Early endometrial carcinoma: Experience and outcomes.

Aim: Endometrial carcinoma (EC) data from India are very sparse. We did a retrospective analysis of our patients registered at this peripheral cancer center based in rural Punjab and studied their outcome. Materials and Methods: Ninety-eight Stage I and II EC patients with endometroid histology registered at our institute from January 2015 to April 2020 were studied for demography, histopathology, treatment received, and outcomes. FIGO 2009 staging and new European Society for Medical Oncology (ESMO) risk group classification was used. Results: Our patients had a median age of 60 years (range 32-93 years). There were 39 (39.8%), 41 (42.0%), 4 (4.1%), 12 (12.2%) patients in the low risk, intermediate risk (IR), high intermediate risk, and high risk groups, respectively, as per new ESMO risk classification. Two (2.0%) patients had incomplete information to assign them to a particular risk group. Fifty (46.7%) patients underwent complete surgical staging and 54 (50.5%) patients received adjuvant RT. With a median follow-up of 27.0 months, there were 1 locoregional and 2 distant recurrences. There were 8 deaths in total. Three-year overall survival for the entire group is 90.6%. Conclusions: The risk group determines adjuvant treatment in endometrial cancer. Patients operated at dedicated cancer center tend to have better surgical staging and thus better outcome because of better risk stratification and grouping for adjuvant therapy. IR histology was more common in our group of patients, which is variable as compared to available literature.

Flow cytometry in reactive lymph node aspirates: Evaluation of distribution of populations with immunophenotypic outliers.

BACKGROUND: Diagnostic accuracy of fine needle aspiration cytology for lymphomas has markedly improved when used in conjunction with flow cytometry (FCM), especially to differentiate reactive lymph node aspirates from low-grade lymphomas, a challenge for cytopathologists. Lymphoma diagnosis by FCM depends on detection of immunophenotypic B- and T-cell outliers, also present in benign lymph nodes albeit in subsets of cells. These can mimic heterogenous populations obtained from lymphomas partially involving lymph nodes. METHODS: In the present study, FCM of fine needle aspiration/scrape material from 30 cases of benign lymph nodes was evaluated for the distribution of lymphoid populations and the presence and percentages of immunophenotypic outliers. RESULTS: The majority of the samples were cervical nodes with all cases showing T-cell predominance. CD5/CD19 co-expression was seen in 23.94 ± 9.51% (20 cases) and CD10/CD19 co-expression in 3.2%-20.2% (8 cases) of B-cell events. None of these cases showed light chain restriction. Loss of CD7 (2%-28.4%) and CD5 (12.7%) expression was seen in 17 cases and 1 case, respectively, of T-cell events. CONCLUSION: Immunophenotypic outliers suggestive of lymphomas could be seen in non-lymphomatous lymph node aspirates in a subset of the cell population. However, they could be defined as benign due to absence of light chain restriction and normal CD4:CD8 ratios in all but one case, which was confirmed to be benign after clinical correlation and excisional biopsy. Thus, multiparameter FCM along with clinicoradiological correlation can prevent overdiagnosis of lymphomas.

COVID-19 Masquerading as Postoperative Surgical Complications after Cancer Surgery.

While the world suffers from pandemic of novel coronavirus infection, also known as COVID-19, the elective surgeries were deferred in most centers due to diversion of services. Cancer surgeries unlike others are considered urgent hence cannot be delayed beyond a point. COVID-19 might disguise itself as prolonged postoperative course and complications. Retrospective audit of cancer surgeries performed from 23rd March 2020 to 31st March 2021 at our cancer center in rural India was done. Up to 3 months after surgery was considered postoperative period for the purpose of this study. Seven hundred ninety-three cancer surgeries were performed. Out of these, eight patients had unusually prolonged postoperative recovery and complications. Symptoms varied from unexplained fever to diarrhea to wound healing problems. Unfortunately, one patient died of complications. Since a lot is yet to be discovered about the virus-host interaction, hence surgeons should take preemptive measures for any unusual postoperative behavior especially in the time of this pandemic and high index of suspicion should be there for coronavirus infection.

Presentation and Spectrum of Male Breast Cancer in a Rural Cancer Center in a Subunit of Tata Memorial Center, India.

This is a retrospective study of the incidence and clinical profile of male breast cancer (MBC) presenting to a rural cancer center in Punjab, India. All MBC cases registered over a period of 4.5 years from January 2015 to July 2019 were included. The study included 34 MBC patients accounting for 1.9% of all breast cancer cases with median age of 62.5 years. All patients were from Punjab except one, with majority from district Sangrur. Family history was present in 7 (20.6%) patients. Mean BMI (n = 23) was 24.8. The median duration of symptoms was 6 months (range 1-60 months). Main complaint was lump in 58.8% of patients followed by lump with ulceration (41.2%). All cases were mostly unilateral, left in 21 (61.8%) and right in 13 (38.2%), and one had bilateral breast cancer. Most tumors were centrally located (70.6%). Infiltrating ductal carcinoma and grade 3 were the commonest histology. ER positivity was high seen in 76.5% cases. In our study, 16 (47.1%) patients presented with distant metastasis at the time of diagnosis, and 10 (39.1%) were locally advance. Bone (41%) followed by lung (17%) were the most common sites of metastasis. Thirteen patients were treated radically, nine were treated with palliative intent, and twelve patients defaulted. Median follow-up period was 16.5 months. MBC constituted 1.9% of all breast cancers registered at our institute, which is higher than worldwide average. Our study population had a longer time to presentation, and majority were metastatic.