scholarly journals Histomorphological and Immunohistochemical Reappraisal of Cutaneous Adnexal Tumours: A Hospital Based Study

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Prakriti Shukla ◽  
Uroos Fatima ◽  
Anil K. Malaviya

Background. Diagnosing adnexal tumours of the skin is a challenge due to their wide variety, infrequent occurrence in practice, and confusing morphological picture.Aims and Objectives. The present study aims to observe the spectrum of adnexal tumours at our institute and to evaluate them based on histomorphological, histochemical, and immunohistochemical methods either alone or in combination for proper identification and classification.Materials and Methods. A partly retrospective and partly prospective study was conducted on adnexal skin tumours over a period of 6 years. Relevant clinical profile was recorded. Histopathological examination was carried out and special stains were applied as and when required. Immunohistochemistry was performed where diagnosis with routine stains was not possible.Results. A total of 150 skin tumour biopsies were received. There were 87 keratotic tumours, 39 adnexal tumours, and 24 melanocytic tumours. Amongst the adnexal tumours, 51.3% eccrine, 30.8% follicular, and 17.9% sebaceous tumours were seen. In five cases, histological diagnosis was troublesome where immunohistochemistry helped in making final diagnosis.Limitations. The sample size is small.Conclusion. Histomorphology is confirmatory in majority of the adnexal tumours but few rare lesions that mimic internal malignancy require a panel of immunomarkers to rule out other possible differentials.

2017 ◽  
Vol 2017 ◽  
pp. 1-10
Author(s):  
Freja Lærke Sand ◽  
Simon Francis Thomsen

Correct and rapid diagnosis of skin tumours often requires biopsy and histopathological examination to differentiate benign lesions such as seborrhoeic keratoses or melanocytic naevi from premalignant and malignant lesions such as malignant melanoma. Particularly, to the untrained eye, any benign skin tumour—pigmented or nonpigmented—is easily mistaken for a malignant lesion. Qualified clinical evaluation is paramount in order to reduce the frequency of unwarranted skin biopsies. Herein, the most common benign, premalignant, and malignant vulvar skin tumours are reviewed.


Author(s):  
Shilpi Saxena ◽  
Suyash Goel ◽  
Alok D. Sen

Smooth muscle tumours of vulva are rare and therefore can be missed clinically. Our patient, 48-year-old lady presented with lump in the left vulva that was clinically diagnosed as Bartholin duct cyst. The lumpectomy was done under local anaesthesia and the lesion was sent for pathological examination. On gross examination the mass was 3.5 cm in diameter. The microscopic examination revealed the lump to be leiomyoma and no necrosis or atypia was present. The final diagnosis of “vulval leiomyoma” was given. Postoperative period was uneventful, and the patient is on regular follow up and there has been no recurrence. Leiomyoma should be kept as a differential diagnosis when a lady presents in late reproductive age group with unilateral swelling in vulvar region which is firm in consistency and the lump must be sent for histopathological examination for definitive diagnosis and rule out malignancy. The pathologists play a critical role in recognition and management of smooth muscle tumors of the vulva and to rule out leiomyosarcoma.


Author(s):  
Bhawana Pant ◽  
Sanjay Gaur ◽  
Prabhat Pant

F.NA.C has been used for ages as a safe and economical tool for fast preoperative diagnosis of parotid tumors. It has certain pitfall which sometimes leads to misdiagnosis and consequently it may have affect on treatment of the tumors. Keeping in view of the diverse classification of parotid tumors’ information from cytology should be combined with radiology as well as clinical diagnosis. Aim: To discuss some cases where there was discrepancy between cytological diagnosis and histopathological result and also suggest measures to improve the efficacy of F.N.A.C. Material and methods: The study includes 50 cases of parotid tumours who presented to the  department of ENT at Government medical college Haldwani which is a tertiary referral centre during 2009 to 2016. Only adult patients were included and inflammatory swelling were excluded from the study. All patients evaluated  Contrast enhanced computerized tomography(CECT) and  Magnetic resonance imaging (MRI) followed by Fine needle aspiration cytology .Preoperative diagnosis was made upon the findings of the above investigations and different types of  parotid surgeries  were done. . Final diagnosis was made on  histopathological  examination. Result :The most common tumour  came out to be pleomorphic adenoma (23 cases-46%) followed by mucoepidermoid carcinoma(12cases-24%). In ten  cases there was no clear cut  association between cytological diagnosis and final histopathological diagnosis. Conclusion: FNAC is highly sensitive and specific technique for diagnosis of many salivary gland swellings. FNAC can be used preoperatively to avoid unnecessary surgery and biopsy. Details of clinical information and radiologic features may help the pathologist to arrive at the appropriate diagnosis and reduce false interpretation. Pitfalls may also occur with improper technique of FNAC which can be overcome by proper caution.


Intervirology ◽  
2021 ◽  
pp. 96-102
Author(s):  
Pedro V.A. Costa ◽  
Patricia S. Ishiy ◽  
Paulo R.P. Urbano ◽  
Camila M. Romano ◽  
Stephen K. Tyring ◽  
...  

Background: Polyomaviruses (PyVs) were initially described in animals. They have also been detected in humans with some evidence that could play a role in skin carcinogenesis. Objectives: This study aimed to verify the presence of PyVs in different skin tumour samples and to make clinical correlations with patients’ epidemiological data from Clinics Hospital of Medical School of University of São Paulo, Brazil. Methods: This is a cross-sectional study. A random selection was performed of 120 patients with histopathological exams of different cutaneous neoplasms equally divided into 6 groups and 20 patients with normal skin. The available skin specimens were analysed with 2 different techniques of PCR (conventional and real time) for detection of PyV DNA. Concomitantly, retrospective analysis of the respective medical records for the collection of epidemiological data was done. Analyses suitable for categorical data were used to compare the proportion of patients in each group. Results: PyV DNA was found in 25.69% of the samples: 15% in basal cell carcinoma group, 15% in squamous cell carcinoma, 28.57% in melanoma, 15% in dermatofibrosarcoma protuberans, 13.33% in Kaposi sarcoma, 65% in Merkel cell carcinoma (MCC), and none in normal skin. Merkel cell PyV detection was statistically significant in MCC patients (p value <0.01), but no correlations were found between PyVs and others skin tumours. Conclusion: This study demonstrated the presence of PyVs in different skin tumours; however, no association of any PyVs found in any skin tumour with epidemiological data could be shown. Further studies are still needed to elucidate the mechanisms of PyVs in skin carcinogenesis.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I Restan ◽  
O.T Steiro ◽  
H.L Tjora ◽  
J Langoergen ◽  
T Omland ◽  
...  

Abstract Background NSTEMI may be ruled out in patients presenting with acute chest pain based on low baseline high sensitivity troponin (cTn) at admission. This procedure is limited by a low expected frequency of ruled out non-cardiac chest pain (NCCP) patients. Purpose To investigate if stress-induced biomarkers (glucose or copeptin) combined with cTn can increase the rate of NCCP ruled out without an unacceptable increase in incorrectly ruled out NSTEMI. Method 971 patients with suspected NSTE-ACS were included. Final diagnosis was adjudicated by two independent cardiologists using clinical data including routine cTnT. Additionally, baseline cTnI, cTnI from Singulex Clarity System (cTnI(sgx)), copeptin and glucose were measured. Diagnostic performance to rule out NSTEMI was compared between the ESC rule out algorithms for cTnT and cTnI(Abbott), a local cTnI(sgx) algorithm and different combinations of cTn with copeptin or glucose Results Median age 61 years, 60% male. 13% had NSTEMI, 12% had UAP and 60% NCCP. Distribution of copeptin and glucose concentrations (NSTEMI and NCCP) is shown in figure 1. Copeptin and cTnT produces an algorithm with lower miss rate for NSTEMI, increased rule out rate for NCCP and significantly higher AUC (DeLong test, p value &lt;0.001) compared to the ESC algorithm (Table 1). cTnI(sgx) and copeptin showed higher rule out for NCCP and higher AUC (p value &lt;0.001), however an increased rule out rate for NSTEMIs. Combining cTnI(Abbott) and glucose gave a similar miss rate for NSTEMI as ESC, but increased rule out rate for NCCP and higher AUC (p value &lt;0.001). Conclusion Combining cTnT or cTnI(sgx) with copeptin; or cTnI with glucose, improves diagnostic precision and efficacy of rule out protocols for NSTEMI in patients presenting with acute chest pain. Figure 1 Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Western Norway Regional Health Authority; Haukeland and Stavanger University Hospitals


2019 ◽  
Vol 24 (3) ◽  
Author(s):  
Ewa Krasuska-Sławińska ◽  
Izabela Królik-Elgas ◽  
Marzena Stypińska ◽  
Anna Matosek-Rutkowska

B-cell lymphoblastic lymphoma which is a type of non-Hodgkin lymphoma is rather uncommon in children. Focal changes in bones in the course of non-Hodgkin lymphoma are mostly secondary changes and their primal location in a bone is rare. PBL (primary bone lymphoma) mainly concerns a thighbone and a tibial bone; the primary location in jaw bones is quite sporadic. In diagnostics, there is mainly magnetic resonance, medical scan (tomography), and above all – histopathological test. There is also chemotherapy by choice, and primary location in a jaw or a mandible significantly advances the prognosis. The aim of the work is to introduce a patient who was definitively diagnosed B-cell lymphoblastic lymphoma from the early B-cells. The girl reported to Laryngological Clinic, Dental Surgery Clinic for Children, Oncological Clinic of Children’s Memorial Health Institute. The cause of the visit was an elevation on the right side of a nose base, present for two months and misdiagnosed by doctors as a post-traumatic swelling in this region. After introducing laboratory and scan diagnostics and taking biopsy from the lesion, a final conclusion was made. Also, a proper treatment according to the protocol for B-cell lymphoblastic lymphoma was introduced. Non-specific B-cell lymphoma picture, as mentioned in the described case, specifically due to location in a jaw bone and a slow pace of growing, may both constitute huge diagnostic problems and deteriorate prognosis. Therefore, it is important to take into account also lymphoma – in such location of a lesion. Moreover, it is worth remembering that the final diagnosis may only be passed on the basis of histopathological examination.


2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Fatemeh Rezaei ◽  
Hesamedin Nazari ◽  
Babak Izadi

A 46-year-old male patient referred to Department of Oral Medicine, with the primary chief complaint of a painless swelling in the right side of mandibular. A panoramic radiograph revealed a well-defined, multilocular radiolucent bony lesion with thin and straight septa in the right side of mandible extending from distal of canine to mesial of third molar. Histological examination showed a solid proliferation of atypical plasmacytoid cells, which was indicative of plasmacytoma. A systemic workup for the final diagnosis was performed to rule out multiple myeloma.


2022 ◽  
pp. 541-543
Author(s):  
Nidha Gaffoor ◽  
Hima Sree Edupuganti ◽  
Jessica Minal ◽  
Archana Shetty ◽  
Supriya T R ◽  
...  

Calcinosis cutis is an uncommon soft tissue lesion characterized by the deposition of calcium salts in the skin or subcutaneous tissue attributed to a wide variety of causes. We present a case of idiopathic calcinosis cutis in an adult male, who presented with a swelling in the right iliac region. Chalky white aspirate and amorphous basophilic granular material on microscopy suggestive of calcium deposits were noted. Histopathological examination of the excised mass coupled with appropriate clinical background led to the final diagnosis of idiopathic calcinosis cutis. We present this case with a complete diagnostic workup to undermine the importance of considering this lesion in the differential diagnoses of a subcutaneous hard lump in an otherwise healthy patient.


Author(s):  
Nikhil Sanjay Deshpande ◽  
Aditi Mittal ◽  
Anil B Munemane ◽  
Ravindra Raosaheb Karle

Cervical melanosis is a rare entity in the spectrum of melanocytic lesions of uterine cervix. Melanosis is defined as presence of melanocytes in the basal layer of squamous epithelium causing hyperpigmentation. Authors here by report a case of 57-year-old female who underwent vaginal hysterectomy for third degree utero-vaginal prolapse, showed an incidental gross pathological finding of brownish macular lesion. Histopathological examination showed hyperpigmentation of basal layer without increase in melanocytes. On immunohistochemical examination, basal melanocytes were highlighted by S-100 and HMB 45 immunostains. Thus final diagnosis of cervical melanosis was made. Clinical differentials of cervical pigmented melanocytic lesions include cervical melanomas, blue nevi, congenital or traumatic lesions and melanosis, hence vigilant clinical, gross pathological examination and biopsy is warranted.


2021 ◽  
Vol 8 (4) ◽  
pp. 1114
Author(s):  
K. Ravichandran ◽  
R. Jayaraman ◽  
K. Nithya

Background: The immediate management of appendicular mass have always been controversial. Early appendicectomy (within 72 hours of presentation) is preferred in some cases, while in others non operative conservative management is advocated. Usually successful conservative management (Ochsner Sherren regimen) is followed by interval appendicectomy (6-8 weeks later). This study determines the outcome of different modalities of intervention in patients with appendicular mass.Methods: A prospective study was conducted in Rajah Muthiah medical college hospital in department of general surgery from June 2018 to December 2020, in cases diagnosed to have appendicular mass. A total of 116 patients were included. After taking detailed history and clinical examination, relevant blood and radiological investigations, were done to achieve the final diagnosis. Presentation, examination findings, investigations, type of surgery, duration of surgery, post-operative complications and duration of hospital stay were studied. Data was collected, compiled, tabulated and analysed.Results: Conservative management followed by interval appendicectomy had lesser incidence of complications like Intraoperative adhesions, surgical site infection, wound dehiscence and enterocutaneous fistula. It also had relatively lesser operative time and lesser period of hospital stay.Conclusions: On comparing the different modalities of intervention, conservative management followed by interval appendicectomy is quite effective and safe method of treatment, with less operative difficulties and better outcome.


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