Primary malignant melanoma of the nose: an unusual presentation

Mucosal malignant melanoma of the nasal cavity and paranasal sinuses is a rare entity. It is an unusual cause of nasal obstruction and epistaxis seen especially in elderly. We report the case of a primary nasal malignant melanoma in a 32 year old woman who presented with the history of epistaxis for 1 month. In our knowledge, this is the first case of primary nasal malignant melanoma to be reported in this age group

A study on morphologic and histological pattern of the central nervous system tumors

Background: It has been revealed by International Agency for Research on Cancer that the worldwide incidence rate of CNS tumors in 2002 was 3.7/100,000 population among males and 2.6/100,000 population among females. Central Nervous System (CNS) tumors account for 85% of brain tumors and 15 % of spinal cord tumors, however metastatic tumors are usually extradural. According to the WHO classification tumors of CNS comprise more than 50 clinico-pathological entities. The major categories include the tumors of neuroepithelial tissue, cranial and paraspinal nerves, meninges, sellar region, lymphomas haematopoietic neoplasms, germ cell and metastatic tumors. An understanding of the epidemiology is needed to facilitate prevention, early detection and treatment of CNS tumours.Methods: The study was conducted in the Department of Pathology, Pt. J.N.M. Medical College Raipur, India from January 2009 to August 2017. The present study was a retrospective study, hence H and E section of every case was re-examined and histopathological reports were reviewed. Sections were stained with H&E. Diagnosis is made according to the WHO classification and diagnostic criteria for CNS neoplasms.Results: CNS tumours occur more frequently in the age group of 41-50 years (57 cases -21.1%) followed by 31-40 years (53 cases -19.7%). The most common entity in the present study were tumours of neuroepithelial tissue 127 cases (47.2%) followed by tumors of meninges 59 cases (22%) and nerve sheath tumours 42 cases (15.6%). The tumors of neuroepithelial tissue comprised mainly of astrocytic tumors 86 cases (32%) followed by embryonal tumors 15 cases (5.6%), ependymal tumors 11 cases (4.1%), oligodendroglial tumors 09 cases (3.3%).Conclusions: Within the scope and limitations of the present study we believe that this effort would help in establishing the grounds for future epidemiologic studies that would, eventually, contribute to give insight into the epidemiology of CNS tumors

Prevalence of occult gynecological cancer in women undergoing surgeries for benign indications in a tertiary healthcare center of Chhattisgarh

Background: Hysterectomy, the surgical removal of uterus, is 2nd most frequently performed major surgical procedures on women,with90% of hysterectomies are performed for benign indications. However, there may be cases in which malignancy or premalignant lesions which are only confirmed on histopathology are defined as occult malignancy.Methods: We conducted a prospective observational study on a cohort of women undergoing various gynaecological surgeries for benign indications in a time period of January 2019 to January 2020 in the Department of obstetrics and gynaecology, Dr. BRAM hospital and Pt. J. N. M. medical college, Raipur (C.G) to find out the prevalence of occult pre malignant and malignant lesions.Results: Of 132 women who underwent surgeries for benign gynecological indications, based on final histopathological report, prevalence of occult premalignant lesion was 11.36% (95% CI 5.7-16.3%) and prevalence of occult malignancy was 2.27% (95% CI 0.2 -4.8%). Prevalence of occult premalignant lesion of corpus uteri and cervix uteri was 2.3 and 9.1% respectively. No occult premalignant lesion of ovary was found. Prevalence of occult malignant lesion of corpus uteri and ovary was 1.5 and 0.75% respectively.Conclusions: We observed that even after complete preoperative workup only 72.7% of the preoperative clinical diagnoses were correlated with their histopathological diagnosis. Thus, while making the diagnosis, risk factors along with standard preoperative approach should be strongly adhered to prevent misdiagnosis and to prevent missing of any pre malignant or malignant findings.

Evaluation of fine needle aspiration cytology in the diagnosis of soft tissue tumors and its correlation with histopathological findings

Background: Fine Needle Aspiration Cytology (FNAC) is a useful, safe and cost effective tool that is used in the diagnosis of lesions in various organs. Even though the literature on FNAC of soft tissue masses is relatively scarce, a large amount of interest has developed in this area in the last few years due to the low cost of the procedure, low incidence of complications, feasibility and high therapeutic efficiency. So the present study was undertaken to study the nature of various soft tissue tumors by FNAC and to compare the cytological diagnosis with the results obtained by biopsy.  Methods: All cases 713 (Prospective-217 and Retrospective 496) included in present series were taken up for study. Aspiration of soft tissue lesions were performed following the technique of Zajicek et al. Smear was prepared, stained and examined. Histopathological details were available in 140 cases. Data was compiled in MS excel and checked for its completeness, correctness and then it was analyzed.Results: Total number of 11,560 FNAC was done in six and half year’s period from 1st April 2003 to 30th September 2009. Out of the total 713 cases of soft tissue tumors, 71.25% were reported as benign and 28.75% as malignant. Soft tissue tumors were more common in males in comparison to females, with M: F-1.63:1. Accuracy of FNAC for benign and malignant soft tissue tumours was 88.1% and 92.9% respectively.  Conclusion: The overall diagnostic accuracy of FNAC in the present study was found 90%. FNAC is a safe and reliable method of recognizing benign and malignant soft tissue tumors and in most instances histological sub typing is possible. Cytological diagnosis must be based on strict cytological criteria and well controlled ancillary techniques.

Teratoid Wilms tumour with chemotherapy resistance

We present a case of Teratoid Wilms tumour (a rare histologic variant) in a 4 year old male who presented with an abdominal lump. Wilms Tumour with paracaval lymphadenopathy and tumour thrombi in right renal vein and inferior vena cava was made radiologically. FNAC report was suggestive of Wilms tumour and patient was subjected to 6 cycles of chemotherapy with not much reduction in size. Post nephrectomy histological diagnosis of Teratoid Wilms tumour was established. Resistance to chemotherapy and radiotherapy is thought to be due to presence of well differentiated histologic appearance. Teratoid Wilms tumour is usually not an aggressive neoplasm and prognosis is comparatively neoplasm and prognosis is comparatively good if the tumour is excised completely thus surgery being the best treatment

Pleomorphic adenoma: A diagnostic pitfall in the diagnosis of salivary gland lesions on FNAC: Case reports with review of the literature

Fine needle aspiration cytology (FNAC) is commonly being used with increasing frequency for the pre-operative evaluation of salivary gland lesions. However, it has areas of considerable interpretational difficulties. The most frequent problems involve variations in the expected cytology of pleomorphic adenoma (PA). Salivary gland FNACs performed at Pt. JNM Medical College, Raipur, Chhattisgarh, during July 2006 to June 2007 were reviewed, and we report four cases of interesting diagnostic dilemma. As PA is the most common salivary gland neoplasm, it should always be considered and ruled out as the first differential in the diagnosis of salivary gland FNACs. In order to avoid diagnostic pitfalls, we emphasize a diagnostic approach based on the mandatory presence of all three elements of PA, i.e. 3-dimensional cohesive clusters of ductal cells, background of singly lying plasmacytoid myoepithelial cells and dense fibrillary brightly metachromatic stroma with partially obscured entrapped myoepithelial cells. To document the same, we advocate liberal use of repeat aspirations with multiple sampling performed from different parts of the tumor. Some differential diagnostic problems, e.g. carcinoma ex PA, may still however remain insolvable by cytologic means