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Background: Morbidity and mortality from chronic lung diseases are increasing worldwide. A combination of various cytological and histopathological techniques are required for the high diagnostic accuracy. This study aims to evaluate and compare diagnostic accuracy of fiberoptic bronchoscope aided cytohistological techniques such as BAL (bronchoalveolar lavage), TBNA (Transbronchoscopic needle aspiration) and FB (forceps biopsy) in diseases of lung. Method: A prospective study conducted on 100 patients with symptoms and signs of various respiratory diseases who underwent fibreoptic bronchoscopy. Diagnostic accuracy of various samples alone and in combination were analysed. Results: Sensitivity of BAL-24%, TBNA 64% and FB 66%. Addition of BAL to FB increased the sensitivity to 69%. Addition of BAL to TBNA increased the sensitivity to 70%. Sensitivity of cytological methods (FB and TBNA) 90%. Addition of both BAL and TBNA to FB increased overall senstivity to 93%. FB the most specific amongst the three techniques with specificity of 94% followed by TBNA (59.4%) and BAL (50%). Conclusions: There are variable results regarding diagnostic yields and utilities of various fibre-optic bronchoscope aided cytohistological techniques but there combination adds the yields. Thus a combination of various cytohistological samples should be taken in a patient undergoing fiberoptic bronchoscopic examination to increase the diagnostic yield, to cut short the diagnostic time and early start of treatment.

Uterine arterio-venous malformation is one of the differentials of dysfunctional uterine bleeding that can result in life-threatening emergency with sudden, unexpected massive vaginal bleeding. We describe a case of 20-year old female, who presented with sudden heavy vaginal bleeding and was diagnosed with uterine arterio-venous malformation on post-mortem examination. High index of suspicion is required to make a timely diagnosis for appropriate management and to avoid maternal morbidity and mortality. Key words: Uterine arterio-venous malformations, embolization, dysfunctional uterine bleeding.

Background: Effusion cytology is a major diagnostic tool in medicine and has both therapeutic and prognostic implications. One of the dilemmas encountered is the differentiation between atypical cells and reactive mesothelial cells. The use of ancillary tools can reduce this grey zone and help to achieve a definitive diagnosis. Objectives: The main objective of this study was to evaluate the role of flow cytometry (FCM) and cell block with immunohistochemistry (IHC), along with the clinicoradiological investigations, to achieve a final diagnosis in effusion cytology to the maximum extent possible. Method: A prospective study was conducted. Effusion fluids, showing adequate amount and cellularity, were processed for conventional cytology, ploidy analysis by FCM, and cell block analysis, followed by IHC wherever required. Conventional cytological analysis was done by 2 independent pathologists, to look for interobserver variation, if any. The final result was achieved on the basis of integration of the results of the aforementioned studies, cytological details, clinicoradiological information, tissue biopsy findings, and follow-up. Result: A total of 90 samples were analyzed. On cytological examination, observer I categorized 60% samples as benign and 18.8% (n = 17) as malignant versus 58% categorized as benign and 23.3% (n = 21) as malignant by observer II. Observer I reported 19 (21.1%) equivocal cases and observer II reported 16 (17.7%). When both pathologists were considered together, the number of equivocal cases increased to 20. Sensitivity and specificity of FCM were 96.67 and 100%, respectively, and 100% for the cell block. On combining all techniques, the equivocal cases were resolved and a total of 33 cases were reported as malignant. However, 3 cases could still not be categorized and were labeled inconclusive. Conclusion: Conventional cytology combined with cell block IHC and FCM has the potential to minimize the requirement of tissue biopsy for confirmation. If the first sample is used judiciously for all the techniques, this may reduce the requirement for a second sample and possibly also the time required for a definite diagnosis and the initiation of therapy.

Lipoid pneumonia is a rare form of pneumonia which was initially described to be caused by inhalation or aspiration of fatty substances. Certain autopsy studies have reported the incidence to be 1.0-2.5%. Based on the mode of lipid acquisition, it has been classified into endogenous, exogenous or idiopathic types. Almost 50% of the patients with lipoid pneumonia are asymptomatic, and may be discovered by chance during routine chest imaging. In symptomatic patients, the symptoms are non- specific. However, it can produce inflammatory pneumonitis that can progress to irreversible pulmonary fibrosis as seen in our case. We present a case of a 53-year-old deceased male. A piece of one of his lungs was received after autopsy, which appeared normal grossly. There was no history of any illness before death. Microscopy revealed interstitial fibrosis with collection of foamy macrophages in alveolar spaces and cholesterol crystals surrounded by inflammatory reaction including occasional giant cells. The clinical picture and radiologic changes in cases of lipoid pneumonia can mimic bacterial pneumonia and tuberculosis. The occupational history is of extreme importance and should always be investigated.

Background: Epidermal inclusion cyst (EIC) is a rare benign condition of breast. Patient presents with palpable breast lump and needs to be differentiated from other breast lesions. This study included cases of epidermal inclusion cyst of breast (EICB) diagnosed on fine needle aspiration cytology (FNAC) and their correlation with histopathological findings. Methods: Study was conducted in a retrospective manner over a period of 2 years. 8 Patients who presented with breast lump and were cytologically diagnosed as EIC were included in the study. Cytological features were suggestive of EIC or infective EICB. Histopathological confirmation was done. Female: Male ratio in the study was 7:1 with an age range of 35 to 54 years. Radiological investigations favoured benign lesions in 5 cases and tubercular collection in one case. Results: FNAC was performed and May-Grunwald-Giemsa stained smears showed numerous anucleate squames and mature squamous epithelial cells in a clean or inflammatory background. Diagnosis of EICB or infective EICB was made on cytology. Diagnosis was confirmed histologically in 6 cases. Conclusions: Asymptomatic lesions do not require biopsy and treatment. Follow-up is sufficient if typical clinical and radiological findings are there. But in symptomatic cases, excision should be done followed by histopathological confirmation to rule out malignant lesion. Diagnosis should be made on FNA whenever associated with characteristic pultaceous aspirate and cytological findings.

Metastatic deposits in skull bones from follicular thyroid carcinoma is rare, and metastatic disease in skull being the presenting symptom without obvious thyroid lesion (occult primary) is even rarer. A 60-year-old female patient presented with a mass in the frontal region of the skull. Fine needle aspiration cytology was done which revealed an adenocarcinoma with repeated follicular pattern, reminiscent of follicular neoplasm of thyroid, which on immunocytochemistry revealed positivity for thyroglobulin. Patient was investigated further for primary thyroid malignancy, and imaging revealed a nodule in the left lobe of thyroid. Neuroimaging showed osteolytic lesion involving the cranium.

Langerhans cell histiocytosis (LCH) is a rare cancer involving clonal proliferation of Langerhans cells (LCs) resembling epidermal dendritic cells. It can involve any organ or system. Temporal bone LCH is often confused with ear inflammatory lesions and malignant tumors. Diagnosis is based on clinical, radiological, and pathological findings. The definitive diagnosis is made on biopsy and by immunohistochemical demonstration of CD 1a and or Langerin positivity in the clonally neoplastic cells. The course of LCH is variable from spontaneous regression to repeated recurrences and death. The main form of treatment is chemotherapy. We describe a case of multifocal multisystem LCH in a 4-year-old child who presented with recurrent chronic suppurative otitis media and an external auditory canal polyp.

Verrucous hemangioma is an uncommon capillary or cavernous hemangioma with reactive epidermal changes of hyperkeratosis, acanthosis, and papillomatosis. Lesions are mostly seen at birth or appear during childhood. These growths are usually located on the lower extremities, and involvement is generally unilateral. Diagnosis of this unusual presentation can only be confirmed following histopathology. Surgical excision resulted in a satisfactory functional and cosmetic outcome.

Background: Breast lesions including breast cancer represent a major public health issue worldwide. Fine needle aspiration cytology (FNAC) is established as most sensitive, specific, accurate, safe and cost effective for diagnosing lesions of breast preoperatively and avoiding unnecessary surgical interventions like diagnostic excision or incisional biopsy. The aim of this study is to determine the most common breast lesions diagnosed by FNAC and its histopathological correlation over a two year period. Material and Methods: A total of 1084 cases with palpable breast lesions were subjected to FNAC over a period of two year. A provisional clinical diagnosis was made in each case at the outset. Routine investigations like DLC, TLC, ESR and special investigations like Mammography were done. Air dried and wet fixed (95% alcohol) smears were prepared for Leishman and Papanicolaou or Hematoxylin and Eosin stain respectively. Special stains were used like Ziehl- Neelsen stain and Periodic Acid Schiff (PAS) stain wherever necessary. Diagnosis was made on the basis of cytomorphological features of the lesion. Out of 1084 patients, only 100 patients who were diagnosed with malignancy on FNAC were reviewed with biopsies or postoperatively in our department and were confirmed histopathologically. Results: The study shows that out of 1084 cases, total number of benign lesions were 73.8%, malignant lesions were 22.1%, equivocal cases were 7.5%, cases for suspicious of malignancy were 2.9% and 1.75% cases were inadequate. Maximum number of cases reported as breast carcinoma were seen in age group of 41-50 years (31.3%) and second highest number were seen in 51-60 years (26.3%) with male (88 cases) to female (977 cases) ratio of 0.09:1. Among 800 benign lesions, fibroadenoma was the most significant lesion observed constituting 44.9%, second most common lesion encountered was benign mammary lesion constituting 18.9% followed by inflamed/ acute cystic lesion, (47.5%). Gynaecomastia constituting (35.4%)

Objective: In recent years, during routine examination of bone marrow aspirates, an increased plasma cell percentage has been noted in a good number of cases which included both neoplastic and non-neoplastic diseases. An attempt has been made to observe the spectra of conditions with plasmacytosis in bone marrow.Methods: The present study was conducted in the department of pathology over a period of one year. A total of 114 bone marrow aspirates that showed increased plasma cells (>3.5%) constitute the study material. A detailed relevant clinical examination followed by complete blood count, peripheral smear examination and bone marrow aspiration was done in all cases.Results: There was slight female predominance with male to female ratio of 1:1.1. The majority of patients were in 4th decade. The plasma cell concentration ranged from 5% to 36%. As far as the etiology is concerned, 96 cases (84.2%) were non-neoplastic and 18 cases (15.7%) had neoplastic etiology.Conclusion: Bone marrow plasmacytosis can present as diagnostic dilemma and some time can be challenging to differentiate reactive from neoplastic condition as there is an overlap both in counts and morphology. Each case with plasmacytosis especially in the overlap range requires complete clinical evaluation, individualized investigations and more specific tests like immunoelectrophoresis and bone marrow biopsy with immunohistochemistry to arrive at a final diagnosis for patient management.Key words: Reactive plasmacytosis, bone marrow, multiple myeloma, megaloblastic anaemia, Amaç: Son yıllarda rutin kemik iliği aspiratı incelemelerinde saptanan neoplastik ve non-neoplastik hastalıklarda giderek artan oranlarda plazma hücrelerine rastlanmaktadır. Bu çalışmada kemik iliği aspiratında plazmasitoz saptanan durumların bir spektrumu çıkarılmaya çalışılmıştır.Yöntemler: Sunulan çalışma bir yıllık süre içinde Patoloji Bölümünde gerçekleştirildi. Çalışma materyalini artmış oranda plazma hücresi (>%3,5) gösteren toplam 114 kemik iliği aspiratı oluşturmaktadır. Tüm olgularda ayrıntılı bir klinik muayene ve takiben tam kan sayımı, periferik yayma ve kemik iliği aspirasyonu yapıldı.Bulgular: Erkek / Kadın oranı açısından hafif bir kadın üstünlüğü görüldü (1 / 1,1). Vakaların çoğu 40’lı yaşlarda idi. Plazma hücre yoğunluğu %5-36 arasında değişmekte idi. Etyoloji açısından 96 (%84,2) olguda non-neoplastik, 18 (%15,8) olguda ise neoplastik bir etyoloji saptandı.Sonuç: Kemik iliği plazmasitozu tanısal bir karmaşaya yol açarak, özellikle sayı ve morfolojik görünümlerinde çakışma olan reaktif patolojilerin neoplastik durumlardan ayırt edilmesini bazen zorlaştırabilir. Özellikle çakışma aralıklarındakiler başta olmak üzere, plazmasitozlu her hastada bireyselleştirilmiş araştırmalar ve immunelektroforez ve immunhistokimya ile boyanmış kemik iliği aspiratı incelemesi ile sonuç tanısı konabilir ve hasta yönetimi gerçekleştirilebilir

Aim and Objective: The main aim of this study is to categorize, type, grade of soft tissue tumors & correlate it with Ki-67 proliferative index. Material and Methods: The present study was conducted in the Department of Pathology, PGIMS, Rohtak. The study group comprised of excised 44 cases of STT (soft tissue tumors) specimens. Tumor grade was assigned based on the FNCLCC (Federation Nationale des Centers de Lutte Contre le Cancer) grading system. According to the Ki-67 index the patients were divided into two groups: high index group (>50/10HPF) and low index group (

Introduction: Morphological differentiation between reactive mesothelial proliferation and metastatic carcinoma cells may be extremely difficult in conventional centrifuge deposit smears stained with papanicolaou and romanowsky dyes. In the present study immunocytochemistry and morphometric analysis were performed on cytospin preparation of effusion categorized as atypical/suspicious on toluidine blue stained wet films. Materials and methods: A total of 100 cases comprising 26 benign (control group) and 74 malignant (study group) effusions were included in the study. Samples showing atypical /suspicious cells on preliminary conventional centrifuged wet film stained with toluidine blue; 63 were aspirated from pleural, 36 from peritoneal and 1 from pericardial effusions. These samples were processed for 6 cytospin preparations, 1 air dried stained with giemsa and others fixed in ethanol stained with papnicolaou stain, Cytokeratin 8/18, Epithelial Membrane Antigen (EMA) and Calretinin. Morphometric analysis was performed using software Image Pro Plus Version 6.3 on a minimum of 20 positive and negative stained cells on IHC stained smears. Results: The sensitivity and specificity of CK 8/18 in diagnosing benign, atypical and malignant cases were 91.89% and 89.5% respectively. The sensitivity and specificity of EMA was 90.5% and 86.6% respectively. Calretinin had 97% sensitivity for mesothelial cells. The 3 negative cases did not express CK 8/18 and EMA also. Thus, Calretinin can be accepted as a technique control to decide that immunocytochemical staining is working in a given case because mesothelial cells are generally present in benign as well as malignant effusions as native exfoliated cells. Nuclear area, cytoplasmic area and N:C ratio of mesothelial cells in benign effusions were 56.2 ± 2.03 um2, 182.41 ± 4.61 um2 and 0.31 ± 0.01 um2 and in malignant effusions were 63.15 ± 2.44 um2, 185.67 ± 2.15 um2 and 0.34 ± 0.01 um2 respectively. Using ROC (Receiver Operating Characteristic) curve nuclear area 88.30 μm2 area [sensitivity (98.6%) and specificity (94%)] cytoplasmic area 200.55 μm2 area [sensitivity (100%) and specificity (90%)] and N:C ratio 0.345 [sensitivity (93%) and specificity (94%)] considered as cut off values. So, we can use this value to discriminate between reactive mesothelial proliferations from malignant cells. Conclusion: IHC can be easily performed on cytospin preparation without requiring antigen retrieval and is extremely useful in differentiating metastasis from reactive mesothelial proliferation. The results of morphometric analysis were useful adjunct.

Background: In recent years basal cell markers (high molecular weight cytokeratin [HMWCK]) and prostate biomarker alpha-methyl acyl-coenzyme A racemase (AMACR) have been used as adjuvant to morphology in diagnostically challenging cases with a very high sensitivity and specificity. This has increased the diagnostic accuracy of prostate cancer worldwide. Materials and Methods: In this prospective study, total of 50 cases including 37 cases of malignant lesions and 13 cases of benign lesions of the prostate were taken. Tumor grade was determined according to Gleason's grading system. AMACR and HMWCK expressions were determined by immunohistochemical staining. The obtained results were analyzed and evaluated using Chi-square statistical test (SPSS version 20). Results: AMACR was not expressed in any of the 13 cases of benign lesions of the prostate while in malignant lesions of prostate it was expressed in 33 of 37 (89.18%) cases. All 4 (100%) cases of well-differentiated carcinoma were positive for AMACR expression. 21 of 25 (84%) moderately differentiated and all 10 (100%) cases of poorly differentiated tumors were positive for AMACR. There was statistically significant difference in expression of AMACR between benign and malignant lesions of the prostate, indicated byP = 0.001. In benign lesions, HMWCK was expressed in all the 13 (100%) cases while in malignant lesions of prostate it was not expressed in any of the (0%) case. All 13 benign lesions were positive for HMWCK only. AMACR expression was not seen in any of the benign lesion. Out of 37 malignant cases, 4 cases were negative for both, 33 cases were positive only for AMACR, but no case was positive only for HMWCK. Conclusions: As an adjunct to biopsy, AMACR and HMWCK have value for resolving diagnostically challenging cases.

Aim: The aim of this study is to analyze the correlation/diagnostic accuracy of cytology and frozen section (FS) preparations in the intraoperative diagnoses of central nervous system (CNS) lesions. Materials and Methods: A total of 63 cases of CNS lesions were included in the study from July 2012 to January 2015 at a tertiary care referral hospital. Intraoperative specimens were used for crush/squash smears and FS and correlated with the final histopathological diagnosis. Results: Majority of the patients (73.02%) were presenting in the age range of 21–50 years. There was a slight female preponderance with male-to-female ratio of 1:1.1. Two out of 63 cases were excluded from the cytology correlation analysis due to inadequate materials and 3 out of 63 cases were excluded from the FS correlation analysis due to freezing artifacts. The diagnostic accuracy of cytological preparation was 80.33% for complete correlation with histopathology and was increased to 93.44% for adding the partial correlations. The corresponding figures for FS were 81.67% and 93.33%, respectively, and the difference was insignificant (P = 0.971). The sensitivity, specificity, positive predictive value, and negative predictive value in detecting neoplastic condition on cytology were 94.4%, 85.7%, 98.07%, and 66.67%, respectively, and that of FS were 96.15%, 75%, 96.15%, and 75%, respectively. The corresponding P = 0.872, 0.652, 0.986, and 0.561, respectively. Conclusion: Crush and FS preparation are considered as effective diagnostic procedures for rapid intraoperative diagnosis in CNS lesions without any significant difference in results and when applied simultaneously can produce a higher diagnostic accuracy complementing each other's results.

Background: Thyroid disease is most common endocrine disorder and is different from other endocrine diseases because of its visible swelling and ease of diagnosis. If left untreated, thyroid disease makes a person more prone for heart disease, infertility and osteoporosis. In India, significant burden of thyroid diseases exist with an estimation of around 42 million cases. The thyroid status and autoimmune status of adult Indian population in the post iodinization phase is largely unknown. Aim: The main objective of this study was to generate valuable epidemiological data regarding the prevalence of thyroid disorders in rural population of Khanpur Kalan, Sonepat in the post-iodinisation era in India. To assess whether thyroid autoimmunity or goitrogens along with environmental factors play role in the development of thyroid.This paper is being presented in view that no such study has been carried out in the rural population of this region in Haryana. Materials and Methods: The present study was conducted in Department of Pathology, Bhagat Phool Singh Medical College for Women, Khanpur Kalan, Sonepat between August 2011 to July 2013. It included retrospective analysis of cytomorphology of fine needle aspiration cytology material of 206 patients presenting with thyroid nodule in the Department of Pathology. Results: The commonest age group affected was 31-40 yrs. The female patients (93.4%) outnumbered the male patients (6.6%).The cytomorphological analysis of 206 patients revealed 190 cases (92.2%) of neoplastic lesions, 10 cases (4.8%) were neoplastic and 6 cases (2.9%) had indeterminate cytomorphology. Maximum number (65.5%) of patients was suffering with goiter followed by lymphocytic thyroiditis (26.2%). Amongst the malignant cases three cases were of papillary carcinoma and one case of medullary carcinoma. Two out of the six cases of follicular neoplasm proved to be follicular adenoma on histopathology. Four patients with high T3 levels were under treatment with neomercazole. They showed change in cytomorphology from hyperplasia to colloid goiter. Only one case of acute suppurative thyroiditis was reported which shows rarity of its type. Conclusion: The increased prevalence of goiter in this post iodinisation era can be attributed to goitrogens, autoimmune thyroid disease and micronutrient deficiency of iron and selenium. Higher prevalence of autoimmune thyroiditis in females is linked with both genetic and environmental factors such as infection, stress.

Metaplastic Carcinoma of Breast with an Intracanalicular Fibrodenoma-A Rare Case Report Fibroadenomas are benign tumors that are labeled under the group proliferative lesions without atypia. Carcinoma arising de novo in fibroadenoma is rare. Presence of carcinoma within fibroadenoma is usually a secondary involvement from adjacent carcinoma. Incidence of a carcinoma evolving within a fibroadenoma is reported to be 0.002-0.0125%. Complex fibroadenoma and proliferative disease adjacent to the fibroadenoma are associated with a slight increase in the risk of breast cancer. But there are no clinical or mammographic features that have value in the diagnosis of carcinoma within a fibroadenoma until breach of false capsule. Metaplastic breast carcinoma arising in a fibroadenoma is a rare incidental finding. The etiology of this rare type of breast cancer is unknown.

Eosinophilic granuloma is a rare bone tumor, representing less than 1% of all bone tumors. Eosinophilic granuloma is the benign form of three clinical variants of Langerhans cell histiocytosis (LCH). It commonly affects children and young adults, particularly males. The characteristic cytologic features of eosinophilic granuloma include langerhans cells in a characteristic milieu which includes histiocytes, eosinophils, neutrophils and lymphocytes. We are reporting a case of eosinophilic granuloma of skull in a 7 years child diagnosed on fine needle aspiration cytology (FNAC). We here by emphasize the importance of rapid and reliable diagnosis of LCH by FNAC and the need to consider the possibility of LCH in the differential diagnosis of a slide showing a large number of histiocytes and eosinophils., Eozinofilik granülom nadir bir kemik tümörü olup, tüm kemik tümörlerinin %1’inden azını oluşturmaktadır. Eozinofilik granülom, üç klinik varyantı olan Langerhans hücreli histiositozisin (LHH) benign formudur. Çoğunlukla çocukları ve genç erişkinleri özellikle de erkekleri etkiler. Eozinofilik granülomun karakteristik sitolojik yapısı histiyositler, eozinofiller, nötrofiller ve lenfositleri içeren tipik bir ortamda langerhans hücrelerinin bulunmasıdır. Bu makalede ince iğne aspirasyon biyopsisi (İİAB) ile tanı alan yedi yaşında bir eozinofilik granülom olgusu sunulmaktadır. Burada özellikle İİAB ile LHH’e hızlı ve güvenilir bir şekilde tanı koyulabileceğini ve üzerinde çok sayıda histiyosit ve eozinofil bulunan bir ince iğne aspirasyon yaymasında ayırıcı tanıda LHH olasılığının bulunması gerektiğini vurgulamak istiyoruz.

Objective: To describe a rare case of lipofibromatosis presenting as a head and neck mass in a 6-year-old child. Method: Design: Case Report Setting: Tertiary Public General Hospital Patient: One Result: A six-year-old male child admitted with a large right head and neck region mass underwent complete excision of a possible soft tissue neoplasm following investigations which included Fine Needle Aspiration Cytology, Ultrasonography and Computed Tomography. Histopathological examination yielded lipofibromatosis, a very rare lesion with a distinctive fibrofatty pattern. The patient was well with no recurrence after three months of follow up. Conclusion: Although lipofibromatosis is a rare lesion in children and has a predilection for distal extremities, it may also present as a mass in the head and neck area. Complete surgical excision is feasible and is the only treatment option available for this rare lesion Keywords: lipofibromatosis

Transferrin, the major iron binding protein in human plasma transports iron to various tissues. The first step in cellular iron uptake is binding of transferrin complex to the cell surface membrane by specific molecule known as transferrin receptors. Transferrin receptors are found in limited sites in normal tissues, in contrast, the receptors are widely distributed in majority of carcinomas and sarcomas. Presence of increased transferrin receptors implies a stage of moderate or less differentiation corresponding to elevated proliferative activity and therefore, has a prognostic value. Demonstration of transferrin receptors and its distribution pattern within a tumour as well as its quantitative determination can provide data helpful for, both, an additional understanding of tumour biology and as an approach for planning therapy. In present study, we analysed 60 cases, 30 each of reactive lymphadenitis and lymphomas for transferrin receptors using immunohistochemical technique (DAKO, Code-K0673). Grade II and Grade III intensity was recorded in the germinal centers and the histiocytes in sinus histocytosis indicating the proliferating cells and activated histocytes. Most of the low grade non-Hodgkin lymphomas (83.66%) showed weak (Grade I) positivity for transferrin receptors. Intermediate grade lymphomas showed moderate (Grade II) to high intensity (Grade III) for transferrin receptors (57.14% and 42.85%) respectively. Seventy five percent of high grade lymphomas showed strong (Grade III) positivity. All the 9 cases of Hodgkin lymphoma (100%) showed grade III positivity. Proportion of the cells within a tumour expressing transferrin receptors in high density are therefore likely to represent the growth fraction of the tumour.

Marjolin's ulcers are malignancies that arise in chronic venous ulcers, scars, burns, long-standing wounds or sinuses. The most common type of carcinoma arising in the Marjolin's ulcer is squamous cell carcinoma (SCC), followed by basal cell carcinoma. Verrucous SCC (VSCC) comprises about 3% of all SCCs. It is most commonly diagnosed in the oral cavity, and the incidence is approximately one in a million/year. To the best of our knowledge, malignancy arising in a postnephrectomy sinus has never been described before. We herein report a case of VSCC in a sinus developed after nephrectomy done for renal stones.

Familial adenomatous polyposis (FAP) is an autosomal dominant condition that results in development of the large number of colorectal, and eventually, small intestinal or even gastric adenomas at an early age (late childhood to early adulthood). Extragonadal yolk sac tumors (YSTs) of the gastrointestinal tract are extremely rare neoplasms. Their greater rarity compared with other extragonadal YSTs suggests that different pathogenetic mechanisms could be involved according to the site of origin. Recent epigenetic studies suggest the involvement of some tumor suppressor genes, including the adenomatous polyposis coli gene in testicular YST. No case has so far been described in setting of FAP. Hereby, we describe a case of extragonadal germ cell tumor arising in colectomy stump of a patient with FAP.

The present study provides an analysis of immunohistochemical expression and localization of epidermal growth factor receptor (EGFR) in formalin fixed paraffin embedded specimens of prostate. Thirty-five cases each of benign prostatic hypertrophy (BPH) and prostatic carcinoma and 30 cases of prostatic intraepithelial neoplasia (PIN) were taken up for study. Streptavidin biotin peroxidase method was employed for immunohistochemical staining. EGFR positivity was observed in all the cases (100%) of BPH and PIN and in only 10 cases (28.5%) of prostatic carcinoma. In both BPH and PIN the basal cells revealed significantly higher intensity and percentage cell positivity than the luminal cells. Intensity and percentage of positively stained basal cells in BPH was higher than PIN basal cells but the difference was not statistically significant. The intensity and percentage cell positivity of BPH basal cells and PIN basal and luminal cells were significantly greater than the epithelial cells of prostatic carcinoma. Presently, the significance of variable expression of EGFR in various types of prostatic lesions is unknown.

Sebaceous carcinoma of the ocular adnexa is a malignant neoplasm which has aggressive local behavior and can metastasize to regional lymph nodes and distant organs. It is a malignant neoplasm known to masquerade as other benign and less malignant lesions, resulting in delay in diagnosis and relatively high morbidity and mortality. Aspiration cytological features of this neoplasm have not been well characterized in the literature. We report a case of this tumor diagnosed on fine needle aspiration. Clinically, a diagnosis of chalazion was made and fine needle aspiration cytology (FNAC) was performed. Cytological diagnosis of a malignant tumor with closest resemblance to sebaceous carcinoma was suggested which was confirmed on histopathology. Eyelid reconstruction was done after histopathological confirmation of tumor-free margins. The article highlights the role of FNAC in early diagnosis and subsequent appropriate surgical management of eyelid sebaceous gland carcinoma to prevent recurrence and metastasis.

Large-sized pulmonary chondroid hamartomas are very uncommon. We report a case of a 40-year-old male patient with a large sized chondroid hamartoma occupying almost the whole of one hemithorax, presenting with superior vena caval obstruction, left vocal cord palsy and adrenal involvement.

Cysticercosis is a condition that occurs when man is infected with larvae of Taenia solium. Oral cysticercosis is a rare event, and it represents difficulty in clinical diagnosis. A case of oral cysticercosis in 11 year old girl is presented which complained of painless swelling for 6 months. A FNAC was performed which revealed bluish pink fibrillary material and interspersed nuclei and fragments of wall of larvae. Patient was treated with antihelminthic.

Introduction The dissecting aneurysm of renal artery is a form of renal artery occlusive disease that is infrequently recognized in the literature. However, when encountered, it is of great clinical significance because symptoms related to aneurysm are rarely seen and there is risk of its rupture. Case Presentation The present case was a 30 year old Indian male, who presented with recurrent episodes of pain mimicking renal colic, which turned out to be a ruptured dissecting aneurysm of renal artery on exploration. The patient could not be salvaged due to delay in the diagnosis. Conclusion This report highlights that rupture of renal artery aneurysm is a rare but potentially lethal clinical entity and should be considered as one of the differential diagnosis in patients with severe and persistent renal colicky type of pain in the absence of obvious findings on routine investigations.

Primary intraosseous meningioma of the skull is an uncommon lesion often confused preoperatively with a primary bone tumor of the skull. We report this rare tumor in a 19-year-old male who was radiographically diagnosed as osteoid osteoma.

[no abstract available]

Malignant tumours affecting the eyelid include basal cell carcinoma (85% to 95%), squamous cell carcinoma (approximately 5%), sebaceous carcinoma (1% to 5%), and malignant melanoma (1%). Non-Hodgkin’s lymphoma of the eyelid is rare. This report is of an 80-year-old woman who presented with diffuse left upper eyelid swelling, clinically suspected to be a haemangioma. Rare diseases should be considered in differential diagnoses because they have the potential for rapid systemic involvement and may need treatment that is different from that of other common diseases at the same site.