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BACKGROUND: A multicentric private hospital-based retrospective study was conducted to understand the epidemiology of breast cancer in terms of demographics and clinical characteristics (staging and hormone receptor status) at the time of diagnosis. METHODS: The data for 5,688 female breast cancer patients were collected from the hospital and clinical records of four study centres. All statistical analysis was performed using Microsoft Excel 2016 and R software. Survival was estimated by the Kaplan-Meier method and compared by the log-rank test. A P value of <.05 was considered statistically significant. RESULTS: The mean and median age of the study population was 52.6 (± 12.4) years and 53.0 (range 51-54 across the four centers) years, respectively. About 68% of patients were in the age category of 41 65 years, 17.6% were <40 years old among whom 23.4% of patients reported a positive family history. Most of the patients (66.3%) were diagnosed at an early stage (Stage I and II). The 3-year OS probability was 100%, 97.5%, 94.1%, and 74.7% for TNM Stages I, II, III, and IV, respectively. The 3-year RFS was 95.7%, 95.5%, 84.5%, and 49% for TNM Stages I, II, III, and IV, respectively. CONCLUSION: The present study highlights the epidemiological distribution of breast cancer patients. It emphasizes the importance of disease awareness among the urban and educated female population as most patients were diagnosed at earlier stages and demonstrated higher OS and RFS than reported in government registries.
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Neoplasias de la Mama , Humanos , Femenino , Persona de Mediana Edad , Adulto , Neoplasias de la Mama/patología , Estudios Retrospectivos , Estadificación de Neoplasias , Sistema de Registros , India/epidemiología , PronósticoRESUMEN
Pure mesenchymal sarcomas and phyllodes tumor with sarcomatous differentiation of the breast are rare tumors. Primary breast sarcomas are a heterogenous group of neoplasms which include malignant fibrous histiocytoma, fibrosarcoma, angiosarcoma, leiomyosarcoma, osteosarcoma, rhabdomyosarcoma, and liposarcoma. Sarcomatous differentiation in phyllodes tumor is seen in the form of angiosarcoma, chondrosarcoma, leiomyosarcoma, osteosarcoma, rhabdomyosarcoma, and liposarcoma. Here, we report a case of a 28-year-old pregnant woman with a breast lump during her second trimester which drastically increased in size in the postpartum period. Wide local excision revealed a malignant phyllodes tumor with liposarcomatous differentiation. Later, the patient underwent completion mastectomy which showed residual tumor.
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Neoplasias de la Mama/patología , Liposarcoma/patología , Tumor Filoide/patología , Complicaciones Neoplásicas del Embarazo/patología , Adulto , Neoplasias de la Mama/cirugía , Femenino , Humanos , Liposarcoma/cirugía , Tumor Filoide/cirugía , Embarazo , Complicaciones Neoplásicas del Embarazo/cirugíaRESUMEN
AIMS: In world literature, Peripheral T-cell lymphomas (PTCLs) constituted about 12% of non-Hodgkin's lymphomas (NHL) of which PTCL not otherwise specified (NOS) was the most common subtype. This study was undertaken to ascertain the frequency and to assess the morphologic and immunophenotypic characteristics of PTCL, NOS over a period of 5 years in a tertiary care referral center in Southern India. MATERIALS AND METHODS: Slides and blocks of all PTCL, NOS were retrieved, and a detailed morphologic and immunophenotypic study using a wide panel of antibodies was done. RESULTS: During this study, NHL constitutes 77.61% of all lymphomas. PTCL formed about 12.55% (251 cases) of all NHL. PTCL NOS was the most common subtype (30.68%). The most common site of involvement was lymph nodes (75%) followed by extranodal sites such as soft tissue (8.33%), gastrointestinal tract including oral cavity (6.67%), nasal cavity (5%), central nervous system (1.67%), lung (1.67%), and spleen (1.67%). PTCL, NOS showed a broad morphologic spectrum and had varied morphologic patterns with some mimicking reactive hyperplasia and some mimicking known type of T-cell lymphomas, B-cell lymphomas, and Hodgkin's lymphoma. CONCLUSIONS: PTCL, NOS constituted about 30.68% of all PTCLs in our institution during a 5-year period and was the second most common type of PTCL. Immunophenotyping using a wide panel of T-cell antibodies is necessary to distinguish PTCL, NOS from other lymphomas which they mimic, as they are known to carry a worse prognosis.
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Enfermedad de Hodgkin/diagnóstico , Linfadenopatía Inmunoblástica/diagnóstico , Leucemia Linfocítica Crónica de Células B/diagnóstico , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma Anaplásico de Células Grandes/diagnóstico , Linfoma de Células T Periférico , Adulto , Anciano , Anciano de 80 o más Años , Sistema Nervioso Central/patología , Diagnóstico Diferencial , Femenino , Tracto Gastrointestinal/patología , Humanos , Inmunohistoquímica , India/epidemiología , Pulmón/patología , Ganglios Linfáticos/patología , Linfoma de Células T Periférico/diagnóstico , Linfoma de Células T Periférico/epidemiología , Linfoma de Células T Periférico/patología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Bazo/patología , Centros de Atención Terciaria , Adulto JovenRESUMEN
Globally, peripheral T-cell lymphomas (PTCLs) constitute about 12% of all non-Hodgkin lymphomas, of which the unspecified category is the most common subtype (30%). Mostly, the unspecified category shows a diffuse pattern of involvement in the lymph nodes. However, rarely, they may show a follicular/nodular pattern mimicking a follicular lymphoma. We report a case of a follicular variant of PTCL, not otherwise specified. This case displayed a striking nodular/follicular pattern with an admixture of small (centrocyte-like) and large (centroblast-like) cells, thus mimicking a follicular lymphoma. The neoplastic cells were strongly positive for both CD3 and CD20. In addition, they were positive for pan T-cell markers and PD-1. T-cell receptor gene rearrangement studies highlighted a monoclonal T-cell population. Even though this variant of PTCL is very rare, it is important to keep it as a differential for the lymphomas exhibiting nodular pattern.
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Linfoma de Células T Periférico/diagnóstico , Linfoma de Células T Periférico/patología , Anciano , Antígenos CD20/análisis , Complejo CD3/análisis , Electroforesis , Femenino , Histocitoquímica , Humanos , Inmunohistoquímica , Microscopía , Receptores de Antígenos de Linfocitos T gamma-delta/análisisRESUMEN
Primary non-Hodgkin lymphomas of the oral region are rare, accounting for 3-5% of all malignant lesions. Of these, peripheral T-cell lymphomas (PTCLs) are extremely rare with only a few cases reported in literature. We describe a case of 50-year-old female who presented with an indurated lesion on the tongue. PTCL was diagnosed after immunohistochemical and T-cell receptor gene rearrangement analysis. Although PTCL of oral cavity is extremely rare, the possibility should always be considered in the differential diagnosis of T-lymphoid proliferations affecting this area.
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BACKGROUND: The aim of this study was to analyze the clinicopathological and immunohistochemical features of primary central nervous system lymphoma (PCNSL) cases occurring in Indian patients and also study the utility of the crush smear preparation in intraoperative diagnosis. MATERIALS AND METHODS: The immune status, clinical, radiological details, immunohistochemical profile, histopathological findings and cytological features in smear preparation of 32 cases of PCNSL were analyzed. Patients with systemic NHL and skull-base lymphomas were excluded. RESULTS: The mean age of our patients was 52 years with a male: female ratio 1:1. A periventricular location was found in 62.5% of patients. None of our PCNSL cases were associated with AIDS. All cases except one were diffuse large B-cell lymphomas. Intraoperative diagnosis using crush smears allowed correct prediction in 93% of cases. CONCLUSIONS: Our study shows that PCNSL is seen predominantly in immunocompetent patients in India .The age of presentation is relatively young as compared to the West. Our study also stresses the utility of crush smear preparation in establishing an intraoperative diagnosis.
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Neoplasias del Sistema Nervioso Central/diagnóstico , Técnicas Citológicas/métodos , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma de Células T/diagnóstico , Adulto , Anciano , Neoplasias del Sistema Nervioso Central/diagnóstico por imagen , Femenino , Humanos , India , Linfoma de Células B Grandes Difuso/diagnóstico por imagen , Linfoma de Células T/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Sistema Nervioso/patología , Radiografía , Centros de Atención TerciariaRESUMEN
BACKGROUND: The MIB-1 labeling index (LI) has proved to be useful in assigning grading and prognosis to astrocytomas. The purpose of our study was to analyze the utility of MIB-1 LI in differentiating astrocytomas of varying grades and the possible relationships of MIB-1 LI with clinical parameters like age and sex. We also wanted to study the prognostic role of MIB-1 index in predicting behavior of astrocytomas. MATERIALS AND METHODS: Our study included 145 patients with astrocytic tumors of varying grades. Immunolabeling for all patients was done using MIB-1 antibody. Survival data could be obtained for 64 patients. A Mann-Whitney U test was used to test the difference in MIB-1 LI between different histological grades. The univariate analysis was done by the Kaplan-Meier method, and the multivariate analysis for survival was performed using the Cox proportional hazard model. RESULTS: Significant differences were noted in mean MIB-1 LI of high-grade and low-grade diffuse astrocytomas. MIB-1 LI did not vary significantly with age and sex. Univariate analysis showed favorable prognostic factors for low histopathological grade, young patient age and low MIB-1 LI; however, multivariate analysis showed that only histopathological grade had independent prognostic significance. CONCLUSIONS: Our study proves that MIB-1 LI is not dependent on factors like age and sex and is solely dependent on histological grade. Though the average level of MIB-1 LI varies considerably in the different grades of astrocytomas, considerable overlap can be observed between them. MIB-1 LI is a very useful adjunct to the histopathological diagnosis and can be of great help in situations where the clinical and radiological findings do not correlate with histological diagnosis.
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Astrocitoma/diagnóstico , Astrocitoma/patología , Ubiquitina-Proteína Ligasas/análisis , Adolescente , Adulto , Astrocitoma/mortalidad , Niño , Femenino , Humanos , Inmunohistoquímica/métodos , Masculino , Microscopía , Persona de Mediana Edad , Pronóstico , Índice de Severidad de la Enfermedad , Análisis de SupervivenciaRESUMEN
The purpose of this study was to analyze the significance of p53, bcl-2 and EGFR expression in the grading and biological behavior of astrocytic tumors, especially in the Indian population. A total of 117 cases of astrocytomas graded using the WHO grading system published in 2007 were immunolabeled using p53, EGFR and bcl-2 monoclonal antibodies and analyzed with respect to grade and other relevant parameters. The 117 cases included 16 cases of pilocytic astrocytomas and 25, 15 and 61 cases of diffuse fibrillary astrocytomas WHO grade II, anaplastic astrocytomas WHO grade III and glioblastomas (GBM), respectively. Our results showed that p53 alterations is an early event in astrocytic gliomagenesis, but is not significant in the evolution of pilocytic astrocytomas. Bcl-2 expression did not correlate with grade and no statistical correlation was seen with p53 expression. EGFR protein expression correlated with the severity of tumor grade. Of the GBM cases, 47.5% were p53 positive only, 18% were EGFR positive only, 16.5% were negative for both and 18% were positive for both. The mean age in the dual positive category was significantly higher when compared to the others. EGFR and p53 alterations are not mutually exclusive and might act synergistically to promote progression. We also noted a significantly higher p53 expression in females in GBMs. Though most of our findings correlated with those of previous studies, some differences were noted, especially in the pattern of immunoexpression in GBMs, perhaps because of ethnicity.
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Astrocitoma/química , Receptores ErbB/análisis , Glioblastoma/química , Neoplasias del Sistema Nervioso/química , Proteínas Proto-Oncogénicas c-bcl-2/análisis , Proteína p53 Supresora de Tumor/análisis , Adulto , Factores de Edad , Astrocitoma/genética , Astrocitoma/patología , Femenino , Genes bcl-2 , Genes erbB-1 , Genes p53 , Glioblastoma/genética , Glioblastoma/patología , Humanos , Inmunohistoquímica , India , Masculino , Persona de Mediana Edad , Neoplasias del Sistema Nervioso/genética , Neoplasias del Sistema Nervioso/patología , Pronóstico , Factores SexualesRESUMEN
Rosai-Dorfman disease (RDD) is an idiopathic, non-neoplastic, lymphoproliferative disorder characterized by sinus histiocytosis and massive lymphadenopathy. When RDD involves the central nervous system the lesion simulates a meningioma. Histological and immunohistochemical confirmation is essential for a definitive diagnosis. In this paper, ten cases of RDD confined to the central nervous system are reported. Another case with orbital RDD was excluded. Nine cases involved the cranial cavity alone; in one, the cervical extradural region was also involved. Treatment consisted of surgical excision or biopsy. Histology and immunohistochemistry revealed a mixed cell population of predominantly mature histiocytes with evidence of emperipolesis and strong positivity for S100 protein in all cases. No recurrence was observed during follow up ranging from three months to eight years.