A study of spectrum of pulmonary pathology and expression of thyroid transcription factor-1 during neonatal period.

CONTEXT: Neonatal period is the single most hazardous period of life. The major causes of neonatal death are prematurity and respiratory distress syndrome. We report a series of neonatal autopsies in our Neonatal Intensive Care Unit with special emphasis on pulmonary pathology. The spectrum of pathological changes in the lungs and thyroid transcription factor-1 (TTF-1) expression was studied in detail with reference to its spatial distribution. AIMS: This study aims to analyze the causes of neonatal death with special attention to pulmonary pathology along with associated histopathological changes in lungs. We also evaluated the expression of TTF-1 at different levels of the airway. MATERIALS AND METHODS: After taking consent and anthropometric measurements, autopsy was performed. Weights of all organs were taken, and histological sections were examined under hematoxylin and eosin stain. TTF-1 immunostaining was done on lung sections. Localization of TTF-1 was evaluated at the intrapulmonary level of terminal bronchioles (TBs), distal bronchioles, and alveoli. RESULTS: We performed a series of 25 autopsies in neonates. In our series, most of the neonates were preterm (64%), had low birth weight (44%), and died within the first 7 days of life (80%). Majority (60%) of the neonates died due to pulmonary causes, followed by septicemia (24%), congenital anomalies (12%), and birth injury (4%). Among the respiratory causes, hyaline membrane disease (HMD) was diagnosed in maximum number of cases (32%), followed by pneumonia (12%) and pulmonary hemorrhage (12%). The TTF-1 expression in TBs, distal airways, and alveoli was significantly reduced or absent in cases of HMD compared to the control group. CONCLUSIONS: In this study, we observed that HMD is the most common cause of perinatal death among respiratory disorders, and in this disease, the expression of TTF-1 is significantly reduced in TBs, distal airways, and alveoli compared to the control group.

Goblet cell carcinoid of appendix: A rare case with literature review.

INTRODUCTION: The goblet cell carcinoid, a rare tumor of the appendix, is a separate entity from adenocarcinoma and carcinoid tumors. PRESENTATION OF CASE: We report a case of goblet cell carcinoid in our institute who presented with acute abdominal symptoms simulating acute appendicitis. DISCUSSION: Goblet cell carcinoid is a rare neoplasm with distinct histological and clinical features. The diagnosis is essentially made on histological grounds. Still the exact biological behavior of this tumor is uncertain. CONCLUSION: Considering the difficulty of clinical suspicion of this tumor, presenting as appendicitis and incidentally found during appendectomies, we review the goblet cell carcinoid of the appendix using an illustrative case report.

Leiomyoma of kidney: An Indian experience with literature review.

INTRODUCTION: Leiomyoma of kidney is an exceptional finding in the urinary tract. Though most of these tumors are detected on autopsy, still it remains a diagnostic challenge. PRESENTATION OF CASE: We report three adult cases of renal leiomyoma in our institute who presented with abdominal mass and haematuria in last 8 years. DISCUSSION: Leiomyoma has been reported in other organs but renal leiomyoma is rare tumour, though in autopsy series they are second in order of frequency among the renal mesenchymal neoplasms, and few cases have been described in the literature. Still no Indian experience is evaluated on this rare site of occurrence. CONCLUSION: Considering the difficulty of clinical diagnosis of this tumour, strong suspicion is indicated when a patient presents with voluminous, well circumscribed renal lesions.

Primary squamous cell carcinoma of breast with ipsilateral axillary lymph node metastasis: An unusual case.

INTRODUCTION: Pure squamous cell carcinoma of the breast [SCCB] is rare. PRESENTATION OF CASE: We report a case of primary squamous cell carcinoma of breast with ipsilateral axillary lymph node metastasis in a 58year old woman. DISCUSSION: It is a breast carcinoma entirely composed of metaplastic squamous cells that may be keratinized, non-keratinized or spindled. The pure squamous cell carcinoma usually present with central cystic cavity, which we found in our case, also supported by immunohistochemical evidence. CONCLUSION: Although a rare breast cancer subtype, SCCB is of considerable interest due to its pathological heterogeneity and differences in clinical behavior and less reported occurrence of nodal metastasis.