Tru-cut Biopsy Research Articles

Extra-skeletal Ewing sarcoma of the diaphragm in a young female: a case report

Introduction and importance: Extra-skeletal Ewing sarcoma (EES) belongs to the family of primitive neuroectodermal tumors (PNET) and arises from soft tissue, with only 30 cases reported in the literature until now. Early diagnosis is crucial, and the management requires a multidisciplinary approach for better patient outcomes and survival. Case presentation: A 20-year-old female presented to the surgical outpatient department with complaints of shortness of breath and right lower chest pain. Upon physical examination, a lipomatous lesion was observed. Ultrasound and CT scan showed a heterogeneously enhancing soft tissue mass in the right lower hemithorax causing erosion and osteolysis of the right 9th rib, involving intercostal muscles, and exerting mass effect on the underlying hemidiaphragm. Later USG-guided Tru-cut biopsy was performed to confirm the diagnosis, which reported Ewing sarcoma with CD 99, FL-1, and NKX 2.2 positive. En-bloc tumor resection along with a portion of the diaphragm was performed, and a tube thoracostomy was carried out. Chest wall reconstruction was done with mesh and a local muscle rotation flap cover. Adjuvant chemotherapy was initiated. Clinical discussion: EES often presents with vague symptoms such as shortness of breath or abdominal or chest pain, thus making the diagnosis even more difficult. However, it has a relatively poor prognosis and thus is an important differential to rule out. Conclusion: Extra-skeletal Ewing Sarcoma is a highly aggressive tumor that requires prompt diagnosis and treatment, with surgical resection being the first line of treatment. Adjuvant chemotherapy has also shown better outcomes.

A Rare Case of Signet Ring Cell Lymphoma and Review of the Literature

Signet ring cell lymphoma (SRCL) is a non-Hodgkin's lymphoma with a very rare variant. Although this morphology is frequently seen in follicular lymphoma, it can also be observed in the group of diffuse large B-cell lymphomas. A seventy-six year old woman with known diagnosis of gastric adenocarcinoma, tubular type, moderately differentiate presented with a lymphadenopathy with high FDG uptake (SUVmax: 21.3) in PET/CT during follow-up. A tru-cut biopsy was performed for histopathological diagnosis. Diffuse infiltrative singet ring neoplastic cells showed negativity for PanCK, CK7, CK20, S100, SMA, calretinin and vimentin. The panel was then expanded to include SRCL, a rare variant of lymphoma. Additional immunohistochemical evaluation revealed positivity for CD20, CD19, PAX-5 and Bcl-2. Ki-67 proliferation index was about 80%. CD3, CD30, Myc, Bcl-6, ALK, Cyclin-D1, CD23, CD10, CD21, and MUM-1 were negative. EBER was also negative by chromogen in situ hybridization (CISH). Based on these data, diffuse large B-cell lymphoma (DLBCL) was considered. We herein reported a case of signet ring cell lymphoma discussed its clinical and morphological features with regard to the literature.

Histopathological features of prostatic carcinoma in a Southwest tertiary institution in Nigeria

Background: The diagnosis of prostatic adenocarcinoma is often straightforward, in some cases there may be benign lesions that mimic prostatic cancer histologically. This study aimed to describe the morphological features of prostatic carcinoma from laboratory specimens. Methods: This was a retrospective study using histologically diagnosed cases of prostatic carcinoma from prostatectomy and trucut biopsy specimens. The histological sub-typing of the tumors according to WHO classification scheme of 2003 was done. The tumors were graded and scored using Gleason’s scoring scheme revised and modified at the consensus conference of the international society of urological pathology (ISUP), in 2005. Results: Prostate cancer constituted 18.7% of all malignant tumors and 4.4% of all neoplastic diseases. The majority of cases were small acinar adenocarcinoma 275 (73.7%). Others include pseudo-hyperplastic variant 47 (12.6%), atrophic variant 35 (9.3%), foamy gland carcinoma 16 (4.2%) and signet ring/colloid carcinoma 1(0.2%). More than half were classified as well-differentiated Gleason prognostic group A tumors. There was a statistically significant association between the age of the patient and the Gleason histologic grade and the histologic grade and histologic variant p<0.05. Conclusions: Prostatic carcinoma was thought to be a malignancy associated with elderly men but people of younger age less than fifty years are now diagnosed with the malignancy. Accurate diagnosis with the right grade and scores will go a long way in the management of the malignancy.

Is Idiopathic Granulomatous Mastitis a Subgroup of Systemic Lupus Erythematosus? A Preliminary Study

Objective: The study aimed to use the systemic lupus erythematosus risk probability index (SLERPI) to assess if patients with idiopathic granulomatous mastitis (IGM) meet the criteria for systemic lupus erythematosus (SLE). Methods: A total of 62 patients with IGM and 55 age- and sex-matched healthy controls (HC) were enrolled. The study included patients who were over 18 years old and had been diagnosed with IGM using a true-cut biopsy. The participants’ demographic, clinical, and laboratory data were recorded in detail. The presence of autoantibodies, such as RF, CCP, C3, C4, ANA, ENA profile, and Anti-dsDNA was documented. For the detection of SLE in IGM patients, we used the SLERPI (SLE risk probability index). Results: A total of 62 patients diagnosed with idiopathic granulomatous mastitis (age 35.22 ± 8.34, BMI 27.15 ± 3.41) were compared to 55 healthy controls (age 32.54 ± 8.67, BMI 26.97 ± 3.54). The present study assessed the performance of SLERPI in IGM, and SLERPI positivity was observed in 12 out of 62 (19.4%) IGM patients. There was a significant difference in arthritis and ANA levels in the SLERPI subgroups (p < 001). Conclusions: The SLERPI index can be utilized to identify patients suspected of having systemic lupus erythematosus (SLE) in the IGM cohort.

Association of p53 expression in various molecular subtypes of invasive breast carcinoma NOS

Breast cancer is the second most common cause of mortality for women after heart disease. Consequently, stopping it is difficult at all times. Metastasis frequently occurs to distant organs such the liver, lung, and brain.All specimens from lumpectomies, simple and modified radical mastectomies, and trucut biopsies identified as Invasive Ductal Carcinoma Not Otherwise Specified at the Central Diagnostic Laboratory of the Pathology Department at tertiary care centre, were included in the study. Immunohistochemical markers were utilised and haematoxylin and eosin sections were examined.Association of p53 expression in various molecular subtypes of invasive breast carcinoma NOS. All lumpectomy specimens simple and modified radical mastectomy, trucut biopsies specimens diagnosed as invasive carcinoma breast not otherwise specified, submitted to the Department of Pathology, AJIMS, Mangalore for histopathological study are included in this study.Statistical analysis of the data was performed using SPSS 20.0.The continuous variables were presented as mean±SD. Categorical variables were presented in frequency and percentage. Categorical variables were analysed using Chi square test. A p value<0.05 was considered statistically significant.This study is on the expression of p53 in invasive ductal carcinoma of the breast type NOS and correlating it with different histological grades, tumour sizes, and molecular subtypes. This study showed expression of p53 is independent of molecular subtype.

12565 Expression Of Sex Hormone Receptors In Levator Ani Muscle Tissue From Patients With Pelvic Organ Prolapse

Abstract Disclosure: T. You: None. A. Halle: None. W. Xu: None. T. Potluri: None. H. Nguyen: None. S.E. Bulun: None. J. Julia Geynisman-Tan: None. H. Zhao: None. Introduction: Women with pelvic floor disorders usually have weakened pelvic floor muscles, which may cause urinary incontinence, fecal incontinence, and pelvic organ prolapse (POP). Histologically, the pelvic floor musculature in POP patients displays increased fibrosis and muscle atrophy. However, the underlying molecular mechanism for POP has not been fully investigated. We and others found that estrogen causes pelvic skeletal muscle fibrosis and inguinal hernias in male animal models. Additionally, clinical trials from the Women's Health Initiative showed women receiving estrogen-only or estrogen plus progestin treatment had statistically significant increases in the risk for urinary incontinence. However, the role of estrogen, progesterone, androgen, and their receptor expression in pelvic floor muscle is not well studied. Methods: TruCut biopsy needles were used to obtain levator ani (LA, the major pelvic floor muscle) biopsies from four groups of patients undergoing surgery: (i) 5 premenopausal women with stage II/III POP (age 38-52 years), (ii) 5 postmenopausal women with stage III POP (59-75 years), (iii) 5 age and parity matched premenopausal controls, and (iv) 5 age and parity matched postmenopausal controls. The control patients did not have any POP (stage 0) or only had sole stress urinary incontinence. H&E staining, Masson’s trichrome staining, and immunohistochemistry (IHC) staining for estrogen receptor α (ERα), progesterone receptor (PGR), and androgen receptor (AR) were performed in LA muscle tissue. Standard patient demographics (age, parity, and diagnosis) were collected. Results: We used H&E staining to morphologically assess stromal cells and myofibers obtained from LA muscle biopsies. Masson’s trichrome staining showed extracellular matrix deposition in the LA muscle from women with or without POP. In addition, we found ERα was present in the stromal cells from nearly every LA biopsy using IHC staining. ERα expression (H-Score) was similar in four groups of patients. ERα IHC staining was absent in LA myofibers. AR was highly expressed in stromal cells in all LA muscles and weakly expressed in myofibers in ∼70% of LA tissues. AR expression (H-Score) was significantly decreased in postmenopausal women with stage III pelvic organ prolapse. PGR was only expressed in a small portion of the LA sample (30%), with PGR exclusively expressed in the stroma of the LA muscle. Conclusion: Our findings indicate that sex hormone receptors (ERα, AR, and PGR) are present in LA muscle stroma, providing the foundation to further define the roles of sex steroid hormones in pelvic organ prolapse. Presentation: 6/3/2024

Assessment of ultrasound-guided tru-cut needle pleural biopsy in the diagnosis of unexplained exudative pleural effusion compared to medical thoracoscopy

Background Ultrasound-guided needle biopsy (USGNB) allows for precise and immediate viewing of pleural lesions, effusions, and needle placement without ionizing radiation. This study aimed to assess the efficacy of US-guided tru-cut needle pleural biopsy in diagnosing unexplained exudative pleural effusion compared to medical thoracoscopy (MT), focusing on safety, accuracy, time, and cost of the treatment. Patients and methods This observational cross-sectional research was conducted on 40 patients over 18 years old, of both sexes, with unexplained exudative pleural effusion. The patients were randomly separated into two equal groups. The girst group is USGNB and the second group is MT. Results Group II exhibited substantially greater costs, sedation levels, procedure duration, biopsy site discomfort, surgical emphysema, lung expansion failure, and psychological distress compared to group I (P<0.05). There was no notable disparity between the two groups regarding radiological detection of pleural effusion, pleural fluid properties, procedural observations, histological results, and diagnostic effectiveness. The duration of hospitalization was considerably shorter in group I compared to group II, assessed from the day of the operation to the day of release (P=0.001). Conclusion USGNB is an important tool in the diagnosis of pleural effusion after failure of pleural fluid analysis, which is performed by a chest physician is an accurate, safer, lower in cost, and shorter in duration with fewer complications compared with MT.

Enhanced Artificial Intelligence Methods for Liver Steatosis Assessment Using Machine Learning and Color Image Processing: Liver Color Project.

The use of livers with significant steatosis is associated with worse transplantation outcomes. Brain death donor liver acceptance is mostly based on subjective surgeon assessment of liver appearance, since steatotic livers acquire a yellowish tone. The aim of this study was to develop a rapid, robust, accurate, and cost-effective method to assess liver steatosis. From June 1, 2018, to November 30, 2023, photographs and tru-cut needle biopsies were taken from adult brain death donor livers at a single university hospital for the study. All the liver photographs were taken by smartphones then color calibrated, segmented, and divided into patches. Color and texture features were then extracted and used as input, and the machine learning method was applied. This is a collaborative project between Vall d'Hebron University Hospital and Barcelona MedTech, Pompeu Fabra University, and is referred to as LiverColor. A total of 192 livers (362 photographs and 7240 patches) were included. When setting a macrosteatosis threshold of 30%, the best results were obtained using the random forest classifier, achieving an AUROC = 0.74, with 85% accuracy. Machine learning coupled with liver texture and color analysis of photographs taken with smartphones provides excellent accuracy for determining liver steatosis.

Interesting Case Of Congenital Tuberculosis

Background: Mycobacterium tuberculosis (TB) is a global public health problem and is the causative organism of TB. There were 234,000 deaths of children due to tuberculosis. Since most of the pregnant women who have active TB are symptomless, diagnosis of TB is usually delayed2,3. It is difficult to differentiate between true congenital TB and postnatally acquired TB. High suspicion is needed for early diagnosis and treatment. Case: A 30-day-old girl had abdominal distension 1 week before admission and refusal to feed appeared on the 30th day. Clinically, sepsis, TORCH infection was suspected. USG abdomen showed multiple hypoechoic lesions in liver. Ct chest and abdomen showed multiple discrete non-calcified nodules in bilateral lung fields and liver. Gastric aspirate for AFB was negative. Mother was screened for TB; the TSTwas positive and TB QuantiFERON gold came positive. Hence, Tru-cut Liver biopsy was done for neonate and Biopsy for Genexpert showed low level Mycobacterium TB detected. Cerebrospinal fluid analysis for acid-fast bacilli was negative. 4 drug ATT regimen was started. Two weeks after anti-TB medication, the distension completely disappeared. Conclusion: Early diagnosis and treatment is the key for the survival of neonatal TB

Diabetic Mastopathy – A Case Report

Introduction: Diabetic mastopathy is a rare benign condition that can occur in patients with long standing Type I or II diabetes mellitus male or female of any age. Diabetic mastopathy is a fibroinflammatory condition that resembles carcinoma of breast. Here, we report a case of Type II Diabetic female patient with suspicious breast lump in right breast Case presentation: A 62 year old female presented with complaints of lump in right breast for 10 days. Clinically, hard lump of size 8x6 cm was palpable in upper outer quadrant. Trucut biopsy showed features of Diabetic mastopathy. Patient undergone wide local excision and biopsy confirmed the diagnosis. Post operative period was uneventful. Discussion: Diabetic mastopathy is an uncommon tumor-like proliferation of fibrous tissue of the breast, clinically and radiologically mimicking breast cancer. Histopathologically, it involves periductal, perilobular and perivascular lymphocytic infiltration. Primary excision with adequate normal tissue margins is the treatment of choice Conclusion: Diabetic mastopathy is a rare clinical entity, however due to increase in prevalence of Diabetes, diagnosis of Diabetic mastopathy should be considered in patients with breast lumps

Mesenteric Dedifferentiated liposarcoma presenting as a massive abdominal lump: A Rare Case

This case study examines a sixty five-year-old male presenting with a distended abdomen, lower back discomfort, and dyspnea on lying down, progressing over three months. Physical examination revealed multiple hard palpable lumps in the abdomen. Initial radiological evaluation indicated a connective tissue tumor, leading to a trucut biopsy revealing a spindle cell neoplasm of uncertain malignant potential. The tumor was found to be resistant to immunotherapy and neoadjuvant chemotherapy. Surgical resection unveiled multiple mesenteric tumors along the small bowel and also involving the descending colon, diagnosed as a dedifferentiated liposarcoma. Liposarcoma encompasses five histological subtypes, with dedifferentiated being the least common and comprised of poorly differentiated cells. Although liposarcomas typically originate from the retroperitoneum, the occurrence of dedifferentiated liposarcoma in the small bowel mesentery is exceedingly rare. This case report aims to underscore this uncommon occurrence, discuss diagnostic and treatment strategies, and advocate for further research into targeted therapies addressing specific immunohistochemistry markers to enhance outcomes for such patients, who generally face a grim prognosis Keywords – dedifferentiated liposarcoma , mesenteric tumors, spindle cell malignancy, mesenchymal tumors of GIT.

Leiomyosarcoma of vascular origin: lessons learned from misdiagnosis

BackgroundLeiomyosarcoma (LMS) of vascular origin is a rare entity of soft tissue sarcomas. Although they arise mostly from retroperitoneal major vascular structures, some encountered cases may arise from the smaller vascular structures of the thigh as the femoral vein. Due to their origin from the vascular structures, they represent a diagnostic challenge as they may be misdiagnosed as deep vein thrombosis (DVT).Case presentationWe present a case of a 45-year-old woman with left femoral and iliac vein LMS that was previously described in the vascular ultrasound (US) report as extensive DVT involving the femoral and external iliac veins. The patient did not improve after receiving the prescribed anticoagulants. Seven months later, the patient underwent computerized tomography (CT) with contrast, revealing a soft tissue mass in the anatomical site of the left common femoral and external iliac veins. The patient underwent both US-guided tru-cut biopsy and incisional biopsy from the iliac lymph nodes which revealed leiomyosarcoma.Materials and methodsThe patient underwent both vascular ultrasound and magnetic resonance imaging of the pelvis and the left thigh at the time of the first presentation. Seven months later, she underwent contrast-enhanced CT of the abdomen and pelvis.OutcomeThe patient was referred to the oncology department to receive the appropriate chemotherapy protocol as the tumor was inoperable.ConclusionsAlthough leiomyosarcoma of vascular origin is a rare entity of neoplasms, it is usually underestimated. A high index of suspicion would help the clinician to suspect such a neoplasm and save time for early diagnosis and management. Special caution should be taken for patients with venous thrombosis not improving on anticoagulants. When there is suspicion, other modalities such as computerized tomography and magnetic resonance imaging help confirm the diagnosis.

Effect of neoadjuvant chemotherapy on the expression of hormone receptors and Ki-67 in patients with locally advanced breast cancer

Background: Neoadjuvant chemotherapy (NACT) affects the tumor protein marker’s expression and status. Changes in the expression of biomarkers during NACT may influence the clinical decision of adjuvant molecular and hormonal therapy. Hence, re-evaluation of receptor status has to be done after NACT to give a specific adjuvant therapy for patient benefit. Aims and Objectives: The aim of this study was to study the status of hormone receptors (HRs) – estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor (Her-2/Neu), and Ki-67 in patients with locally advanced breast cancer (LABC) in both core needle biopsies and post-mastectomy specimens after administering neoadjuvant chemotherapy. Materials and Methods: The present study was conducted in the Department of Pathology in collaboration with the Department of Surgery, Pt B D Sharma PGIMS, Rohtak, for a period of 1 year. The study comprised 52 patients with LABC who received neoadjuvant chemotherapy and 20 control cases who did not receive neoadjuvant chemotherapy. Each case comprised two specimens: Trucut biopsy and a mastectomy specimen. Results: ER changed from positive to negative in 15.4% of the cases and from negative to positive in 1.9% of the cases. The overall change in ER was statistically significant (P=0.020). For PR, 9.6% of the cases changed from positive to negative while none of the cases showed change from negative to positive. The overall change in PR was statistically significant (P=0.025). For HER2/Neu, 19.2% of the cases changed from positive to negative, and 11.5% of the cases changed from negative to positive. The overall change in HER2/Neu was not statistically significant (P=0.317). For Ki-67, 30% of patients changed from positive to negative while 11.5% of patients changed from negative to positive. The overall change in Ki-67 was statistically significant (P=0.024). Conclusion: There was discordance in the HR status and proliferation marker after NACT in patients with breast cancer. The administration of NACT might be the main reason for the change in receptor status thus understanding the chemotherapy-induced biological conversion in the tumor cell behavior is strategically important in planning adjuvant endocrine therapy and for disease follow-up.

Male breast cancer: Case report and review of literature

Introduction: Male breast cancer (MBC) is an uncommon disease that makes up less than 1% of all breast cancer diagnoses worldwide. While breast carcinomas have some similarities in both sexes, there are significant differences. Case Report: We present a case of breast cancer in a 57-year-old man who had a left breast mass of 3.5 cm classified as breast imaging reporting and data system (BIRADS 4) by the American College of Radiology (ACR). The presence of invasive breast carcinoma of grade II Scarff–Bloom–Richardson (SBR) with a negative molecular phenotype B HER2 was confirmed by a tru-cut biopsy. The axillary cytopuncture did not show any abnormalities. The patient was later treated for a left mastectomy with homolateral axillary dissection. Conclusion: Male breast cancer represents a therapeutic dilemma. A multidisciplinary approach is mandatory.

Evaluation of Breast Cancer Screening Program in Al-Warith Hospital

Introduction: Breast cancer is a significant threat to Iraqi women's health. Early diagnosis of breast cancer increases the chance of recovery and life expectancy. Screening is the primary tool for early diagnosis and timely treatment of breast cancer in the early stages. Objectives: To evaluate the screening program in detecting breast cancer in the Al-Warith screening center, Karbalaa, Iraq, from 1/8/2023 to 1/5/2024. Methods: A cross-sectional descriptive study was conducted among 510 Iraqi women who came to the outpatient breast clinic. Their demographic information related to the current research was selected randomly; it was taken from the medical records in the statistics unit in the hospital. The collected data were coded and entered into SPSS 16.0 (Statistical Package for the Social Sciences (SPSS) 22.0 by IBM) (SPSS for Windows, Rel. 22.0., 2016, SPSS Inc., Chicago, IL, USA). The categorical data were analyzed by frequency and percentage. Results: 167 were screened, representing 32.75% of the total mean age (54.3±13.20) years old. Clinical screening identified normal findings in 87.50% of participants, while 4.17% had benign findings, and 8.33% were clinically screened and advised to review breast clinical recurrently. Ultrasound screening showed normal findings in 32.00% of patients and benign results in 60.00%, with 8.00% having BIRAD [4, 5] results. Mammography screening revealed normal findings in 40.43% of patients and benign results in 53.19%, with 6.38% having BIRAD [4, 5] results. Biopsies were performed on eight patients, resulting in 75.00% undergoing FNA and 25.00% undergoing True Cut Biopsy. Ultimately, breast cancer was detected in 1.20% of the asymptomatic patients screened. Conclusion: The data highlights the crucial role of regular screening for both asymptomatic and symptomatic women in the early detection of breast conditions. Raising public awareness is a vital strategy for healthcare providers. These efforts can greatly enhance the early detection and treatment of breast cancer and other related conditions. By following these recommendations, we can achieve better patient outcomes and improve overall public health.

Efficiency of Fine-Needle Aspiration (FNA) in Relation to Tru-Cut Biopsy of Lateral Neck Swellings.

Background Lateral neck masses have always been difficult to diagnose without proposing a differential diagnosis. Fine-needle aspiration (FNA) was proposed to be a cost-effective method and less invasive than a tru-cut biopsy and may provide a provisional diagnosis in relation to cytopathology. FNA has also been shown to improve the diagnosis of neck masses such as cervical lymphadenopathy, neck cysts, and parotid masses, whether malignant or benign. This study aims to evaluate the accuracy of FNA cytopathology versus a tru-cut biopsy histopathological examination. Materials and methods This study was conducted retrospectively in King Hussein Medical Hospital, Royal Medical Services, Hashemite Kingdom of Jordan, from January 2019 to January 2024. Ethical approval was taken to conduct this study with reference number 06/2024. All patients included in this study have given verbal and written consent to perform FNA and surgical tru-cut biopsy. The inclusion of patients was based on any person above the age of 16 who underwent an FNA followed by a surgical biopsy to correlate with the primary diagnosis. Exclusion criteria involved any patient who missed one of the above criteria. Statistical analysis was performed using IBM SPSS v29 (IBM Corp., Armonk, NY, US) with significant results considered with a p-value <0.05. Results A total of 107 patients were included in this study. A correlation between FNA results and final histopathological biopsy was done with an accuracy of 90.6%, specificity of 94.3, predictive positive value of 73.6%, andnegative predictive value of 94.3%. There was a statistical significance between FNA and tru-cut biopsy with a p-value of <0.001. Conclusion FNA is a great tool to consider when diagnosing lateral neck swellings. Since it was statistically significant, FNA should be considered for any lateral neck swelling before any surgical tru-cut biopsy for a definitive diagnosis.

Role of Core Needle Biopsy in Liver Metastases: A Histopathological and Immunohistochemical Approach

Abstract Background: The liver is the second most common organ involved by secondary neoplasms. Core needle biopsy of oncological patients requires an accurate histological diagnosis for the subsequent prescription of adequate management plans. Objectives: The aim of this study was to evaluate the diagnostic accuracy of core needle biopsy for suspected hepatic metastasis and to assess factors that influence the accuracy of the procedure. Materials and Methods: A cross-sectional study randomly enrolled 74 percutaneous ultrasound-guided core needle biopsies from patients with suspected hepatic neoplasm. A 16-gauge tru-cut biopsy needle was performed for all patients. Patient characteristics, procedure information, histopathology reports, and slides were collected from the Department of Histopathology at Al-Jamhorii Teaching Hospital, Mosul City, Iraq. All cases were analyzed using SPSS software, version 18.0. Results: Among 74 patients diagnosed with liver metastasis, the median age was 57 years (range 33–90 years) at the time of biopsy; of them, 61 patients (82.4%) reported a previous history of malignancy, P = 0.003. Histologically, metastatic adenocarcinoma was the most common neoplasm identified in 56 patients (75.7%), with the predominance of colorectal carcinoma. Forty-seven (63.5%) patients underwent two–five passes, which was statistically correlated with an increase in diagnostic accuracy (k = 0.21, 95% confidence interval [CI]= 0.038–1.189, P = 0.04). The overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of tru-cut biopsies were 100%, 97.1%, 95.7%, 100%, and 98.2%, respectively. Conclusions: The core needle biopsy is a reliable and valid diagnostic option for the histological assessment of suspected liver metastasis, particularly when supplemented by ancillary immunohistochemistry.

Role of Ultrasound-guided Tru-cut Needle Biopsy in the Diagnosis of Suspicious Breast Masses at South Valley University Hospitals

Role of Ultrasound-guided Tru-cut Needle Biopsy in the Diagnosis of Suspicious Breast Masses at South Valley University Hospitals

Efficacy of Tru-cut biopsy of the cervical lymphnodes over FNAC for detecting MTB using CBNAAT histopathology and cultures

Efficacy of Tru-cut biopsy of the cervical lymphnodes over FNAC for detecting MTB using CBNAAT histopathology and cultures

Risk predictors as companion diagnostics for ER positive, HER2 negative early staged breast cancers from India.

e13049 Background: Gene expression profiling tests can identify women with breast cancer most likely to benefit from chemotherapy providing accurate prognostic information than other non-genetic clinicopathological parameters. These derive specific molecular features of a tumour indicating an increased likelihood of rapid growth, metastasis risk, and response to chemotherapy. The tests are typically performed after surgery, in conjunction with other available information such as tumour size and grade. The objective of the current study was to evaluate the risk prediction as a companion diagnostic assay for women with early staged breast cancers (ER+,HER2-ve). Methods: The risk prediction was done evaluating quantitative gene expression profiling on Nanostring nCounter Flex platform using total RNA extracted from FFPE tissues (n = 81) obtained from trucut biopsy tissues and post MRM specimens after ensuring the tumour representation. The gene quantitations were derived after normalisation and using nSolver and Roselind software based statistical analysis. Results: We found 55.5% (45/81) and 44.5% (36/81) to be of intrinsic subtype Luminal A and Luminal B among our breast tumours respectively. The risk of recurrence score was high for luminal B (36.1% ; 13/36) compared to luminal A (13.4% ; 6/45). There was no difference pertaining to the Tumour Inflammation score (TIS score) among the luminal A and B that depicted good response to immunotherapy with 80% (36/45) among the luminal A and 72.3% (26/36) among the luminal B. We have identified top 38 differentially expressed genes that drive the high breast cancer proliferation score among the breast cancers in Indian women. The top 5 genes influencing the risk of recurrence with high BCP among the luminal A tumours were GNLY, CHRNA5, CDC20, MELK, RRM2 and among luminal B we got FGFR2, AURKA, MYBL2, CCNE2 and UBE2C. The top genes combining both types influencing the genomic risk of recurrence were FGFR2, MYBL2, AURKA, TTK, UBE2c and ORC6. The genomic risk of recurrence is based only on the gene expression unlike the risk of recurrence which includes the tumour size and nodal involvement. The top genes influencing a poor response to immunotherapy among luminal A was CNTFR, HAPLN1, FGF12, COL4A6 and CDH2 and the top genes influencing poor response to immunotherapy among luminal B was FGFR2, MYCN, AURKA and FAM198B. Conclusions: This is the first study from India using risk prediction test as a companion diagnostics assay for ER+ HER2-ve early staged breast cancer. The salient genes important to drive the breast cancer proliferation increasing the risk of recurrence scores in both luminal A and Luminal B intrinsic subtypes have been derived. We can validate these gene signatures as smaller panels of tests that can be low cost and more suitable for LMIC like India. The BCP panel of genes were relevant driving the recurrence.