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To quantitate tumor angiogenesis in carcinoma of the breast (stage T2N0M0) by computerized image analysis of CD-31-stained histologic sections and, keeping in view the heterogeneity of tumors, to assess which areas of neovascularization provide the best prognostic indicator.Thirty-six cases of infiltrating duct carcinoma of the breast, stage T2N0M0, with follow-up of five years, were analyzed. All cases had received uniform initial treatment in the form of mastectomy with axillary clearance and radiotherapy. Intratumoral microvessel density (IMD) counts were done on "hot spots" and "non-hot spots" on CD-31-stained sections using computerized image analysis. Angiogenesis was correlated with other variables, such as age, menopausal status, histologic grade and proliferative activity by univariate and multivariate analyses.Hot-spot IMD counts were highly significant independent prognostic markers in univariate and multivariate analyses. Background vascularity of a tumor was of no value in prognosticating.In patients with node negative breast carcinoma, IMD counts in hot spots are an independent prognostic factor in disease-free and overall survival and can be used to separate out patients with T2N0M0 stage in need of systemic adjuvant therapy.

Myofibroblastoma is an uncommon neoplasm of the male breast. Herein, we describe the cytologic features seen in the fine-needle aspirate of a 45-year-old man. The smears were cellular with intimate association of tumor cells with extracellular matrix material. The cells were spindle to polygonal and were without significant atypia. Numerous mast cells were observed. Nuclear grooving was present only occasionally, although this was conspicuous histologically. The presence of hyaline bands in between tumor cells, another interesting feature, was appreciated retrospectively. This neoplasm was initially misinterpreted as a malignant soft tissue tumor. Awareness of the cytologic features coupled with mammography should prevent a misdiagnosis of this tumor.

AIM: To assess the clinicopathological features and outcome in patients of primary gliosarcoma with changing trends of treatment. MATERIALS AND METHODS: Medical records were reviewed over a 5yearsperiod from 2009 to2013 of Gliosarcoma treated in the department. All patients who received 3D-Conformal Radiotherapy (3DCRT) with or without concurrent and adjuvant Temozolomide post surgery were included in the analysis. RESULTS: A total 27 patients were included in this study. Median age of presentation was 54 years (rang9-69 years), male to female ratio was 1.25:1, median KPS at presentation was 70. At presentation all patients had raised intracranial tension with motor symptoms in 48.1%, Memory impairment in 6 patients, Seizures and dimness of vision was seen in 18.5% and 11.1% cases respectively. Most common location of the tumour was temporal lobe (48.1%).About 60% (n = 16) patients underwent Gross total resection. On histopathological examination all patients showed biphasic pattern with glial fibrillary acidic protein positivity for (GFAP) glial component and vimentin positivity for mesenchymal component. Twenty three (80.8%) patients received radical radiotherapy i.e. 60 Gy/30#/6 weeks and 4 patients received hypo-fractionated radiotherapy 40 Gy in 15 fractions in 3 weeks. Eleven (42.3%) patients received Concurrent and adjuvant Temozolomide. Median overall survival of our patients was 9 months. Six months survival in the chemo-radiation arm was 82% as compared to 58% seen in patients who were treated with radiotherapy alone. CONCLUSION: Treating Gliosarcoma is a major therapeutic challenge to a clinician because of its poor prognosis, aggressive clinical behavior, rarity and limited clinical experience. Addition of Temozolomide has shown a better trend in survival though it is statistically not significant

Non-Hodgkin's lymphoma rarely presents with an osseous lesion in the foot. Two cases of primary lymphoma of the foot are reported. The patients presented with a history of pain and swelling of the foot. Radiographs revealed a lytic lesion in the calcaneus of one patient, and in the second metatarsal of the other. Open biopsy revealed high grade lymphoblastic non-Hodgkin's lymphoma of the diffuse variety. The patients were treated with localized radiation therapy and have been disease free for more than a year.

We describe here an unusual case of rheumatoid arthritis in a patient who showed necrotising glomerulonephritis as well as non-Hodgkin lymphoma at autopsy

Concurrent skin and nerve histology was evaluated in 60 leprosy patients (25 BT, 28 BL and 7 LL). The twin aims were to study the comparative histology and the usefulness of nerve histology in the classification of the disease. In BT patients, clinical and histological classification was in agreement in 11 (44%) skin and 17 (68%) nerve biopsies. Concurrent skin and nerve histology was in consonance in 14 (56%) BT patients, while in 6 (24%) patients, only nerve histology was helpful in the classification of the disease, the skin histology being non-specific. Nerve histology was classified as BL in 3 (12%) BT patients, the skin histology was non-specific. In the BL group, the histology of 23 (82.4%) nerve biopsies correlated with the clinical classification, in contrast to skin histology which correlated with clinical assessment in 19 (68%) patients only. In the LL patients, the histology of nerve correlated with the clinical classification in 5 patients (71.4%), compared to histology of the skin in 4 (57%) patients only. The GF was higher in the nerves than in the skin throughout the leprosy spectrum (BT, BL, LL); the difference was, however, marginal in BL leprosy. The average bacteriological index (BI) was higher in nerves (4+) compared to that of skin histology and slit skin smears (3+) in BL leprosy. There was, however, no difference in the BI of the slit skin smears, skin and nerve biopsies in lepromatous leprosy.(ABSTRACT TRUNCATED AT 250 WORDS)

Background. Involvement of the oral cavity in lepromatous leprosy is well-documented. The tongue may demonstrate multiple nodules, thickening, and scarring. Methods. Ten consecutive untreated patients with lepromatous leprosy with a bacteriologic index of 4+ or more were clinically and histopathologically studied for evidence of tongue involvement. Results. Three patients showed clinical tongue involvement, as a noduloplaque lesion in one patient and fissured tongue (lingua plicata) in two patients. Tongue was clinically normal or showed nonspecific changes in the remaining seven patients. Histologic evidence of tongue involvement by lepromatous process was seen in six patients, including three without clinical involvement. Conclusions. We conclude from this study that the tongue is as prone to involvement by lepromatous process as buccal and palatal mucosa.

A thoracic intradural extramedullary enterogenous cyst in association with a syringomeningomyelocele in a 5-year-old boy is presented. The pathogenesis of this rare association is discussed and the pertinent literature reviewed.

Lymphangioma circumscriptum, a variety of capillary hymphangioma is rarely seen in the oral cavity. We present a case of lymphangioma circumscriptum of right buccal mucosa in an adult patient. The leston was excised completely and mucosal defect was coverd with split thickness skin graft.

Primary adenocarcinoma of the middle ear is a rare tumour, be it primary or metastatic (Rosenwasser 1941). Schuller et al (1983) mentioned only 13 cases reported previously and added 4 of their own. We present a case of primary papillary adenocarcinoma of the middle ear in an elderly male which is its most uncommon histological variety. The patient was treated with radical mastoidectomy and post operative external radiotherapy.

The clinical records of 162 cases of salivary gland tumours were studied. Parotid gland was the commonest site for origin of tumour (110 cases.) Commonest benign tumour was pleomorphic adenoma (42 cases) and the commonest malignant tumour was mucoepidermoid carcinoma (26 out of 162 cases). The next common tumours were adenoidcystic and undifferentiated carcinoma which constituted 23 and 20 cases respectively. Surgery or surgery with radiotherapy were the main modalities of treatment for the primary tumours. Twenty patients had recurrence within three years after the treatment. These patients were treated with either revision surgery or external radiations. Chemotherapy was given to one patient of soft tissue sarcoma. Twenty nine patients had post-operative complications like facial paralysis, parotid fistula, skin necrosis and Frey’s syndrome.

Rothmund-Thomson syndrome, a rare autosomal recessive disorder, is characterized by photosensitivity; specific skin changes including poikiloderma, atrophy, and telangiectases; juvenile cataracts; short stature; and bone defects. We describe two siblings with this syndrome.

Two patients had classical clinico-pathological features of Sweet′s syndrome. One of them had associated polycythaemia vera, myelofibrosis, mucosal lesions and haemorrhagic blisters. The patient showed a prompt response to corticosteroids. A long-term haematological follow up, is imperative in all patients.

Two cases of malignant fibrous histiocytoma with widely varying clinicopathological behaviour are reported. The treatment employed was combined surgery and radiotherapy.

A case of cystic hygroma of retropharyngeal space is being reported in a 5 years male child. The patient presented with a painless swelling on right side of the neck, dysphagia, change in voice and respiratory stridor. Surgical excision was done under general anaesthesia and the histopathology of which was consistent with cystic hygroma.