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Neutrophil–lymphocyte ratio (NLR), as an indicator of heightened systemic inflammatory response, predicts increased disease burden and poor oncological outcomes in urothelial carcinoma (UC). The study was undertaken with an aim to evaluate the association of NLR with clinicopathological variables and survival outcomes. A total of 80 patients of UC were enrolled in the current retrospective study. Pre-operative NLR (within one month prior to the procedure), patient age, sex, tumour grade, pathological stage, recurrence free survival (RFS), progression free survival (PFS) and cancer specific survival (CSS) were recorded. We chose a cut-off value of 2.7 for NLR and patients were divide into two groups (NLR <2.7 and ≥2.7). NLR ≥2.7 was significantly associated with advanced tumour stage (p=0.001), but not with tumour grade (p=0.116). Progression (p=0.032) and death rates (p=0.026) were high in patients with NLR ≥2.7. Mean RFS (p=0.03), PFS (p=0.04) and CSS (p=0.04) were reduced in patients with NLR ≥2.7. On univariate analysis, NLR ≥2.7 predicted worse RFS (HR=2.928, p=0.007), PFS (HR=3.180, p=0.006) and CSS (HR=3.109, p=0.016). However, it was not an independent predictor of outcomes on multivariate analysis. Tumour stage and grade are the only independent predictors of RFS, PFS and CSS. High NLR at a cut-off value of ≥2.7 is associated with advanced pathological stage, but does not have an independent predictive value for RFS, PFS and CSS. [ABSTRACT FROM AUTHOR]

Introduction: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract (GIT) but have a low incidence. Arising from the interstitial cells of Cajal, GISTs occur at different sites in the GIT with stomach being the most common. They can rarely be seen at sites outside the GIT such as omentum, retroperitoneum and are called as extraintestinal GISTs (EGIST). They have a spindle or epithelioid cell morphology and show positivity by immunohistochemistry (IHC) for CD117. Our aim was to study the clinicopathological and immunohistochemical profile of our cases of EGISTs.Materials and Methods: A cross-sectional study of EGISTs received from 2010 to 2015 was done. IHC with CD117 and discovered on GIST1 (DOG1) was performed and tumors were scored based on the percentage of cells that stained positive. Thirteen abdominal non-GIST spindle cell tumors were included in the study as controls.Results: Seven cases of EGIST were included (four-omental, three-retroperitoneal). All cases stained positive for CD117 and DOG1. One case of epithelioid EGIST scored 4 + with DOG1 and 2 + with CD117. Another case with mixed morphology scored 2 + with DOG1 and 4 + with CD117. All controls were negative for both markers.Conclusion: EGISTs are one of the rare differentials for spindle cell lesions outside the GIT. Although both markers stain positive, DOG1 showed higher score with epithelioid GISTs. [ABSTRACT FROM AUTHOR]

Introduction: Papillary neoplasms are a group of lesions that are characterized by presence of papillae supported by fibrovascular cores lined by epithelial cells with or without myoepithelial cell layer. These neoplasms may be benign, atypical or malignant. Aims: This study was conducted to analyse the clinicopathological characteristics of papillary lesions of the breast. Materials and Methods: A retrospective and prospective analysis of 34 cases of papillary lesions received over a period of 7 years from 2009 to 2015 was done. The patient's clinical details were collected from medical archives and the histopathological findings were reviewed. The lesions were classified into benign, atypical and malignant categories. Results: During the study period, there were 34 cases of papillary lesions of breast. The mean age was 58 years. The central quadrant was the most common location (66.6%). The most common presenting complaint was lump (76.5% cases). Papillary lesions presented more commonly as solitary lump (82.4%) rather than multifocal disease. Benign papillary lesions were more common than the atypical and malignant lesions. The most common papillary lesion accounting for 43% of the cases was intraductal papilloma. Malignant lesions accounted for 41.2% cases with intraductal papillary carcinoma and invasive papillary carcinoma constituting 14.7% cases each. Conclusion: Diagnosis of papillary carcinoma is challenging and its classification includes different entities that have specific diagnostic criteria. Due to their heterozygosity in morphology with benign, atypical and malignant subtypes, morphological features such as type of fibrovascular core and continuity of myoepithelial layer along with immunohistochemical stains for myoepithelial cells should be considered for proper and accurate diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Neuroendocrine differentiation in colorectal carcinomas, detected using immunohistochemistry and ultrastructural techniques, has been studied as a prognostic marker for invention of targeted therapy. There are a few studies done on this aspect which have shown conflicting results ranging from poor prognosis to no prognostic significance. Aim: The aim of the study was to determine the clinical significance of neuroendocrine differentiation in colorectal carcinomas using immunohistochemical stains such as chromogranin A & synaptophysin in relation to its prognostic significance. Materials and Methods: A retrospective study was conducted wherein all the colorectal carcinomas, received in the Department of Pathology, over a period of 3 years, were reviewed. Neuroendocrine markers were done on 53 cases of moderately, poorly and undifferentiated adenocarcinomas. Based on the degree of immunoreactivity for these markers, tumours were divided into group 0, group 1, group 2, group 3 & group 4. Group 0 & 1 were categorized as neuroendocrine differentiation absent & group 2, 3 & 4 as present. Neuroendocrine differentiation was correlated with age, sex, grade, stage, diagnosis & survival. Follow up data of the cases was recorded. Results: Neuroendocrine differentiation was present in 18 cases (33.9%). The degree of immunoreactivity for neuroendocrine markers in present study were; group 0- 58%, 1- 7.5%, 2- 9%, 3- 13% & 4- 11%. The mean age of patients was 54 years with a slight male preponderance {M:F::1.6:1}. Most of the carcinomas with neuroendocrine differentiation belonged to Grade II (61%) & Stage II & III (83%). Neuroendocrine differentiation did not show any significant association with age, sex, location, histological type, grade, stage & survival. Conclusion: The above results indicate that the presence of neuroendocrine differentiation cannot be recommended as a prognostic marker in colorectal carcinomas. [ABSTRACT FROM AUTHOR]

Giant cell tumours of the clivus are rare. These tumours present in the second and third decades of life and they are slightly more frequent in women than in men. We are presenting a case of a 20 years young patient who came with the complaints of headache, retro-orbital pain and recurrent transient bleeding from the nose since two and half months. MRI of the brain with contrast was done and its features were suggestive of a Giant cell tumour of the clivus. A transnasal endoscopic biopsy was done under general anaesthesia and the histopathology report suggested that the features were of a giant cell tumour. Excision of the mass was done by Transnasal endoscopy. Post operatively, the patient did not recover from the lateral rectus palsy which was there on the right side. The patient was discharged with an advice of a follow up and radiotherapy. Radiation therapy and chemotherapy may be effective as adjuvant treatments. Even though a recurrence usually occurs within 4 years of the initial treatment, these patients will need to be carefully followed for the remainder of their lives. [ABSTRACT FROM AUTHOR]

This report highlights the utility of the reticulin stain in a completely infarcted chorangioma that facilitated the diagnosis. The patient had normal spontaneous delivery with good neonatal outcome in spite of the large size of the chorangioma and the presence of hydramnios in the antenatal period which may perhaps be due to the complete infarction of the tumor. [ABSTRACT FROM AUTHOR]

Bone marrow involvement by Hodgkin lymphoma is rare with an average incidence of 10%. However, the incidence of bone marrow involvement has been shown to be less than 1% in patients with clinical stage IA or IIA disease. The involvement of the marrow in a patient with Hodgkin lymphoma represents stage IV disease. We report our experience wherein three cases of marrow involvement were picked up on bone marrow aspirates/ -imprints and confirmed on trephine biopsy. In this paper we wish to highlight the significance of bone marrow examination in the initial diagnosis and staging of even clinically early stage Hodgkin lymphoma. Staging investigations performed at the time of diagnosis for patients with Hodgkin lymphoma are vital for determining the appropriate treatment and prognosis. [ABSTRACT FROM AUTHOR]

Background: Spindle Cell Carcinoma (SpCC) is a rare type of squamous cell carcinoma (SCC) with prominent malignant spindle cell component. This unique biphasic feature on histopathological examination makes its diagnosis problematic. Detection of p63 antigens in SpCC can be helpful however its expression in variousb proliferating soft tissue lesions demands for better marker., Methods: In this study, histopathologically diagnosed SpCC of head and neck region were considered as cases, and 22 soft tissue sarcomas, reactive lesions and spindle cell lesions of the body were taken as controls. Immunohistochemistry (IHC) was done using Anti-p63 and p40 clone and the results were compared. CK was done for negative cases to prove their epithelial origin. P. value < 0.05 considered statistically significant., Results: Among 22 cases of SpCC, 19 cases showed positive immunoreactivity to p63, and 18 cases for p40. IHC of controls showed no immunoreactivity in any of the sarcomas, reactive lesions or spindle cell lesions. The sensitivity of p63 is 86% while that of p40 is 82%. Specificity of both the markers was 100% CONCLUSION: Though p63 is a slightly (4%) more sensitive marker than p40, percentage of cell positivity for p40 is higher compared to p63. Both of these markers are 100% specific for SpCC., (Copyright © 2021 Elsevier GmbH. All rights reserved.)

Epidermoid cyst of intrapancreatic spleen is described but epidermoid cyst occurring in the pancreas itself is not documented. We report a 36-year-old man who presented with abdominal pain radiating to the back. On ultrasonography, a multilocular cyst was seen in the head of the pancreas. Fine-needle aspiration cytology suggested a diagnosis of epidermoid cyst, which was confirmed on histology of the resected specimen.