Morphological Spectrum of Basal Cell Carcinoma in Southern Karnataka.

INTRODUCTION: Basal Cell Carcinoma (BCC) is the most common skin cancer worldwide, which appears over sun-exposed skin as slow-growing, locally invasive lesion that rarely metastasizes. Many phenotypic presentations are possible. BCCs are more common in males and tend to occur in older people. Majority is found on the head and neck. Many histopathological subtypes have been defined including nodular, micronodular, cystic, superficial, pigmented, adenoid, infiltrating, sclerosing, keratotic, infundibulocystic, metatypical, basosquamous and fibroepitheliomatous. Mixed patterns are common. AIM: The aim was to study morphological spectrum of BCC in a tertiary care hospital in southern Karnataka. MATERIALS AND METHODS: This was a retrospective analysis of 100 cases of BCCs reported in the Department of Pathology over a 9-year period from 2006 to 2014. RESULTS: The mean age of presentation was 62 years. There was slight female preponderance (56%). The most common location was face (65%) and the most common presentation was ulceration (45%). Of the 100 BCCs, 50% were nodular, 13% infiltrating, 6% basosquamous, 4% superficial, 3% keratotic, 3% multinodular and 1% mixed. CONCLUSION: BCC, besides being the commonest cutaneous cancer, is also known for its numerous histological patterns which are shown to have prognostic implications. This study reveals the frequency of the various histological patterns of BCC in southern Karnataka, where it has been rarely studied before.

Sclerosing stromal tumour of the ovary--a clinicopathologic spectrum.

Majority of the Sclerosing stromal tumours of the ovary documented in the literature are single case reports. We report a series of 4 cases. Among the 4 cases encountered the mean age at presentation was 22.2 years. The clinical presentation varied from asymptomatic mass per abdomen (2 cases), menorrhagia (1 case) and amenorrhoea (1 case). The tumour was unilateral in all the cases with an average size of 10 cms. Grossly the appearances varied from a solid, partly cystic, edematous tumour (2 cases) to solid,firm tumour with yellow flecks (1 case) to unilocular cystic tumour (1 case). Microscopically, the tumour was characterized by cellular pseudolobules composed of a disorderly admixture of collagen-producing fibroblasts and lipid rich lutein cells with shrunken nuclei. In one case the lutein cells had a robust appearance with abundant cytoplasm and vesicular nuclei. The pseudolobules were very vascular and separated by hypocellular dense to oedematous fibrous tissue. Frozen section demonstrated fat in luteinized cells in 3 cases.

Prolymphocytic leukaemia--report of three cases.

Prolymphocytic leukaemia is a rare subtype of chronic lymphocytic leukaemia. Three such cases are reported here along with clinical details. All these cases were seen in males above 5th decade of life. These patients showed moderate to massive splenomegaly, inconspicuous lymphadenopathy in two cases and one with minimal lymphadenopathy. Peripheral smear showed high leucocyte count with more than 55% of prolymphocytes. Bone marrow aspiration showed diffuse involvement; and in one with minimal lymphadenopathy, lymph node aspiration showed prolymphocytes. All the three patients died within a year after diagnosis.

T-cell rich B-cell lymphoma--a case report.

T-Cell-Rich B-Cell lymphoma (TCRBCL) is a recently described variant of diffuse large B-cell lymphoma characterized by a predominance of reactive T-cells and a minority of neoplastic large cells which may resemble the Reed-Sternberg cell or its variants. TCRBCL is a notorious mimicker of both lymphocyte predominance Hodgkin's disease (LPHD) and peripheral T-cell lymphoma (PTCL). Immunohistochemistry is mandatory for a definitive diagnosis. We report a case of TCRBCL which was mistaken for HD both on fine needle aspiration cytology and histopathology due to the presence of RS like cells. Immunohistochemistry resolved the diagnostic dilemma.

Prolymphocytic leukaemia--report of three cases.

Prolymphocytic leukaemia is a rare subtype of chronic lymphocytic leukaemia. Three such cases were reported here along with clinical details. All these cases were seen in males above 5th decade. These patients showed moderate to massive splenomegaly, inconspicuous lymphadenoapthy in two cases and one with minimal lymphadenopathy. Peripheral smear showed high leukocyte count with more than 55% of prolymphocytes. Bone marrow aspiration showed diffuse involvement and in one with minimal lymphadenopathy, lymphnode aspiration showed prolymphocytes. All the three patients died within a year after diagnosis.