Helicobacter Pylori Infection And Its Association With Histomorphological Changes In The Gall Bladder Of Patients With Chronic Cholecystitis

Role of H.pylori in chronic gastritis, peptic ulcers, gastric carcinoma and malignant lymphoma of gastric mucosa associated lymphoid tissue (MALToma) is well established. However its role in gall bladder diseases is still not clear. The aim of this study is to find the prevalence of H.pylori in patients with symptomatic cholelithiasis and to assess its role in various morphological changes in gall bladders of the patients with chronic cholecystitis. Our study comprised of 150 patients operated for chronic cholecystitis with cholelithiasis , with100 patients giving consent for gastric biopsies. Patients were divided into two groups depending on the presence and absence of H.pylori in gall bladder mucosa respectively. Histopathological changes were then assessed in both the groups and findings were analysed statistically. On comparing the morphological changes in gall bladders of patients in both groups, statistically significant difference were seen in mucosal hyperplasia (P=0.01926), mucosal metaplasia (P=0.01890) and in lymphocytic infiltrate (P=0.0307). Concomitant presence of H.pylori in gastric and gallbladder mucosa also showed positive correlation. As these lesions are believed to be key factor for the progress of numerous cancers, so the presence of H.pylori may be considered as potential risk factor for gallbladder cancers.

A Rare Case of a Dermoid Cyst of Parotid Gland

Dermoid cysts are benign lesions containing tissues of ectodermal and mesodermal germ layers. The incidence of dermoid cyst in head and neck region is only 7% while in parotid gland only 18 cases have been reported in the literature. An 18-year-old male presented with a slow growing, painless and soft swelling in the right pre-auricular region. According to the patient, he had this swelling since birth. Ultrasonography was suggestive of a 3X3 cm cystic lesion within the right parotid gland. Fine needle aspiration cytology (FNAC) showed predominantly anucleate squames and keratinous debris indicating towards the possibility of a dermoid cyst of parotid. The lesion was surgically excised with superficial parotidectomy, preserving the facial nerve. Histopathology confirmed the diagnosis. Post-operative period was uneventful and patient recovered well. Owing to the rarity of dermoid cysts in the head and neck region and more so within the parotid gland, this case is being reported here.

Trends in Molecular Classification of Breast Carcinoma in a Tertiary Health Care Centre: A 5 year Retrospective Study

Introduction: ER, PR and HER2 are the most important factors for predicting prognosis and response to treatment. In the present study we retrospectively  measured the frequency of estrogen receptor (ER), progesterone receptor (PR), and Her 2 Neu positivity in breast cancer patients during a span of 5 years and classified them into luminal A (estrogen receptor/progesterone receptor [ER/PR]-positive and human epidermal growth factor receptor-2 [HER2]-negative), luminal B (ER/PR- positive and HER2-positive), HER2 (ER/PR-negative and HER2-positive), and triple negative (ER/PR- and HER2-negative) molecular subtypes. In this study we have also tried to correlate various molecular subtypes of breast cancer with age distribution, histological grade, lymph node status and distant metastasis. Methodology: We conducted a 5-year retrospective study on 547 patients. Clinical data including the age, sex, lymphnode status along with histological type and, grade of the tumour were recorded and the cases were subjected for immunohistochemical evaluation of HER-2/neu, ER, PR receptor status. Results: The results showed that HER2 neu was the most predominant immunomarker, while ER and PR was almost half of it. Among the molecular sub typing HER 2 type was the most prevalent constituting 53% of the cases, followed by almost triple negative and luminal A subtype with 20% cases each. Luminal B was least frequent with 9% of the cases. An inverse relationship exists between expression of her 2 neu and ER/PR. Conclusion: Our study concluded that molecular subtyping of breast carcinoma is an important part of complete histopathology report, in terms of prognosis, recurrence and treatment. A shift in occurrence of breast malignancies towards younger age leads to increased Her-2 neu expression.

Mixed Medullary and Papillary Carcinoma Thyroid in a Young Female- A Rare Case Report

The medullary thyroid carcinomas (MTC) comprise 5-10% of all thyroid carcinomas. It is known to show many cyto-architectural variations. The WHO classification of thyroid tumors includes an entity called mixed medullary-papillary carcinoma, a rare malignancy known to represent <1% of all thyroid malignancies. Fewer than 40 such cases have been reported so far and include tumors showing morphological features of both medullary carcinoma and papillary carcinoma with immunoreactivity for calcitonin and CK19 &thyroglobulin respectively. We report a case of a 27-year-old female with complaints of gradually increasing neck swelling for 2 years, with difficulty in swallowing in the last 2 months. The swelling was more localized towards left. Ultrasound neck revealed a nodule in the left lobe of thyroid with benign features most likely nodular colloid goiter. Thyroid profile of the patient was normal. FNA revealed sheets and follicles lined by both hyperplastic and involutional follicular cells. Few micro follicles showed pleomorphic cells having hyperchromatic nuclei and mild anisonucleosis. A diagnosis of colloid goiter was given on cytology; however, on grounds of suspicion of a neoplastic process, histopathology was advised. The patient underwent total thyroidectomy. Hematoxylin & Eosin stained sections showed features of mixed medullary-papillary carcinoma of the thyroid which was further confirmed on Immunohistochemistry and raised serum calcitonin levels. It is important to know about this entity due to its prognostic implications, association with other endocrine disorders and to prevent any diagnostic dilemmas.

Prostatic adenocarcinoma metastasizing to the parietal bones.

Prostate cancer metastasis to the axial skeleton occurs at high frequency in patients with advanced disease causing significant morbidity and mortality. Apart from bone, brain is also a common site of metastasis but the involvement of the parietal bones is extremely unusual. Parietal bone metastasis from prostatic adenocarcinoma was the initial presentation seen in our patient. This is the first case of its kind in the literature where the prostatic carcinoma had metastasized to the parietal bones of the skull without any symptomatology of prostatic involvement. The report is intended to alert the reader of this rare site of metastasis from the prostate.

Hydatid cyst of gall bladder.

Gall bladder hydatid cyst is a rare entity. Concurrent occurrence of gall blader hydatid cysts along with liver cysts, especially with the biliary channels clear of cysts, is very rare. We report a 27-year-old man with a gall bladder hydatid cyst that was diagnosed only after opening the resected specimen of the gall bladder.