Mohammed Naim

Apoptotic effect of green tea polyphenol (EGCG) on cervical carcinoma cells

The objective of this study was to probe the apoptotic effect of green tea polyphenol epigallocatechin‐3‐gallate (EGCG) on cervical carcinoma cells. This study was conducted in Departments of Pathology and Biochemistry, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India over a span of one and half years from January 2005 to August 2006. Caspase‐3 assay was performed on monocytes isolated from cervical carcinoma patients and cultured with EGCG; cytosmears and sections from cervical carcinoma tissue cultured with EGCG were prepared for the morphological evidence of apoptosis. EGCG in a dose of 5 μg/ml and 10 μg/ml increased the caspase‐3 levels in human cells. Cytosmears and sections from cervical carcinoma tissue cultured with EGCG showed better differentiation and increased number of apoptotic cells as compared to non EGCG controls. The number of such cells was increased more in 48 hours than in 24 hours. EGCG in a dose of 5 μg/ml and 10 μg/ml promoted apoptotic preparedness of human cells and induced apoptotic change in cervical carcinoma cells. Diagn. Cytopathol., 2011.

Reticular schwannoma mimicking myxoid sarcoma

Reticular/microcystic schwannoma is a recently described rare distinctive variant of schwannoma with a predilection for gastrointestinal tract. Its occurrence in soft tissue is extremely rare. We report a case of reticular/microcystic variant of schwannoma in a 55-year-old Indian woman who presented with a painless slow-growing swelling in the right forearm for the past 6 months. MRI findings suggested myxoid sarcoma. However, histological and immunohistochemical findings in the excised specimen were consistent with reticular/microcystic variant of schwannoma. This case report emphasises that the diagnosis of reticular/microcystic schwannoma should always be considered in cases where myxoid sarcomas are suspected as it can mimic malignant myxoid sarcomas, clinically and radiologically, thereby avoiding aggressive intervention and overtreatment.

Immature embryoid teratoma of the gall bladder: case of a primary primitive neoplasm

This study presents diagnostic histopathological features of a primary embryoid teratomatous neoplasm in the gall bladder of a 60-year-old woman, and also discusses its pathogenesis. Sections revealed immature and typical embryoid bodies and dispersed syncytial trophoblasts along with mature and immature neuroectodermal and mesodermal elements. The residual endothelial lining of the gall bladder showed in situ and proliferative changes characteristic of an endodermal tumour. Ultrasonographic and magnetic resonance imaging findings of the rest of the abdominal and pelvic organs appeared normal. Results show that the mature adult gall bladder is susceptible to primary neoplasms of a primitive nature ranging from immature embryoma and teratoma to neuroectodermal tumour. Such primitive neoplasms in adult organs where benign neuroectodermal elements are present may evolve from a constituent cell of an adult organ acquired during embryogenesis from a morula that differentiated into trophoblastic (outer) and embryoblastic (inner) cells, and existing dormant cells at rest until reactivation during oncogenesis.

Filarial abscess: Aspiration of adult gravid female worm from submandibular region, an unusual presentation

Microfilaria is a major public health problem in tropical and subtropical countries and is an endemic problem in India. Wuchereria bancrofti is the most common filarial infection. In some cases, microfilariae and adult filarial worm have been incidentally detected in fine-needle aspirates of various lesions; detection of microfilaria from subcutaneous site or from abscess site is even rarer. We here report an unusual case of Bancroftian microfilariasis in a 68-year-old female coming from endemic area presenting with right submandibular abscess. Our aim is to highlight the chances of finding microfilaria and adult worm in cytology of an unsuspected case at an unusual site.

Mature embryoid teratoma in the wall of a mucinous cyst adenoma of ovary in multiparous female.

A collision tumour in ovary comprising a small ovoid embryoid mature teratoma in the surface wall of large mucinous cyst adenoma is reported in a 36-year-old female and its pathogenesis is discussed. The oval teratoid mass externally to the mucinous cyst lining did not show any columnar epithelial or mucin-secreting cyst. Findings suggested that the mature embryoid teratoma originated from ovarian germ cell rest in the surface wall of the cyst adenomatous neoplasm. Another possibility could be that the mature embryoid teratoma resulted from parthenogenesis of ovum together with the mucinous adenoma cysts by epithelial metaplasia of the follicular lining.

Septic disruption of lactiferous ducts with heterogeneous carcinoma of the breast in a lactating woman.

This report documents the diagnostic histopathological features of heterogeneous breast carcinoma following sepsis and disruption of the lactiferous ducts in a lactating woman and discusses the pathogenesis. Sections from the nipple revealed disrupted collecting lactiferous ducts presenting with intraduct precarcinoma and carcinoma of the epidermoid type, and attached reparative sprouts lined by lactiferous cells. Breast lobules showed generalised benign adenotic change with various foci of carcinoma microscopically identifiable as intraduct primitive lactiferal ectodermal carcinoma, lactating carcinoma, primitive neuroendocrine carcinoma and myoepithelioid granulomatous carcinoma. The findings led to the conclusion that the lactiferous ducts are susceptible to sepsis and disruption, which may predispose a patient to breast carcinoma. The pattern of carcinoma suggested that lactiferous epithelial cells behaved colonially, with different metaplastic changes, precarcinoma and carcinoma.

Pyelocalyceal cysts with hydrotic nephritis of the kidney: case of a unilateral congenital developmental anomaly

This report describes the diagnostic, morbid, anatomical and histopathological features of pyelocalyceal cysts with hydrotic nephritis of the kidney in a 3-year-old boy, and discusses the pathogenesis. Calyceal cysts gave rise to a ‘large blue cystic lobulated kidney’ with microscopic changes in nephrons identifiable as ‘hydrotic nephritic glomerulosclerosis’. Pelvic and calyceal cysts were identifiable by location, number, arrangement, and morbid anatomical and microscopic features of their lining walls. Such cysts may develop due to partial or complete obliterate adhesions at the uretero-pelvic and pyelocalyceal junctions. Patent calyceo-tubulonephric junctions in such cases may give rise to hydrotic nephritis. Pyelocalyceal cystic disease with hydrotic nephritis of the kidney needs to be distinguished from megacalycosis and hydronephrosis and deserves recognition. Observations in this case may provide the basis for future classifications of cystic renal diseases.

Recurrent angio-fibroma of breast masquerading as phyllodes tumor.

A young Indian female presented with a recurring tumor in the right breast masquerading as phyllodes tumor. Patient had history of five times excision and recurrences of the tumor, diagnosed as fibrous phyllodes of the breast. Presently, a well-circumscribed tumor of about 10 cm size, comprising of benign fibrous-angiomatous tissue with evidence of foci of pyogenic vasculitis was observed. Immuno-histochemical markers for the myo-epithelial and epithelial elements excluded the possibility of fibrous phyllodes, inflammatory myofibroblastic tumor, desmoid fibromatosis, and metaplastic carcinoma. The present findings were diagnostic of an inflammatory angio-fibroma of the right breast, not reported in the earlier literature. The observations indicated that the female breast may be susceptible to spontaneous productive and common-antibiotic-resistant focal septic vascular inflammation giving rise to angio-fibromatous proliferation producing a well-defined tumor mass in the breast, distinguishable from the other breast lesions by the connective tissue stains and immuno-histochemical markers.

Sclerosing stromal tumor of the ovary presenting as precocious puberty: Unusual presentation of the rare neoplasm

Sclerosing stromal tumor (SST) is a rare sex cord stromal neoplasm of the ovary. Precocious puberty resulting from this tumor is extremely rare. We report a case of SST of the ovary in a 7-year-old Indian girl, who presented with the complaints of excessive development of breasts, early menarche, growth of pubic hairs, accelerated growth and abdominal distension. On clinical examination, a large right-sided abdomino-pelvic mass was palpable. Magnetic resonance imaging revealed a large, heterogeneous, solid and cystic tumor in the right adenexal region, suggestive of an ovarian neoplasm. Hormonal profile showed markedly elevated estradiol and low follicle stimulating hormone levels. Clinical diagnosis of precocious puberty with right-sided ovarian mass was thus concluded. Right-sided salpingo-oophorectomy was then performed. Histopathology showed features consistent with SST of the ovary. Postoperatively, signs and symptoms of precocity gradually regressed and her serum estradiol level came down to normal.

Sclerosing stromal tumour of the ovary presenting as precocious puberty: a rare neoplasm.

A 7-year-old Indian girl presented with symptoms of excessive development of breasts, early menarche, growth of pubic hairs, accelerated growth and abdominal distension. On clinical examination, a large right abdominopelvic mass was palpable. MRI revealed a large, heterogeneous, solid and cystic tumour in the right adnexal region, suggestive of an ovarian neoplasm. The hormonal profile showed markedly elevated oestradiol and low follicle-stimulating hormone levels. Clinical diagnosis of precocious puberty with right ovarian mass was concluded. Right-sided salpingo-oophorectomy was performed. Histopathology showed features consistent with sclerosing stromal tumour of the ovary. Postoperatively, signs and symptoms of precocity gradually regressed and her serum oestradiol level came down to normal. This is the first reported case from India.