The Predictive and Prognostic behavior of Breast Cancer by NACT in Relation to Tumor Grade, ER/PR and Her- 2/neu Expression- Study in a Tertiary Care Hospital of Eastern India

Introduction: Neo-adjuvant chemotherapy (NACT) isconsidered as initial management of all patients with locallyadvanced breast cancers and followed by surgery. NACTenables reduction of breast tumor size- thereby prolongingsurvival and altered the expression of steroid receptor (ER/PR)and Her-2/NEU in the cancer cells. Our aims and objectivewas to look into the association of patient age, tumor grade,expression status of ER/ PR / Her-2/neu receptor status beforeand after NACT in Indian women patients.Material and methods: The study was conducted over aperiod of 4 years. Hormone receptor and Her-2/neu status wasdetermined by IHC over 412 samples. The patients receivingNACT and having both core needle biopsy and surgery(MRM) are considered as NACT group. The other group didnot receive NACT but have core needle biopsy and surgeryare taken as non NACT group. The discordance was comparedbetween these two groups.Results: Patients of more than 40years of age hadpredominantly favorable hormone receptor status expression.In the NACT group favorable receptor status was 60.35%and discordance was higher in ER, PR and HER- 2/neu incomparison to non-NACT group.Conclusions: Significant alteration of hormone receptorsand Her-2/neu expression was found in biopsy of the patientsreceiving NACT. So reevaluation of the hormonal status andHer 2 neu receptor in residual invasive carcinoma may beconsidered as it has advantage on chemotherapy after finalsurgery.

A Study of β-Catenin and PTEN Expression in Ovarian Surface Epithelial Neoplasms and their Correlation with Grade and Stage in Malignant Cases

Introduction: Ovarian carcinoma is most common ovarianmalignancy which accounts for vast majority (90%) of ovariantumors. It is invariably accompanied by changes in signaltransduction pathways. The aim of the study was to evaluatethe expression of β– catenin and PTEN in diagnosed casesof ovarian surface epithelial neoplasm and correlate themto histological grade and stage of ovarian carcinoma. Studydesign: This was a cross-sectional observational study.Material and methods: The study was conducted over a periodof one year (February 2017 to July 2018). β– catenin and PTENexpression was evaluated in 50 histologically diagnosed casesof ovarian epithelial neoplasm by immunohistochemistry(IHC) using a scoring system. Statistical analysis StatisticalAnalysis was performed with help of Epi Info (TM) 7.2.2.2. Ap-value <0.05 was considered statistically significant.Results: Membranous, Cytoplasmic and Nuclear β-cateninexpression was significantly higher for high grade tumors thanthat of low grade tumors. No significant association betweenβ-catenin expression and stage was found. A significantassociation of PTEN expression with tumor grade (p=0.0367)and histological subtype (p=0.03) has been found. Significantassociation of loss of PTEN expression with stage of the tumorwas also found (p=0.023). No significant correlation betweennuclear score of β-catenin and PTEN score was found.Conclusion: Considering the observations of the presentstudy, it can be concluded that β-catenin and PTEN mayplay an active role in the pathogenesis of ovarian carcinomasubtypes and they have a positive correlation with grade andstage of tumours. So, these biomarkers may be consideredas prognostic parameters and critical evaluator of targetedtherapy

Extranodal non-Hodgkin's lymphoma presenting as an ovarian mass.

An 8-year-old female presented with an abdominal lump. A ultrasonography showed a heterogeneous, mainly solid space-occupying lesion with few cystic components and irregular margin in both adnexae measuring 10.5 x 5.2 x 3.5 cm and 9.2 x 4.8 x 3.0 cm. The tumors were removed by exploratory laparotomy and the histopathological report was primary NHL of the ovary. The uterus and cervix were healthy and there was no tumor extension or omental deposit. The patient was referred for chemotherapy.

Cutaneous metastasis from follicular variant of papillary thyroid carcinoma: a case diagnosed on cytology.

A 40-year-old woman presented with a scalp swelling. A careful clinical examination revealed a left-sided deep-seated thyroid nodule. Fine needle aspiration from both sites disclosed a microfollicular architectural pattern on Giemsa stain and pale nuclei with nuclear grooves on Papanicolaou stain, indicating the possibility of follicular variant of papillary thyroid carcinoma with metastasis to the scalp. Histologic tissue evaluation confirmed the diagnosis. Thus, a diligent search for nuclear features should be performed to enable a diagnosis of follicular variant of papillary thyroid carcinoma on cytology. This helps in patient management obviating the need for a second surgical intervention.

Recurrent and aggressive chondroblastoma: a case report.

Recurrent chondroblastoma with pulmonary and palatal metastasis is a rare occurrence. We report the cytological and histological findings of such a case in a 33 years old male, where the primary diagnosis of metastatic chondroblastoma was made on FNAC, which was later confirmed on histopathology. The present case highlights that, some chondroblastomas do exist, that are capable of pursuing a malignant course.

A study of morphometric and histopathological features of muscle biopsies from patients of myopathy.

The aim of this study is to analyse the morphological pattern of different types of myopathies including morphometric data. The cases were diagnosed as myopathy on the basis of clinical details, EMG findings, serum CK values. Muscle biopsies were performed and hematoxylin & eosin stain and Masson's trichrome stain were done. Muscle fiber diameters were measured using an eye piece micrometer of 100 fibers in each biopsy, these values were plotted and histograms were constructed. From this, mean fiber diameter (MFD), standard Deviation (SD), atrophy factor (AF), hypertrophy factor (HF) and variability coefficient (VC) were calculated. Degree of inflammation was scored semiquantitatively and presence of degenerating fibers, regenerating fibers, perifascicular atrophy, perivascular lymphocytic infiltration and vasculitis were noted. Out of 25 patients, 9 patients of inflammatory myopathy were adults, of the 16 patients of dystrophy 9 patients were adults. Along with weakness of limbs, skin rash was seen in 2 patients of dermatomyositis. Degree of inflammation was more in the patients of inflammatory myopathy than in the patients of dystrophy. Necrotic and regenerating fibers were seen in both groups. Perifascicular atrophy was seen in 1 case of dermatomyositis. Atrophy factor was higher in cases of dystrophy and so was hypertrophy factor. Variability coefficient >250 was found on 90% of dystrophy cases and it was <250 in the cases of inflammatory myopathy. Morphometry provides valuable data, which helps in distinguishing dystrophy from cases of myopathy with inflammation.