Shagufta Qadri

Evaluation of a modified dye pour-plate auxanographic method for the rapid identification of clinically significant yeasts. Comparison with two commercial systems.

A modified dye pour-plate auxanographic (DPPA) method for the presumptive identification of medically important yeasts was evaluated, in a comparative study with a conventional procedure, the API 20C clinical yeast system (Analytab Products Inc.), and the Uni-Yeast-Tek (UYT) system. The 174 coded clinical isolates were members of the generaCandida, Cryptococcus, Rhodotorula, Saccharomyces, Torulopsis, andTrichosporon. The identification accuracies with DPPA, API, and UYT were 95%, 93%, and 99% respectively. DPPA and API required more time to inoculate but gave rapid identification profiles. UYT was simple to inoculate and both UYT and DPPA were easy to read. Cost analysis of the three rapid methods demonstrated DPPA to be the most economical making it a feasible alternative for small clinical laboratories as well as large laboratories possessing the facilities to make their own media.

Detection of herpes simplex virus by biotinylated DNA probes

Clinical specimens from 159 patients suspected with herpes simplex virus (HSV) were examined by monoclonal antibody immunofluorescence (IF) and by a commercial biotinylated DNA probe kit following cell culture isolation. Herpes simplex virus was isolated from 57 samples. All cultures were positive by IF when the cytopathic effect (CPE) was less than 1+ but only 49 (86%) yielded positive reaction with the DNA probe when CPE was at least 1+. A total of 54 clinical specimens was also examined directly by immunoperoxidase histopathology (IHP), IF, and DNA hybridization. Of these, 16 were positive by IHP, 15 by IF, and only five by DNA probe. The DNA probe kit was found to be reasonably sensitive only after cell culture isolation of HSV. Compared to the IF procedure, the DNA probe kit was found to be costly, labor intensive, and time consuming.

Magnitude of neurogenic tumor burden in pediatric population: A tertiary care center study

Objective: Progress in the diagnosis and treatment of childhood neoplasm in the past few decades is one of the most gratifying achievements in the field of oncology. This study was aimed to ascertain the burden (incidence and prevalence) and histopathologic features of neurogenic tumors occurring in the pediatric population. Materials and Methods: The study evaluated a total of 492 cases of pediatric tumors over a period of 8 years from 2007 to 2015, including patients of 0–12 years of age group; attending the out-patients and in-patients Department of Pediatrics and Pediatric Surgery at Jawaharlal Nehru Medical College, AMU, Aligarh, with the complaints of tumor or tumor associated sign and symptoms. Clinical profile, hematological and histopathological examination along with immunohistochemical analysis were implicated to attain a conclusive diagnosis. Result: Out of 492 pediatric tumor cases, 255 (52%) cases were benign and 237 (48%) cases were malignant. Neurogenic tumor (brain tumors) comprised 49 (10%) of the total case, being most common malignant solid neoplasm and second most common (next to leukemia) overall malignancy, constituting 49/237 (21%) cases. Astrocytoma 22/49 (45%) cases were the most common type brain tumor followed by medulloblastoma 15/49 (31%), ependymoma 9/49 (18%), and craniopharyngioma 3/49 (6%). Conclusion: Effective management of pediatric neurogenic tumor is a multipronged approach involving effort of good Pediatric neurosurgeon, Pathologist and a host of Oncology specialists with insight into childhood neoplasms.

Detrimental effect of mandibular mucormycosis burlesquing as osteosarcoma

Mucormycosis is an acute, opportunistic infection caused by a saprophytic fungi typically inhabiting the soil or decaying organic matter. It is an invasive and potentially fatal infection caused by fungi of the order Mucorales, which commonly affects structures in the head and neck including air sinuses, orbits, and the brain. We describe our clinical experience of a case of mandibular mucormycosis, developing in a 45-year-old male who had a family history of diabetes. He presented with complaints of pain and foul-smelling discharge from a nonhealing, ulcerative wound at the mandibular alveolus, encompassing the area around the left canine and 1st premolar. The x-ray revealed osteolytic bony lesion with massive destruction of the mandibular ramus. A clinical impression of osteosarcoma was deduced. Surgical curettage was performed; however, the histopathological examination and subsequent treatment with periodic acid-Schiff stain aided in achieving a conclusive diagnosis of mandibular mucormycosis.

Oncocytoma of the parotid gland: Dilemma for the cytopathologist

Oncocytoma is a rare benign tumor of the salivary glands usually seen in elderly patients in the sixth to eighth decade. Microscopically, the hallmark of this lesion is the presence of oncocytes that comprise the entire tumor. These are large polygonal cells which have abundant eosinophilic granular cytoplasm, and from central to eccentric round nucleus. Several reactive as well as neoplastic lesions of salivary glands often have concurrent oncocytic changes. On fine-needle aspiration cytology, all of them have overlapping morphological features, thus making the diagnosis difficult by cytology alone. We report a case of oncocytoma of the right parotid gland in a 32-year-old Indian male. Although the tumor was initially suspected on cytology, confirmation was possible only after histopathological examination. The main purpose of this case report is to discuss the cytological differential diagnosis of oncocytic lesions of salivary glands and simultaneously emphasize the importance of histopathology for arriving at conclusive diagnosis in such cases.

Fibrosarcoma developing in the Parotid Gland: An Unusual Presentation

Primary sarcomas of the salivary glands occur rarely with few cases having been reported. Fibrosarcoma is a rare type of primary sarcoma with a poor prognosis and low life expectancy. Microscopically, these tumors resemble their counterparts encountered in other areas. They can be easily confused with spindle cell (sarcomatoid) carcinomas, myoepithelial carcinomas or malignant melanomas. We present an unusual case of a primary fibrosarcoma that arose in the right parotid gland of a 50 years male, who presented with a large nodular mass in the right preauricular region. Computed tomography (CT) scan revealed a tumor arising from the right parotid gland. A near total parotidectomy was performed and the histopathology report showed neoplastic spindle cells predominantly arranged in a ‘herring bone’ pattern. On immunohistochemistry, the tumor was positive for vimentin and was negative for pancytokeratin and S-100, which lead to a firm diagnosis of fibrosarcoma.

Retroperitoneal pleomorphic rhabdomyosarcoma metastasizing to inguinal lymph node

Rhabdomyosarcoma (RMS) is a highly aggressive, malignant tumor of skeletal muscle cell, associated with an early and a wide spread metastasis. Although a commonly occurring soft tissue sarcoma in the pediatric population, it is seldom encountered in adults. Outcome for adult RMS is poorly documented due to its rarity. We report a case of pleomorphic RMS (PRMS) in a 50 years male presenting with an intra-abdominal mass along with a swelling in the right inguinal region measuring 4 cm Χ 3 cm. Computed tomography revealed an ill-defined intra-abdominal mass arising from the peritoneum. Abdominal mass was resected along with the dissection of inguinal lymph node. Histopathological examination of these masses coupled with the immunohistochemistry, confirmed the diagnosis of PRMS metastasizing into inguinal lymph node. Despite of adjuvant radiotherapy and chemotherapy, the patient couldn′t survive >3 months and died of widespread lung metastasis.

Low Grade Appendiceal Mucinous Neoplasm with Pseudomyxoma Peritonei: An Enigma for Pathologist

ABSTRACT Malignant mucinous neoplasms of the appendix is an infrequently encountered entity. Extra-appendiceal spread of these tumor is one of the commonest etiology of pseudomyxoma peritonei, which demands a hightened vigilance in their early diagnosis. Although low-grade appendiceal mucinous neoplasms (LAMNs) largely stay confined to the appendix, but they can spread to the peritoneum as pseudomyxoma peritonei leading to an unpredictable outcome. Due to the rare occurrence of low-grade appendiceal neoplasm only tenuous and limited information is present in the medical literature. We report a case of LAMN with pseudomyxoma peritonei in a 45-year-old male, who presented with the complaints of abdominal distension associated with abdominal pain and constipation. Clinical examinations and computed tomography (CT) scan were suggestive of pseudomyxoma peritonei. Peroperative findings and histopathological examination rendered a conclusive diagnosis of low-grade appendiceal neoplasm. How to cite this article: Qadri S, Alam K, Alam F, Maheshwari V. Low Grade Appendiceal Muci-nous Neoplasm with Pseudomyxoma Peritonei: An Enigma for Pathologist. Euroasian J Hepato-Gastroenterol 2014;4(2):113-116.

Cystic glioblastoma multiforme masquerading as a cerebral tuberculoma.

Glioblastoma multiforme (GBM) is by far the most common and most aggressive malignant neoplasm of the primary brain tumours. It arises from the astrocytes and classified as WHO grade 4 astrocytoma. Diagnosis of GBM is sometimes difficult as radiological picture sometimes mimic with cerebral tuberculoma. In both the cases contrast-enhanced CT may show similar finding of a mass lesion with a hypodense centre surrounded by a ring of enhancement and any cyst if present. In the present case, a 45-year-old male patient presented with seizures and headache, a provisional diagnosis of tuberculoma was made on the basis of clinical and CT findings. However, on grounds of suspicion the patient was operated and fluid from the cyst was sent peroperatively for cytopathological examination which suggested the diagnosis of cystic GBM. This helped the surgeon to do maximum debulking of the tumour. Diagnosis was further confirmed by histopathology.

Eosinophilic granuloma of the mandible: a diagnostic dilemma

Eosinophilic granuloma (EG) is a rare histiocytic disorder resulting from clonal proliferation of Langerhans cells. It accounts for less than 1% of all osseous neoplasms and has a predilection for involving the axial skeleton. Although suspicion of the disease may arise from clinical features and radiographic demonstration of destructive bone lesions, it is still difficult to make a correct diagnosis without proper pathological evaluation. This is more evident when common differentials mimicking EG, both clinically and radiologically, need to be ruled out. This report describes a case of unifocal EG of the mandible occurring in a 4-year-old boy whose initial presentation led to confusion between osteomyelitis, primary bone tumour and lymphoma. A final diagnosis of EG was established after histopathological examination of the biopsy specimen.