Primary Central Nervous System Lymphoma: A Clinicopathological and Cytomorpholgical Study from A Tertiary Care Centre in Chennai, India

Ambroise, Marie Moses; Ghosh, Mitra; Mallikarjuna, V S; Annapurneswari, S; Kurian, Achamma; Chakravarthy, Ranjani

doi:10.7314/apjcp.2013.14.2.727

Cited by 3 publications

(20 citation statements)

References 43 publications

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“…[1,2] Clinically and radiologically, the differential diagnosis includes glioma, metastasis, demyelinating disorders, sarcoidosis, abscess or infection like toxoplasmosis which necessitates a histological diagnosis for confirmation. [3] On cytology, the characteristic perivascular arrangement of atypical lymphoid cells clinches the diagnosis of lymphoma. Lymphocytes and foamy macrophages may confuse the cytological picture with vasculitis, infection or demyelinating disorder.…”

Section: Discussionmentioning

confidence: 99%

“…Lymphocytes and foamy macrophages may confuse the cytological picture with vasculitis, infection or demyelinating disorder. [3,4] During smearing, the cytoplasm of foamy macrophages may get stripped and the naked nuclei may resemble nuclei of lymphoma. However, neutrophils are more commonly seen in infections and macrophages are seen in demyelination or infarcts.…”

Section: Discussionmentioning

confidence: 99%

“…Focally, reactive astrocytes, microglial cells and reactive T lymphocytes are also seen. [2][3][4] Causes of discrepancy between frozen section and formalin fixed paraffin embedded sections include sampling error and inaccurate assessment of histological grade or cell type of tumor. [2,4] Squash Cytology and imprint smears circumvent the problem caused by freezing artifact, are cheaper, faster and use minimal tissue, thus conserving tissue for histopathology and immunophenotyping tests.…”

Section: Discussionmentioning

confidence: 99%

“…[4] Rapid intraoperative diagnosis of lesion as lymphoma is invaluable for the operating surgeon as extensive excision is avoided and only tissue adequate for histopathology and immunophenotyping studies is taken while extensive surgical resection and intracavitary radiation is done in case of glioma. [2][3][4]8] Lymphoma is treated by chemotherapy with high dose methotrexate followed by radiotherapy. [3]…”

Section: Discussionmentioning

confidence: 99%

“…Diagnosing Primary CNS Lymphoma (PCNL) on squash and imprint cytology can be a challenge for the pathologist but a boon for the operating surgeon as the nature of the lesion determines the nature of surgery and further management. [2,3]…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Rapid Intra-operative Diagnosis of CNS Lymphoma on Squash & Imprint Smears – A Boon for the Surgeon: Case Report

Sandhu¹,

Tyagi

Mittal

et al. 2020

Ann of Pathol and Lab Med

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Primary CNS Lymphoma [PCNL] accounts for 3% of all brain tumors. Diagnosing PCNL on squash and imprint cytology is a challenge for the pathologist but a boon for the operating surgeon as the knowledge of the nature of the lesion determines the nature of surgery. We report a case of 59 years old immunocompetent male who presented with right hemiparesis and headache. MRI Brain was suggestive of Left frontal Glioma. Intra-operatively, squash cytology and imprint smears of tissue from the lesion showed scattered lymphoid cells which also exhibited perivascular cuffing. Cytology was suggestive of lymphoma with differential of an inflammatory pathology. Histopathological examination and positivity for LCA, CD 20, Bcl 2 and Mum 1 on IHC confirmed the diagnosis of Diffuse Large B Cell Lymphoma-Brain. It is important to distinguish lymphoma from glioma or metastasis in CNS because of totally different lines of management. Knowledge of empirical diagnosis during surgery can guide the surgeon to ensure that adequate tissue is excised so that sample for immunophenotyping or further tests is available.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Rapid Intra-operative Diagnosis of CNS Lymphoma on Squash & Imprint Smears – A Boon for the Surgeon: Case Report

Sandhu¹,

Tyagi

Mittal

et al. 2020

Ann of Pathol and Lab Med

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High prevalance of triple negative markers in breast cancer patients in North Maharashtra

Agrawal¹,

Jadhav

Dravid³

et al. 2023

IJPO

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Breast cancer is the most prevalent cancer among women worldwide. The Bloom Richardson grading has been applied to most breast cancers. There are different biologic subtypes of breast cancer according to immunohistochemistry (IHC). Clinically, these subtypes are characterized on the basis of expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Among them, Triple Negative Breast Cancer (TNBC) which lacks expression of the ER, PR, and HER-2-neu, is most aggressive form. TNBC cases have worse prognosis, require aggressive chemotherapy and are difficult to manage. The advent of neoadjuvant chemotherapy has highlighted the importance of IHC, Breast Ca and TNBC. The aim and objective of this study is to find prevalence of TNBC in Breast Cancer patients in North Maharashtra. This is a 3- Year ambiceptive analysis done to study the incidence of TNBC among Breast Cancer cases. Out of 58 Breast Cancer cases diagnosed in our institute, 30 cases in which IHC was done were included in this study. Postmortem breast cancer cases, core needle biopsies and mastectomies in which IHC was not done were excluded. Among 30 cases studied, 53.33% cases were TNBC, 23.33% cases were ER and PR positive, 10% cases were only HER-2-neu positive, 6.66% cases were only ER positive, 3.33% cases were only PR positive, and 3.33% cases were all three ER, PR and HER-2 neu positive. To conclude, India has considerably higher prevalence of TNBC, as compared to the Western countries. This finding has significant clinical relevance as it may have contributed to poor outcomes in patients with breast cancer in India. With advent of neoadjuvant chemotherapy, use of Modified Bloom- Richardson Grading & IHC is of crucial importance. To understand the determinants of TNBC in India additional research is needed for diagnosis and treatment follow-up.

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Hormone receptor status (estrogen receptor, progesterone receptor), human epidermal growth factor-2 and p53 in South Indian breast cancer patients: A tertiary care center experience

Patnayak

Jena

Rukmangadha

et al. 2015

Indian J Med Paediatr Oncol

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Breast cancer, in India, is the second commonest cancer in females. Receptor status with ER/PR/Her 2 is now routinely done in patients with invasive carcinoma. The tumour suppressor gene, p53, is also present in most breast cancers. Proteins produced by a mutated p53 gene, accumulate in the nucleus of tumour cells and are detected by immunohistochemistry (IHC). We have undertaken this study with the aim to evaluate the ER, PR, HER-2 and p53 expressions in invasive breast carcinomas by IHC and to compare the HER-2 expression with various clinicopathological parameters.Materials and Methods:In this retrospective single institutional study from January 2001 to December 2010, 389 cases of histopathologically diagnosed infiltrating carcinoma of breast were evaluated taking into account various parameters like age, tumour size, grade, lymph node involvement, ER and PR. HER-2 and p53 was done in 352 cases.Results:The age range was 23-90 years with a mean of 50.7 years. Majority of tumours were T2 (79.6%) and Grade II (60.9%). Our data showed overall 47.6% ER, 48.8% PR, 29.6% HER-2 and 69.2% p53 positivity. There was no significant correlation between HER-2 and age, tumour size, lymph node status, ER, and PR. There was significant correlation between HER-2 and tumour grade (P = 0.031), p53 (P < 0.001). There was no inverse correlation between HER-2 and combined ER, PR status. Triple-negative breast cancers which constituted 22.7% of our cases did not reveal any correlation with various parameters.Conclusion:In our study, ER status was low, and incidence of p53 was high. These findings suggest that many of the tumours in Indian females may be of an aggressive type, and novel treatment approaches may be tried. We conclude that the assessment of all four markers is desirable.

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Primary Central Nervous System Lymphoma: A Clinicopathological and Cytomorpholgical Study from A Tertiary Care Centre in Chennai, India

Cited by 3 publications

References 43 publications

Rapid Intra-operative Diagnosis of CNS Lymphoma on Squash & Imprint Smears – A Boon for the Surgeon: Case Report

Rapid Intra-operative Diagnosis of CNS Lymphoma on Squash & Imprint Smears – A Boon for the Surgeon: Case Report

High prevalance of triple negative markers in breast cancer patients in North Maharashtra

Hormone receptor status (estrogen receptor, progesterone receptor), human epidermal growth factor-2 and p53 in South Indian breast cancer patients: A tertiary care center experience

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