A study on expression pattern of cyclooxygenase-2 in carcinoma of cervix.

Objective: The purpose of the present study was to determine the differential expression pattern of cyclooxygenase-2 (COX-2) in patients of carcinoma of uterine cervix and its correlation with tumor differentiation and lymphovascular invasion. Materials and Methods: Seventy (70) cases of cervical carcinoma were included (20 in-situ, 42 invasive squamous cell, and 8 cases of adenocarcinoma). Formalin-fixed paraffin-embedded tissue sections were stained by Hematoxylin and Eosin. Immunohistochemistry for COX-2 were performed on these blocks. Results: A higher expression of COX-2 was seen in invasive squamous cell carcinoma than in in-situ carcinoma (P = 0.002). Five out of eight cases of adenocarcinoma showed strong positivity for COX-2 antibody. Among the histopathological correlates, tumor differentiation did not show a positive correlation (P = 0.717), while lymphovascular invasion was associated with positive staining in majority of the cases (P = 0.001). Conclusion: Expression of COX-2 is more in cases of invasive than in in-situ carcinoma. Adenocarcinomas showed a strong expression of COX-2. A positive association of COX-2 expression and the presence of lymphovascular emboli were found in the present study. COX-2 inhibitors need to be studied as a therapeutic adjunct for the treatment of carcinoma cervix.

Ocular surface disorder in pterygium: Role of conjunctival impression cytology.

Objective: To study ocular surface abnormalities in patients with pterygium, conjunctival impression cytology was explored as a tool for the assessment of the cytological changes. Materials and Methods: A comparative case control study was undertaken to evaluate the ocular surface disorders in pterygium. Fifty cases of pterygium and 50 age and sex-matched controls were analyzed for the presence of local tear film abnormalities as assessed by the tear film break up time and Schirmer test. The spectrum of changes in cytomorphology was studied in detail using conjunctival imprint cytology. Results: Tear film break-up time and Schirmer's strip wetting were found to be significantly different in study and control groups. Studying the cytomorphology of the conjunctival imprint smears, reduced cellularity and squamous metaplasia of different grades was observed more frequently in patients compared to controls. On overall grading of cytological changes, statistically significant difference was noted between the study and control groups (P value 0.00172). Conclusion: From the present study we can suggest that aqueous tear film deficiency leading to ocular surface disorder brings about a change at the cytological level, and ocular surface disorders found in pterygium can be interpreted by conjunctival impression cytology.

A case report of unifocal Langerhans' cell histiocytosis or eosinophilic granuloma.

A case of unifocal Langerhans' cell histiocytosis or eosinophilic granuloma in a child is reported where the frontal, zygomatic and maxillary bones of the left orbital wall are affected. As eosinophilic granuloma is a rare disease and the involvement of maxillary bone in orbital eosinophilic granuloma is not well documented in the literature, this case is reported for its unusual involvement of 3 bones at a single site. The diagnosis was established by clinical, radiological and histological findings. As no other system or site was involved and considering the osseous involvement of multiple bones at one site, local radiotherapy was preferred as the mode of treatment. The patient responded favourably to radiotherapy with reduction of proptosis and tumour mass but there was no visual recovery. In the absence of universal agreement over the mode of treatment, the result emphasises the probable benign nature of the tumour and the need to withhold more aggressive treatment modalities for extensive multisystem involvements.

Fine needle aspiration biopsy in the management of tumours in superolateral quadrant of orbit.

Forty-two cases of orbital lesions in superolateral quadrant were evaluated in our study by fine needle aspiration biopsy. Cases were histologically proven wherever possible. In 92.85% cases the diseases were correctly diagnosed. Females were mainly affected. Lymphomatous tumours were diagnosed on the basis of atypical lymphoid proliferation, correlated with clinical features and findings of computed tomographic scan and managed by radiotherapy. Pseudotumours, dermoid and epithelial tumours of lacrimal gland were diagnosed accurately except in one case of malignant mixed tumour where the malignant component was aspirated. Pseudotumours were treated by steroid, dermoid by excision. In case of adenocarcinoma and adenocystic carcinoma, tumour masses were removed by lateral orbitotomy and radiotherapy was applied when bony erosion was present. One case of eosinophilic granuloma was treated by radiotherapy and curettage. The suspected case of intra-osseous cavernous haemangioma did not turn up for treatment.

Role of potassium hydroxide mount in rapid diagnosis of fungal corneal ulcers.

The aim of the study was to establish the importance of KOH mount in rapid diagnosis of fungal corneal ulcers. Corneal scrapings were collected from 50 patients with corneal ulcers where clinical features suggested fungal aetiology and ulcers showed no signs of healing on initial treatment. Corneal scrapings were subjected to wet mount with 10% KOH, Gram's stain, and culture on SDA media. Wet mount showed fungal elements in 34 cases (68%) and were classified according to morphology. Gram's stain of corneal scrapings did not provide much help. Fungal culture was positive in 9 (26.4%) out of 34 cases. Specific antifungal treatment was instituted in all cases that showed positive wet mount without waiting for culture reports and on follow-up all these 34 patients showed improvement. Thus wet mount with 10% KOH can be relied upon as the singlemost important screening tool for rapid diagnosis of fungal corneal ulcer and treatment should be dispensed on its basis.