Pilomatricoma, pilomatrixoma, or calcified epithelioma of Malherbe is an uncommon, benign, isolated tumor of hair matrix primarily seen in children and young adults. The most common location is the head and neck region. It usually manifests as a small nodular mass. Here we report a rare case of giant pilomatricoma over the sternum in a 60-year-old male patient with an unusual clinical and radiological presentation mimicking a calcified sebaceous cyst.
Background and Objectives The status of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 expression in core needle biopsy and excision specimens has concurrent results, but many show discordance. However, only a few studies on the subject are available in India. Therefore, this study aims to compare the ER and Ki-67 expression status in core needle biopsy and excision specimens of breast carcinoma. Materials and Methods In this cross-sectional analytical study, 50 breast carcinoma cases were histopathologically examined for ER and Ki-67 expression in both core needle biopsy and excision specimen. The interpreter was blinded for the evaluation of ER and Ki-67 expression index and the data obtained were analyzed using SPSS version 27. Results The average age of the participants was 50 years and breast lump was the most common presenting complaint in all the cases. The concordance rate of histological typing between core needle biopsy and excision specimens was 96%, and the majority were invasive ductal carcinoma (60%) and not otherwise specified (48%) having Nottingham histologic grade 3 (46%). The concordance rate between core needle biopsy and excision specimen for ER and Ki-67 expression was 86% (n = 43) and 54% (n = 27), respectively. Most of the cases were found to be luminal A type (38%). Additionally, the sensitivity, specificity, positive predictive value, and negative predictive value of ER between core needle biopsy and excision specimen were 78.79, 100, 100, and 70.83%, respectively; however, these were 44, 64, 55, and 53.33%, respectively, for Ki-67. Conclusion Although the concordance of the ER status between core needle biopsy and excision specimen was substantial, the discordance rate of Ki-67 was found to be high. Hence, relying solely on core needle biopsy for critical decision-making is inadvisable; however, core needle biopsy can be used as an initial procedure to examine histology and receptor status, Therefore, it is better to reconsider performing immunohistochemistry for the excision specimen, more importantly in ER-negative cases, to benefit the patient with targeted therapy.
Acute leukaemia (AL) is a heterogeneous neoplastic disease that occurs by the growth of abnormal lymphoid and myeloid cells in the bone marrow and blood leading to acute myeloid leukaemia (AML) and acute lymphocytic leukaemia (ALL). Conventional cytogenetics is a characteristic technique to hunch chromosomal abnormalities, it helps in the diagnosis and therapeutic approach of the disease by the molecular cytogenetics technique of fluorescence in situ hybridization (FISH). Chromosomal abnormalities in AL are performed by karyotyping to confirm specific chromosomal abnormalities using FISH. The descriptive study included 42 clinically diagnosed AL patients. Karyotyping analysis was performed using the standard Giemsa banding procedure. To confirm specific chromosomal abnormalities and all culture failure (CF) cases, FISH was done. Among 42 cases, 29 (69.4%) males and 13 (30.9%) females, AML comprised 22 (52.38%) cases, ALL 14 (33.33%) cases, and AL 6 (14.2%) cases. Normal karyotype was found in 18 (42.85%), abnormal karyotype in 16 (39.09%), and 8 (19.09%) were CF. Specific abnormalities of t(15;17), hyperdiploidy; t(3;3) with monosomy 7 in; del(9q22); del(2p); del(17p); del(Xq); 1~2 dmin; der(3); +11, +13 and composite karyotype. Hypodiploidy was strongly associated with AL, which signifies the loss of chromosomes causing potential risk. Composite karyotype, rare t(3;3) double minutes, +11,+13, del(9q), and del(Xq) were the novel findings reported in the South Canara region of Karnataka. Despite other molecular techniques, conventional cytogenetics remains the baseline in the diagnosis of malignancies.
Breast tissue reacts to estrogen and progesterone stimulation, not only during puberty, pregnancy and lactation, but during each menstrual cycle. As the menopausal period is approached and postmenopausal period evolves, progressive atrophy of the epithelial and connective tissue components of the breast occurs. The loose connective tissue becomes dense and hyalinized and finally, the lobule is converted into ordinary stroma which in the process of involution is replaced by fat. All patients undergoing core needle biopsy of breast were selected for the study. An informed consent will be taken for the procedure. Under local anesthesia using 14 G needle, ultrasound guided core needle biopsy will be performed by radiologist. The biopsy specimen will be sent to histopathology department in 10% formalin. The tissue will be processed, stained with haematoxylin and eosin and examined microscopically. In present study, the most common presenting complaint is breast lump comprising of 59 cases (98.3%). Out of 59 cases 31 cases (51.7%) had lump on left side, 28 cases (46.7%) had lump on right side.1 case had no lump (1%). In the present study 41 cases underwent mammogram, 24 cases (58.5%) showed BIRADS 5 scoring followed by BIRADS 4 in 12 cases (29.3%) and BIRADS 2 in 5 cases (12.2%).
Breast cancer is the most common cancer in women both in the developed and developing world. In India, the age adjusted incidence of breast cancer in urban areas ranges between 20-30 per 1,00,000 population. Core needle biopsy (CNB) has been the first approach in cases of large lesions clearly malignant at mammogram. Therefore, CNB enables more definitive diagnosis than FNAC to differentiate benign and malignant tumors. A sample size of 60 cases are included in this study. The specimens sent to the department of pathology will be processed by routine histopathological techniques. Data is entered in SPSS and analyzed. Chi-square test is used to find sensitivity, specificity, NPV and PPV of core needle biopsy. Among benign lesions, mastitis comprising of 5 cases (11.5%). Among malignant cases IDC -NST was most common type comprising of 27 cases, 8 cases were inconclusive. Out of 60 cases 50 cases underwent mastectomy/lumpectomy, 7 were benign and 43 were malignant. All 50 cases were correlating with core needle biopsy diagnosis. 8 cases which were inconclusive in CNB underwent mastectomy/lumpectomy as BIRADS/FNAC were showing carcinoma features. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) are 86.6%, 100%, 86.6% and 100% respectively.
Congenital pulmonary airway malformation (CPAM) is a broad spectrum of congenital cystic lung lesions caused by the arrested bronchoalveolar development. Approximately, 80% of CPAMs are diagnosed prenatally or during the neonatal period when patients present with respiratory failure and cyanosis. CPAM is often associated with other organ anomalies and aplasia, and they have poor prognoses. Many CPAMs are detected in infants and school-age children, and infections like pneumonia trigger these diagnoses. It rarely manifests in adults. These often get missed because of the superadded diseases, and hence, it is essential to have a correct approach to their diagnosis to avoid misdiagnosis.
Background: The spectrum of bone lesions include inflammatory, neoplastic, degenerative and metabolic diseases. Histopathology is a confirmatory evidence for bone lesions and helps arrive at a diagnosis and plan further prognosis and management. A proper execution from technique (radioguided or surgical), choice of sections from the lesion and proper management of specimen is the requirement for accuracy of diagnosis and further management. Aims and objectives: To analyse the histo-pathological spectrum of bone lesions and co relating it with demographic details and radiological findings. Results: 100 bone biopsies received in the Department of Pathology between September 2015 to September 2017. They were routinely processed after decalcification. Out of 100 cases, 55 nonneoplastic lesions and 45 neoplastic lesions were reported. Around 10 cases were inconclusive due to inadequacy of biopsy sample. Osteochondroma was the most common benign lesion. Osteosarcoma and chondrosarcoma were the most common malignant lesion, with equal incidence. Chronic osteomyelitis was the most common non neoplastic lesion. The lesions occurred most commonly below the age group of 20 years with a male preponderance. Femur was the most common bone involved and metaphysis was the most common anatomical site of lesion. Conclusion:A detailed histo-pathological interpretation of bone lesions, along with history, radiological and other relevant investigations are important for the patient's treatment and the further management including the follow up.
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