The aim of this study was to evaluate the histopathologic parameters that predict lymph node metastasis in patients with oral squamous cell carcinoma (OSCC) and to design a new assessment score on the basis of these parameters that could ultimately allow for changes in treatment decisions or aid clinicians in deciding whether there is a need for close follow-up or to perform early lymph node dissection. Histopathologic parameters of 336 cases of OSCC with stage cT1/T2 N0M0 disease were analyzed. The location of the tumor and the type of surgery used for the management of the tumor were recorded for all patients. The parameters, including T stage, grading of tumor, tumor budding, tumor thickness, depth of invasion, shape of tumor nest, lymphoid response at tumor-host interface and pattern of invasion, eosinophilic reaction, foreign-body giant cell reaction, lymphovascular invasion, and perineural invasion, were examined. Ninety-two patients had metastasis in lymph nodes. On univariate and multivariate analysis, independent variables for predicting lymph node metastasis in descending order were depth of invasion (P=0.003), pattern of invasion (P=0.007), perineural invasion (P=0.014), grade (P=0.028), lymphovascular invasion (P=0.038), lymphoid response (P=0.037), and tumor budding (P=0.039). We designed a scoring system on the basis of these statistical results and tested it. Cases with scores ranging from 7 to 11, 12 to 16, and ≥17 points showed LN metastasis in 6.4%, 22.8%, and 77.1% of cases, respectively. The difference between these 3 groups in relation to nodal metastasis was very significant (P<0.0001). A patient at low risk for lymph node metastasis (score, 7 to 11) had a 5-year survival of 93%, moderate-risk patients (score, 12 to 16) had a 5-year survival of 67%, and high-risk patients (score, 17 to 21) had a 5-year survival of 39%. The risk of lymph node metastasis in OSCC is influenced by many histologic parameters that are not routinely analyzed in pathologic reports. These significant independent factors were graded to design a scoring system that permits accurate evaluation of the risk of metastasis with accuracy independent of the traditional TNM system or isolated histologic parameters. The need for neck node dissection can be predicted depending upon the scores obtained.

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Cardiovascular disease trends, complications, and associated therapeutics impact the dental health and treatment. Such patients require special consideration with regard to when and which dental treatment is appropriate and what precautions are required. Alertness to potential oral adverse drug reactions enables referral of patient's to his physician or cardiologist. Cardiovascular drugs are also known to have mild to potentially fatal drug interactions. Dental professionals may be the first line of defense in the detection and referral of a patient suspected of having cardiovascular disease, an uncontrolled disease status, or oral adverse drug reactions, and they have a key role to play in oral and systemic disease prevention and treatment, in partnership with the patient and his physician.

Rhabdomyosarcomas are malignant neoplasms with striated muscle differentiation. This is the most common type of soft-tissue sarcoma in children, but occurs rarely in adults. Its occurrence in liver is infrequent. We report a case of primary hepatic embryonal rhabdomyosarcoma in a 67-year-old man. The tumour was occupying the left lobe of the liver with large component of lesion seen bulging in left subhepatic space indenting over the stomach, compressing the pancreas and gall bladder. A percutaneous biopsy was performed which revealed embryonal rhabdomyosarcoma. He underwent a successful left lobectomy with complete resection of the tumour, followed by adjuvant chemotherapy. The patient is free of disease at 24 months of follow-up. Hence, an early diagnosis, prompt surgical resection with negative resection margin along with adjuvant chemotherapy can provide complete remission. This case is extremely rare both due to the age of the patient at presentation and location of the tumour.

BACKGROUND & OBJECTIVE: Lymph node biopsy is an important tool for diagnosis,staging & prognosis determination. This study was undertaken to determine the histopathological spectrum of lymphadenectomies at a tertiary care Centre at Rajasthan. METHODS: In a cross sectional observational study, 573 histologically diagnosed lymph node biopsies from January 2008 to December 2012 were reviewed. The patient's history, clinical features & definite pathologic findings were reviewed. RESULTS: 573 patients (Male 306, Females 267) maximum biopsies were cervical (53.5%), Axillary (22.8%). Overall biopsies revealed TB (63.3%), Chronic Non Specific Lymphadenitis (13.4%), Reactive Hyperplasia (6.4%) & Lymphoproliferative disorder (2%).76 patients were suspected to have Metastatic lesion clinically, but it was found in 29(5.06%) on histological evaluation. Tubercular lymphadenitis was the commonest diagnosis in all age groups. CNSL (20.6%) was commonest in 1-20 years, Metastatic (15.3%) in 61-80 years. CONCLUSION: Lymph node biopsy plays an important role in establishing the cause of lymphadenopathy. Tubercular lymphadenitis is the commonest finding in spectrum of diseases affecting lymph nodes from this region.

Fibroadenoma is the most common benign tumor of the breast. It may be associated with proliferative epithelial changes, fibrocystic changes, and very rarely, insitu and invasive cancer. This report describes malignant transformation of a bilateral fibroadenoma. The histopathological characteristics and clinical course of a rare case of invasive bilateral lobular carcinoma arising within fibroadenoma in a young female are discussed.

Akt, a known serine/threonine‐protein kinase B has been revealed to be an imperative protein of the PI3K/Akt pathway. Akt is available in three isoforms, Akt1, Akt2, and Akt3. Ubiquitously expressed Akt1 & Akt2 are essential for cell survival and are believed to be involved in regulating glucose homeostasis. PI3K/Akt pathway has been evidenced to be associated with metabolic diseases viz. hypertension, dyslipidemia, and diabetes. Akt interacting proteins have been revealed to be scaffold proteins of the PI3K/Akt pathway. Notably, some protein–protein interactions are imperative for the inhibition or uncontrolled activation of these signaling pathways. For instance, Akt interacting protein binds with other protein namely, FOXO1 and mTOR, and play a key role in the onset and progression of metabolic syndrome (MS). The purpose of this review is to highlight the role of the PI3K/Akt pathway and associated protein–protein interactions which might serve as a valuable tool for investigators to develop some new promising therapeutic agents in the management of MS.

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