A study of tumour infiltrating lymphocytes and neutrophil to lymphocyte ratio in papillary carcinoma thyroid

Background: Papillary thyroid carcinoma accounts for 70-80% of all diagnosed thyroid carcinomas. Immune response including systemic inflammation is thought to be essential for suppression of carcinogenesis. This study aims to correlate the tumour infiltrating lymphocytes (TIL) and neutrophil to lymphocyte ratio (NLR) in various demographic data and histomorphological features of papillary carcinoma thyroid. Methods: A total of 60 cases of papillary carcinoma were taken from a period between January 2018 and July 2021. TIL was analyzed as diffuse or focal at the area of highest concentration and was graded subjectively as: absent (no lymphocytes), mild (1-10%), moderate (>10-50%) and dense (>50%). NLR was calculated as the neutrophil count divided by the lymphocyte count, based on the preoperative complete blood cell counts. Results: The cases belonged to age group varying from 20 to 75 years with female preponderance (88.3%). In this study, there was significant correlation between TIL and tumour stage with a p value of 0.001. Lower the tumour stage, higher was the concentration of TIL. A cut of value of 2.17 was taken for NLR. Cases with diffuse, moderate to dense peritumoural lymphocytes had lower NLR and were statistically significant. High NLR was also seen in higher TNM stage. On the other hand, there were no association with gender, age, tumour size, histological subtype and focality with NLR. Conclusions: As an index of inflammation, tumour infiltrating lymphocytes and NLR can be considered. We found increased TIL in lower tumour stage and increased NLR values in higher tumour stages

Potential role of BRCA1 protein expression as a prognostic tissue biomarker in breast carcinoma: An immunohistochemical and clinicopathologic study from South India

Introduction. BRCA1 dysfunction is a hallmark of both hereditary and sporadic breast cancer. BRCA1 protein expression can be lost by germline mutation, somatic mutation or promoter hypermethylation. This study aimed to explore BRCA1 dysfunction in breast cancer patients by immunohistochemistry and to study its association with prognostic factors. Material and methods. BRCA1 protein expression was assessed by immunohistochemistry on formalin fixed paraffin embedded tissue blocks of 110 invasive breast carcinoma patients. Furthermore, the clinical findings and tumor features associated with BRCA1 dysfunction were characterized. Results. Reduced BRCA1 immunoreactivity was observed in 19% of breast cancer cases. Although these patients presented with aggressive tumor characteristics, statistical significance was observed only with presence of lymphovascular emboli (p < 0.05). These results suggest that loss of BRCA1 protein expression is associated with an aggressive phenotype of breast carcinoma. Conclusions. Immunohistochemistry for BRCA1 protein expression in tumor tissues may provide a less expensive screening tool to identify BRCA1 dysfunction due to genetic or epigenetic alterations

Eponyms in Tuberculosis

Tuberculosis is an ancient disease which has been extensively studied by various scientists. Many have the tuberculous lesions named after them for which they will be remembered forever. This article gives details of the contributions of these scientists who we should never forget

Low-grade endometrial stromal sarcoma: A report of five cases

Endometrial stromal sarcoma (ESS) is a very rare uterine tumor, composed of cells resembling endometrial stromal cells. As these tumors have indistinct clinical and radiological features, they are very rarely diagnosed preoperatively. We are reporting a series of five cases clinically mistaken as benign masses. The age range of these patients was 38–65 years, with a mean age of 49 years. The patients presented with vaginal bleeding, lower abdominal pain, and abdominal mass. All the cases were clinically diagnosed on ultrasound as leiomyoma and underwent total abdominal hysterectomy. Microscopically, all the cases showed a densely cellular tumor composed of small oval cells bearing a close resemblance to normal endometrial stromal cells and were diagnosed as low-grade ESS. This is an aggressive tumor but has a better prognosis in early stage

Cutaneous basal cell carcinoma: A morphological spectrum

Background: Basal cell carcinomas (BCCs) are much less common than squamous cell carcinomas (SCCs) among the cutaneous malignancies in India. Most of the BCCs behave indolently with low metastatic potential. Histological diagnosis and classification of BCCs are essential to predict their behavior and course. This study was done to analyze the histological spectrum. Materials and Methods: A retrospective study was done with 25 cases diagnosed over a 5-year period. The relevant clinical details were obtained and the slides were reviewed. Results: Twenty-five cases of cutaneous BCC were analyzed. The age of the patients ranged from 50 to 95 years with equal incidence in males and females. The duration of the lesions varied from 2 months to 10 years. Most of the lesions occurred on the face with 12 cases in the periorbital region and 9 cases on the cheek. There were one case each with a lesion on the scalp, back, chest, and abdominal wall. The histological subtypes found in our study included nodular type (undifferentiated -14 cases, and with differentiation -7 cases), nodulocystic type -1 case and basosquamous (metatypical) type -3 cases. Conclusion: It is important to differentiate basal cell carcinoma from other skin tumors and also type the tumors as the prognosis and risk of recurrence depends on the subtype