ABSTRACT
Background and Aims: Breast cancer is one of the leading causes of mortality in Indian women. Although breast cancer is an epithelial malignancy, stroma plays a key role in its development and pathogenesis. Stromal markers are now emerging as novel markers in assessing the prognosis of invasive breast cancer and have not been studied extensively till date. The aim of the present study is to study the stromal expression of CD10 in breast carcinoma, fi nd its relationship with other prognostic markers and study the role stroma plays in breast cancer pathogenesis. Materials and Methods: A total of 70 cases of breast cancer were included in the study. Representative sections were taken and hematoxylin and eosin staining was done. Immunohistochemistry was performed with ER, PR, Her2neu and CD10. Stromal expression of CD10 (>10% stromal positivity was considered positive) in invasive breast carcinoma was noted and was statistically analyzed with different known prognostic markers of breast carcinoma. Results: Stromal expression of CD10 was found to be signifi cantly associated with increasing tumor grade (P = 0.04), increasing mitotic rate (P = 0.33), worsening prognosis (P = 0.01), ER negativity (P = 0.0001), Her2neu positivity (P = 0.19) and with molecular subtypes (CD10 positivity with the HER2 type, and CD10 negativity with Luminal type). No correlation was found between CD10 overexpression and PR, age, menopausal status, tumor size, lymph node positivity and tumor stage. Conclusions: This study gives substantial proof to the various models/research papers explaining the role of stroma/CD10 in breast cancer pathogenesis. Keeping the role stroma plays in predicting prognosis and tumor response, CD10 should be included as a routine pre-chemotherapy marker in breast carcinoma. Further studies should be performed to see the role stroma plays in hormonal expression and the usefulness of CD10 to predict treatment failure in breast carcinomas receiving neoadjuvant therapy.
ABSTRACT
Background: Oropharyngeal carcinoma is one of the leading causes of morbidity and mortality in Indian population due to increased use of tobacco chewing products. Mucosal biopsy is widely regarded as the gold standard for detecting oral carcinomas, but exfoliative cytology are increasingly used for early detection of malignancy and strict follow up in suspicious looking lesions. Aims & Objective: The aim of this study was to see the reliability of oral scrape cytology to detect pre-malignant and malignant oral lesions in terms of sensitivity and specificity and to see whether it can replace biopsy for diagnosing the same. Material and Methods: A total of 100 cases with oral lesions were included in the study. All patients underwent oral scrape cytology and 55 cases were followed up with punch biopsy. Sensitivity, specificity, positive and negative predictive values were calculated. Cytopathology and histopathology of premalignant and malignant lesions were compared using T test. Results: Oral cancer is most common in male (M: F 7:1). Premalignant lesions were more common in the tongue, whereas the floor of mouth was more involved by malignant lesions. Four cases were marked insufficient on cytopathology. 25% of cases were false negatives. The sensitivity, specificity, positive predictive value and negative predictive value were 91.5%, 100%, 100% and 66.7%, respectively. Statistical analysis showed P of 0.7491 suggesting that there is no significant difference between histopathology and brush cytology in assessing clinically premalignant lesions but for clinically malignant lesions P values of 0.0001 suggesting that there is significant difference between histopathology and scrape smear cytopathology in assessing malignant lesions. Conclusion: The high specificity and the high positive predictive value of oral scrape cytology makes it an ideal screening test for early detection of oral cancer. However, its low sensitivity means that it can miss cases of carcinoma, and should be followed up with biopsy with string clinical suspicion. Also, there is statistically significant difference between histopathological and cytopathological diagnosis in diagnosing dysplasia or carcinoma.
ABSTRACT
Background: Bone tumours are comparatively uncommon among wide array of lesions and pose a diagnostic problem as they constitute a small portion of diagnostic experience among pathologist. Aims & Objective: To study the histopathological features of bone lesions and their correlation with age of presentation, site and type of lesion. Material and Methods: The present study was carried out at a tertiary care center from October 2003 to January 2006. A total of 79 bone lesions were analyzed. A detail clinical and radiological history was taken. Bone biopsy was performed by either percutaneous method with needle/drill or Open surgical biopsy. If attached soft tissue was also received, bony tissues were put for decalcification (10% nitric acid) and soft tissue was immediately fixed into 10 % formalin and processed by paraffin embedding. Sections were stained by haematoxylin and eosin stain. Results: Incidence of non-neoplatic and benign neoplastic lesions was 68.40% while that of malignant lesion was only 20.22%.Younger patients (58.24%) and males (59.49%) were more commonly affected. Amongst non-neoplastic lesions, tuberculous lesions (17.72%) were commonest while exostosis (15.19%) and osteosarcoma and chondrosarcoma were common benign and malignant neoplastic lesions respectively. Overall most common bone involved was femur. In tuberculous lesions, vertebrae were commonly involved. Osteolytic lesions were more common. Metaphysis was the commonest site. Conclusion: Though bone tumours are less common lesions and pose a diagnostic problem, if viewed in perspective of clinico-radiology and histopathology, a correct diagnosis can be reached.
ABSTRACT
Background: Neurosurgical practice frequently requires intraoperative consultation to optimize surgical procedure. Frozen section and Squash smear cytology can offer the same. As brain tissue is friable & predisposed to show ice crystal artefacts, frozen section is often difficult to interpret. Squash smear examination provides good cytological details to offer diagnosis in most cases except where anatomical correlation is needed. Present study was undertaken to evaluate the efficacy of Squash smear in absence of frozen section facility. Aims & Objective: To evaluate the value of Squash smear cytology for rapid intraoperative diagnosis in CNS lesions and its correlation with final histomorphological diagnosis. Material and Methods: Total 35 case of CNS tumours were examined by squash smear technique for cytomorphological analysis followed by histomorphological correlation on paraffin section. Results: Complete correlation with histomorphological findings was observed in 82.35% of cases. Complete correlation was observed more with glial neoplasm. Conclusion: Squash smear preparation proved to be a simple, inexpensive and rapid technique for intraoperative consultation of CNS tumours and can be effectively utilized as a diagnostic tool for intraoperative diagnosis in absence of frozen section facility.
ABSTRACT
Background: Newer development in radiology has completely revolutionized the approach to percutaneous aspiration of space occupying deep seated lesions making it rapid, inexpensive, versatile and an adjunctive tool for evaluating internal organs. Aims & Objective: The present study was conducted to evaluate the effectiveness of image guided fine needle aspiration cytology in cases of deep seated lesions. Material and Methods: Total 169 aspirations performed from 161 cases in period of two years, 131 (77.51%) were under USG guidance and 38 (22.49%) were under CT guidance. Results: Overall adequacy rate was 76.92% for guided aspirations. Adequacy rate in case of aspirations done by pathologist was much higher than clinicians with P value (with Yates correction) of < 0.05. The most common organ for aspiration was liver (30.18 %), followed by ovary (23.67 %). Guided aspirations were also done from various organs like lung, retroperitoneal lymph nodes, pancreas, stomach, gall bladder, kidney, mediastinum, pleura, suprarenal gland and abdominal wall with high adequacy rate and without complications though with smaller sample size. Cytological diagnosis was possible in 73% cases. Conclusion: Guided aspiration is a simple, safe and cost effective screening test for deep seated lesions with a significant role in the detection of clinically unsuspected malignancy making it an investigation of choice for early confirmation or exclusion of pathology.