Osseous metaplasia of antrochoanal polyp: Case report and radiological-pathological correlation.

Osseous metaplasia of inflammatory sinonasal polyp is an extremely rare entity. Correct preoperative diagnosis by noncontrast CT scan is needed to rule out other more common bony neoplasms in paranasal sinuses and for accurate surgical planning. Here, we present a case of 20-year-old patient with an antrochoanal polyp with osseous metaplasia. We describe the lesion and discuss the radiological differential diagnosis thereby providing a brief review of literature of the few published cases worldwide along with histopathological correlation.

VEGF Expression to Support Targeted Therapy in Ovarian Surface Epithelial Neoplasms.

INTRODUCTION: Vascular Endothelial Growth Factor (VEGF), a promoter of angiogenesis, is a promising target for anti-angiogenic therapy in ovarian cancer. In our study, we examined the expression of VEGF in the spectrum of epithelial ovarian neoplasms (benign, borderline and malignant) by Immunohistochemistry (IHC). AIM: Diagnosing ovarian epithelial neoplasms, examining the expression of VEGF in benign, borderline and malignant neoplasms and correlating it with histological grade and stage of malignant cases. MATERIALS AND METHODS: This is a cross-sectional, observational study where, total of 50 cases of surface epithelial ovarian neoplasms were examined for expression of VEGF by IHC. Scoring for VEGF expression was done for each case. RESULTS: A total of 42 of the 50 cases (84%) showed VEGF expression. Out of the 42 positive cases, 19 were high VEGF expressors and 23 were low VEGF expressors. VEGF expression was significantly higher in carcinomas as compared to benign and borderline neoplasms (p=<0.001). All neoplasms of serous morphology were positive for VEGF. High VEGF expression was significantly associated with high grade (p=0.003) and stage (p=0.001) of disease. CONCLUSION: Ovarian surface epithelial neoplasms significantly express VEGF. Though, some VEGF expression was noted in benign and some borderline neoplasms, high VEGF expression was noted only in carcinomas and one case of borderline serous papillary tumour. Thus, these results suggest that epithelial ovarian tumours are candidates for VEGF targeting therapy as most of them are dependent on VEGF for progression.

Diagnosis of erythema nodosum leprosum (type 2 reaction) by cytology.

OBJECTIVE: It was the aim of this study to evaluate the possible role of cytology in erythema nodosum leprosum (ENL) and its use for early treatment of the disease. STUDY DESIGN: We present a prospective study conducted with 15 clinically diagnosed ENL cases. Among them, 13 cases had previously been diagnosed with lepromatous leprosy (LL) and 2 patients were new LL cases with signs and symptoms of ENL lesions. Haematoxylin and eosin stain with modified Ziehl-Neelsen stain was performed on fine needle aspiration material. One case was sent for biopsy. RESULTS: Complete cytological diagnosis of ENL was done in all 15 cases. Histopathological study revealed classical ENL lesions which also showed ENL features in cytodiagnosis. CONCLUSION: In the past, the accurate mode of diagnosis of ENL lesions was histopathology. However, clinicians have to wait a long time for the report and generally they start treatment only on the basis of clinical signs and symptoms. Cytodiagnosis of ENL lesions is an early, effective method for accurate diagnosis and helps to initiate treatment for these painful lesions.

Microfilaria in breast aspiration--an uncommon finding.

Filariasis is a major public health problem in many tropics and subtropics of Africa, Western Pacific and parts of the Americas, affecting over 83 countries. It is also a public health problem in India. A large majority of the cases found in India are attributed to infection by Wuchereria bancrofti which mainly affects the lymph nodes and the lymphatic channels. Breast is an unusual site for filariasis. In the present case report the patient presented with a gradually increasing breast lump, clinically diagnosed as fibroadenoma.

Study of lymph node lesions with fine needle aspiration cytology and histopathology along with immunohistochemistry.

Lymphadenopathy is one of the commonest clinical presentations of the patients attending hospital outdoor. Aetiology varies from Inflammatory process to malignant conditions. Fine needle aspiration cytology has become an integral part of the initial diagnosis. Histology remains the gold standard. But there exists some gray zones both in cytology and histology where immunohistochemistry plays a major role for final diagnosis. In this study, an attempt has been made to evaluate the importance of immunohistochemistry in this field. Fifty cases were studied. Clinical history was noted and examination done. All cases were examined both cytologically and histologically. Immunocytochemistry was done in all the cases by monoclonal antibody against p53 and Ki67. The results were tabulated and analysed according to unpaired 't' test. Reactive hyperplasia was present in maximum number followed by tuberculosis, non-Hodgkin's lymphoma and Hodgkin's lymphoma. All of these lesions showed statistically significant difference in p53 and Ki67 expression both in cytology and in histology. To conclude, fine needle aspiration cytology is an adjuvant to histology for early diagnosis and immunohistochemistry can help us in the gray zones.

Case report: "spina ventosa" tuberculous dactylitis in a 2 year old boy - a very rare disease.

Tuberculous infection of metacarpals, metatarsals and phalanges is known as tuberculous dactylitis. There is a spindle shaped expansion of the short tubular bones due to tuberculous granuloma. Hence it is also known as spina ventosa. In our case, a two year old boy with a swelling in the metacarpal was provisionally diagnosed as enchondromata while the possibility of spina ventosa was kept in mind. He was posted for excision of the metacarpal followed by bone grafting. Histopathological examination report confirmed it as spina ventosa.