Secretory meningioma: A diagnostic pitfall.

Context: Secretory meningioma is a rare subtype of meningiomas, displaying epithelial and secretory differentiation of meningothelial cells. It has unique radiological, morphological, and immunohistochemical features, but runs a benign course. Radiological picture because of the variable degrees of peritumoral edema can be confused with aggressive neoplasms. Morphologically, it is diffi cult to distinguish secretory meningioma from other tumors having a clear cell appearance and aggressive clinical behavior. Materials and Methods: Retrospective analysis over a period of 16 years (1997-2012) brought out fi ve cases diagnosed as secretory meningioma. The slides were restained and subject to special stains and immunohistochemistry and the clinical details were retrieved. Results: On histopathology, the tumors showed a characteristic vacuolated appearance due to the presence of variably sized intracytoplasmic lumina. Another unique feature was the presence of hyaline inclusions within these intracytoplasmic lumina and in the intercellular spaces. These inclusions were periodic acid-Schiff positive diastase-resistant, yellowish-orange on Elastic Van Giesson stain and strongly carcinoembryonic antigen positive. Conclusion: Owing to its rarity and unique morphology secretory meningioma poses a diagnostic challenge to the pathologists. As this tumor follows a benign course, it is crucial to correctly diagnose this entity to avoid unnecessary over treatment.

Pattern of fibronectin in hepatocellular carcinoma and its significance.

Fibronectin is a multifunctional large molecular weight glycoprotein that can bind extra-cellular and cellular components. The aim of the present study was to evaluate expression of fibronectin and its significance in cases of hepatocellular carcinoma (HCC). A few previous studies have shown abnormal over- expression of fibronectin in cases of HCC. Expression of the fibronectin protein was studied in eleven cases of HCC by immunohistochemical method. Fibronectin was seen to localize predominantly in perisinusoidal region and strong positivity was noted in other fibrotic areas. Positivity around nests of cells and tumor nodules was noted in 8/11 cases of HCC and faint cytoplasmic positivity in tumor cells was seen in 5/11 cases. Staining pattern of fibronectin in HCC was definitely abnormal but decreased in the present study. The controversial results as seen in few previous studies also have been partially explained in the present article and further studies using larger sample size is suggested to clarify the issue.

Prognostic and predictive value of c-erbB2 overexpression in osteogenic sarcoma.

BACKGROUND: Osteogenic sarcoma (OS) is a highly malignant tumor of the bone. There are few reports in the literature regarding determination of c-erb B-2 (HER-2/neu) expression in cases of OS and also the results are quite variable. AIM: The present study was undertaken to correlate the expression of c-erbB2 with the survival of patients of OS. SETTINGS AND DESIGN: A retrospective study of cases of OS, in which the expression of c-erbB-2 by immunohistochemistry (IHC) was studied and correlated with the survival rate of the patients. MATERIALS AND METHODS: Out of a total of 49 cases, proper follow up data in the form of total and disease free survival was available in only 20 cases. IHC for c-erb-B2 was carried out in these 20 cases. RESULTS: The staining pattern was as follows: no staining in 3 cases, 1 + in 5 cases, 2 + in 3 cases, 3 + in 3 cases and 4 + cytoplasmic positivity in 6 cases. Statistical analysis: Spearman rank correlation test was used to correlate the intensity of cytoplasmic staining of c-erbB-2 with survival rate of the patients, response to chemotherapy and metastasis. CONCLUSIONS: Previous studies have shown that c-erbB-2/HER-2 is an independent prognostic factor in osteogenic sarcoma, but in the present study, its expression was not seen to be correlating with survival rate of the patients. Therefore, further studies are needed to reach a consensus regarding the reliability of c-erbB-2 as an independent prognostic factor in OS.

Primary small bowel melanoma: a case report.

The small intestine is the most common site of gastrointestinal metastasis from cutaneous melanoma. However, the small intestine itself is rarely the site of a primary melanotic tumour. We describe a case of primary small bowel melanoma in a 70-year-old man, and discuss the features of primary and metasttic melanoma.

Metanephric adenoma of the kidney--a case report.

Metanephric adenoma is a relatively novel renal epithelial neoplasm. Herein we report a case of metanephric adenoma in a 38 year male patient.

Intracavitary metastatic non-Hodgkin's lymphoma simulating an atrial myxoma.

We describe a case of intracavitary metastasis of Mantle Cell Lymphoma of gastrointestinal tract, which mimicked an atrial myxoma. The gastrointestinal lymphoma led to widespread metastasis and a large metastatic tumor deposit at the hilum of the right lung caught up the hilar vessels. This led to infiltration into the pulmonary veins and intracavitary metastatis to the left side of the heart.