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An overview of cancer registration in India: Present status and future challenges
Soumya Swaroop Sahoo, Madhur Verma, Pragyan Paramita Parija
October-December 2018, 2(4):86-89
Cancer registration is pivotal for cancer epidemiology and for planning and implementation of cancer policy and research. Morbidity and mortality burden of cancer in India is one of the highest in the world. India has a network of cancer registry distributed across the country, a process which began in the 1960s. The cancer registration in India has expanded including many new hospital-based and population-based cancer registries. Some new initiatives such as cancer atlas and online software programmes have been started for streamlining the process. However representativeness, urban-centric data, timeliness, and quality of cancer data are some of the problems still troubling the process of cancer registration in India. In this context, we should look for a unified systemic framework using newer information and management systems for capturing a complete and clear picture of cancer in India.
  7,854 948 10
Comparison between crush/squash cytology and frozen section preparation in intraoperative diagnosis of central nervous system lesions
Swagatika Samal, Rajnish Kalra, Jyoti Sharma, Ishwar Singh, Devasis Panda, Megha Ralli
October-December 2017, 1(2):25-30
Aim: The aim of this study is to analyze the correlation/diagnostic accuracy of cytology and frozen section (FS) preparations in the intraoperative diagnoses of central nervous system (CNS) lesions. Materials and Methods: A total of 63 cases of CNS lesions were included in the study from July 2012 to January 2015 at a tertiary care referral hospital. Intraoperative specimens were used for crush/squash smears and FS and correlated with the final histopathological diagnosis. Results: Majority of the patients (73.02%) were presenting in the age range of 21–50 years. There was a slight female preponderance with male-to-female ratio of 1:1.1. Two out of 63 cases were excluded from the cytology correlation analysis due to inadequate materials and 3 out of 63 cases were excluded from the FS correlation analysis due to freezing artifacts. The diagnostic accuracy of cytological preparation was 80.33% for complete correlation with histopathology and was increased to 93.44% for adding the partial correlations. The corresponding figures for FS were 81.67% and 93.33%, respectively, and the difference was insignificant (P = 0.971). The sensitivity, specificity, positive predictive value, and negative predictive value in detecting neoplastic condition on cytology were 94.4%, 85.7%, 98.07%, and 66.67%, respectively, and that of FS were 96.15%, 75%, 96.15%, and 75%, respectively. The corresponding P = 0.872, 0.652, 0.986, and 0.561, respectively. Conclusion: Crush and FS preparation are considered as effective diagnostic procedures for rapid intraoperative diagnosis in CNS lesions without any significant difference in results and when applied simultaneously can produce a higher diagnostic accuracy complementing each other's results.
  6,483 498 3
Carcinoma of gall bladder: Demographic and clinicopathological profile in Indian patients
AP Dubey, Kavita Rawat, Nikhil Pathi, S Viswanath, Anvesh Rathore, Rajan Kapoor, Abhishek Pathak
January-March 2018, 2(1):3-6
Aim of the Study: The aim of this study is to evaluate the demographic and clinicopathological profile of the patients with gallbladder cancer (GBC). Materials and Methods: A total of 68 diagnosed cases of GBC were taken in the study during the study period from January 2016 to December 2017. A detail questionnaire was filled through the counseling to take demographic profile including socioeconomic status, nonclinical characteristics, dietary, and other risk factors apart from clinicopathological profile of patients. Results: We found most of the patients were females with median age 51.8 years. More than half of them were postmenopausal (56.60%), and high parity was seen in 39.62% of females. Obesity was associated factor mainly in females (28/53), and none of the males were obese. Nearly 83.82% (57/68) of patients had advanced stage disease, with metastatic disease in 72.06% (49/68) patients. Majority of the patients had at least two sites of metastasis (73.47%), with liver (57.14%), omentum (40.82%), and nonregional lymph nodes (53.06%) being common sites of dissemination. Bony metastasis, being rare in literature, was found in 6 (12.24%) of patients, most of them developed it later during the disease course. Conclusion: Majority of the patients was female within the age group of 41–60 years, associated with gallstones and had advanced disease. We did not find greater impact of diet on the incidence as vegans and nonvegans were almost equally divided in our study. A high index of suspicion and health education seems to be the only answers available for early detection and improvement of survival.
  5,639 683 2
Calcaneal osteosarcoma: An unusual cause of chronic pediatric heel pain
Pradosh Kumar Sarangi, Elluru Santosh Kumar, Jayashree Mohanty
October-December 2017, 1(2):31-33
Calcaneal osteosarcoma is a rare entity, which presents with chronic heel pain and swelling and often clinically misdiagnosed as a traumatic or inflammatory process. The diagnostic confusion is because of the rarity of this entity and unawareness of such rare areas of affection of osteosarcoma. This usually leads to delayed diagnosis and treatment and may severely affect the prognosis. We present a rare case of osteosarcoma involving calcaneus in a 10-year-old female who presented with long-standing left heel pain and swelling where the diagnosis of a sinister underlying bone lesion was delayed.
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Acute lymphoblastic leukemia with normal platelet count
Reema Bhushan, Kiran Agarwal, Jyoti Garg
October-December 2017, 1(2):43-45
B-acute lymphoblastic leukemia (ALL) often presents as pancytopenia/bicytopenia with thrombocytopenia being very common. A 15-year-old child with high-grade fever showed bicytopenia on peripheral smear with 10% blasts. Bone marrow examination showed 65% lymphoblasts which were negative for myeloperoxidase. The blasts suppressed the erythroid population but not the megakaryocytic population. On flow cytometry, a diagnosis of common – ALL antigen-positive B – precursor ALL was given. To conclude, ALL cannot be excluded in patients who present with a normal platelet count. A bone marrow aspirate is crucial in patients with bi/pancytopenia.
  5,626 261 -
Primary synovial chondromatosis of knee with both intra-articular and extra-articular involvement: A case report with delayed diagnosis
Pradosh Kumar Sarangi, T Seetam Kumar
October-December 2017, 1(2):46-48
Primary synovial chondromatosis (PSC) is an uncommon benign disease process of unknown etiology in which the synovium undergoes metaplasia, leading to cartilaginous nodules that progressively undergo detachment, mineralization, and even ossification forming loose bodies. It is usually a monoarticular disease with involvement of large joints with knee being the most common. Involvement of smaller joints such as distal radioulnar, tibiofibular, metacarpophalangeal, and metatarsophalangeal joint has also been reported. This disease process is usually intra-articular. Involvement of extra-articular tissues such as bursae and tendon sheaths is rare, and combination of intra- and extra-articular diseases described here is an extremely rare condition. Herewith, we report a male patient with PSC of left knee with involvement of suprapatellar bursa who presented with recurrent knee swelling and pain with diagnostic delay of 2 years. We have also highlighted the role of imaging in the early diagnosis of this disease and briefly reviewed relevant literature.
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Effect of denosumab in giant cell tumor of bone
Ramesh Chandra Maharaj, Sibasish Panigrahi, Biplabi Sarangadhar Das
October-December 2017, 1(2):34-36
Giant cell tumor (GCT) of bone is a benign tumor with locally aggressive nature. The presence of mononuclear stromal cells and multinucleated giant cells is the microscopic characteristic feature of the GCT. It is an osteoclastic tumor with destruction of tumor is mediated by the receptor activator of nuclear factor kappa-B ligand (RANKL). Denosumab, a RANKL inhibitor, may reduce or eliminate tumor giant cells, the relative content of proliferative, densely cellular tumor stromal cells, replacing with nonproliferative, differentiated woven new bone. We report a case of GCT of the right distal femur in a 20-year-old female, treated with 6 cycles of denosumab as neoadjuvant therapy, which shows consolidation of the lesion and became amenable for extended curettage with phenol cauterization and cementing without going for any radical surgery shown to have very good functional outcome.
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Intraosseous lipoma of ilium: A rare case report with review of literature
Nirmal Chandra Mohapatra, Anshuman Sahoo, Jitendra Mishra, H Vinay Kumar
July-September 2017, 1(1):10-12
Intraosseous lipoma (IL) is a rare benign bone lesion, and it constitutes about 0.1% of all bone tumors. The majority of cases are located in the metaphyseal region of the long bones in the lower limbs. We report a rare case of lipoma of the ilium in a 12-year-old male child presenting with mass over the right gluteal region. Meticulous marginal dissection was done, and a pedunculated mass originating from the lower right sacroiliac region was excised in toto. The case was an atypical example of an IL with a large outgrowth involving sacroiliac region with inconclusive magnetic resonance imaging and needle biopsy findings.
  4,154 286 -
Cancer and stigma: Present situation and challenges in India
Soumya Swaroop Sahoo, Dinesh Prasad Sahu, Madhur Verma, Pragyan Paramita Parija, Udit Kumar Panda
September-December 2019, 3(3):51-53
India is going through a significant epidemiological transition with the rising of chronic diseases such as cancer. An accompanying aspect is social stigma and negative perceptions regarding cancer. This not only affects cancer care and treatment but also puts a strain on prevention efforts. It is particularly worrisome in a low- and middle-income country like India with low levels of health literacy and the lack of access to cancer care. There have been attempts by the government and positive changes toward mitigating stigma, but a lot needs to be done to address this issue. The family and the community need to be significant players in synergy with the health system in the efforts to minimize the stigma in cancer.
  3,769 334 1
Subungual glomus tumor in hand and treatment: A report of three cases
Ramesh Chandra Maharaj, Jitendra Kumar, Satish Kumar Nanda, Tapas Kumar Panigrahi
January-March 2018, 2(1):7-9
Hand pain is a common presenting symptom in orthopedic, but digital pain due to glomus tumor is a rare entity. It is a benign vascular neoplasm arising from glomus body with subungual space of nail plate of the hand being the common location. Bluish- or pinkish-red discoloration of the nail plate with classical triad of localized tenderness, severe pain, and cold sensitivity are the common presentations of the glomus tumor. Treatment is purely surgical, i.e., complete surgical excision with dramatic results. We report three cases of subungual glomus tumor in the hand, and all the cases underwent complete excision of the tumor followed by complete relief of the symptoms.
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Role of immunohistochemistry in gynecological malignancies
Asaranti Kar
January-March 2018, 2(1):1-2
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Unusual histological variants and a rare bone involvement of osteosarcoma in a referral hospital
Kaumudeee Pattnaik, Pranati Pradhan, Asaranti Kar, Subrat Burma, Sasmita Panda
July-September 2017, 1(1):2-6
Aim: This study aimed to document the total number of osteosarcomas of bone diagnosed in a referral hospital differentiating from its close mimics with biologic behavior. Materials and Methods: This study analyzes the total cases diagnosed as osteosarcoma from 2014 to 2016 in the Department of Pathology, SCB Medical College, Cuttack, Odisha. Results: A total of 21 cases were diagnosed with osteosarcoma, the most common subtype being conventional osteosarcoma. This subtype constituted the majority (18 cases); the age range varied between 14 and 20 years. This article describes two rare histologic subtypes; small cell variant and giant cell-rich osteosarcoma, a rare bone involvement, like mandibular jaw bone, in an elderly female was also documented along with histologic features of each one. Conclusion: Three cases with unusual histologic subtypes and rare bone involvement, gnathic type, prompted us to report these cases.
  3,659 316 -
Glioblastoma multiforme in a pediatric child
Subhasis Mishra, Ashis Patnaik, Saroj Kumar Das Majumdar, Dillip Kumar Parida
April-June 2018, 2(2):38-40
Glioblastoma multiforme (GBM) is the most aggressive, malignant primary brain tumor with increasing frequency in older age group. The majority of cases occur in the 6th to 8th decade of life, with a male predominance. GBM is unusual in the pediatric age group and accounts for only 3% of all the childhood brain tumors. The treatment of GBM is still challenging in children. We report a case of GBM in an 11-year-old male child located in the right cerebral hemisphere. Right fronto-parietal craniotomy and gross total excision of the tumor were performed successfully.
  3,596 267 -
Metaplastic carcinoma of breast: A series of nine cases from a regional cancer center in Northeast India
Srigopal Mohanty, Yumkhaibam Sobita Devi, Daffilyne Lyngdoh Nongrum, Laishram Jaichand Singh, Vimal Sekar, Deep Sikha Das
October-December 2018, 2(4):69-74
Background: Metaplastic carcinoma of the breast (MCB) is a rare histological subtype of breast carcinoma containing glandular and nonglandular components with mixed epithelial and mesenchymal differentiations. Aim of the Study: The study aimed to report clinical, radiological and pathological profiles, treatment and outcome of patients diagnosed with MCB from a tertiary care institute along with literature review. Materials and Methods: Diagnosed cases of MCB were obtained from the record over a period of January 2010 to December 2017, and data were recorded in a structured pro forma. Results: A total of 9 (0.9%) cases of MCB were identified out of 1031 breast cancer patients with the median age of presentation of 53 years. The palpable lump was the most common presentation (77.78%). The mean tumor size was 4.9 cm in greatest dimension. Sonographically, most of the lesions were solid (44.44%) followed by cystic (33.33%). Mammographically, microcalcifications were absent in eight cases. Histologically, 55.56% of cases were purely epithelial subtype (3: pure squamous and 2: adenosquamous) and 4 (44.44%) cases were mixed epithelial and mesenchymal subtypes (3: carcinosarcoma and 1: invasive lobular carcinoma with sarcomatous component and osseous metaplasia). All the cases were having triple-negative receptor status. Modified radical mastectomy (MRM) was performed in all cases and 33.33% of cases had axillary node positive. About 77.88% and 88.89% of cases received adjuvant chemotherapy and adjuvant radiotherapy, respectively. At median follow-up of 27 months, local recurrence and distant metastases were seen in 1 and 3 cases, respectively. At present, 33.33%, 22.22%, and 44.45% of patients were died, alive, and lost for follow-up, respectively. Conclusion: MCB is a rare histologic subtype of breast cancer with larger tumor size at presentation and MRM is the preferred surgical procedure over breast conservation surgery. Long-term and regular follow-up is necessary to know the outcome.
  3,503 326 1
Giant liposarcoma of the anterior chest wall
Sanjoy Panda, Krupasindhu Panda, Sasmita Panda
April-June 2018, 2(2):29-31
Liposarcoma is a malignant tumor of the adipose tissue and is primarily a tumor of adults above the age group of 50 years. It may occur anywhere in the body. However, the most common sites are thigh and retroperitoneum. Liposarcoma with the chest wall primary is a rare entity with only few cases reported. We report a case of well-differentiated liposarcoma of the anterior chest wall in a 75-year-old male with a presentation of large growth extending to the anterior neck and successfully operated.
  3,549 206 -
Primary patellar giant cell tumor: A report of two cases
Jitendra Mishra, Bikram Keshari Kar, Nirmal Chandra Mohapatra, Anshuman Sahoo
October-December 2017, 1(2):37-39
Giant cell tumor (GCT) commonly arises from epiphysis of the long bones, and the most common sites for primary are distal femur, proximal tibia, proximal humerus, and distal radius. Patella is a very rare site for the development of primary GCT. We report two cases with primary GCT of the patella. Both the patients presented with a long history of intermittent right anterior knee pain and knee swelling and were treated by radical excision. In one case, temporary immobilization done by knee arthrodesis with cross K-wires followed by mobilization using hinged knee brace.
  3,442 245 -
Carcinoma of prostate with endobronchial and mediastinal lymph node metastasis
KO Rohit, K Praveen Valsalan, Jacob Baby, Nita John, Elizabeth Sunila, Mitchelle Lolly
April-June 2018, 2(2):32-34
Endobronchial malignancies are usually associated with bronchogenic carcinoma. About 1.1% of cases may be due to extrapulmonary source of metastasis. Only few case reports have mentioned about the carcinoma of prostate with mediastinal lymph node and endobronchial metastasis. Here, we report such a case where endobronchial lesions were removed bronchoscopically and the patient improved symptomatically. Biopsy showed the metastatic adenocarcinoma and immunohistochemistry was positive for prostate-specific antigen.
  3,418 254 -
Hidradenoma papilliferum of the vulva with extensive squamous metaplasia mimicking malignancy: Rare entity with diagnostic challenge
Dhaval Jetly, Ritwika Dabral, Deepak Goel
May-August 2019, 3(2):38-40
Hidradenoma papilliferum (HP) is an uncommon benign cutaneous adnexal neoplasm of the anogenital region commonly seen in middle-aged, Caucasian females. Anastomosing and branching tubules, lined by columnar cells, and a basal layer of myoepithelial cells are the characteristic histopathological features. We report a case of HP in a 60-year-old female presented with a vulvar lesion. The case was evaluated for malignancy, with the initial histopathology showing extensive squamous metaplasia but ultimately found to have HP.
  3,392 245 1
Clinical dosimetric impact of AAA and Acuros XB on high-density metallic implants in case of carcinoma cervix
Manindra Bhushan, Girigesh Yadav, Deepak Tripathi, Lalit Kumar, Vimal Kishore, Rahul Lal Chowdhary, Gourav Kumar, Soumya Datta, Swarupa Mitra, Munish Gairola
May-August 2019, 3(2):28-37
Background: Metallic implant in radiotherapy leads to difficulty in tumor target and critical organ delineation. Four-field box technique is conventional approach to treat pelvic malignancies. Aim of the Study: The aim of study is to evaluate the dosimetric impact of calculation algorithms in the treatment of carcinoma cervix with metallic implants. Materials and Methods: A paraffin wax-coated iron rod was used to evaluate the beam characteristics under the influence of metallic implant. Beam characteristics such as tissue phantom ratio (TPR20,10) were measured and analyzed. 15 patients with and without metallic prosthesis of carcinoma cervix were compared in the study. Planning was done for the prescription dose of 45 Gy/25 fractions. Plans were calculated using AAA algorithm and recalculated using Acuros XB (AXB) and pencil beam convolution algorithms for the same monitor units. RTOG and Quantec Protocol were used for plan evaluation. Results: Transmission and TPR20,10increases with field size and beam energy. Surface dose Dsalso increases with field size. D98%and D2%of planning target volume showed a significant difference for AAA versus AXB. 4FN (AAA) are significantly better for all the 4F plans, calculated by three algorithms in case of V15Gyof small bowel. Analyzed data indicated the significant attenuation caused by high-Z material. Analyzed value of conformity index showed that value of index comes >1 in all the cases. Conclusion: The results indicate that when creating treatment plans for cervical cancer lesions with metallic prosthesis, the AAA algorithm would be a more appropriate choice.
  3,262 293 -
Cytological pattern of papanicolaou smears and detection of cervical cancers: An experience from a tertiary care center of eastern zone of India
Debasmita Das, Asaranti Kar, Shreya Rath, Subrat Kumar Baliarsingh, Dibyajyoti Prusty, Akhyaya Kumar Dash
April-June 2018, 2(2):25-28
Aim of the Study: The present study attempts to explore various types of lesion of the uterine cervix and to find target age groups in which screening efforts can be concentrated for early detection of cervical cancers. Materials and Methods: The study was carried out at a tertiary care institute during the period from May 2016 to December 2017. All the previously conducted cervical Papanicolaou (Pap) smears were analyzed and reported as per the 2001 Bethesda system. The data were noted in a structured pro forma and evaluated. Results: A total of 5025 Pap smears were examined. Maximum number of patients was in the age group of 31–40 years (33.25%). Out of 5025 pap smears, 6.60% (332) of cases were found to be unsatisfactory or inadequate samples, 90.97% (4571) cases were reported as negative for intraepithelial lesion or malignancy, and 2.43% (122) cases had epithelial cell abnormality (ECA). Premalignant lesions such as: atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), high-grade intraepithelial lesion (HSIL) and atypical squamous cells-cannot exclude HSIL (ASCH), and malignant lesions such as squamous cell carcinoma and adenocarcinoma were reported under the ECA positive cases. Majority of premaligant lesions found in the age group of 41–50 years and constitute 44.64% (25/56). Whereas, majority of frank malignancy cases found in the age group of 51–60 and >60 years constituting 43.94% and 37.88%, respectively. Among all the ECA positive cases, 54.10% of cases found to be with malignancies. Conclusion: Proper implementation of Pap smear screening examination can decrease the incidence of cancer cervix along with its downstaging by early detection of precancerous lesions.
  3,137 326 1
Diagnostic utility of touch imprint cytology in the evaluation of intraabdominal tumors
Amit Kumar Adhya, Madhabananda Kar, Ranjan Mohanty
July-September 2018, 2(3):47-50
Objectives: Touch imprint cytology (TIC) of biopsy specimen can be utilized for a rapid on-site evaluation of tumors. Its usefulness for intraoperative diagnosis is well known. We evaluated the advantages and limitations of TIC of trucut biopsies of intraabdominal tumors. Materials and Methods: TIC was obtained in 42 consecutive cases of intraabdominal masses. The sensitivity, specificity, and diagnostic accuracy of TIC were evaluated by comparing it with the final biopsy diagnosis. Results: The study included retroperitoneal tumors (13 cases, 30.95%), liver mass (11 cases, 26.19%), gall bladder mass (4 cases, 9.53%), pelvic mass (3 cases, 7.14%), iliac bone mass (2 cases, 4.76%), mesenteric nodule (4 cases, 9.53%), kidney mass (3 cases, 7.14%), and 1 case (2.38%) each of epigastric mass and loin mass. Thirty-two (76.19%) cases were diagnosed as malignant and 10 (23.81%) cases were diagnosed as benign/negative on TIC. The overall sensitivity was 87.88%, the specificity was 77.78%, the positive predictive value was 93.55%, and the negative predictive value was 63.60%. The accuracy of the test was 85.71%.Conclusions: TIC is a simple and cost-effective method that aids in the diagnostic evaluation of tumors. It is fairly accurate with high positive predictive value and hence can be used as an adjunct to the biopsy diagnosis.
  3,192 250 -
Malignant brenner tumor of ovary: A case report and review of literature
Rohani Nayak, Suchismita Biswal, Ashok Kumar Padhy, Janmejay Mohapatra
July-September 2017, 1(1):19-21
Brenner tumors are the rare solid ovarian tumor, malignant variant being rarer. It commonly presents with vaginal bleeding, a palpable pelvic mass, and pelvic pain. Mostly, it is unilateral with local dissemination and spreading beyond the pelvis to distant organs is rare. It closely resembles transitional cell carcinoma of urinary bladder. Optimal surgery in advanced disease and surgical staging in the early stage is the corner stone of management. We report a case of malignant Brenner tumor of the ovary in 70-year-old female treated with staging laparotomy followed by adjuvant chemotherapy and having no evidence of disease after 2 years follow-up.
  3,115 270 -
Accuracy of magnetic resonance imaging in evaluation of sellar and juxtasellar tumors
Pratisruti Hui, Sasmita Parida, Jayashree Mohanty, Mamata Singh, Pradosh Kumar Sarangi
January-April 2019, 3(1):3-9
Background: Sellar and parasellar/juxtasellar regions are complex areas of the brain, and different varieties of tumors can occur in this area. Preoperative noninvasive diagnosis with magnetic resonance imaging (MRI) is essential for treatment planning. Aim of the Study: The aim of this study is to characterize MRI features of the sellar and juxtasellar tumors and to correlate MRI diagnosis with histopathological diagnosis in order to evaluate the efficiency of MRI. Materials and Methods: Patients with sellar and juxtasellar lesions who were operated during September 2015–August 2017 and the pathological reports were compared with the MRI findings retrospectively. Results: A total of 50 patients were enrolled in the study, and the mean age of presentation was 34.6 years. MRI-based radiological diagnosis showed 21 cases of pituitary macroadenoma, 15 cases of craniopharyngioma, 9 cases of meningioma, 2 cases of germinoma, 1 case of glioma, and 2 cases of epidermoid cysts. Histopathological correlation revealed MRI accuracy of 94.12%, 94%, 100%, 98%, 100%, and 100% for the diagnosis of pituitary macroadenoma, craniopharyngioma, meningioma, germinoma, glioma, and epidermoid cyst, respectively. One case each of pituitary macroadenoma and germinoma diagnosed on MRI comes out to be as craniopharyngioma after final histopathological correlation, whereas one case of craniopharyngioma turned out to be macroadenoma after final histopathological examination. Conclusions: The present study revealed a strong correlation between MRI and histopathological diagnosis for sellar and juxtasellar tumors. MRI is the modality of choice for characterizing sellar and suprasellar lesions.
  2,937 313 -
Microcystic adnexal carcinoma of face a rare aggressive pathology
Tribikram Debata, Punyasloka Pati, Suryanarayan Das
July-September 2017, 1(1):16-18
Microcystic adnexal carcinoma (MAC) is an uncommon, locally aggressive, malignant cutaneous tumor having pilar and eccrine differentiation and most commonly occurs in the head and neck region but rare among skin cancer. It is characterized by slow, but locally aggressive growth pattern with infiltration into surrounding structures which is characterized by a combination of keratinous cysts in the upper dermis, islands, and strands of small basaloid, benign-appearing keratinocytes or squamous cells in the deeper dermis within a dense desmoplastic stroma, and areas of ductal differentiation. We report a case of MAC of right cheek in a 50-year-old male patient with diagnostic challenges. MAC may include in the differential diagnosis list of slowly growing tumors of the face.
  2,999 219 -
Significance of mast cells in diagnosis and grading of non-Hodgkin's lymphomas on fine-needle aspiration cytology
J Praveen, Neelaiah Siddaraju, Prita Pradhan
July-September 2018, 2(3):51-54
Background: Information regarding the diagnostic role of mast cells in non-Hodgkin's lymphomas (NHLs) on fine-needle aspiration cytology (FNAC) is negligible. Aim of the Study: To assess the role of mast cells in diagnosing and distinguishing reactive lymphoid hyperplasia (RLH) versus low-grade NHL and low- versus high-grade NHLs on FNAC. Materials and Methods: Fine-needle aspirates from 50 reactive lymph nodes and 51 NHLs were studied. Cytologic smears of NHL cases and reactive controls were evaluated in a blinded manner. A standardized mast cell count (MCC) was performed on May–Grünwald–Giemsa smears of both “NHL” and “RLH” cases. MCC was compared between RLH and NHL groups and between low- and high-grade NHLs. Mann–Whitney U-test and Wilcoxon W-test were done for statistical analysis, takingP> 0.05 as statistically significant. A receptor operator characteristic curve was plotted to calculate the cutoffs for MCC. Results: Various morphologic types of NHL were encountered with 25 high-grade and 26 low-grade NHLs. The standardized MCC in RLH ranged from 0/25 hpf to 14/25 hpf (a mean MCC of 1.54/25 hpf), while for NHL group, it ranged from 0/25 hpf to 30/25 hpf (a mean MCC of 2.39/25 hpf). The difference in the median MCC between the two groups was statistically not significant (P > 0.05). Conclusion: Performing an MCC on cytologic smears may not be of significant practical value in distinguishing RLH versus low-grade NHL, and low/intermediate grade versus high-grade NHLs. Further larger studies are required to refute or support the cytodiagnostic role of mast cells in some specific subtypes of NHL.
  2,887 213 -