Immunohistochemical evaluation of neuronal dysfunction in paediatric patients with Hirschsprung’s disease and allied disorder

Background: Neonatal bowel obstruction may result due to defect in the intestine wall which may be classified as neuropathic, myopathic or idiopathic types according to the pathological changes observed. The present study was conducted between September 2014 to December 2015 with the aim to study histomorphological changes and evaluate the role of various IHC markers (calretinin, S-100, CD117) in Hirschsprung’s disease (HD) to assess neuronal dysfunction in these patients.Methods: Thirty cases with clinical suspicion of HD were included in our study. The tissue sections were processed and wax blocks were prepared. Histopathological diagnosis was established on routine H and E. Representative sections were further subjected to IHC staining with calretinin, CD117 and S-100 protein. A descriptive study was carried out. Chi-square was used with P-value less than 0.05 accepted as statistically significant.Results: Out of 30 cases with clinical suspicion of HD, 13 cases were diagnosed as HD, 10 as Non-HD motility disorder whereas 7 were without any definitive diagnosis. All the cases were subjected to IHC staining using calretinin. Out of 13 cases diagnosed as HD, 1 case showed presence of ganglion cell using calretinin. All 7 equivocal cases were accurately diagnosed by calretinin. Thus 12 cases were confirmed HD while 18 were diagnosed as Non HD motility disorder. On statistical analysis, sensitivity (92.3%) of calretinin was lower than specificity (100%). Nerve bundle hypertrophy was observed in 11 cases of HD and 9 cases of Non-HD motility disorder using S-100 as an IHC marker. CD117 was used to demonstrate altered density and distribution of ICCs was statistically significant in cases of Non-HD motility disorder.Conclusions: IHC is being widely used as a reliable adjunctive test in evaluation of motility disorders of bowel. In view of its ease and reproducibility, it can be routinely used, avoiding need for repeated biopsies, and delay in treatment

Epidermal inclusion cyst of breast diagnosed on fine needle aspiration cytology: a retrospective study

Background: Epidermal inclusion cyst (EIC) is a rare benign condition of breast. Patient presents with palpable breast lump and needs to be differentiated from other breast lesions. This study included cases of epidermal inclusion cyst of breast (EICB) diagnosed on fine needle aspiration cytology (FNAC) and their correlation with histopathological findings.Methods: Study was conducted in a retrospective manner over a period of 2 years.  8 Patients who presented with breast lump and were cytologically diagnosed as EIC were included in the study. Cytological features were suggestive of EIC or infective EICB. Histopathological confirmation was done. Female: Male ratio in the study was 7:1 with an age range of 35 to 54 years. Radiological investigations favoured benign lesions in 5 cases and tubercular collection in one case.Results: FNAC was performed and May-Grunwald-Giemsa stained smears showed numerous anucleate squames and mature squamous epithelial cells in a clean or inflammatory background. Diagnosis of EICB or infective EICB was made on cytology. Diagnosis was confirmed histologically in 6 cases.Conclusions: Asymptomatic lesions do not require biopsy and treatment. Follow-up is sufficient if typical clinical and radiological findings are there. But in symptomatic cases, excision should be done followed by histopathological confirmation to rule out malignant lesion. Diagnosis should be made on FNA whenever associated with characteristic pultaceous aspirate and cytological findings.

Tubercular panophthalmitis: Case report of a rare entity

Tuberculosis (TB) remains the leading cause of infection-related deaths in adults worldwide. The ocular involvement in TB is extremely rare. The incidence of ocular TB is reported to be 1%–2% of ocular diseases. We report an interesting case of mycobacterial panophthalmitis in an adult male who presented with painful red eye with loss of vision

Unilateral tonsillar hypertrophy masquerading as malignant neoplasm: Actinomycosis – The Culprit

Actinomycosis is an infrequent bacterial infection encountered nowadays, caused by anaerobic Gram-negative bacterium of Actinomyces species. We report an unusual case of a unilateral tonsillar hypertrophy in a 40-year-old male, caused by actinomycosis masquerading as malignant tumor. To the best of our knowledge, only seven cases of actinomycosis causing unilateral tonsillar hypertrophy have previously been published. Since this anaerobic organism is difficult to culture, the diagnosis is made by observing its associated sulfur granules in the biopsy specimens. Still, actinomycosis represents an important entity in today's context as it is the great masquerader of the head-and-neck lesions because of its myriad presentation that may mimic other common diseases, the difficulties involved in its diagnosis, and the long course of treatment mandatory to eradicate the disease

Unilateral multicystic dysplastic kidney with ipsilateral grade V vesicoureteral reflux: A case report of a rare association

Multicystic renal dysplasia is a common cause of childhood end-stage renal failure and is categorized under the entity known as congenital anomalies of kidney and urinary tract. With the increasing knowledge about their natural history, it is now known that most of the cases of unilateral multicystic dysplastic kidney undergo spontaneous involution; thus, most of the pediatric urologists now prefer conservative management with long-term nephrological and urological observation. However, the presence of recurrent urinary tract infection as in the present case report due to associated ipsilateral Grade V vesicoureteral reflux, a rare associated finding mandates nephrectomy

Solitary Fibrous Tumor of the Parotid Gland in a Young Female: A Rare Case Report and Review of the Literature

Solitary fibrous tumor is a rare tumor of the salivary gland. To date, 27 cases have been reported. The clinical and radiological features are the same as other lesions of the parotid gland. Hence, light microscopy and immunostaining is important to confirm the diagnosis. Fine needle aspiration cytology yield depends on the area sampled and can be inconclusive in many cases. Treatment of choice is complete surgical excision with regular long-term follow up. Most cases are benign, however three malignant cases have been reported. Here, we report a case of solitary fibrous tumor in the parotid gland seen in a 14-year old female diagnosed by histopathological examination and immunohistochemistry analysis

Palatogingival groove: A pathway to periodontal destruction

Palatogingival or radicular groove is another developmental aberration known to maximally affect the palatal surfaces of maxillary lateral incisors but is often missed during a routine. It is a malformation which presents as a groove or channel that begins in the central fossa, crosses the cingulum of the tooth and extends apically to or beyond the cementoenamel junction at varying distances and directions along the root surface. It serves as a perfect bacterial harbor predisposing to pocket formation, concomitant bone loss and pulpal involvement, thereby encouraging the development of endodontic-periodontal lesions. Depending on severity, the groove may render a direct communication between the periodontium and pulp cavity promoting effortless bacterial invasion. It creates an area where plaque accumulation can be difficult, if not impossible to control using oral hygiene measures. The diagnosis of these grooves is quite difficult, as they cannot be differentiated in the X-ray images. The treatment procedures employed for treating palatogingival grooves will include pulpectomy if the tooth is nonvital along with odontoplasty of the groove or restoration of the groove with glass ionomer cement after the elevation of mucoperiosteal flap. Bone defects around the involved teeth also have to be treated with grafts and membrane. This case report describes the diagnosis and treatment of a palatogingival groove on maxillary lateral incisor

Congenital acral verrucous hemangioma: A rare entity

Verrucous hemangioma is an uncommon capillary or cavernous hemangioma with reactive epidermal changes of hyperkeratosis, acanthosis, and papillomatosis. Lesions are mostly seen at birth or appear during childhood. These growths are usually located on the lower extremities, and involvement is generally unilateral. Diagnosis of this unusual presentation can only be confirmed following histopathology. Surgical excision resulted in a satisfactory functional and cosmetic outcome

Significance of p53 and ki-67 expression in prostate cancer

Background: Prostate cancer is a major health problem throughout the developed world. Tumor grade is one of the most important prognostic factors of prostate cancer. At present, adequate prognostic markers for prostate cancer progression are still lacking, in spite of intensive investigation. Accordingly, we studied the role of immunohistochemical (IHC) expression of p53 and Ki-67 as a prognostic factor in carcinoma prostate and correlated their expression with Gleason's grade. Materials and Methods: In this prospective study, a total of 60 cases including 50 cases of prostate carcinoma and 10 of benign prostatic hyperplasia (BPH) were taken. Tumor grade was determined according to Gleason's grading system. p53 and Ki-67 expressions were determined by IHC staining. The obtained results were analyzed and evaluated using Spearman's statistical test (SPSS version 20). Results: In BPH, p53 was expressed in only 2 of 10 (20%) cases while in carcinoma it was expressed in 38 of 50 (76%) cases. Ki-67 was expressed in only 1 of 10 (10%) BPH cases while in carcinoma it was expressed in 32 of 50 (64%) cases. In present study, 1 of 4 (25%) well differentiated, 23 of 31 (74.19%) moderately differentiated and 14 of 15 (93.33%) poorly differentiated tumors revealed p53 immunopositivity and a statistically significant correlation was observed between p53 expression and increased Gleason's grade (P = 0.038). All 4 (100%) cases of well-differentiated carcinoma were negative for Ki-67 expression. Nineteen of 31 (61.29%) moderately differentiated and 13 of 15 (86.66%) poorly differentiated tumors were positive for Ki-67 and a statistically significant correlation was observed between Ki-67 positivity and increased Gleason's grade (P = 0.002). Conclusions: Both p53 and Ki-67 were significantly up-regulated in malignant lesions as compared to benign lesions and a strong relationship with the Gleason's grading was noticed, therefore, we propose that these markers can be applied along with other prostate cancer prognostic factors