Evaluation of variable p16 immunostaining patterns, Ki-67 indices and HPV status in cervical SILs and squamous cell carcinomas: An institutional experience

Objective: The present study evaluates the immunoexpression of p16 and Ki-67 in cervical squamous intraepithelial lesion (SIL) and carcinomas and correlates their expression with clinicopathological features and HPV-DNA status. Material and Methods: A total 36 included cases of SIL and squamous cell carcinoma (SCC) were subjected to p16 and Ki-67 immunostaining. p16 staining was evaluated depending on grading, distribution, localization pattern, intensity and IHC score. Ki-67 expression was graded based on percentage of positive cells. Results: Incidence of HSIL and SCC cases was found to be significantly increased with parity > 5. p16 grade III diffuse nucleocytoplasmic immunostaining was observed in 62.5% LSIL, 80% HSIL and 87% SCC cases. Significant association of p16 staining intensity, IHC score and Ki-67 indices was noted with increasing grades of SILs and carcinomas. Conclusion: Our experience indicates that a combination of p16 and Ki-67 immunostaining may be useful to determine the severity of dysplastic change.

Malignant melanoma of nasopharynx extending to the nose with metastasis in the neck.

Malignant melanoma is a rare tumor in otorhinolaryngology. In this paper, we have reported the first case of melanoma of nasopharynx which we came across in 20 years of ENT practice. A 55 year old male patient with complaints of swelling of nose and left side of neck, nasal blockage and epistaxis was diagnosed as melanoma of nose with metastasis in the neck based on clinical and radiological examination. The tumour was excised by lateral rhinotomy with supraomohyoid block dissection on the left side. The tumour was found to originate from lateral wall of nasopharynx and middle turbinate. The surgery was followed by radiotherapy. Diagnosis of melanoma was confirmed on histopathology. During 30 months follow-up, no recurrence was noticed.

Multiple chylous cysts of abdomen causing intestinal obstruction.

A case of multiple chylous cysts of the abdomen in a 35 years old female is presented here. The patient presented with signs and symptoms of acute intestinal obstruction. Exploratory laparotomy revealed few intestinal adhesions along with multiple small cysts containing blood stained gelatinous material in the abdominal cavity, some of which were excised alongwith lymph nodes. The abdomen was closed after a saline peritoneal lavage. Chylous nature of the cysts was confirmed on histopathology. The post-operative course was asymptomatic.