Cytological Diagnosis Suggesting Candidal Infection of the Nasolacrimal Duct in an Uncontrolled Diabetic Patient With Gingival Abscess.

In this unique cytology case of a 64-year-old diabetic male who presented with left-sided facial swelling between the ala and lateral canthus of the left eye, conventional fine-needle aspiration cytology (FNAC) was done. FNAC of the swelling showed desquamated epithelial cells from the nasolacrimal duct and abundant proteinaceous material admixed with fungal organisms like that of budding yeast forms, morphologically resembling Candida on May-Grunwald-Giemsa stain. Special stain with periodic acid-Schiff revealed positivity for budding yeast forms. In this case report, we discuss the causes and clinical effects of nasolacrimal duct obstruction, cytological diagnostic features, and microscopic recognition of fungal organisms on routine staining as well as on special fungal stains.

Expression of Matrix Metalloproteinase-9 in Gastric Cancer.

Background Matrix-metalloproteinase-9 (MMP-9) is expressed by a wide range of cells and plays a significant role in the regulation of the tumor microenvironment of various cancers including gastric cancer. This study aims at the correlation of MMP-9 expression in gastric cancer with existing prognostic factors. Methods The MMP-9 expression in gastric cancer was identified by immunohistochemistry using a monoclonal antibody in paraffin-embedded sections, correlated with various clinicopathological parameters, and statistically analyzed. Results MMP-9 expression in gastric cancer was significantly correlated with the grade, depth of invasion, and TNM stage (p-value = 0.003, 0.019, and 0.025, respectively). A significant difference in expression between tumor tissue and adjacent gastric mucosa (p-value = 0.000) was also observed. 100% negative expression was found in well-differentiated tumors and early gastric carcinoma (T1). Conclusion The study results suggest that MMP-9 expression could be a potential biomarker of aggressive gastric cancer and candidates for the possible diagnostic and prognostic tool.

Detection of Human Leukocyte Antigen B27 by Flowcytometry in Patients With Suspected Ankylosing Spondylitis in a Tertiary Care Centre.

Introduction Human leukocyte antigen B27 (HLA-B27) is strongly implicated in the pathogenesis of ankylosing spondylitis (AS). Hence, HLA-B27 testing is routinely used in the diagnosis of AS. Objectives We aimed to establish the frequency of HLA-B27 in AS patients by flow cytometry and relate the differences between B27+ and B27- cases to the serum concentrations of rheumatoid arthritis factor (RA), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Methods  The study population included a total of 210 patients who visited the tertiary health care center. The peripheral blood samples obtained from AS patients were subjected to a qualitative two-color direct immunofluorescence method using the HLA-B27/CD3 antibody for the rapid detection of HLA-B27 antigen expression in erythrocyte-lysed whole blood in FACSCalibur flow cytometer (Becton Dickinson, USA). Results Out of 210 AS patients, the distribution of HLA-B27 positivity was observed only in 46 (22%) patients. The remaining 164 patients (78.1%) were negative for HLA-B27. Of the 46 HLA positive patients, 39 (25.34%) were males and only seven (12.5%) were females. In both sexes, HLA-B27 frequency was significantly higher in the age group 21-30 years, followed by 41-50 years. The current study also revealed a significant association between sex and age of onset of HLA­B27 detection in patients with suspected AS. Disease activity was not significantly correlated with RA, ESR, and CRP. Conclusions The detection of HLA-B27 by flow cytometry proved to be a reliable test in the screening of AS in the Indian population.