Correlations of aldehyde dehydrogenase-1 (ALDH1) expression with traditional prognostic parameters and different molecular subtypes of breast carcinoma.

BACKGROUND AND AIM: Breast cancer, a heterogeneous disease, is the most common cause of cancer-related death in women worldwide. Despite considerable developments in treatment modalities, a subset of patients with advanced-stage breast carcinoma display poor prognosis. Breast cancer heterogeneity and risk of recurrence could be explained with the help of cancer stem cell hypothesis. Stem cells have the capacity to self-renew and differentiate into multiple cell types. Aldehyde dehydrogenase-1 (ALDH1), an enzyme responsible for the oxidation of intracellular aldehydes, contributes to normal and tumor stem cell differentiation. Invasion and metastasis in breast cancer are found to be mediated by a subpopulation of tumor cells which exhibit stem cell-like features and express ALDH1.The aim was to document ALDH1 expression in breast carcinoma and find its association with other clinico-pathologic prognostic parameters. STUDY DESIGN: This was a cross-sectional observational study. METHODS: A total of 62 patients with breast carcinoma undergoing mastectomy were included in this study. The tumors were classified into molecular subtypes by assessing immunohistochemical (IHC) expression of ER, PgR, HER2 and Ki-67 according to St. Gallen Consensus Conference 2013. ALDH1 expression was studied by IHC and correlated with clinicoathological parameters. STATISTICAL ANALYSIS: Statistical analysis was done using Graph Pad software (Prism 5 version) for Windows 7. A p-value <0.05 was considered statistically significant. RESULTS AND ANALYSIS: Out of 62 tumors, 35 tumors (56.4%) showed ALDH1 positivity. ALDH1 expression was significantly associated with larger size, lymph node involvement, higher grade, higher stage and HER2+ or triple negative tumors. CONCLUSION: This study suggests that ALDH1 expression is associated with poor prognostic parameters and aggressive tumor behavior. Larger population-based prospective trials on Indian patients are required to validate these results.

Cytological and histological correlation of granular cell tumor in a series of three cases.

Granular cell tumor (GCT) is an uncommon soft tissue tumor characterized by proliferation of cells with granular eosinophilic cytoplasm. We came across three such tumors, one in the tongue, one in the chest wall, and one in the right deltoid region, which were referred for fine-needle aspiration cytology. On cytological examination, the first two cases were diagnosed as GCT, and the mass in deltoid region was suggestive of proliferative myositis. The cytological details of these cases are discussed. The excision biopsies of the first two cases and Tru-cut biopsy of the deltoid mass confirmed the diagnosis of GCT.

Clinicopathological study of rhinosporidiosis with special reference to cytodiagnosis.

BACKGROUND: Rhinosporidiosis is a chronic infective disorder caused by Rhinosporidium seeberi. It usually presents as a soft polypoidal pedunculated or sessile mass. Nose and nasopharynx are the commonest sites, followed by conjunctiva, maxillary sinuses, penis, urethra. AIMS: The aim of this study is to present the clinicopathological features of rhinosporidiosis in a large series of cases and to asses the role of cytology in diagnosis. MATERIALS AND METHODS: 63 cases were included in the study group. Diagnosis of rhinosporidiosis was confirmed in all cases by histology with or without cytological evaluation. May-Grünwald-Giemsa and hematoxylin and eosin (H and E) staining was used in all cases, and special stains like periodic acid Schiff and mucicarmine were used in a few cases. Detailed clinical history of all the cases was noted. Routine hematological investigations including ABO blood grouping were done in all possible cases. RESULTS: Evaluation of the clinical data in our series demonstrated male predominance (36 out of 63; 56%). Nose and nasopharynx were the commonest sites involved (74.6%). Routine hematology tests did not show any significant change in most of the cases. However, a significant proportion of the study population (18 out of 41; 44%) had blood group O. Cytodiagnosis attempted in 17 cases out of 63 cases achieved 100% correlation with histology. CONCLUSION: Morphological appearance alone in a few cases failed to give diagnosis of rhinosporidiosis. Cytology can be very helpful in diagnosis in these cases, but histology is the mainstay of diagnosis.

Cytodiagnosis of glomus tumor.

Glomus tumors are uncommon, with an estimated incidence of 1.6%. Cytological descriptions of this tumor are few. We report a 15-year-old boy presenting with a painful subungual swelling. Fine needle aspiration cytology showed uniform cells with homogeneous chromatin and scanty cytoplasm. Cytology was reported as "suggestive of glomus tumor". Histopathological examination confirmed the diagnosis. Careful cytomorphological examination supported by appropriate clinical history should suggest the diagnosis of glomus tumor and help in preoperative diagnosis.

Pattern of cancer occurrence in rural population of West Bengal--a hospital-based study.

Incidence of cancer in India is lower than in the West and the commonly affected sites are very different. Cancers of the upper alimentary and respiratory tracts (oral cavity, pharynx, larynx) contribute more than half of the cancers in men and about a quarter in women. Indigenous habits of chewing and smoking seem to be primarily responsible for the high incidence of these cancers. During a 10-year study period, out of a total 20072 cases biopsied, 3226 (16.07%) were malignant. The maximum number of malignancies were from cervix uteri ie, 1499 (44.92%); next oral cavity and pharynx (n = 437; 13.55%) frequently found in males; breast was third in the series. Cancer of the cervix uteri is a major problem in women. Practical measures are to be taken for the prevention of these cancers common in India.

Primary pleomorphic sarcoma of the ovary with rhabdomyosarcomatous differentiation.

A 49-year-old patient presented with a right ovarian mass, which, on microscopy, showed to consist of haphazardly oriented large pleomorphic cells with abundant cytoplasm. Periodic acid Schiff stain was positive but negative with diastase digestion. Immunohistochemical staining with Desmin showed intense cytoplasmic positivity in almost all the cells. Cytokeratin, epithelial membrane antigen, smooth muscle actin, HMB-45, S-100 and neurone-specific enolase were negative. Immunohistochemical staining with Myogenin showed intense nuclear positivity. There was no other primary tumor on extensive search. A diagnosis of primary sarcoma of the ovary with rhabdomyosarcomatous differentiation was made. The incidence of similar tumors of the ovary are low and therefore little data are available on this uniformly lethal tumor. Thus, such cases need to be reported to pool experience so that the tumor can be diagnosed early.

Computed tomography-guided fine needle aspiration cytology of thoracic mass lesions: A study of 57 cases.

BACKGROUND: Computed tomography (CT)-guided fine needle aspiration cytology (FNAC) is regarded as a rapid, safe, and accurate diagnostic tool in examining thoracic mass lesions for the last three decades. AIMS: To assess the role of CT-guided FNAC in thoracic mass lesions, to analyse the results, and to compare the results with other studies. MATERIALS AND METHODS: Fifty-seven patients were studied over a year (July 2007 to June 2008) for their age, sex, and topographic distribution, pleural infiltration (based on CT findings), and cytological diagnoses. RESULTS: Out of 57 cases, 78.9% (n = 45) were male and 21.1% (n = 12) were female. The age range varied from 34 to 79 years with the peak in the fifth decade. There were 54 parenchymal (lung) tumors and the remaining three tumor cases were mediastinal. The most common tumor was squamous cell carcinoma (42.6%) followed by adenocarcinoma (29.6%) and small cell carcinoma. Postprocedural complications were minimal and were noted in only three cases (a little pulmonary hemorrhage in two and hemoptysis in one). CONCLUSIONS: CT-guided FNAC of thoracic mass lesions provides a rapid and safe diagnostic procedure with minimal complications. The categorical diagnosis can also be achieved on the basis of cytomorphology. The figures obtained from this study are comparable with other studies except for a few differences.

Cutaneous metastasis from follicular variant of papillary thyroid carcinoma: a case diagnosed on cytology.

A 40-year-old woman presented with a scalp swelling. A careful clinical examination revealed a left-sided deep-seated thyroid nodule. Fine needle aspiration from both sites disclosed a microfollicular architectural pattern on Giemsa stain and pale nuclei with nuclear grooves on Papanicolaou stain, indicating the possibility of follicular variant of papillary thyroid carcinoma with metastasis to the scalp. Histologic tissue evaluation confirmed the diagnosis. Thus, a diligent search for nuclear features should be performed to enable a diagnosis of follicular variant of papillary thyroid carcinoma on cytology. This helps in patient management obviating the need for a second surgical intervention.

Recurrent and aggressive chondroblastoma: a case report.

Recurrent chondroblastoma with pulmonary and palatal metastasis is a rare occurrence. We report the cytological and histological findings of such a case in a 33 years old male, where the primary diagnosis of metastatic chondroblastoma was made on FNAC, which was later confirmed on histopathology. The present case highlights that, some chondroblastomas do exist, that are capable of pursuing a malignant course.