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Introduction: Ovarian tumours represent 3% of female malignancies, with epithelial tumours constituting more than 90% of all ovarian cancers. Tumour suppressor gene 53 (TP53) mutations play an important role in the prognosis and treatment of ovarian cancer. The tumour suppressor gene Tumour Protein 53 (p53), located on the short arm of chromosome 17, acts by suppressing abnormal cell growth at the beginning of the Synthesis phase (S-phase) of the cell cycle. Previous studies have shown a correlation between p53 mutation or overexpression and patient prognosis in various types of tumours, including breast cancer, rectal cancer, intestinal cancer, lung cancer, and ovarian cancer. Aim: To investigate the clinicohistopathological features and immunohistochemical expression of p53 in Epithelial Ovarian Tumours (EOT). Materials and Methods: A cross-sectional study was conducted in the Department of Pathology at Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India. The duration of the study was one year and two months, from September 2021 to November 2022. A total of 80 cases of EOT were included and histopathological diagnosis was performed, and immunohistochemical expression of p53 was evaluated in all cases. The Chi-square test was used to compare categorical data (the number of benign, borderline, and malignant EOT) and determine whether the difference in p53 expression (positive or negative) was statistically significant, using Statistical Package for the Social Sciences (SPSS) version 26.0. Results: The total of 80 cases of EOT in the present study comprised 56 (70%) benign, 5 (6.25%) borderline, and 19 (23.75%) malignant tumours. The p53 expression was statistically significant. Immunohistochemistry (IHC) for p53 showed diffuse strong positive nuclear staining (>60%) of the tumour cells in 14 cases, all of which were malignant epithelial tumours. Focally weak and patchy positive nuclear staining patterns (5%-60%) were observed in 64 cases, including 56 benign cases, four borderline cases, and four cases of malignant epithelial tumours, respectively. p53 positivity (

Introduction: The majority of gallbladder adenocarcinomas have been known to develop from dysplasia or carcinoma in situ, without pre-existing adenomas, hence observation of these non-neoplastic or preneoplastic lesions is important as it may underlie an occult malignancy. To study the role of morphology and immunohistochemistry in the diagnosis of incidental cancers in cases of gall stone disease by adopting a universal histopathological screening policy for all the gallstone disease cases operated at our tertiary care center. Material and Methods: The present study was designed as an observational cross sectional study completed over a time period of 14 months. A total of 176 cases were included in the study including all the patients of gall stone disease in the adult age group. All the indeterminate and frankly malignant cases were subjected to immunohistochemistry with a panel of antibody markers including p53, CEA and Ki-67 using Streptavidin Biotin immunoperoxidase method Fisher-exact test was used to compare the data taking'p' value less than 0.05 as statistically significant. Results: Mean age of patients was 40.55±13.25 years. Majority of patients (n=141; 80.1%) were females. The final diagnosis revealed a dominance of non-neoplastic inflammatory (n=168; 95.5%) pathology. There were 8 (4.5%) of malignancy, of these 7 were adenocarcinoma and 1 was adenosquamous carcinoma. Atypia was seen in 5 (2.8%) cases and 3 (1.7%) cases were of dysplasia. Histopathology detected carcinoma in 7 (4%) cases whereas addition of immunohistochemistry helped to find out one more unidentified case, thus the diagnostic yield increased to 8 (4.5%) cases. Out of three dysplasia cases, one (33.3%) was found positive on immunohistochemistry, which was later confirmed to be malignant. None of the cases of atypia were positive on p53, Ki-67 and CEA immunohistochemistry. On comparison between the three groups, the results were statistically significant (p=0.00062). Conclusion: Immunohistochemistry has a useful role in detection of incidental gallbladder carcinoma when morphology is limited by indeterminate results. A panel of immunohistochemical markers including p53, Ki-67 and CEA may prove very useful to pick up cases of malignancy in such cases of diagnostic dilemma.

Introduction: Apoptosis plays a major role in maintaining the balance between cellular proliferation and cell death in the skin. Blockage of apoptosis has been implicated as one of the contributing factors in the pathogenesis of psoriasis. P53 has a role in induction of cell cycle arrest, apoptosis as well as regulation of cell proliferation, bcl-2 is anti-apoptotic protein. Previous studies have reported controversial results relating to their expression in psoriatic skin. Aim: To evaluate the immunohistochemical expression of p53 and bcl-2 in the epidermis, basal cells and lymphocytes of psoriatic skin and compare it with the adjacent perilesional skin. Materials and Methods: This cross-sectional study was conducted in Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh, India from June 2016 to December 2017. Fifty cases of psoriasis were included and punch skin biopsies including a small part of perilesional skin was taken. The sections were studied for the presence of immunohistochemical expression of p53 and bcl-2 using scoring systems. The perilesional part of the biopsy was used for comparing the histopathological and immunohistochemical expressions. The student t-test was used for comparison of groups using Statistical Package for the Social Sciences (SPSS) version 23.0 program and a p-value of

Introduction: Tuberculosis (TB) is one of the leading causes of mortality and morbidity in India, and extrapulmonary cases from the lymph nodes account for one-fifth of the overall disease burden. TB is known for its varied clinical presentations as well as different sites (organs) of involvement. Fine-needle aspiration cytology (FNAC) plays an important role in diagnosing a significant number of cases which present as granulomatous lesions. Here, we study the cytomorphological and clinical presentation of swellings showing granulomatous pattern of inflammation and correlate them with acid-fast bacilli (AFB) positivity. Materials and Methods: A retrospective study of 3-years duration was done from January 2018 to December 2020 in a tertiary care hospital. Slides of 356 cases showing epithelioid granulomas on cytology were taken out. The clinical data were collected from patient requisition forms. All the available clinical and cytological findings were recorded. The slides were re-examined and characterized into specific patterns of granulomatous inflammation on the basis of predominant background population of cells, necrosis, and hemorrhage. These were correlated with the presence of positive AFB staining on Ziehl–Neelsen (ZN) stain. Chi-square test was used for comparison between groups and P < 0.05 was taken to be statistically significant. Results: The mean age of presentation was 25 years (ranging from 5 months to 75 years) with a slight female preponderance (male-to-female ratio being 0.9:1). The cervical lymph nodes were the most common site. The sites of presentation were varied. The aspirates were gray–white to blood mixed on gross and cytological examination in 186 cases (52.25%). On microscopy, the suppurative pattern was seen in 202 cases (56.74%) and necrosis was seen in 182 cases (51.12%). The AFB positivity on ZN staining was seen in 96 (26.96%) cases in FNAC smears. There was a significant association of positive AFB staining with younger age group (2 cm), fixed and matted swellings, longer duration of symptoms (>2 weeks), and absence of pain and fever. The whitish/purulent aspirates on gross examination as well as suppurative and necrotic patterns on cytomorphology on microscopic examination showed a highly significant positive correlation with AFB staining. Conclusion: The gross and microscopic patterns of suppuration and necrosis on FNAC in combination with clinical signs and symptoms are highly suggestive of TB. ZN staining on cytology smears is a very simple and useful investigation, especially in suppurative and necrotic patterns of cytology, for clinching an early diagnosis, which goes a long way in the management of tuberculosis.

Background: Intraoperative cytology (IOC) is a simple and quick technique with excellent preservation of cellular details. In the present study, we have evaluated the role of IOC by various methods of smear preparation and compared it with frozen section diagnosis. A scoring system was followed for epithelial tumors for characterization and grading on the basis of cellularity, pattern, nuclear, cytoplasmic features, and background details. Materials and Methods: The study was conducted during a time span of 2 years in total 48 cases of ovarian tumors. Fine-needle aspiration cytology, touch/imprint, scrape, and crush techniques were used. The smears so prepared were processed for toluidine blue and Giemsa and Papanicolaou staining. Cases were cytomorphologically categorized into four groups: Indeterminate; unequivocally benign; borderline tumor with equivocal morphology; and unequivocally malignant (graded into well, moderately, and poorly differentiated). Results: In our study, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 88.88, 96, 96, 88.88, and 92.31%, respectively, were recorded. This was comparable to frozen section diagnosis with a sensitivity, specificity, PPV, NPV, and accuracy of 85.18, 96.15, 95.83, 86.21, and 90.56%, respectively. In epithelial tumors, cytological grading correlated with histopathological grading in 85.29% cases of epithelial tumors. Conclusion: IOC gives comparable results to frozen section and can be used for intraoperative assessment of ovarian tumors. Grading of epithelial tumors on IOC can be performed and may become an important step in intraoperative decision-making for better management and outcome of the patient.

Ceruminous adenoma (CA) is a rare, benign tumor of the ceruminous gland found in the cartilaginous part of the external auditory canal (EAC). The tumor is diagnosed on histopathology and shows a characteristic dual population of luminal epithelial cells and basal myoepithelial cells. However, CA can be diagnosed on fine-needle aspiration cytology (FNAC) prior to surgery and the cytopathologist should be well aware of its cytological findings to avoid any misdiagnosis. The tumor shows an excellent prognosis with possible recurrence and malignant transformation. The present case emphasizes the cytological features of CA, which have been scantily described in the literature and highlights the role of cytopathologists in preoperative diagnosis.

Primary extradural meningiomas of the skull comprise 1% of all meningiomas, and lytic skull meningiomas are still rarer and are said to be more aggressive. We present a case of 38-year-old male with an extradural tumor which on histopathological examination showed features of inflammatory atypical meningioma (WHO Grade II). The intense inflammatory nature of osteolytic primary intraosseous meningioma has not been reported before. This entity deserves special mention because of the need for adjuvant therapy and proper follow-up.

Acinic Cell Carcinoma (AcCC) is a slow growing, malignant tumour of salivary glands, predominantly found in parotid gland and rarely in submandibular gland or minor salivary glands. Rarely, the tumour can arise in Heterotopic Salivary Gland Tissue (HSGT) and can present bilaterally. Synchronous contralateral tumour or tumour arising in HSGT is easily missed clinically. Fine Needle Aspiration Cytology (FNAC) is an important preoperative diagnostic investigation in cases of AcCC. Sometimes its diagnosis on cytology is very difficult and it is easily misdiagnosed as benign, affecting the long term prognosis. Here, we present two unusual cases of AcCC. One developed in HSGT and the other was synchronous bilateral. Though the histological features of AcCC appear to be characteristic but clinical suspicion and cytological features have been described as equally important for preoperative diagnosis. Present cases highlight the importance of a cytopathologist who plays an important role in its preliminary diagnosis.

The clinical presentation of metastatic renal cell carcinoma to ovary is extremely rare as well as confusing due to its close resemblance to primary ovarian tumors, especially clear cell carcinoma. We present a case of metastatic renal cell carcinoma diagnosed in a 48-year-old female, who had renal cell carcinoma of the right kidney and right sphenoid wing meningioma of transitional type.

One-third of schwannomas occur in head and neck region, mostly in the parapharyngeal region. Cystic change is seen in only 4% of schwannomas. The diagnosis of such tumors remains a challenge due to the rarity of these lesions and limited utility of fine needle aspiration cytology. When cystic, branchial cleft cyst is an important differential diagnosis more so due to radiological resemblance. We present a case of 42-year-old male with left sided neck mass masquerading as branchial cleft cyst clinically and radiologically. Multiple sections examined from the cystic areas of the mass revealed lymphoid aggregates beneath the cyst wall in addition to the schwannomatous areas.