STNMP Staging of Oral Squamous Cell Carcinoma in Patients Above and Below 40 Years of Age: An Instituition Based Study

Background: A study on Oral Squamous Cell Carcinoma (OSCC) in patients above and below forty years of age. Aims: To compare the clinicopathological features of OSCC in patients below and above 40 years using STNMP [S-site, T- Tumor, N- Node, M – Metastasis, P- Pathology] staging system. Materials and Methods: A cross sectional study with data of patients reported with OSCC from January 2015 to September 2019 in the Department of Oral Pathology and Department of Radiotherapy, was done and analyzed using Chi-square test. The 937 study subjects obtained were categorized according to age as Group I (? 40 years) and Group II (?>40 years). A comparative study of clinicopathological variables using STNMP staging was done. Statistical analysis used: Statistical Package for Social Sciences (SPSS) version 23.0 Results: Of the 937 cases of OSCC, 87 were in Group I and 850 in Group II. Both the groups showed a male predilection. Tongue was the most common site among Group I and the buccal mucosa in Group II. STNMP staging of OSCC showed a higher percentage of individuals in the most advanced stage of the disease Stage IV, 42.5% and 32.2% in Group I and Group II respectively. Conclusions: Both the study groups showed a higher percentage of OSCC presentation in Stage IV which highlights the need for routine oral screening and awareness campaigns about OSCC. Study also points out the advantage of STNMP staging system in giving a detailed information about the tumor which makes it easy for future analysis.

HTLV 1 associated adult T cell lymphoma/leukemia a clinicopathologic, immunophenotypic tale of three cases from non-endemic region of south India.

Adult T cell lymphoma/leukemia is a peripheral T-cell neoplasm caused by human T-cell lymphotrophic virus-1, affects mostly adults with systemic involvement and poor prognosis. Diagnosis of adult T-Cell leukemia/Lymphoma is challenging. The clinico-pathologic and immuno-phenotypic features of the three cases will be presented.

CALLA negative precursor B lymphoblastic leukemia with MLL gene translocation and an unusual FISH signal pattern.

Rearrangements of the mixed lineage leukemia (MLL) gene at 11q23 commonly occur in infants with CALLA negative B lymphoblastic leukemia (B-ALL). Most often, these are detected by conventional karyotyping; however, fluorescent in-situ hybridization (FISH) with the help of a dual-color break-apart probe is used to identify cryptic translocations. When there is an MLL gene translocations the usual FISH signal pattern is 1 red-1 yellow fusion signal pattern We present a case of an infant with CALLA negative precursor B-ALL with a characteristic translocations t(4;11) (q21;q23),however,with an unusual MLL FISH signal pattern.

Elevated frequencies of micronuclei and other nuclear abnormalities of chrome plating workers occupationally exposed to hexavalent chromium

Biomonitoring provides a useful tool to estimate the genetic risk from exposure to genotoxic agents. The aim of this study was to assess the potential cytogenetic damage associated with occupational exposure to hexavalent chromium by using micronuclei [MN] as a biomarker. This was a cross-sectional study and all participants were males. Both the exposed and control individuals were selected from Coimbatore, Southern India. Exfoliated buccal cells from 44 chrome plating workers and 40 age and sex matched control subjects were examined for MN frequency and nuclear abnormalities [NA] other than micronuclei, such as binucleates, broken eggs, karyorrhexis, karyolysis and pyknosis. Results showed statistically significant difference between chrome plating workers and control groups. MN and NA frequencies in chrome plating workers were significantly higher than those in control groups [p < 0.05] and also significantly related to smoking habit [P < 0.05]. A significant difference in NA was observed in workers exposed to chromium for longer duration. In addition to this, a higher degree of NA was observed among smokers. MN and other NA reflect genetic changes, events associated with carcinogenesis. Therefore the results of this study indicate that chrome plating workers are under risk of significant cytogenetic damage. Therefore, there is a need to educate those who work with heavy metals about the potential hazard of occupational exposure and the importance of using protective measures

Undifferentiated sarcoma of the mitral valve with secondaries in brain in a girl of 22 years.

During a mitral valve replacement surgery in a girl of 22 years of age, it was accidentally discovered that the valve was destroyed due to a tumor and the histopathology and immunohistochemistry findings have proved it to be undifferentiated sarcoma. She was advised by the surgeon to go for chemotherapy. There was a delay of three months from the side of the patient to reach us and during that interval she has developed secondaries in the brain. This case is being presented here for its rarity.

Multiple myeloma of mandible: a case report

Multiple myeloma [MM] is a neoplastic disorder that is characterized by monoclonal proliferation of plasma cells. Dental professionals may play a major role in the recognition and diagnosis of this disease, if it is presenting as the primary manifestation in oral cavity. In oral manifestations, the mandible is involved far frequently than the maxilla. We report a case of multiple myeloma of mandible in a 70 year old lady. A brief review of literature is also discussed

Image Analysis in the evaluation of chronic hepatitis

Chronic hepatitis, a major chronic liver disease with morbidity, continues to affect a large segment of population in the underdeveloped and developing countries. The prognosis not only depends on the etiology but also on the severity of lesions. Prognosis as well as the interference in the pathobiology of the disease with drugs like interferon require definite morphological criteria with regard to severity and progress. The Knodell scoring system is based on the assessment of inflammation, necrobiosis, fibrosis and nodular transformation and given scores [points].The sum of all parameters is finally added to indicate the severity. However, objectivity in identifying the location and severity using image analysis is not carried out hitherto. Image analysis essentially consists of computer assisted morphometric analysis, with tailormade tools for assessment of area, intensity and perimeter and built-in statistical system. An attempt has been made to corroborate Knodell's score with the image analysis. Morphometric evaluation in a selected group of sixteen cases of chronic hepatitis satisfying the clinical criteria. As the portal and parenchymal changes, according to Knodell may reach maximum 20 points' score as fibrosis and nodular transformation to 6, it is considered to group the severity into three -namely 0-4, 5-8 and more than 8. This would obviate ill defined borderline cases falling into one or other groups. The area, perimetry and intensity values are corroborated with Knodell's score of 0-4, 5-8, >8. The three groups are statistically evaluated. Image analysis enabled us to assess the severity of lesions belonging to different categories of Knodell Score. The area and perimeter findings showed significant correlation [P < 0.0007 and P < 0.00] with Knodell score group I, II and III. However, the intensity score did not have any acceptable significance. Based on this statistics the objective evaluation by image analysis is considered rapid, reproducible and accurate