 45 cases (90%), definitive diagnosis (with two possibilities) in 4 cases (8%) and noncontributory in 1case (2%). Conclusion: Despite the rapid development of molecular genetic techniques, IHC still remains the most important diagnostic tool in the diagnosis of soft tissue tumours aside from recognition of morphologic features and clinical correlation. One of its major utilities is to correctly identify a tumour as mesenchymal or nonmesenchymal origin and then accurate typing done according to specific cell lineage. IHC is specifically useful in tumours of uncertain cell lineage and primitive round cell tumours. Indeed IHC has brought Brown revolution in sarcoma diagnosis and accurate typing. But important not to forget histopathology which provide the basic platform for the panel approach of IHC.

Histopathological spectrum of tumours of upper aero digestive tract in Surat - A study of 156 cases.

Background: Cancers of the upper aero-digestive tract (UADT) constitute 3.5-4% of all malignancies. Majority of cases are squamous cell carcinomas which are related with various epidemiologic factors. Aims & Objective: The objective of this study is to know the histopathological spectrum of tumours of UADT. Material and Methods: This study comprises of 156 cases of histopathological diagnosed tumours of upper aero digestive tract who attended new civil hospital, government medical college, Surat, from August 2010 to august 2012. All prospective and neoplastic cases were included and retrospective and non- neoplastic cases were excluded. Routine paraffin sectioning and staining was done and immunohistochemistry was applied when required. Results: Out of total 156 cases of UADT, 129 malignant, 19 cases benign and 8 were carcinoma in-situ cases. In malignant cases, 124 (96.00%) cases of carcinomas, 1 (0.80%) case of sarcoma, 2 (1.60%) cases of melanoma, and 2 (1.60%) cases were of lymphomas. Most common site of carcinoma was oral cavity (tongue). Most common carcinoma was Squamous cell carcinoma. Most common site of SCC was hypo pharynx (pyriform Fossa), followed by oral cavity (tongue) and larynx (supra glottis). In benign tumours, most common site was nasal cavity (7 cases) and common varieties were Angiofibroma and Capillary Haemangioma. Conclusion: Tumours of UADT are predominant in males affecting older age group. People with tobacco chewing, smoking, alcoholism, poor socioeconomic background, mixed diet and poor oral hygiene are more vulnerable.

Immunohistochemistry: A diagnostic tool for accurate characterization of undifferentiated malignant tumours.

Background: The impact of diagnostic immunohistochemistry for the surgical pathology is legendary especially when it provides true identity of undifferentiated tumours. This not only is important for prognostication & therapy but also provide further insights into the pathobiology of these tumours. Aims & Objective: This study was undertaken to determine the role and significance of immunohistochemistry for accurate diagnosis and subtyping of undifferentiated malignant tumours as it is essential in guiding therapy and prognosis. Material and Methods: Immunohistochemical staining (IHC) performed was based on Peroxidase Antiperoxidase (PAP) method on paraffin sections, using appropriate mono/polyclonal antibodies. Total 74 cases including six consultation cases were studied from August 2008 to November 2011, which were reported as undifferentiated or poorly differentiated malignant tumor using routine hematoxylin- eosin stains. Results: The histopathology and IHC reports of 74 tumours were reviewed and assigned to appropriate categories. It was possible to arrive at a diagnosis in 73 cases (98.65%) with the help of IHC. Carcinoma was the commonest diagnosis (27 cases, 36.50%) followed by lymphoma (18 cases, 24.32%), sarcoma (14 cases, 18.92%), malignant melanoma (3 cases, 4.05%) and neuroblastoma (3 cases, 4.05%). Conclusion: Immunohistochemistry is helpful in the majority of difficulties arising during histological diagnosis of undifferentiated malignant tumours and serves as a diagnostic, prognostic, and predictive tool.