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In 1971, Arrigoni MG et al., used the term “hamartoma” for breast lesions in 10 patients who presented with encapsulated breast tumours clinically and grossly resembling fibroadenomas. Hamartomas in breast lesions are very uncommon and include adenolipoma and chondrolipoma. Despite the availability of imaging modalities, it is often difficult to distinguish fibroadenoma from breast carcinoma. Chondrolipoma of the breast is a rare benign mesenchymal tumour composed of adipose and mature cartilaginous tissue, which is often mistaken for malignant lesions in preoperative studies, leading to overdiagnosis and overtreatment. Hence, a proper histopathological examination is required for a correct diagnosis. Only eight cases have been reported in the literature. This report presents one such rare case of lump in a 67-year-old female, which was suspected to be a fibroadenoma clinically and radiologically, but was diagnosed as chondrolipoma on histopathological examination. All routine investigations were within normal limits, and a clinical diagnosis of fibroadenoma was made. Mammography was done, comprising fat, soft tissue, and calcific strandings along with coarse calcific specks suggestive of BI-RADS (Breast Imaging-Reporting and Data System) Category 3: high probability of being benign.

Introduction: Breast cancer is the most frequent cancer among women. The CD34 immunohistochemical antigen serves as a tool in differentiating between benign and malignant breast lesions. It has been suggested that CD34 may be related to invasive potential. Aim: To evaluate the expression of the CD34 antigen in the stroma of benign and malignant breast lesions using the Immunohistochemistry (IHC) method. Materials and Methods: This cross-sectional study was conducted in the Department of Pathology in collaboration with the Department of Surgery at Sarojini Naidu Medical College, Agra, Uttar Pradesh, India over a period of 18 months (from January 2021 to June 2022), involving a total of 50 histopathologically confirmed cases of benign and malignant breast lesions. Postsurgical specimens, including biopsies and mastectomies, were fixed in 10% neutral buffered formalin. The initial diagnosis was made by Haematoxylin and Eosin (H&E)- stained tissue sections. Sections from the same block were subjected to IHC staining using a monoclonal antibody to the CD34 antigen, and the intensity of expression in stromal cells was graded from 0 to 3+ based on nuclear positivity: up to 5% stromal cells immunoreactive (grade-0), >5% and up to 25% (grade-1), >25% and up to 50% (grade-2), and > 50% (grade-3). The data was entered into Microsoft Excel 2007 and analysed using Statistical Package for Social Sciences (SPSS) statistical software version 19.0. The inferential statistics included the use of the Chi-square test. Results: Out of the total 50 cases evaluated, 25 (50%) were categorised as benign, and rest 25 (50%) were categorised as malignant lesions. Among the benign lesions, the most common lesion was fibroadenoma, accounting for 9 (36%) cases, followed by benign phyllode tumour, with 6 (24%) cases. Among malignant lesions, the most common lesion was Invasive Ductal Carcinoma (IDC), accounting for 23 (92%) cases. The intensity of CD34 expression was found to be significantly higher in benign as compared to malignant breast lesions. Out of the 25 benign breast cases, the maximum number of cases (19) showed Grade-3+ positivity, 5 cases showed Grade-2+, and 1 case showed Grade-0 positivity. However, among malignant lesions, maximum cases (23, 92%) showed Grade-0 on CD34 immunostaining. Conclusion: This study was undertaken to evaluate the CD34 expression in benign and malignant breast lesions which might be able to distinguish between the benign and malignant breast lesions. The most benign breast lesions express CD34 in the stroma, while it is almost totally lost in all malignant neoplasms. Loss of CD34 is associated with the tumour’s capacity for invasion. However, to determine its function as a therapeutic target in cases of breast cancer, additional research can also be done.

Myopericytoma (MPC) is a rare benign mesenchymal neoplasm with perivascular myoid differentiation that most commonly arises in middle adulthood. The lesion generally involves the subcutaneous soft tissue of the lower extremities. Histologically, it is characterised by concentric perivascular proliferation of spindled myoid cells with bland elongated nuclei associated with blood vessels. The present case series emphasises five cases of MPC in relatively younger-aged female patients. Fine Needle Aspiration Cytology (FNAC) was inconclusive in all five patients. Histopathological examination showed perivascular concentric proliferation of myoid tumour cells, which were ovoid, spindled, or round cells with abundant eosinophilic cytoplasm, and no nuclear atypia, hyperchromasia, or necrosis. Immunohistochemistry (IHC) was positive for Smooth Muscle Actin (SMA). Although MPC can be diagnosed through histopathological examination, IHC is required for confirmation.

Introduction: Oral cancer presents challenging and unresolved problems for the human population, accounting for as much as 30-40% of all carcinomas in India. The current research focuses on the use of the tumour marker β2-microglobulin as a surrogate marker in patients with Oral Squamous Cell Carcinoma (OSCC) for early detection of cancer. Aim: To evaluate the level of serum β2-microglobulin in histologically diagnosed OSCC patients and compare it with age- and sex-matched healthy controls. Materials and Methods: This was a cross-sectional study conducted in the Department of Pathology at SN Medical College, Agra, over a period of one year and six months. The study included 50 histologically diagnosed OSCC cases and 40 age- and sex-matched healthy controls. Blood samples were taken from the healthy controls and OSCC patients, and the level of serum β2-microglobulin was measured using Enzyme Linked Immunosorbent Assay (ELISA). Statistical analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 11. Z test and ANOVA test were used to compare various parameters. A p-value of

Introduction: The appropriate diagnosis of intra-abdominal lesions is difficult and often requires histopathological confirmation. Image guided Fine Needle Aspiration Cytology (FNAC) is a simple, readily available, safe, inexpensive, time saving, rapid procedure which prevent unnecessary surgical interventions. Aim: The study was conducted to determine the diagnostic efficacy of image guided FNAC in the assessment of intra- abdominal lesions and to determine age and sex distribution. Materials and Methods: This cross-sectional study was conducted in Department of Pathology SN Medical College Agra (from September 2019 to September 2021. Two hundred and seven patients who were detected to have abdominal lesions by Ultrasonography (USG) or Computed Tomography (CT), image guided Fine Needle Aspiration (FNA) was performed under all aseptic condition. The sample was spread onto slides, air-dried and stained with Giemsa and was fixed in 95% ethanol and stained with Papanicolaou’s stain. The cyto-histopathological association was done wherever possible, the overall accuracy, sensitivity, specificity, the Negative Predictive Value (NPV) and Positive Predictive Value (PPV) was calculated. Results: Out of 207 patients, 110 were males and 97 were females with male to female ratio of 1.13:1. Out of 207 cases, the aspirate was satisfactory in 201 (97%) cases. Unsatisfactory aspirate was obtained in 06 (3.0%) of cases. Among 207 cases, most common lesions were malignant 170(82.1%) cases, followed by inflammatory 31 (14.9%) cases and unsatisfactory 06 (3.0%) cases. Most common age group for malignant lesions was 59-68 years with 45 (26.4%) cases followed by 49-58 years with 41 (24.1%) cases. The majority of aspirates were from liver 78 cases (38.2%), followed by 47 cases (22.71%) from gall bladder and 44 cases (21.30%) from the lymph nodes. The sensitivity was 92.3% while specificity was 100%. The Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were 100% and 91.4%, respectively. The diagnostic accuracy of image guided FNAC was 95.8%. Conclusion: FNA of abdominal lesions guided by ultrasound is a quick, low-cost, safe, highly accurate, and minimally invasive approach for getting a tissue diagnosis in solid localised lesions of the abdomen.

Introduction: The granulomatous reaction is defined as a distinctive inflammatory pattern characterised by the granuloma. The term Granuloma was first coined by Virchow in 1864. The granuloma is characterised by collection of activated histiocytes, epithelioid cells and multinucleate giant cells that may or may not be rimed by lymphocytes and/or show central necrosis. The pattern of skin disease varies from one country to another and across different parts within same country. The granulomatous lesions of skin are a common and intriguing problem in developing countries. Aim: To study the histomorphological spectrum of granulomatous lesions of skin. Materials and Methods: This cross-sectional study was conducted in Department of Pathology, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India, over a period of two years (from September 2018 to September 2020). All skin biopsies coming to the Department of Pathology were fixed in 10% neutral buffered formalin for duration of 12 to 24 hours. Paraffin wax blocks were made and 3-4 micrometer section were taken and stained with Haematoxylin and Eosin (H&E), showing granulomas on histology were included in the study. On H&E, stained slide, granulomas were studied for type, morphology and site. Special stains were used for further evaluations and analysis. Results: Out of total 124 cases studied, the maximum patients 34 (27.41%) were of 11-20 years age group. The epithelioid granuloma was the most common type in 76 (61.29%) cases followed by histiocytic granuloma in 24 (19.35%). The infectious granulomatous dermatoses were the most common histological type in which tuberculosis was most common followed by leprosy. Most commonly the lesions were found to involve the whole dermis in 74 (59.68%) cases, followed by upper and mid dermis in 35 (28.22%) cases. Out of 40 cases of leprosy, 17 (42.50%) cases were found Wade-Fite Stain positive. Out of total 57 cases of tuberculosis, 31 (54.38%) cases were found Acid-Fast Bacillus (AFB) positive. Conclusion: Authors concluded that major cause of granulomatous dermatoses in developing countries is still infectious, tuberculosis and leprosy being the leading causes. Histopathology is gold standard for diagnosis and categorisation of granulomatous dermatoses. Special stains are useful in cases of any dilemma

Introduction: Ovary is the most common site of neoplastic and non neoplastic lesion, can present in childhood to postmenopausal age group and remain the most lethal of all gynaecological malignancies. Tumour Protein (p53) gene mutations or deletions are most common in ovarian carcinoma. However, Wilms’ Tumour gene1 (WT1) and p16 expression are also seen in serous ovarian carcinoma. These Immunohistochemistry (IHC) markers are useful in the differential diagnosis of serous ovarian carcinomas. Aim: To study histomorphology of ovarian neoplasm along with expression of p53 and WT1 in surface epithelial tumours and to assess the prevalence of various ovarian neoplasms in different age groups. Materials and Methods: This cross-sectional study was conducted in Department of Pathology, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India, over a period of two years (from September 2018-September 2020). A total of 78 ovarian specimen received in histology laboratory was studied for gross and microscopic features. The p53 and WT1 IHC expression pattern was studied in surface epithelial tumours. Statistical significance was calculated in relation to p53 and WT1 expression with histological type and grade of tumour using Chi-square test. Results: A total of 78 cases were studied, out of which benign tumours were the most common 40 (51.3%) cases, followed by malignant tumours 32 (41.0%) cases and borderline malignancy 6 (7.7%) cases. The most common benign lesions were mucinous cystadenoma 20 (50%) cases. Serous carcinomas were most common malignant tumours 19 (59.3%) cases followed by Germ Cell Tumours (GCT) 5 (15.6%) cases. All benign and borderline epithelial ovarian tumours were found p53 and WT1 negative. Out of 22 cases of malignant surface epithelial tumour, 14 (63.6%) and 12 (54.4%) were positive for p53 and WT1 respectively and all were serous carcinomas. Conclusion: Ovarian lesions present with wide spectrum of histomorphological features. The p53 and WT1 show different rates of expression and staining pattern in various epithelial ovarian carcinomas. Hence routine gross, proper histological examination and correct IHC interpretation is required for specific diagnosis.

Previously, Solitary Fibrous Tumour (SFT) was thought to originate from the pleura, a relatively rare mesenchymal neoplasm with an indolent course. Vulva is a very uncommon site of extrathoracic SFT. This is a report of a very uncommon case of vulval SFT in a 30-year-old female with complaint of a swelling over vulval region. Fine Needle Aspiration Cytology (FNAC) of the growth was attempted twice and only blood was aspirated. The swelling was excised completely. On histological examination, the sections revealed a cellular tumour of ovoid-to-fusiform spindle cells with indistinct cell borders, with haphazard arrangement or patternless pattern along with proliferation of variable sized blood vessels. The diagnosis was finalised to be a benign stromal tumour (most probably SFT), which was confirmed on immunohistochemical examination using Cluster of Differentiation 34 (CD34), CD99 and Signal Transducer and Activator of Transcription 6 (STAT6) markers.

Granular Cell Tumour (GCT) of nasal and paranasal area is an extremely rare entity, while the most common site is the tongue in oral cavity. GCT was first time described by Abrikossoff in 1926, which occurs in 3rd to 5th decades of life and most frequently involving the head and neck region. Abrikossoff in 1926, first time described GCT, to be derived from smooth muscle and gave the term myoblastomas, also known as Abrikossoff’s tumours. Schwann cell origin of GCT was demonstrated on immunohistochemistry through positive S100 protein identification. Herein, the authors report a case of GCT arising from right nasal vestibule in a 28-year-old female who presented with swelling since three months. On gross examination, the specimen revealed firm red and white pieces of tissue measuring 0.8x0.8x0.5 cm. Diagnosis was made by histopathological examination which was confirmed by PAS special stain and S100 immunohistochemistry. Author also abridged the clinical information, microscopic features, treatment and patient status after follow-up. This case is believed to be the 7th reported case of GCT as primary lesion at this location.

Myeloid sarcoma, also known as chloroma, granulocytic sarcoma, extramedullary Acute Myeloid Leukaemia (AML), myeloblastoma or extramedullary myeloid tumour, is a rare manifestation, characterised by the proliferation of immature myeloid cells, myeloblasts or monoblasts occurring as one or more tumour at an extramedullary site. It is associated with disruption of normal architecture of tissue in which it is found. Monoblastic sarcoma is a rare variant of myeloid sarcoma. Hereby, the authors report a rare case of primary monoblastic sarcoma in a 64-year-old male patient presented with complaint of swelling over right side lower cervical region. He had no history of AML. On physical examination, the swelling was over medial one-third of right clavicle measuring 6×5.8×3 cm. The swelling was excised and sent for histopathological examination, which was diagnosed as monoblastic sarcoma, and confirmed on immunohistochemistry.

Hairy Cell Leukaemia (HCL) is an uncommon disease accounting approximately 2% of all lymphoid leukaemias. Cytologically and immunophenotypically, it is indolent neoplasm of intermediate mature lymphoid cells. The neoplastic cells have oval nuclei with abundant basophilic cytoplasm having circumferential hairy projections involving peripheral blood and diffusely involving the bone marrow and splenic red pulp. It occurs more predominantly in middle aged to elderly adults with median age of 52 years; with male predominance (M:F=4:1). HCL was firstly recognised by Ewald in 1923 and described as Leukaemische reticuloendotheliose and term HCL was coined by Schrek and Donelly in 1966. A 75-year-old male known case of diabetes and hypertension with chronic kidney disease, visited to Outpatient Department (OPD) with history of severe fatigue and weight loss of 5kg in last one month. On physical examination; massive splenomegaly was found measuring 15 cm below left costal margin. Complete Blood Count (CBC) revealed Hemoglobin (Hb) of 10.9 gm%, Total Leucocyte Count (TLC) was 40,200/mm3 , Differential leukocyte counts were Neutrophils (N)07, Lymphocytes (L)11, Eosinophils (E)01, Monocytes (M)01 and 80% of atypical lymphoid cells and Platelets count 1.08 L/mm3 . Peripheral blood smear showed Red Blood Cells (RBCs) predominantly normocytic normochromic with mild anisocytosis and 80% of atypical lymphoid cells with hairy projections (hairy cells). On Contrast-Enhanced Computed Tomography (CECT), whole abdomen showed massive splenomegaly (size=27cm). Bone marrow aspiration examination was done showing low cellularity and comprising of 45% cells of HCL type and suggestive of HCL. On flow cytometry, immunophenotyping showed CD19, CD20, CD79b, CD11C, CD103, FMC-7, CD123, CD200 positive abnormal cells and confirming the diagnosis of classical HCL.