Cystic lesions of the female pelvis are common. Clinically, symptomatic lesions are mostly ovarian in origin and neoplastic in nature. Considerable diagnostic dilemma may be encountered if clinical, radiological, and estimation of serum markers failed to classify the origin and nature of such cysts. One such exceptional case is being described where a 35-year-old female presented with a rapidly growing cystic mass in lower abdomen, clinically suspicious of malignancy. Investigations failed to identify the nature. On laparotomy, excision of the mass was done. Suprisingly histopathological examination identified the lesion as hydatid cyst arising from the broad ligament. Female genital tract hydatidosis is uncommon and in most cases the involvement is secondary. Primary hydatid disease of female genital tract is even very rarer and generates considerable diagnostic difficulty. A significant clinical suspicion is necessary in the differential diagnosis of pelvic cystic diseases to identify such a rare entity.
Introduction: In systemic malignancies, thyroid carcinoma represents only 1%, but it is the most common endocrine malignancy with poor prognosis. Fine Needle Aspiration (FNA) is considered a requisite tool in providing a rational advent for the clinical management of these nodules. However, when solely based on cytopathological assessment, FNA leads to imprecise biopsy results in 10-20% of all cases. So, immunohistochemical markers, Galectin-3 (Gal-3) and Cytokeratin 19 (CK19) have received considerable attention as diagnostic marker for thyroid cancer. Aim: To study the expression of Gal-3 and CK19 in different thyroid neoplasms. Materials and Methods: This cross-sectional study was conducted at a tertiary care hospital from January 2019 to January 2021 on 120 cases. The thyroidectomy specimens received were fixed in 10% buffered formalin followed by gross examination. The paraffin embedded tissue blocks were subsequently stained for Haematoxylin and Eosin stain (H&E) followed by histopathological reporting. Qualitative immunohistochemical assessment of the marker Gal-3 and CK19 was performed on representative histologic sections of the thyroid neoplasms. Data were analysed using Graph Pad Instat 3. Results: The positive expression of Gal-3 was significantly more in malignant tumours (87.5%) than in benign (36.0%) (p-value <0.001). In Papillary Thyroid Carcinomas (PTC) and in Follicular Variant of Papillary Thyroid Carcinomas (FVPTC) expression of Gal-3 was notably higher than in Follicular Adenoma (FA) (p-value=0.01 and p-value=0.0001, respectively). Follicular Thyroid Carcinomas (FTC) had higher expression FA (p-value=0.003). In malignant tumours (71.8%), positive expression of CK19 was significantly more than benign tumours (24.0%) (p-value <0.001). Significant difference in expression of CK19 was seen between PTC and FTC (p-value=0.019). Between PTC and FA, differences in expression were significant (p-value <0.001). Significant difference in expression was also seen between FVPTC and FTC (p-value=0.032) as well as with FA (p-value=0.028). Conclusion: The most sensitive marker is Gal-3 for the diagnosis of thyroid malignancies. When combined with CK19, the specificity increases in identifying the thyroid cancers. More combination of markers together with Gal-3 and CK19 can be useful in the distinction between malignant and benign thyroid tumours because it is essential for further treatment and long-term management of the patient.
The thoracic cavity consists of the mediastinum located centrally which is bordered by two pleural cavities laterally. The major organs included are the thymus gland, the heart, the lungs, the tracheobronchial tree, lymph nodes and vessels. The lesions originating from the various organs are diverse and occasionally some lesions occurring are extremely rare. The aim was to study demographic features, anatomical site and histological findings of the cases. This was a prospective evaluation of the intrathoracic lesions in a tertiary care center from June 2018 to June 2020. This comprised of patient’s age and sex, the clinical characteristics and location of the tumour, the duration of the lesion and the histopathological findings along with Immunohistochemistry (IHC). This case series describes 10 cases of intrathoracic lesions originating from mediastinal soft tissue, thymus gland, lungs and heart. Patient’s age ranged from five months old to 48 years old with males and females equally affected. All the patients have undergone treatment and were followed-up as well. Intrathoracic lesions are unusual tumours with varied histology. These intrathoracic lesions require a multidisciplinary approach. These lesions should be examined well to determine the source of the lesion for a conclusive diagnosis. Radiological correlation along with histopathology and immunohistochemistry assists in accurate diagnosis.
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