Kanthilatha Pai

E-cadherin expression: a diagnostic utility for differentiating breast carcinomas with ductal and lobular morphologies.

OBJECTIVES The objective of this study was to evaluate the diagnostic utility of the E-Cadherin (EC) expression in differentiating between an infiltrating ductal carcinoma (IDC) and an infiltrating lobular carcinoma (ILC), the two most common forms of invasive breast carcinomas. METHODS The authors evaluated the E-Cadherin expression by doing immunohistochemistical studies of all the cases of invasive lobular carcinomas (ILC) which were diagnosed in the pathology laboratory during a 3 year period and they compared the expression of E-Cadherin in an equal number of invasive ductal carcinomas (IDC) of the breast. RESULTS A moderate to strong inter-membranous E-Cadherin expression on immunohistochemistry was seen in all the cases of IDC, while only 1 case of ILC showed a moderate E-Cadherin expression. Hence, the E-cadherin expression can be reliably used as a marker to differentiate IDC and ILC. However, an aberrant cytoplasmic expression of E-Cadherin may be seen in some cases of ILC, which should be interpreted with caution.

Xanthogranulomatous pancreatitis mimicking a malignant solid tumour

Xanthogranulomatous inflammation, which is known to occur in several viscera, is rarely found to affect the pancreas. We report a case of xanthogranulomatous pancreatitis (XGP) occurring in a 60-year-old man who presented with epigastric pain and vomiting. Physical examination did not reveal any abnormality. Contrast-enhanced CT of the abdomen revealed an ill-defined, heterogeneous mass lesion in the uncinate process of the pancreas, suggestive of malignancy. Whipples pancreaticoduodenectomy was performed and the final pathological diagnosis was XGP. The patients postoperative course was uneventful. When a pancreatic mass does not show clinicoradiological features typical of common pancreatic neoplasms, XGP should be considered for a differential diagnosis and duodenum preserving surgery can be considered.

Diagnosis of tuberculous cervicitis by Papanicolaou-stained smear

Tuberculosis (TB) is a common infection in the developing countries. It can involve most organs. Genital TB is usually secondary to pulmonary or extragenital TB. Tuberculosis most commonly involves the upper genital tract. Involvement of the cervix is rare. In countries like India, where carcinoma of cervix is very common, cervical TB may easily be mistaken clinically for malignancy. We report a case of tuberculosis cervicits (secondary to pulmonary tuberculosis) in a 54-year-old postmenauposal woman, who presented with a complaint of discharge per vaginum for a short duration. Per speculum examination showed an ulcerated lesion over anterior lip of cervix, clinically suggestive of malignancy. However, a Papanicolaou-smear showed features suggestive of tuberculosis which was confirmed by biopsy, resulting in early diagnosis and treatment of the patient. Hence, in a patient with a suspicious cervical lesion and a prior history of tuberculosis, a diagnosis of cervical tuberculoiss must be considered.

Prenatal Diagnosis of Congenital Mesenchymal Hamartoma of Liver: A Case Report

Hepatic mesenchymal hamartoma is a rare benign tumor. We present an unusual case of a fetal abdominal cyst, later diagnosed histopathologically to be mesenchymal hamartoma of liver. The organ of origin was indeterminate on both prenatal and postnatal ultrasounds. As there are no specific sonological findings, whenever a large multicystic fetal abdominal cyst is seen, mesenchymal hamartoma should be considered as a possibility.

Cutaneous nocardiosis: an underdiagnosed pathogenic infection

A 35-year-old woman presented with raised red lesions over the elbow at the site of a prior injury from a road traffic accident which had occurred 3 years ago. She gave history of pus discharge from the lesions occasionally. A previous biopsy suggested a diagnosis of cutaneous botryomycosis following which the patient received a course of antibiotics for a week. A culture revealed no bacterial or fungal growth. But the lesions continued to progress with pus drainage. On clinical examination, multiple skin-coloured nodules with erosions and crusting were seen over the extensor …

Cutaneous rhinosporidiosis clinically masquerading as a soft tissue sarcoma : a rare occurrence

Rhinosporidiosis is a chronic infection caused by Rhinosporodium seeberi , an endosporulating organism that predominantly affects the mucous membranes of the nose and nasopharynx. This infection is endemic in parts of India and Sri Lanka. Cutaneous lesions due to rhinosporidiosis, although rare, could occur. Disseminated cutaneous lesions associated with nasal involvement have also been reported. 1,2 There are very few documented cases of isolated giant cutaneous rhinosporidiosis presenting as a soft tissue mass. We report a case of giant cutaneous rhinosporidiosis in a 57-year-old male

Conjugal Leprosy: is there a need for active Surveillance in Endemic Areas?

Leprosy is an ancient chronic disease caused by Mycobacterium leprae, primarily residing in skin and peripheral nerves, leading to varied spectrum of clinical manifestations.1 Leprosy has been endemic to India since antiquity.During the 20th century, health authorities and private agencies waged war towards elimination of the disease.The elimination of leprosy as a public health prob-lem was officially declared in India on 31 December 2005.2 This does not mean the disease is eliminated.However, many do not now consider leprosy to be a significant health issue.3–5 We report a case of conjugal leprosy which provides substantial evidence of the continued threat of leprosy in India.

Unusual neoplasm on the hard palate of a child: a case report.

BackgroundMyoepitheliomas account for less than 1% of salivary gland tumors. They mostly affect the parotid glands of adults during the third to fifth decades.Case presentationA 10-year-old Indian boy reported a small swelling in the roof of his mouth of 10 days’ duration. History revealed that the lesion was painless and not associated with bleeding or pus discharge. On examination, a purplish well-circumscribed growth was noted on his posterior hard palate. Magnetic resonance imaging was suggestive of a well-encapsulated hemangioma. An excisional biopsy was performed and histopathology along with immunohistochemistry analysis showed that the lesion was a spindle cell variant of benign myoepithelioma.ConclusionPalatal myoepitheliomas are rare and their occurrence in young individuals is rarer.

Neonatal lingual choristoma with thyroid hemiagenesis.

A 45-day-old infant presented with choking spells and cyanosis. Examination revealed a lingual cyst. Contrast-enhanced CT confirmed the diagnosis of lingual cyst with incidental thyroid hemiagenesis. The child underwent excision of the lesion, which was reported as lingual choristoma.

Acantholytic Variant of Bowen's Disease with Micro-invasive Squamous Cell Carcinoma: A Case Report of a Unique Variant.

Bowens disease is generally regarded as premalignant dermatoses. The disease affects both skin and the mucosa and has the potential to progress to invasive squamous cell carcinoma. There are descriptions of several histological variants of Bowens disease like psoriasiform, atrophic, pagetoid, etc. Acantholysis of anaplastic keratinocytes with bullae/cleft formation is described in premalignant condition like actinic keratosis and adenoid variant of squamous cell carcinoma, but there is lack of report describing this phenomena in Bowens disease. We present a case of unusual acantholytic variant of Bowens disease with focus of micro-invasive carcinoma.