Histopathological Study of Ovarian Tumors.

The ovarian tumors show wide variation in the clinical and morphological features. The incidence also varies in different parts of the world. This is a histopathological study of 100 ovarian tumors over a period of 5 years in our institute. The ovarian tumors were classified according to WHO Classification. The aim of this work was to study the incidence and gross and microscopic features of different benign and malignant ovarian tumors. Benign tumors were more common than malignant tumors. Among benign tumors serous cystadenoma (41.89%) was the most common followed by mucinous cystadenoma (29.72%) and mature cystic teratoma (16.21%). Among malignant ovarian tumors, the most common type was serous cystadenocarcinoma (38.46%) followed by dysgerminoma (11.53%) and clear cell carcinoma (11.53%). Majority of the ovarian tumors were surface epithelial tumors (77%) followed by germ cell tumors (16%) and sex cord stromal tumors (6%).

Primary Osteosarcoma of the Breast.

Primary osteosarcoma of the breast is an extremely rare and aggressive tumor representing 12.5% of mammary sarcomas. It is associated with early recurrence and hematogenous rather than lymphatic spread, most commonly to the lungs. We report a case of 55 year old lady with gradually increasing painless lump measuring 7 × 6 cm in upper outer quadrant of left breast of 2 months duration. FNAC smears revealed pleomorphic spindle cells admixed with osteoid and chondroid material. A differential diagnosis of metaplastic carcinoma and malignant phyllodes tumor was offered. Histopathology of the modified radical mastectomy specimen showed predominantly osteosarcomatous areas. Epithelial component was not seen even after extensive sampling of the tumor. On immunohistochemistry, vimentin, S100 and CD68 were positive while AE1/AE3, CAM5.2, ER, PR, Her2-neu and desmin were negative confirming a diagnosis of osteosarcoma. Primary osteosarcoma of breast must be differentiated from metaplastic carcinoma and malignant phyllodes tumor because of different biological behaviour and treatment approach. Immunohistochemistry plays a pivotal role in the diagnosis of this tumor.

Interobserver reproducibility of Gleason grading of prostatic adenocarcinoma among general pathologists.

Context: Gleason grade is the most widely used grading system for prostatic carcinoma and is recommended by World Health Organization. It is essential that there should be good interobserver reproducibility of this grading system as it has important implications in patient management. Aim: To assess interobserver reproducibility of Gleason grading of prostatic adenocarcinoma. Design: A total of 20 cases of prostatic adenocarcinoma were scored using Gleason grade by 21 general pathologists. The scores were then compared using κ-coefficient and consensus score. Results: For Gleason score groups (2-4, 5-6, 7 and 8-10) overall agreement with consensus score was 68%. Exact agreement for Gleason scores with consensus score was 43.3% and 92.3% within ±1 of the consensus score. κ coefficient for primary grade ranged from -0.32 to 0.92 with 60% of the readings in fair to moderate agreement range; and for secondary grade κ ranged from -0.30 to 0.62 with 78% of the readings in slight to fair agreement range. Kappa for Gleason scores ranged from -0.13 to 0.55 with 80% of the readings in slight to fair agreement range; and for Gleason score groups κ ranged from -0.11 to 0.82 with 68.5% of the readings in fair to moderate agreement range. Conclusions: In our study interobserver reproducibility of Gleason scores among general pathologists was at lower level and it highlights the need to improve the observer reproducibility by continuous educational sessions and taking second opinion in cases where grade could significantly influence management.