Digital pathology: elementary, rapid and reliable automated image analysis.

AIMS: Slide digitalization has brought pathology to a new era, including powerful image analysis possibilities. However, while being a powerful prognostic tool, immunostaining automated analysis on digital images is still not implemented worldwide in routine clinical practice. METHODS AND RESULTS: Digitalized biopsy sections from two independent cohorts of patients, immunostained for membrane or nuclear markers, were quantified with two automated methods. The first was based on stained cell counting through tissue segmentation, while the second relied upon stained area proportion within tissue sections. Different steps of image preparation, such as automated tissue detection, folds exclusion and scanning magnification, were also assessed and validated. Quantification of either stained cells or the stained area was found to be correlated highly for all tested markers. Both methods were also correlated with visual scoring performed by a pathologist. For an equivalent reliability, quantification of the stained area is, however, faster and easier to fine-tune and is therefore more compatible with time constraints for prognosis. CONCLUSIONS: This work provides an incentive for the implementation of automated immunostaining analysis with a stained area method in routine laboratory practice.

Gastric diffuse large B cell lymphoma presenting as paraneoplastic cerebellar degeneration: case report and review of literature.

Paraneoplastic cerebellar degeneration (PCD) is a type of paraneoplastic neurological disorder (PND) that is associated with many solid tumors, Hodgkin's lymphoma (HL) and very rarely with non-Hodgkin's lymphoma (NHL). We report a case of PCD associated with gastric diffuse large B-cell lymphoma (DLBCL) in a patient who presented with acute onset of giddiness and double vision and had complete remission of the gastric lesion and marked improvement of cerebellar syndrome with rituximab-based combination chemotherapy. A brief review of the literature is also presented.

Challenges in launching multinational oncology clinical trials in India.

In the recent past, there has been an impressive growth in the number of clinical trials launched worldwide, including India. Participation in well-designed oncology clinical trials is of advantage to Indian healthcare system in general, and cancer patients in particular. However, the number of clinical trials being run in India is not commensurate with the cancer burden prevailing in the country. In this article, the authors investigate the reasons for this discrepancy, highlight critical bottlenecks, and propose ways to ameliorate the situation.

Neural fibrolipoma without macrodactyly: a subcutaneous rare benign tumor.

Neural fibrolipoma, also known as lipofibromatous hamartoma of nerves and neurolipomatosis, is a rare subcutaneous benign lesion involving the upper extremity with a marked predilection for median nerve. In one-third of the cases, it is associated with macrodactyly (enlargement of one or several digits of hands or feet), diminished sensation, paraesthesias and compression neuropathy. A 23-year-old male presented with a gradually increasing mass in the right palm without associated macrodactyly or neurodeficit. The surgical specimen showed a 20 x 18 x 3 cm, grey yellow fusiform mass. Cut section revealed presence of fibrofatty tissue within and around the enlarged nerve. Microscopy established the relation of nerve enlargement to infiltration of epineurium and perineurium by fibroadipose tissue separating normal nerve fascicles. Limited excision was the mainstay of conservative treatment. Neural fibrolipomas are a rare entity. Knowledge of characteristic histological and radiological findings is necessary for diagnosis and treatment.