Neoplastic Cases Research Articles

Unveiling a Surgical Revolution: The Use of Conventional Histology versus Ex Vivo Fusion Confocal Microscopy in Breast Cancer Surgery.

Ex vivo fusion confocal microscopy (EVFCM) enables the rapid examination of breast tissue and has the potential to reduce the surgical margins and the necessity for further surgeries. Traditional methods, such as frozen section analysis, are limited by the distortion of tissue and artefacts, leading to false negatives and the need for additional surgeries. This study on observational diagnostic accuracy evaluated the ability of EVFCM to detect breast cancer. A total of 36 breast tissue samples, comprising 20 non-neoplastic and 16 neoplastic cases, were analysed using EVFCM and compared to the results obtained from routine histopathology. A Mohs surgeon experienced in EVFCM (evaluator A) and two breast pathologists unfamiliar with EVFCM (evaluators B and C) performed blinded analyses. EVFCM showed high concordance with the histopathology and the detection of neoplasia, with significant kappa values (p < 0.001). Evaluator A achieved 100% sensitivity and specificity. Evaluators B and C achieved a sensitivity of >87%, a specificity of >94%, positive predictive values of >95%, and negative predictive values of 81% and 94%, respectively. EVFCM therefore offers a promising technique for the assessment of margins in breast-conserving surgery. Its widespread adoption could significantly reduce re-excisions, lower healthcare costs, and improve cosmetic and oncological outcomes.

Age at Tumor Diagnosis in 14,636 Canine Cases from the Pathology-Based UNIPI Animal Cancer Registry, Italy: One Size Doesn't Fit All.

Cancer is the most common cause of death in adult dogs. All dogs would benefit from early diagnosis, but there are no specific guidelines regarding the schedule of cancer screening in companion animals. The aim of this study was to retrospectively evaluate the age at diagnosis in Italian oncological canine patients. A total of 14,636 canine histologically confirmed neoplastic cases were coded according to the Vet-ICD-O-canine-1 and stratified by malignancy, sex, neutering status, breed, cephalic index, body size, and tumor type. Differences in age distribution were analyzed and the influence of these variables on the time of first malignancy diagnosis was assessed using an event history analysis model. The median age at diagnosis for benign and malignant tumors was 9 and 10 years, respectively. Intact and purebred dogs were diagnosed earlier, but the median age differed significantly by breed. The earliest age at diagnosis was recorded for lymphomas and mast cell tumors. The model showed an accelerating effect of large size, brachy- and dolichocephaly, and sexual integrity in female dogs on the time of malignancy diagnosis. Our results confirm that a "one-size-fits-all" approach to cancer screening is not accurate in dogs and provide relevant data that may lead to the establishment of breed-based screening schedules.

Cholangioscopy-based convoluted neuronal network vs. confocal laser endomicroscopy in identification of neoplastic biliary strictures.

Background and study aims Artificial intelligence (AI) models have demonstrated high diagnostic performance identifying neoplasia during digital single-operator cholangioscopy (DSOC). To date, there are no studies directly comparing AI vs. DSOC-guided probe-base confocal laser endomicroscopy (DSOC-pCLE). Thus, we aimed to compare the diagnostic accuracy of a DSOC-based AI model with DSOC-pCLE for identifying neoplasia in patients with indeterminate biliary strictures. Patients and methods This retrospective cohort-based diagnostic accuracy study included patients ≥ 18 years old who underwent DSOC and DSOC-pCLE (June 2014 to May 2022). Four methods were used to diagnose each patient's biliary structure, including DSOC direct visualization, DSOC-pCLE, an offline DSOC-based AI model analysis performed in DSOC recordings, and DSOC/pCLE-guided biopsies. The reference standard for neoplasia was a diagnosis based on further clinical evolution, imaging, or surgical specimen findings during a 12-month follow-up period. Results A total of 90 patients were included in the study. Eighty-six of 90 (95.5%) had neoplastic lesions including cholangiocarcinoma (98.8%) and tubulopapillary adenoma (1.2%). Four cases were inflammatory including two cases with chronic inflammation and two cases of primary sclerosing cholangitis. Compared with DSOC-AI, which obtained an area under the receiver operator curve (AUC) of 0.79, DSOC direct visualization had an AUC of 0.74 ( P = 0.763), DSOC-pCLE had an AUC of 0.72 ( P = 0.634), and DSOC- and pCLE-guided biopsy had an AUC of 0.83 ( P = 0.809). Conclusions The DSOC-AI model demonstrated an offline diagnostic performance similar to that of DSOC-pCLE, DSOC alone, and DSOC/pCLE-guided biopsies. Larger multicenter, prospective, head-to-head trials with a proportional sample among neoplastic and nonneoplastic cases are advisable to confirm the obtained results.

Comprehensive Analysis of Garcin Syndrome: A Systematic Review of the Etiology, Diagnosis, and Treatment.

Garcin syndrome is a rare neurological condition characterized by progressive unilateral involvement of multiple cranial nerves, without typical intracranial hypertension. It is often linked with aggressive malignancies and invasive infections; hence, it presents significant diagnostic and therapeutic challenges. Despite the advances in medical technology, the prognosis still remains poor, and there is limited literature on comprehensive reviews regarding its etiology, diagnosis, and management. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-based systematic review was performed in order to compile updated evidence related to Garcin syndrome. The PubMed and Scopus databases were comprehensively searched using the search terms "Garcin syndrome" AND ("etiology" OR "diagnosis" OR "treatment" OR "management"). Information was obtained from case reports and focused on common etiologies, clinical presentations, diagnostic methodologies, treatment protocols, and outcomes. The review discussed very diverse etiologies of Garcin syndrome. The most common among these were skull base tumors, metastatic lesions, and invasive infections like mucormycosis. Most of these were multiple cranial nerve (CN) involvements in which CN V (trigeminal nerve), CN VII (facial nerve), or CN XII (hypoglossal nerve) involvement was common. Advanced imaging, especially MRI, played a very crucial role in diagnosis, showing the presence of extensive bony destruction with the involvement of cranial nerves. Treatment was varied according to the etiology, ranging from chemotherapy and radiotherapy in neoplastic cases to active surgical intervention supported by antifungal therapy in infected cases. Garcin syndrome is a clinical challenge due to its diverse etiologies and complex management profile. While early diagnosis and intervention are emphasized, the prognosis remains grave, especially in cases presenting with metastatic disease or immunocompromised states. Future research should focus on better, more sensitive diagnostic modalities and the investigation of newer therapeutic approaches for Garcin syndrome patients.

Histopathological Spectrum of the Upper Gastrointestinal Tract Endoscopic Biopsies at a Tertiary Hospital: A Descriptive Cross-sectional Study.

Upper gastrointestinal tract disorders are prevalent worldwide, encompassing neoplastic and non-neoplastic lesions like infections and inflammation. Endoscopic biopsies play a crucial role in diagnosis, treatment monitoring, and complication detection. Despite their routine use, comprehensive data on their histopathological spectrum is sparse. This study aimed to delineate this spectrum and assess the prevalence of non-neoplastic and neoplastic lesions in upper gastrointestinal tract endoscopic biopsies. This descriptive cross-sectional study at a tertiary care center analyzed upper gastrointestinal endoscopic biopsies from August 1, 2019, to July 31, 2021. After obtaining ethical clearance (reference number: 039-078/079), we collected all upper gastrointestinal endoscopic biopsies received during the two-year study period, excluding inadequate biopsies, resection specimens, therapeutic cases, and specific lesions.Histopathological examination was conducted using H&E, Giemsa, and Periodic acid-Schiff stains. Diagnoses were categorized into non-neoplastic and neoplastic lesions following WHO guidelines. Data were analyzed using SPSS 16.0 to determine the frequency of neoplastic and non-neoplastic cases. Among 155 upper gastrointestinal biopsies, 124 (80%) were non-neoplastic (95% CI: 73.71-86.29%) and 31 (20%) were neoplastic (95% CI: 13.71-26.29%). Non-neoplastic lesions were predominantly chronic gastritis, with chronic active gastritis being the most frequent 34 (27.41%). Neoplastic lesions were mainly adenocarcinomas in the stomach 20 (64.51%) and squamous cell carcinomas in the esophagus 7 (22.58%). The prevalence of neoplastic lesions were found to lower compared to the published literature and showed predominance of adenocarcinoma in upper gastrointestinal neoplastic lesions.

Immunohistochemical Expression of Human Epidermal Growth Factor Receptor 2 and Ki67 in Apocrine Gland Anal Sac Adenocarcinoma.

Apocrine gland anal sac adenocarcinoma is an aggressive neoplasm, and surgery remains the treatment of choice, although it is controversial in advanced cases. The prognostic factors are not well established. Human Epidermal Growth Factor Receptor 2 (HER2) is a membrane protein related to tumorigenesis, whereas Ki67 is a nuclear protein related to cell proliferation. Both are potential prognostic markers and therapeutic targets. This study aimed to evaluate the expression of HER2 and Ki67 markers in canine apocrine gland anal sac adenocarcinoma. The tumor samples were divided into four groups: largest tumor diameter less than 2.5 cm, largest tumor diameter greater than 2.5 cm, metastatic lymph nodes, and control group of non-neoplastic anal sacs. Each contained 10 samples. Immunohistochemistry was performed to verify the expression of HER2 and Ki67 markers. Positive HER2 staining was observed in 45% of the neoplastic cases and negative HER2 staining in 100% of the control group. The Ki67 expression had a median of 25% in all groups, except for the control group, which had a median of 8%. The HER2 and Ki67 expression was present in apocrine gland anal sac adenocarcinoma, making them potential therapeutic targets. However, it was not possible to determine the clinical value of either marker.

Multiplex imaging reveals spatially resolved DNA-damage response neighborhoods in TP53-mutated myelodysplastic neoplasms.

While increased DNA damage is a well-described feature of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML), it is unclear whether all lineages and all regions of the marrow are homogeneously affected. In this study, we performed immunohistochemistry on formalin-fixed, paraffin-embedded whole-section bone marrow biopsies using a well-established antibody to detect pH2A.X (phosphorylated histone variant H2A.X) that recognizes DNA double-strand breaks. Focusing on TP53-mutated and complex karyotype MDS/AML, we find a greater pH2A.X+ DNA damage burden compared to TP53 wild-type neoplastic cases and non-neoplastic controls. To understand how double-strand breaks vary between lineages and spatially in TP53-mutated specimens, we applied a low-multiplex immunofluorescence staining and spatial analysis protocol to visualize pH2A.X+ cells with p53 protein staining and lineage markers. pH2A.X marked predominantly mid- to late-stage erythroids, whereas early erythroids and CD34+ blasts were relatively spared. In a prototypical example, these pH2A.X+ erythroids were organized locally as distinct colonies, and each colony displayed pH2A.X+ puncta at a synchronous level. This highly coordinated immunophenotypic expression was also seen for p53 protein staining and among presumed early myeloid colonies. Neighborhood clustering analysis showed distinct marrow regions differentially enriched in pH2A.X+/p53+ erythroid or myeloid colonies, indicating spatial heterogeneity of DNA-damage response and p53 protein expression. The lineage and architectural context within which DNA damage phenotype and oncogenic protein are expressed is relevant to current therapeutic developments that leverage macrophage phagocytosis to remove leukemic cells in part due to irreparable DNA damage. © 2024 The Pathological Society of Great Britain and Ireland.

Survey of Animal Neoplastic Cases Diagnosed in Nigerian Veterinary Teaching Hospitals, 2000-2017.

Incidence data from 17-year veterinary neoplasm surveillance and registration were reviewed. Most of the neoplastic cases diagnosed in Nigerian veterinary teaching hospitals (VTHs) were in the avian (49%) and canine species (44%). Fewer cases were recorded in the equine (3.2%), bovine (2.4%), ovine (1.5%), caprine (0.3%) and porcine (0.15%) species. Marek's disease was the most prevalently diagnosed neoplastic disease of domestic animals in Nigerian VTHs from 2000-2017. Also, the Nigerian local breed had a higher mean distribution than any other dog breed and this was statistically significant (p < 0.05). Nearly all of the neoplastic cases diagnosed, were found in females (60.4%) and so the mean distribution of sex was statistically significant (p < 0.05). The digestive system, with 296 (46.25%) cases, was the anatomic location where the majority of the neoplastic cases were found. However, the mean distribution of different neoplastic anatomic sites was not statistically significant (p > 0.05). In conclusion, little emphasis is given to the appropriate diagnosis and recording of neoplastic cases that are diagnosed. The study provides information regarding the prevalence and distribution of tumours in different animal species consulted in Nigeria veterinary teaching hospitals. To illustrate all of this, ArcGIS software was used. Veterinary clinicians, pathologists and epidemiologists from Nigeria may benefit from the results of this study by freely accessing some specific data regarding the breed, the age group or the gender of some animal species diagnosed with different tumours.

Cytologic Parameters in Predicting the Outcome of Atypical Glandular Cells on Papanicolaou Smears: A Single-Institutional Experience.

Atypical glandular cells (AGCs) diagnosis on Pap (Papanicolaou) smears are uncommon and may represent various benign and malignant lesions. This study aims to report the incidence of AGC on Pap smear, to study the relationship of AGC with malignancy, and to determine cytomorphological features that help in predicting malignancy. Retrospective analytical study conducted in the Department of Oncopathology at Tertiary Cancer and Research Institute. In this retrospective study, we included cases diagnosed with AGC between July 2017 to July 2022. All slides were reviewed and subclassified according to the Bethesda 2014 classification system (TBS). The predetermined cytomorphological features observed in the smears were recorded. The follow-up histopathological diagnoses of the cases were retrieved. The significant cytomorphological and clinicopathological findings for malignancy were determined. Pearson χ2 test with SPSS software version 22 to compare cytologic features of cases with benign and malignant follow-up. The significant cytomorphological features observed in neoplastic cases were cells in 3-dimensional clusters, nuclear overlapping, reniform nucleus, irregular nuclear membrane, increased nuclear size, single macronucleoli, engulfed neutrophils, and prominently vacuolated cytoplasm. The diagnosis of AGC on cytology is associated with clinically significant lesions, and cytomorphologic parameters can be used to predict the benign and malignant outcome.

Unveiling Variations: A Comprehensive Comparison of Five Globally Used Thyroid Cytology Reporting Systems With Histopathological Correlation.

Introduction Accurate cytological assessment is pivotal for managing thyroid lesions and various global reporting systems are in use, such as the globally acclaimed The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), alongside other reporting systems namely, the Japanese Reporting System for Thyroid Aspiration Cytology (JRSTAC), Italian Consensus for the Classification and Reporting of Thyroid Cytology (ICCRTC), the UK Royal College of Pathologists System for Reporting Thyroid Cytopathology (UK RCPath), the Royal College of Pathologists of Australasia and Australian Society of Cytology Classification System (RCPA/ASC). Notably, variations exist among these systems which are influenced by country-specific statistics. Given the lack of large-scale data in India and the difference in prevalence of diagnostic entities compared to the western population, this study aimed to identify reporting systems suitable for the Indian population focusing on distinguishing neoplastic from non-neoplastic lesions. Materials and methods A cross-sectional analysis of 40 thyroid cytology cases with histopathological correlation was conducted. Pathologists independently assessed cytology slides using JRSTAC, ICCRTC, RCPA/ASC, UK RCPath and TBSRTC. Five performance indicators, sensitivity, specificity, positive predictive value (PPV) of neoplastic conditions, negative predictive value (NPV) of non-neoplastic conditions, diagnostic accuracy and two quality indicators, percentage of Atypia of undetermined significance (AUS) and AUS/Malignant ratio were analyzed and compared. Results Among 40 cases, 22 cases were neoplastic (16 papillary thyroid carcinoma, six follicular adenoma) and 18 non-neoplastic (14 multinodular goiter, four lymphocytic thyroiditis). Specific patterns emerged in cases labeled "Non-diagnostic", prompted questions about categorizing inadequately cellular cases as "benign" in light of the presence of specific findings. All reporting systems showed 100% specificity in detecting non-neoplastic and neoplastic conditions in Category 1 and Category 6 respectively. Performance and quality indicators varied among reporting systems with TBSRTC (PPV of neoplastic cases 85.71%, NPV of non-neoplastic cases 70.58%, specificity 85.7%, sensitivity 70.58%, diagnostic accuracy 60%, AUS percentage 22.5% and AUS/Malignant ratio 3%) and RCPA/ASC (PPV of neoplastic cases 76.47%, NPV of non-neoplastic cases 70.58%, specificity 75%, sensitivity 72.2%, diagnostic accuracy 62.5%, AUS percentage 15% and AUS/Malignant ratio 3%) showing better results. Conclusion Among the five thyroid cytology reporting systems studied, TBSRTC and RCPA/ASC showed better overall performance results and quality indicators were close to benchmark. Better performance by TBSRTC 2023 could be due to the detailed criterion mentioned per category with subcategorization of AUS and suspicious for malignancy by features of cytological and architectural atypia. Similarly, RCPA/ASC has subcategorized AUS with defined criteria and certain background features were included as an isolated criterion for the suspicious for malignancy category. These defined criteriaoutlined in TBSRTC and RCPA/ASC played a crucial role in minimizing and reclassifying cases from the indeterminate categories (AUS and suspicious for malignancy) into well-defined categories with established management protocols.

Spectrum of intestinal lesion: A clinicopathological study in a tertiary care centre

Intestine has wide spectrum of diseases comprising neoplastic and non-neoplastic lesions. Inflammatory bowel diseases are showing increasing trend and intestinal neoplasms are the most frequently observed and leading cause of death in India. This study aims to find the occurrence of various intestinal lesions, classify them as neoplastic and non-neoplastic and to correlate the histopathological findings with clinical profile of patient in tertiary care hospital of north India. 1129 biopsies and resection specimens of intestinal lesions were examined over a period of two years. Sections were fixed, paraffin embedded and stained by H&amp;E. Immunohistochemistry was applied wherever required. Nearly two third patients were males in their second decade who presented with abdominal pain as the most common complaint and majority were diagnosed with non-neoplastic diseases. Among non-neoplastic lesions non-specific inflammation was predominant in small intestine (47.04% cases) and appendicitis (55.0%) in large intestine. Adenocarcinoma was predominant in both small and large intestine with 80.77% and79.45% of neoplastic cases respectively. This work gives a panoramic view of different intestinal pathologies and emphasises on the need of planning accurate diagnostic and screening strategies along with effective treatment plans both for neoplastic as well as non-neoplastic diseases.

Histopathological Spectrum of Ovarian Tumours in a Tertiary Care Centre in South Kerala, India: A Cross-sectional Study

Introduction: Ovarian tumours are among the most common tumours in females, exhibiting diverse histopathological patterns that remain crucial for early diagnosis. Proper classification of ovarian neoplasms, particularly malignant ones, is essential for accurate treatment. Accurately subclassifying ovarian tumours aids in treatments such as targeted therapy. Aim: To examine the histopathological spectrum of ovarian tumours and to assess the role of histopathology in accurate diagnosis and treatment. Materials and Methods: A cross-sectional study on the histopathological spectrum of ovarian tumours was conducted in Department of Pathology, Travancore Medical College, Kollam, Kerala, India, over a five-year period (January 2017 to December 2021). The study included 850 ovarian specimens, and the various histopathological patterns were studied according to the World Health Organisation (WHO) classification of ovarian tumours, 5th edition, 2020. These patterns and age distribution were expressed in frequency and percentage. Results: Out of the 850 ovarian specimens, 140 were neoplastic and 710 were non neoplastic. Abdominal pain was the most common clinical presentation (30%). Among the 140 neoplastic cases, 115 were benign, 20 were malignant, and five were borderline. The majority of cases, including benign, borderline, and malignant tumours, were seen in the age group of 31-40 years (25.71%). Benign tumours were more common than malignant ones in all age groups. Categorising based on histopathological patterns, epithelial tumours were the most common (88 cases, 62.86%). Serous cystadenoma was the most common benign tumour, constituting 36 out of 115 benign cases (25.71%). Borderline serous tumour was the most common borderline epithelial tumour (3 out of total 5 borderline ovarian neoplasms, 2.14%). Serous cystadenocarcinoma was the most common malignant tumour (5 cases, 03.57%). Conclusion: The wide spectrum of ovarian tumours presents diagnostic challenges. Effective therapeutic management of ovarian malignant tumours continues to be a challenge for clinicians. Histopathological examination remains crucial in diagnosis. Accurate histopathological diagnosis, combined with clinical staging, facilitates prompt and appropriate treatment and timely patient management.

A CLINICOPATHOLOGICAL STUDY OF LESIONS OF BONE

Objective: The objective is to study the clinico-pathological diagnosis of bone lesions. Methods: The present study was a prospective and observational (non-interventional) type of study. A total of 100 patients from March 2012 to April 2013 were recruited. All excised bone specimens received in the Department of Pathology, SBKS MI and RC, Pipariya, constituted the study material. The specimens were subjected to a detailed histopathological examination. In each case, the pathological reaction pattern was studied carefully and documented. Results: The total number of cases studied was one hundred, of which 63 were males and 37 were females in the age group of 3 years–65 years. The most common presenting symptoms were pain and swelling in all bone lesions. Out of 100 cases, non-neoplastic cases were 54% and neoplastic cases were 46%. Among 46% of neoplastic lesions, we found that 30% were benign and 16% were malignant. Among non-neoplastic lesions, 14% were tumor-like lesions, 13% were non-specific osteomyelitis, 12% were tuberculosis inflammation, and 15% were avascular necrosis. The most common benign lesion was a giant cell tumor (17%). The most common malignant lesion was osteosarcoma (6%). The most common tumor-like lesion was fibrous dysplasia (9%). The majority of bone tumors were located in the epiphysis of long bones. Conclusion: Light microscopy or histopathological examination is the gold standard in the diagnosis of bone lesions and is invariably accurate when correlated with clinico-radiological features.

Clinicopathologic Characteristics of Renal Cell Carcinoma in Prof. dr. I.G.N.G. Ngoerah General Hospital 2018 – 2022

RCC is a tumor that manifests in proximal tubule epithelial cells and accounts for 3% of total adult neoplastic cases. In Indonesia, RCC cases are still deemed low, but show a tendency to increase annually. This study’s objective is to provide a description on the clinicopathologic features of RCC patients in Prof. dr. I.G.N.G. Ngoerah General Hospital in the province of Bali from 2018 to 2022. This is a cross-sectional study which implemented total sampling in collecting secondary data from the laboratory of anatomical pathology in Prof. dr. I.G.N.G. Ngoerah General Hospital. There were 38 cases of RCC from a total of 108 kidney cases which underwent histopathologic examinations. Descriptive analysis showed that the majority of RCC cases were found in the age range of 51 – 60 years old (36.8%), males (76,3%), left tumor laterality (57,9%), operative procedures for specimen collection (94,7%), ccRCC subtype (63,2%), tumor size of &gt;10 cm (50,0%), grade III – IV (57,9%), and pT3a stage (47,4%). The combination of these clinicopathologic findings suggested that the RCC patients in Bali were shown to be associated with worse prognosis and should consider further analytical studies.

A profile of hematological malignancies diagnosed in a tertiary care center of Assam: Highlighting the experience from a resource constraint perspective

Background: Hematological disorders require a systematic approach, from clinical examination to a complete blood count, followed by a bone marrow study for diagnosis. To effectively plan, treat, and prognosticate, immunophenotyping and molecular studies are essential to incorporate. Aims and Objectives: The aim of our study is to understand the pattern of neoplastic hematological conditions encountered in Assam and share our experience during the diagnosis. Materials and Methods: This was a single-centered, observational study carried out for 18 months (January 2022–June 2023). A thorough hematological workout was done, including cytochemical staining and conventional polymerase chain reaction for the BCR-ABL transcript, after satisfying inclusion and exclusion criteria. The data were analyzed and correlated before arriving at the final diagnosis. Results: The total of 38 neoplastic cases confirmed by bone marrow study. Out of 38 cases, 14 were chronic myeloid leukemia, 10 were chronic, 4 were in the blastic phase, and BCR-ABL was positive in 13 cases. Two cases were pediatric, of which 1 was in the blastic phase. All 8 cases of plasma cell dyscrasia presented with anemia, bone lesions, and hypercalcemia. The acute leukemia category consisted of 4 acute myeloid leukemia cases, of which 1 was acute promyelocytic leukemia. A total of 10 acute lymphoblastic leukemia (ALL) cases, where 1 case was T-ALL and the rest was B-ALL. Two cases showed a subleukemic presentation in peripheral blood. Conclusion: The experience of pathologists and their meticulous approach can greatly aid in accurate diagnosis, but the immunophenotyping facility and molecular hematology setup can provide most of the relevant information for the best decision-making.

Cytological study of different thyroid lesions and its correlation with thyroid function test

The research relevance of the combined use of fine needle aspiration cytology, sonography, and thyroid function tests is determined by accurate diagnostics of thyroid enlargement in both adults and children. The study aimed to analyse thyroid lesions through cytological analysis and their correlation with thyroid function test results. This cross-sectional study enrolled 100 patients with suspected thyroid disorders and nodules. Comprehensive assessments included clinic demographics, fine needle aspiration cytology procedures, and thyroid hormone profiles. Based on the Bethesda system, cytological diagnoses were correlated with thyroid function test results using the chemiluminescent microparticle immunoassay method. Non-tumour thyroid lesions were found to be the most common (95%), with colloidal goitre being the most common. Neoplastic cases mainly included papillary and follicular carcinoma. Most thyroid lesions occurred among the 21-30 age group, non-neoplastic cases were more frequent among the 10-20 age group, and neoplastic cases were more common in those aged 21-40. All patients had neck swelling. Most cases were euthyroid (76%), predominantly classified as Category 2. A strong correlation between cytological diagnoses and thyroid hormone levels (p=0.04) was observed. Fine needle aspiration cytology demonstrated good sensitivity (80%) and high specificity (98.46%), with an 80% positive predictive value and 98.46% negative predictive value, resulting in a diagnostic accuracy of 97.14%. The study highlights the valuable role of fine needle aspiration cytology, when coupled with thyroid function tests, in effectively guiding the management of patients with thyroid lesions, owing to its impressive accuracy, sensitivity, and specificity

Histological and Immunohistochemical Characterization of Osteoimmunological Processes in Scaffold-Guided Bone Regeneration in an Ovine Large Segmental Defect Model.

Large-volume bone defect regeneration is complex and demands time to complete. Several regeneration phases with unique characteristics, including immune responses, follow, overlap, and interdepend on each other and, if successful, lead to the regeneration of the organ bone's form and function. However, during traumatic, infectious, or neoplastic clinical cases, the intrinsic bone regeneration capacity may exceed, and surgical intervention is indicated. Scaffold-guided bone regeneration (SGBR) has recently shown efficacy in preclinical and clinical studies. To investigate different SGBR strategies over periods of up to three years, we have established a well-characterized ovine large segmental tibial bone defect model, for which we have developed and optimized immunohistochemistry (IHC) protocols. We present an overview of the immunohistochemical characterization of different experimental groups, in which all ovine segmental defects were treated with a bone grafting technique combined with an additively manufactured medical-grade polycaprolactone/tricalcium phosphate (mPCL-TCP) scaffold. The qualitative dataset was based on osteoimmunological findings gained from IHC analyses of over 350 sheep surgeries over the past two decades. Our systematic and standardized IHC protocols enabled us to gain further insight into the complex and long-drawn-out bone regeneration processes, which ultimately proved to be a critical element for successful translational research.

HBME-1 expression by thyroid neoplasms in a Nigerian tertiary health Centre

Aim: The aim of this study is to review the histopathological diagnosis of thyroid neoplasms seen in OAUTHC Ile Ife using HBME-1 immunohistochemical marker.&#x0D; Materials and methods: We studied all thyroid neoplasms diagnosed in the Department of Morbid Anatomy and Forensic Medicine OAUTHC, Ile-Ife from 1st July 1996 to 30th June 2016. We noted the age, sex of the patients, nature of histological diagnosis (benign and malignant) and the specific histologic diagnosis. We evaluated HBME-1 immunostain grade (0, 1+, 2+, 3+, 4+) for all the tumours.&#x0D; Results: We studied only fifty-six cases (all neoplastic thyroid diseases). Sixteen (28.6%) and forty (71.4%) cases of the cases were benign and malignant, respectively. The Malignant thyroid neoplasms were 2.5 times more frequent than the benign thyroid lesions. There is a significant statistical relationship between HBME-1 expression and the nature of the neoplastic cases (p = 0.001). The sensitivity of HBME-1 in distinguishing benign from malignant thyroid neoplasms in this study was 77.5%, the specificity was 87.5%, the positive predictive value (PPV) was 93.3% and the negative predictive value (NPV) was 60.1%. &#x0D; Conclusion: There is a significant statistical association between HBME-1 and the nature of thyroid neoplasms. HBME-1 can be used as an added tool in distinguishing malignant thyroid neoplasms from the benign tumours.

Bladder Lesions in Cystoscopic Bladder Biopsies-A Clinicopathological Study

Introduction: In urinary bladder lesions, the clinical presentation is quite variable, the nonneoplastic lesions can mimic neoplastic and vice-versa bothering both clinicians and patients. The present study aims to study the clinic-pathological and histological features of various lesions of the urinary bladder in the specimens received through cystoscopic biopsy or transurethral resection.&#x0D; Objectives: The objectives of this study were to study the clinicopathological features of various bladder lesions and their frequencies and to correlate the clinical diagnosis with histological diagnosis.&#x0D; Methodology: The study was a descriptive cross-sectional involving patients with urinary bladder lesions requiring cystoscopic biopsy or transurethral resection conducted in the Department of Pathology of BP Koirala Institute of Health Sciences, Dharan over a period of one year (November 2016 to October 2017) .&#x0D; Results: Among 40 patients, mean age was 56.40 years and male and female ratio was 1.5:1. The mean duration of symptoms was 3.49 months. The most common presenting feature for both neoplastic and non-neoplastic was 75%, but hematuria was (86.36%) presenting feature in neoplastic cases and dysuria (88.88%) in non-neoplastic with each group accounting 55% and 45% respectively. Urothelial carcinoma (86.36%) was the commonest neoplastic lesion while cystitis (72.22%) was the commonest non-neoplastic lesion. NMIBC was the predominant lesion (78.95%) in urothelial tumor. Grading showed low grade (63.15%) and high grade (36.85%) respectively. The correlation analysis between clinical diagnosis and histological diagnosis revealed perfect correlation for non-neoplastic lesions and strong correlation for neoplastic lesions having highly significant result (p&lt;0.001)&#x0D; Conclusion: Urinary bladder is a common site of diverse lesions; with neoplastic being more common. Urothelial carcinoma was the most common type of neoplastic lesion and cystitis was the most common type of non-neoplastic lesion. Non-neoplastic lesions can mimic neoplastic lesions clinically. Histological diagnosis differs significantly from the clinical diagnosis indicating the importance of histological diagnosis in planning treatment.

HISTOMORPHOLOGICAL PATTERNS OF VARIOUS KIDNEY LESIONS IN NEPHRECTOMY SPECIMENS: A FIVE YEARS EXPERIENCE IN A TERTIARY CARE HOSPITAL

Background: A variety of non-neoplastic diseases and both benign and malignant neoplasms occur in the kidney. Radiological studies like ultrasound, CT and MRI are useful to provide a preoperative diagnosis, but histopathological study still remains the gold standard for definite diagnosis. This study aimed to explore the histomorphological patterns of various kidney lesions in nephrectomy specimens. Methods: This was a retrospective study conducted in the department of Pathology at College of Medical Sciences, Bharatpur, Chitwan from the period of 1st August 2017 to 31st July 2022. 57 samples of nephrectomy specimens were received during the study period of five years and were included in the study. Results: Maximum number of patients undergoing nephrectomy were in the age group of 40 to 49 years. Non neoplastic lesions constituted 87.72% of the nephrectomy specimens while the remaining were neoplastic cases. Chronic pyelonephritis was the commonest non neoplastic lesion. The commonest neoplastic lesion was renal cell carcinoma followed by transitional cell carcinoma and squamous cell carcinoma. Conclusions: Chronic pyelonephritis is a preventable cause of nephrectomy which could be avoided with early diagnosis and no operative management. The commonest malignant neoplasm was renal cell carcinoma.