Annals of Pathology and Laboratory Medicine

Cytology of Bile Duct Brushings: Streaming Ahead with Time

Mega Lahori — 2022-05-04

Endoscopic retrograde brush cytology of the biliary duct is an established tool for evaluation of obstructive biliary strictures or screening of primary sclerosing cholangitis (PSC) patients for dysplasia. It is a simple, minimally invasive procedure that can be performed during a therapeutic ERCP. Most authors have reported a sensitivity of 30-60% and a specificity of 90-100%. A positive result can be a reliable indicator of malignant neoplasm. However, there is no standardized reporting terminology designed specifically for bile duct brushings. Majority of bile duct brushings yield either benign ductal epithelium, reactive atypia of ductal epithelium or suspicious/positive for malignancy. Diagnosing malignancy in bile duct brushings is based on a constellation of cytologic features, and consideration of the overall picture- clinical presentation, radiology/endoscopy findings, etc. Different studies have highlighted various key features for diagnosing malignancy in bile duct brushings. Features most consistently associated with a malignant category are- loss of honeycomb architecture, 3D clusters, high n:c ratio, anisonucleosis (≥1:4 variation), irregular nuclear outlines, coarse clumped chromatin, and single malignant cells in the background. The utility of biliary brush cytology has been expanded by using FISH, immunocytochemistry, and Next-generation sequencing.

Diagnostic Utility of Proliferative Cell Markers in Prostatic Lesions: An Institutional Experience

Vartika Goel — 2022-05-04

Background: Prostatic cancer is a complex and biologically heterogenous disease. Diagnosis of prostatic lesions with immunohistochemistry still faces challenges because of difference in reactivity of monoclonal antibodies in benign, equivocal, and malignant lesions. Proliferative markers Ki-67 and Proliferating Cell Nuclear Antigen (PCNA) can be used for diagnosis and prognostic stratification of prostatic carcinoma.

Methods: A total of hundred prostate biopsies with 50 cases each of benign prostatic hyperplasia and prostate carcinoma received in the Department of Pathology, PGIMS, Rohtak, India were included in the study. Ki-67 and PCNA expression was studied immunohistochemically in each case.

Result: Ki-67 expression was significantly upregulated in malignant cases and increased with increasing Gleason grade. PCNA expression was also found to be increased in increasing Gleason grades in carcinoma cases, however, the results were ambiguous as it was found to be positive in all benign cases also.

Conclusion: Ki-67 is useful in predicting biological behavior in prostate carcinoma cases, however PCNA expression needs to be studied further.

Disseminated Tuberculosis with Myocardial Involvement: A Rare Case Entity

Sameeksha Alva — 2022-05-04

A disease like tuberculosis, which is quite common in India, there is still a delay in diagnosing cardiac involvement by tuberculosis. Here we reported an autopsy case report of a middle-aged man who presented with sudden death. On histopathological examination we found that the deceased is involved of myocardium by Tuberculosis along with lungs. It is important to diagnose the condition earlier to treat the patient accordingly.

Cutaneous Rosai-Dorfman Disease – A Case Report and Review of Literature

Shalu Thomas — 2022-05-04

Rosai–Dorfman disease (RDD), or Sinus Histiocytosis with Massive Lymphadenopathy (SHML) is a self-limiting, rare benign proliferative disorder of histiocytes in the lymph nodes with occasional extra-nodal involvement of the skin. Isolated Cutaneous Rosai-Dorfman disease(C-RDD) without node involvement is an exceedingly rare occurrence. Despite its unique characteristics, the diagnosis of Cutaneous Rosai Dorfman disease is hampered by its variable clinical presentation, misleading histopathological patterns, and the absence of lymphadenopathy. Herein we present a case report of Cutaneous Rosai-Dorfman disease without any lymph node involvement.

Osseocartilaginous metaplasia in the Endometrium: A Rare Reversible Cause of Secondary Infertility

Swagatika Senapati — 2022-05-04

Osteo-cartilaginous metaplasia in endometrium is an infrequent finding and usually presents with secondary infertility. This is a benign entity and usually associated with a previous history of abortion. It can be treated successfully with hysteroscopy and henceforth reverting infertility. Awareness of this entity is important in order to avoid overdiagnosis of mixed Mullerian tumor of the endometrium followed by hysterectomy. Herein, we present one such case of a 28-year-old female who presented with secondary infertility.

Nasal leiomyoma: Prevalent tumor at a peculiar location

Md Ali Osama — 2022-05-04