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Colorectal carcinoma (CRC) is the third most common cancer worldwide. Along with many established prognostic factors, tumor budding is emerging as a valuable marker of prognosis. Tumor budding is not yet universally reported but it has recently been suggested in guidelines by ITBCC (International Tumor Budding Consensus Conference). Our aim is to study prognostic implications of tumor budding in CRC. Hundred cases of primary CRC specimens were retrospectively studied from January, 2016, to February, 2017. Tumor bud count and other histopathological parameters were evaluated from hematoxyline and eosin (HE) stained slides. Survival analysis was done using Cox proportional hazards model. Association of tumor budding and cancer-specific survival was found to be statistically significant (

Introduction: Granulocytic sarcoma is a rare extramedullary tumor comprising of immature myeloid cells in an extramedullary site which is commonly found with myeloid leukemia (acute or chronic) or occasionally with chronic myeloproliferaive disorders or myelodysplastic syndrome. GS may also be the initial manifestation of leukemia. Because of the diverse clinical presentation, differentiation of Granulocytic sarcoma (GS) from malignant lymphomas (Non Hodgkin's lymphoma or Hodgkin’s lymphoma), extramedullary hematopoiesis, poorly differentiated carcinoma and infections is very important for cytopathologist. Materials and Methods: A retrospective study of total 16 cases of GS diagnosed by FNAC (14 FNAs and 2 pleural effusion fluid specimen) was done. Cytology smears were examined for cytomorphology in conjunction with clinical details. Depending upon the population of the cells present on the smears, GS was categorized as blastic, immature or mature GS. Results: The age of patients ranged from 8 years to 50 years with male dominance. (10 males and 6 females).The most commonest site of aspiration was subcutaneous or soft tissue (9 cases) followed by lymphnodes (4 cases) and breast (1 case). 2 cases of GS involving pleural fluid were also included. A detailed history, clinical examination and relevant investigations of patients showed that GS was secondary to acute myeloid leukemia (AML) in 6 patients, was secondary to chronic myeloid leukemia (CML) in 3 patients, and was secondary to juvenile myelomonocytic leukemia (JMNL) in one patients. 6 patients were presented with concurrent myeloproliferative disorder [AML in 4 patients and CML-CP in 2 patients]. Depending upon the population of the cells present on the smears, GS was categorized as blastic GS (7 aspirates), immature GS (3 aspirates) and mature GS (6 aspirates). Conclusion: FNAC plays important role in diagnosis of GS .GS should be included in the diagnosis of undifferentiated neoplasm of the soft tiss

Background: Secondaries of brain (Brain metastases, BM) are most common central nervous system (CNS) tumors and it may be initial manifestation of systemic malignancies. Histomorphology of brain metastatic tumors along with immunohistochemistry (IHC) will helpful in the detection of unknown primary site (UPS) of brain metastases. Aim: To evaluate unknown primary site of brain metastases with help of immunohistochemistry. Material and Method: This study was conducted at the department of onco-pathology of our institute. Five years data from 2014 to 2018 were obtained from online Laboratory Information System (LIS), department of onco-pathology of our institute. IHC was performed on basis of histomorphology. Results: Total 128 brain metastatic tumors were retrieved. Of which the present study have applied IHC on 107 cases and in remaining 21 cases, systemic malignancies were already diagnosed. Out of 107 cases, primary site was detected in 92.53% cases (n=99) and in 7.47% cases (n = 8), not able to detect primary site even after IHC. Lung was the most common primary site detected (n = 73) followed Gastrointestinal tract (GIT, n = 9). Conclusion: Lung followed by breast are the most common primary malignancies for secondaries of brain (BM). Systemic approach using immunohistochemistry is really helpful in detection of unknown primary site of secondaries of brain (BM).

Background Soft-tissue sarcoma (STS) rarely metastasizes to lymph node compared to carcinoma. Fine-needle aspiration cytology (FNAC) carries a pivotal role in diagnosis of metastatic tumor to lymph node. This study highlights the role of FNAC in diagnosis of STS metastasis to lymph node. Method A retrospective study over a period by 4 years carried out. FNAC of enlarged lymph node was performed in patients with STS. Cytology smears were examined in conjunction with clinical details. Histopathology and Immunohistochemistry (IHC) were correlated in synchronous cases. Results Out of 326 patients, 21 with STS had enlarged lymph nodes, of which 19 cases showed involvement (5.8%). Sixteen cases were metachronous and 3 cases showed synchronous involvement. Fifteen cases had regional lymph nodes while 4 cases had distal lymph node involvement. Head and neck and lower extremities were the most common primary sites of STS. Rhabdomyosarcoma was the most common sarcoma metastasing to the lymph nodes followed by synovial sarcoma, malignant peripheral nerve sheath tumor, and clear cell sarcoma. Other rare tumors included leiomyosarcoma, epitheloid sarcoma, liposarcoma, malignant fibrous histiocytoma, and Ewing's sarcoma/peripheral neuroectodermal tumor. We had a case of dermatofibrosarcoma protuberance (DFSP) of scalp with cervical lymph node metastasis. Very unusual about this case was its rare primary site and the rarer lymph node metastasis. Conclusion FNAC plays an important role in the diagnosis of lymph node metastasis in cases of STS.

Background Sub typing of non small cell lung carcinoma (NSCLC) has an important task in the era of molecular and targeted therapies. Differentiating between squamous cell carcinoma (SQCC) and adenocarcinoma (ADC) is challenging when limited material is available in lung carcinoma. We investigated the accuracy and feasibility of sub typing NSCLCs in cytology and small biopsy material. Methods Concurrent cytology and biopsy material obtained in a single CT- guided procedure in lung carcinoma over a year period retrospectively. Both materials were individually sub typed and analyzed. Immunohistochemistry (IHC) was performed. Accuracy was determined by comparing the results with IHC. Results Total 107 of 126 cases of NSCLCs were included for analysis, where both cytology and biopsy material were adequate for interpretation. FNAC allowed tumor typing in 83 (77.6%) cases; 36 (33.6%) were ADC, 47 (43.9%) cases were SQCC and 24 (22.4%) cases diagnosed as Non-small cell carcinoma not otherwise specified (NSCLC-NOS). In biopsy, 86 cases (80.4%) were typed, among which 34 (31.8%) were ADC, 52 (48.6%) were SQCC and 21 (19.6%) were of NSCLC-NOS type. The result of Chi-square index was significant. With the aid of IHC, NSCLC-NOS reduced from 14 (13%) cases to 2 (1.9%) cases. Conclusion Cytology and small biopsy specimens achieved comparable specificity and accuracy in sub-typing NSCLC and optimal results were obtain when findings from both modalities combine. The advantage of paired specimens is to maximize overall diagnostic yield and the remaining material will be available for ancillary technique like IHC or for molecular testing. Diagn. Cytopathol. 2017;45:598-603. © 2017 Wiley Periodicals, Inc.

Sub typing of non small cell lung carcinoma (NSCLC) has an important task in the era of molecular and targeted therapies. Differentiating between squamous cell carcinoma (SQCC) and adenocarcinoma (ADC) is challenging when limited material is available in lung carcinoma. We investigated the accuracy and feasibility of sub typing NSCLCs in cytology and small biopsy material.Concurrent cytology and biopsy material obtained in a single CT- guided procedure in lung carcinoma over a year period retrospectively. Both materials were individually sub typed and analyzed. Immunohistochemistry (IHC) was performed. Accuracy was determined by comparing the results with IHC.Total 107 of 126 cases of NSCLCs were included for analysis, where both cytology and biopsy material were adequate for interpretation. FNAC allowed tumor typing in 83 (77.6%) cases; 36 (33.6%) were ADC, 47 (43.9%) cases were SQCC and 24 (22.4%) cases diagnosed as Non-small cell carcinoma not otherwise specified (NSCLC-NOS). In biopsy, 86 cases (80.4%) were typed, among which 34 (31.8%) were ADC, 52 (48.6%) were SQCC and 21 (19.6%) were of NSCLC-NOS type. The result of Chi-square index was significant. With the aid of IHC, NSCLC-NOS reduced from 14 (13%) cases to 2 (1.9%) cases.Cytology and small biopsy specimens achieved comparable specificity and accuracy in sub-typing NSCLC and optimal results were obtain when findings from both modalities combine. The advantage of paired specimens is to maximize overall diagnostic yield and the remaining material will be available for ancillary technique like IHC or for molecular testing. Diagn. Cytopathol. 2017;45:598-603. © 2017 Wiley Periodicals, Inc.