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Introduction Translocation t(12;21)(p13;q22), a recurrent and an invisible chromosomal abnormality, resulting in TEL/AML1 gene fusion, associated with good prognosis, has been described to be a common abnormality, in children with B-acute lymphoblastic leukemia (B-ALL). Objectives The initial observation of very few TEL/AML1 positive patients at this center on testing by fluorescence in situ hybridization (FISH) led to study the prevalence of the abnormality, compare with the global distribution, and evaluate clinical, pathological, molecular, and cytogenetic features in TEL/AML1 positive patients. Materials and Methods A retrospective study of all B-ALL patients tested for TEL/AML1 gene fusion during the period January 2009 to November 2020 was undertaken. Clinicopathological, molecular, cytogenetic, treatment, and follow-up details were collected. All publications dealing with TEL/AML1 gene rearrangement were reviewed post Google and PubMed search. Results TEL/AML1gene rearrangement was assessed by FISH in 178 patients and by reverse transcription polymerase chain reaction in 36 patients and detected as the sole abnormality in 8.4% patients with additional genetic abnormalities noted on FISH evaluation. Normal karyotype was noted in 14/18 (77.7%) of these patients and 2 had complex karyotype. Complete blood count revealed hemoglobin to range from 35 to 116 g/L (median: 74 g/L), white blood count: 1.01–110×109/L (median: 7.8×109/L), platelet counts: 10–115×109/L (median: 42×109/L), blast count in peripheral smear: 0–98% (median: 41%). Immunophenotyping demonstrated 94.4% were CD34 positive, common acute lymphoblastic leukemia associated antigen (CALLA) positive with aberrant expression of CD13, CD33, CD56, singly or in combination in 58.8%. Conclusion TEL/AML1 fusion is rare in Indian patients with B-ALL and appears to be much rarer in our region. The detection of relevant specific abnormalities is of fundamental importance in B-ALL patients and these geographic variations can be used in defining management policies.

Crystal storage histiocytosis (CSH) is a rare clinical entity. It comprises of benign histiocytes showing accumulation of refractile generally immunoglobulin crystals in the cytoplasm. Accumulation of non-immunoglobulin substances is also described, common being clofazimine, charcot-leyden, and cystine. Here, we present a case of generalized CSH presenting as a chest wall mass in a 62-year-old gentleman. X-ray showed a chest wall mass with destruction of the right sixth rib. Histopathological examination revealed plasmacytoma with the presence of histiocytes showing abundant pink cytoplasm. Bone marrow examination revealed the presence of plasma cells with dense azurophilic granules. The patient was started on chemotherapy for multiple myeloma. It is clinically important to identify these cases as part of published literature since it annotates poor prognosis to the generalised form of CSH compared to localized one. The unusual location, presence of morphologically distinct plasma cells in marrow, made the diagnosis challenging. The case also highlights the role played by immunohistochemistry to arrive at the right diagnosis.

Introduction:The diagnosis of Ewing sarcoma family of tumours (ESFT) is challenging, especially in adults and in extra-skeletal or visceral location. Several morphologic mimics with varied treatment options and prognosis confer diagnostic dilemmas. Application of ancillary diagnostic modalities in surgical pathology in clinical routine has enabled accurate diagnosis of ESFT in bone, soft tissues, and viscera.Aim:The study aims to assess the clinicopathological features including molecular test results of ESFT with emphasis on sex, age, and location, especially extra-skeletal soft tissue and visceral location.Material and Methods:Data of clinicopathological, molecular tests (wherever performed), diagnosis rendered in 302 ESFT over a decade from our centre were reviewed. Statistical comparison of skeletal and extra-skeletal tumours with reference to age and sex was done using SPSS package. The P value of Results:The cohort included 302 ESFTs with 49% skeletal and 51% extra-skeletal tumours. Thigh was most common site among skeletal tumours; chest wall, paraspinal location, and retroperitoneum among soft tissues (39.4%); and kidney, ovary, and cervix among visceral tumours (11.3%). Fluorescence in situ hybridisation for EWSR1 gene rearrangement was positive in 54 patients and reverse-transcriptase polymerase chain reaction in 19 patients. Predominance of male sex, younger age and location in extremities among skeletal tumours and lack of gender predilection, higher age and axial location in extra-skeletal tumours were noted, which were statistically significant. Molecular tests were performed more frequently in extra-skeletal tumours, especially in visceral tumours to establish the diagnosis.Conclusions:The study showed statistically significant differences in the age, sex, and location between skeletal and extra-skeletal ESFT. The increased percentage of extra-skeletal tumours especially in viscera was attributed to the increased awareness and availability of ancillary techniques.

T cell/histiocyte-rich large B cell lymphoma (THRLBCL) is an unusual variant of diffuse large B cell lymphoma with poor prognosis. We describe a case of THRLBCL with an uncommon isolated spinal involvement. A 37-year-old male came to the neurosurgery outpatient department with weakness of both upper and lower limbs. Histopathology and immunohistochemistry revealed features consistent with THRLBCL. The patient was treated with D5-D6 laminectomy followed by six cycles of chemotherapy (CHOP; cyclophosphamide, hydroxydaunorubicin, oncovin, prednisolone) and was disease free for 5 years until he had relapse of disease at the same location in 2016 for which he is receiving palliative radiation therapy. Isolated spinal involvement as the first or only manifestation of THRLBCL is very rare and has been described very occasionally in the literature. It is important to correctly diagnose this entity and differentiate it from its mimics because of different prognostic and therapeutic implications.

Nucleophosmin (NPM1) mutation is one of the most common recurring genetic abnormalities seen in acute myeloid leukemia (AML). Immunohistochemistry serves as a cost effective and simple surrogate testing method for detection of NPM1 mutation. This study was conducted to evaluate the frequency of aberrant cytoplasmic nucleophosmin 1 expression in leukemic blast cells on formalin fixed bone marrow trephine biopsy (BMB) sections and also to correlate this data with the reference molecular method (reverse transcriptase-polymerase chain reaction; RT-PCR and gene sequencing), where available. Immunostains were performed using mouse anti-NPM1 monoclonal antibody on 71 paraffin embedded bone marrow biopsies (BMB) of patients with AML of any French-American-British (FAB) subtype. Results of immunohistochemistry (IHC) were then compared with the reference molecular method. The proportion of NPM1 expression by immunostaining in AML cases was found to be 17%. Twelve of the total 71 cases demonstrated cytoplasmic nucleophosmin (NPMc+) on immunostaining. Eleven of the positive cases that were correlated with the molecular standard demonstrated mutation in exon 12 of NPM1 gene. Cytoplasmic nucleophosmin expression by immunostaining was found to be in complete agreement with the standard molecular method. In a resource restricted setup, the information from this study might help in providing an inexpensive and accurate detection method to facilitate introduction of this marker in diagnostic and prognostic workup of AML especially in patients showing normal karyotype and no common recurrent translocations.

Background: Immunohistochemistry (IHC) is a cost-effective and routinely available ancillary technique for the diagnosis of Ewing sarcoma family of tumors (ESFT). However, molecular confirmation is needed for precise diagnosis. Aim: This study aimed to determine the sensitivity and specificity of the commonly used IHC markers cluster differentiation (CD99) and friend leukemia integration1 (FLI1) in a series of molecularly confirmed ESFT. Materials and Methods: Retrospective review of the ESFT confirmed by either fluorescence in situ hybridization (FISH) or reverse transcriptase polymerase chain reaction (RT-PCR) during a period of 10 years was done. The demographic, clinical, and radiologic data were noted from medical records. The histology was reviewed with CD99, FLI1, and additional markers, wherever performed. The sensitivity and specificity of CD99 and FLI1 for the diagnosis of ESFT were calculated. Results: There were 72 ESFT patients in the study period, confirmed by FISH (EWSR1 rearrangement) in 53 and RT-PCR (EWS-FLI1) in 19. The female-to-male ratio was 1.06. The median age at diagnosis was 21 years. The cases included 22 skeletal and 50 extraskeletal sites. The positivity of CD99 and FLI1 was 98.46% and 94.83%, respectively, and both were positive in 55/72 (76.39%) cases. The sensitivity and specificity of CD99 were 98.46% and 20%, and those of FLI1 were 94.83% and 28.57%, respectively. Conclusion: Although the sensitivity for CD99 and FLI1 was high, the specificity was low toward the diagnosis of ESFT. The combined use of CD99 and FLI1 could confirm only 76.39% of molecularly confirmed ESFT, emphasizing the need for a precise diagnosis by molecular technique.

Management of wireless communication systems has been investigated thoroughly with novel methods, which led to the development of mainly software based methods rather than hardware. SoftwareDefined Radio (SDR) is a common method for developing and implementing wireless communication protocols. In the proposed artificial intelligence based SDR system, wireless nodes are made self-organized in distributed form by using only local information. The proposed software based method can be used to control the channel frequency, bandwidth, and modulation format. The advantages of the software based system are explained. The general performance of the system is improved in terms of connectivity which belong to the SDR capabilities supported by wireless nodes, as well as a controlled mobility function. The requirements for the restricted connectivity by using SDR are made more stringent with regard to the maximum coverage., TABLE OF CONTENTS Page ACKNOWLEDGMENT .........................................................................................................................İİİ TABLE OF CONTENTS ........................................................................................................................İV LIST OF FIGURES............................................................................................................................... Vİİ ABBREVIATIONS AND SYMBOL LISTS.......................................................................................Vİİİ ÖZET........................................................................................................................................................İX ABSTRACT................................................................................................................................................X 1. INTRODUCTION ................................................................................................................................. 1 1.1 PROBLEM STATEMENT ....................................................................................................................... 5 1.2. HYPOTHESIS...................................................................................................................................... 7 1.3. RESEARCH FOCUS ............................................................................................................................. 7 1.4. PURPOSE STATEMENT ....................................................................................................................... 7 1.5. SCOPE AND LIMITATIONS OF THE STUDY ........................................................................................... 9 1.6. THE AIM OF THE STUDY..................................................................................................................... 9 1.7. THESIS OUTLINE ............................................................................................................................... 9 2. LITERATURE REVIEW ................................................................................................................... 10 2.1. SDR AND ITS CAPABILITIES ............................................................................................................ 11 2.2. THE APPLICATION OF SDR.............................................................................................................. 14 2.3. THE IMPACT OF SDR IN NETWORK MANAGEMENT AND COMMUNICATION SYSTEM ........................ 15 2.4. ARTIFICIAL NEURAL NETWORKS..................................................................................................... 16 2.5. THE ANN ARCHITECTURE .............................................................................................................. 19 2.6. THE IMPACT OF ANN IN THE MANAGEMENT OF A WIRELESS COMMUNICATION SYSTEM................. 22 2.7. MODULATION SCHEMES IN SDR..................................................................................................... 23 3. MATERIALS AND METHODS ........................................................................................................ 24 3.1. WORK STEPS: .................................................................................................................................. 24 3.2. THE DESCRIPTION OF THE WIRELESS MOBILE PLATFORM .............................................................. 24 3.3. SDR................................................................................................................................................ 24 3.4. THE SYSTEM STRUCTURE ................................................................................................................ 24 3.4.1. Purchase................................................................................................................................. 25 3.4.2. Host PC and Enabling Software............................................................................................. 26 3.4.3. Connecting the RTL-SDR ....................................................................................................... 27 3.4.4. RTL-SDR Ready to Receive and Process FM Signals............................................................ 28 v 3.5. THE MATHEMATICAL MODEL......................................................................................................... 30 3. 6. ANN STEPS .................................................................................................................................... 31 3.7. THE GA FOR TSP............................................................................................................................ 35 4. RESULTS AND DISCUSSION..................................................................................................... 37 4.1 THE SDR INSTALLATION AND SIGNAL PROCESSING ......................................................................... 37 4.2. ANN RESULTS ................................................................................................................................ 46 4.2.1 ANN training results................................................................................................................ 46 4.2.2 GA for TSP Results.................................................................................................................. 48 4.2.3 The ANN and GA for one TSP to select nodes locations......................................................... 51 4.2.4 GA for TSP optimization nodes distribution in the specific area ............................................ 52 5. CONCLUSIONS AND FUTURE WORK ......................................................................................... 56 5.1. CONCLUSIONS................................................................................................................................. 56 5.2. FUTURE WORK................................................................................................................................ 56 CURRICULUM VITAE.......................................................................................................................... 61

Plasmablastic lymphoma (PBL) is a rare aggressive neoplasm characterized by diffuse proliferation of large neoplastic cells with plasma cell immunophenotype. Cell of origin of PBL is believed to be a postgerminal center B-lymphocyte or plasmablast. The malignant cells in PBL usually do not express CD20 (B cell marker) but do express markers of plasmacytic differentiation, such as CD38, CD138, or MUM1/IRF4, akin to plasma cell myeloma (PCM). PBL though originally described in the oral cavity, has now been found to occur in extraoral locations as well. Small intestine as a site of PBL has been described very rarely. PBL remains a diagnostic challenge given its overlapping morphologic and immunophenotypic features with other high grade lymphomas and PCM. We report a rare case of PBL of small intestine in a 48 years old HIV infected male patient. To the best of our knowledge this represents sixth case in the literature described in this location. An unusual rare pattern of CD138 positivity by IHC is also reported along with extensive review of literature of PBL in extraoral locations.

Objective Molecular genetic analysis of FLT3, NPM1, and CEBPA is already the standard of care in patients with acute myeloid leukaemia (AML) and represents the most frequent genetic alterations and important diagnostic and prognostic indicators. This study was undertaken to determine the frequency of FLT3 and NPM1 gene mutations in our institution and to characterize the association between gene mutations and haematological parameters as well as immunophenotypic features. Material and method Morphological, haematological and immunophenotypic characteristics of NPM1 and FLT3 mutations in 126 patients of de novo AML including adults and children were studied. Apart from the French American British (FAB) method for classification, blasts were assessed for cuplike morphology as per strict definition for cuplike nuclei, ≥10% blasts with nuclear invaginations ≥25% of the nuclear area. Results FLT3 mutation in 31/126 (25%) and NPM1 mutation was found in 17/126 (13.4%) of the AML patients. 6 (5%) samples were positive for both NPM1 and FLT3/ITD mutations. Associations between the FLT3 and NPM1 gene mutations with haematological and immunophenotypic characteristics are reported. Conclusion The results suggest that presence of distinct morphology and haematological and immunophenotypic characteristics together may serve as important indicators and surrogate for NPM1 and FLT3/ITD mutations. Further, comprehensive studies on the biological effects of NPM1 and FLT3/ITD mutations and their interactions with other genetic alterations are needed to gain insight into the molecular mechanism of these mutations involved in the pathogenesis of AML.

Burkitt lymphoma is an aggressive B-cell neoplasm arising from the germinal center B cells. Clinically, it exists in three forms: endemic, sporadic, and immunodeficiency associated. Immunodeficiency-associated Burkitt lymphoma is usually extranodal and occurs with a CD4 count more than 200 μl. We report a retrospective study of a 47-year-old male patient, seropositive for HIV infection, presenting with nasopharyngeal mass and generalized lymphadenopathy. His CD4 count was 192 cells/μl, and lactate dehydrogenase was high. Diagnosis was established by biopsy, immunohistochemistry, and fluorescence in-situ hybridization. He was treated with chemotherapy. The disease progressed to involve central nervous system despite treatment. He received palliative radiotherapy and was stable at 11-month follow-up. This report highlights the uncommon clinical presentation, heavy disease burden, and progression of the disease in a HIV seropositive patient.

Mixed phenotypic acute leukemia (MPAL) is an uncommon hematological neoplasm which can either contain distinct blast populations, each of a different lineage (bilineal) or one population with multiple antigens of different lineage on the same cells (biphenotypic). t(9;22)(q34;q11.2;BCR-ABL1) is the most common recurrent genetic abnormality in MPAL; however, it is a very rare leukemia that accounts for less than 1 % of all acute leukemias and is usually associated with poor outcome. Common phenotypic expression of MPAL includes T/Myeloid and B/Myeloid. Leukemic blast showing evidence of both B and T lineage commitment has been described as a very rare phenomenon in the existing literature. We here report a rare case of MPAL (B/T lineage) with t(9;22)(q34;q11.2;BCR-ABL1) along with morphologic and immunophenotypic findings with special emphasis on need to differentiate such cases from patients with CML-Blast crisis as therapy, and prognosis in these two scenarios differ significantly.

Acute myeloid leukemia with maturation (AML-M2) is associated with the 8;21 translocation. For the first time in an adult patient with AML-M2, a novel unbalanced translocation involving the short arm of chromosome 11 and long arm of chromosome18 with new breakpoints is presented. CD82 on band 11p11.2 and GATA 6 on 18q11.2 may play a role in the pathogenesis of de novo AML M2. The report with translocation (11;18)(p11.2;q11.2), as the sole cytogenetic abnormality provides more data on the leukemogenesis of de novo AML M2.

• Angiogenesis is the hallmark of tumor growth and metastasis and VEGF is an angiogenic marker with enhanced expression in colorectal carcinoma.

Langerhans cell histiocytosis (LCH) is a rare disease characterized by clonal neoplastic proliferation of normal antigen presenting cell (APC), the Langerhans cell. Most cases occur in childhood and the disease is rare in adults. LCH can involve solitary organ or can present as a multi-system disease in children. In adults, isolated pulmonary LCH is the commonest presentation. Tonsillar infiltration as a sole manifestation is extremely rare. We herewith report a case with isolated tonsillar involvement by LCH in an adult patient.

Conventional/molecular cytogenetics is important in identification of genomic abnormalities, for prognostication and in risk stratification of de novo patients with acute myeloid leukemias (AML). Here we present an AML M2 case showing the sole karyotypic abnormality, the rare interstitial deletion in the long arm of chromosome 9 with the loss of segment q12–q13.

Introduction: Acute myeloid leukemia (AML) is a heterogeneous group of disorders classified as per FAB subtypes and more recently by WHO by underlying genetic abnormalities. Aims and Objectives: This study aims to analyze the morphology, immunophenotype, cytogenetic and molecular abnormalities in around 200 patients of AML diagnosed over a period of 7 years at our institute and to determine relative frequency of various subtypes (based on FAB and WHO classification). An attempt to characterize the associations between hematological parameters, immunophenotype and these subtypes was also made. Materials and Methods: All cases diagnosed as AML on morphology, cytochemistry and/or immunophenotyping and tested for recurrent genetic abnormalities during period of Jan 2008-July 2014 were included in the study. Results: Age of presentation was younger in our AML patients as compared to western literature. Amongst FAB and WHO subtypes, M2 and t (15;17) PML-RARA were the most common groups respectively. As expected, CD33, CD13, were the most commonly expressed markers followed by HLA-DR, CD117, CD34 and CD14. Aberrant expression was seen in 62(41.6%) cases, most common was CD7 (15.4%), followed by CD56 (14.8%), CD19 (6.7%) and CD2 (4.7%). Significant associations between immunophenotypic markers and FAB subtypes as well as WHO subtypes were established. Conclusion: This is a hospital based study, giving a detailed account of frequencies of AML subtypes, hematological parameters and immunophenotypic markers in AML patients at our institute. Being a large and one of its kind study to establish significant associations between various haematological and immunophenotypic parameters with respective AML subtypes and genetic abnormalities, it might prove to be very useful in Indian setup where facilities for cytogenetic analysis are not available in many laboratories.

Introduction: HER-2/neu status determines the eligibility for targeted therapy with trastuzumab in breast carcinoma. Evaluation for HER-2/neu protein expression by immunohistochemistry (IHC) and gene amplification by fluorescence in situ hybridization (FISH) has become the gold standard. Aims: Since data on HER-2/neu assessment by IHC and FISH and studies regarding concordance between the results of the two techniques are limited, especially from India, we sought to study HER-2 gene amplification status by FISH in equivocal (2+) cases by IHC and also study aberrant signal patterns. Settings and Design: Mastectomies and breast core biopsies, equivocal for HER-2/neu protein expression, were analyzed for HER-2 amplification by FISH. Materials and Methods: IHC (DAKO) and FISH (PathVysion dual-probe system) tests were performed on 68 of 112 (after exclusion) 10% neutral buffered formalin (NBF)-fixed paraffin-embedded tissues and evaluated according to American Society of Clinical Oncology ASCO guidelines. Statistical Analysis Used: Chi-square (χ2 ) test and the two-tailed P value were applied using Graphpad Quickcels software, version 2006. Results: It was found that 73.5% of the IHC 2+ patients were negative for HER-2/neu amplification, 25% were positive (ratios ranging from 2.3 to 5.6) and 1 patient was equivocal (2.2). Retesting FISH HER-2 equivocal case on another tumor block by IHC demonstrated HER-2 overexpression of protein 3+, thus resolving the equivocal status. Polysomy and HER-2 genetic heterogeneity were seen frequently. Conclusions: The findings reiterate that IHC HER-2 equivocal cases are a heterogenous group and need FISH for further categorization. Low concurrence (25%) rate between both IHC and FISH results in the equivocal scenario can be attributed to tumors with polysomy 17 and HER-2/neu genetic heterogeneity.

A case of plasmablastic lymphoma that has not been described previously in the thyroid is presented with its clinicopathological features and the diagnostic difficulties encountered. A detailed histopathology in conjunction with immunohistochemistry is recommended for appropriate diagnosis and management in the setting of HIV-negative status. Dealing with a case presenting primarily as a thyroid mass can be challenging in the scenario of a CD20-negative immunoprofile.

The occurrence of a malignant lesion in oral cavity raises the possibility of most commonly squamous cell carcinoma. However, there are other malignant lesions that can arise in the tongue. Lymphomas in the tongue/Waldeyer's ring can pose a diagnostic challenge. Here, we present a rare case of Mantle cell lymphoma primarily presenting as a tongue lesion with a deceptive appearance that requires a high grade of suspicion and judicious use of immunohistochemistry (IHC) to reach the diagnosis. The recognition and differentiation of this entity are important because of its aggressive clinical behavior.

Acute myeloid leukemia (AML) is a heterogeneous disorder characterized by specific morphology, immunophenotype and genetic rearrangements. Multiple recurrent chromosomal aberrations have been identified by conventional cytogenetic analysis, which are now widely recognized as one of the most important diagnostic and prognostic determinants in AML. Here, we present a case with unusual cytogenetics, which has been described in very few patients.