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   2018| January-February  | Volume 7 | Issue 1  
    Online since January 29, 2018

 
 
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ORIGINAL ARTICLES
Clinicopathological attributes of T-lymphoblastic lymphoma seen in a tertiary care centre
Leo Prince Mathan, Anuradha Ananthamurthy
January-February 2018, 7(1):1-8
DOI:10.4103/ccij.ccij_67_17  
Background and Aims: T-lymphoblastic lymphoma (T-LBL) is a type of non-Hodgkin lymphoma (NHL), the cell of origin being the precursor T cell. This study was undertaken to describe the distribution, clinical presentation, morphological spectrum, immunohistochemical profile, and outcomes in patients with LBL presenting to our institution which is a tertiary care center. Methods: A total of 41 cases of T-LBL diagnosed during a 7-year period were included in this study. These patients were stratified into T-LBL cases and T-LBL/acute lymphoblastic leukemia cases, the latter defined as those with a lymphomatous mass and more than 25% blasts in the bone marrow. Medical records were reviewed for clinical, laboratory data, imaging findings, treatment, and follow-up. The histopathology and immunohistochemistry slides were reviewed. Results: T-LBL constituted 8.4% of all NHL seen in the period. This lymphoma is most common in childhood and adolescence. Mediastinal compression and pleural effusion are very common in patients with T-LBL (65% and 40%, respectively). The morphology consists of small-to-medium sized blasts that typically are positive for CD3, CD99, and TdT. T-LBL is an aggressive disease; relapse and progression being markers of poor outcome. Conclusion: This study is a comprehensive account of T-LBL from a tertiary care center in South India which describes the distribution, clinicopathological attributes and outcome in patients with this aggressive form of NHL.
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CASE REPORTS
Primary Ewing's sarcoma/primitive neuroectodermal tumor of kidney: A rare case report
Archana Akshay Randale, Sanjay Nanaji Parate, Milind Anil Bhatkule, Saroj Ashwin Meshram, Shilpa Pankaj Tathe
January-February 2018, 7(1):26-29
DOI:10.4103/ccij.ccij_68_17  
Ewing's sarcoma/primitive neuroectodermal tumor (ES/PNET) is a member of small round cell “blue tumor” family, occurring primarily in kidney is quite rare. Hence, detail appraisal is needed using histopathology, immunohistochemistry, and cytogenetic studies to attest the final diagnosis of ES/PNET, as this has an aggressive course and poor outcome. Here, we present a case of primary ES/PNET of kidney in 22-year-old male with locally invasive disease. Tumor cells were strongly positive for CD99 and FLI-1 on immunohistochemistry, thus confirming the final diagnosis.
  1,941 16 -
ORIGINAL ARTICLES
Retrospective comparative study between gemcitabine/cisplatin and gemcitabine/capecitabine in the treatment of metastatic carcinoma of gallbladder
Soumita Poddar, Santu Mondal, Amitabha Chakraborty, Bodhisattwa Dutta
January-February 2018, 7(1):9-13
DOI:10.4103/ccij.ccij_60_17  
Introduction: Metastatic carcinoma of gallbladder is a disease with a dismal prognosis. Chemotherapy is mainstay of treatment. Gemcitabine/cisplatin is used as first-line chemotherapy. In some study, gemcitabine/capecitabine has been used with good result. A retrospective study has been performed to compare efficacy between these two chemotherapeutic regimens.Materials and Methods: The objective of this study was to compare tumor control rate, progression-free survival (PFS), overall survival (OS), and toxicity between these two chemotherapeutic regimens. In arm A, patients received gemcitabine (1000 mg/m2 on day 1 and on day 8) and cisplatin (75 mg/m2 on day 1). In arm B, patients received gemcitabine (1000 mg/m2 on day 1 and on day 8) and capecitabine (1000 mg/m2 BD from day 1 to day 14). Response evaluation has been done by response evaluation criteria in solid tumor criteria. Results: A total of 55 (25 in arm A and 30 in arm B) patients were included in the study. Tumor control rate was 88% in arm A and 86.7% in arm B. PFS in arm A was 7.2 months (95% confidence interval [CI]: 6.19–8.21 months) and 7.58 months (95% CI: 6.66–8.5 months) in arm B. OS in arm A was 10.8 months (95% CI: 9.51–12.09 months) and 11.57 months (95% CI, 10.3–12.84 months) in arm B. These differences between the two arms were not statistically significant. Conclusion: There is no statistically significant difference between gemcitabine/cisplatin and gemcitabine/capecitabine regarding disease control rate, PFS, and OS in the treatment of metastatic carcinoma of gallbladder. Hence, gemcitabine/capecitabine can also be used as first-line chemotherapy in metastatic carcinoma of gallbladder.
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CASE REPORTS
Diabetic mastopathy: An entity clinically mimicking malignancy; review of a series of three cases
KR Anila, K Chandramohan, Sumod Mathew Koshy, K Jayasree
January-February 2018, 7(1):23-25
DOI:10.4103/ccij.ccij_65_17  
Diabetic mastopathy is an unusual lesion affecting the breast of patients with longstanding diabetes mellitus (DM). This lesion presents as large hard masses, leading to clinical suspicion of malignancy, and may result in unnecessary surgeries. It is characterized histopathologically by sclerosing lymphocytic mastitis. During 1-year period from January 2016 to December 2016, we came across three cases of sclerosing lymphocytic mastitis. All were females with longstanding DM and presented with palpable, nontender, hard breast masses. Clinical impression was malignancy. They underwent imaging studies, fine needle aspiration cytology, and core needle biopsies before excision biopsy. The specimens consisted of firm-to-hard fibrotic masses with a grayish-white cut surface. Histopathology showed characteristic keloid-like sclerosing fibrosis, dense perilobular and intralobular lymphocytic infiltrates. Clinicopathological correlation will resolve these cases in most instances and aid in preventing radical surgical procedures. Imaging studies however may not be helpful in all cases.
  1,724 16 -
ORIGINAL ARTICLES
The expression level of vascular endothelial growth factor receptor-2, vascular endothelial growth factor receptor-3, and insulin-like growth factor II mRNA binding protein 3 in renal cell carcinoma: Can these markers indicate poor prognosis in immunohistochemical examination?
O Eronat, Olcay Kandemir, Aykut Onursever
January-February 2018, 7(1):14-22
DOI:10.4103/ccij.ccij_84_17  
Background: The malignant tumors of the kidney are the most aggressive among urologic cancers. To treat patients with renal cell carcinoma (RCC), it is important to understand the disease's prognostic factors. Angiogenesis is an essential process, responsible for the growing, and spreading of neoplastic tissues. Vascular endothelial growth factor (VEGF), the most potent angiogenetic factor known, and its receptor VEGF (VEGFR) play an important role in angiogenesis. Insulin-like growth factor-II mRNA binding protein 3 (IMP-3) is found in some malignant tumors and contributes to cell growth and cell migration during the early stages of embryogenesis. Material and Methods: The following study retrospectively evaluated 48 radical, 29 simple, and 23 partial nephrectomy specimens with RCC. Pathologic prognostic parameters, including tumor size, tumor stage, Fuhrman nuclear grade, distant metastasis status, and lymph node involvement status were compared with the immunohistochemical expression levels of VEGFR-2, VEGFR-3, and IMP-3. Results: Except the relation between VEGFR-3 and Fuhrman nuclear grade, there was no significant relation with the expressions of VEGFR-2, VEGFR-3, and IMP-3 and the pathologic prognostic parameters such as tumor size, tumor stage, Fuhrman nuclear grade, distant metastasis status, and lymph node involvement status. All three markers showed significant expression in almost all chromophobe and papillary histologic subtypes. The expression rates for chromophobe, papillary type 1, and type 2 RCC were 100%, 90%, and 100% for VEGFR-2, respectively, and 87.5%, 90%, and 100% for VEGFR-3, respectively. The expression rates of IMP-3 were 50% for papillary type 1, 83.3% for papillary type 2, and 100% for chromophobe RCC. Conclusion: Although the limited number of cases, current data gathered from our study shows that these markers have no relation with pathologic prognostic parameters and would not provide additional information in the immunohistochemical examination. Anyway, their tendency of expression in chromophobe and papillary type RCC is remarkable which should be evaluated with a larger number of cases.
  1,394 16 -
CASE REPORTS
A rare case of bilateral sertoli cell adenoma in gonads associated with unilateral serous cyst in a patient with complete androgen insensitivity syndrome
Nidhi Raina, Akshay Rana, Vijay Kaushal, Anita Pal, Pooja Chauhan
January-February 2018, 7(1):30-33
DOI:10.4103/ccij.ccij_153_16  
Complete androgen insensitivity syndrome (CAIS) is an extremely infrequent disease. The patients exhibit female phenotype because of insensitivity to the androgen receptor and may develop tumors, especially in their undescended gonads. We present here a case of CAIS with bilateral Sertoli cell adenoma along with unilateral serous cyst in a 16-year-old patient.
  1,104 15 -
LETTER TO THE EDITOR
Cell block procedure as a relevant diagnostic tool in human pathology
Antonio Ieni, Giovanni Tuccari
January-February 2018, 7(1):34-35
DOI:10.4103/ccij.ccij_79_17  
  813 15 -
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