Résumé
Introduction: Breast carcinoma is the leading cause ofcancer mortality among females. Estrogen and Progesteronereceptors (ER, PR) and HER2 have been used for theranosticsin breast cancer. Fine needle aspiration cytology (FNAC)can yield highly cellular material for cytological diagnosis.Predictive biomarker assessment can be done on cytologicspecimens to know the patient’s eligibility for endocrinetherapy and anti- HER2- targeted therapy. Cell blocks furthercan increase the diagnostic accuracy through morphology andthe use of immunohistochemistry (IHC). The present studywas undertaken to evaluate immunohistochemical expressionof estrogen receptor, progesterone receptor and HER2 in fineneedle aspiration cell blocks and surgical biopsies in primarybreast carcinoma cases.Material and methods: IHC for ER, PR and HER2 wasassessed on 50 pre chemotherapy breast carcinoma cell blocks(fixed in 10% formalin) and subsequent tissue sections.The scoring for ER/ PR was done according to ASCO/CAPguidelines. Strong circumferential membrane staining ingreater than 10% of tumor cells was considered positive forHER2.Results: Immunostaining assessment on cell block and theircorresponding tumor tissues showed a good concordance: ER(92%), PR (92%) and HER2 (93.75%). Taking histology asthe final outcome, the sensitivity of ER, PR and HER2 on cellblock was 92.30%, 86.36% and 91.67%, respectively, whilespecificity was 92.85%, 96.43% and 94.44%, respectively.Conclusion: IHC on cell blocks from breast carcinoma casesis useful especially when planning neoadjuvant chemotherapy.The pre analytic and analytic variables should be validated tooptimize the diagnostic utility of cell blocks.
Résumé
Introduction: Primary fallopian tube carcinoma is a rare tumour accounting to almost 0.1-1.8% of all genital malignancies and difficult to diagnose preoperatively, because of its non-specific presentation as well as simulation with ovarian carcinoma. It is usually an intraoperative finding or a histopathological diagnosis. Case Report:The study present a case of 48 yr old post menopausal women who underwent abdominal hysterectomy with unilateral salpingo-oopherectomy for hydrosalpinx and ovarian cyst. Histopathological examination revealed, primary serous papillary adenocarcinom of fallopian tube. Conclusion: Primary tubal cancer is rare, mostly mistaken for ovarian carcinoma. Histopathological examination is the gold standard for final diagnosis
Résumé
Introduction: Diagnostic cytology is the science of interpretation of cells that are exfoliated from the epithelial surfaces or removed from various tissues. The aim of this study was to assess the utility of cell block in increasing the cytodiagnosis of fine needle aspirates of head and neck lesions and to apply immunohistochemical markers on cell blocks. Material and methods: Total sample of 50 patients of head and neck lesions were received in the Department of Pathology, after approval from the Institutional Ethics Committee. Informed consent of the patient was taken. Relevant history of the patient was taken as per the written proforma. Patients of all age group presenting with head and neck lesions underwent FNAC and histopathological examination was included in the study. Results: Thus FNAC served better than cell block in determining the cellularity (kappa κ – statistic = -0.04, P 0.0002) while on morphological preservation grounds,superior nuclear and cytoplasmic characteristics were observed in cell block in comparision to FNAC (κ – statistic= -0.08).Overall Sensitivity and positive predictive value of cell block method with imunohistochemistry (96% and 100% respectively) proved to be better as compared to FNAC alone (88.8% and 95.65%). Conclusion: The diagnostic value of a Cell Block technique with immunohistochemistry is found to be superior to FNAC smears for the diagnosis of benign and malignat lesions of head and neck region. Taking into consideration the advantages of Cell Block method an excellent complementary tool for improving cytodiagnosis, we can recommend that cell blocks preprations should be routine practice so as to augment the information that is obtained solely from FNAC smear cytology.
Résumé
Immunophenotyping, although has emerged indispensable in the diagnosis and classification of lymphoid neoplasms, has to be used cautiously with knowledge of the antibodies used. No antigen is totally lineage or lymphoma specific, and for this reason, immunostaining must be performed in the context of a panel. In addition, familiarity with the diagnostic criteria and differential diagnosis of each lymphoid tumor and ultimately correlation with morphology, and clinical history are essential to enhance the diagnostic accuracy and reproducibility. AIM: The present retrospective study aimed to analyse the differentiation and grading of Non-Hodgkin’s lymphoma by immunohistochemical expression of CD20, CD3 and Ki-67 in lymph node. Methods: A total of 50 samples of NHL were included in the study. Written informed consent of the patient was taken where ever required in the vernacular. Relevant history of the patient was also taken as per the proforma attached along with. The tissues were stained with H and E staining, CD20, CD 3 and Ki-67 immunostaining. The positive immunostained slides were then evaluated and scored both qualitatively and quantitatively. Results: In the present study a total of 50 samples of NHL were included with an age range from 12 to 72 years and a mean age of 46.54 years and male predominance.45 cases showed immunopositivity for CD 20, showing that they belong to B cell phenotype and only 5 cases showed immunopositivity for CD 3, thus showing T cell phenotype. The mean Ki-67 for B cell lymphoma patients was 47.86 ±28.04,with a minimum score of 2 and a max score of 92 and for T cell lymphoma patients was 61.4±18.02, with a minimum score of 40 and a max score of 81, but there was no significant correlation between them (P=0.382). Conclusion: Ki-67 expression in NHL can help in monitoring of patients at risk and can to some extent also aid in detecting the degree of aggressiveness of the disease to give suitable treatment but Ki-67 alone cannot be a risk factor in NHL patients and other factors such as age, sex and type of NHL can be affective, too. The outcome of further analyzing the association between Ki-67 expression and the prognosis of various subtypes of lymphoma should be supported.
Résumé
Nodular fasciitis is a rare benign soft tissue tumor. The similarity in the cytological appearance of nodular fasciitis to that of pleomorphic adenoma makes it diffi cult to diagnose preoperatively that adds to its peculiarity. We report here a case of a middle-aged female with swelling in the neck that was diagnosed as pleomorphic adenoma on cytology. Surgical excision of the swelling was done and histopathological examination revealed it to be nodular fasciitis. This case is presented to highlight the challenge of correctly diagnosing nodular fasciitis.