CD10-A new prognostic stromal marker in breast carcinoma, its utility, limitations and role in breast cancer pathogenesis.

Background and Aims: Breast cancer is one of the leading causes of mortality in Indian women. Although breast cancer is an epithelial malignancy, stroma plays a key role in its development and pathogenesis. Stromal markers are now emerging as novel markers in assessing the prognosis of invasive breast cancer and have not been studied extensively till date. The aim of the present study is to study the stromal expression of CD10 in breast carcinoma, fi nd its relationship with other prognostic markers and study the role stroma plays in breast cancer pathogenesis. Materials and Methods: A total of 70 cases of breast cancer were included in the study. Representative sections were taken and hematoxylin and eosin staining was done. Immunohistochemistry was performed with ER, PR, Her2neu and CD10. Stromal expression of CD10 (>10% stromal positivity was considered positive) in invasive breast carcinoma was noted and was statistically analyzed with different known prognostic markers of breast carcinoma. Results: Stromal expression of CD10 was found to be signifi cantly associated with increasing tumor grade (P = 0.04), increasing mitotic rate (P = 0.33), worsening prognosis (P = 0.01), ER negativity (P = 0.0001), Her2neu positivity (P = 0.19) and with molecular subtypes (CD10 positivity with the HER2 type, and CD10 negativity with Luminal type). No correlation was found between CD10 overexpression and PR, age, menopausal status, tumor size, lymph node positivity and tumor stage. Conclusions: This study gives substantial proof to the various models/research papers explaining the role of stroma/CD10 in breast cancer pathogenesis. Keeping the role stroma plays in predicting prognosis and tumor response, CD10 should be included as a routine pre-chemotherapy marker in breast carcinoma. Further studies should be performed to see the role stroma plays in hormonal expression and the usefulness of CD10 to predict treatment failure in breast carcinomas receiving neoadjuvant therapy.

Plasma cell leukemia: A retrospective study of 10 cases.

BACKGROUND: Plasma cell leukemia (PCL) is a rare aggressive variant of multiple myeloma (MM) characterized by a fulminant course and poor prognosis. Flow cytometry (FCM) is very useful in the diagnosis of the plasma cell leukemia. Herein, we present 10 cases of PCL. MATERIALS AND METHODS: We retrospectively studied immunophenotypic profile of 10 cases of PCL from Jan 2009 to Dec 2013 using 5 parameters, 6 color flow cytometric analysis. We also studied their clinical presentation and other laboratory findings. RESULTS: Common clinical features at presentation were weakness, bone pain, anemia, thrombocytopenia and osteolytic lesions. Plasma cell population were identified by strong expression of CD38 and co‑expression of CD38 and CD138. CD56 was expressed in 20% cases. CD19 and CD117 were negative in all cases. CONCLUSIONS: Immunophenotyping is highly useful to differentiate PCL from other chronic lymphoproliferative disorders with plasmacytoid morphology as well as from non‑neoplastic reactive plasma cells. Co‑expression of CD38 and CD138 is a best combination to identify the plasma cells by using FCM.

Role of squash smear technique in intraoperative diagnosis of CNS tunmors.

Background: Neurosurgical practice frequently requires intraoperative consultation to optimize surgical procedure. Frozen section and Squash smear cytology can offer the same. As brain tissue is friable & predisposed to show ice crystal artefacts, frozen section is often difficult to interpret. Squash smear examination provides good cytological details to offer diagnosis in most cases except where anatomical correlation is needed. Present study was undertaken to evaluate the efficacy of Squash smear in absence of frozen section facility. Aims & Objective: To evaluate the value of Squash smear cytology for rapid intraoperative diagnosis in CNS lesions and its correlation with final histomorphological diagnosis. Material and Methods: Total 35 case of CNS tumours were examined by squash smear technique for cytomorphological analysis followed by histomorphological correlation on paraffin section. Results: Complete correlation with histomorphological findings was observed in 82.35% of cases. Complete correlation was observed more with glial neoplasm. Conclusion: Squash smear preparation proved to be a simple, inexpensive and rapid technique for intraoperative consultation of CNS tumours and can be effectively utilized as a diagnostic tool for intraoperative diagnosis in absence of frozen section facility.

Incidence of atherosclerosis in different coronary arteries and its relation with myocardial infarction- A randomized study in 300 autopsy hearts in a tertiary care hospital.

Background: Cardiovascular disease especially myocardial infarction is one of the major causes of death in today’s world. Atherosclerosis is thought to be one of the most important factors behind the increasing incidence of myocardial infarction. Aims & Objective: This study was undertaken to find out the incidence of atherosclerosis in different coronary arteries, its correlation with increasing age and sex and with that of myocardial infarction of heart. Material and Methods: Study was performed on 300 hearts received from medicolegal autopsy cases in a tertiary care hospital, that were examined to find out the incidence of myocardial infarction and atherosclerosis in different coronary arteries. Results: Incidence of atherosclerosis and myocardial infarction was found to be more in men than in women (M:F ratio is 7:1 in atherosclerosis and 11:1 in myocardial infarction). The incidence of both increases with age. The left anterior descending artery (LAD) was the most common coronary artery involved by atherosclerosis (33%), especially type V atherosclerosis and in myocardial infarction (31%). Root of aorta was involved by atherosclerosis in only 16% cases and in 35% cases of myocardial infarction (MI). Triple vessel disease was most commonly (67.5%) associated with myocardial infarction, but a single case of myocardial infarction without involvement of any of the coronaries was reported. Regarding MI and type of atherosclerosis, more number of coronaries in MI was involved by type V atherosclerosis with occlusion, but type VI was more associated with MI. Conclusion: Atherosclerosis and myocardial infarction are more common in men and with increasing age group. Atherosclerosis of coronary arteries may lead to myocardial infarction, but the confounding effect of other lifestyle factors and age, sex and comorbid diseases can’t be excluded, for which further study is required.