Manmeet Kaur

A clinicopathological and immunohistochemical correlation in cutaneous metastases from internal malignancies: a five-year study.

Cutaneous metastases from internal malignancies are uncommon and occur in 0.6%–10.4% of all patients with cancer. In most cases, cutaneous metastases develop after the initial diagnosis of the primary internal malignancy and late in the course of the disease. Skin tumors are infrequent in Asian population and cutaneous metastases are quite rare. Cutaneous metastases carry a poor prognosis with average survival of few months. In the present five-year study 1924 malignant tumors were screened which included only nine cases of cutaneous metastatic deposits. A wide range of site and clinical presentations including nodules, plaques, and ulcers was noted. Histopathological findings were significant and corresponded with the primary internal malignancy. Cutaneous metastases from breast carcinoma (44.4%) were the most common finding followed by non-Hodgkin lymphoma and renal cell carcinoma (22.2% each) and carcinoma cervix (11.1%). The aim of our study is to classify the cutaneous metastases and to evaluate their clinicopathologic and immunohistochemical correlation with the primary tumor.

Rapid transformation of chronic lymphocytic leukemia to acute lymphoblastic leukemia: A rare case report

Chronic lymphocytic leukemia (CLL) is characterized by the accumulation of mature-appearing lymphocytes in blood, bone marrow, lymph nodes, and spleen with a median lymphocyte count of 20–30 × 109/L at the time of diagnosis. In half of the patients, the lymphocyte count doubles over a period of 1-year and cyclic rise up to 50 × 109/L can occur in untreated patients while in others the count may remain stable for years. Based on the cytogenetic and molecular studies, it has been demonstrated that multiple clones may occur in CLL and clonal evolution is a frequent occurrence. The transformation of CLL to a high-grade non-Hodgkins lymphoma such as diffuse large B cell lymphoma, Hodgkin lymphoma, and prolymphocytic leukemia is well documented. Whereas the transformation of CLL to acute leukemia occurs in <1% cases and this contrasts the almost invariable progression in patients with chronic myeloid leukemia. Here, we report a rare case of a 55-year-old lady, a diagnosed case of CLL transforming into B-cell acute lymphocytic leukemia over a very short interval of 1 week period.

Pulmonary Candidiasis: A Rare Diagnosis on Autopsy-A 5 Year Study in a Tertiary Care Hospital

There is an upward trend in the incidence of various mycotic infections. Deaths from HIV-associated opportunistic mycoses and other immuno-compromised patients (malignancies like leukemia, solid cancers, organ transplants, bone marrow transplant associated nosocomial infections) are becoming one of the major cause of mortality. However, the definitive diagnosis of invasive mycotic diseases is can be made on routine histopathology biopsy of the lung and post-mortem histopathological examination of the viscera for the cause of death. We conducted the present study on 271 medicolegal cases in which viscera was received in the department of Pathology at GGS medical college, Faridkot in last 5 years (2010–2016). Of the total, 143 cases having both the lungs as the part of viscera we encountered only two cases (1.3%) of pulmonary candidiasis. This study highlights the utility and indispensability of histopathological autopsies for complete and accurate diagnosis at demonstration of rare diagnosis.

Oculomotor nerve schwannoma of orbit with extension into cavernous sinus

Schwannomas (neurilemmomas) are benign encapsulated, slow growing peripheral nerve sheath tumors. Primary orbital schwannomas are uncommon, accounting for about 1–4% of orbital tumors. Characteristically, they arise from the first division of the trigeminal nerve. Oculomotor schwannomas are rare tumors with only one case reported till date. Here, we report a 28-year-old male presenting with an axial proptosis of left eyeball with progressive loss of vision. Magnetic resonance imaging of orbit revealed a large left-sided orbital mass extending into cavernous sinus. Surgical excision of the mass was done, and based on clinical, histological, and immunohistochemical analysis, a final diagnosis of oculomotor nerve schwannoma with left orbital extension was made.

Recurrent parotid pleomorphic adenoma with transcranial spread

Recurrence of pleomorphic adenoma after excision is a well-known phenomenon and can present years after surgical resection of the primary tumor. Recurrent lesions are frequently located in the parapharyngeal space whereas transcranial spread with intracranial invasion is exceptionally rare and has only been sparsely reported. A rare case of transcranial spread of recurrent Pleomorphic adenoma in a 40-year-old patient with preauricular swelling is presented.

Postchemotherapy Histopathological Evaluation of Ovarian Carcinoma: A 40-Case Study

Ovarian carcinomas are conventionally treated with primary debulking surgery followed by chemotherapy. Nowadays neoadjuvant chemotherapy followed by surgery is an upcoming treatment modality for ovarian carcinoma. This study highlights the histopathological changes observed after neoadjuvant chemotherapy. Present study is a 40-case study stressing five histological parameters: residual tumour, fibrosis, necrosis, inflammation, and psammoma bodies. All these parameters carry prognostic significance and they are easily reproducible. Fleiss kappa statistics were used to measure intraobserver agreement between pathologists which was found to be substantial to almost perfect with κ ranging between 0.621 and 1.00. This study highlights easily reproducible parameters and their incorporation in histopathology report, thus helping in patient management.