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Background: Oral submucous fibrosis (OSMF), a well-recognized oral potentially malignant disorder, results due to increased collagen production and reduced collagen degradation. Aims and Objectives: To qualitatively compare the staining properties of collagen in OSMF using two special stains based on their birefringent property using polarizing microscopy. The study also assessed the distribution and orientation of collagen fibers in different grades of OSMF. Materials and Methods: A total of 73 subjects with different clinical and histopathological staging of OSMF comprised the study population. Histopathological examination was done using hematoxylin and eosin stain, Van Gieson and picrosirius red. Collagen fibers were analyzed for polarization colors, distribution, and orientation. Results: Picrosirius red stained both thick and thin collagen fibers. Irrespective of the histopathological grades reddish orange and yellowish orange were the most predominant colors. Parallel arrangement of fibers was observed when stained with Van Gieson but picrosirius red stained sections showed a majority of parallel type I fibers with perpendicular type III fibers which increased with advancement in the histopathological grade. Yellowish orange and greenish yellow fibers were predominant in the lamina propria, while reddish orange fibers were predominant in the submucosa. Conclusion: Picrosirius red was found to be a better stain. Histopathological grading and polarization colors showed no association with each other. Collagen fibers were more thickly and tightly packed in the submucosa indicating that the process of fibrosis began there. The increase in perpendicular type III fibers with advancing histopathological grades suggested their role in fibrosis.
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Background: Renal diseases constitute a major cause of morbidity in clinical practice and their incidence is on rise. Investigation usually requires division into even smaller samples to permit the application of specialized techniques.Methods: This is a prospective study conducted over a period of one year from January 2018 to December 2018 in the Department of Pathology, Coimbatore. A total of 58 renal biopsies were received from the Nephrology Department and the tissues were subjected to light microscopic and special stain studies.Results: Total 53 patients (91.38%) had high blood urea nitrogen value more than 20.0 mg/dl. 48 patients (82.76%) had high serum creatinine value more than 1.2 mg/dl. Out of 58 biopsy specimens, 46 (79.31%) showed primary glomerular lesions, 10 (17.24%) showed secondary glomerular lesion and 2 (3.45%) showed tubulointerstitial nephritis. Jones’s methanamine silver stain along with PAS stain helped in typing/staging of membranous glomerulopathy and membranoproliferative glomerulonephritis. Various changes in GBM like spike formation, thickening and moth-eaten appearance of GBM was noted which is seen in MGN stage II, IV and III respectively. Double contour and thickening of GBM was noted which is seen in type I and II MPGN respectively. In Myeloma cast nephropathy, tubular casts stained negative with Congo red which was used to differentiate it from amyloid deposition.Conclusions: The special stains used in this study helped in supplementing the light microscopic findings for diagnosis of kidney lesions. However, the use of other ancillary techniques like immunofluorescence and electron microscopy would help the pathologists in better and more accurate diagnosis.
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Background: Oral squamous cell carcinoma (OSCC) primarily spreads through direct invasion and/or lymphatic route. During the invasion, tumor cells break through the basement membrane, penetrate the connective tissue to interact with the extracellular matrix (ECM). An attempt was made to evaluate the connective tissue changes in different grades of OSCCs and their influence in predicting the biological behavior of these tumors. Materials and Methods: A total of 30 histologically proven cases comprising 5 normal mucosa, 10 well‑differentiated OSCC’s, 10 moderately differentiated OSCC’s, and 5 poorly differentiated OSCC’s were examined for the presence of any ECM changes by using special stains. Interpretation of staining intensity was carried out and statistically analyzed. Results: Van Gieson stain showed abundant thick collagen fibers, dispersed collagen fibers, thin few dispersed collagen fibers in well‑, moderately‑ and poorly‑differentiated OSCC’s, respectively. Verhoeff’s Van‑Gieson showed negative staining for elastic fibers around tumor islands in different grades of OSCCs. PAS stain showed moderate staining for glycoprotein in well‑differentiated OSCC and negative in moderately and poorly differentiated cases. Picrosirius red stain showed Type 1 collagen fibers in well and moderately differentiated OSCC cases and Type 3 collagen fibers in poorly differentiated cases. Conclusion: The observations of this study revealed altered staining reactions of the collagenous stroma and glycoproteins suggesting that tumor cells may release certain enzymes that play a role in the manipulation of ECM to enhance their own survival.
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Background: Soft tissue sarcomas are uncommon malignant mesenchymal tumours, of unknown etiology, accounting for less than 1% of the all the malignant neoplasms, with a median age of occurrence at 65 years, having male preponderance, 3/4th of them occurring in the deep soft tissues, especially thigh, with median diameter of 9 cm. 2/3rd of them metastasizing to the lung. Sarcomas need thorough evaluation by radiology to assess the extent, depth and neurovascular involvement. Morphology has to be correlated with histochemistry and immunohistochemistry. Aim: To study the prevalence, in relation to age, sex, site and size. To correlate histopathological findings with immunohistochemistry marker studies at our institution, studying and comparing with changing overviews and evolving literature. Materials and methods: All the soft tissue mass specimens submitted to the Department of Pathology, Gandhi Hospital, Hyderabad, from January 2011 to December 2015, were subjected to routine processing and those cases on histopathology, suspected to be sarcomas were included in the study, analyzed with ancillary techniques to arrive at final diagnosis. Results: A total of 40 sarcomas were encountered out of 20460, histopathology biopsy load at Gandhi Hospital, Hyderabad, constituting an incidence rate of 2%. Majority of the tumours were seen in the age groups of 40-49 years and 60-69 (20% each) with male preponderance (67.5%), occurring mostly in the trunk region (50%), with average size of 10 cm and constituting 0.6% of cancer incidence. Liposarcoma was the commonest soft tissue sarcoma in the present study. Conclusion: Liposarcoma was the commonest soft tissue sarcoma in the present study followed by Undifferentiated Pleomorphic sarcoma and Leiomyosarcoma. Most of the tumors presented with N. Sreemani Kumari, Shyamala Srujana, O. Shravan Kumar. 5 years study of soft tissue sarcomas at Gandhi Hospital, Hyderabad - A tertiary care centre. IAIM, 2016; 3(7): 334-344. Page 335 mass lesion, pressure symptoms and incidentally detected on imageology. FNAC was not very helpful in present study. Prediction of the course of the disease was difficult as most of the patients were referred to cancer institutions in the city, for further management.
ABSTRACT
Objectives: The aim of the study is to evaluate the connective tissue changes in different grades of Oral Squamous Cell Carcinoma (OSCC's) and the influence of these changes in predicting the biological behavior of these tumors. Materials and Methods: A total of 39 cases of OSCC's and 6 sections of controls were examined using seven connective tissue special histochemical stains. Results: Staining intensity of collagen, reticulin, acid mucins, fibrin, glycoproteins, sulfated mucins, elastic fibers around the tumor islands and within the connective tissue was observed. Conclusions: Tumor cells which grow progressively in the host stroma have the capacity to pre-empt and subvert the response of host, which is essential for their growth and spread. Clinical Relevance: The reactive changes in the tumor stroma may alter the biological aggressiveness of oral cancer, and by incorporating this concept into a prognostic system, we may help to reflect the biologic diversity of oral cancer and predict its clinical outcomes.