11 research outputs found
Squash Smear Technique in Rapid Intraoperative Diagnosis of Brain Tumors
The role of rapid intraoperative diagnosis is crucial to neurosurgeons to not only define surgical approach, but also to ensure that minimum injury is caused to normal structures surrounding the lesion. Intraoperative cytology has been shown to be an important diagnostic modality. Squash smears are gaining popularity with increasing use of stereotactic biopsies which give limited tissue yield. The study was designed to assess the accuracy of intraoperative squash smear in the rapid intraoperative diagnosis of brain tumors. 100 consecutive cases of CNS tumors in which the tissue was removed at craniotomy or burr-hole biopsy were studied. The age range of the cases varied from 1 to 80 years. The diagnostic accuracy of squash smears was found to be 91%.In all the cases, clinicoradiological correlation was done with smear diagnosis. Smears were stained with 1% toluidine blue/H&E. In all the cases, results were compared with the paraffin section prepared from tissue remaining after the squash smears were made. Immunohistochemistry/Immunocytochemistry wasdone as needed
Squash Smear Technique in Rapid Intraoperative Diagnosis of Non-neoplastic and Cystic Lesions of CNS
In neurosurgical practice, a rapid intraoperative diagnosis helps the neurosurgeon to monitor and modify the approach at surgery. Smears and frozen sections are the two rapid tissue preparations that may be used by neuropathologists for giving opinion on intraoperative biopsy specimens of suspected lesions. The smear technique, which could be either squash/crush smears or impression smears, has been applied in neurosurgical units worldwide. This method plays a very important role in the analysis of sample from craniotomies and the small specimens obtained from stereotactic biopsies.Squash smear technique is a very rapid technique and the study was designed to assess the accuracy of squash smear in the rapid intraoperative diagnosis of non-neoplastic and cystic lesions of CNS and to document the cytomorphology of these lesions. A total of 23 cases were studied. The tissue was removedat craniotomy or by burr hole biopsy.In all the cases clinicoradiological correlation was done with smear diagnosis. Smears were stained with 1% Toluidine blue and H&E. In all cases, results were compared with the paraffin section prepared from the tissue remaining after the squash smears. Immunohistochemistry was done in one case. Special stainswere used as required.Amongst non-neoplastic lesions, tuberculous lesions comprised the maximum number of cases (n=9), two cases of PML, one case of fungal lesion, one case of non-specific abscess, one case of infarct, only reactive changes in one and normal cortex and white matter in one. In cystic lesions of the CNS, there was one case of Rathke’s Cleft cyst, four cases of Epidermoid cyst and two cases of arachnoid cyst. Cases of PML and Rathke’s cleft cyst could not be identified on smears. In all the cases, smear diagnosis was compared with histopathological diagnosis
Histological spectrum of ependymomas and correlation of p53 and Ki- 67 expression with ependymoma grade and subtype
BACKGROUND: Clinical and histological criteria for ependymoma
prognosis are well recognized. Recently few studies have been done
based on Immunohistochemistry for prognostication of these tumours. In
this study we have correlated the histlogical spectrum with
immmunoexpression of p53 and Ki67 in these tumors. AIMS: To know the
incidence of ependymomas; study their morphological spectrum and to
evaluate expression of P53 and Ki 67 in diffferent morphological
subtypes. MATERIAL AND METHOD: A retrospective sudy was preformed on
70 ependymomas received in a period between 1994 and 2001. Entire
tissue received was processed for routine paraffin embedded H&E
stained sections. Immunocytochemistry was performed using antibodies to
GFAP, EMA, Pancytokeratin and synaptophysin, to differentiate papillary
ependymoma from choroid plexus papilloma; clear cell ependymoma from
oligodendroglioma and central neurocytoma; ependymoblastoma from other
embryonal tumours. p53 and Ki-67 immunohistochemistry was performed to
correlate their expression with various tumour grades and subtypes.
RESULTS: There were 3 cases (4.2%) of Grade I ependymoma (2 cases of
myxopapillary ependymoma and 1 case of subependymoma); 57 cases (81.5%)
of ependymoma grade II (43 of these were of classical variety, 11 of
clear cell ependymoma, 2 of papillary and 1 case of cellular
ependymoma). There were 9 cases (12.8%) of anaplastic ependymoma (one
of these was a clear cell ependymoma and 1 case (1.5%) of
ependymoblastoma CONCLUSION: p53 and Ki67 indices can be used in
routine diagnostic laboratories to supplement the tumor grade on
histology and more studies with follow up should be performed toanalyse
the prognsis of different subtypes. The expression of Ki 67 and p53 was
significantly higher in anaplastic ependymomas. 4 out of 11 cases of
clear cell ependymomas showed higher Ki 67 indices as compared to
classical grade II ependymomas, thus further highlighting the
importance of differentiating the various subtypes
Synchronous anaplastic oligodendroglioma and carcinoma tongue: A rare association
We present the case of a 45-year-old female patient who harbored two
synchronous primary malignant neoplasms-an anaplastic oligodendroglioma
of the right frontal lobe and a squamous cell carcinoma of the tongue.
Both neoplasms were in advanced stage and carried a dismal prognosis.
To the best of our knowledge, this is the first documentation in the
english literature of such a presentation. The purpose of this article
is to alert clinicians to this possibility and to outline the
management approach in a different manner in patients presenting with
multiple primary neoplasms
Letter to Editor - Scalp and intracranial metastasis from pleomorphic adenocarcinoma of the parotid gland
Histological spectrum of ependymomas and correlation of p53 and Ki- 67 expression with ependymoma grade and subtype
BACKGROUND: Clinical and histological criteria for ependymoma prognosis are well recognized. Recently few studies have been done based on Immunohistochemistry for prognostication of these tumours. In this study we have correlated the histlogical spectrum with immmunoexpression of p53 and Ki67 in these tumors. AIMS: To know the incidence of ependymomas; study their morphological spectrum and to evaluate expression of P53 and Ki 67 in diffferent morphological subtypes. MATERIAL AND METHOD: A retrospective sudy was preformed on 70 ependymomas received in a period between 1994 and 2001. Entire tissue received was processed for routine paraffin embedded H&E stained sections. Immunocytochemistry was performed using antibodies to GFAP, EMA, Pancytokeratin and synaptophysin, to differentiate papillary ependymoma from choroid plexus papilloma; clear cell ependymoma from oligodendroglioma and central neurocytoma; ependymoblastoma from other embryonal tumours. p53 and Ki-67 immunohistochemistry was performed to correlate their expression with various tumour grades and subtypes. RESULTS: There were 3 cases (4.2%) of Grade I ependymoma (2 cases of myxopapillary ependymoma and 1 case of subependymoma); 57 cases (81.5%) of ependymoma grade II (43 of these were of classical variety, 11 of clear cell ependymoma, 2 of papillary and 1 case of cellular ependymoma). There were 9 cases (12.8%) of anaplastic ependymoma (one of these was a clear cell ependymoma and 1 case (1.5%) of ependymoblastoma CONCLUSION: p53 and Ki67 indices can be used in routine diagnostic laboratories to supplement the tumor grade on histology and more studies with follow up should be performed toanalyse the prognsis of different subtypes. The expression of Ki 67 and p53 was significantly higher in anaplastic ependymomas. 4 out of 11 cases of clear cell ependymomas showed higher Ki 67 indices as compared to classical grade II ependymomas, thus further highlighting the importance of differentiating the various subtypes
Progressive multifocal leukoencephalopathy in a patient with idiopathic CD4+T lymphocytopenia
Progressive multifocal leukoencephalopathy (PML) is demyelinating of
central nervous system caused by JC virus infection and often occurs in
immunodeficient individuals. We report progressive PML in a 30-year-old
male with idiopathic severely depressed CD4+T lymphocyte count. He was
sero-negative for human immunodeficiency virus (HIV) infection
Synchronous anaplastic oligodendroglioma and carcinoma tongue: A rare association
We present the case of a 45-year-old female patient who harbored two
synchronous primary malignant neoplasms-an anaplastic oligodendroglioma
of the right frontal lobe and a squamous cell carcinoma of the tongue.
Both neoplasms were in advanced stage and carried a dismal prognosis.
To the best of our knowledge, this is the first documentation in the
english literature of such a presentation. The purpose of this article
is to alert clinicians to this possibility and to outline the
management approach in a different manner in patients presenting with
multiple primary neoplasms
Spectrum of pediatric brain tumors in India: A multi-institutional study
Background : Till date there is no published multi-institutional data
regarding the epidemiological profile of pediatric brain tumors in
India. Aim : The present retrospective study analyses the histological
spectrum of pediatric age group brain tumors in seven tertiary care
hospitals in India. Material and Methods : Data regarding frequencies
of various primary brain tumors (diagnosed according to the World
Health Organization (WHO) classification), in 3936 pediatric patients
(<18 yrs of age), was collected from seven tertiary care hospitals
in India. Results : The most common primary pediatric brain tumors were
astrocytic tumors (34.7%), followed by medulloblastoma and
supratentorial primitive neuro-ectodermal tumors (22.4%),
craniopharyngiomas (10.2%) and ependymal tumors (9.8%). The most common
astrocytic tumor was pilocytic astrocytoma. In comparison to adults,
oligodendrogliomas and lymphomas were rare in children. Conclusions :
Our study is the first such report on the histological spectrum of
brain tumors in children in India. Except for a slightly higher
frequency of craniopharyngiomas, the histological profile of pediatric
brain tumors in India is similar to that reported in the Western
literature