histochemistry, composition of calculi and metaplasia, fibrosis and mucin histochemistry, fibrosis and stone composition indicated a decrease in intraepithelial total acid mucin content in chronic calculous cholecystitis. cases with severe inflammation showed the maximum decrease in sulfomucin, concomitant increase in sialomucin scores and a high incidence of gastric metaplasia. Intestinal metaplasia on other hand did not correlate with the degree of inflammation or sialomucin content. conclusion: this study concludes that normally gallbladder epithelium contains sulfated acid mucins with traces of neutral and sialomucins. the sulfomucin content decreases in chronic calculous cholecystitis and with severe inflammation, total acid mucin content decreases, neutral mucin increases, and there is a higher incidence of gastric metaplasia and pigment stones and correlating with pigment stones. this tends to have an association with severe inflammation, higher degree of fibrosis, gastric metaplasia and presence of sialomucin. Keywords: chronic calculous cholecystitis, Gallbladder stones, Metaplasia, Mucin histochemistryHow to cite this article Anupama P, Menon Nirmala V, Janaky R, Mohammed IL, Alingal MB, Sideeque NA. A histopathological and histochemical study of cholecystitis. Int J Hepatobiliary Pancreat Dis 2014;4:70-80.

Caesarean scar ectopic pregnancy (CSEP) is where the conceptus is implanted deep in the myometrium and at the exact scar site of the previous caesarean section. Symptoms include amenorrhea, pelvic pain and vaginal bleeding in the first trimester. The investigation of choice is transvaginal ultrasound. Individualized treatment options are based on gestational age, presence of embryonal cardiac activity, severity of symptoms, serum hCG levels and ultrasonography findings for CSEP. The combined use of laparoscopy and ultrasound guidance for the evacuation is helpful in deeply impacted CSEP. Because early diagnosis and treatment is important for the best outcome, every pregnant woman with a history of cesarean should be screened early in the first trimester of pregnancy.

Introduction: Rapid histopathological processing of neoplastic biopsies is crucial for initiating early therapy in patients. Microwave processing shortens the time to diagnosis and is less labour intensive. Aim: To compare the quality of immunohistochemical staining of Estrogen Receptors (ER) and Progesterone Receptors (PR) on paired breast samples using microwave processing versus conventional processing. Materials and Methods: A cross-sectional study was conducted at a tertiary care hospital in Kerala, India, from February 2014 to September 2015. A total of 44 paired samples from breast carcinoma patients were taken. Baseline characteristics of the patients such as age and type of carcinoma were noted. Haematoxylin and Eosin (H&E) stain was used. One slide of the pair was processed conventionally and the other using a microwave. The stained slides were observed by three pathologists. The validity of ER and PR receptor status was evaluated with sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV). Kappa statistics and Spearman’s correlation test was used to denote the agreement between them. Results: The mean age was 51.32±11.16 years. There was agreement (Cohen k=0.902) between the microwave processed and conventionally processed paired breast samples for ER. The sensitivity and specificity of microwave processing in ER evaluation was 87.5% and 100% while that of PR evaluation was 92.9% and 100% respectively. The PPV was 100% and NPV was 93.3% for ER evaluation by microwave processing. Conclusion: Microwave aided tissue processing had significant advantages over conventional methods for providing a rapid diagnosis, being less laborious and had effective staining, which makes it a better choice.

Metastatic foci situated in dermal or subcutaneous tissue without the involvement of overlying skin, between the closest lymph node and primary tumor is called in transit metastasis. Although in transit metastasis has been commonly described in malignant melanoma, there are rare cases of squamous cell carcinomas, presenting with the same. It is an uncommon form of metastasis through lymphatics and is found in immunocompromised individuals. We present a case report of squamous cell carcinoma, presenting in an elderly male, as multiple nodules beneath skin. With this case, we highlight the variety of forms of spread in cutaneous squamous cell carcinoma and its prognostic importance.

Introduction: There are several scoring systems in use to determine the endoscopic, clinical and histopathological activity in Ulcerative Colitis (UC) which helps in defining the optimal management strategy. Aim: To understand the correlation between histological activity with simplified Geboes Score (GS), clinical activity with Truelove and Witts Score (TLWS) and endoscopic activity with Mayo Endoscopic Score (MES) in UC. The study also aimed at describing the common histopathological features of UC. Materials and Methods: A cross-sectional analysis was conducted at a tertiary care hospital in Southern India for 1.5 years (November 2014 to May 2016). Consecutive colonoscopy biopsies of patients who presented with lower gastrointestinal symptoms and endoscopic findings suggestive of UC were included. Baseline characteristics including age, gender, symptoms, clinical signs and extent of disease were recorded. Disease severity was graded using TLWS, MES using endoscopy and GS. Spearman’s correlations between the MES, GS and TLWS were calculated. Results: A total of 62 cases of clinically diagnosed UC patients were evaluated based on endoscopy and histopathology findings. The mean age was 44.7 years and 42 (67.74%) were males in the study. Proctosigmoiditis was the most common extent (32.25%), followed by cases of proctitis (25.80%), pancolitis (22.58%), and left sided colitis (14.51%). There was a strong correlation between MES/TLWS with a rho=0.614 (p<0.001), followed by MES/GS with rho=0.421 (p<0.001) and GS/MES with a rho=0.375 (p<0.01). Basal plasmacytosis was found in 92.86% of moderate to severe disease. Conclusion: The GS system strongly correlates with both MES and TWLS in patients with UC which could be used concurrently to determine the extent of healing and optimise treatment strategy. Findings of basal plasmacytosis, mucin depletion, dysplasia and pseudopolyps are associated with moderate to severe disease activity.