Reporting trends, practices, and resource utilization in neuroendocrine tumors of the prostate gland: a survey among thirty-nine genitourinary pathologists

Background: Neuroendocrine differentiation in the prostate gland ranges from clinically insignificant neuroendocrine differentiation detected with markers in an otherwise conventional prostatic adenocarcinoma to a lethal high-grade small/large cell neuroendocrine carcinoma. The concept of neuroendocrine differentiation in prostatic adenocarcinoma has gained considerable importance due to its prognostic and therapeutic ramifications and pathologists play a pivotal role in its recognition. However, its awareness, reporting, and resource utilization practice patterns among pathologists are largely unknown. Methods: Representative examples of different spectrums of neuroendocrine differentiation along with a detailed questionnaire were shared among 39 urologic pathologists using the survey monkey software. Participants were specifically questioned about the use and awareness of the 2016 WHO classification of neuroendocrine tumors of the prostate, understanding of the clinical significance of each entity, and use of different immunohistochemical (IHC) markers. De-identified respondent data were analyzed. Results: A vast majority (90%) of the participants utilize IHC markers to confirm the diagnosis of small cell neuroendocrine carcinoma. A majority (87%) of the respondents were in agreement regarding the utilization of type of IHC markers for small cell neuroendocrine carcinoma for which 85% of the pathologists agreed that determination of the site of origin of a high-grade neuroendocrine carcinoma is not critical, as these are treated similarly. In the setting of mixed carcinomas, 62% of respondents indicated that they provide quantification and grading of the acinar component. There were varied responses regarding the prognostic implication of focal neuroendocrine cells in an otherwise conventional acinar adenocarcinoma and for Paneth cell-like differentiation. The classification of large cell neuroendocrine carcinoma was highly varied, with only 38% agreement in the illustrated case. Finally, despite the recommendation not to perform neuroendocrine markers in the absence of morphologic evidence of neuroendocrine differentiation, 62% would routinely utilize IHC in the work-up of a Gleason score 5 + 5 = 10 acinar adenocarcinoma and its differentiation from high-grade neuroendocrine carcinoma. Conclusion: There is a disparity in the practice utilization patterns among the urologic pathologists with regard to diagnosing high-grade neuroendocrine carcinoma and in understanding the clinical significance of focal neuroendocrine cells in an otherwise conventional acinar adenocarcinoma and Paneth cell-like neuroendocrine differentiation. There seems to have a trend towards overutilization of IHC to determine neuroendocrine differentiation in the absence of neuroendocrine features on morphology. The survey results suggest a need for further refinement and development of standardized guidelines for the classification and reporting of neuroendocrine differentiation in the prostate gland

Reactivity of carboxylato cyclophane with hexafluorobenzene and CuII-2,2' -hi pyridine

Department of Chemistry, Faculty of Science, Banaras Hindu University, Varanasi-221 005, Uttar Pradesh, India E-mail : [email protected] Fax : 91-542-2368127 Manuscript received 03 June 2011, accepted 06 June 2011 N,N',N'',N'"-Tetrakis(3-earboxy-propionyl)-1,6,20,25-tetraaza[6.1.6.1)paracyclophane, H4cp is allowed to react with hexanuorobenzene (hfb) and the binding of H4cp with hfb in solution is monitored using spectroscopic techniques (absorption, emission and 1H NMR). However, a reaction of H4cp with CuII-2,2'-bipyridine provides a solid complex of composition [{Cu(bpy)}2(cp)n 4(H2O).CH3OH (bpy = 2,2'-bipyridine) which Is characterized using spectroscopic (IR, Solid state UV-Vis, ESR)), elemental analysis and single-crystal X-ray diffraction measurements. The complex provides a 3D supramolecular structure using non-covalent interaction. Its thermal and photoluminescence properties are also described

Spectrum of adrenal lesions on fine needle aspiration cytology

Background: Fine needle aspiration (FNA) cytology of adrenal gland is not a commonly performed technique and is limited primarily to tertiary care centers. However, it is a sensitive and specific procedure in the workup of patients with adrenal gland′s mass lesions. Though cytomorphological features for various lesions have been described, there are a limited number of studies in cytologic literature. Aims: We report our 7 years of experience in FNAC of adrenal lesions. We have not only described the cytomorphological details of different lesions, but also tried to discuss the various diagnostic difficulties encountered during reporting of adrenal fine needle aspirations. Materials and Methods: All ultrasound-guided percutaneous aspirations of adrenal gland received in the department between the years 2002 and 2009 were reviewed. There were a total of 52 FNA samples of adrenal masses from 35 patients in 7 years. The lesions were categorized as non-neoplastic and neoplastic categories. Neoplastic lesions were further divided into benign and malignant lesions. Results: In our study, FNA proved to be 100% specific for diagnosing malignant lesions. The overall inadequacy rate was 11.4% with no major complications of the procedure. A wide variety of non-neoplastic as well as neoplastic lesions were identified

Meningeal chondroma in a young female

Meningeal chondroma is a rare intracranial neoplasm. It is usually diagnosed clinically as meningioma. Histologically it may have a differential diagnosis of chordoid meningioma, a malignant lesion, and needs radiotherapy. A chondroma is a benign lesion where surgical removal is the treatment. A 20-year-old female presented with symptoms of space occupying lesion which was clinically and radiologically considered meningioma. On histopathology, the lesion turned out to be a chondroma. Meningeal chondroma is a benign lesion for which surgical removal is the curative treatment. No further treatment in the form of radiation is required

Reactivity of tricine in the presence of Cu(ClO₄)₂.6H₂O and 2,2'-bipyridine: Synthesis, characterization and magnetic property of the complexes

1035-1042Three complexes, [Cu(bpy)(μ-OH)]2·2ClO4 (1) [Cu(H4TRI)(bpy)]ClO4 (2) and [Cu3(bpy)5(μ-O)(NO3)]2·6ClO4 (3) {H4TRI= tricine, bpy= 2,2'-bipyridine} have been synthesized and characterized using their IR, UV-vis and ESR spectroscopic data , elemental analysis and single crystal X-ray diffraction studies. The π-π interaction along the a-axis in complex (1) provides a channel- type structure while similar interaction in complex (2) generates a channel with floating ClO4- anions. Complex (3) comprises a pair of Cu(II) centers connected via (μ2-O) oxo bridges. These are further linked to Cu3 and Cu3#1 centers via oxygen atoms of the nitrate anion. The assembled structure of this complex along the c- axis displays a zig-zag chain formation. The variable temperature magnetic measurement of a representative complex (3), [Cu3(bpy)5(μ-O)(NO3)]2·6ClO4, shows that two of the Cu(II) centers couple ferromagnetically

A prospective study of serum adenosine deaminase and alkaline phosphatase in rheumatoid arthritis

Introduction: Rheumatoid arthritis (RA) is a systemic autoimmune disorder causing chronic inflammation and proliferation of the synovial tissues, destruction of articular cartilage and also affects many other sites that include the heart, blood vessels and skin. In general population the prevalence of RA is believed to range from 0.5-1.0 %. RA is reported to affect almost 1% of adult population worldwide and approximately 0.75% of adult Indian population. In India alone there are some 10 million people with RA. Materials and methods: The study was conducted at Department of Biochemistry, RIMS, Ranchi and test performed in Medall scans and lab, RIMS, Ranchi, Jharkhand. The study comprised of 30 patients of rheumatoid arthritis in the age group of 30-60 years who were diagnosed by clinical analysis, rheumatoid factor and E.S.R tests (Group 1). 60 healthy individual with no known history of any disease matched by age and sex with group 1 were taken as controls (Group 2). After taking informed consent and noting the name, age and sex, venous samples were drawn from both the groups. Results: In rheumatoid arthritis patients, serum Adenosine deaminase levels were high, the mean serum Adenosine deaminase levels were 60 ± 9.55 and in controls the mean Adenosine deaminase levels were 21 ± 3.04. The p value was significant at p < 0.001. We conclude that serum Adenosine deaminase can be used as a marker for cell mediated immunity to monitor disease activity in rheumatoid arthritis. Serum Alkaline phosphatase was found to be raised in rheumatoid arthritis, the mean serum Alkaline phosphatase levels were 291.63 ± 35.84 in patients of rheumatoid arthritis when compared to healthy controls (196.73 ± 32.71).The p value was significant at p<0.001. Conclusion: The present study has focused on investigating the serum total Alkaline phosphatase levels in Rheumatoid Arthritis Patients and The findings have indicated a raised serum Alkaline phosphatase in patients of rheumatoid arthritis when compared to healthy controls thereby suggesting the role of serum Alkaline phosphatase as a marker of disease activity in rheumatoid arthritis

A descriptive study of effect of blood donation on lipid profile in healthy volunteers

Introduction: Blood donation is a process by which a blood donor voluntarily has drawn the blood for the shortage in the blood bank or for subsequent use in blood transfusion. There is considerable shortage of blood even in large metropolitan cities with supply being less than 50% than the requirement. Materials and methods: This is descriptive study. Blood donation camp was organized in RIMS, Ranchi. 60 healthy males who were willing to participate were selected for the study. The Inclusion criteria being age between 18 years and 25 years, weight between 50 kg and 60 kg and haemoglobin levels should be > 10 mg %. Exclusion criteria are volunteers having history suggestive of chronic illnesses like Hypertension, Diabetes Mellitus, Hepatitis B, Haemoglobinopathies, Bleeding disorders, Alcoholics, Chronic smokers, Drug abuser, H/O blood donation within last one month. The samples of 60 healthy volunteers were collected in fasting condition. With all aseptic condition, 5 ml venous blood was withdrawn and centrifuged. Separated serum was used for further analysis. Results: All the parameters of lipid profile, e.g. TC, LDL, VLDL except HDL was highly significantly decreased (p<0.001) after 7th and the effects continued till 30th day after blood donation, which was highly significantly decreased (p<0.05, HDL). It was significantly increased (p <0.05) after 7th and 30th day of blood donation. At 90th day, all values were normalised. Conclusion: Blood donation has lipid lowering effects as early as 7 days after blood donation and effects were maintained till 30th day after blood donation. During this period, i.e. on day 7 and 30, there was significant decrease in TC, LDL, TG and VLDL levels with significant elevation of HDL concentration. The lipid profile returns to normal after 90 days of blood donation in healthy volunteers

Localized amyloidosis of urinary bladder: A diagnostic dilemma

Amyloidosis is a heterogeneous group of disorders affecting a single-or multiple-organ system and presents as generalized or localized disease. Both generalized amyloidosis and localized amyloidosis can be primary or secondary. Localized amyloidosis affects organs like urinary bladder, lung, larynx, skin, tongue and the region around the eye, producing detectable nodular masses which are clinically suspected as malignancy. We present six cases of localized urinary bladder amyloidosis that were clinically and cystoscopically suspected as bladder tumor or cystitis, which occurred over a period of last 10 years. Histology in all cases revealed diagnosis of primary amyloidosis. None of them had any stigmata of secondary disease. The cases were treated by simple transurethral resection of bladder. Two out of the six cases recurred after 3 to 5 years of initial presentation and were asymptomatic thereafter. Amyloidosis of the bladder is a rare condition which often mimics bladder neoplasm clinically and cystoscopically and histological examination is a must for definite diagnosis and proper management