Immunohistochemical detection of axillary lymph node micrometastases in breast cancer patients: Increasing the accuracy of detection and decreasing labor intensive serial sectioning.

Background: The histological detection of axillary lymph node tumor metastases in cases of breast carcinoma is of major prognostic significance, but may be difficult when metastases are of microscopic size. The micrometastases can be detected either by immunohistochemistry (IHC) or serial sectioning. Aims: We investigated whether immunohistochemical techniques and serial sectioning can increase the accuracy of metastatic detection and compared the efficacy of both. Materials and Methods: Thirty cases of breast carcinoma were studied in all of whom the axillary lymph nodes had been reported as free of metastases. Blocks from these cases were serially sectioned and stained with hematoxylin and eosin and a single section was stained with monoclonal antibody to cytokeratin AE1/AE3 and epithelial membrane antigen. The positivity for micrometastases was correlated with size, number, grade and histological type of primary tumor, lymph node size and number. Results and Conclusion: In 5/30 previously unsuspected cases, micrometastases were revealed by IHC and in 1/30 by serial sectioning. These findings suggested that serial sectioning is a labor intensive, time consuming and impractical procedure. Micrometastases were more frequently detected with age of patient >50 years, Grade 2/3 tumor, tumor size >5 cm and more than one primary tumor. Immunohistochemical analysis can be recommended as a routine procedure or an adjunct to routine histological procedures for the correct staging of breast carcinoma and use of adjuvant chemotherapy, especially in the high risk group.

In vivo wound healing performance of drug loaded electrospun composite nanofibers transdermal patch.

Acute injuries or wound is required the fast delivery of drug to control infections without any side effect. In this direction in the present investigation, antibiotic ciprofloxacin loaded hydrophilic biodegradable poly vinyl alcohol (PVA) and sodium alginate (NaAlg) electrospun composite nanofiber based transdermal patch was developed for local delivery of antibiotic drug. The antibiotic drug ciprofloxacin was loaded in it by active loading. The drug entrapped in the composite nanofibers was confirmed by the scanning electron microscopy and swelling behavior. The in vivo studies were carried on male rabbits by using the drug loaded and unloaded composite nanofibers transdermal patch and marketed one. It is observed that, in vitro activity provides a sustained and controlled release pattern of the drug from transdermal patch. The mechanism of drug release was also studied using different models. The nanofiber transdermal patch follows the Higuchi and Korsmeyer-Peppas model for drug release. The in vivo studies demonstrate that, wound healing takes place in less time as compared drug unloaded patch. Hydroxyproline produced in wound bed with time shows that it content is maximum in case drug loaded PAV-NaAlg patch. This demonstrates that wound healing rate is higher in case drug loaded PVA-NaAlg transdermal patch.

Mucinous cystadenocarcinoma arising in an ectopic kidney simulating a retroperitoneal dermoid cyst: a rare tumour presenting as a diagnostic dilemma.

Primary mucinous cystic neoplasms are rare tumours of the kidney, with a very few case reports in the literature. They arise from metaplasia of renal pelvic urothelium. We describe here a 45-year-old male who presented with pain in the abdomen and a lump in the left iliac fossa for two months. Ultrasound and CT scan showed a large, complex, heterogenous mass in the central abdomen and left iliac fossa, suggesting the possibility of dermoid cyst. Excision of the mass showed an enlarged multicystic kidney filled with mucin, destruction of renal parenchyma and a small viable area of grey white tumour. Histopathology revealed a peripherally located mucinous cystadenocarcinoma arising in the background of chronic pyelonephritis and mucinous metaplasia. We report this case for the rarity of the lesion and the associated clinical and radiological diagnostic dilemma.

Sarcomatoid carcinoma of the gall bladder.

Primary gallbladder carcinoma is a malignant neoplasm with an incidence of 1.2 cases per 100 000 people each year. Its occurrence increases with age, particularly in women. It is the fifth most common cancer of the gastrointestinal tract, and the most common malignancy in the biliary tract. Adenocarcinoma is the most common type of gallbladder neoplasm whereas sarcomatoid carcinoma is rare with an incidence of less than one percent of all malignant gall bladder neoplasms. Sarcomatoid carcinomas are composed of malignant epithelial and sarcomatous components, sometimes with heterologous sarcomatous elements. In general, conservative treatments are thought to be unfavourable to the tumor. Prognosis is poor following curative resection for carcinosarcoma of the gall bladder because of recurrence as systemic metastasis of the liver and peritoneal dissemination.