Mast Cells in Non-neoplastic Skin Lesions.

Background: Mast cells are found in tissues throughout body, particularly in proximity to surfaces that interface with the external environment. They are found at all levels of dermis, where they are grouped around blood vessels, nerves and appendages. Increase in mast cell number have been reported in various cutaneous diseases. Aims: We aim to identify and analyse the morphological aspects of distribution of mast cells and their value in non-neoplastic skin lesions. Material and Methods: Ninety seven biopsies of various skin lesions were studied for mast cells by Toluidine Blue at pH 3.9. Result: All the skin lesions showed significant increase in mast cell number. Psoriasis showed maximum number of mast cells (127/mm2) followed by Lichen planus (108/mm2). Among the cases of cutaneous bacterial infections, mast cells were maximum in leprosy cases (99/mm2) and lowest in cutaneous tuberculosis. A comparative decrease in number of mast cells was seen from lepromatous leprosy to tuberculoid leprosy. A wide range of morphological alterations of mast cells were observed in these skin lesions. Psoriasis and bullous pemphigoid cases showed maximum spindle cell morphology. Conclusion: Tissue mast cell number, distribution and morphology vary in different skin lesions depending on the degree of mast cell activation. This may have a bearing on diagnosis and management.

The clinical and histopathological co-relation of psoriasiform dermatoses.

Background: Psoriasiform dermatoses is a common presentation of a wide spectrum of underlying diseases from a relatively harmless disease like chronic dermatitis to a detrimental disease like mycosis fungoides. Psoriasiform reaction pattern is a commonly encountered denominator in a wide variety of unrelated disorders. They include several unrelated disorders of the integument, which either in the beginning or in the course of progression/resolution, exhibit lesions resembling psoriasis. Aims: This study was designed and conducted to enlist clinical parameters, histopathology and clinicohistopathological co-relation of psoriasiform disorders. Methodology: 100 cases of psoriasiform dermatoses over a period of two years were studied. Their history, age, sex as well as morphology, distribution and histopathology of skin lesions were analysed. Results: Psoriasis is the commonest of all psoriasiform dermatoses (31%) followed by lichen planus (23%),lichen nitidus(9%), pitryasis rosea (7%) , seborrheic dermatitis (6%). The remaining dermatoses like lichenoid drug eruptions ,parapsoriasis , Reiter’s disease , mycosis fungoides , pitryriasis rubra pilaris and lichen striatus, lichen simplex chronic etc were uncommon. There was a slight male preponderance. (M: F: 1.3:1). Lesions were more common in limbs. There was a wide age variation for example lichen striatus was seen in 5 year male and mycosis fungoides in a 69 year old male. A good clinicopathological co-relation filled up the lacunae of both, the clinical approach as well as that of histopathology and helped in pinpointing the diagnosis (62 cases). In 10 cases, there was no co-relation between clinical and histopathological diagnosis. Conclusion: As the morbidity of these disorders ranges from a trifling affliction to a life threat, thorough clinico-pathological co-relation and prompt institution of specific treatment results in a better prognosis.

A cytological and histomorphological case study of an uncommon breast carcinoma: Invasive papillary type.

Pure papillary carcinoma of the breast is a rare tumour affecting elderly postmenopausal women. We report one case in a relatively younger woman presenting with a clinically benign breast lump.The tumour showed extensive apocrine metaplasia. The ease with which abundant material with highly cellular papillary clumps is obtained on fine needle aspirate should be an important consideration favouring papillary carcinoma. The quality and quantity of stroma in papillae rather than the presence or absence of stromal support should also be a guiding criteria for excluding benign papillary lesions.

Rosai-Dorfman disease presenting as a meningioma.

This report documents an unusal case of extranodal sinus histiocytosis (Rosai-Dorfman disease) which produced a solitary intracranial mass lesion that was diagnosed clinically and radiologically as a meningioma. Morphological features have been described and literature extensively reviewed.

A clinical study of adult leukaemias.

The incidence of adult leukaemias, their response to therapy and the complications of therapy were studied in 121 cases over seven years (1981-1987). All cases were followed up till recovery or death for periods ranging from seven days to seven years. Adult leukaemias accounted for 2.56% of all admissions due to malignancies. There were 21 cases of acute lymphoblastic leukaemia, 61 of acute myelogenous leukaemia, 36 of chronic myelocytic leukaemia and 3 chronic lymphocytic leukaemia. All received aggressive combination chemotherapy. Remission could be achieved in 57% to 60% of cases. Infection (34%), bleeding (34%), and central nervous system involvement (25%) were the complications during therapy. The cause of death was ascertained in 87 of 90 deaths by a detailed postmortem. Haemorrhage (34.5%), infection (31%) and uncontrolled leukaemia (22%) were the leading causes, either singly or in combination. Some of the uncommon causes of death were fulminant hepatic failure, coronary artery disease, gangrene of the colon and disseminated tuberculosis.