No abstract

Background: Foetal death or stillbirth is a major obstetrical complication and a devastating experience for the pregnant patients and relatives. Worldwide an estimate of at least 3.2 million stillbirths occurs each year. There are intensified demands on medical, political and epidemiological ground for proper determination and classification of causes of perinatal death. The aim of this study was to test a new classification system- Re. Co. De. Classification (Relevant Condition at Death) for stillbirths to improve our understanding of the main causes and conditions associated with foetal deaths.Methods: This study was a hospital based Prospective study conducted in department of obstetrics and Gynaecology, SZH, Bhopal. The study included 463 women who were admitted with Intra Uterine Foetal Demise. All cases were evaluated and after delivery the stillborn baby, the placenta and cord were examined. The causes were classified according to Re. Co. De. System.Results: The analysis of the new classification system Re. Co. De. Allowed attributable causes to about 90.72% of causes of still births explained where 9.28% were unexplained. The commonest cause was found to be class F4-Toxaemia of pregnancy (13.17%) followed by class A7- IUGR (10.58%), class C1-Abruptio placentae (10.36%), class E3-Obstructed labour (9.8%) and class A1- Lethal congenital malformations (8.42%).Conclusions: The Re. Co. De. Classification system gives us a better understanding of antecedents of stillbirths and the clinical practices, which need to be addressed to reduce perinatal mortality and have a better obstetric result in the next pregnancy.

Background: Breast lymphoma is a rare malignancy which may be misdiagnosed. Differential diagnosis between breast lymphoma and invasive carcinoma in core needle biopsy are crucial for treatment choice. Methods: 72 cases of breast lymphoma in core needle biopsy were extracted from the pathology database of Shanghai Cancer Center Fudan University. The clinicopathologic features were evaluated. Immunohistochemistry and molecular detections were performed.Results: (1)The median age was 54 years. 65 cases were primary breast lymphoma and 7 patients had a previous history of lymphoma. Most of the cases presented as a single and painless breast mass. 9 patients received excision and all patients received systemic therapy. (2)The common morphological feature was single tumor cells infiltrating in the stroma of the breast, losing adhesiveness and lacking glandular or nested epithelioid structures. The normal breast ductal and lobular structures were basically preserved. Tumor cells in some cases were distributed in single rows which should be differentiated from invasive carcinoma.(3)Classification was based on immunohistochemical and molecular detection results. All cases were positive for LCA and negative for cytokeratin.68 cases were classified as B-cell lymphoma, including 63 cases(87.50%) of diffuse large B-cell lymphoma(DLBCL), Burkitt lymphoma(2 cases), mantle cell lymphoma(1 case), extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue(1 case) and precursor B lymphoblastic leukemia/lymphoma(1 case). The remaining cases included peripheral T-cell lymphoma (NOS)(2 cases), extranodal NK/ T cell lymphoma(Nasal type)(1 case) and myeloid sarcoma(1 case). In 63 cases of DLBCL,22(34.92%) expressed germinal center B-cell-like(GCB) phenotype and 41(65.08%) were non-germinal center B-cell-like(non-GCB) phenotype. Conclusions: Core needle biopsy could be the preferred method for diagnosis of breast lymphoma.The history of lymphoma was important for differentiating primary breast lymphoma from secondary lymphoma. Pathological features are crucial for differential diagnosis between breast lymphoma and invasive carcinoma. DLBCL was the most common histologic type of breast lymphoma,and non-GCB subtype was more frequent than GCB subtype.

Background: Breast lymphoma is a rare malignancy which may be misdiagnosed. Differential diagnosis between breast lymphoma and invasive carcinoma in core needle biopsy are crucial for treatment choice. Methods: 72 cases of breast lymphoma in core needle biopsy were extracted from the pathology database of Shanghai Cancer Center Fudan University. The clinicopathologic features were evaluated. Immunohistochemistry and molecular detections were performed.Results: (1)The median age was 54 years. 65 cases were primary breast lymphoma and 7 patients had a previous history of lymphoma. Most of the cases presented as a single and painless breast mass. 9 patients received excision and all patients received systemic therapy. (2)The common morphological feature was single tumor cells infiltrating in the stroma of the breast, losing adhesiveness and lacking glandular or nested epithelioid structures. The normal breast ductal and lobular structures were basically preserved. Tumor cells in some cases were distributed in single rows which should be differentiated from invasive carcinoma.(3)Classification was based on immunohistochemical and molecular detection results. All cases were positive for LCA and negative for cytokeratin.68 cases were classified as B-cell lymphoma, including 63 cases(87.50%) of diffuse large B-cell lymphoma(DLBCL), Burkitt lymphoma(2 cases), mantle cell lymphoma(1 case), extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue(1 case) and precursor B lymphoblastic leukemia/lymphoma(1 case). The remaining cases included peripheral T-cell lymphoma (NOS)(2 cases), extranodal NK/ T cell lymphoma(Nasal type)(1 case) and myeloid sarcoma(1 case). In 63 cases of DLBCL,22(34.92%) expressed germinal center B-cell-like(GCB) phenotype and 41(65.08%) were non-germinal center B-cell-like(non-GCB) phenotype. Conclusions: Core needle biopsy could be the preferred method for diagnosis of breast lymphoma.The history of lymphoma was important for differentiating primary breast lymphoma from secondary lymphoma. Pathological features are crucial for differential diagnosis between breast lymphoma and invasive carcinoma. DLBCL was the most common histologic type of breast lymphoma,and non-GCB subtype was more frequent than GCB subtype.