BACKGROUND Pineal gland tumours are slow growing tumours arising in the pineal gland that resemble normal pineal gland. In WHO classification, they are considered as WHO Grade 1 tumours. Incidence of these tumours is very low. The germ cell tumours in this region are much more common arising from the pluripotent germ cells mistakenly lodged in this region during embryogenesis. Tumours which arise from the stroma are Gliomas and Atypical Teratoid Rhabdoid Tumours (ATRT). Commonest clinical presentation is hydrocephalus due to compression of tectum and upward gaze due to compression of superior colliculi. Radiology aids in giving a provisional diagnosis on CT and MRI. Confirmation with histopathology is important for proper treatment and prognosis. MATERIALS AND METHODS We present a retrospective study done over 3 years at a tertiary care centre. Radiologically diagnosed cases as pineal gland tumours, which were well demarcated within the region of pineal gland were included in the study. The surgically resected specimen were examined by squash cytology and then processed routinely for histopathology and immunohistochemistry. RESULTS AND CONCLUSION A total of 18 cases were studied and analysed. The lesions encountered were germ cell tumours, pineal parenchymal tumours and gliomas. On intraoperative squash, one case, which was diagnosed as glioma was later reported as Pineocytoma on histopathology and immunohistochemistry. Histological subtypes of pineal gland tumours on comparison with SEER database was correlated with our study. CONCLUSION Though pineal gland is a very small organ also considered as vestigial organ in lower primates the tumours present aggressively and are proved to be fatal except pineocytomas, which have a good prognosis with 5 year survival rate of 60 to 75% and hence exact diagnosis is critical to choose correct therapy.
BACKGROUNDDistinction between Fibroadenoma and Phyllodes tumour is important. Accurate diagnosis of these lesions can be arrived at based upon the triple assessment approach comprising of clinical history and examination; radiological and pathologic examinations. Fine Needle Aspiration Cytology (FNAC) is widely and commonly adopted minimally invasive technique for the pathologic assessment because of its relative accuracy, sensitivity, specificity and ease of use. Distinction between a cellular fibroadenoma and phyllodes tumour poses diagnostic challenge from cytopathologist's perception due to many overlapping features between the two entities. Thorough analysis of cytology smears helps in categorisation of these tumours helping in arriving at a definitive diagnosis. METHODSThe study included 165 patients who presented to our outpatient department, Osmania General Hospital, as breast lump during one year study period between March 2015 and March 2016. FNAC was done for all the cases and their cytomorphological features were studied.A retrospective study of Fine Needle Aspiration Cytology (FNAC) of breast lumps was done and their cytomorphological features were studied and analysed to categorise them into Fibroadenoma and Phyllodes tumour respectively. RESULTSOut of 165 cases presenting with breast lump, the study revealed 55 (33.3%) cases of Fibroadenomas, 10 (6.06%) cases of Phyllodes tumour and the remaining cases were categorised into other breast lesions. CONCLUSIONIn conclusion the present study emphasised the importance of FNAC, which is a minimally invasive OPD technique which helps in distinction of Fibroadenoma and Phyllodes tumour based on their cytomorphological features, thus providing a quick and near accurate diagnosis.
BACKGROUND Thyroid disorders are common in females and their impact on the female reproduction is well established. The role of thyroid hormone on male reproduction received much attention with recognition of thyroid hormone receptor expression on gonadal cells. Studies in humans evaluating the impact of varying severity of thyroid hypofunction on male fertility are limited. OBJECTIVE To study the thyroid status and correlation with semen parameters in male partners of couples attending infertility clinic. MATERIALS AND METHODS In this retrospective study, data on thyroid hormone levels, anti-TPO antibodies, semen parameters of 125 men attending infertility clinic, after excluding men with known thyroid disorder, on thyroid medication, other drugs and medical conditions which have an influence on thyroid status, were analysed. RESULTS Of the total 125 subjects, 84% men were euthyroid, whereas thyroid hypofunction, which included subclinical hypothyroidism and overt hypothyroidism was observed in 14.4% and 1.6% of men respectively. 11% of the subjects had positive anti-TPO antibodies. Normal semen parameters were observed in 82 subjects whereas 43 men had abnormal semen parameters. None of the semen parameters correlated with TSH; however, there was a non-significant increase in spermatozoa with abnormal morphology (95% vs. 90.8%, p=0.522), decrease in spermatozoa with normal morphology (5% vs. 7.38, p=0.273) and decrease in sperm count (49.24 vs. 37.67 million/mL, p=0.473) in subjects with TSH>10 in comparison with subjects with TSH<10. CONCLUSION This study found higher prevalence of thyroid hypofunction, and higher positive TPO antibody status among men attending infertility clinic. No correlation was found between thyroid hormones and semen parameters.
BACKGROUND Solid pseudopapillary tumour of the pancreas is a rare tumour of low malignant potential occurring predominantly in young females. Its incidence has been increasing due to advanced imaging modalities. As this tumour offers a good prognosis, it is important to make a proper diagnosis to offer better treatment and reduce morbidity. MATERIALS AND METHODS This is a prospective study for a period of 2 years (From May 2014 to April 2016). Of the 52 pancreatic specimens we received after surgery, 9 cases had a prior radiological diagnosis of solid pseudopapillary tumour of the pancreas. The clinical and histopathological characteristics of SPT were studied along with review of literature. Whipple resection specimens which were radiologically diagnosed as adenocarcinoma of the periampullary region were excluded. RESULTS Nine cases were reported radiologically as papillary neoplasm of pancreas. On histopathology, 8 of them were confirmed as solid pseudopapillary tumours of the pancreas. One was a case of serous cystadenoma and other one was pancreatic neuroendocrine tumour. One case which was suspected as pancreatic endocrine tumour radiologically was diagnosed as SPT. CONCLUSION SPT typically is limited to the pancreas at the time of diagnosis, and even with metastasis, an extended complete surgical excision offers good prognosis. Hence, it is important to distinguish it from other tumours of similar morphology. In this study, we discuss the process of establishing the diagnosis accurately of SPN in young patients presenting with pancreatic mass.
BACKGROUNDBreast cancer is a heterogeneous disease with variable morphological features, clinical outcomes and response to different therapeutic options. Gene expression profiling studies on breast carcinomas have revolutionised the classification of breast carcinomas into molecular subtypes enhancing the treatment protocols and offering better prediction of outcomes. MATERIALS AND METHODSThe present study aims to discuss the special histological variants with special emphasis on their molecular phenotype using surrogate immunohistochemical markers. RESULTSSpecial variants of breast carcinomas diagnosed during the study period of two years from August 2013 and July 2015 were classified into molecular subtypes using immunohistochemical expression of ER, PR and HER-2. CONCLUSIONSSpecial types of breast carcinomas are very rare and have different clinicopathologic behaviours. It is important to know their characteristics to make proper management decisions and to predict the prognosis. KEYWORDSIHC, Molecular Typing of Breast Carcinomas, Special Types of Breast Cancers. HOW TO CITE THIS ARTICLE: Mekhala PM, Aruna L, Arasi NE, et al. Immunohistochemistry as surrogate marker for molecular typing of special types of breast carcinomas.
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