Histopathological Patterns Research Articles

The Study of Abnormal Uterine Bleeding, Estrogen And Progesterone Receptor Expression In Cases of Endometrial Hyperplasia And Neoplasia

AUB is the very common condition of patients in gynaecological OPD.The aim of study is to evaluate the histopatholological patterns of endometrium and to correlate it with different age groups and study ER and PR receptor expression in them. Meterials and Methods: It is a reterograde study from 1 st jan 2021 to 30th june 2022 in the Department of Pathology ,T S Misra Medical College and Hospital in collaboration with King George’s Medical University. The study includes around 87 patients in the age group 30 to 80 yrs. .All the relevant cinical details and investigations was obtained from patients record.The study includes AUB cases of histopathologicaly diagnosed endometrial pathology .Those cases with inadequate sample or with history of pregnancy was excluded from study.The specimens were routinely processed and Hand E stained slides are studied for endometrial patterns and their frequencies and percentages were classified age group wise.ER and PR positivity percentage was determined in different patterns with immunohistochemistry. Results: Number of patients falling in different age groups were noted and the result concluded was maximum number of AUB cases were in 40 -50 yrs in perimenopausal and post menopausal age group less number was in the reproductive age group Number of patients in different histopathological pattern was also noted. Endometrial patterns included non malignant( 65/87,) proliferative (%) followed by secretary (%) and endometrial hyperplasia without atypia( %),simple hyperplasia with atypia (%) ,complex hyperplasia with atypia (%) and malignant(22/87)endometrial carcinoma (25.3%). ER and PR positivity rate was 95.4% and 96.6% respectively in whole study. ER and PR expression in each pattern was also studied. Conclusion; Histopathological examination plays a critical role in early diagnosis of endometrial pathology and to plan appropriate gynaecological management. Knowledge of ER ,PR expression is helpful in determining the prognosis for survival and hormone replacement therapy.

Histopathological Diagnosis of Hysterectomy Specimens in Abnormal Uterine Bleeding

Background: Abnormal uterine bleeding (AUB) is a common and distressing condition effecting predominantly perimenopausal women. Heavy menstrual bleeding (HMB) is the most common presentation of AUB. There are many structural and non structural causes of AUB. Histopathology of endometrial curettings is well studies before but the histopathological patterns of hysterectomy specimens are not well studied. Objective: The objective of this study is to: Find out histopathological diagnosis of hysterectomy specimens in patients of AUB. Study Design: Retrospective Cohort study. Place and Duration of Study: Gynecology and Pathology departments of Azra Naheed and Rashid Latif medical colleges from January 2022 to January 2023. Methods: Histopathology reports of all hysterectomies done for AUB in both medical colleges allied hospitals were retrieved retrospectively and evaluated in detail. Four age groups were defined 30-40 years, 41-50, 51-60 and 61-70 years. Various patterns were recorded overall and separately for each group and results established. Results: A total of 221 abdominal hysterectomy histopathology reports were retrieved and evaluated. All hysterectomies were performed for AUB during one year period between January 2022 to January 2023. 40(18.09%) women were between 30-40 years of age, 134(60.6%) were between 41-50 years of age, 39(17.6%) were between 51-60 years of age and 08(3.61%) patients were between 61-70 years of age. Distorted proliferative phase endometrium was seen in 28(12.6%) of cases, Adenomyosis was seen in 76(34.38%), endometrial polyps in 19(8.55%), fibroids in 92(41.6%), metaplasia 07(3.1%), hyperplasia 10(4.5%), and endometrial carcinoma was seen 09 (4.07%) of cases. Conclusion: AUB is most common in perimenopausal women. Fibroids, Adenomyosis, and disordered proliferative endometrium were most common in perimenopausal women while carcinoma endometrium was most common cause of AUB in postmenopausal women. This study will help Gynecologists to better find out the cause of AUB and treat accordingly. Keywords: Abnormal uterine bleeding (AUB), Heavy menstrual bleeding (HMB), Perimenopausal, Hysterectomy. Histopathology, Endometrium

Atypical thymoma (epithelial-rich thymoma, well-differentiated thymic carcinoma, WHO type B3 thymoma): A conundrum.

Thymomas composed predominantly of epithelioid tumor cells with scattered lymphocytes have been well recognized in the literature. This subtype of thymoma has been variously termed epithelial-rich thymoma, well-differentiated thymic carcinoma, atypical thymoma, or World Health Organization (WHO) type B3 thymoma. Regardless of the designation however, these tumors are known to show a spectrum of histopathological growth patterns that may pose challenges in interpretation and diagnosis, particularly when dealing with small mediastinoscopic biopsies. Just like any other type of thymoma, those composed predominantly of epithelioid cells may present as encapsulated or invasive tumors. Nevertheless, compared to other subtypes of thymoma, they are uncommon neoplasms. Therefore, it becomes very important to sufficiently sample thymomas before making a diagnosis of a particular subtype, especially when the tumor is rich in epithelioid cells and only has a scant lymphocytic component. Because of the unusual occurrence of these tumors, there are only few large series of cases that attempt to highlight not only the more salient histopathological features but also the most important immunohistochemical and molecular characteristics.

Comparison of Interleukin-33 Serum Levels in Patients with Breast Cancer and Idiopathic Granulomatous Mastitis

Breast cancer (BC) is the main cause of cancer death in women. Idiopathic granulomatous mastitis (IGM), a rare chronic disease that clinically mimics breast carcinoma, and is associated with high mortality and morbidity, but an immediate and accurate diagnosis can substantially decrease these rates. Expressed by numerous human tissues, interleukin-33 (IL-33) has an inductive role in the network of pro-inflammatory cytokines. The aim of this study was to investigate the serum levels of IL-33 in BC and IGM patients in comparison with healthy women. This descriptive-analytical study was carried out on 28 patients with BC and 25 patients with IGM as the patient groups and 25 healthy volunteers with normal screening reports as the control group. Histopathological pattern of BC and IGM were confirmed by specialized pathologists. The serum concentration of IL-33 was measured using enzyme-linked immunosorbent assay (ELISA) kit according to the manufacturer's instructions. The mean age of the patients with BC and IGM and the control group was 49.1, 37.1, and 36.8 years, respectively. There was no significant difference in IL-33 expression among the participants with regard to age, marital status, body mass index (BMI), and menopausal status. IL-33 assay indicated a significant difference between the BC (P=0.011) and IGM (P=0.031) groups compared to the controls, although no substantial differences were observed between the IGM and BC groups. IL-33 can be considered a significant factor distinguishing IGM and BC patients from controls, although it cannot be applied to diagnose and differentiate BC from IGM patients.<br />.

Clinical, radiological and pathological features of anti-MDA5 antibody-associated interstitial lung disease

IntroductionTo investigate the clinical, radiographic and pathological features of interstitial lung disease (ILD) in patients with anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis (anti-MDA5+DM).MethodsWe retrospectively analysed the medical records of patients...

Sex differences and histopathological patterns of lung damage in Syrian hamsters induced by SARS-CoV-2 experimental infection

Sex differences and histopathological patterns of lung damage in Syrian hamsters induced by SARS-CoV-2 experimental infection

Histo-pathological patterns in hysterectomy specimens at a tertiary care centre in India.

It is of interest to document histo-pathological patterns in hysterectomy specimens at tertiary care centre in India. This study included 442 cases. In this study, leiomyoma (9.17 %) was the most common preoperatively clinical diagnosis made in hysterectomy specimen. In this study, uterine fibroid showed a 90.47% correlation between pre-operative and histological findings. There was a 50 % correlation noted between adenomyosis and endocervical polyp.

Immunomorphological Patterns of Chaperone System Components in Rare Thyroid Tumors with Promise as Biomarkers for Differential Diagnosis and Providing Clues on Molecular Mechanisms of Carcinogenesis.

Hurthle cell (HC), anaplastic (AC), and medullary (MC) carcinomas are low frequency thyroid tumors that pose several challenges for physicians and pathologists due to the scarcity of cases, information, and histopathological images, especially in the many areas around the world in which sophisticated molecular and genetic diagnostic facilities are unavailable. It is, therefore, cogent to provide tools for microscopists to achieve accurate diagnosis, such as histopathological images with reliable biomarkers, which can help them to reach a differential diagnosis. We are investigating whether components of the chaperone system (CS), such as the molecular chaperones, can be considered dependable biomarkers, whose levels and distribution inside and outside cells in the tumor tissue could present a distinctive histopathological pattern for each tumor type. Here, we report data on the chaperones Hsp27, Hsp60, and Hsp90. They presented quantitative levels and distribution patterns that were different for each tumor and differed from those of a benign thyroid pathology, goiter (BG). Therefore, the reported methodology can be beneficial when the microscopist must differentiate between HC, AC, MC, and BG.

An Investigation of the Clinico-histopathologic Trend of Salivary Gland Tumors in Amir Alam Hospital During 2010- 2019: A Retrospective Study

Background: The incidence and mortality rates of salivary gland tumors have increased according to previous evidence. No study has so far focused on the trend of clinical and histopathologic patterns of salivary gland tumors in Iran. Therefore, the aim was to investigate the incidence and clinico-histopathologic trend of salivary gland tumors in a retrospective, cross-sectional, institutional study from 2010-2019 in Amir Alam hospital. Methods: The archived medical records were collected from patients with the histopathologic diagnosis of benign and malignant salivary gland tumors from Amir Alam hospital, Tehran during (April-April) 2010- 2019. Demographic data and histopathologic features, including tumor size, lymph node involvement, vascular invasion, perineural involvement, and histopathologic differentiation were retrieved, and the samples were categorized and reviewed based on the new classification of head and neck tumors. Finally, the frequencies of characteristics were determined and expressed as numbers (percentage values). Results: Of 1203 salivary gland tumors, 77.6% and 22.4% were benign and malignant, respectively. The incidence of benign tumors was increased from 37 (22.2%) in 2010 to 178 (364.9%) in 2019. In the collection of the total samples, the incidence of malignant tumors was relatively steady from 23 (13.8%) samples in 2010 to 27 (55.35%) in 2019. However, an increase in the incidence of tumors with low-grade differentiation was found from 12.5% in 2010 to 80% in 2019. Conclusions: The incidence of benign and malignant salivary tumors with a higher degree of malignancy had an increasing trend in Amir Alam hospital during 2010-2019.

Histopathological Study of Appendectomy Specimens in a Rural Tertiary Care Hospital in Bangladesh

Background: Appendicitis is one of the most common causes of the acute abdomen that demands emergency surgical intervention. It is a clinical condition that is frequently encountered as a diagnostic challenge. Sometimes grossly normal-appearing appendix, removed from patients with suspected acute appendicitis, on histopathological examination may reveal a more serious underlying pathology. Hence, histopathological studies form the gold standard for the diagnosis of appendicitis. Aim: To study the histopathological patterns of appendicitis in patients who underwent appendectomy. Methods: This study was carried out in the department of Pathology, Jahurul Islam Medical College, Bajitpur, Kishoreganj from January 2020 to December 2020. All the appendectomy specimens were received in 10% formalin as fixative. Sections obtained were studied to determine various histopathological patterns in appendectomy specimens. Results: A total of 252 specimens were undertaken for histopathological examination. There were 154 (61.1%) males and 98 (38.1%) females with male to female ratio of 1.6:1. The most common lesion observed was acute appendicitis (51.98%) followed by recurrent appendicitis (28.17%), acute suppurative appendicitis (07.15%), gangrenous appendicitis (06.36%), eosinophilic appendicitis (02.38%), follicular lymphoid hyperplasia (02.38%), mucinous adenoma (0.40%) and mucinous adenocarcinoma (02.38%). Conclusion: Most of the cases in this study were diagnosed with the usual features of appendicitis, though a few of them were incidental diagnoses that were missed clinically. These important incidental diagnoses undisputedly support the notion that every appendectomy specimen must be sent routinely for histopathological examination. Mediscope 2023;10(1): 17-21

Histopathologic patterns of intracranial neoplasms at Lagos University Teaching Hospital, Nigeria. A ten-year hospital-based retrospective study.

The most common intracranial neoplasm worldwide is meningioma, followed by gliomas, and then pituitary adenomas. There are geographical differences in the pattern of occurrence of intracranial neoplasms.The purpose of this study is to establish the pattern of occurrence of different histological types of intracranial neoplasms with their age and sex distributions in our environment - Lagos, Nigeria.The histological patterns, age, and gender distributions of all the intracranial neoplasms diagnosed within the study period at the Department of Anatomic and Molecular Pathology, LUTH, Lagos, Nigeria were noted and analysed with SPSS version 23. There were 296 patients (165 females, 131 males; mean age of 37.0 years) diagnosed with an intracranial neoplasm within the study period. The most frequently diagnosed intracranial neoplasm was meningioma (105 cases; 35%, median age of 42 years, male to female ratio of 1:2.2), followed by pituitary adenoma (78 cases; 26%, median age of 47 years, male to female ratio of 1.3:1), and then gliomas (71 cases; 24%, median age of 28, male to female ratio of 1:1.39). The result of the study shows pituitary adenoma to be more common than gliomas, unlike what is seen in Caucasians where the reverse is the case.

Abstract 4535: Clinical outcomes and molecular features of different histopathologic patterns in patients with stage IB non-squamous non-small-cell lung cancer

Abstract Background: About 15% to 20% of patients with stage IB non-small-cell lung cancer (NSCLC) may develop recurrence within 5 years. However, the use of adjuvant therapy for resected stage IB patients remains controversial. This study investigated the differences in prognosis and molecular features between different histopathologic patterns of stage IB non-squamous NSCLC (nsNSCLC) and tried to identify patients who most in need of adjuvant therapy. Methods: A total of 215 patients with completely resected pathologic stage IB (tumor size 3-4 cm) nsNSCLC from Tianjin Medical University Cancer Institute &amp; Hospital between 2014 and 2018 were included in the study. For 130 patients, genomic profiling of tumor tissues was sequenced by a panel of 9 driver genes (OncoScreen® Focus CDx Tissue Kit, Burning Rock Biotech) and the molecular risk stratification was assessed by 14-gene quantitative PCR (qPCR) assay (DetermaRxTM, Burning Rock Biotech). Results: Among the 215 patients, 67.9% were solid/micropapillary-predominant pattern (S/MP), 40.5% had received platinum-based doublet adjuvant chemotherapy, and 5.1% had received adjuvant targeted therapy with or without chemotherapy. Patients with S/MP pattern had significantly worse DFS than those with lepidic/acinar/papillary-predominant (L/A/P) pattern (hazard ratio [HR]: 2.16, 95% confidence interval (CI): 1.28 to 3.67; P = 0.013). However, neither pattern could benefit from adjuvant therapy. EGFR mutation was successfully detected in 75 out of 126 patients (59.5%), and the positive rate in S/MP pattern was significantly lower than that in L/A/P pattern (50.6% vs 79.5%, P = 0.002). However, EGFR mutation status was not a prognostic factor for DFS in neither overall population nor different histopathologic patterns. EGFR-mutant patients showed the trend to benefit from adjuvant targeted-based therapy in the limited samples. Molecular risk stratification was successfully assessed in 99 patients, of which 37.4%, 26.3%, and 36.4% were predicted as molecularly high-risk, intermediate-risk, and low-risk patients, respectively. There were significant differences in the proportion of high- and low-risk patients between S/MP and L/A/P patterns (for high-risk: 46.2% vs 20.6%; for low-risk: 26.2% vs 55.9%; P = 0.009). The high-risk patients had significantly shorter DFS than the low-risk patients (HR, 2.93, 95% CI: 1.31-6.54; P = 0.012), especially those in S/MP pattern (HR, 3.45, 95% CI: 1.46-8.15; P = 0.017). Conclusion: Our study confirms that S/MP pattern is a significantly worse prognostic factor for DFS in nsNSCLC and that there are significant differences in molecular features between these two different histopathologic patterns. qPCR-based assay could reliably identify patients with a worse prognosis in S/MP pattern, suggesting that such patients are most likely to benefit from personalized adjuvant therapy. Citation Format: Dongsheng Yue, Bin Zhang, Chen Chen, Qiang Zhang, Xinyi Wu, Jiping Xie, Changli Wang, Zhenfa Zhang. Clinical outcomes and molecular features of different histopathologic patterns in patients with stage IB non-squamous non-small-cell lung cancer. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4535.

Abstract 4601: Vitamin D supplementation attenuates resistance to anti-angiogenic therapy in colorectal cancer liver metastases

Abstract Colorectal cancer liver metastasis (CRCLM) is one of the deadliest cancers. CRCLM tumours have two distinct histopathological growth patterns (HGPs) including desmoplastic HGP (DHGP) and replacement HGP (RHGP). The DHGP tumours are angiogenic, while their RHGP counterparts are vessel co-opting. The patients with RHGP tumours showed poor response to anti-angiogenic agents, as well as a worse prognosis. Herein, we conducted a retrospective cohort study that comprised 106 CRCLM patients to examine the effect of vitamin D supplementation on the HGPs of the tumours and the 5-year overall survival (OS). Interestingly, we found an inverse correlation between vitamin D supplementation and the presence of RHGP tumours in CRCLM patients. Additionally, the population who used vitamin D supplementation had significantly better 5-year OS. Moreover, our in vivo results suggested that vitamin D supplementation significantly improves the response of CRCLM tumours to anti-angiogenic therapy. Mechanistically, we found that vitamin D can suppress cancer cell motility, which is essential for the development of vessel co-option tumours and resistance to anti-angiogenic therapy. Collectively, this study suggests vitamin D supplementation is a promising way to attenuate resistance to anti-angiogenic therapy and improve the prognosis of CRCLM patients. Citation Format: Miran Rada, Lucyna Krzywon, Audrey Kapelanski-Lamoureux, Stephanie Petrillo, Anthoula Lazaris, Peter Metrakos. Vitamin D supplementation attenuates resistance to anti-angiogenic therapy in colorectal cancer liver metastases. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4601.

Abstract 1741: Inhibition of pcsk9 impairs the development of vessel co-option and potentiates anti-angiogenic therapy in colorectal cancer liver metastases

Abstract Colorectal cancer liver metastatic (CRCLM) tumours present as two main histopathological growth patterns (HGPs) including desmoplastic HGP (DHGP) and replacement HGP (RHGP). The DHGP tumours obtain their blood supply by sprouting angiogenesis, whereas the RHGP tumours utilize an alternative vascularisation known as vessel co-option. In vessel co-option, the cancer cells hijack the mature sinusoidal vessels to obtain blood supply. Vessel co-option has been reported as an acquired mechanism of resistance to anti-angiogenic treatment in CRCLM. Herein, we show the connection between serum cholesterol concentration and vessel co-option development in CRCLM. Our clinical data suggested that the elevation of serum cholesterol levels correlates with the risk of developing vessel co-opting tumours. Moreover, inhibition of PCSK9, the key modulator of cholesterol metabolism, significantly attenuated the development of vessel co-opting CRCLM tumours and sensitized the tumours to anti-angiogenic therapy in vivo. Altogether, these data suggest the importance of cholesterol in the development of vessel co-option tumours and propose that inhibiting PCSK9 is a promising strategy to overcome resistance to anti-angiogenic therapy in CRCLM. Citation Format: Miran Rada, Lucyna Krzywon, Audrey Kapelanski-Lamoureux, Stephanie Petrillo, Andrew Reynolds, Anthoula Lazaris, Nabil Seidah, Peter Metrakos. Inhibition of pcsk9 impairs the development of vessel co-option and potentiates anti-angiogenic therapy in colorectal cancer liver metastases [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1741.

CLINICO-PATHOLOGICAL STUDY OF NON-NEOPLASTIC AND NEOPLASTIC LESIONS OF SINONASAL TRACT AND NASOPHARYNX

Introduction: A various non- neoplastic and neoplastic lesions of sinonasal tract and nasopharynx (NP) are commonly present in clinical practice. The aim of this study is to study clinical and histopathological patterns of lesions of sinonasal tract and nasopharynx in a tertiary care hospital over the period of January 2022 to June 2022. This study of 121 cases (Male 82, Female 39) of nas Methods &amp; Material: al cavity, paranasal sinuses and nasopharynx over the period of 6 months. All received tissues after examination, xed in 10% buffered formalin, processed and stained with Hematoxylin &amp; Eosin to study histopathological patterns. These nasal, paranasa Results: l and nasopharynx lesions were common in sixth and seventh decade of life. Among them 70 (57.85%) non neoplastic and 51 (42.14%) neoplastic lesions. Mucormycosis (23.96%) and polyps (17.35%) were the most common among the non- neoplastic masses; Inverted papilloma (2.47%) most common among benign neoplastic and squamous cell carcinoma (30.75%) was commonest out of all malignant masses. Conclusions: We concluded that complete clinical, radiological/imaging and histopathological helps to categorized lesions into various non-neoplastic and neoplastic types. But histopathological examinations provide a conrmatory diagnosis. Although immunohistochemistry is the nal diagnostic method in few cases.

Histopathological spectrum of lesions of kidney: A morphological study

Introduction: The kidneys, as essential organs with diverse functions, are of paramount importance in the human body. Their primary role involves eliminating metabolic waste products and maintaining the balance of water, salt, calcium, phosphorus, anions, and cations to uphold the plasma's acid-base equilibrium. The objective of the current study is to investigate and understand the various morphological patterns exhibited by renal diseases, as well as assess their distribution across different age groups and genders. Material and Methods: The present study was conducted at Department of Pathology, Mamata Medical College, Khammam. A total of 32 nephrectomy specimens were studied.Results: The study shows, male to female ratio is 2.5:1 with male preponderance and among 32 nephrectomy specimens 20 were non-neoplastic and 12 were neoplastic. Neoplastic lesions constitute about 20 cases with chronic pyelonephritis being the most common cause (8 cases) leading to nephrectomy. Hydronephrosis (5 cases) majority of them showed enlarged kidneys with depressed scars and loss of corticomedullary differentiation. In the age group between 5th to 6th decades maximum number of non-neoplastic lesions was seen and least is observed in between 1st to 2nd decade. Conclusion: To conclude, these findings provide valuable insights into the histopathological patterns and distribution of kidney diseases in the studied population, contributing to our understanding of the prevalence and characteristics of these conditions.

Endoscopic features help to identify the histopathological patterns of colorectal polyps in Cronkhite-Canada syndrome.

Cronkhite-Canada syndrome (CCS) is a rare nonhereditary gastrointestinal hamartomatous polyposis syndrome with a high risk of colorectal cancerogenesis. It is challenging to discriminate adenomas from nonneoplastic colorectal polyps macroscopically. This study aimed to explore the endoscopic features of different histopathological patterns of colorectal polyps in CCS. Sixty-seven lesions from 23 CCS patients were prospectively biopsied or resected during the colonoscopic examinationfor histopathological analysis. The Fisher's exact test and multivariate logistical analysis were conducted to reveal the predictive endoscopic features of CCS polyps with low-grade dysplasia (LGD) and adenomas. There were seven (10.4%) adenomas, 20 (29.9%) CCS-LGD, and 40 (59.7%) nonneoplastic CCS polyps. Polyps were large (>20 mm) in none of the adenomas, 30.0% of CCS-LGD polyps, and 2.5% of nonneoplastic CCS polyps (P < 0.001). The color of the polyps was whitish for 71.4% of adenomas, 10.0% of CCS-LGD polyps, and 15.0% of nonneoplastic CCS polyps (P = 0.004). Pedunculated polyps were detected in 42.9% of adenomas, 45.0% of CCS-LGD polyps, and 5.0% of nonneoplastic CCS polyps (P < 0.001). The proportions of types IV and VI in the Kudo classification were 42.9%, 95.0%, and 35.0% in adenomatous, CCS-LGD, and nonneoplastic CCS polyps, respectively (P = 0.002). The endoscopic activity was in remission for 71.4% of adenomas, 5.0% of CCS-LGD polyps, and 10.0% of nonneoplastic CCS polyps (P < 0.001). Endoscopic features, including the size, color, sessility, Kudo's pit pattern classification of polyps, and endoscopic activity, help identify the histopathological patterns of colorectal polyps in CCS.

Histopathological spectrum of ovarian neoplasms at tertiary health care hospital

Background: The aim of the study was to identify histopathological pattern involving in ovarian neoplasm which where received for histopathological evaluation at tertiary health care centre over a period of 2 year in Pathology department at Guru Gobind Government Hospital, Shri M. P. Shah Government Medical College, Jamnagar.Materials and Methods: This Prospective and Retrospective study was conducted over a period of two year (January 2020 to December 2022) in the Department of Histopathology, shri M.P, Shah Government medical college, Jamnagar. The study included 100 cases of ovarian neoplasms . After proper fixation and thorough gross examination, sections were routinely processed and examined. The distribution of the various histomorphological spectrum of ovarian tumors was studied according to the WHO classification. Aims and Objectives 1) To study frequency of ovarian tumor.2) To study their histopathological features.3) To study age wise incidence of ovarian tumor.Results: In the present study, a total of 100 cases of Ovarian neoplasm were analyzed, out of which Surface epithelial tumors were the most prevalent, comprising 70 cases (70%). Serous cystadenomas were the most common benign neoplasm encountered in our study. Germ Cell Tumors 22 (22%), Mature teratoma were most common germ cell tumor. Sex cord Stromal Tumors 07 (07%). The majority of our patients were in the age group 31-40 years (45 patients, 45% of patients).Conclusion: The present study shows various histopathological features of ovarian neoplasm. Benign tumors are more common than malignant tumors. Among the benign tumors, serous tumors were most common of all. Thus, an accurate histological diagnosis is important to initiate a proper management plan.

The effectiveness of neoadjuvant chemoradiotherapy in oesophageal adenocarcinoma with presence of extracellular mucin, signet-ring cells, and/or poorly cohesive cells.

Oesophageal adenocarcinomas may show different histopathological patterns, including excessive acellular mucin pools, signet-ring cells (SRCs), and poorly cohesive cells (PCCs). These components have been suggested to correlate with poor outcomes after neoadjuvant chemoradiotherapy (nCRT), which might influence patient management. However, these factors have not been studied independently of each other with adjustment for tumour differentiation grade (i.e. the presence of well-formed glands), which is a possible confounder. We studied the pre- and post-treatment presence of extracellular mucin, SRCs, and/or PCCs in relation to pathological response and prognosis after nCRT in patients with oesophageal or oesophagogastric junction adenocarcinoma. A total of 325 patients were retrospectively identified from institutional databases of two university hospitals. All patients were scheduled for ChemoRadiotherapy for Oesophageal cancer followed by Surgery Study (CROSS) nCRT and oesophagectomy between 2001 and 2019. Percentages of well-formed glands, extracellular mucin, SRCs, and PCCs were scored in pre-treatment biopsies and post-treatment resection specimens. The association between histopathological factors (≥1 and >10%) and tumour regression grade 3-4 (i.e. >10% residual tumour), overall survival, and disease-free survival (DFS) was evaluated, adjusted for tumour differentiation grade amongst other clinicopathological variables. In pre-treatment biopsies, ≥1% extracellular mucin was present in 66 of 325 patients (20%); ≥1% SRCs in 43 of 325 (13%), and ≥1% PCCs in 126 of 325 (39%). We show that pre-treatment histopathological factors were unrelated to tumour regression grade. Pre-treatment presence of >10% PCCs was associated with lower DFS (hazard ratio [HR] 1.73, 95% CI 1.19-2.53). Patients with post-treatment presence of ≥1% SRCs had higher risk of death (HR 1.81, 95% CI 1.10-2.99). In conclusion, pre-treatment presence of extracellular mucin, SRCs, and/or PCCs is unrelated to pathological response. The presence of these factors should not be an argument to refrain from CROSS. At least 10% PCCs pre-treatment and any SRCs post-treatment, irrespective of the tumour differentiation grade, seem indicative of inferior prognosis, but require further validation in larger cohorts.

Relationship Between the Diffusing Capacity of the Lung for Carbon Monoxide (DLCO) and Lung Adenocarcinoma Patterns: New Possible Insights

IntroductionThis study aimed to evaluate a potential relationship between the diffusing capacity of the lung for carbon monoxide (DLCO) and the aggressiveness of lung adenocarcinoma (ADC). MethodsPatients who underwent radical surgery for lung ADC between 2001 and 2018 were retrospectively reviewed. DLCO values were dichotomized into DLCOlow (<80% of predicted) and DLCOnormal (≥80%). Relationships between DLCO and ADC histopathological features, clinical features, as well as with overall survival (OS), were evaluated. ResultsFour-hundred and sixty patients were enrolled, of which 193 (42%) were included in the DLCOlow group. DLCOlow was associated with smoking status, low FEV1, micropapillary and solid ADC, tumour grade 3, high tumour lymphoid infiltrate and presence of tumour desmoplasia. In addition, DLCO values were higher in low-grade ADC and progressively decreased in intermediate and high-grade ADC (p=0.024). After adjusting for clinical variables, at multivariable logistic regression analysis, DLCOlow still showed a significant correlation with high lymphoid infiltrate (p=0.017), presence of desmoplasia (p=0.065), tumour grade 3 (p=0.062), micropapillary and solid ADC subtypes (p=0.008). To exclude the association between non-smokers and well-differentiated ADC, the relationship between DLCO and histopathological ADC patterns was confirmed in the subset of 377 former and current smokers (p=0.021). At univariate analysis, gender, DLCO, FEV1, ADC histotype, tumour grade, stage, pleural invasion, tumour necrosis, tumour desmoplasia, lymphatic and blood invasion were significantly related with OS. At multivariate analysis, only gender (p<0.001), tumour stage (p<0.001) and DLCO (p=0.050) were significantly related with the OS. ConclusionsWe found a relationship between DLCO and ADC patterns as well as with tumour grade, tumour lymphoid infiltrate and desmoplasia, suggesting that lung damage may be associated with tumour aggressiveness.