34 results on '"Tanuja Shet"'
Search Results
2. Outcomes of non-metastatic triple negative breast cancers: Real-world data from a large Indian cohort
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Jyoti Bajpai, Lakhan Kashyap, Dilip Harindran Vallathol, Ankita Das, Maneesh Singh, Rima Pathak, Sushmita Rath, Anbarasan Sekar, Subham Mohanta, Asha Reddy, Shalaka Joshi, Ravindra Nandhana, Rahul Ravind, Tabassum Wadasadawala, Nita Nair, Jaya Ghosh, Vani Parmar, Seema Gulia, Sangeeta Desai, Tanuja Shet, Meenakshi Thakur, Asawari Patil, Rajiv Sarin, Sudeep Gupta, and Rajendra Badwe
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Triple negative breast cancer (TNBC) ,Non-metastatic ,Low-middle income countries (LMIC) ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Triple negative Breast tumor (TNBC) is an aggressive tumor with sparse data worldwide. Methods: We analyzed non-metastatic TNBC from 2013 to 2019 for demographics, practice patterns, and survival by the Kaplan Meir method. Prognostic factors for OS and DFS were evaluated using Cox Proportional Hazard model estimator for univariate and multivariable analysis after checking for collinearity among the variables. Results: There were 1297 patients with median age of 38 years; 41 (33.3%) among 123 tested were BRCA-positives. Among these 593 (45.7%) had stage III disease, 1279 (98.6%) were grade III, 165 (13.0%) had peri-nodal extension (PNE), 212 (16.0%) lympho-vascular invasion (LVI), and 21 (1.6%) were metaplastic; 1256 (96.8%) received chemotherapy including 820 (63.2%) neoadjuvant with 306 (40.0%) pCR. Grade ≥3 toxicities occurred in 155 (12.4%) including two deaths and 3 s-primaries. 1234 (95.2%) underwent surgery [722 (55.7%) breast conservations] and 1034 (79.7%) received radiotherapy.At a median follow-up of 54 months, median disease-free (DFS) was 92.2 months and overall survival (OS) was not reached. 5-year estimated DFS and OS was 65.9% and 80.3%. There were 259 (20.0%) failures; predominantly distant (204, 15.7%) - lung (51%), liver (31.8%).In multivariate analysis presence of LVI (HR-2.00, p-0.003), PNE (HR-2.09 p-0.003), older age (HR-1.03, p-0.002) and stage III disease (HR-4.89, p-0.027), were associated with poor OS. Conclusion: Relatively large contemporary data of non-metastatic TNBC confirms aggressive biology and predominant advanced stage presentation which adversely affects outcomes. The data strongly indicate the unmet need for early detection to optimize care.
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- 2022
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3. Clinical Profile and Outcome of Patients With Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer With Brain Metastases: Real-World Experience
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Prabhat Bhargava, Narmadha Rathnasamy, Ramnath Shenoy, Seema Gulia, Jyoti Bajpai, Jaya Ghosh, Sushmita Rath, Ashwini Budrukkar, Tanuja Shet, Asawari Patil, Sangeeta Desai, Nita Nair, Shalaka Joshi, Palak Popat, Tabassum Wadasadawala, Rima Pathak, Rajiv Sarin, Sadhana Kannan, Rajendra Badwe, and Sudeep Gupta
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
PURPOSEThere are sparse data in patients with human epidermal growth factor receptor 2 (HER2)–positive breast cancer with brain metastases from real-world settings, especially where access to newer targeted therapies is limited.METHODSThis was a single institution, retrospective cohort study of patients with HER2-positive breast cancer diagnosed between January 2013 and December 2017 to have brain metastases and treated with any HER2-targeted therapy. The main objectives were to estimate progression-free survival (PFS) and overall survival (OS) from the time of brain metastases.RESULTSA total of 102 patients with a median age of 52 (interquartile range, 45-57) years were included, of whom 63 (61.8%) had received one line and 14 (13.7%) had received two lines of HER2-targeted therapies before brain metastasis, 98 (96.1%) were symptomatic at presentation, 22 (25.3%) had solitary brain lesion, 22 (25.3%) had 2-5 lesions, and 43 (49.4%) had ≥ 5 lesions. Local treatment included surgical resection in nine (8.9%) and radiotherapy in all (100%) patients. The first HER2-targeted therapy after brain metastasis was lapatinib in 71 (68.6%), trastuzumab in 19 (18.6%), lapatinib and trastuzumab in three (2.9%), trastuzumab emtansine in four (3.9%), and intrathecal trastuzumab in five (4.9%) patients. At a median follow-up of 13.9 months, the median PFS and OS were 8 (95% CI, 6.2 to 9.8) months and 14 (95% CI, 10.8 to 17.2) months, respectively, with a 2-year OS of 25% (95% CI, 16.7 to 34.4). The median PFS in patients who received lapatinib-capecitabine regimen (n = 62) was 9.0 (95% CI, 7.3 to 10.7) months.CONCLUSIONThere was a substantial clinical benefit of local and systemic therapy in patients with brain metastases and HER2-positive disease in a real-world setting with limited access to newer HER2-targeted drugs.
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- 2022
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4. Multicentric Castleman's disease in India – Does EBV rather than HHV8 play a role?
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Viral Bhanvadia, Tanuja Shet, Vidya Rao, Sridhar Epari, Sumeet Gujral, Hasmukh Jain, Bhausaheb Bagal, and Manju Sengar
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castleman's disease ,multicentric castleman's disease ,poems syndrome ,Pathology ,RB1-214 ,Microbiology ,QR1-502 - Abstract
Background and Aim: Multicentric Castleman's disease (MCD) is a rare lymphoproliferative disorder manifesting as multiple lymphadenopathy, multiorgan involvement, and inflammatory symptoms. This study aims at highlighting some unique features of MCD in Indian patients. Materials and Methods: These 17 patients from review of 78 cases of Castleman's disease (CD) diagnosed. Besides routine tissue sections were stained for Human Herpes Virus 8 latency associated nuclear antigen (HHV8-LANA) by immunohistochemistry (IHC) and Epstein Barr virus latent membrane protein (EBV-LMP) or Epstein Barr Virus by in situ hybridization (EBER-ISH). Result: The cases included Plasma cell variant (11 cases), mixed MCD (4 cases) and two concurrent MCD with large B cell lymphoma in HIV positive patients. Median age of disease onset was 47 years and female predominance was seen. Out of 15 MCD uncomplicated by lymphoma, 5 had POEMS (Polyneuropathy, organomegaly, endocrinopathy, myeloma protein, skin changes) and one also had TAFRO (Thrombocytopenia, anasarca, fever, marrow reticulin fibrosis, organomegaly, normal or slightly elevated immunoglobulin) syndrome. Out of 10 MCD without lymphoma, 2 cases showed few EBV positive large cells, both have features of POEMS. All 17 MCD cases were negative for HHV8-LANA IHC. Two HIV patients with MCD had large cell lymphoma, intrasinusoidal pattern, of which one was EBV positive. Though four relapses were seen, none died from disease. One of the two patients complicated by lymphoma died from disease. Conclusion: Indian patients with MCD show female preponderance and are negative for HHV8 but show EBV positive cells. This makes a case for role of EBV in etiopathogenesis of MCD in India.
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- 2021
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5. Sentinel Node Biopsy Versus Low Axillary Sampling in Predicting Nodal Status of Postchemotherapy Axilla in Women With Breast Cancer
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Vani Parmar, Nita S. Nair, Vaibhav Vanmali, Rohini W. Hawaldar, Shabina Siddique, Tanuja Shet, Sangeeta Desai, Venkatesh Rangarajan, Asawari Patil, Sudeep Gupta, and Rajendra A. Badwe
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
PURPOSEWe tested low axillary sampling (LAS) and sentinel node biopsy (SNB) performed in the same patient to predict axillary nodal status post–neoadjuvant chemotherapy (NACT) in women undergoing elective breast surgery, clinically N0 after NACT.PATIENTS AND METHODSA total of 751 women clinically node negative post-NACT underwent LAS (excision of lymph node [LN] and fat below first intercostobrachial nerve). Of these women, 730 also underwent SNB by dual technique (methylene blue plus radioisotope). SNB (defined as targeted plus palpable LNs) and LAS specimens were distinctly examined for metastasis. All patients underwent completion axillary lymph node dissection. Post-NACT, 290 (38.6%) of 751 women had residual positive lymph nodes on pathology.RESULTSThe median clinical tumor size was 5 cm (range, 1-15 cm), and 533 (71%) of patients were N1 or N2 at presentation. Targeted sentinel node (SN) identification was 85.7% (626 of 730; median, two LNs); SN with palpable nodes was found in 95.2% (695 of 730; median, five LNs); LAS node was identified in 98.5% (740 of 751; median, seven LNs). In all but one case, the SN was found within the LAS specimen. The false negative rate (FNR) of SNB (blue, hot, and adjacent palpable nodes) was 19.7% (47 of 238; one-sided 95% CI upper limit, 24.0), compared with an FNR of 9.9% for LAS (29 of 292; one-sided 95% CI upper limit, 12.8; P < .001). If SNB was confined to blue/hot node, excluding adjacent palpable nodes, the FNR was 31.6% (74 of 234; one-sided 95% CI upper limit, 36.6). The FNR could be brought down to < 8.8% if three or more LNs were identified by LAS.CONCLUSIONLAS is superior to SNB in identification rate, FNR, and negative predictive value in predicting node-negative axilla post-NACT. LAS can be safely used to predict negative axilla with < 10% chance of leaving residual disease.
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- 2020
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6. Sterilization Rate of the Axilla After Neoadjuvant Chemotherapy: The Scope for Conservative Surgery
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Jarin Noronha, Shalaka Joshi, Rohini Hawaldar, Nita Nair, Vaibhav Vanmali, Vani Parmar, Tanuja Shet, and Rajendra Badwe
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
PURPOSE The role of axillary conservation after neoadjuvant chemotherapy (NACT) is debatable. We routinely carry out complete axillary lymph node dissection (ALND). This study was conducted to understand the pathologic axillary complete response (pAxCR) after NACT. MATERIALS AND METHODS We evaluated a prospective database of patients with breast cancer who underwent surgery after NACT in the year 2017 at our institution. NACT was administered to downstage locally advanced breast cancer or facilitate breast-conservation surgery. RESULTS Of 793 patients who underwent surgery after NACT, 97(12.2%) had cN0 disease, 407 (51.3%) had cN1, 262 (32%) had cN2, and 27 (3.4%) had cN3 at presentation. Eighty-eight patients (11.1%) had cT1-2 primary tumor stage, and 623 patients (78.6%) had cT3-4 primary tumor stage; primary tumor stage details were unavailable for 82 patients (10.3%). The median age was 46 years (range, 21-74 years). On histopathology, the overall pAxCR rate was 52.8%. In the cN1 and cN2 settings, 58.7% and 36.6% of patients achieved ypN0 status, respectively. The overall pathologic complete response rate was 22.64% (161 of 711 patients). On univariable analysis, cN stage, histologic grade, hormone receptor status, NACT duration, and lymphovascular invasion were significantly associated with pAxCR (P
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- 2020
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7. Critical Role of Flow Cytometric Immunophenotyping in the Diagnosis, Subtyping, and Staging of T-Cell/NK-Cell Non-Hodgkin’s Lymphoma in Real-World Practice: A Study of 232 Cases From a Tertiary Cancer Center in India
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Prashant R. Tembhare, Gaurav Chatterjee, Anumeha Chaturvedi, Niharika Dasgupta, Twinkle Khanka, Shefali Verma, Sitaram G. Ghogale, Nilesh Deshpande, Karishma Girase, Manju Sengar, Bhausaheb Bagal, Hasmukh Jain, Dhanalaxmi Shetty, Sweta Rajpal, Nikhil Patkar, Tushar Agrawal, Sridhar Epari, Tanuja Shet, Papagudi G. Subramanian, and Sumeet Gujral
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immunophenotyping ,T cell ,non-Hodgkin’s lymphoma ,real-world practice ,flow cytometry ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
BackgroundT-cell/NK-cell non-Hodgkin’s lymphoma (T/NK-NHL) is an uncommon heterogeneous group of diseases. The current classification of T/NK-NHL is mainly based on histopathology and immunohistochemistry. In practice, however, the lack of unique histopathological patterns, overlapping cytomorphology, immunophenotypic complexity, inadequate panels, and diverse clinical presentations pose a great challenge. Flow cytometric immunophenotyping (FCI) is a gold standard for the diagnosis, subtyping, and monitoring of many hematological neoplasms. However, studies emphasizing the role of FCI in the diagnosis and staging of T/NK-NHL in real-world practice are scarce.MethodsWe included T-cell non-Hodgkin’s lymphoma (T-NHL) patients evaluated for the diagnosis and/or staging of T/NK-NHL using FCI between 2014 and 2020. We studied the utility of FCI in the diagnosis and subtyping of T/NK-NHL and correlated the FCI findings with the results of histopathology/immunohistochemistry. For correlation purposes, patients were categorized under definitive diagnosis and subtyping, inadequate subtyping, inadequate diagnosis, and misdiagnosis based on the findings of each technique.ResultsA total of 232 patients were diagnosed with T/NK-NHL. FCI findings provided definitive diagnoses in 198 patients and subtyping in 187/198 (95.45%) patients. The correlation between FCI and histopathological/immunohistochemistry results (n = 150) demonstrated an agreement on the diagnosis and subtyping in 69/150 (46%) patients. Of the remaining cases, the diagnosis and subtyping were inadequate in 64/150 (42.7%), and 14/150 (9.33%) were misdiagnosed on histopathology/immunohistochemistry results. FCI provided definitive diagnosis and subtyping in 51/64 (79.7%) patients. Among these, 13 patients diagnosed with peripheral T-cell lymphoma not-otherwise-specified were reclassified (angioimmunoblastic T-cell lymphoma (AITL)-11 and prolymphocytic leukemia-2) on FCI. It corrected the diagnosis in 14 patients that were misdiagnosed (6 B-cell NHL (B-NHL), 3 Hodgkin’s lymphoma, 1 acute leukemia, and 1 subcutaneous panniculitis-like T-cell lymphoma) and misclassified (3 T-NHL) on histopathological results. AITL was the commonest T-NHL misclassified on histopathological results. FCI also confirmed the definite involvement in 7/83 (8.4%) and 27/83 (32.5%) bone marrow (BM) samples reported as suspicious and uninvolved, respectively, on histopathological evaluation.ConclusionAITL was the most frequently diagnosed T/NK-NHL in this study. FCI provided a distinct advantage in detecting BM involvement by T/NK-NHL, especially in patients with low-level involvement. Overall, our study concluded that FCI plays a critical role in the diagnosis, subtyping, and staging of T/NK-NHL in real-world practice.
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- 2022
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8. Impact of COVID-19 on quality checks of solid tumor molecular diagnostic testing-A surveillance by EQAS provider in India.
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Omshree Shetty, Tanuja Shet, Ramya Iyer, Prachi Gogte, Mamta Gurav, Pradnya Joshi, Nupur Karnik, Trupti Pai, Sridhar Epari, and Sangeeta Desai
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Medicine ,Science - Abstract
BackgroundMolecular tests in solid tumours for targeted therapies call for the need to ensure precision testing. To accomplish this participation in the External Quality Assessment Program (EQAS) is required. This evaluates the consistency of diagnostic testing procedures and offers guidance for improving quality. Outbreak of COVID-19 pandemic led to worldwide lockdown and disruption of healthcare services including participation in EQAS.The present study describes the extended scope of EQAS offered byMPQAP (Molecular Pathology Quality Assurance Program), the first proficiency test provider for solid tumor diagnostics in India. The study surveys the preparedness of molecular testing laboratories in routine diagnostics and participation for quality assessment scheme.MethodsA documented guideline for measures and precautions to be carried by testing laboratories in performing routine diagnostic tests during the lockdown period were charted and distributed to all MPQAP participant centres. A survey was conducted for MPQAP participants to check whether laboratories were involved in COVID-19 testing and to evaluate the impact of lockdown on the operations of diagnostics procedures. From the acquired response of the survey, 2 cycles out of initially proposed 11 cycles were executed with transformed approach using digital tools and image interpretation modules.FindingsOut of 25 solid tumour testing laboratories registered as participants, 15 consented to participate in survey. The summary of survey conveyed the impact of COVID-19onroutine operations of diagnostics tests such as shortcomings in inventory and human resource management. Thirteen participants showed active willingness and consented to participate in EQAS test scheme.InterpretationsThe survey findings and assessment of EQAS cycles endorsed the quality testing procedures carried by participating laboratories throughout the lockdown. It highlighted the utility of EQAS participation during pandemic along with emphasis on safety measures for continual improvement in quality of diagnostic services.
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- 2022
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9. Merits of Level III Axillary Dissection in Node-Positive Breast Cancer: A Prospective, Single-Institution Study From India
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Shalaka Joshi, Jarin Noronha, Rohini Hawaldar, Girish Kundgulwar, Vaibhav Vanmali, Vani Parmar, Nita Nair, Tanuja Shet, and Rajendra Badwe
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
PURPOSE: A complete axillary lymph node (ALN) dissection is therapeutic in node-positive breast cancer. Presently, there is no international consensus regarding anatomic levels to be addressed in complete axillary dissection. We assessed the burden of disease in level III axilla. MATERIALS AND METHODS: A prospectively maintained database was assessed for 1,591 consecutive patients with nonmetastatic breast cancer registered at Tata Memorial Center, Mumbai, between January 2009 and December 2014. RESULTS: A median of four (zero to 20) level III ALNs were dissected and a median of two (one to 17) nodes were positive. A total of 27.3% (434 of 1,591) patients had level III ALN metastasis, and 4.7% of patients had positive interpectoral nodes. Some 53.2% of patients had level III metastases in the presence of four or more positive level I and II ALNs. A total of 9.4% of patients had level III involvement when one to three ALNs were positive in level I and II (P < .001). Some 53.2% of patients had level III metastases in the presence of four or more positive level I and II ALNs. On logistic regression analysis, four or more positive ALNs in level I or II (P < .001), inner/central quadrant tumor location (P = .013), and perinodal extension (P < .001) were associated with level III ALN involvement. At a median follow-up of 36 months, the disease-free survival was significantly worse for level III ALN metastases on univariate analysis (P < .001). On multivariate Cox regression analysis, histologic grade (P = .006), four or more positive ALNs (P < .001), hormone receptor status (P < .001), and tumor size (P = .037) were independent prognostic factors for disease-free survival. CONCLUSION: The axillary nodal burden is high in patients with breast cancer in developing countries like India. One of two women with four or more positive level I and II ALNs may have residual disease in level III if it is not cleared during surgery. Intraoperative interpectoral space clearance should be considered in the presence of either palpable interpectoral lymph nodes or multiple positive ALNs.
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- 2019
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10. Rare presentations and literature review of Rosai Dorfman disease of the breast
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Asha Reddy, Shalaka Joshi, Palak Popat, and Tanuja Shet
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Rosai Dorfman disease of breast ,Breast cancer mimic ,Pathology ,RB1-214 - Abstract
Introduction: Rosai-Dorfman disease (RDD) is a rare, idiopathic, proliferative disorder of histiocytes usually involving head-neck lymph nodes. It can also involve extra nodal sites like skin, nasal sinuses, and soft tissue. It rarely affects the breast. Case presentation: We present three unusual case scenarios of breast RDD. One presented with breast lump, clinico-radiologically mimicking early breast cancer. The second case was thought to be de-novo metastatic breast cancer, but was found to have disseminated RDD of breast, lymph nodes and bones. The third patient was that of cervical lymphadenopathy in a breast cancer survivor masquerading as recurrence. In all 3, histopathology showing emperipolesis and immunohistochemical staining with S100 clinched the diagnosis. Discussion: The diagnosis of RDD is made by histopathology. The classic histological picture consists of a lymphoid rich associated infiltrate, atypical nuclei of the histiocytes and lack of fat necrosis or acute inflammatory cells. These histiocytes typically stain positive with S100 and CD168 on immunohistochemistry. Hence, an excision biopsy is often necessary, and mostly the only treatment needed. However, if the disease is disseminated or has massive lymphadenopathy, a course of oral steroids or chemotherapy is indicated. Conclusion: RDD of the breast usually has an indolent, benign, and non-aggressive course that requires minimum treatment. A high index of suspicion and accurate histopathological diagnosis is utmost important for proper management.
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- 2021
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11. Epithelioid hemangioendothelioma of breast with nodal metastasis masquerading as breast carcinoma: An unusual case with review of literature
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Trupti Pai, Tanuja Shet, Asawari Patil, Vani Parmar, Tabassum Wadasadawala, and Sangeeta B. Desai
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Breast ,Epithelioid hemangioendothelioma ,CD31 ,Mastectomy ,Nodal metastases ,Pathology ,RB1-214 - Abstract
Epithelioid Hemangioendothelioma (EHE) is a vascular tumour with intermediate malignant potential which rarely occurs in the breast. We report a unique case of EHE of breast that presented with nodal metastases along with the review of literature. This case was initially misdiagnosed on fine needle aspiration cytology (FNAC) as breast carcinoma; however, histopathology revealed the characteristic short strands and single cell infiltrating pattern by epithelioid cells embedded in a myxohyaline matrix. The typical intracytoplasmic vacuoles with red blood cells were seen in occasional cell hinting at the vascular nature of tumor. Patchy foci of nuclear atypia, pleomorphism and frequent mitoses were seen. Although focal reactivity for AE1/AE3 initially did lead to a differential diagnosis of carcinoma, diffuse positivity for vascular differentiation markers like CD31, CD34 and FLI-1 clenched the diagnosis of EHE. The patient underwent modified radical mastectomy with axillary dissection with post-operative locoregional adjuvant radiation therapy. Till date, with a follow-up of 36 months patient is fine with no event. To conclude EHE can occur in breast and show nodal metastasis like breast carcinomas. However awareness of histologic features with typical immunohistochemistry (IHC) will assist the diagnosis. Inspite of nodal metastasis patient has an uneventful follow up indicating a non-aggressive behavior of this tumor.
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- 2021
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12. Applicability of 2008 World Health Organization classification system of hematolymphoid neoplasms: Learning experiences
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Sushil Modkharkar, Pooja Navale, Pratibha Kadam Amare, Anuradha Chougule, Nikhil Patkar, Prashant Tembhare, Hari Menon, Manju Sengar, Navin Khattry, Shripad Banavali, Brijesh Arora, Gaurav Narula, Siddhartha Laskar, Nehal Khanna, Mary Ann Muckaden, Venkatesh Rangarajan, Archi Agrawal, Tanuja Shet, Sridhar Epari, P G Subramanian, and Sumeet Gujral
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Extranodal lymphomas ,hematolymphoid neoplasms ,leukemia ,lymphoma ,pediatric hematolymphoid neoplasms ,World Health Organization classification ,Pathology ,RB1-214 ,Microbiology ,QR1-502 - Abstract
Background: 2008 World Health Organization (WHO) classification of hematolymphoid neoplasms (HLN) has classified them based on morphology, results of various ancillary techniques, and clinical features.[1] There are no studies looking at the applicability of WHO classification. Aims: The aim of the study was to calculate proportions of all HLN subtypes seen during 1-year period based on 2008 WHO classification of HLN and study applicability and also shortcomings of practices in a tertiary care center in India. Materials and Methods: This was a 1-year retrospective study (January 1st, to December 31st, 2010) where cases were identified using hospital/laboratory electronic records. Old follow-up and referral cases were excluded from the study. Only newly diagnosed cases classified into categories laid down by 2008 WHO classification of HLN included. Results: Out of 2118 newly diagnosed classifiable cases, 1602 (75.6%) cases were of lymphoid neoplasms, 489 (23.1%) cases of myeloid neoplasms, 16 (0.8%) cases of histiocytic and dendritic cell neoplasms, and 11 (0.5%) cases of acute leukemias of ambiguous lineage. Overall, most common HLN subtype was diffuse large B-cell lymphoma (n = 361, 17.0%). Precursor B-lymphoblastic leukaemia/lymphoma (n = 177, 48.2%) was the most common subtype within pediatric age group. Conclusions: All major subtypes of HLN were seen at our center and showed trends almost similar to those seen in other Indian studies. Molecular/cytogenetic studies could not be performed on a significant number of cases owing to logistic reasons (unavailability of complete panels and also cost-related issues) and such cases could not be classified as per the WHO classification system.
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- 2018
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13. An unusual presentation of large B-cell lymphoma with interferon regulatory factor 4 gene rearrangement
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Anuj Verma, Sridhar Epari, Sumeet Gujral, and Tanuja Shet
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Diffuse ,follicular ,interferon regulatory factor 4 ,lymphoma ,multiple myeloma oncogene 1 ,pediatric ,Pathology ,RB1-214 ,Microbiology ,QR1-502 - Abstract
Rearrangements involving interferon regulatory factor 4 (IRF4) gene has been recently described in a subtype of diffuse large B-cell lymphoma (DLBCL). They occur in a typical clinical setting of a pediatric age group, predominantly with tonsillar mass, usually as a low-stage disease and with good response to chemotherapy. Histomorphologically, they show nodular/follicular architecture with diffuse strong immunopositivity for multiple myeloma oncogene 1. Here, the authors describe one such unusual case of large B-cell lymphoma with IRF4 gene rearrangement in a young child with the unusual location of inguinal region and detailed pathological (histological, immunohistochemical, and molecular) findings.
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- 2018
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14. Activation of phosphoinositide 3-kinase/Akt/mechanistic target of rapamycin pathway and response to everolimus in endocrine receptor-positive metastatic breast cancer – A retrospective pilot analysis and viewpoint
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Jyoti Bajpai, Anant Ramaswamy, Arun Chandrasekharan, Surya Mishra, Tanuja Shet, Sudeep Gupta, and R A Badwe
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Everolimus ,mechanistic target of rapamycin ,metastatic breast cancer ,phosphatase and tensin homolog ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Introduction: Biomarkers predictive of response to mechanistic target of rapamycin (mTOR) inhibitor, everolimus, in endocrine receptor (ER)-positive metastatic breast cancer (MBC) are a work in progress. We evaluated the feasibility of directly measuring mTOR activity and phosphatase and tensin homolog (PTEN) expression and correlating their expression with response and survival. Materials and Methods: MBC patients who received everolimus with endocrine therapy (ET) after progression on an aromatase inhibitor and had adequate tissue preservation for estimation of mTOR activity and PTEN expression were selected for analysis from a prospectively maintained database. Progression-free survival (PFS) and overall survival (OS) were estimated by Kaplan–Meier method, and correlation between mTOR activity and PTEN expression with survival was done by log-rank test. Results: Thirteen ER-positive MBC patients were available for analysis. PTEN expression was lost in 11/13 (84.6%) patients and retained in 2/13 patients (15.4%). mTOR activity was absent in four patients (30.7%), weak in six patients (46.1%), and moderate in 3 patients (23.2%). Median PFS for the entire population was 2.5 months while median OS was not reached. Patients with an absent mTOR activity showed a longer PFS (5 vs. 1.5 vs. 2 months) than those with weak and moderate activity, respectively (P = 0.043). There was no correlation between loss of PTEN expression and PFS. Conclusions: Measurement of direct mTOR activity in patients with MBC receiving everolimus/ET combination appears feasible. Absent mTOR activity may predict for longer PFS with everolimus-ET combination and requires further study.
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- 2017
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15. Story of survival in anaplastic large cell lymphoma - sometimes more than the anaplastic lymphoma kinase status: An evaluation of pathologic prognostic factors in 102 cases
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Komal Agrawal, Tanuja Shet, Epari Sridhar, Suhas Dhende, Manju Sengar, Brijesh Arora, Siddhartha Laskar, Sumeet Gujral, Hari Menon, and Shripad Banavali
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Anaplastic lymphoma kinase ,large cell lymphoma ,non-Hodgkin's lymphoma ,Pathology ,RB1-214 ,Microbiology ,QR1-502 - Abstract
Introduction: Systemic anaplastic large cell lymphoma (ALCL) accounts for 5%–10% of adult non Hodgkin's lymphoma (NHL) and 10%–30% of childhood NHL. Owing to significant differences in survival and gene expression profile, current WHO classifies ALCL into two distinct entities as anaplastic lymphoma receptor tyrosine kinase (ALK) positive and ALK negative ALCL with ALK expression by tumour as a good prognostic indicator. However, in our institute which is a cancer referral institute, our preliminary experience was that even ALK positive tumours did not fare well as compared to ALK- negative ALCL. So, the current study aims at exploring more clinical and pathological factors impacting survival in ALCL patients. Objective: To study clinical and pathological prognostic factors in cases of ALCL. Methods: 102 cases of ALCL were retrieved from pathology database. Pathological features and clinical features of these cases were recorded and factors found to impact overall survival (OAS) and disease-free survival (DFS) curves were identified based on univariate and multivariate analysis. Results: ALK 1 expression was seen in 71/102 (69.6%) cases and was not found to impact OAS or DFS. The 2 year OAS rate for ALK positive patients was 63.5% and DFS rate was 54.4%, while for ALK negative patients, the OAS was 60.5% and DFS was 43.5%. The Ann Arbor stage, performance status, international prognostic index, histological subtype, and the degree of the background inflammatory infiltrate were found to impact the OAS significantly. Increased reactive inflammatory component also negatively impacted DFS. In the multivariate analysis, only the histologic type emerged as significant for OAS. Conclusion: Though ALK plays a role in prognostication of systemic ALCL, advanced stage disease and an inflammatory milieu may modulate the final outcome. We report a study of clinical and pathologic prognostic features in 102 cases of anaplastic large cell lymphoma (ALCL) from a cancer referral institute in India. Anaplastic lymphoma receptor tyrosine kinase (ALK-1) expression was seen in 71/102 (69.6%) cases and was not found to impact overall survival (OAS) or disease-free survival (DFS). The 2-year OAS rate for ALK-positive patients was 63.5% and DFS rate was 54.4%, while for ALK-negative patients, the OAS was 60.5% and DFS was 43.5%. The Ann Arbor stage, performance status, international prognostic index, histological subtype, and the degree of the background inflammatory infiltrate were found to impact the OAS significantly. Increased reactive inflammatory component also negatively impacted DFS. In the multivariate analysis, only the histologic type emerged as significant for OAS. Thus, though ALK plays a role in prognostication of systemic ALCL, advanced stage disease and an inflammatory milieu may modulate the final outcome.
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- 2017
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16. Breast cancer: An overview of published Indian data
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Bharath Rangarajan, Tanuja Shet, Tabassum Wadasadawala, Nita S Nair, R Madhu Sairam, Sachin S Hingmire, and Jyoti Bajpai
- Subjects
Breast cancer ,carcinoma breast ,Indian data ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
The Incidence of breast cancer has been steadily increasing in the last two decades, more so in urban areas of the sub-continent. Cancer ceters across the country have large numbers of patients being treated with multiple publications in this field. Inspite of paucity of prospective data and randomised clinical trials from India, there are large number of retrospective publications on various aspects of the disease including pathology, radiology, surgery, chemotherapy, radiation, palliative care and alternatitive treatment modalities. These published data provide an insight into the trends of breast cancer in the country and this comprehensive data review of Indian data will provide a basis for designing trials relevant to our population and planning health care.
- Published
- 2016
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17. Metastatic nasopharyngeal carcinoma presenting as an isolated breast mass: A diagnostic pitfall and a review of literature
- Author
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Trupti Pai, Nita Nair, Gauri Pantvaidya, Kedar Deodhar, and Tanuja Shet
- Subjects
Epstein–Barr virus-encoded RNA-in situ hybridization ,metastases to breast ,nasopharyngeal carcinoma ,Pathology ,RB1-214 ,Microbiology ,QR1-502 - Abstract
Metastases to breast are much rarer than primary breast tumors. We now present a case of 45-year-old female, who presented with an isolated breast mass. A positron emission tomography-computed tomography (PET-CT) done revealed hypermetabolic right breast nodules, soft tissue deposits, and multiple nodal involvement. The biopsy from the breast and axillary lymph node showed dense lymphoid infiltrate and was interpreted initially as granulomatous inflammation. However, the lumps were hard and suspicious for primary breast cancer, so an immunohistochemistry for cytokeratin was performed which highlighted the epithelial cell clusters masked within the inflammatory infiltrate and the diagnosis of undifferentiated carcinoma, lymphoepithelioma-like was made. After the diagnosis was made, it was realized that the patient had been treated earlier for a nasopharyngeal carcinoma (NPC). The in situ hybridization (ISH) test for Epstein–Barr virus-encoded RNA ISH was positive in the tumor cells, and hence, a diagnosis of metastatic NPC was finally made. The patient subsequently developed extensive nodal, skeletal, and soft tissue metastatic disease but was alive till September 2015. Although extremely rare, metastatic NPC can occur in the breast and the above case highlights that it mimics an inflammatory lesion. This case highlights the importance of the multidisciplinary approach for appropriate tumor diagnosis and patient management.
- Published
- 2017
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18. HER 2 status in invasive breast cancer: Immunohistochemistry, fluorescence in-situ hybridization and chromogenic in-situ hybridization
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Hemlata S Shirsat, Sridhar Epari, Tanuja Shet, Rajani Bagal, Rohini Hawaldar, and Sangeeta B Desai
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Breast cancer ,chromogenic in-situ hybridization ,fluorescence in-situ hybridization ,HER2/neu ,immunohistochemistry ,Pathology ,RB1-214 ,Microbiology ,QR1-502 - Abstract
Introduction : HER2/neu gene status in breast cancers can be evaluated by targeting protein and gene - immunohistochemistry (IHC) and fluorescence in-situ hybridization (FISH). Recent studies have shown chromogenic in-situ hybridization (CISH) as a relatively cheaper alternative. Materials and Methods : Forty-three nonconsecutive, randomly selected primary invasive breast cancer cases were evaluated for c-erbB-2 (HER2 protein) by IHC and gene amplification by FISH and CISH. Results of each of the same were compared. Results : CISH showed approximately 90% and 100% concordance for IHC negative and positive cases, respectively; while approximately 94.4% and 91% concordance with FISH amplified and non-amplified cases, respectively. Conclusion : This study showed feasibility of incorporation of CISH as a low cost option in routine management of breast carcinoma in the Indian setting. Secondly, reconfirmation of IHC negative and positive cases can be done by CISH.
- Published
- 2012
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19. Primary cutaneous marginal zone lymphoma (immunocytoma like) with lymphoepithelioid or Lennert′s lymphoma like involvement of nodes
- Author
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Tanuja Shet, Rajan Basak, and Sridhar Epari
- Subjects
Immunocytoma ,lymphoepithelioid lymphoma ,lymphoma ,primary cutaneous marginal zone lymphoma ,Pathology ,RB1-214 ,Microbiology ,QR1-502 - Abstract
Primary cutaneous marginal zone lymphomas (PCMZL) have a wide range of morphology from tumors with monocytoid B cells to those composed entirely of plasma cells and the T-cell rich variants. We report a 60-year-old male with a PCMZL rich in plasma cells of the foot with a lymphoepithelioid-like pattern of dissemination to the lymph nodes posing problems in the diagnosis. The patient had a lesion on the dorsum of the foot which histologically revealed dense perivascular collections of lymphoid cells and plasma cells amidst fibrous tissue. Though the plasma cells did show light chain restriction, CD20 and CD3 did not reveal an overwhelming B/T-cell population and hence a diagnosis of a reactive process was offered. Subsequently the patient developed inguinal nodes with diffuse loss of architecture and replacement by epithelioid histiocytes and reactive T cells with few large B cells (lymphoepithelioid-like pattern). On pathology review it was realized that the two lesions may be related and clonality studies were asked for. The skin lesion showed clonally rearranged IgH receptor while the T-cell receptor rearrangement was negative. The patient developed disseminated disease and received six cycles of chemotherapy with partial response and 6 years after the initial presentation was alive with nonprogressive disease. Thus, the polymorphous background in PCMZL is evolving and an immunocytoma-like tumor can show a T-cell rich or Lennert′s like growth pattern of spread and early recognition these odd patterns may aid in appropriate management of patients.
- Published
- 2012
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- View/download PDF
20. In situ follicular neoplasia/lymphoma: Three illustrative cases exemplifying unique disease presentations
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Uma Sakhadeo, Ashwini Mane, and Tanuja Shet
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Follicular lymphoma ,follicular lymphoma in situ ,non-Hodgkin′s lymphoma ,Pathology ,RB1-214 ,Microbiology ,QR1-502 - Abstract
We report three elderly patients with follicular lymphoma in situ (FLIS) each highlighting a unique pattern of disease presentation and progression. The first patient had incidentally detected FLIS with peripheral blood spill and yet had an 11-year uneventful follow up. The second patient with an overt follicular lymphoma (FL) developed high-grade transformation in jejunum with FLIS extensively involving the Payers patches. The third patient had a FLIS but that qualified as higher grade and was treated in spite of lack of overt FL mainly because of higher grade and patient subsequently did develop overt FL. The first case of typical FLIS confirms that peripheral blood spill does not connote poor prognosis in FLIS, the second case illustrates that FLIS may colonize mucosa-associated lymphoid tissue as part of homing in process of a disseminated FL and the third case validates the aggressive nature of high-grade FLIS.
- Published
- 2012
- Full Text
- View/download PDF
21. Concomitant follicular lymphoma and histiocytic sarcoma: A rare progression, trans-differentiation or co-occurrence?
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Anuj Verma and Tanuja Shet
- Subjects
Follicular lymphoma ,histiocytic sarcoma ,trans-differentiation ,Pathology ,RB1-214 ,Microbiology ,QR1-502 - Abstract
Trans-differentiation of follicular lymphoma (FL) into a histiocytic sarcoma (HS) is a rare event and usually occurs as a sequential event. We report a case where in the same node with two distinct areas one of low-grade FL and another with HS was observed. This patient was a 58 years old with generalized lymphadenopathy and Ann Arbor Stage III disease. The cervical node biopsy on histological examination revealed two distinct areas, firstly a FL with nodular architecture and the other a smaller focus of sheets of pleomorphic histiocytic cells diffusely arranged at the edge of the section contiguous with FL with few cells in transiting phase. On immunohistochemistry the FL was positive for CD20, CD10, PU.1, PAX5 and Bcl2, while the large histiocytic cells were positive for CD163, CD68, LCA, and PU.1, weakly for PAX5 and negative for CD20, CD10, CD30, CD3, CD1a, Bcl2, S100, and Alk-1. The therapeutic implications of this diagnosis and postulated theories on trans-differentiation are discussed.
- Published
- 2015
- Full Text
- View/download PDF
22. Tubulocystic carcinoma of kidney associated with papillary renal cell carcinoma
- Author
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Mahesh Deshmukh, Tanuja Shet, Ganesh Bakshi, and Sangeeta Desai
- Subjects
Kidney tumor ,renal carcinoma ,tubulocystic renal cell carcinoma ,Pathology ,RB1-214 ,Microbiology ,QR1-502 - Abstract
Tubulocystic renal cell carcinoma (TCRCC) is a rare variant of renal cell carcinoma, which has distinct histology but there is some controversy about its association with papillary renal cell carcinoma (PRCC) and cell of origin in literature. We report an 18-year-old girl with the rare TCRCC of kidney associated with PRCC with metastases to the para-aortic nodes. The patient presented with hematuria and a right renal mass with enlarged regional nodes for which a radical nephrectomy with retroperitoneal lymph node dissection was done. On gross examination, a solid cystic lesion involving the lower pole and middle pole of the kidney measuring 12x9x9 cm was seen along with an additional cystic lesion in upper pole of kidney. Microscopically the main tumor showed the typical histology of a tubulocystic carcinoma with multiple cysts filled with secretions lined by variably flattened epithelium with hobnailing of cells. The mass in the upper pole was a high-grade PRCC and the nodal metastases had morphology similar to this component. To conclude, at least a small but definite subset of TCRCC is associated with PRCC, and cases associated with PRCC do seem to have a higher propensity for nodal metastasis as in the case we report.
- Published
- 2011
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- View/download PDF
23. Gastric myeloid sarcoma - A report of two cases addressing diagnostic issues
- Author
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Viijaya Gadage, Gargi Zutshi, Santosh Menon, Tanuja Shet, and Sudeep Gupta
- Subjects
Acute myeloid leukemia ,myeloid sarcoma ,stomach ,Pathology ,RB1-214 ,Microbiology ,QR1-502 - Abstract
Presented herein are two cases of gastric myeloid sarcoma to highlight the diagnostic conundrum and pointers toward accurate diagnosis in such instances. The first case was a 35-year-old man with an ulceronodular mass in the body of stomach. Multiple biopsies were reported as inconclusive chiefly due to the fact that the lamina propria infiltrate was innocuous and failed to mark with CD20 or CD3. Subsequently the patient had extensive disseminated disease which was recognized as myeloid sarcoma but patient succumbed to the disease soon. The second case was a 25-year-old boy who presented with symptoms of gastric outlet obstruction since 6 months. An endoscopy revealed diffuse gastric wall thickening which on biopsy was recognized as myeloid sarcoma but patient developed intestinal obstruction and required ileal resection for symptomatic relief, postoperative patient never recovered and succumbed to the disease. Both patients had marrow involvement by acute myeloid leukemia (AML-M2) with a normal leukocyte count in peripheral blood. Thus gastric myeloid sarcomas are prone to a delayed diagnosis chiefly due to rarity. Pathologist should think of myeloid sarcoma in a hematolymphoid appearing tumor in stomach that is CD20, CD3 negative, has avid Ki67 and shows an infiltrate chiefly centered in lamina propria.
- Published
- 2011
- Full Text
- View/download PDF
24. Nodular lymphocyte predominant Hodgkin's lymphoma (NLPHL): Early outcomes
- Author
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Bhavin Visariya, Nehal R. Khanna, Nikhil Kalyani, Jayant Godasastry, Hari Menon, Manju Sengar, Navin Khattry, Uma Dangi, Brijesh Arora, Tanuja Shet, Sumeet Gujral, Epari Sridhar, Venkatesh Rangarajan, Shripad Banavali, and Siddhartha Laskar
- Subjects
Pediatrics ,RJ1-570 - Published
- 2016
- Full Text
- View/download PDF
25. Primary cardiac diffuse large B-cell lymphoma with activated B-cell-like phenotype
- Author
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Vijaya Gadage, Seema Kembhavi, Prabhash Kumar, and Tanuja Shet
- Subjects
Cardiac tumor ,diffuse large B-cell lymphoma ,non-Hodgkin′s lymphoma ,Pathology ,RB1-214 ,Microbiology ,QR1-502 - Abstract
Primary cardiac lymphoma (PCL) is a rare and fatal disorder. It may often mimic other common cardiac tumors like cardiac myxoma because of similarities in the clinical presentation. We report a case of PCL of diffuse large B-cell type, in a 38-year-old, immunocompetent male who presented with superior vena cava syndrome that was excised as a myxoma. Histology revealed a large cell population diffusely and strongly expressing CD45, CD20, MUM1/IRF4 and FOXP1 hinting at an activated B-cell (ABC)-like phenotype. After four cycles of Rituximab with CHOP (cyclophosphamide, hydroxydaunorubicin, Oncovin, and prednisolone) the tumor regressed completely but the patient had a relapse and subsequently succumbed to the disease confirming the aggressive nature. The aggressive behavior of PCL may be possibly linked to its ABC-like origin.
- Published
- 2011
- Full Text
- View/download PDF
26. Splenic angiomatoid nodular transformation in child with inflammatory pseudotumor-like areas
- Author
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Monika Vyas, Mahesh Deshmukh, Tanuja Shet, and Nirmala Jambhekar
- Subjects
Pediatric ,sclerosing angiomatoid nodular transformation ,spleen ,Pathology ,RB1-214 ,Microbiology ,QR1-502 - Abstract
Reports of sclerosing angiomatoid transformation (SANT) in the pediatric age group are rare. We present a case of SANT in an 11-year-old child with a history of trauma presenting with rapidly growing splenic lesion since 2 months. A partial splenectomy revealed a well-demarcated nodular lesion 5 × 4 × 4 cm with central area of fibrosis. Most part of the lesion showed ill-defined nodules or diffuse areas of plump epithelioid appearing endothelial units that marked with CD31, but the internodular stroma was inflammatory pseudotumor (IPT)-like with a mitotic count of 1-2/10 hpf. The angiomatoid nodules were diffusely positive for CD31, CD163, and CD68; however, they were negative for CD34, CD30, smooth muscle actin, and CD8. Epstein-Barr virus-encoded RNA in situ hybridization (EBER-ISH) was negative. The MIB1 labeling was fairly high in the IPT area but low in the angiomatoid areas. After the diagnosis of SANT, the patient has had an uneventful follow-up for more than 3 years since surgery. The morphologic findings in the case being discussed reaffirm the finding that SANT may have an IPT component and it can be seen even in pediatric age group.
- Published
- 2011
- Full Text
- View/download PDF
27. Unique challenges and outcomes of young women with breast cancers from a tertiary care cancer centre in India
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Jyoti Bajpai, Pradeep Ventrapati, Shalaka Joshi, Tabassum Wadasadawala, Sushmita Rath, Rima Pathak, Ravindra Nandhana, Samarpita Mohanty, Qurratulain Chougle, Mitchelle Engineer, Nissie Abraham, Jaya Ghosh, Nita Nair, Seema Gulia, Palak Popat, Patil A, Tanuja Sheth, Sangeeta Desai, Meenakshi Thakur, Venkatesh Rangrajan, Vani Parmar, R. Sarin, S. Gupta, and R.A. Badwe
- Subjects
Young breast cancer ,Chemotherapy ,Outcomes ,Fertility ,Quality of life ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Young (≤40 years) breast cancers (YBC) are uncommon, inadequately represented in trials and have unique concerns and merit studying. Methods: The YBC treated with a curative intent between 2015 and 2016 at our institute were analysed. Results: There were 1228 patients with a median age of 36 (12–40) years; 38 (3.1%) had Stage I, 455 (37.1%) - II, 692 (56.3%) –III, and remaining 43 (3.5%) Stage IV (oligo-metastatic) disease; 927 (75.5%) were node positive; 422 (34.4%) were Triple negatives (TNBC), 331 (27%) were HER-2 positive. There were 549 (48.2%) breast conservations and 591 (51.8%) mastectomies of which 62 (10.4%) underwent breast reconstruction. 1143 women received chemotherapy, 617 (53.9%) received as neoadjuvant and 142 (23.1%) had pathological complete response; 934 (81.9%) received adjuvant radiotherapy. At the median follow-up of 48 (0–131) months, 5-year overall and disease-free survival was 79.6% (76.8–82.5) and 59.1% (55.8–62.6). For stage I, II, III and IV, the 5-year overall-survival was 100%, 86.7% (82.8–90.6), 77.3% (73.4–81.2), 69.7% (52.5–86.9) and disease-free survival was 94% (85.9–100), 65.9% (60.3–71.5), 55% (50.5–59.5), and 29.6% (14–45.2) respectively. On multivariate analysis, TNBC and HER-2+ subgroups had poorer survival (p = 0.0035). 25 patients had BRCA mutations with a 5-year DFS of 65.1% (95% CI:43.6–86.6). Fertility preservation was administered in 104 (8.5%) patients; seven women conceived and 5 had live births. Significant postmenopausal symptoms were present in 153 (13%) patients. Conclusion: More than half of the YBC in India were diagnosed at an advanced stage with aggressive features leading to suboptimal outcomes. Awareness via national registry and early diagnosis is highly warranted. Menopausal symptoms and fertility issues are prevalent and demand special focus.
- Published
- 2021
- Full Text
- View/download PDF
28. Outcomes of Patients with Splenic Marginal Zone Lymphoma Treated with Rituximab or Splenectomy: Report from Tertiary Cancer Center in India
- Author
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Bagal, Bhausaheb, Mandal, Tanmoy, Bonda, Avinash, Punatar, Sachin, Gokarn, Anant, Tembhare, Prashant, Jain, Hasmukh, Patkar, Nikhil, Epari, Sridhar, Sengar, Manju, Khattry, Navin, Tanuja shet, Gujral, Sumit, and Banavali, Shripad
- Published
- 2018
- Full Text
- View/download PDF
29. Pregnancy associated breast cancer (PABC): Report from a gestational cancer registry from a tertiary cancer care centre, India
- Author
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Jyoti Bajpai, Vijay Simha, T.S. Shylasree, Rajeev Sarin, Reema Pathak, Palak Popat, Smruti Mokal, Sonal Dandekar, Jaya Ghosh, Neeta Nair, Seema Gulia, Sushmita Rath, Shalaka Joshi, Tabassum Wadasadawala, Tanuja Sheth, Vani Parmar, S.D. Banavali, R.A. Badwe, and Sudeep Gupta
- Subjects
Pregnancy associated breast cancer (PABC) ,Registry ,Gestational ,Trimester ,Antepartum ,Postpartum ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Pregnancy associated breast cancer (PABC) is a rare entity and defined as breast cancer diagnosed during pregnancy or one-year post-partum. There is sparse data especially from low and middle-income countries (LMIC) and merits exploration. Methods: The study (2013–2020) evaluated demographics, treatment patterns and outcomes of PABC. Results: There were 104 patients, median age of 31 years; 43 (41%) had triple-negative disease, 31(29.8%) had hormone-receptor (HR) positive and HER2 negative, 14 (13.5%) had HER2-positive and HR negative and 16(15.4%) had triple positive disease. 101(97%) had IDC grade III tumors and 74% had delayed diagnosis. 72% presented with early stage (24, EBC) or locally advanced breast cancer (53, LABC) and received either neoadjuvant (n = 49) or adjuvant (n = 26) chemotherapy and surgery. Trastuzumab, tamoxifen, and radiotherapy were administered post-delivery. At a median follow up of 27 (IQR:19–35) months, the estimated 3-year event-free survival (EFS) for EBC and LABC was 82% (95% CI: 65.2–100) and 56% (95% CI: 42–75.6%) and for metastatic 24% (95% CI: 10.1%–58.5%) respectively.Of the 104 patients, 34 were diagnosed antepartum (AP) and 15 had termination, 2 had preterm and 16 had full-term deliveries(FTDs). Among postpartum cohort (n = 70), 2 had termination, 1 had preterm, 67 had FTDs. 83(including 17 from AP) children from both cohorts were experiencing normal milestones. Conclusion: Data from the first Indian PABC registry showed that the majority had delayed diagnosis and aggressive features(TNBC, higher grade). Treatment was feasible in majority and stage matched outcomes were comparable to non-PABCs.
- Published
- 2021
- Full Text
- View/download PDF
30. Primary angiosarcoma of the breast: Observations in Asian Indian women.
- Author
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Tanuja Shet, Alopa Malaviya, Mandar Nadkarni, Anagha Kakade, Vani Parmar, Rajan Badwe, and Roshni Chinoy
- Published
- 2006
- Full Text
- View/download PDF
31. Cytological evaluation of head and neck tumors in children—A pattern analysis.
- Author
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Brijal Dave, Tanuja Shet, Mukta Ramadwar, and Shubhada Kane
- Published
- 2006
- Full Text
- View/download PDF
32. Desmoplastic round cell tumor of childhood: Can cytology with immunocytochemistry serve as an alternative for tissue diagnosis?
- Author
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Brijal Dave, Tanuja Shet, and Roshni Chinoy
- Published
- 2005
- Full Text
- View/download PDF
33. THE RENAL PATHOLOGY IN CHILDREN DYING WITH HEPATIC CIRRHOSIS.
- Author
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KANDALKAR, TANUJA SHET BHUVANESHWARI, BALASUBRAMANIAM, MEENAKSHI, and PHATAK, ANURADHA
- Published
- 2002
34. Masquerade syndrome: sebaceous carcinoma presenting as an unknown primary with pagetoid spread to the nasal cavity.
- Author
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Tanuja Shet, Gauri Kelkar, Shashi Juvekar, Rajesh Mistry, and Anita Borges
- Subjects
CANCER patients ,EYELIDS ,NASAL cavity ,THERAPEUTICS ,CANCER - Abstract
Sebaceous carcinoma of the eyelid is an uncommon tumour with unusual modes of presentation. It can remain occult at the primary site, without producing any mass, masquerading as chronic blepharoconjunctivitis, while setting up metastases in the regional lymph nodes especially in the pre-auricular group. We report here a case that not only masqueraded as chronic blepharoconjunctivitis with nodal metastases from an 'unknown primary' in the neck, but whose tumour spread in a pagetoid manner along the nasolacrimal duct producing a nasal tumour that was believed to be the 'unknown primary'. This case emphasizes the need for ophthalmologists, ENT surgeons and pathologists to keep sebaceous carcinoma in mind while evaluating patients with chronic blepharoconjunctivitis and cervical node metastases from 'unknown primary'. Histological clues for picking up a sebaceous carcinoma at a metastatic site include a tumour with comedo or ductal growth pattern and intracytoplasmic lipid. [ABSTRACT FROM AUTHOR]
- Published
- 2004
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