Expression of Ki67 and CerbB-2 in Gall Bladder, Oesophageal, Small Intestinal and Colorectal Adenocarcinomas: A Study from a Tertiary Care Hospital in Western U.P.

Introduction: Gall bladder cancer is the commonestbiliary tract malignancy with poor prognosis. Oesophagealadenocarcinomas are aggressive with very poor survival.Adenocarcinomas of small intestine are rare, in comparisonto colorectal carcinomas. We studied the expression of twocommonly studied immunohistochemical markers Ki67 andCerbB-2 in gall bladder and gastrointestinal carcinomas, tofind out their prognostic significance.Material and Methods: Histopathologically confirmed casesof adenocarcinomas of gall bladder (19 cases), oesophagus(3 cases), small intestine (3 cases) and colorectal region (8cases) were included. Formalin fixed paraffin embeddedtissue blocks were retrieved and sections were studiedimmunohistochemically for expression of Ki67 and CerbB-2.Tumors of all stages and grades were studied.Results: Our study revealed a significantly high Ki67in neoplastic glands of gall bladder, oesophageal, smallintestinal and colorectal adenocarcinomas as comparedto the non neoplastic areas. The Ki67 labelling index washigher in moderately and poorly differentiated areas as wellas mucinous and signet ring type adenocarcinomas. Therewas no relation with stage/depth of tumor invasion. CerbB-2was significantly overexpressed in gall bladder and colorectaladenocarcinomas. Expression was higher in advanced stageand greater depth of invasion. There was no associationwith tumor grade or type. In esophageal and small intestineadenocarcinomas, expression was not related to either tumorstage or grade.Conclusion: A panel of Ki67 and CerbB-2 in gastrointestinaland biliary tract malignancies may correlate well with differentprognostic indicators in these malignancies, like tumor stage,histologic type and grade.

Lipofibromatous hamartoma of the digital branches of the median nerve presenting as carpal tunnel syndrome: A rare case report with review of the literature.

Lipofibromatous hamartoma (LFH) is a rare, benign fibrofatty tumor composed of a proliferation of mature adipocytes within peripheral nerves, which form a palpable neurogenic mass. It affects the median nerve in 66–80% of cases, causing pain and sensory and motor deficits in the affected nerve distribution. Patients typically present with gradually enlarging nontender lesions in the distribution of the affected nerve. The lesion is also seen to be associated with macrodactyly. The pathophysiology of LFH is unknown. Treatment of LFH is based on symptoms of the condition. Histopathology is characteristic. We present a case of young male diagnosed as lipofibromatous hamartoma of the median nerve involving the right index finger. The case is presented due to its rarity.

Role of FNAC in cytological diagnosis of metastatic lymph node.

Background: FNAC not only confirms the presence of metastatic disease, but also gives the clue regarding the nature and origin of primary malignancy Aim and objective: To Assess the usefulness of FNAC in diagnosis of metastatic lymph node. Data were arranged according to lymph node involved and morphological diagnosis. Study design: Study material comprises of 56 lymph node aspirate diagnosed metastatic carcinoma in cytology out of total 383 cases of Lymphnode aspiration in a one year. Method: All FNACs were performed using a 22 gauge needle. An average minimum of 4 slides were made, Slides were routinely stained with both leishmann, Giemsa and Papanicolaou (PAP) stains. Results: Out of total 383 lymph node aspirate 56 cases showed metastasis Lymphnode while 327 cases showed other lesion of lymph node. Cervical lymph node was the commonest group involved. Metastasis from squamous cell carcinoma was the most common diagnosis made on cytology. Conclusion: In our study we feel that FNAC of lymph nodes as a first line of investigation in developing countries. It is not only useful in the diagnosis of suspected or unsuspected metastatic neck nodes, but can also help in starting the specific therapy in time thus reducing mortality and morbidity.

Primary tuberculosis vulva - A case report.

A case of primary tuberculosis of vulva in a young female is presented herewith due to the rarity of the site and also since spread from no other structure could be found.