Background: Malignant lymphomas (ML) are often complicated by serous effusions.The present study is an attempt to cytologically assess a large series of serous effusions associated with ML, identify the immunoreactivity of cells and to evaluate the role of various ancillary methods in confirming and subtyping these cases. Methods: A cross-sectional study of 4612 serous effusions was undertaken at the Department of Cytology, Gujarat Cancer and Research Institute by retrieving data from the year 2015 to 2017. Total 169 cases of ML, clinically suspicious, were included. All cerebrospinal fluids, serous effusions involved by myeloid neoplasms, and cases of primary effusion lymphomas were excluded from our study. Pap stained smears of all these serous effusions were examined. Ancillary methods such as immunohistochemistry were used to further subtype the positive cases using the WHO classification of hematopoietic and lymphoid neoplasms (2016). Results: Out of total 169 clinically suspicious cases, 109 cases were cytologically positive for ML which included 73 (66.9%) pleural effusions, 34 (31.1%) ascitic fluids, and 2 (1.8%) pericardial effusions. T-lymphoblastic lymphoma (36.9%) and Burkitt's lymphoma (38.2%) were the most common ML involving the pleural and ascitic fluids respectively. Non-Hodgkin's lymphoma (NHL) more frequently involved the serous cavities than Hodgkin's lymphoma. (P value <.0001). Among the NHL, T-cell lymphomas more commonly lead to serous effusions than B-cell lymphomas (P value <.0048). Conclusion: Cytological examination of serous effusions is an accurate, prompt, affordable technique having diagnostic and therapeutic implications. With the help of ancillary methods, we can identify the phenotype of cells, classify as well as confirm our diagnosis. K E Y W O R D S immunohistochemistry, malignant lymphomas, serous effusions
Being married for a young woman is considered important in India. A female is born and brought up in the country with teachings of how to be a good housewife i.e. how to be respectful to the elders, husband and in-laws. The pressure of holding onto this responsibility is detrimental to her psychological well-being and further impacts her holistic growth. The case series unfold how the lives of Indian housewives change completely after marriage, even in the contemporary times, and impacts their individuality that result in the collapse of their mental health and personality.
Adenoid Cystic Carcinoma of the prostate is a rare variant of prostatic adenocarcinoma considered to have an indolent biological potential. However, outcome data are scant. We report a case of 49 year old male who presented with urinary obstruction. Digital rectal examination and ultrasound revealed enlarged hard nodular prostate. His serum PSA level was 0.729 ng/ml. Histologically, Adenoid cystic or cribriform pattern with prominent peri-neural invasion was seen on TURP chips and it was immunoreactive for c-KIT. After the diagnosis, patient underwent radical prostatectomy. Patient was clinically stable during a limited follow up of two months.
Undifferentiated embryonal sarcoma of liver (USEL) is a rare primary hepatic malignancy principally affecting patients of pediatric age group. We present a case undifferentiated embryonal sarcoma of liver in a 1-year old female. She presented with complaints of abdominal distension and vomiting for 2 weeks. Ultrasonography showed grossly enlarged liver with multiple heterogenous lesions. Computed tomography revealed presence of large exophytic lesion of size 11.3 × 7 cm involving left lobe of liver. Ultrasound guided biopsy was performed, and specimen was sent for histopathological examination. On Microscopic examination undifferentiated round to spindle cells in myxoid background were seen. Immunohistochemistry revealed positivity for vimentin and AE1 thus proving undifferentiated embryonal sarcoma of liver. Diagnosis is often challenging because of overlapping epidemiological, clinical, radiological findings with those of other liver tumors.
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