Context: Several randomized trials have established that the best survival can be achieved in patients with locally advanced non-small cell lung cancer (NSCLC) with concurrent chemoradiation (CRT). In this study, we have compared different chemotherapy regime along with radiation in locally advanced NSCLC. Aims: Compare the disease response, toxicity, quality of life (QoL) and overall survival in concomitant CRT using paclitaxel-carboplatin versus cisplatin-etoposide for the radical treatment of NSCLC. Subjects and Methods: In this randomized study, 36 patients were enrolled. In study arm, patients were treated with injection cisplatin-etoposide along with external beam radiotherapy (EBRT) to a total dose of 60 Gy, using CO-60 machine. In study arm, patients were treated with injection paclitaxel-carboplatin along with EBRT. QoL was evaluated using QLQ–LC13 questionnaire. Results: The median age of patients was 65 years. Complete response was obtained in two patients in control and two patients in the study arm. Partial response was obtained in 11 patients in the control arm and 13 patients in the study arm. The observation was statistically insignificant. When Grade ≥III toxicities are analyzed, the total number of events in the control arm were three (16.7%) and in the study arm were five (27.8%) which is statistically insignificant. Statistical Analysis Used: The data were analyzed using Chi-square and t-test, and P values were calculated. Conclusion: The response rates and disease progression are similar between the two arms. The other endpoints are also similar between the two arms. However, larger studies are needed to establish comparability.

Background: Human leukocyte antigen (HLA) phenotype is a prognostic marker of cancer immunotherapy, and the expression profile of its alleles is associated with therapeutic rate. Therefore, there is the likelihood of a relationship between HLA phenotype and minimal residual disease (MRD) in chronic myelogenous leukemia (CML) patients treated with imatinib. The goal of this study was to assess the relationship between the expressions of HLA-B7, 8, 27, 5, and 51 molecules with MRD in CML patients who were treated with imatinib for the first time. Materials and Methods: Blood samples were collected from 33 CML patients who were subject to imatinib therapy for at least 6 months. The expressions of HLA-B molecules were evaluated using standard lymphocytotoxicity technique and MRD was measured by real-time polymerase chain reaction technique. Results: No significant association was found between the expressions of HLA molecules with MRD nor white blood cell, hemoglobin, and platelet counts (P > 0.05). However, CML patients expressing HLA-B5 and 51 molecules were more likely to show optimal response in imatinib therapy. Conclusion: We conclude that HLA-B5 and 51 molecules may have independent prognostic values in imatinib-treated CML patients, which suggests that they could be a prognostic marker for this disease. Nevertheless, investigation of HLA-B5 and 51 molecules in large-scale studies can be helpful in determining the true prognostic value of these molecules in predicting response rates to imatinib therapy among CML patients.

Introduction: Lymphoma is a neoplastic proliferation of lymphoid cells at various stages of differentiation and affects lymph nodes, with infiltration into the bone marrow, spleen, and thymus, which form the primary lymphatic organs. Extranodal lymphoma, by definition, involves sites other than lymph nodes, spleen, thymus, and the pharyngeal lymphatic ring. Extranodal involvement is less common with Hodgkin lymphoma (HL) than with non-Hodgkin lymphoma (NHL). Materials and Methods: A single-center retrospective observational study was conducted over the period of 2017–2019. Age, gender, histologic type, location, type of clinical presentation, histologic diagnosis, and presence of specific symptoms were recorded, as were the specialty of the physician initially consulted and of the physician taking the diagnostic sample. Results: Twenty-seven cases of extranodal lymphoma were diagnosed: 12 (44.4%) were male and 15 (56.6%) were female patients. The median age for males was 49.6 years and for females was 45.7 years. In this study, we had varied presentations of the lymphoma with involvement of various structures. We had few patients with very rare site of involvement like an elderly female patient presented with firm swelling over the right forearm which on excision turned out to myeloid sarcoma. Similarly, an elderly woman had presented with pyrexia of unknown origin that was later diagnosed as having primary bone Hodgkin lymphoma (HL) which is a very rare diagnosis and rarely has been described in world literature. The most common site of extranodal lymphoma was gastrointestinal tract (7 out of 27 patients; 25.9%); the other sites reported were testis (14.8%), breast (7.4%) thyroid, and ovary. Few rare sites reported were bone, central nervous system, and mediastinum. We report an extremely rare patient who had presented with anterior chest wall swelling, and on evaluation was detected to have primary mediastinal B cell lymphoma. Conclusion: Extranodal lymphoma is the rare presentation of NHL and extremely rare for HL. As it is a very rare disease, there are very limited studies available for its staging and management. We have presented a case series of extranodal lymphoma with few very rare presentations.

Background: There is growing evidence that intranodal pressure (INP) can predict metastatic sentinel lymph nodes (SLNs). The objective of this study was to measure and utilize INP to evaluate the metastatic involvement of axillary SLNs in breast cancer patients. Materials and Methods: INP was measured in 73 clinically node-negative (cN0) breast cancer patients who were candidate for SLN biopsy. Clinical evaluation of the lymph node, coupled with frozen section analysis of the same excised SLN, was conducted. The level of suspicion (LOS) was used to assess the likelihood of metastases in the SLNs by the surgeons. Then, the miniature catheter tip pressure transducer was used to measure INP in the operation room. Finally, excised SLN was sent for permanent pathologic analysis as a gold standard for the evaluation of SLNs metastatic.Results: We identified the statistically significant increase in INP in nodes containing tumor metastasis in comparison with tumor-free SLNs (19.17 ± 13.63 vs. 8.82 ± 4.23) (P = 0.003). We considered the cutoff value for INP at 16 mmHg, which resulted in sensitivity of 80% and specificity of 87%. When the combination of INP above 16 mmHg and the LOS were taken into account for determining the likelihood of metastatic involvement of the LNs, the sensitivity and specificity were 87.5% and 91.7%, respectively. Conclusion: Our data suggest that INP measurement has the potential to help surgeons differentiate metastatic and nonmetastatic SLNs in combination with LOS. Meanwhile, it can be used along with frozen analysis to decrease false-negative rate.

Langerhans cell histiocytosis (LCH) is a rare cancer involving clonal proliferation of Langerhans cells (LCs) resembling epidermal dendritic cells. It can involve any organ or system. Temporal bone LCH is often confused with ear inflammatory lesions and malignant tumors. Diagnosis is based on clinical, radiological, and pathological findings. The definitive diagnosis is made on biopsy and by immunohistochemical demonstration of CD 1a and or Langerin positivity in the clonally neoplastic cells. The course of LCH is variable from spontaneous regression to repeated recurrences and death. The main form of treatment is chemotherapy. We describe a case of multifocal multisystem LCH in a 4-year-old child who presented with recurrent chronic suppurative otitis media and an external auditory canal polyp.

Giant cell angiofibroma (GCA) is a rare, soft-tissue neoplasm that has a tendency to arise from the mesenchymal tissues of the head and neck, especially involving the orbital region. It is a benign neoplasm characterized by the presence of multinucleated stromal giant cells and angiectoid spaces. GCA belongs to the group of solitary fibrous tumor with histomorphological features intermediate between those of solitary fibrous tumor and giant cell fibroblastoma. CD34 immunoreactivity of tumor cells carries potential diagnostic value. Recurrence after the complete surgical excision is rare. We report the case of a 62-year-old male who presented with complaints of pain and heaviness in the lower abdomen. On computed tomography, a well-defined solid cystic mass was observed in the pelvis. Surgical resection was done, and the histopathological and immunohistochemical examination findings rendered the diagnosis of GCA. The patient had an uneventful postoperative period.