Necrotizing fasciitis is most often associated with bacterial infections. Zygomycosis is an uncommon infection causing necrotizing fasciitis. We report 18 such cases of zygomycotic necrotizing fasciitis, of these, 15 were immunocompetent. Of the eight cases cultured, five were positive for Apophysomyces elegans. A retrospective case review conducted at a tertiary referral center, from 1998 to 2004, 18 cases of fungal necrotizing fasciitis were diagnosed based on histomorphology of fungal organisms; and in few of the cases diagnosis was supported by mycologic culture reports. Of the total of 18 cases, culture report was available in eight cases, and out of which five of them grew A. elegans. Fifteen patients were immunocompetent. Clinical presentation, mycologic findings and histopathologic results were evaluated. A review of the literature pertaining to A. elegans infection was also done. Histopathologic examination showed broad, predominantly aseptate and occasional pauciseptate, thin-walled fungal hyphae with occasional angioinvasion. To the best of our knowledge, this is the first largest series of zygomycotic necrotizing fasciitis from India. Herein, we present data on 18 cases of necrotizing fasciitis assosiated with zygomycosis. Most of the cases in our series were immunocompetent. Nonsuppurative necrosis with presence of typical fungal profiles was important histologic feature. Zygomycosis must be considered in the differential diagnosis not only in immunocompromised patients but also in the absence of any underlying disorders.

In this study, we applied artificial neural network (ANN) for the diagnosis of lobular carcinoma in fine-needle aspiration cytology (FNAC) material. We selected a total of 64 cases of histology proven breast lesions consisting of 20 fibroadenomas, 28 infiltrating ductal carcinomas (IDC), and 16 infiltrating lobular carcinomas (ILC). Detailed cytomorphological features were studied on representative Haematoxylin-Eosin (H&E) and May-Grunwald Giemsa stained slides. Image morphometric analysis was performed on Haematoxylin-Eosin stained smears to study nuclear area, diameter, perimeter, roundness, convex area, and convex perimeter. Both the qualitative cytological features and objective morphometric data were collected and a total of 18 variables were studied. Back propagation ANN was designed and this data were used as input values. ANN network was designed as 34-17-3. There were a total of 34 first layers neurons, 17 hidden neurons and three output neurons. The total cases were randomly divided automatically by the program into three groups: training set (40), validation set (8), and test set (16). After the successful training, the program was able to differentiate all the benign and lobular carcinoma cases and majority of the ductal carcinoma cases. In test set, the ANN program successfully classified all the cases of benign, and ILC cases and six of seven IDC cases. A suitably designed ANN may be able to diagnose the lobular carcinoma of breast on FNAC material. ANN is an efficient software program with immense potential.

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Background: Sarcoidosis is a granulomatous disease of unknown aetiology. Over 90% patients of sarcoidosis present with pulmonary findings. Other organs such as lymph nodes, skin, and joints may be involved. Isolated granulomatous disease confined to the spleen is rare.

Carcinoma ex pleomorphic adenoma poses a challenge to diagnosis and treatment. Herein we describe an extremely unusual case, which presented initially as an intracapsular carcinoma ex pleomorphic adenoma in the right parotid gland. The first recurrence, after an interval of 8 years, showed only recurrence of the benign component. Five years later, a myoepithelial carcinoma arose from the same site. No ductal carcinoma as seen in the initial intracapsular carcinoma ex pleomorphic adenoma was identified. This case report elucidates the atypical clinical behaviour and interesting histological features encountered within this group of salivary neoplasm.

Background: Nm23 protein is a metastasis suppressor protein, expressed in all tissues. Reduced Nm23 expression is related to a high incidence of lymph node and distant metastasis and poor prognosis in patients with cancers. The present study was done to analyze the expression of Nm23 using immunohistochemistry in non-neoplastic and neoplastic breast lesions.