Clinicopathological study of skin tumours

Background: Skin cancers are relatively uncommon malignancies worldwide, but the incidence of skin cancers has progressively increased over the last few decades. The distinction between benign and malignant neoplasm are more difficult to define when they appear in skin than when found elsewhere and histopathological examination is frequently required to establish a definitive diagnosis. Diagnosis of any skin tumours can be done by correlating clinical features and histological features. The aim and objective were to study age-sex wise distribution, clinical presentation and histopathological spectrum of various skin tumours.Methods: This is a retrospective study of three years conducted in the Department of Pathology, Government Medical College, Aurangabad, India from December 2015 to December 2018. Specimens received from Department of Dermatology were fixed in formalin and after adequately processing the sections were stained routinely with H and E stain and properly evaluated for histopathological examination. This study includes tumors of epidermis along with melanogenic tumors and skin appendageal tumors. The data collected was tabulated, analysed and compared to other similar studies.Results: The study consists of 130 cases. The ratio of male to female was 1.24:1. Head and neck region (48.46%) was the most common site observed where skin lesions were present followed by extremities (37.69%). Most of the malignant tumours were presented with non-healing ulcers (30.76%) and Noduloulcerative lesions (20.33%). Out of 130 cases, 83 (63.84%) were benign whereas 47 (36.15%) were malignant tumour. According to WHO classification, keratinocytic tumour 55 (42.30%) was the most common tumour type in the present study. Skin adnexal tumours and melanocytic tumours were observed in 54 (41.53%) and 21 (16.15%) respectively.Conclusions: The skin is a complex organ. Because of complexity of skin, a wide range of diseases can develop from the skin. The majority of benign neoplasms are from skin adnexal group whereas most common malignant neoplasm were from keratinocytic group. Skin adnexal tumors can occur anywhere in the body, however head and neck region constitute the most common site. Skin adnexal tumours are clinically often misdiagnosed, so histopathological examination remains gold standard for their correct diagnosis and for their differentiation between benign and malignant neoplasm.

A clinicohematological profile of splenomegaly

Background: Splenomegaly is a matter of considerable clinical concern as spleen is not normally palpable. Splenomegaly is associated with large number of disorders including hematological, infectious, congestive states related to portal hypertension, lymphohematogenous disorders, immunological conditions, storage disorders and miscellaneous conditions. So, all the cases of splenomegaly should be thoroughly investigated to ascertain etiology. Splenomegaly can be an important diagnostic clue to existence of an underlying pathology. The aim and objective of present study was to find out relative frequency of clinical conditions associated with splenomegaly, to study clinic-hematological profile of splenomegaly and to find out the role of hematological investigations as a diagnostic tool in elucidating etiopathogenesis of splenomegaly.Methods: This was a cross sectional, observational study. Study was conducted on 135 pediatric as well as adult patients with splenomegaly admitted in medical ward, Government Medical College and tertiary care hospital Aurangabad, Maharashtra, India from December 2015 to October 2017. Hematological parameters of 135 cases of splenomegaly were analysed and correlated with clinical findings.Results: Study comprises 135 patients. Age range was 3 months to 78 years. Males (54.81%) were affected more commonly than females (45.19%). The most common presenting complaint was fever (59.26%) followed by generalized weakness (51.11%) and pallor (44.44%). Majority of cases (48.15%) had grade II splenomegaly. Splenomegaly was associated with hepatomegaly (60.74%) and lymphadenopathy (18.52%). The commonest cause of splenomegaly found was anemia (39.26%) followed by hematological malignancies (20.74%), congestive states (11.85%) and infections (11.85%). Hematological investigations revealed diagnosis in majority of cases (71%).Conclusions: Splenomegaly is an important clinical sign that must be investigated thoroughly as most of the common causes are treatable. Hematological causes outnumbered the non-hematological causes of splenomegaly. Hematological profile in cases of enlarged spleen are of utmost importance as a diagnostic or additional tool in elucidating the etiogenesis of splenomegaly.

Clinicopathological study of testicular lesions

Background: Testis is affected by both neoplastic and non neoplastic conditions. Non neoplastic lesions of the testis include epididymo-orchitis, testicular atrophy, undescended testis, testicular abscess etc. Testicular tumors are relatively rare. They constitute the 4th most common cause of death from neoplasia in the young males. This study was undertaken to study the histopathological spectrum, age wise distribution and clinical symptoms of testicular lesions.Methods: This is a retrospective study of three years conducted in the department of pathology, Aurangabad from June 2015 to May 2018. It included all the orchidectomy specimens received from the department of surgery and excluded the orchidectomy specimens sent for infertility and prostatic carcinoma. A detail clinical history was taken. Histopathological examination was done after routine processing and staining with H and E. The data collected was tabulated, analysed and compared to other similar studies.Results: We studied 70 cases. Non neoplastic testicular lesions were 57 and 13 were neoplastic. Non neoplastic testicular lesions were more common than the neoplastic ones. Non neoplastic testicular lesions presented most commonly in the 2nd decade. Most common non neoplastic lesion was epididymo-orchitis followed by torsion, atrophy and testicular abscess. Most common neoplasm was malignant mixed germ cell tumor. Most of the patients of neoplasms presented in the 3rd decade. The most common complaint was testicular swelling and pain.Conclusions: Majority of testicular lesions are non neoplastic. Neoplastic lesions are rare. Non neoplastic lesions mimic neoplastic ones clinically, as testicular swelling is the most common complaint. So histopathological diagnosis is necessary for an accurate diagnosis of testicular lesions.

Metaplastic Carcinoma of Breast - Squamous Variant.

Metaplastic carcinoma of breast is a rare neoplasm. Although it is a tumor of ductal type, the predominant component may have appearance other than the glandular pattern and usually runs an aggressive course.

Langerhans Cell Histiocytosis Presenting with Hypopigmented Macules.

Langerhans cell histiocytosis (LCH) is a complex disease characterized by proliferation of the Langerhans cells. The clinical course is variable and ranges from a solitary lytic bone lesion or skin lesion with complete remission to a multisystem disorder with possible lethal outcome. The diagnosis is suspected by clinical signs and symptoms and radiological features commonly in craniofacial bones and skin lesions. Diagnosis is confirmed by biopsy and immunohistochemical studies. We present case of a 8 year old child presenting with proptosis, diabetes insipidus and hypopigmented macules on chest and back showing bilateral distribution which is a rare presentation. Skin biopsy revealed the diagnosis of Langerhans cell histiocytosis.

Primary malignant melanoma of cervix: a case report.

Primary malignant melanoma of cervix is a rare entity. A case of primary malignant melanoma of cervix presented with vaginal discharge and black colored growth over cervix. Histology showed malignant pleomorphic cells with melanin pigment in the cytoplasm.