Focal Cortical Dysplasia with hippocampal sclerosis

ABSTRACT Focal Cortical Dysplasia (FCD) is a group of focal developmental malformations of the cerebral cortex cytoarchitecture. FCD usually manifests as medically intractable epilepsy, especially in young children. Live patients are diagnosed by radiological examination such as magnetic resonance imaging (MRI), fluorodeoxyglucose positron emission tomography (FDG PET), magnetoencephalography (MEG), diffusion-tensor imaging (DTI), and intracranial electroencephalogram (EEG). While some cases can be missed by radiological examination, they are usually diagnosed on the histopathological examination of the surgically removed specimens of medically intractable epilepsy patients. We report a case of a young girl with cerebral palsy, mental retardation, and seizure disorder who died in her sleep. The deceased was diagnosed with FCD type III with hippocampal sclerosis on histopathological examination at autopsy. H & E stain and NeuN immunohistochemistry neuronal cell marker were used to demonstrate the findings of FCD.

Pure yolk sac tumor of sacrococcygeal region

The sacrococcygeal region is the most common site for the extragonadal germ cell tumors comprising seminomatous and non-seminomatous tumors. Seminomatous tumors are seminomas, and non-seminomatous tumors comprise mainly teratoma (mature and immature), yolk sac tumor (YST), embryonal carcinoma (EC), and choriocarcinoma. These tumors occur in newborns, infants, and adolescents. Other common sites for extragonadal germ cell tumors are the brain and mediastinum, although they may occur anywhere in the body. These tumors may occur in mixed as well as pure form. So, sectioning from different areas should be done before labeling them as pure germ cell tumors. YST, in its pure form, is rare and therefore should not be missed as it is chemosensitive. The patient should be thoroughly assessed clinically. Imaging also becomes necessary while evaluating swelling in the sacrococcygeal region and can aid in differentials. When the clinical and imaging suspicion of either Sacrococcygeal teratoma or other germ cell tumor is high, serum biomarkers as alfa-fetoprotein should be requested. The serum levels are necessary and should be done preoperatively, postoperatively, and during the course of chemotherapy as follow-up. However, the final diagnosis rests on the histopathological diagnosis. We report one such case of pure YST in the sacrococcygeal region in a 9-month-old female child. The imaging suggested sacrococcygeal teratoma type 4, and high alfa-fetoprotein levels were determined postoperatively.

Metaplastic breast carcinoma with extensive osseous differentiation

Metaplastic breast carcinoma is a rare subtype of invasive breast carcinoma. Metaplastic carcinoma with osseous differentiation is exceptionally uncommon. Because of the heterogenous microscopy of the lesion, various clinical and radiological features are observed, leading to diagnostic difficulty. Herein, we present a case of a 43-year-old female with a recurrent breast lump, who was clinically diagnosed as a phyllodes tumor. However, histopathological examination revealed metaplastic carcinoma with extensive osseous differentiation.

A rare presentation of Sinonasal Undifferentiated Carcinoma with brain metastasis and para-aortic mass

Sinonasal Undifferentiated carcinoma (SNUC) comprises 3% of the head and neck tumors, including metastatic neoplasms. Herein we report the case of a 60-year-old male who was brought dead to our institute with previous records of a contrast-enhanced CT scan of the brain and MRI with evidence of tumor in the maxillary sinus with intracranial extensions. The histopathological examination of the mass in the maxillary sinus proved to be SNUC with metastases to the brain, lungs, and around the aorta. These tumors are undifferentiated and are distinct from other poorly differentiated tumors in deriving their origin from the Schneiderian epithelium. The aggressive nature of the tumor renders the prognosis quite dismal. SNUCs need to be early recognized and distinguished from other poorly differentiated carcinomas with the help of immunohistochemistry.

A prospective study of cervical lesions diagnosed by liquid based cytology in Western Rajasthan, India population

Background: Carcinoma cervix is the second most common malignancy of women in India after breast cancer. The present study was conducted to determine the spectrum of cervical lesions by liquid-based cytology in Western Rajasthan population.Methods: It is a Prospective study on 1087 cervical samples carried over a period of 1 year. Cervical samples were taken and processed by SurePath™ LBC.Results: Of total 1087 cases 959 were negative for intraepithelial lesion or malignancy (88.22%). 88 cases (8.09%) were reported as unsatisfactory. Among the non- neoplastic cases- bacterial vaginosis was reported in 209 cases (21.8%), Candida in 77 cases (8.02%), both Candida and bacterial vaginosis in 12 cases (1.25%), reactive cellular changes in 193 cases (20.12%), and Trichomonas vaginalis in 01 case. Among pre-malignant and malignant lesions, 40 cases (4.17%) the distribution was as follows-atypical squamous cells of undetermined significance 16(1.67%), atypical squamous cell-cannot rule out high grade 08 cases (0.83%), Low grade squamous intraepithelial lesion 04 cases (0.42%), high grade squamous intraepithelial lesion 07 cases (0.73%), Atypical glandular cell favoring neoplastic 01 case (0.15%), and squamous cell carcinoma 04 cases (0.42%). Histopathological co-relation of premalignant and malignant lesions was further studied.Conclusions: Liquid based cytology is an effective screening and diagnostic procedure for cervical abnormalities. Among pre-malignant and malignant lesions, histo-pathological correlation increased with increased grade of severity of lesions. To the best of knowledge, this is the largest study of liquid based cytology in the Western Rajasthan.