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.
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.
BACKGROUND Ischaemic Heart Disease (IHD) is one of the most common causes of death worldwide. There has been an increase in incidence of ischaemic heart disease in recent times particularly in the younger age groups with or without risk factors. Various parameters are used in different scoring systems to assess the risk of developing ischaemic heart disease. RDW and NLR are the two emerging parameters from the time Price-Jones C first described variation in RBC size, RDW has evolved as an easily available parameter after the invention of impedance haematology auto analysers. NLR is an inflammatory marker, which is superior to ESR and its level rises in ischaemic heart disease. RDW and NLR can be used as an independent parameter to assess risk of developing CAD. Many studies in the past have worked on either RDW or NLR alone; hence, in the present study, we have considered both RDW and NLR as an attempt to assess their correlation and also the utility of these parameters in risk scoring systems. MATERIALS AND METHODS This is a prospective study where blood from the patients diagnosed with ischaemic heart disease sent for haematological analysis was studied. A complete haemogram, ESR, and haematological analysis using a pure impedance fully automated 3part differential haematology analyser was done. 100 patients of ischaemic heart disease in whom haemoglobin levels were >11 gm/dL were included in the study. 50 non-ischaemic heart disease subjects with haemoglobin >11 gm/dL were selected as control group. RESULTS RDW was found to be high in patients with IHD (47.9±11.02) as compared to control group (41.3±6) with p=0.0001. NLR was also found to be high in patients with IHD (5.09±2.5) as compared to the control group (2.8±1.5) with p<0.0001. ESR was also high in patients (26±6.7) compared to control group (18±7) with p<0.0001. RDW was independent of ESR or NLR or any other risk factor of IHD. CONCLUSION RDW is independent of inflammatory markers and other risk factors in IHD. All the three can be included in the screening programs for IHD, if standardised. NLR appears to be superior to ESR as plasma factors don't play a role in their ratio.
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