K. Uma Chaturvedi

Diagnosis of nail psoriasis: importance of biopsy and histopathology

Background  Involvement of the nail is quite common in psoriasis and at times may be the sole diagnostic clue. However, the histopathology of nail psoriasis has not been adequately evaluated. A confirmation of the diagnosis is required in cases suspected to have nail psoriasis in order to plan long‐term therapy.

Adenomatoid odontogenic tumor--a rare cause of jaw swelling.

Adenomatoid odontogenic tumor (AOT) is an uncommon tumor of odontogenic origin, characterized histologically by the formation of ductlike structures with amyloid-like deposits. Histogenesis of AOT is still uncertain and it is often considered as a hamartomatous lesion rather than a true neoplasm. AOT has a benign behavior and conservative surgical enucleation or curettage is sufficient. We report a case of AOT in a 15-year-old female who presented with left-sided jaw swelling with tooth resorption. Histopathology revealed intraosseus follicular variant of AOT. A brief review of literature is also discussed.

Endometrial hormone receptors in women with dysfunctional uterine bleeding

ObjectiveThe objective was to study the estrogen receptor (ER) and progesterone receptor (PR) expression in endometrium of women with dysfunctional uterine bleeding (DUB) as compared to women with normal menstrual cycles.MethodsIn this study, 30 patients and 20 controls were selected. Transvaginal ultrasound and endometrial sampling for histology and ER and PR estimation immunohistochemically was carried out for all the subjects. Student’s t-test and linear correlation was used for statistical analysis. Their response to treatment was assessed by clinical follow-up.ResultsEndometrial thickness and ER and PR levels in DUB patients were significantly higher. In cases showing hyperplastic endometria, ER and PR levels were higher than patients with normal histology. In contrast to hyperplastic tissue, steroid receptor levels decrease in hyperplastic tissue containing atypia.ConclusionAltered endometrial morphology and increased receptor levels in DUB patients suggest that unopposed estrogen effect could have an important role in the pathogenesis of DUB. Cases of DUB, which showed atypical hyperplasia, may have a down-regulation of these receptors and could be a precursor lesion to carcinoma and thus do not respond to medical therapy by hormones.

Immunohistochemical expression of c-erbB-2 oncoprotein and EGF-R in pre- and postmenopausal breast cancer

Tissues from 40 cases each of premenopausal and postmenopausal breast cancer were studied immunohistochemically for epidermal growth factor receptor (EGF‐R) and c‐erbB‐2 oncoprotein. In the premenopausal group, immunopositivity for c‐erbB‐2 was 15% and for EGF‐R 22.5%, whereas in the postmenopausal group, 45% of cases were positive for c‐erbB‐2 and 42.5% for EGF‐R. The difference in immunoexpression of c‐erbB‐2 between the two groups was significant. A significant correlation was observed between the concomitant expression of c‐erbB‐2 as well as EGF‐R and lymph node involvement. Furthermore, an association was found between c‐erbB‐2 positivity and histological grading of the tumour. It is interesting that the pattern of the investigated parameters indicates the difference in the pathological events of pre‐ and postmenopausal breast cancer.

Ovarian stromal luteoma in a patient with endometrial carcinoma.

A 65‐year‐old patient with endometrial adenocarcinoma underwent hysterectomy. Pathological examination of the right ovary revealed a coexisting stromal luteoma. The possible relationship between the two neoplasms as well as the intriguing pathogenesis and controversial nomenclature of ovarian steroid cell tumors are discussed. The incidental discovery of a stromal luteoma in a total hysterectomy specimen removed for endometrial carcinoma raises interesting questions about the perceived innocuous nature of these rare lipid cell tumors.

Granulocytic Sarcoma of the Female Genital Tract: Report of a Case with an Unusual Presentation

Granulocytic sarcoma of the female genital tract is a rare occurrence. A case of a perimenopausal female is presented who reported with a history of menorrhagia with a lump in the abdomen. A diagnosis of fibroid uterus was made but laparotomy findings were suggestive of inoperable ovarian malignancy with metastases. Postoperatively the patient suddenly became very anemic. Hematological investigations and histopathological reports from ovaries, myometrium, endometrium and intraperitoneal deposits all revealed acute myeloid leukemia. The patient received two cycles of chemotherapy but later succumbed to her disease. Extrauterine causes of menorrhagia should be considered before instituting definitive treatment. Preoperative induction chemotherapy may be more successful in cases of granulocytic sarcoma who tend to have a poor prognosis.

Neurilemmoma of tongue

Neurilemmoma is usually soimry, benign tumour derived from schwan cells of the Sheaths of peripheral cranial or autonomie nerves. In thehead and neck region it occurs most commonly in association with acoustic nerve within the skuil and is rely fottnd in the oral cavity (1,2). We report here two cases of the iongue diagnosed on histopathohgy.

Renal dysplasia with multisystem malformation—A Study of 9 Cases

Nine cases of renal dysplasia encountered in a review of necropsy material are described. All these cases had associated major and minor malformations of other systems. Three out of four cases identifying with ‘prune belly’ syndrome had lower urinary tract obstruction. Three cases fulfilled the criteria of Meckel’s syndrome. Three of these six cases, in addition, showed overlapping features with other syndromes. Three cases of unilateral dysplasia with contralateral agenesis had associated anomalies not conforming to any definite combination. We suggest that the association of malformations of developmentally unrelated systems may be random, not sharing any feature except being incompatible with life.

Primary endometrial squamous-cell carcinoma

Primary endometrial squamous-cell carcinoma (ESCC) is very rare. We report a case of a 60-year-old postmenopausal female who presented with abdominal distension with cervical discharge for 6 months. Peroperatively, her uterine cavity was filled with pus, which was subsequently drained. The uterus was cystic and had an irregularly folded inner surface. Microscopically, the endometrium showed extensive areas of carcinoma in situ with foci of micro invasion and emboli. There was no cervical lesion continuous with that of the uterus. This patient satisfied Fluhmanns criteria and was hence diagnosed as primary ESCC.