Body Stalk Syndrome: A Curiosity

Limb body wall complex (LBWC) /Body stalk syndrome anomaly refers to a rare complicated polymalformative fetal malformation syndrome of uncertain etiology firstly described by Van Allen et al in 1987. There are very few cases reported in literature and thus we report a rare case of LBWC. Twenty seven years female presented to labour room with 32 weeks of gestation with no prenatal care and delivered a low birth weight still born fetus weighing 1100gms. On fetal autopsy large abdominal wall defect was noted with difficulty in identifying abdomino-pelvic organs and ambiguous genitalia. Placenta weighed 250gms with attached short umbilical cord measuring 7cms, arising from periphery. A cyst noted attached to placental membrane measuring 9x5cms which on dissection retrieved partially maldeveloped organs. Post mortem radiological findings included Absence of right femur with short tibia and right fibula, Complex vestibral malformation, Craniosynostosis and Overcrowding of ribs

Histopathological study of endometrial biopsy in infertility: A cross sectional study in a teaching hospital

Background: Endometrium is dynamic tissue which responds to hormones hence is the most sensitive indicator of ovarian function. Uterine pathology and cervical pathology like chronic infections or quality of cervical mucus plays a role in failure of conception. Hence endometrial biopsy is one of the most important investigations in infertility. Aim and Objectives: To document the morphological changes seen in endometrial biopsies and their demographic distribution in patients with infertility. Secondly to examine cervico-vaginal pap smear changes in infertility cases. Material and Methods: The study is a prospective cross-sectional study carried out during the period of June 2018 to July 2020. Married women visiting infertility clinic, who have undergone endometrial biopsy as an infertility evaluation were included in the study. Informed consent for the procedure was taken. Only premenstrual endometrial biopsy was included and inadequate biopsy samples were excluded from the study. Cervico-vaginal pap smear of these cases was processed under liquid-based cytology and reported using Bethesda system for cervical cytology. The histopathological findings and pap smear findings were statistically analyzed. Results: Ten percent of endometrial biopsies were indicated in evaluation of infertility among all biopsy registries. Primary infertility accounted 64% and secondary infertility as 36%. Sixty-six cases of endometrial biopsy were studied during study period. The most common histopathological findings were secretory endometrium, followed by proliferative (anovulatory and 2 cases luteal phase defect) endometrium, progestin induced changes, endometrial polyps, chronic endometritis and benign hyperplasia. Seventy-seven percentage of pap smears were negative for intraepithelial lesions (no squamous or endocervical abnormalities), predominantly showing signs of cervicitis and bacterial vaginitis. Conclusion: Histopathological study of endometrium forms an important, safe and cheaper diagnostic tool. Uterine pathology contributes to major pathogenesis of infertility and thus endometrial biopsy plays a significant role in preliminary evaluation of cases with infertility

Immunohistochemical Expression Status of HER2/neu and E-cadherin in Prostate Adenocarcinoma: A Cross-sectional Study

Introduction: Prostate cancer is a common tumour, accounting for 92% of malignancies in the male genital tract. Due to the high recurrence rate, it is important to identify prognostic markers in prostate cancer. Human Epidermal Growth Factor Receptor 2 (HER2) and Epithelial cadherin (E-cadherin) are speculated to be associated with carcinogenesis, but the literature has provided controversial results. Aim: To investigate the expression of HER2/neu and E-cadherin in prostatic adenocarcinoma and its correlation with clinicopathological parameters. Materials and Methods: A retrospective cross-sectional study was conducted at the Department of Pathology, SDM University, Dharwad, Karnataka, India. The study duration was one year and five months, from October 2020 to March 2022. A total of 45 cases diagnosed as prostatic adenocarcinoma between October 2016 and September 2019 were included. Clinicopathological parameters such as age, Prostate-Specific Antigen (PSA) levels, metastasis, perineural invasion, Gleason score, Gleason grade, and two-year survival were retrieved from hospital records and through telephone interviews. Immunohistochemistry (IHC) staining for HER2 and E-cadherin was performed and assessed by pathologists. Statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) version 20.0, and the Chi-square test was applied. Results: The mean age of the study participants was 69.6 years, ranging from 52 to 95 years. The rates of HER2/neu overexpression/positivity and reduced E-cadherin expression were 25 (55.5%) and 14 (31.1%), respectively. No statistically significant associations were found between HER2 and E-cadherin expression and age, PSA levels, perineural invasion, Gleason score, Gleason grade, and two-year survival (p>0.05). However, a statistically significant association was observed between HER2 expression and distant metastasis (p-value=0.006), whereas no significant association was found with E-cadherin (p-value=0.81). Conclusion: The study demonstrated a significant association between HER2/neu overexpression and tumour metastasis, suggesting that HER2/neu could serve as a prognostic parameter to assist surgeons. In contrast, E-cadherin showed no association with clinicopathological parameters, raising questions about its involvement in the progression of prostatic adenocarcinoma

Cutaneous Tuberculosis – A Profile of Cases 3 Years Cross Sectional Study

Background: Tuberculosis is an ancient disease known since pre-historic times and remains important infectious disease today in terms of morbidity, mortality and economic impact. Cutaneous tuberculosis makes up a small proportion (1.5%) of all cases of extra pulmonary tuberculosis. In a recent study from India cases of cutaneous tuberculosis make upto 0.15% of all skin outpatients. Irrespective of immunodeficiency status, cutaneous tuberculosis still contributes markedly in morbidity of developing countries and it remains at times a diagnostic challenge in dermatology clinic due to its varied clinical manifestations and varied histomorphology, hence proper clinical management with assisted histopathological diagnosis, the morbidity can be reduced. Aim and Objective: To study clinical and morphological variants of cutaneous tuberculosis with age and sex distribution. Materials and Methods: 3 years prospective study was done in the Department of Pathology, Shri Nijilingappa Medical College, Bagalkot from 2009 to 2011. Total 267 skin biopsies were received in the histopathology section. The biopsy tissue was processed as per routine procedure and stained with Hematoxylin and Eosin stains and special stains (ZN with 20% H2SO4). Microscopic features were studied and diagnosis of cutaneous tuberculosis made with sub typing and clinical co-relation. Results: Out of 267 skin biopsies, 37 were diagnosed as cutaneous tuberculosis based on clinical examination and morphology, Lupus vulgaris (62.16%) was a commonest variant affecting males (64.86%) predominantly. Most frequent age group affected was 21-40 years (59.45%). Face and neck were the usual sites for manifestation. Forty one percent of cases were mantoux test positive. All cases were HIV negative and free from active pulmonary tuberculosis. Conclusion: Lupus vulgaris remains most frequent form of cutaneous tuberculosis in dermatopathology irrespective of HIV status. Strong clinical suspicion, histopathological study and response to anti-tuberculosis treatment are sufficient for diagnosis and thus reducing the morbidity and mortality

Tuberculous Dactylitis in a 20 Year Old – A Rare Case Report

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis and manifested by formation of tubercles and caseous necrosis in tissues. Tuberculous spondylitis is the most typical form of disease in the musculoskeletal system. Tubercular dactylitis is the tuberculous infection of metacarpal, metatarsal and phalanges and is uncommon. Tuberculous granuloma results in spindle shaped expansion of the short tubular bones, so it is also called as Spina Ventosa (Spina=thorn, Ventosa=full of air). We present a case of 20 year old female with an isolated swelling in the right thumb of 3 months duration

Multiple Eccrine Spiradenoma- An Unusual Clinical Presentation

Eccrine spiradenoma is an uncommon benign adnexal tumour of apocrine differentiation. It is commonly seen in young adults with no sex predilection on upper ventral aspect of body as a solitary papule or nodule. Here we are reporting a rare case of Multiple Eccrine Spiradenoma (MES) in a 29 year male patient, who presented with multiple nodules on the anterior chest wall