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Endometrial stromal sarcomas are rare uterine tumours usually seen in perimenopausal females. We report here a case of low grade endometrial stromal sarcoma in a 45 year female with a clinical diagnosis of fibroid uterus and final histological diagnosis of low grade endometrial stromal sarcoma.
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Background: In English literature it is documented that the expression of ER and PR is low in Asian countries when compared to that of Western countries. HER2/neu over expression is uniform throughout the world. Studies have shown that triple-negative breast carcinomas are aggressive, likely to spread beyond the breast and recur after treatment. Aims and objectives: To correlate the expression of ER, PR and HER 2/neu with clinico-pathological parameters in infiltrating ductal carcinoma and other variants of breast carcinoma. To determine the clinicopathological parameters in triple negative cases. Methods: This is a prospective study for a period of two years in the Department of Pathology, Andhra Medical College, a tertiary care centre. We received 111 mastectomy specimens during this period out of which 52 patients were funded under Arogyasri and were subjected for ER, PR, HER2/neu receptor study. Results: In the present study total cases analyzed were 52. Infiltrating ductal carcinoma was 41/52 (78.84%) and other variants were 11/52 (21.15%). In our institute infiltrating duct cell carcinoma (NOS) type was the commonest type of carcinoma breast with significant group occurring in less than 45 years of age, 95 % of women were multipara with two or more children and triple negative tumors being 54.83%.In infiltrating ductal carcinoma ER, PR positive expression has no association with age and size of tumor. Their expression was higher in grade 1 tumors 83.3%.The ER,PR negative expression was more in size of tumor being greater than 2 cm; (92.5%),positive lymph nodes (51.8%) and stage II and stage III tumors (96.2%). HER2/neu negative expression was seen in 51.61% of cases. Triple negative receptor expression was seen in 54.83% of infiltrating ductal carcinoma. In the English literature medullary carcinoma is negative for HER2/neu expression but in the present study in 2 cases the expression for HER2/neu was positive. Conclusion: In the present study significant group occurred in less than 45 years of age presenting in advanced stage of the disease. Triple negative cases were seen in 54.8% cases of infiltrating duct cell carcinoma indicating bad prognosis.
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Acinic Cell Carcinoma (ACC) was previously called acinic cell tumor and it is a neoplasm demonstrating cytological differentiation towards serous acinar cells. The histological architecture of ACC is diverse and classification consists of various histological subtypes. This is a case of acinic cell carcinoma of parotid gland in a 45 years female patient which showed predominant follicular variant of ACC. It is a least frequent variant of ACC occurring in only 5% and it mimics follicular neoplasm of thyroid.
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Background: The functional reserve of the kidney being large, serum biochemical parameters do not show abnormality until late. The need to recognize minimal damage in the kidneys is hence valuable. Urine sediment examination is cost effective, time saving and is called “liquid renal biopsy”. The present study was aimed to evaluate the role of urine sediment examination in predicting the severity of renal damage and compare the results with serum biochemical parameters, 24 hour urine protein values and renal biopsy findings. Methods: A total of 149 patients presenting with symptoms pertaining to renal disease were included in the study. Clinical information and serum biochemical parameters were obtained. Urine examination was done and renal biopsy performed in all the cases. 2 scoring systems were adopted to grade the urine sediment findings and renal biopsy grading devised by A. Z. Gyory et al. was used to grade the renal injury. 24 hour urine protein was estimated by Esbach’s method. Urine sediment scores, serum biochemical parameters, 24 hour urine protein values were compared with the grades of renal injury on renal biopsies and statistical significance calculated. Results: 32.8% of patients with renal disease were in the age group of 31-40 years. Nephrotic syndrome was the most common clinical presentation (33.5%) followed by nephritic syndrome (21.4%). The most common histopathological diagnosis was post infectious glomerulonephritis (n = 26) followed by acute interstitial nephritis (n = 17). 14 cases of lupus nephritis were diagnosed all of which were confirmed by “full house” pattern of immunofluorescence. Both the urine sediment scores had high specificity and positive predictive values in predicting the severity of renal injury. 24 hour urine protein had high positive predictive value in predicting the severity of renal injury. Serum biochemical parameters were insignificant in predicting the severity of renal injury. Conclusion: Urine sediment examination can be used as an effective diagnostic test for predicting the severity of renal injury. The decision of further investigations and follow-up can be certainly decided by taking urine microscopy findings and 24 hour urine protein values into consideration.
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Salivary gland tumors are rare, comprising less than 3% of all neoplasia of head and neck region. Pleomorphic adenomas are the most common benign neoplasms of the parotid gland. The vast majority are 2-6cms in size, when resected. Untreated pleomorphic adenomas can enlarge in size and weigh several kilograms. There are only few cases of giant pleomorphic adenomas reported in the literature. Here we present one of such case.
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Giant congenital melanocytic nevus (garment nevus) is a kind of congenital malformation of neural crest cells with size greater than 20 cm. Malignant melanoma may develop in 2-31% of these lesions. The objective of this paper is to present a unique case of giant nevus which is rare.