Accuracy of concurrent visual and cytology screening in detecting cervical cancer precursors in rural India.

The high burden of cervical cancer and inadequate/suboptimal cytology screening in developing countries led to the evaluation of visual screening tests, like visual inspection with acetic acid (VIA) and Lugol's iodine (VILI). We describe the performance of VIA, VILI and cytology, carried out in a multinational project called "Screening Technologies to Advance Rapid Testing" in 5,519 women aged 30-49 years, in detecting cervical intraepithelial neoplasia (CIN). VIA, VILI and cytology were positive in 16.

Assessment of HER-2/neu status in breast cancer using fluorescence in situ hybridization & immunohistochemistry: Experience of a tertiary cancer referral centre in India.

Background & Objectives: Determination of HER2 status in breast cancer has become important to identify potential candidates for anti-HER2 therapy. In this study we compared fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) for the determination of HER2 status in breast cancer patients referred to a tertiary care referral centre.

Methods: A total of 200 cases of invasive breast cancer were evaluated for HER2 status using IHC and FISH and results were compared.

Cytodiagnostic problems in cervicovaginal smears from symptomatic breast cancer patients on tamoxifen therapy.

Objective: To evaluate the effect of tamoxifen on cervicovaginal epithelium, identify tamoxifen-related changes that mimic cancer and detennine the morphologic features differentiating the 2 changes.

Study Design: Cervicovaginal smears from 153 conventionally treated primary breast cancer patients presenting with gynecologic symptoms were studied.

Results: All 153 patients presented with menorrhagia or irregular periods.

Diagnostic dilemmas in fine needle aspiration cytology of an ectopic kidney: a case report.

Background: Congenital anomalies are easily diagnosed on radiology and rarely have an unusual presentation requiring an invasive diagnostic procedure. Fine needle aspiration cytology (FNAC), though a well-established diagnostic technique for abdominal and retroperitoneal lesions, is fraught with several challenges and pitfalls.

Case: We report a case of a 39-year-old woman with an ectopic kidney presenting as an abdominal mass.

Presence of a micropapillary pattern in mucinous carcinomas of the breast and its impact on the clinical behavior.

Infiltrating micropapillary carcinomas (IMPC) of breast are highly angioinvasive tumors with poor prognosis. This study is based on the observation that a similar micropapillary pattern is also observed in mucinous carcinomas of breast. About 102 mucinous carcinomas were evaluated for the presence and impact of this micropapillary pattern on the clinical behavior.

Epithelioid sarcoma of the foot with subsequent lesion in hand: metastatic lesion or second primary?

Epithelioid sarcomas (ES) are rare tumors of soft tissue that have a propensity to occur in the extremities. Epithelioid sarcomas are known to metastatise to draining lymph nodes and commonly to the lungs. Herein, a case of epithelioid sarcoma which recurred in an unusual site namely the distal phalanx of left middle finger, six months post amputation of the primary lesion in the left foot is being reported.

Changes in the tumor grade and biological markers in locally advanced breast cancer after chemotherapy--implications for a pathologist.

There is insurgence of literature evaluating prognostic and predictive factors in breast carcinomas treated with chemotherapy, with a parallel need to develop guidelines for the pathologist interpreting such excisions. Prechemotherapy gun biopsy and postchemotherapy excision specimens from 78 women with locally advanced breast cancer were analyzed for histological changes in the tumor, changes in the tumor grade, hormone receptors, cerb2, and bcl2 and their impact on disease-free survival (DFS). An unusually prominent granulomatous response to tumor was seen in three cases.

Proximal-type epithelioid sarcoma--a rare, aggressive subtype of epithelioid sarcoma presenting as a recurrent perineal mass in a middle-aged male.

Background: Epithelioid sarcoma (ES) is an uncommon soft tissue sarcoma. Lately, subtypes of ES, including proximal-type ES have been recognized, with relatively few reports on such cases.

Case Presentation: A 47-year-old male presented with a perineal soft tissue mass that was excised elsewhere and the biopsy was submitted for a review diagnosis.

Cytologic findings in infiltrating micropapillary carcinoma and mucinous carcinomas with micropapillary pattern.

Objective: To examine the observation that some mucinous carcinomas have a micropapillary pattern and are mucinous variants of the highly angioinvasive infiltrating micropapillary carcinomas (IMPC).

Study Design: We evaluated cytologic findings of 13 IMPC and 55 mucinous carcinomas for comparative features.

Results: In mucinous carcinomas, 37 of 50 (74%) had a micropapillary pattern.

Fibromatosis-like carcinoma-an unusual phenotype of a metaplastic breast tumor associated with a micropapilloma.

Background: Fibromatosis-like metaplastic carcinoma is a newly described metaplastic breast tumor, literature on which is still evolving.

Case Presentation: A 77-year-old lady presented with a 2 x 2 cm mass with irregular margins in the upper and outer quadrant of left breast. Fine needle aspiration cytology (FNAC) from the lump was inconclusive.

Papanicolaou stain: Is it economical to switch to rapid, economical, acetic acid, papanicolaou stain?

Objective: To standardize an inexpensive and rapid Papanicolaou staining technique with limited ethanol usage.

Study Design: Smears from 200 patients were collected (2 per patient) and fixed in methanol. Half were subjected to conventional Papanicolaou and half to stain ing with rapid, economical, acetic acid Papanicolaou (REAP) stain.

An analysis of 46 static telecytology cases over a period of two years.

We analysed 46 telecytology cases sent from two rural hospitals about 500 km from a tertiary cancer centre. The cases were submitted for second opinion over a period of two years and evaluated using a static store and forward telecytology approach. A total of 715 digital images were studied (average 15 per case).

Primary angiosarcoma of the breast: observations in Asian Indian women.

Background: Primary angiosarcomas of breast are rare tumors, with a fatal outcome.

Material And Methods: We studied histological prognostic factors and c-kit expression by immunohistochemistry (IHC) in 12 angiosarcomas accessioned at a cancer referral center in India.

Results: All patients had primary angiosarcoma; no case of secondary angiosarcoma was accessioned during the study period.

Pure malignant myoepitheliomas of the breast: an immunohistochemical study.

Myoepithelioma of breast are extremely rare. We report two cases of pure malignant myoepithelioma of the breast, utilising light microscopic and immunohistochemical methods for diagnosis. Both the cases presented as breast lump.

Cytomorphologic patterns in papillary cystic variant of acinic cell carcinoma of the salivary gland.

Objective: To study the cytomorphologic profile of the papillary and cystic variant of acinic cell carcinoma (ACC-PCV) of the salivary glands.

Study Design: We studied 6 aspirates from 5 cases of ACC-PCV.

Results: All the cases had varied cytomorphologic features depending upon the degree of vacuolation of cells.

Case report: metastatic adamantinoma of the tibia--an unusual presentation.

A 26-year-old female with a tibial lesion diagnosed as an adamantinoma was treated with intra-lesional curettage, bone grafting and intra-medullary nailing. Six years post-surgery, she presented with an asymptomatic primary site but with a metastatic lesion in the mid-shaft of the ipsilateral femur and lung metastases. The femoral lesion was treated with wide excision and reconstructed with an allograft and plate fixation.

Renal angiomyolipomas--a study of 18 cases.

Angiomyolipoma is a distinctive neoplasm composed of an intimate admixture of three components, viz. mature adipocytes, smooth muscle cells and blood vessels. This study was undertaken to better define the various morphological patterns of angiomyolipoma and their immunohistochemical profile.

Static telepathology consultation service between Tata Memorial Centre, Mumbai and Nargis Dutt Memorial Charitable Hospital, Barshi, Solapur, Maharashtra: an analysis of the first 100 cases.

Telepathology is the practice of pathology at a distance. Static telepathology is employed to achieve teleconsultation between a tertiary cancer referral centre, Tata Memorial Centre and a sister concern in rural area viz. Nargis Dutt Memorial Cancer Hospital, Barshi, Solapur.

Desmoplastic round cell tumor of childhood: can cytology with immunocytochemistry serve as an alternative for tissue diagnosis?

There are limited reports on the cytology of desmoplastic small round cell tumors (DSRCT). Fine needle aspiration biopsy (FNAB) findings in seven aspirates from four cases of histologically and immunohistochemically confirmed cases were analyzed with the main intention of ascertaining if cytological diagnosis of DSRCT is possible. Also assessed were the immunocytochemistry(ICC) findings in these cases.

Experience with telepathology at a tertiary cancer centre and a rural cancer hospital.

Background: Telepathology allows quick and timely access to an expert opinion, no matter where the patient is located. We analysed the experience with the use of telepathology between a tertiary cancer centre and a rural cancer hospital.

Methods: Ninety-three cases were analysed in which static telepathology was used to obtain a consultation between Tata Memorial Centre and Nargis Dutt Memorial Cancer Hospital at Barshi, a rural area.

Proliferative lesions of the breast: carcinoma in situ.

Many breast carcinomas probably arise in a multi-step fashion through a series of intermediate lesions viz. ductal hyperplasia to atypical ductal hyperplasias to ductal carcinoma in situ (DCIS), and thence to invasive ductal cancer, each of which has a greater probability of becoming malignant than the one that preceded it. These precursor lesions have differing risk implications, hence treatment decisions vary with the risk.

Solitary extramedullary plasmacytoma of the premaxilla.

Solitary extramedullary plasmacytoma is a rare tumour with radiotherapy playing an important role in its management. This report describes the case history of a man with a solitary extramedullary plasmacytoma at an extremely rare site, the premaxilla, that posed certain diagnostic and therapeutic dilemmas. The patient underwent surgery followed by postoperative radiotherapy.