Histopatological Spectrum Of Breast Carcinomas And Correlation Of Histological Grade With Er, Pr, Her2neu Status In A Tertiary Care Centre Of Eastern India

Background: Carcinoma of the breast is a truly complex disease with a large intratumoral heterogeneity, leading to markedly variable clinical course and response to treatment modalities. Prognosis and management of breast cancer are influenced by variables such as stage, grade, hormone receptor status of estrogen(ER), progesterone(PR) and Human epidermal growth factor receptor2 (HER2/neu) over expression. Aims and Objectives:To highlight the histomorphological spectrum of breast carcinomas and their ER,PR, HER2NEU status. And also to find out correlation between their histological grade and the hormone status . Materials and Methods - 115 breast carcinomas were clinicopathologically and immunohistochemically analyzed in which assessment of Her2/neu, ER, PR had been performed prospectively. Statistical analysis was then used to correlate the above observation. Conclusion: This study highlights the importance of histopathology and immunohistochemistry in breast cancers not only in diagnosing the lesion but also in predicting the prognosis and target therapy.

Diagnostic evaluation of childhood cervical lymphadenopathy by fine needle aspiration cytology.

Lymphadenopathy is an age old affliction of mankind. It is one of the very common presentations in clinical practice. The present study was carried out to evaluate the merits and demerits of fine needle aspiration cytology (FNAC) as a diagnostic procedure in childhood lymphadenopathy in comparison to open surgical biopsy. Altogether 70 children with lymphadenopathy in the age group of up to 12 years were selected for FNAC. Only 38 could be motivated for open surgical biopsy. Out of 38 cases, FNAC was consistent with histopathology in 33 cases, thus giving a diagnostic accuracy or percentage of agreement-86.8%. The diagnostic accuracy of FNAC, sensitivity, specificity, positive predictive values of FNAC in the present study were fairly high ranging from 80%-100%. FNAC gave false positive diagnosis in 13.2% cases and false negative result in 13.2% cases.

Primary non-Hodgkin's lymphoma of breast: a case report.

Primary breast lymphoma is a relatively uncommon neoplasm, majority being of B-cell origin. Mucosa associated lymphoid tissue (MALT) is one of the common types of breast lymphomas. Though cytologic diagnosis of breast lymphoma is an easy procedure and provides guidance for appropriate pre-operative management, it is often impossible to differentiate a low grade lymphoma from reactive proliferation. A similar difficulty was encountered in the present case, a 42 year old female with a breast lump. Fine needle aspiration cytology revealed a mixed lymphoid cell population. Lymphoepithelial lesions were identified histologically, and the majority of the cell population were confirmed as lymphoma cells of B-cell origin on immunohistochemistry. This case highlights the limitations of cytology and the importance of histological examination supported by immunohistochemistry for making a diagnosis of low grade primary breast lymphoma.

Gastro-intestinal stromal tumour--role of CD117 in diagnosis and management.

Gastro-intestinal stromal tumours (GIST) are a biologically distinct heterogenous group of tumours of the gut. They are said to arise from interstitial cells of Cajal in gut wall. The turnour results from mutation of c-kit gene which codes for CD117 containing tyrosine kinase receptor of Cajal cells. Identification of this mutation by immunohistochemistry (IHC) is the key to the diagnosis of these tumours. CD117 negative GISTs develop from gene mutation through alternate pathway (PDGFRA). The accurate diagnosis is important as specific chemotherapeutic agents are now available for their management. We have studied 8 cases of GISTs during last 2 years in our institute. Half of the cases were female, six cases were in the age group between 35 to 50 years, the other two being of 19 and 70 years. On histology, 5 cases were categorized as high grade on the basis of their size and mitotic count. All cases were subjected to IHC. Only 4 cases were CDll7 positive, one case was positive for S100 and one case for SMA. Remaining 2 cases, negative for CD117, S100 and SMA, histologically resembled GISTs. CD117 positive cases are ideal candidates for treatment with molecularly targeted specific chemotherapeutic agents, e.g., imatinib as these tumours are non-responsive to conventional chemotherapy. Histologically diagnosed stromal tumours of the gut should be subjected to immunostain for CD117 so that specific medical management can be provided to prevent recurrence and metastasis as well as pre-operative debulking of the tumour.

Immature mediastinal teratoma--a rare pathology.

A 9 year old female presented with 8 months history of right sided chest pain and respiratory distress. Chest X-ray revealed a large anterior mediastinal mass. Histopathology of the mass revealed features of an immature teratoma. The case is being presented because of its rare occurrence in the mediastinum.