Non-neoplastic Lesions Research Articles

Orbital Lesions: A bird's eye view of series of 2068 cases in 27 years in a tertiary care hospital in Pakistan.

To determine the relative frequency of orbital lesions based on the site of origin and histopathology at a Tertiary care hospital (Mayo Hospital, Lahore Pakistan) from 1996 till 2022 (27 years). This descriptive case series included 2651 patients of all age groups presenting with orbital lesions who initially got enrolled at Institute of Ophthalmology Mayo Hospital, Lahore from 1996 till 2022. Of these, 583 patients left against medical advice. So, clinical data of 2068 patients were completely analyzed. Lesions were managed medically and/ or surgically. Final clinical diagnosis, with the help of histopathology, was used to classify the lesions. There were 1258 (60.9%) adults and 810 (39.1%) children, 1358 (65.66%) were neoplastic while 710 (34.33%) non-neoplastic lesions. Amongst the neoplastic lesions, 405 (29.8 %) were benign and 953 (70.2%) malignant. Primary orbital lesions were 1676 (81.04%), Secondary orbital lesions were 300 (14.51%), Endocrine/ hematopoietic reticulo-endothelial system lesions were 84 (4.06%) and Metastatic lesions from distant organs were 08 (0.39%). Retinoblastoma, rhabdomyosarcoma, optic nerve gliomata were common in children. Pleomorphic adenoma & adenocystic carcinoma of lacrimal gland, cavernous hemangioma, optic nerve meningioma, neurofibroma, schwannoma, squamous cell carcinoma of eyelid, carcinoma of maxillary antrum and lymphomas were more common in adults.

Cytomorphological Spectrum of Hepatic Lesions on Ultrasonography (USG) or CT-Guided Fine-Needle Aspiration Cytology (FNAC) in a Tertiary Care Centre, Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand, India.

Background Ultrasonography (USG)-guided fine-needle aspiration cytology (FNAC) of the liver is a primary diagnostic procedure for primary and metastatic hepatic lesions. Despite histopathology being the gold standard, the outcomes of ultrasound-guided fine needle aspiration cytology are encouraging. Aims and objective The purpose of the study is to determine the diagnostic utility of ultrasonography (USG) or computerized tomography (CT)-guided FNAC in the detection of liver lesions, to investigate cytomorphological patterns of liver lesions identified by guided FNAC, and, wherever feasible, to correlate FNAC diagnosis with histopathology and imaging modalities. Materials and methods This was a hospital-based observational study of 62 patients carried out in the Department of Pathology, Rajendra Institute of Medical Sciences (RIMS) Ranchi during a period of 1.5 years from August 2020 to February 2022. The patients with suspected hepatic lesions were subjected to ultrasound-guided or CT-guided fine needle aspiration cytology (FNAC) following clinical and radiological evaluation and cytomorphological features were analyzed. Results Cyto-morphological diagnosis of 62 cases was categorized into 19 (30.64%) non-neoplastic lesions and 43 (69.35%) malignant neoplastic lesions. The different neoplastic lesions were 17 (27.41%) hepatocellular carcinoma, 1 (1.61%) hepatoblastoma, 1 (1.61%) cholangiocarcinoma, 23 (37.09%) metastatic adenocarcinoma and one case (1.61%) of unclassified malignancy. Histopathological correlation for confirming the diagnosis could be done in 33 malignant neoplastic lesions and the concordance rate of FNAC with respect to histopathological examination (HPE) was 92.11%. Overall diagnostic accuracy of the FNAC of liver to detect malignant lesions was 98.39%. Conclusion Compared to ultrasonography alone, ultrasound or CT-guided fine needle aspiration of the liver has a more promising role in the diagnosis and classification of hepatic lesions as it demands a higher level of precision to achieve diagnostic accuracy.

Oncocytic Lipoadenoma of the Parotid Gland against a Background of Multifocal Oncocytic Hyperplasia: Report of a Rare Case

ABSTRACT Oncocytic lipoadenoma is an extremely rare benign salivary gland tumor with only few cases reported in the literature. We herein report a case of oncocytic lipoadenoma originating in the parotid gland of a 65-year-old man. The tumor presented as a slowly growing asymptomatic right-sided parotid gland mass. On MRI, right parotid showed a 40 × 32 × 20 mm well-encapsulated, neoplastic mass in the superficial lobe. On core biopsy, differentials considered were nodular oncocytosis and oncocytoma. Subsequently, superficial parotidectomy was performed. The resected tumor was encapsulated, yellowish brown, and homogenous. Microscopically, it was composed of oncocytoma-like epithelial component admixed with mature adipocytes, each contributing to 50% of the mass. Adjacent salivary gland showed multiple foci of oncocytosis. Differential diagnosis includes lipomatous tumors as well as neoplastic and non-neoplastic oncocytic lesions of the salivary gland. The present case of oncocytic lipoadenoma against a background of multifocal oncocytic hyperplasia has been reported for its rarity.

An Arachnoid Cyst Incidentally Found in a Young Man Who Died of Sudden Cardiac Death

An arachnoid cyst is a rare cerebrospinal fluid–filled non-neoplastic cystic lesion. Most arachnoid cysts are asymptomatic; however, depending on their location and size, they may show various clinical symptoms and rarely can cause serious complications. We report a case of an arachnoid cyst incidentally found in a 25-year-old male soldier, which was not the cause of death. A 2.3×1.7 cm unilocular cystic lesion filled with colorless serous fluid was observed near the interpeduncular fossa of the brain. Microscopy revealed the cyst membrane to be lined by a single layer of meningothelial cells with no edema or inflammatory reaction in the surrounding structures. Considering the medical history, circumstances of death, and autopsy findings, the cause of death was determined to be sudden cardiac death, and the cyst found in the brain was consistent with an arachnoid cyst. Reviewing this case and related literature would help to determine the cause and manner of death if an arachnoid cyst is incidentally found during an autopsy.

Unraveling Rarity: Decoding an Unusual Ovarian Mass in a Young Woman with Menstrual Irregularities

Sclerosing Stromal Tumor (SST) is a relatively rare sex cord stromal tumor with only a hand full of cases reported in the literature till now. Due to its unique benign nature with nil recurrence rate, it is essential to diagnose this entity and differentiate it from the non-neoplastic and malignant lesions of the ovary. Here, we report a case of SST in a young female who presented with irregular menstruation and abdominal distension. A combined approach involving clinical suspiciousness, radiological, histopathological and immunohistochemistry findings helped us to arrive the diagnosis of this extremely rare entity, which aided in the effective management of the patient.

Histopathological Features of Colorectal Polyps and Tumors at Sumber Waras Hospital from 2015-2023

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>Colorectal tumours pose a significant global health issue, including in Indonesia. The development of colorectal polyps and tumours involves various risk factors such as poor lifestyle choices, male gender, and advancing age. This study aims to determine the characteristics of patients with colorectal polyps and tumours, their histopathological features, and the most common gender and age group for each histopathological feature. The study was conducted at Sumber Waras Hospital, implementing a descriptive cross-sectional approach with retrospective data of 113 patients with colorectal polyps and tumours from 2015-2023. This study's findings indicate that most patients were males (58.4%), with the highest number in the 61-70 age group (29.2%). Among non-neoplastic lesions, inflammatory polyp was the most prevalent histopathological finding (18.3%), whereas adenocarcinoma (NOS) was the most common feature among all neoplastic lesions (53.3%). All non-neoplastic lesions were predominantly found in males. Neoplastic lesions such as adenocarcinoma (NOS), mucinous adenocarcinoma, neuroendocrine tumours, and lymphoma were also more prevalent in males. In contrast, adenoma, signet ring, and squamous cell carcinoma were more frequently found in females. Non-neoplastic lesions such as hamartoma were most common in the 11-20 age group, while hyperplastic and inflammatory polyps were prevalent in the 61-70 age group. Neoplastic lesions such as adenoma were most prevalent in the 61-70 and 71-80 age groups; mucinous adenocarcinoma and lymphoma in the 51-60 age group; adenocarcinoma (NOS), squamous cell carcinoma, and neuroendocrine tumours in the 61-70 age group; as well as signet ring cell carcinoma in the 71-80 age group. To reduce the prevalence of colorectal polyps and tumours, it may be crucial to consider performing histopathological examinations for a thorough evaluation, given their wide variety that requires different diagnostic and treatment strategies. </em><em></em></p><p class="TableParagraph"><strong><em> </em></strong></p></td></tr></tbody></table></div><p><strong><em>Keywords: Age Group, Colorectal Polyp, Colorectal Tumor, Gender, Histopathological Features</em></strong></p>

Efficacy of Follicular Cell Pattern Analysis in Thyroid Fine-needle Aspiration Cytology Evaluation.

Fine-needle aspiration cytology (FNAC) is widely utilized for thyroid lesion diagnosis but faces challenges such as sample inadequacy and overlapping cytological features. This study examines how accurately these patterns correlate with histopathological diagnoses, shedding light on FNAC's limitations and diagnostic potential. To study the application of the architectural pattern of follicular cells in the interpretation of thyroid lesions and to demonstrate the diagnostic accuracy (DA) of FNAC. Cross-sectional study carried over 1 year. A total of 110 cases were reviewed by the cytopathologists. The prominent follicular cell architecture, namely macrofollicular, microfollicular, papillary, trabecular, three-dimensional clusters, and dispersed cells, was described in each case. In addition to these patterns, cellular morphology and background features were also noted, and a final cytological diagnosis was established. The cytology diagnosis was correlated with the histopathological diagnosis. Sensitivity, specificity, positive predictive value, negative predictive value, DA of FNAC in diagnosing nonneoplastic and neoplastic lesions. Macrofollicular pattern was seen in 80.26% of colloid goiter cases. Microfollicular pattern was observed in 72.2% of follicular neoplasm. About 62.5% of papillary thyroid carcinomas showed a papillary pattern. The trabecular pattern was seen in 42.86% of chronic lymphocytic thyroiditis and 16.67% of follicular neoplasms. The sensitivity and specificity of FNAC in diagnosing neoplastic lesions was 92.59% and 97.59%, respectively. FNAC is a simple, rapid, definite, and cost-effective primary diagnostic tool for thyroid evaluation. Cell architecture pattern is a simple and appropriate approach that complements cell morphology and background details in arriving at the final cytological diagnosis of thyroid lesions.

Florid vascular proliferation due to focal necrotizing enterocolitis in infancy: A case report

Vascular anomalies rarely emerge in the gastrointestinal tract. The most prevalent benign vascular lesions include angiodysplasia, Dieulafoy’s lesion, vascular ectasia, vascular malformations, and hemangiomas. Florid vascular proliferation (FVP) is also a rare benign vascular lesion associated with intussusception in adults. In infants, there are only a few cases in literature. Although FVP usually presents as a mass in the intestine, it is a nonneoplastic lesion and is thought to occur due to a reactive process. In this study, we present a case of FVP due to an attack of focal necrotizing enterocolitis in a 10-month-old infant.

Prompt Cytopathological Diagnosis of Multiple Xanthomatous Skin Nodules in an Adolescent Girl Opening the Doors to Detection of Familial Hypercholesterolemia

Background Xanthomas are papulo-nodular, yellow, soft, painless, dermal-based non-neoplastic cutaneous lesions that comprise of localized aggregates of lipid-laden histiocytes. Case report A thirteen-year-old adolescent girl presented with multiple, large, bilateral, nodules present over elbows, posterior aspect of heel, and knees for five years. Fine needle aspiration cytology was performed, and the smears showed numerous foamy histiocytes, a few benign spindle cells, and foreign-body giant cells against a lipidaceous background. Her maternal aunt and grandmother also had xanthelasma palpebrarum. Serum lipid levels were advised and were markedly deranged in all three of them. Based on the corroborative clinical, biochemical, and cytopathological findings, a final diagnosis of familial hypercholesterolemia (FH) was rendered. Conclusion The present case sheds light on the importance of prompt cytopathological diagnosis of xanthomatous lesions, especially in children and adolescents, as it can help prevent morbidity and mortality due to associated premature adverse cardiovascular and cerebrovascular events if left undiagnosed.

Classic Lesions of the Biliary Tree.

Abnormal findings in the biliary tree are frequently encountered in response to acute and chronic exposures to various compounds. The more common findings are described here in an overview of previous publications such as the INHAND Proliferative and Nonproliferative Lesions of the Rodent Liver and the Liver-Nonneoplastic Lesion Atlas NTP with comments regarding current considerations. This was presented at the 2023 Annual Meeting of the Society of Toxicologic Pathology. Histologic descriptions and some discussions regarding the pathogenesis of the various categories of non-neoplastic lesions in the biliary tree are presented. Discussions regarding the use of the term oval cell versus ductular reaction and the potentially neoplastic nature of cholangiofibrosis are presented in some detail.

Follow-up of non-palpable testicular incidentalomas under 1 cm: does growth rate differentiate malignant and non-malignant lesions?

To determine whether small, incidentally detected testicular lesions can be safely followed up, by assessing growth rate and volume threshold for benign vs. malignant lesions. This retrospective observational study includes a consecutive series of 130 testicular incidentalomas < 1 cm and with negative tumour markers identified from October 2001 to November 2022, which were initially followed up with ultrasound. A total of 39 cases proceeded to surgery during the study period, either due to lesion growth (n = 28) or patient preference/recommendation by the referring urologist (n = 11). For the lesions that were growing, specific growth rate (SGR) and doubling time (DT) were calculated assuming an exponential growth pattern. In addition, the velocity of increase of the average diameter (∆Dav) and of the maximum diameter (∆Dmax) were calculated. Of the 130 nodules that were initially followed up, six disappeared, eight were reduced in size, eighty-eight were stable, and twenty-eight increased in size. For operated nodules all 18 malignant tumours, 8/9 benign tumours, and 2/12 surgically proved non-neoplastic lesions were growing. The best cut-off values of the growth indicators to differentiate between malignant and non-malignant histology were 3.47 × 10-3%volume/day, ≤ 179 days, > 10 × 10-3 mm/day, and > 5 × 10-3 mm/day for SGR, DT, ∆Dmax, ∆Dav, respectively. Malignant and non-malignant small incidentalomas can be effectively differentiated based on growing parameters, even though overlap exists. An increase of the maximum diameter of about 1 mm and 2 mm in three months and in six months, respectively, suggests malignancy. Growing parameters allow an educated assessment of benign and malignant small testicular incidentalomas. Non-aggressive management is justified and safe when follow-up includes self-examination and tumour marker assessment to reduce the risk of interval tumour growth. Small, non-palpable and asymptomatic testicular nodules < 1 cm are unexpectedly discovered during scrotal ultrasound. Growth indicators estimate the potential malignancy, even though overlap with non-malignant lesions exists. Non-growing incidentalomas can be safely followed up.

Neoplastic and non-neoplastic lesions in biopsy samples from pet rabbits in Hong Kong: a retrospective analysis, 2019-2022.

Rabbits are popular pets in the urban environment of Hong Kong, ranking third behind cats and dogs. Here we describe the frequency of neoplastic and non-neoplastic lesions in biopsies from pet rabbits submitted to the CityU Veterinary Diagnostic Laboratory between 2019 and 2022, comprising 247 tissue samples from 243 rabbits collected by veterinarians in 19 veterinary clinics. Among the 243 rabbits, there were 128 females (65 spayed), 114 males (54 castrated); sex information was not provided for 1 rabbit. The rabbit breeds included 45 Lionhead, 35 Dwarf, 14 Lop, 11 Dwarf Lop, 5 French Lop, 3 Angora, 2 Dutch, 2 Holland Lop, and 1 each of Netherland Dwarf, Velveteen, Mini Lop, and New Zealand White. The mean ages of rabbits with neoplastic and non-neoplastic lesions were 7.1 and 5.7 y, respectively. The most common neoplastic lesions were adenocarcinoma (26.4%), trichoblastoma (21.4%), sarcoma (9.4%), and thymoma (8.2%). The most common non-neoplastic lesion was uterine cystic endometrial hyperplasia (14.8%), followed by dermal abscess formation in the ventral abdomen or skin of the head (12.5%). Although a broad spectrum of other lesions was described, our findings in biopsies from pet rabbits in Hong Kong are consistent with those in other jurisdictions.

Clinicopathological Spectrum of Head and Neck Lesions By FNAC at a Tertiary Care Centre in Barpeta, Assam – A Retrospective Study

Background: Various neoplastic and non-neoplastic lesions arising from lymph nodes, salivary glands, thyroid gland, soft tissue and metastatic deposits comprises the wide spectrum of lesions in the head &amp; neck region. The Foundation of Head and Neck Cancer (FHNC) helps in differentiating non-neoplastic lesions from neoplastic and further from benign and malignant lesions. The aim of this study was to evaluate the role and diagnostic accuracy of FNAC in diagnosis of palpable head and neck lesions. Materials and methods: A total of 360 cases were included in the study. Out of the 360 cases, 122 (33.89%) cases were sent for histopathological examination and the results were correlated histologically. Aspirations were done by using 10 ml syringe and 22/23-gauge needles. Smears were stained with May Grunwald Giemsa (MGG). Cytomorphological diagnosis was given. Results: Out of 360 patients of head and neck lesions studied, lymph node (40.56%) was the predominant site aspirated with reactive lymphoid hyperplasia being the commonest lesion. Soft tissue constitutes 31.11% cases followed by thyroid lesions with 19.72% cases, salivary gland 7.22% cases, and oral cavity 1.39% cases. FNAC was inconclusive in 4.17% cases. Conclusion: Head and neck lesions are common lesions located superficially that can be easily diagnosed on cytology. Although excisional biopsy is the gold standard for diagnosing head and neck malignant lesions, FNAC plays a vital role as a quick and inexpensive diagnostic procedure with high diagnostic accuracy. It distinguishes between inflammatory/infection and neoplastic lesions, avoiding needless procedures and expediting therapy. FNAC is a low-cost, accurate diagnostic method that may be used as a first-line examination.

The Clinical Impact of Different Types of Preoperative Biliary Intervention on Postoperative Biliary Tract Infection of Patients Undergoing Pancreaticoduodenectomy.

Background: For patients with obstructive jaundice and who are indicated for pancreaticoduodenectomy (PD) or biliary intervention, either endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography and drainage (PTCD) may be indicated preoperatively. However, the possibility of procedure-related postoperative biliary tract infection (BTI) should be a concern. We tried to evaluate the impact of ERCP and PTCD on postoperative BTI. Methods: Patients diagnosed from June 2013 to March 2022 with periampullary lesions and with PD indicated were enrolled in this cohort. Patients without intraoperative bile culture and non-neoplastic lesions were excluded. Clinical information, including demographic and laboratory data, pathologic diagnosis, results of microbiologic tests, and relevant infectious outcomes, was extracted from medical records for analysis. Results: One-hundred-and-sixty-four patients from the cohort (164/689) underwent preoperative biliary intervention, either ERCP (n = 125) or PTCD (n = 39). The positive yield of intraoperative biliary culture was significantly higher in patients who underwent ERCP than in PTCD (90.4% vs. 41.0%, p < 0.001). Although there was no significance, a trend of higher postoperative BTI (13.8% vs. 2.7%) and BTI-related septic shock (5 vs. 0, 4.0% vs. 0%) in the ERCP group was noticed. While the risk factors for postoperative BTI have not been confirmed, a trend suggesting a higher incidence of BTI associated with ERCP procedures was observed, with a borderline p-value (p = 0.05, regarding ERCP biopsy). Conclusions: ERCP in patients undergoing PD increases the positive yield of intraoperative biliary culture. PTCD may be the favorable option if preoperative biliary intervention is indicated.

Exploring the Histopathological Landscape of Urinary Bladder Diseases: A Tertiary Care Center Study.

Introduction Urinary bladder lesions encompass a wide spectrum, from benign inflammatory conditions to malignant neoplasms, presenting diagnostic and therapeutic challenges. Urothelial carcinoma predominates among bladder malignancies, exhibiting diverse clinical presentations and prognoses. Objective This study aimed to delineate the histopathological spectrum of urinary bladder lesions and correlate demographic profiles, clinical features, and cystoscopic findings with various bladder lesions. Methods This prospective descriptive observational study spanned 24 months at a tertiary care center, involving 65 cases of urinary bladder biopsies, including transurethral resection of bladder tumors, cystoscopic biopsies, and cystectomy specimens. The histopathological examination followed the WHO 2022 classification of urinary bladder tumors and the American Joint Committee on Cancer eighth edition staging. Clinical data, including age, gender, cystoscopic findings, and presenting symptoms, were correlated with histopathological diagnoses to explore the spectrum of bladder lesions. Results Neoplastic lesions predominated, constituting 92.3% of cases, with urothelial carcinoma comprising 83.33% of these cases. Among neoplastic lesions, invasive high-grade urothelial carcinoma (36.7%) and non-invasive low-grade papillary urothelial neoplasm (20.0%) were the most frequently observed subtypes. Non-neoplastic lesions accounted for 7.7%, including various forms of cystitis. Hematuria was the predominant presenting symptom (81.5%), while cystoscopic examinations revealed that most lesions were situated in the lateral bladder wall. High-grade urothelial carcinomas were mostly associated with muscularis propria invasion. Conclusion This study underscores the critical role of histopathological examination in diagnosing and managing urinary bladder diseases and distinguishing between non-neoplastic and neoplastic lesions. Urothelial carcinoma, prevalent among older age groups, often demonstrated muscle invasion indicative of high-grade tumors. Including the muscle layer in cystoscopic biopsies is crucial for an accurate diagnosis. Conversely, though less common, non-neoplastic conditions encompass various forms of cystitis. These findings highlight the importance of precise diagnostic tools such as cystoscopy and histopathological examination for the early detection and management of bladder neoplasms. Histopathological assessment offers essential prognostic guidance, aids in precise staging and grading, and directs tailored treatment strategies.

Cysts of the ligamentum flavum are often linked to ischemic conditions: A morphological study.

"Cysts of the ligamentum flavum (cysts-LF)" is the term for non-neoplastic cystic lesion involving LF. The aim of the present study was to elucidate the histopathological characteristics and pathogenesis of "cysts-LF". Herein, we defined cysts-LF as spinal cysts containing degenerative LF components. From archival cases, we investigated 18 symptomatic cysts-LF surgically removed from 18 patients (13 males and five females; median age 68.5 years [range, 42-86 years]). The elastic fibers of LF components in the wall were separated and/or torn, and cyst walls were accompanied by chondroid metaplasia (17 cases), myxoid changes (13 cases), ossification (11 cases), amyloid deposits (14 cases), hemosiderosis (six cases), granular/smudgy calcification (four cases), synovial cell linings (three cases), and severe inflammatory infiltrates (one case). These histologic features of our cysts-LF were shared by previously reported "cysts-LF." Fourteen cysts-LF demonstrated vascular stenosis/occlusion, and eight showed thick hyalinized vessels, suggesting local circulatory insufficiency. Eight cases (44%) exhibited lipomembranous fat necrosis, accompanied by hyalinized vascular changes (p = 0.003). Ischemic conditions were observed in nearly half of the present cysts-LF, and may be one of the main contributing factors for the formation of cysts-LF, via degeneration and cystic changes in the LF.

Reliability of Kudo’s Glandular Pit Pattern in Predicting Colorectal Lesion Histology at Routine Colonoscopy with Digital Chromoendoscopy

Background. The large number of lesions detected via high-definition (HD) imaging during colonoscopy calls for the reliable real-time histological characterization of polyps, especially diminutive and small ones, to permit tailored management based on the neoplastic risk, such as a “resect-and-discard” or a “diagnose-and-leave” strategy for low-risk adenomas and hyperplastic polyps (HPs). The Kudo classification of glandular pit pattern is currently used for predicting polyp histology. Aim. The aim in this study was to assess whether Kudo’s glandular pit pattern, assessed via HD digital chromoendoscopy (i-Scan) without magnification and optical enhancement, reliably predicts polyp histology and differentiates neoplastic lesions (NLs) from non-neoplastic lesions (non-NLs) during routine colonoscopy. Methods. Consecutive colorectal lesions recorded in a database over 12 months, with Kudo’s glandular pit pattern classification, were retrospectively compared with histology. The diagnostic accuracy and negative predictive value (NPV) for adenomatous histology of Kudo’s pit patterns were assessed separately for diminutive (≤5 mm) and small (6–9 mm) polyps, accordingly to the American Society for Gastrointestinal Endoscopy (ASGE) Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI), and in large (≥10 mm) lesions. Results. A total of 2230 lesions were recorded: 898 diminutive, 704 small, and 628 large. Kudo’s type II pit pattern was prevalent in diminutive polyps and recognized mostly in HPs (83.27%); it was also found in 38.8% of adenomas. In the right colon, Kudo’s type II pit pattern was prevalent in adenomas (70.04% vs. 20.74% in HPs); among the serrated lesions, it was evenly distributed between HPs and adenomas. Kudo’s type IIIL/IIIs/IV pit pattern was prevalent in NLs (61% vs. 8.37% of non-NLs) in diminutive polyps, evenly distributed between non-NLs and NLs in small polyps, and found only in NLs in large polyps. Kudo’s type Vi/Vn pit pattern correctly identified all but one adenocarcinoma. The NPV for adenomatous histology did not reach the recommended 90% PIVI threshold for differentiation between NLs and non-NLs in diminutive polyps showing Kudo’s type II pit pattern and in small polyps showing type IIIL/IIIs/IV pit pattern. Conclusions. Kudo’s pit pattern classification carried out with digital chromoendoscopy (i-Scan) during routine colonoscopy does not allow the reliable differentiation between non-NLs and NLs in diminutive and small polyps, so a “diagnose-and-leave” strategy for diminutive polyps may leave undetected adenomas, while a “resect-and-discard” strategy could miss lesions requiring closer follow-up.

Cytomegalovirus in Adenoma and Carcinoma Lesions: Detecting Mono-Infection and Co-Infection in Salivary Glands.

Salivary glands' neoplasms are hard to diagnose and present a complex etiology. However, several viruses have been detected in these neoplasms, such as HCMV, which can play a role in certain cancers through oncomodulation. The co-infections between HCMV with betaherpesviruses (HHV-6 and HHV-7) and polyomaviruses (JCV and BKV) has been investigated. The aim of the current study is to describe the frequency of HCMV and co-infections in patients presenting neoplastic and non-neoplastic lesions, including in the salivary gland. Multiplex quantitative polymerase chain reaction was used for betaherpesvirus and polyomavirus quantification purposes after DNA extraction. In total, 50.7% of the 67 analyzed samples were mucocele, 40.3% were adenoma pleomorphic, and 8.9% were mucoepidermoid carcinoma. Overall, 20.9% of samples presented triple-infections with HCMV/HHV-6/HHV-7, whereas 9.0% were co-infections with HCMV/HHV-6 and HCMV/HHV-7. The largest number of co-infections was detected in pleomorphic adenoma cases. All samples tested negative for polyomaviruses, such as BKV and JCV. It was possible to conclude that HCMV can be abundant in salivary gland lesions. A high viral load can be useful to help better understand the etiological role played by viruses in these lesions. A lack of JCV and BKV in the samples analyzed herein does not rule out the involvement of these viruses in one or more salivary gland lesion subtypes.

Diagnostic performance of the Japanese Narrow-band imaging expert team classification system using dual focus magnification in real-time Vietnamese setting.

The JNET classification, combined with magnified narrowband imaging (NBI), is essential for predicting the histology of colorectal polyps and guiding personalized treatment strategies. Despite its recognized utility, the diagnostic efficacy of JNET classification using NBI with dual focus (DF) magnification requires exploration in the Vietnamese context. This study aimed to investigate the diagnostic performance of the JNET classification with the NBI-DF mode in predicting the histology of colorectal polyps in Vietnam. A cross-sectional study was conducted at the University Medical Center in Ho Chi Minh City, Vietnam. During real-time endoscopy, endoscopists evaluated the lesion characteristics and recorded optical diagnoses using the dual focus mode magnification according to the JNET classification. En bloc lesion resection (endoscopic or surgical) provided the final pathology, serving as the reference standard for optical diagnoses. A total of 739 patients with 1353 lesions were recruited between October 2021 and March 2023. The overall concordance with the JNET classification was 86.9%. Specificities and positive predictive values for JNET types were: type 1 (95.7%, 88.3%); type 2A (81.4%, 90%); type 2B (96.6%, 54.7%); and type 3 (99.9%, 93.3%). The sensitivity and negative predictive value for differentiating neoplastic from non-neoplastic lesions were 97.8% and 88.3%, respectively. However, the sensitivity for distinguishing malignant from benign neoplasia was lower at 64.1%, despite a specificity of 95.9%. Notably, the specificity and positive predictive value for identifying deep submucosal cancer were high at 99.8% and 93.3%. In Vietnam, applying the JNET classification with NBI-DF demonstrates significant value in predicting the histology of colorectal polyps. This classification guides treatment decisions and prevents unnecessary surgeries.

Pink and Blue of Bones- A Histopathological Analysis of Bony Neoplasm in a Tertiary Hospital of Bihar

Background: Bone lesions have low incidence with diverse presentation and due to the presence of their limited studies it has become a challenging task to reach an accurate diagnosis. Aim and Objective: This study aims in studying variety of bony lesions observed clinically and histopathologically. Further categorizing into non neoplastic, tumour-like, benign tumour or malignant tumour and determining its correlation with the age and gender predisposition of these lesions. Materials and Methods: An ambispective study was executed in Pathology department , PMCH, Patna from May 2020 to April 2024 in which a total of 102 cases were collected. The necessary information for the retrospective analysis, such as the patient's age, sex, lesion location, and diagnosis, was obtained from the requisition form and the histopathology data kept in the department of pathology from May 2020 to May 2022. And for prospective study all the radiological proven bony lesions which were excised during period of May 2022 to April 2024 and were sent for histopathological examination were examined. Results: Non-neoplastic lesions were more common than neoplastic lesions among the 102 specimens that underwent histological examination (53 versus 49). With 21.5% of cases, tuberculous osteomyelitis was the most prevalent non-neoplastic lesion. The most common benign neoplastic lesion detected was a giant cell tumor of the bone (11.76%), while the most common malignant lesion found was osteosarcoma (2.94%). Conclusion: To improve patient management and diagnosis accuracy, it is advised to utilize clinical, radiological, and histological findings in an integrated manner.