RESUMEN
Melanomas of vertebral body are usually metastatic lesions. Isolated vertebral body melanomas are rare may be due to unknown primary. Only threesuch cases havebeen reported in literature. We are reporting a 30-year-old female presented with progressive quadriparesis and bladder involvement. On evaluation, an extradural lesion at the C4-5 level with the destruction of C4 vertebral body and anterior in the prevertebral space seen with areas of blooming. The patient underwent surgery and biopsy was suggestive of melanoma. On further evaluation, we could find any other lesion in the body. The lesion can be either metastatic with unknown primary or primarily arising from vertebrae. Primary vertebral body melanomas are rare, surgical decompressions followed by immunotherapy may prolong the survival in this patients.
Asunto(s)
Melanoma , Neoplasias Primarias Desconocidas , Femenino , Humanos , Adulto , Cuerpo Vertebral , Melanoma/diagnóstico , Vértebras Cervicales/diagnóstico por imagen , Melanoma Cutáneo MalignoRESUMEN
We are reporting two patients of fatal and rapidly progressive amoebic encephalitis in immunocompetent host from poor socioeconomic status. Both these patient had acute neurological worsening preoperatively and did not respond to subsequent surgical decompression. Biopsy report confirmed acanthamoebic cerebral infection.
Asunto(s)
Amebiasis , Meningoencefalitis , Amebiasis/diagnóstico , Amebiasis/patología , Humanos , Meningoencefalitis/patologíaRESUMEN
Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare adnexal tumor with a predilection for the skin of the eyelid. It has also been reported in other areas of the face. Extra facial location has rarely been reported. They are twice as common in the females as compared to men and frequently affect the elderly between 50 and 80 years of age. It is a low-grade carcinoma with no reported cases of metastases, although a few cases with recurrences have been reported. Since it was first described by Flieder et al. in 1997, fewer than 60 cases have been reported in the literature. We describe one such case of EMPSGC in an adult male occurring at an unusual location, the peno-scrotal junction with systemic metastases to bilateral inguinal and iliac lymph nodes, multiple bones, and pancreas. Unlike previously reported cases, our patient worsened rapidly and succumbed to the disease six months after initiation of chemotherapy and radiotherapy. To the best of our knowledge, this is the first reported case of its kind in modern published literature.
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Adenocarcinoma Mucinoso/diagnóstico por imagen , Recurrencia Local de Neoplasia/secundario , Escroto/patología , Neoplasias de las Glándulas Sudoríparas/diagnóstico por imagen , Neoplasias de las Glándulas Sudoríparas/secundario , Glándulas Sudoríparas/patología , Biomarcadores de Tumor , Resultado Fatal , Humanos , Masculino , Persona de Mediana Edad , Mucinas , Recurrencia Local de Neoplasia/diagnóstico , Tomografía de Emisión de Positrones , Escroto/diagnóstico por imagenRESUMEN
Developmental vascular anomalies of brain are non-modifiable risk factors for the development of aneurysms and are prone for rupture. We report one such association in a 44-year-old gentleman who succumbed to subarachnoid hemorrhage (SAH) secondary to ruptured distal anterior cerebral artery aneurysm associated with vascular anomalies in the anterior and posterior circulation that included trifurcation of anterior cerebral artery and bilateral fetal posterior cerebral arteries. We identified multiple anomalies in circle of Willis that could have contributed to the formation of aneurysm and early rupture. Knowledge of these variations is essential to plan early and optimum management with close follow-up.
Asunto(s)
Arteria Cerebral Anterior/patología , Aneurisma Intracraneal/diagnóstico por imagen , Arteria Cerebral Posterior/patología , Hemorragia Subaracnoidea/etiología , Adulto , Trastornos Cerebrovasculares/congénito , Resultado Fatal , Humanos , Aneurisma Intracraneal/patología , Masculino , Tomografía Computarizada por Rayos XRESUMEN
Supratentorial ependymomas (ST EPNs) are molecularly characterized, of which the RELA fusion positive tumors are the most common and aggressive subgroup. Moreover, histologically, anaplastic ST EPN (ST-AE) often mimic other central nervous system primary high-grade tumors resulting in a diagnostic dilemma. We aimed to study a cohort of ST-AE; evaluate the expression of two RELA fusion-associated markers-L1CAM and p65 (NF-κB); and correlate their expression with clinical and histological parameters. Cases of ST-AE diagnosed in our department from January 2011 to June 2016 (n = 72) were reviewed. A battery of immunohistochemical markers was employed. A total of 65 confirmed ST-AE were included in the study. Age ranged from 9 months to 60 years. There was a slight predominance in the pediatric population (57%). Male-to-female ratio was 1:1.16. Histomorphological features were varied and mimicked other high-grade tumors in several cases. L1CAM immunopositive tumors constituted 26% of cases and were predominantly seen in young children, in the frontoparietal location, and exhibited clear cell morphology with calcification. A consistent pattern of L1CAM immunopositivity was noted in paired primary and recurrent tumor samples. Our study portrays the varied clinical and histomorphological spectrum of ST-AE. The study emphasizes the association of L1CAM immunopositivity with a wide spectrum of histological parameters, literature on which is scant till date. Since ST EPN-RELA are tumors with aggressive behavior, such a correlation would be clinically relevant, particularly when there is limited access to molecular testing.
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Biomarcadores de Tumor/inmunología , Ependimoma/patología , Molécula L1 de Adhesión de Célula Nerviosa/inmunología , Neoplasias Supratentoriales/patología , Factor de Transcripción ReIA/metabolismo , Adolescente , Adulto , Factores de Edad , Biomarcadores de Tumor/análisis , Biomarcadores de Tumor/genética , Encéfalo/patología , Niño , Preescolar , Diagnóstico Diferencial , Ependimoma/diagnóstico , Ependimoma/genética , Femenino , Glioma/diagnóstico , Humanos , Lactante , Masculino , Persona de Mediana Edad , Neoplasias de Células Germinales y Embrionarias/diagnóstico , Molécula L1 de Adhesión de Célula Nerviosa/análisis , Molécula L1 de Adhesión de Célula Nerviosa/genética , Proteínas de Fusión Oncogénica/análisis , Proteínas de Fusión Oncogénica/genética , Proteínas de Fusión Oncogénica/metabolismo , Estudios Retrospectivos , Factores Sexuales , Neoplasias Supratentoriales/diagnóstico , Neoplasias Supratentoriales/genética , Análisis de Matrices Tisulares , Factor de Transcripción ReIA/análisis , Factor de Transcripción ReIA/genética , Adulto JovenRESUMEN
BACKGROUND: The most reliable histological correlate of recurrence risk in meningiomas is increased mitotic activity. Proliferative index with Ki-67 immunostaining is a helpful adjunct to manual counting. However, both show considerable inter-observer variability. A new immunohistochemical method for counting mitotic figures, using antibody against the phosphohistone H3 (PHH3) protein was introduced. Similarly, a computer based automated counting for Ki-67 labelling index (LI) is available. AIMS AND OBJECTIVES: To study the use of these new techniques in the objective assessment of proliferation indices in meningiomas. MATERIALS AND METHODS: This was a retrospective study of intracranial meningiomas diagnosed during the year 2013.The hematoxylin and eosin (H and E) sections and immunohistochemistry (IHC) with Ki-67 were reviewed by two pathologists. Photomicrographs of the representative areas were subjected to Ki-67 analysis by Immunoratio (IR) software. Mean Ki-67 LI, both manual and by IR were calculated. IHC with PHH3 was performed. PHH3 positive nuclei were counted and mean values calculated. Data analysis was done using SPSS software. RESULTS: A total of 64 intracranial meningiomas were diagnosed. Evaluation on H and E, PHH3, Ki-67 LI (both manual and IR) were done in 32 cases (22 grade I and 10 grade II meningiomas). Statistically significant correlation was seen between the mitotic count in each grade and PHH3 values and also between the grade of the tumor and values of Ki-67 and PHH3. CONCLUSION: Both the techniques used in the study had advantage over, as well as, correlated well with the existing techniques and hence, can be applied to routine use.
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Inmunohistoquímica , Neoplasias Meníngeas/patología , Meningioma/metabolismo , Meningioma/patología , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Inmunohistoquímica/métodos , Antígeno Ki-67/metabolismo , Masculino , Meningioma/diagnóstico , Persona de Mediana Edad , Índice Mitótico/métodos , Estudios Retrospectivos , Adulto JovenRESUMEN
BACKGROUND: The role played by cytology in primary diagnosis is undeniable. With improved management protocols and targeted therapy, the need for accurate diagnosis has become mandatory. Immunochemistry and molecular techniques are increasingly being used on limited tissue samples. AIMS: This study was conducted to find out the impact of immunocytochemistry (ICC) on cytology material in cytology practice. MATERIALS AND METHODS: Immunochemistry was done on alcohol-fixed smears and cell-block preparations. It was done with i6000 BioGenex autostainer using BioGenex reagents. RESULTS: A total of 148 cases occurring over a period of 3 years (September 2010-June 2013) were analyzed. Staining was done on cytology smears in 77 cases and on cell-block sections in 71 cases. ICC helped in diagnosis in 8 cases, confirmed the diagnosis in 26 cases, helped in subtyping in 60 cases, and helped in prognostication in 6 cases. ICC has altered the diagnosis in two cases. It was noncontributory in 43 cases, and the material was inadequate in three cases. CONCLUSION: In 102 cases (69%), ICC proved to be a useful adjunct in the diagnosis and prognostication; hence, its use is recommended in practice to aid in cytology services.