IntroductionEwing sarcoma (ES) family of tumors (EFT) represents the second most common primary bone malignancy affecting children and adolescents after osteosarcoma. The tumor is characteristically associated with a chromosomal translocation resulting in a fusion transcript (EWSR1-FLI1). However, new molecular techniques have significantly transformed our understanding of this rare disease. The present study aims to analyze the incidence and demographic profile of Ewings sarcoma with an insight into the recent updates of the Ewing sarcoma (ES) family of tumors (EFT). Materials and methodsAll cases of Ewings sarcoma/peripheral neuroectodermal tumor (PNET) presented at a tertiary care center in South India from January 2010-December 2020 were included in this study. The demographic profile and patient details were obtained from the medical records section. Pathology reports of the included cases were retrieved, and associated factors were analyzed, including immunohistochemical studies and molecular workup. ResultsOut of the 58 cases included in the study, 30 cases (52%) were children and adolescents (< 20 years) and the rest 28 cases (48%) were adults. The mean age was 22.56. Female preponderance was noted, with 32 cases (56%) being females and 26 cases (44%) were males. The location of the tumor was variable. Twenty-five ( 25) cases (44%) were found in bones such as the clavicle, tibia, and mandible. Seven cases were seen on the anterior chest wall. Other sites included the oropharynx, lungs, endobronchial, infrascapular region, retroperitoneum, and thighs. One case presented as metastatic Ewings sarcoma with divergent differentiation in lungs with the primary site of the tumor being the right humerus. Immunohistochemical (IHC) studies were done on 55 of the 58 tumors. Forty-six ( 46) cases (80.9%) were CD99 positive and 41 cases(71.4%) were FLI-1 positive. Eleven (11) cases were both CD 99 and FLI-1 positive. NKX2.2, a recent IHC marker, was positive in six cases. ConclusionEwings sarcoma has a peak incidence in the second decade of life with a propensity toward the axial skeletal location. Understanding the pathobiology and molecular updates of ES is significant to differentiate them from aggressive round cell sarcomas. They not only aid in predicting the prognosis of these aggressive tumors but also guide in therapy.
Collision tumours are relatively rare entities and are thus, not well recognised. Collision tumour can be defined as two coexisting but histologically different malignancies involving the same organ or adjacent organ with an equivocal intermediate transitional zone between them. Collision tumours of the lung and oesophagus are very rare. Such cases are diagnosed by Computerised Tomogram (CT) Scan or Chest X-Ray for complaint of dysphagia. Definitive diagnosis is made by tissue biopsy. Here, a 66-year-old male is admitted for evaluation of an anterior mediastinal mass. Radiology revealed an anterior mediastinal mass extending in to the left hilar region and upper lobe of right lung anteriorly and in to the lower end of oesophagus posteriorly. Biopsy was performed. Microscopically, transbronchial biopsy revealed a cellular lesion, composed of round-to-oval cells with streaming nucleus, positive for Immunohistochemistry (IHC) markers, CD-56 and Synaptophysin pertaining to a diagnosis of small cell carcinoma. Biopsy of the oesophageal growth shows nest of dysplastic squamous epithelium which infiltrates into underlying muscularis propria showing features of a squamous cell carcinoma. Multiple fragments of squamous epithelium are also seen with necrotic tissue in vicinity and acute inflammatory exudate. Few cells show multinucleation, molding and margination of chromatin, showing the characteristic morphological features of Herpes oesophagitis. The patient was administered platinum-based Chemotherpy.
The older adults constitute a considerable part of the Indian population and due to advancements in the Medical field this population is fast growing. With the current advancements in treatment modalities there is an increased life expectancy. Low haemoglobin level is a potential contributing factors for cognitive impairment in older adults. Objective: The present study focuses on correlation between haemoglobin levels and attention, concentration, learning and memory among older adult population in Chennai. Materials and Methods: The present study was conducted in Sri Ramachandra Hospital OPD, Porur, Chennai. A total of 304 older subjects were included in this study. Older adults of both male and female were selected from the OPD based on theInclusion criteria -Age [50 to 65 years] matched subjects were selected. The Digit Span test,a subtest from Wechsler Adult Intelligence scale is used to assess the subjects attention and concentration. Ray auditory and verbal learning test (RAVLT) is used to measure learning and memory. Results: The digit span forward test in males is higher when compared with the females, this difference is statistically significant. (t= 9.669 and p=0.000). The digit span backward test in males is higher when compared with the females, this difference is statistically significant. (t= 9.669 and p=0.000).The digit AVLT trial test scores in males is higher when compared with the females, this difference is statistically significant. (p=0.000)All the scores of normal haemoglobin group were higher than the low haemoglobin group and the results were statistically significant. (p=0.000). Conclusion:In this study, we were able to observe that lower haemoglobin levels were associated with decreased cognitive functions in the domains of attention, concentration, learning and memory among older adult population in Chennai.
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