Clinical profile of patients with vernal keratoconjunctivitis.

Background: Ocular allergy is a common disorder, which can be debilitating for patients and at times challenging physicians to diagnose and treat. Allergic disease affects 30-50% of the population. Vernal keratoconjunctivitis (VKC) has predilection for young age group and the diagnosis is generally based on signs and symptoms of the disease. This study was undertaken to stress upon the disease and those secondary to its long-term medication. Methods: 74 patients with VKC detected at random, who attended the Department of Ophthalmology KIMS, Hubli from December 2012 to May 2014. The relevant details of history and clinical examination of the patients were recorded on a specifically designed Proforma. The type and severity of VKC was noted. Clinical observation and evaluation of clinical signs and symptoms were performed before and after drug therapy at first visit, weekly interval for 2 weeks and at the end of 3 months. Results: 22 out of 74 (29.72%) were in the 6-10 years of age. The male: female ratio was 2.7:1.13. Majority of the patients presented in the month of May. Family history of allergy was present in 4 (5.04%) of patients. 59 (72.72%) patients showed seasonal symptoms and 15 (20.27%) patients showed perennial symptoms. Mixed type was found in 60.81%. Itching was present in 59 (79.72%). 72 (97.29%) had papillae on the upper tarsal conjunctiva. Conclusions: VKC was common in males, during hot climate. Mixed type of VKC was more commonly present.

Expression of vimentin in breast carcinoma, its correlation with Ki67 and other histopathological parameters.

CONTEXT: Vimentin is a mesenchymal marker, known to express in some epithelial carcinomas. AIMS: 1. To find out the expression of vimentin in infiltrating ductal carcinoma of breast (not otherwise specified), 2. To find out the correlation between expression of vimentin and prognostic markers such as tumor size, tumor grade, lymph node status, proliferation index (measured by Ki 67), and Nottingham prognostic index (NPI). MATERIALS AND METHODS: Study was done at Department of Pathology; 50 cases of infiltrating ductal carcinoma (NOS) were studied for tumor grade; immunohistochemistry was done using antibodies against vimentin and Ki 67. Percentages of positive cells were documented. An immunoscore was also calculated for vimentin. Vimentin expression was correlated with tumor size, lymph node status, Nottingham prognostic index, and Ki 67. Statistical analysis used: statistical correlation was done using Pearson’s chi-square test. A P value less than 0.01 was considered significant. RESULTS: Vimentin expression was seen in 18% of cases. Its expression correlated with high tumor grade and high growth fraction (P value < 0.01). It did not correlate with lymph node status, tumor size, and NPI. CONCLUSIONS: Increased vimentin expression is associated with bad prognostic factors. Immunohistochemistry with vimentin may be helpful in knowing the prognosis in cases of infiltrating ductal carcinoma of breast (NOS).

Intra-pulmonary teratoma: A rare case.

A 28-year-old female, home-maker presented to our department with a four-year history of intermittent episodes of cough and haemoptysis. She had no history of fever, weight loss or expectoration. Physical examination was unremarkable.

Metaplastic carcinoma of the breast-A rare neoplasm with transitional cell differentiation: An exceptional feature.

Metaplastic carcinomas of the breast are malignant breast neoplasms composed of a mixture of both epithelial and mesenchymal elements. The rarity of this tumor is exemplified by the fact that it accounts for only about 0.2% of all breast carcinomas. It can present histologically with diverse differentiation and the exact histogenesis of these tumors is unknown. The present case is reported for its rarity and for the presence of transitional cell differentiation along with the other usual components of metaplastic carcinoma. Transitional cell differentiation in a metaplastic carcinoma has not been documented in the literature. Besides this, it highlights the importance of special stains and immunohistochemistry in evaluating these carcinomas and the need for early diagnosis and excision of these tumors as these carcinomas generally have a poorer prognosis as compared to breast carcinomas without metaplasia, with the tumor size having an important bearing on the outcome of this condition.

Malignant ovarian tumor co-existing with pregnancy: a case report.

Ovarian tumors have occasionally been reported in pregnant women, the incidence as per literature being 1 in 81 to 1 in 2000 pregnancies. Out of this, about 2-5% are malignant, thus contributing to the rarity of malignant ovarian tumors in pregnant women. One such occurrence in a 24-year old female patient is reported here considering its extreme rarity.

Papillary serous carcinoma of the broad ligament: a rare case report.

Primary broad ligament carcinomas unassociated with either uterine or ovarian disease are extremely rare. This case report deals with such a rare occurrence of primary broad ligament carcinoma of the serous papillary type with foci of transitional differentiation in a 40 yr old woman with a clinical diagnosis of multiple fibroids of uterus. The highlight of this case is that besides being a rare tumor occurring in an unusual site such as the broad ligament the papillary serous carcinoma reported here also has a unique feature of transitional cell differentiation.

Placental site trophoblastic tumour: a case report.

Placental site trophoblastic tumour (PSTT) is a rare form of trophoblastic disease accounting for < 2% of all gestational trophoblastic neoplasms. Most of the cases follow a normal pregnancy and a small number have a preceeding molar pregnancy or spontaneous abortion. It can occur as early as several weeks or as late as 15 years after normal delivery, molar pregnancy or abortion. Excessive intermediate trophoblastic activity is the most important diagnostic criterion of this tumour originating from non villous trophoblast. But the possibility of a PSTT should be considered when there is excessive intermediate trophoblastic activity despite the presence of chorionic villi as in the present case. This case report highlights the unusual features like rarity of the tumour (< 2%), occurrence following spontaneous abortion which happens only in a minority of cases, and presence of chorionic villi in the tumour despite the fact that the tumour is of non villous trophoblastic origin.

Paratesticular myxoid liposarcoma: a case report.

Liposarcoma of the paratesticular region is a rare malignant soft tissue neoplasm. Out of all the possible sites of liposarcoma, the incidence in spermatic cord is rare, accounting for only 5% of these neoplasms. Among the various subtypes of liposarcoma described in the paratesticular region, myxoid variant of liposarcoma is seen very rarely. One such case is we ported here for its rarity and also to draw attention to the fact that, early diagnosis and complete excision carry better prognostic value.

Antioxidant response to oxidative stress induced by smoking.

Oxygen free radicals have been hypothesized to play a pivotal role in the deleterious effects of smoking on health. The present study was undertaken to examine the oxidant and antioxidant system among smokers and nonsmokers. Fourteen smokers and 11 nonsmokers were enrolled for this study. The protein carbonyl levels in smokers were found to be significantly higher than in nonsmokers. The levels of plasma ascorbic acid, free sulfhydryl group, and erythrocyte reduced glutathione were lower in smokers compared to nonsmokers. In smokers the erythrocyte activities of both glutathione peroxidase and catalase were decreased when compared to that in nonsmokers. The data from the study reemphasizes the presence of oxidative stress in smokers. The concomitant decrease in the activities of both catalase and glutathione peroxidase found in the erythrocytes of smokers raises rational grounds for expressing concern over the increased susceptibility towards oxidative stress in these subjects.

Nonenzymatic glycation of plasma proteins in smokers.

Glycation is known to play a key role in complications of many pathophysiological processes. The present study was carried out to assess whether there are abnormalities of nonenzymatic glycation of proteins in smokers. Fourteen current smokers and 10 healthy nonsmokers were enrolled for the present study. Fasting plasma glucose, insulin, fructosamine and total plasma glycated proteins were evaluated. A significant rise in the mean levels of fructosamine and total plasma glycated proteins were found in smokers when compared with controls. Significant difference in insulin values was observed between these two groups. When Pearson's correlation analysis was performed, no significant correlation was found between fasting plasma glucose with either fructosamine or total plasma glycated protein levels. These data suggest an increased glycation of proteins in smokers independent of glucose concentration.

Carcinoma within a fibroadenoma: a case report.

Carcinoma within a fibroadenoma is an extremely rare occurrence with a reported incidence of 0.1% and is most often diagnosed incidentally on post-operative examination of excision biopsy specimens. One such case is reported here for its rarity and also for stressing upon the need for compulsory excision of all breast masses clinically diagnosed as fibroadenoma and for highlighting the importance of histopathological evaluation of all breast masses irrespective of their clinical diagnosis as benign.

Effect of smoking on lipid profile and lipid peroxidation in normal subjects.

The aim of the present study was to assess the association between smoking and the alteration in plasma concentration of lipid profile and lipid peroxides. Fourteen smokers and 11 age matched control were enrolled. Plasma levels of fasting cholesterol, triglycerides, lipoprotein cholesterol and malondialdehyde were estimated. In smokers the levels of total cholesterol, LDL cholesterol, Non-HDL cholesterol and MDA were significantly elevated when compared with the controls. The atherogenic index as indicated by various risk ratios were also found to be increased in smokers as compared to controls. These findings indicate that current smokers are at a pro- atherogenic state and as in other countries, in India smokers require particular attention in terms of public health interventions.

Malignant peripheral nerve sheath tumor in oral cavity--a rare site.

MPNST occurring in oral cavity, which is a rare site for the tumour, in a 35 year old female patient with history of swelling underneath the tongue present since one year diagnosed clinically as ranula is presented here. Histopathological examination of the excised mass showed features of spindle cell sarcoma following which a provisional diagnosis of MPNST was offered. The differential diagnosis considered were leiomyosarcoma, rhabdomyosarcoma and spindle cell variant of squamous cell carcinoma (being the commoner tumour in oral cavity). Immunohistochemistry confirmed neural origin of the tumour. The case is reported in view of the rarity of the lesion in oral cavity.

Endometrial aspiration cytology in dysfunctional uterine bleeding.

Aspiration cytology is a safe simple and reliable technique without any complication This can be used as a safe and reliable out patient procedure with minimum discomfort to the patient. The use of a cannula as a device for endometrial aspiration provides adequate material for cytological examination. So the present study was undertaken, to assess the ease of collection of endometrial material and to assess the relative compatibility of aspiration cytology and histopathology.

Image-directed percutaneous FNAC of ovarian neoplasms.

Fine needle aspiration of ovarian neoplasms is a relatively less frequented area of diagnostic aspiration cytology. Hence, an attempt has been made in the present study to evaluate the current status of Image-directed percutaneous needle aspiration in ovarian neoplasms and to assess its value and limitations in the diagnosis and management of ovarian neoplasms. The present study involves 105 cases of ovarian neoplasms, which were assessed by ultrasound-guided FNAC. Only those cases with adequate material on aspiration and availability of cellblock or biopsy material following FNAC for correlative histopathological study were included in the study. The diagnostic accuracy of ovarian neoplasms in the present study was 89.85%, with a false negative rate of 4.76%. Considering the rapidity and reliability of the procedure with its added advantages like cost-effectiveness and increased patient acceptability, it can be concluded that image-guided FNAC holds a key position in the diagnosis and management of ovarian neoplasms.

Parachordoma of tibia--a case report.

A rare case of a 24-year old male patient with 'parachordoma' of left tibia having the characteristic histopathological and histochemical features of chordoma occurring in an unconventional site, which was clinically and radiologically diagnosed as osteoclastoma is presented here. The case is presented considering the extreme rarity of the lesion in literature in long bones.