Tumor Typing Research Articles

Histopathological Evaluation of Estrogen Receptors, Progesterone Receptors, and Human Epidermal Growth Factor Receptor-2/Neu Expressions in Breast Carcinoma and their Correlations with Other Prognostic Factors

Background: Breast carcinoma is a leading cause of death among women. Factors such as estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER-2/neu) have important prognostic and predictive value. Aim: The aim of the study is to demonstrate ER, PR, and HER-2/neu expression in breast cancer specimens and to correlate these expressions with other prognostic factors such as tumor size, type, grade, and lymph node status. Methods: This prospective study included 70 cases of female breast carcinoma. Histopathological evaluation of all cases done and tumor size, site, presence, or absence of lymph node was recorded. Typing of tumor, grade, and lymph node status were determined. Immunohistochemical staining for ER, PR, and HER-2/neu of breast lesions was done, and the data were analyzed to find out any correlation of expression of ER, PR, HER-2/neu with the above prognostic factors. Results: The majority of patients were in 41–50 years (44.29%). Most of tumors were 2–5 cm in size and the infiltrating duct carcinoma-not otherwise specified was the commonest type. ER and PR expression decreases (P = 0.02340 and P = 0.02413 respectively), while HER-2/neu expression increases with increase tumor size (P = 0.02289). ER and PR expression were low while Her-2/neu expression was more in higher tumor grade (P = 0.022472, P = 0.04149 and P = 0.03339 respectively). No significant association was identified between ER, PR, HER-2/neu and number of metastatic lymph node. Conclusion: ER, PR, and HER-2/neu status correlates well with histopathological grading and tumor size. However, no significant association is seen with cancer type and lymph node status.

Expression and Prognostic Role of CXCL1 Gene in Colorectal Adenocarcinoma.

In this manuscript, we have extensively examined expression and prognosis of CXCL1 gene in colorectal adenocarcinoma (COAD) using different cases of colorectal adenocarcinoma and tissues. To verify this, protein and mRNA expressions of cxcl1 were identified through RT-PCR and immunohistochemistry in 30 cases of colorectal adenocarcinoma and adjacent tissues, which were surgically resected from January to July 2021 in our hospital, and relationship between CXCL1 mRNA and clinicopathological features and protein expression was analyzed. CXCL 1 mRNA in COAD carcinoma's expression was considerably higher than in the adjacent normal intestine. At the same time, CXCL 1 diagnostic receiver operating characteristic (ROC) curve had preferably higher value of the diagnostic for area under curve (AUC) = 0.912, 95%, COAD (P < 0.001, CI = 0.825–0.969). We have observed that CXCL1 gene was closely linked with preoperative CEA level (P=0.007) and gross tumor typing (P=0.039). Finally, we have concluded that that CXCL1 can be a possible biomarker for stress prognosis and diagnosis.

Consideration on the Research and Development of New Drugs for Rare Tumors

近年来，我国抗肿瘤药物呈现持续增长趋势，我国抗肿瘤研发的活跃程度占全球比例增高。然而，进一步分析研发热点，抗肿瘤药物在各瘤种中的研发并不均衡。对于发病率低的罕见肿瘤，由于患者少，临床试验开展难度大，研发热情普遍较低。然而，患者的治疗需求，也会为制药企业带来潜在机遇。基础研究的发展，以及新的肿瘤分子分型的发现，使“罕见肿瘤”成为一种动态的概念，“罕见肿瘤”的范围可能随着治疗的精准化发展而逐步拓宽；也可能随着对肿瘤的认识逐步由组织细胞学向分子学层面发展，使某些伴有特定突变的瘤种，共同组合成一组非罕见的“泛肿瘤”。罕见肿瘤同时具备罕见病和肿瘤的特征。其药物研发既要满足肿瘤药物研发的要求，又要适应于罕见疾病药物研发的特点，因此药物研发中可参考罕见病药物的研发思路，同时结合肿瘤疾病的特征，充分利用非罕见瘤种临床试验中的数据，充分利用科学工具、精巧的试验设计，实现对罕见肿瘤药物研发的促进。本文将对罕见肿瘤领域新药审评中的思考进行总结，以期为业界提供参考。

Major Changes in 2021 World Health Organization Classification of Central Nervous System Tumors.

The World Health Organization (WHO) published the fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5) in 2021, as an update of the WHO central nervous system (CNS) classification system published in 2016. WHO CNS5 was drafted on the basis of recommendations from the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy (cIMPACT-NOW) and expounds the classification scheme of the previous edition, which emphasized the importance of genetic and molecular changes in the characteristics of CNS tumors. Multiple newly recognized tumor types, including those for which there is limited knowledge regarding neuroimaging features, are detailed in WHO CNS5. The authors describe the major changes introduced in WHO CNS5, including revisions to tumor nomenclature. For example, WHO grade IV tumors in the fourth edition are equivalent to CNS WHO grade 4 tumors in the fifth edition, and diffuse midline glioma, H3 K27M-mutant, is equivalent to midline glioma, H3 K27-altered. With regard to tumor typing, isocitrate dehydrogenase (IDH)-mutant glioblastoma has been modified to IDH-mutant astrocytoma. In tumor grading, IDH-mutant astrocytomas are now graded according to the presence or absence of homozygous CDKN2A/B deletion. Moreover, the molecular mechanisms of tumorigenesis, as well as the clinical characteristics and imaging features of the tumor types newly recognized in WHO CNS5, are summarized. Given that WHO CNS5 has become the foundation for daily practice, radiologists need to be familiar with this new edition of the WHO CNS tumor classification system. Online supplemental material and the slide presentation from the RSNA Annual Meeting are available for this article. ©RSNA, 2022.

H^2-MIL: Exploring Hierarchical Representation with Heterogeneous Multiple Instance Learning for Whole Slide Image Analysis

Current representation learning methods for whole slide image (WSI) with pyramidal resolutions are inherently homogeneous and flat, which cannot fully exploit the multiscale and heterogeneous diagnostic information of different structures for comprehensive analysis. This paper presents a novel graph neural network-based multiple instance learning framework (i.e., H^2-MIL) to learn hierarchical representation from a heterogeneous graph with different resolutions for WSI analysis. A heterogeneous graph with the “resolution” attribute is constructed to explicitly model the feature and spatial-scaling relationship of multi-resolution patches. We then design a novel resolution-aware attention convolution (RAConv) block to learn compact yet discriminative representation from the graph, which tackles the heterogeneity of node neighbors with different resolutions and yields more reliable message passing. More importantly, to explore the task-related structured information of WSI pyramid, we elaborately design a novel iterative hierarchical pooling (IHPool) module to progressively aggregate the heterogeneous graph based on scaling relationships of different nodes. We evaluated our method on two public WSI datasets from the TCGA project, i.e., esophageal cancer and kidney cancer. Experimental results show that our method clearly outperforms the state-of-the-art methods on both tumor typing and staging tasks.

Liquid biopsy in CNS tumors: Current status & future perspectives.

Precise classification of central nervous system (CNS) malignancies is vital for the treatment and prognostication. Identification of noninvasive markers can be of importance to guide treatment decisions and in monitoring treatment response. CNS tumors are classified based on morphology with an essential complement of molecular changes, including mutations, amplifications, and methylation. Neuroimaging is the mainstay for initial diagnosis and monitoring tumor response with obvious limitations of imprecise tumor typing and no information on diagnostic, predictive and prognostic markers. Liquid biopsy has evolved as a diagnostic tool in body fluids and is being investigated as a surrogate for tissue biopsy in managing primary and metastatic brain tumors. Liquid biopsy refers to analyzing biological fluids such as peripheral blood, urine, pleural effusion, ascites, and cerebrospinal fluid (CSF); however, peripheral blood remains the primary source of fluid biopsy. The analytes include cell-free DNA (cfDNA) circulating tumor cells (CTCs), circulating micro RNAs (miRNAs), circulating proteins and extracellular vesicles (EVs). Analysis of these components is actively used for early cancer detection, auxiliary staging, prognosis assessment, detection of minimal residual disease (MRD), and monitoring drug resistance in various solid tumors. In recent years, liquid biopsy has been studied in CNS tumors, and analysis of CTCs and cfDNA have become relevant research topics. In the current review, we have explained the clinical potential of liquid biopsy in CNS tumors to assist in diagnosing and predicting prognosis and response to treatment.

Indications for fine-needle aspiration and core needle biopsy for diagnosis of salivary gland tumors

Salivary gland malignancies are rare neoplasms of the head and neck area. Preoperative clinical and imaging assessment of salivary gland masses is challenging. However, preoperative identification of malignancy is crucial for further treatment and for the course of the disease. This article presents the advantages and disadvantages of fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB). Additionally, the sensitivity and specificity of both methods for predicting malignancy were analyzed. Furthermore, it is discussed which procedure is suitable for the diagnostic work-up of salivary gland tumors. This current article summarizes important and recent studies in the field of the diagnostic work-up for salivary gland lesions, with discussion of original articles, metanalyses, and systematic reviews concerning FNAC and CNB. The sensitivity and specificity of the predictive ability of FNAC for malignancy is described at between 70.0-80.0% and 87.5-97.9%. The pooled sensitivity and specificity for CNB were 92.0-98.0% and 95.0-100.0%, respectively. Tumor cell seeding or facial nerve palsy are very rare complications of both procedures. If malignancy is suspected based on clinical examination or imaging, FNAC or CNB should be performed. FNAC is easy to perform; however, an onsite cytologist is necessary. CNB has ahigher sensitivity for routine diagnosis of malignancy; tumor typing and grading is facilitated by preserving the histological architecture. In conclusion, CNB is the procedure of choice in the diagnostic work-up for suspected malignant salivary gland tumors.

Updates in the classification of ependymal neoplasms: The 2021 WHO Classification and beyond.

Ependymal neoplasms occur at all ages and encompass multiple tumor types and subtypes that develop in the supratentorial compartment, the posterior fossa, or the spinal cord. Clinically, ependymomas represent a very heterogeneous group of tumors from rather benign subependymomas to very aggressive and often deadly childhood ependymomas of the posterior fossa. Newly identified biological markers and classification schemes, e. g. based on global DNA methylation profiling, have led to the definition of 10 types of ependymal tumors and an improved prediction of patients’ outcome by applying the new classification system. While the exact genetic basis for several ependymoma types still remains unclear, the knowledge about ependymoma driving events has significantly increased within the last decade and contributed to a classification based on molecular characteristics and localization rather than histological features alone. Convincing evidence is now pointing towards gene fusions involving ZFTA or YAP1 causing the development of supratentorial ependymomas. Also, H3, EZHIP, or TERT mutations have been detected in a fraction of infratentorial ependymal tumors. Finally, MYCN amplifications have recently been identified in spinal ependymomas, in addition to the previously known mutations in NF2. This review summarizes how recent findings regarding biology, molecular tumor typing, and clinical outcome have impacted the classification of ependymomas as suggested by the updated 2021 WHO CNS tumor classification system. We focus on changes compared to the previous classification of 2016 and discuss how a formal grading could evolve in the future and guide clinicians to treat ependymoma patients.

Application of next-generation sequencing in detection of BRCA1/2 and homologous recombination repair pathway multi-genes germline mutation and correlation analysis

Objective: To investigate the germline mutation status of related genes in breast cancer patients and high-risk individuals by next-generation sequencing. To analyze the correlations between homologous recombination repair (HR) pathway gene mutation status and clinicopathological characteristics of breast cancer patients. To supplement the database of breast cancer related gene mutations in Chinese population. Methods: This study is a cross-sectional study. From October 2020 to September 2021, whole blood samples were collected from 350 breast cancer patients and 49 high-risk individuals, admitted to Peking University People's Hospital and accepted genetic testing voluntarily. Germline mutations in 32 breast cancer related genes were detected by NGS. The clinicopathological characteristics, including age at the onset, family history, unilateral/bilateral tumor, Luminal typing (Luminal A subtype, Luminal B subtype, HER2-enriched subtype and triple negative breast cancer), tumor size and metastasis, were analyzed, and the correlations between HR pathway gene mutation status and clinicopathological characteristics were analyzed by Chi-squared test and Fisher's exact probability test. Results: Among 350 breast cancer patients, 64 (18.3%) cases carried gene pathogenic mutations (including pathogenic and likely pathogenic mutations), including 47 (13.4%) in BRCA1/2, 16 (4.6%) in non-BRCA1/2 genes, 1 (0.3%) in BRCA2 and FANCL. Among 49 high-risk individuals, 7 (14.3%) cases carried gene pathogenic mutations, including 6 (12.3%) in BRCA1/2 and 1 (2%) in ATM genes. BRCA1/2 pathogenic mutations were associated with age at the onset (18%, 8.7%, χ²=6.346, P=0.012), and the BRCA1/2 pathogenic mutation frequency was higher in patients diagnosed at age ≤45 years. HR pathway gene mutations (including pathogenic, likely pathogenic and uncertain significance mutations) were correlated with unilateral/bilateral tumor (49.5%, 68.4%, χ²=4.841, P=0.028) and Luminal typing (45.7%, 62.2%, 32%, 60%, χ²=12.004, P=0.007), and the HR mutation frequencies were higher in patients with bilateral tumor, Luminal B breast cancer and triple negative breast cancer (TNBC). Conclusion: The BRCA1/2 pathogenic mutation frequency in high-risk individuals is similar to that in breast cancer patients, and BRCA1/2 testing is helpful to guide breast cancer screening and prevention in high-risk individuals. Patients with early onset breast cancer, bilateral breast cancer, Luminal B breast cancer and TNBC have higher mutation frequencies of HR pathway genes, and HR pathway genes testing should be conducted as soon as possible to provide laboratory evidence for diagnosis, treatment, prognosis and risk evaluation of breast cancer.

Integrative Analysis of m6A RNA Methylation Regulators and the Tumor Immune Microenvironment in Non-Small-Cell Lung Cancer.

Background Non-small-cell lung cancer (NSCLC) is a major component of lung cancer and is significantly correlated with poor prognosis. N6-methyladenosine (m6A) RNA methylation is closely related to the occurrence, progression, and prognosis of cancer. The potential biological functions and mechanisms of m6A RNA methylation in the immune microenvironment are still unclear. Methods We assessed m6A RNA methylation modification patterns in 1326 NSCLC patient samples based on 20 m6A regulators, linking these clusters to the tumor microenvironment and immune cell infiltration. The m6Ascore was created to quantify the m6A modification patterns of individual tumors. We then assessed the value of NSCLC patients in terms of clinical prognosis and immunotherapy response. Results According to different mRNA expression levels, two different m6A clusters were identified. m6A aggregation was significantly associated with clinical prognostic characteristics, the tumor microenvironment, and immune-related biological processes. Fifteen differential genes were screened based on these two m6A clusters, and to further investigate the mechanisms of action of these differential genes, they were subjected to unsupervised clustering analysis, which classified them into four different genomic isoforms. Prognostic analysis indicated that the survival advantage of the m6A gene cluster A modification mode was significantly prominent. We continued to construct the m6Ascore, which was used as a scoring tool to evaluate tumor typing, immunity, and prognosis. Patients with a low m6Ascore showed a significant survival advantage, and the group with a low m6Ascore had a better prognosis predicted by immunotherapy. The anti-PD-1/L1 immunotherapy cohort showed that a lower m6Ascore was associated with higher efficacy of immunotherapy. Conclusions The results suggest that m6A RNA methylation regulators make an important difference in the tumor immune microenvironment of patients with NSCLC. m6A gene characterization and the construction of the m6Ascore provide us with a richer understanding of m6A RNA methylation modification patterns in NSCLC patients and help to predict clinical prognosis and immunotherapeutic response.

Research progress in CT-based radiomics constructing hypopharyngeal cancer and multisystem tumor prediction model

Radiomics, a technique for quantitative analysis of tumor imaging information through high-throughput extraction, uses a non-invasive way to capture a large number of internal heterogeneity characteristics of tumors, providing imaging basis for tumor staging and typing, tumor invasion site and distant metastasis, postoperative induction chemotherapy and prognosis, and providing new ideas and new thinking for the field of personalized precision medicine of tumors. This review aims to briefly summarize the latest research progress of imaging omics in the diagnosis and treatment design of head and neck tumor, and to discuss the research progress of constructing the treatment plan and prognosis evaluation model of hypopharyngeal cancer based on imaging omics, and to predict and forecast its development direction and clinical application.

Human papillomavirus vaccine efficacy against invasive, HPV-positive cancers: population-based follow-up of a cluster-randomised trial

BackgroundHuman papillomavirus (HPV) vaccination protects against HPV, a necessary risk factor for cervical cancer. We now report results from population-based follow-up of randomised cohorts that vaccination provides HPV-type-specific protection against...

Histologie und Molekularpathologie von Speicheldrüsentumoren

BackgroundSalivary gland tumors are rare but display great morphological heterogeneity with more than 30 entities. Recently, the different tumors have not only been better characterized using conventional histochemical and immunohistochemical methods, but also by molecular means. Hence, so-called driver mutations which play a role in the development of novel molecularly targeted therapies could be identified.ObjectiveThe article aims to show morphological criteria and immunohistochemical characteristics of different tumor entities. Additionally, an overview of tumor-specific genetic aberrations of the most common salivary gland tumors is given.Materials and methodsSamples from daily routine practice are presented with histochemical and immunohistochemical staining. To compile recent molecular findings in salivary gland tumors, a literature review was performed.Results and conclusionFor histopathological diagnosis of differentiated salivary gland tumors, immunohistochemical staining of basal/myoepithelial and luminal/epithelial cells is essential to assess cellular architecture and attribute proliferative activity. Based on correct tumor typing, various molecular parameters can be investigated in order to verify the diagnosis of highly differentiated nonmetastatic tumors. In the case of less differentiated, metastatic cancers, molecular pathology permits identification of potential therapeutic targets. Comprehensive genome profiling should nowadays be applied to highly aggressive salivary gland cancers.

Analysis of the MOSAIC correlative cancer database integrating molecular cancer classification and tumor profiling to identify targeted treatment options for metastatic cancer.

3121 Background: Unless tumor type and genetic alterations can be identified, metastatic cancer patients with unknown or uncertain diagnoses may be limited to empiric chemotherapy. The 92-gene assay (CancerTYPE ID) is a validated gene expression classifier of 50 tumor types and subtypes for patients with cancer of unknown primary (CUP) or ambiguous diagnoses. Multimodal molecular biomarker testing by next-generation sequencing (NGS), tumor mutational burden (TMB), fluorescent in situ hybridization (FISH), microsatellite instability (MSI), and immunohistochemistry (IHC) can identify genetic targets. A database integrating tumor typing with biomarker analysis in metastatic cases was utilized to identify the most prevalent genetic alterations by tumor type. Methods: MOSAIC (Molecular Synergy to Advance Individualized Cancer Care) is an IRB-approved database of cases with CancerTYPE ID testing plus multimodal biomarker testing. The current study determined molecular tumor type followed by molecular profiling by NGS for up to 323 genes, (NeoTYPE profiles, Neogenomics). Results: Tumor type was determined in 1992 of 2151 cases (92.7%), comprised of 27 different tumor types. 72% of cases were comprised of the 7 tumor types shown in the table,which also shows the frequency of the 10 most commonly mutated genes by tumor type. Bolded are genes with actionable genetic mutations for which FDA-approved therapies are not currently indicated in the identified tumor type. Conclusions: Precise targeted treatment for many patients with CUP or ambiguous diagnoses requires accurate diagnosis of the cancer origin combined with multimodal molecular testing to identify actionable genetic alterations in the appropriate cellular context. Future studies will evaluate additional biomarker profiles, including TMB, FISH, MSI, and IHC for cases in the MOSAIC database.[Table: see text]

Crush cytology: an expeditious diagnostic tool for gastrointestinal tract malignancy.

Background and study aims Crush cytology is a simple and rapid method used for diagnosis of central nervous system lesions. We have evaluated the diagnostic accuracy of crush cytology for gastrointestinal tract lesions. Patients and methods This was a prospective, cross-sectional, single center study, conducted on the patients who had suspected malignant lesions between August 2018 and March 2020. The crush cytologic diagnoses were correlated with histology to determine the diagnostic accuracy. Results During the period of interest, a total of 451 patients (26.4 % esophagus & GE junction, 16.6 % stomach, 5.9 % ampulla & duodenum, and 50.9 % colorectal) had a suspected malignant lesion on endoscopic examination. Histology confirmed 92.9 % cases as malignant lesions and 7.1 % as nonmalignant. On crush cytology, 84.5 % were positive for malignancy, 8.9 % were negative for malignancy and 6.6 % were reported as suspicious for malignancy. The overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of crush cytology were 97.3 %, 90 %, 99.2 %, 72.5 % and 96.9 %, respectively. Conclusions Crush cytology is a highly sensitive, specific, rapid and cost effective technique to diagnose gastrointestinal malignancies in endoscopically suspected malignant lesions. However, it cannot entirely substitute histopathological examination for definite tumor typing, grading, confirming invasion and in cases in which cytology is suspicious. Crush cytology is an added asset to the histology to maximize diagnostic accuracy and accelerating decision making for the management of lesions.

Micro-morphological feature visualization, auto-classification, and evolution quantitative analysis of tumors by using SR-PCT.

Tissue micro‐morphological abnormalities and interrelated quantitative data can provide immediate evidences for tumorigenesis and metastasis in microenvironment. However, the multiscale three‐dimensional nondestructive pathological visualization, measurement, and quantitative analysis are still a challenging for the medical imaging and diagnosis. In this work, we employed the synchrotron‐based X‐ray phase‐contrast tomography (SR‐PCT) combined with phase‐and‐attenuation duality phase retrieval to reconstruct and extract the volumetric inner‐structural characteristics of tumors in digesting system, helpful for tumor typing and statistic calculation of different tumor specimens. On the basis of the feature set including eight types of tumor micro‐lesions presented by our SR‐PCT reconstruction with high density resolution, the AlexNet‐based deep convolutional neural network model was trained and obtained the 94.21% of average accuracy of auto‐classification for the eight types of tumors in digesting system. The micro‐pathomophological relationship of liver tumor angiogenesis and progression were revealed by quantitatively analyzing the microscopic changes of texture and grayscale features screened by a machine learning method of area under curve and principal component analysis. The results showed the specific path and clinical manifestations of tumor evolution and indicated that these progressions of tumor lesions rely on its inflammation microenvironment. Hence, this high phase‐contrast 3D pathological characteristics and automatic analysis methods exhibited excellent recognizable and classifiable for micro tumor lesions.

Tumor Typing of Endocervical Adenocarcinoma: Contemporary Review and Recommendations From the International Society of Gynecological Pathologists.

The incidence of endocervical adenocarcinoma, the second most common cervical cancer in the world, has been on the rise. While most cervical cancers are squamous cell carcinomas and associated with high-risk oncogenic human papillomavirus (HPV), approximately 15% of endocervical adenocarcinomas, which now represent about one quarter of all cervical cancers, are HPV-independent. In this review, we will focus on the shortcomings of historical histologic classification systems of female genital tract tumors as they pertain to endocervical adenocarcinomas, and we will highlight the advantages of the new International Endocervical Adenocarcinoma Criteria and Classification system, which forms the basis for the WHO 2020 classification. We will cover the various histologic types, subtypes, and variants of endocervical adenocarcinoma with regard to morphology, immunophenotype, molecular genetics, HPV status and differential diagnosis, and we will provide International Society of Gynecological Pathologists recommendations for diagnosing these tumors.

English

BACKGROUND Fine needle aspiration cytology (FNAC) is commonly used as a safe and minimally invasive diagnostic test in benign salivary gland lesions. Nevertheless, the capacity of aspiration cytology in diagnosing benign lesions in the salivary gland is still disputed because accurate tumour typing is dependent on the quality and yield of the aspirate, as well as the competence of the cytopathologist. We aim to assess the precision of fine needle aspirate in the pre-operative diagnosis of benign salivary gland lesions and compare it with the histopathological findings. METHODS This is a longitudinal study conducted among 45 patients with preoperative cytological diagnosis of benign salivary gland lesions, who were followed-up till surgery with subsequent histopathological examination in Government Medical College, Thrissur, from 1 st January 2013 to 30th June 2015. RESULTS Among the benign neoplasms, 29 out of 30 cases of pleomorphic adenoma were confirmed on histopathology and one was basal cell adenoma. Out of nine cases of Warthin’s tumour, only seven were confirmed by histopathology. Of the remaining two, one was found to be salivary duct carcinoma showing the typical comedo necrosis and the other was found to be low grade mucoepidermoid carcinoma. So, these two cases were found to be false negative. The statistical analysis showed an overall diagnostic accuracy of 95.5 % for benign salivary gland lesions. CONCLUSIONS FNAC is a minimally invasive technique useful in salivary gland lesions. In nonneoplastic lesions surgery can be avoided and in neoplasms appropriate surgery can be planned. An accurate cytological diagnosis is often possible but may sometimes require the expertise of the cytopathology and use of ancillary techniques KEYWORDS Salivary Gland, Fine Needle Aspiration Cytology, Benign Tumours, Pleomorphic Adenoma, Warthin’s Tumour, Mucoepidermoid Carcinoma, Salivary Duct Carcinoma

Value of bronchial wash and brush cytology in addition to histology in the diagnosis of lung cancer

A retrospective study was performed to evaluate the diagnostic yield of lung cancer on biopsy, bronchial washings and brushings taken at fibreoptic bronchoscopy. Records of 526 patients were analysed and eventually 107 patients with endobronchial lesions, who had had biopsy, washing and brushing were included in this study. 89 cases were found to be malignant. Squamous cell carcinoma was the most common malignancy. Brush was found to be better than wash in tumor typing, though overall tumor typing using cytology was poor. Sensitivities of bronchial wash, bronchial brush and biopsy were found to be 70.8%, 64% and 94.4% respectively. Biopsy gave the only positive result in 38.2%, only brush in 1.1% and only wash in 1.1% malignant cases. Diagnostic accuracy of bronchial biopsy, brush and wash was found to be 95.3%, 70% and 73.8% respectively. Addition of bronchial wash and brush increased the positive yield by only 2.2% which was insignificant. It was concluded that the wash and brush cytology do not significantly add to the overall yield of positive results obtained from biopsies in endobronchial lesions. Keywords: Lung cancer, Fibreoptic bronchoscopy, Bronchial wash cytology, Bronchial brush, Endobronchial biopsy, Diagnostic accuracy.

Pathological variations of lung masses

Introduction: Lung is a common place for the spread of tumors from within or other parts of the body. Lung shadows with a diameter less than or larger than 3 cm are termed lung nodule or mass respectively. Aims: To study the histopathological spectrum of lung masses and efficacy of computerized tomography guided FNAC/biopsy in diagnosis of lung masses. Materials and Methods: Forty (40) cases picked up as lung masses on conventional screening & CT scan were subjected to CT guided FNAC/Biopsy and their pathological variations were studied. Results: A total of 40 cases were studied. The mean age of the patients was 60.57 years with 25 (62.5%) males and 15 (37.5%) females. 65% of lesions were in right lung. Malignant lesions were more common and accounted for 27 (67.5 %) cases and benign in 8 (20%) cases. Amongst the malignant lesions, adenocarcinoma was seen in 16 (59.25%), squamous cell carcinoma in 10 (37.03%) and small cell carcinoma in 1 (3.70%) case. Conclusion: FNAC is a simple, relatively safe, rapid, reliable technique for the diagnosis of pulmonary mass lesions, particularly with the aid of computed tomography (CT) scan. FNAC not only distinguishes between benign and malignant lesions but also helps in tumor typing of lung cancer. Keywords: Lung mass, Computed tomography, Needle biopsy.