Twenty-three cases of ovarian fibroma, comprising 3% of all benign tumors seen over a 20-year period, were analyzed. It was unilateral in all cases affecting more commonly the left ovary (70%). Whilst a majority of cases (77%) were encountered in the reproductive age group, the tumor was rare before the second decade. Only in 13% of cases was ascitis clinically detectable. This was not influenced by the size and weight (average of 9.3 x 10.8 x 11.1 cm and 959 g, respectively) of the tumors; a smooth-surfaced tumor was, however, associated with a greater amount of peritoneal fluid. Varying degrees of calcification in some tumors are detectable on ultrasonography and occasionally on abdominal radiography. The classical Meig's Syndrome was seldom encountered. The histopathological features, diagnostic problems and management are discussed.
The most prevalent cancers in ladies are cervical, endometrial and Ovarian. The biomarkers prevalent in use for these gynaecological cancers are commonly Cancer antigen 125 (CA-125), B, Alpha-fetoprotein (AFP), Inhibin, Carcinoembryonic antigen (CEA), Squamous cell carcinoma (SCC) antigen, Carbohydrate antigen 19-9, Cancer antigen 27-29, Human epididymis protein 4 (HE4), Osteopontin, transthyretin, Immunosuppressive acidic protein(IAP), leptin, CA15-3, CK19 and Thymidine kinase. The biomarker marker Squamous cell carcinoma (SCC) antigen, CK19 and immunosuppressive acidic protein IAP are raised in cervical squamous cell carcinomas. Endometrial cancer is a common cancer in women. In 75% of endometrial cancer cases, the tumor remains confined to the uterus and has a favorable prognosis if early detected. The prognosis, however, worsens dramatically as the disease progresses. The objective of this review is to elucidate the importance of the tumor markers for early diagnosis of gynaecological malignancies which are vital and life saving. Similarly the relevant biomarkers in combination are found to have positive predictive values and significant p values in the endometrial and cervical cancer. In Cervix cancer the positive predictive value of these markers combined is usually 92% -95% and negative predictive value 93% -96%. The confidence interval is 98% and p value significant 0.005. Sensitivity of tumor markers combined CK19, SCC and immunosuppressive acidic protein IAP in Cervix cancer detection is 95% and specificity 96%. The highest sensitivity was for SCC antigen (98.7%) while the highest specificity was for Cytokeratin 19 (99.7%). The positive predictive value by combination of CK19, SCC and IAP for the detection of Cervix cancer was 90% -94%. In endometrial cancer the sensitivity of tumor markers combined CA19-9, CA125, leptin, thymidine kinase, CEA, CA15-3, and HE4 in endometrial cancer detection was 95% and specificity 96%. The highest sensitivity was for CA125 (99.7%) while the highest specificity was for CA19-9 (95.7%) which revealed that the efficacy of
Angioimmunoblastic T cell lymphoma (AITL) is a peripheral T cell non-Hodgkin lymphoma with an aggressive fatal course and it has varied clinical presentation with an uncommon presentation when they present as soft tissue masses or when there is spill in the peripheral blood or there are composite lymphomas that are rare presentations. Common presentations include lymphadenopathy, fever and systemic symptoms, hemolytic anemias, skin rashes, and rheumatoid arthritis. The classical histopathology is absence of follicles in lymph nodes with presence of high endothelial venules and the tumor cells of small to medium-sized lymphocytes with pale cytoplasm mixed with reactive T cells. On immunohistochemistry, the cells are positive for CD3, CD4, CD10, BCL2, and CXCL13. In this observational study, the clinicopathologic presentation and the immunohistochemical profile of five cases who initially presented with a soft tissue mass which is an extremely rare presentation of this rare type of non-Hodgkin lymphoma that was diagnosed at our center with peripheral blood and bone marrow involvement and the clinicopathologic presentation, immunohistochemical profile, and response to treatment on follow-up are correlated with the literature review. One case had a fulminant and aggressive course and was fatal within 2 months of diagnosis. The rest of the four cases are on regular chemotherapy and follow-up. Our five cases had presented with soft tissue masses, two in the axillary regio,n two in the hand, and one in the scapular region with an extranodal presentation, and there was associated lymphadenopathy which developed subsequently with classic histomorphology and immunohistochemical findings. The age range was 46-54 years and all five cases were males. Three cases were with anemia (hemoglobin range 6.5-8.0 mg/dl) and all five cases were having peripheral blood plasmacytosis. Histopathology was classic with paracortical involvement with polymorphous population of cells with neoplastic lymphocytes of small and large sizes with numerous arborizing blood vessels which correspond to high endothelial venules. Microscopically, three architectural patterns; pattern I was seen in three cases (60%) and then pattern II and III in one case each (20% each). Immunohistochemistry revealed CD4+, CD8-, CXCL13+, CD10+, BCL6+, CD19, CD20, CD1a, Tdt, CD21, and CD23+ in follicular dendritic cells. AITL is a rare and aggressive non-Hodgkin lymphoma with varied clinical presentation with classic histomorphology with various patterns which may cause diagnostic dilemma and immunophenotypic findings, and prompt and early diagnosis is mandatory for institution of therapy.
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