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Mohin M, Mukherjee R, Dewan L, Karan S, Chatterjee U. Cytological findings in a case of undifferentiated embryonal sarcoma of liver in a child: Report of a case with review of literature. Cytopathology 2024; 35:416-420. [PMID: 38226775 DOI: 10.1111/cyt.13357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/15/2023] [Accepted: 01/08/2024] [Indexed: 01/17/2024]
Abstract
The cytological features of undifferentiated embryonal sarcoma of the liver in a child are described in this report. It is important to be aware of this entity and its cytological features in order to avoid misdiagnosis with more common entities such as the hepatoblastoma.
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Affiliation(s)
- Md Mohin
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Raktim Mukherjee
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Lucky Dewan
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Sanjana Karan
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
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Mohin M, Dey S, Ray R, Wasim Sk F, Das O, Chatterjee U. Testicular Mixed Teratoma and Yolk Sac Tumor, Prepubertal Type: A Case Report with Summary of Prior Published Cases. Fetal Pediatr Pathol 2024; 43:182-187. [PMID: 37946365 DOI: 10.1080/15513815.2023.2279132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Testicular mixed germ cell tumor is common in the post-pubertal age, less so in prepuberty. There are only 3 reports of prepubertal mixed teratoma and yolk sac tumor. Two of these cases had immature teratoma component and were in the neonatal age group. The third case in a toddler had a mature teratoma component. CASE REPORT An 18-month-old boy presented with a testicular mass. Serum AFP was elevated (2200 ng/ml). The orchidectomy specimen contained a yolk-sac tumor and a small epidermoid cyst, indicating a mature teratomatous component. CONCLUSION We report a testicular mixed teratoma and yolk sac tumor, prepubertal type along with summary of prior published cases. There is only one report describing this combination of mature teratoma with yolk sac tumor in the prepubertal testis.
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Affiliation(s)
- Md Mohin
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Soumya Dey
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Raktim Ray
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Firdous Wasim Sk
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Oindrila Das
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
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Das O, Mohin M, Dey S, Kar A, Singhania P, Adhikari S, Chowdhury S, Chatterjee U. Cytological findings of phosphaturic mesenchymal tumor: Report of a case with summary of prior published cases. Diagn Cytopathol 2024; 52:E44-E47. [PMID: 37897246 DOI: 10.1002/dc.25245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/16/2023] [Indexed: 10/30/2023]
Abstract
Phosphaturic mesenchymal tumor (PMT) is a rare neoplasm causing tumor-induced osteomalacia (TIO) and is characterized by secretion of FGF23, renal phosphate wasting and hypophosphataemia. It can be completely cured by resection and therefore its diagnosis is of utmost importance. Although the histology is well described, there is sparse literature on cytology of PMT and only three cases have been described so far. A 45-year-old lady presented with a non-tender mass in hard palate for 2 years from which fine-needle aspiration was done. The smears were paucicellular and showed bland spindle cells embedded in osteoid-like stromal matrix in a hemorrhagic background. Here we take the opportunity to describe the cytological findings of PMT along with its cytological differentials and a summary of prior published cases.
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Affiliation(s)
- Oindrila Das
- Department of Pathology, IPGME&R, Kolkata, India
| | - Md Mohin
- Department of Pathology, IPGME&R, Kolkata, India
| | - Soumya Dey
- Department of Pathology, IPGME&R, Kolkata, India
| | - Anish Kar
- Department of Endocrinology, IPGME&R, Kolkata, India
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Mohin M, Lakra N, Jain P, Datta S, Chatterjee U. Cytological features of hyaline fibromatosis syndrome: A case report with summary of prior published cases. Cytopathology 2024; 35:177-179. [PMID: 37897091 DOI: 10.1111/cyt.13327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
Cytological diagnosis of hyaline fibromatosis syndrome can be challenging. The main features on cytology are the presence of abundant acellular, bright pink‐purple matrix within which groups of bland spindle cells are embedded. Cytological features of a case of hyaline fibromatosis syndrome is described here along with the cytological differentials.
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Affiliation(s)
- Md Mohin
- Department of Pathology, IPGME&R, Kolkata, India
| | - Niva Lakra
- Department of Pediatric Medicine, IPGME&R, Kolkata, India
| | - Parul Jain
- Department of Pathology, IPGME&R, Kolkata, India
| | - Supratim Datta
- Department of Pediatric Medicine, IPGME&R, Kolkata, India
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Mohin M, Das A, Roy PS, Barman S, Sarkar R, Chatterjee U. Metastatic Neuroblastoma in the Testis: Report of a Case with Review of Literature. J Indian Assoc Pediatr Surg 2024; 29:56-58. [PMID: 38405257 PMCID: PMC10883177 DOI: 10.4103/jiaps.jiaps_160_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 08/22/2023] [Indexed: 02/27/2024] Open
Abstract
Neuroblastoma is the most common extracranial malignant solid tumor in childhood. Neuroblastoma is known to metastasize in certain niche areas such as the bone, bone marrow, liver, and skin. Testicular metastasis of neuroblastoma is uncommon, and only a few cases have been reported. In this communique, we describe an infant with neuroblastoma presenting with testicular metastasis. Testicular metastasis of neuroblastoma, although uncommon, should be considered a differential of testicular masses in children.
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Affiliation(s)
- Md Mohin
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Anirban Das
- Department of Pediatric Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Pritam Singha Roy
- Department of Pediatric Hemato-Oncology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Shibsankar Barman
- Department of Pediatric Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Ruchirendu Sarkar
- Department of Pediatric Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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Sarkar A, Karmakar D, Saha JK, Saha Basu K, Chatterjee U, Saha K, Mishra DK. Giant Congenital Melanocytic Nevus with Congenital Neurofibroma: A Case Report. Fetal Pediatr Pathol 2023; 42:972-978. [PMID: 37584237 DOI: 10.1080/15513815.2023.2244582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 07/31/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Giant congenital melanocytic nevus (GCMN) is characterized by its large size and potential for transformation into melanoma. It can be associated with other neural cristopathies, including neurofibroma, however, it has not previously been described with a congenital neurofibroma. CASE REPORT A newborn girl presented with a large congenital neurofibroma arising in a bathing trunk type of giant congenital melanocytic nevus. CONCLUSION Congenital neurofibromas can be associated with (or a component of) a GCMN.
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Affiliation(s)
- Atreyee Sarkar
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Debalina Karmakar
- Department of Pediatric Surgery, NRS Medical College, Kolkata, India
| | - Jayanta Kumar Saha
- Department of Plastic Surgery, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Kalyani Saha Basu
- Department of Pediatric Surgery, NRS Medical College, Kolkata, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Koushik Saha
- Department of Pediatric Surgery, NRS Medical College, Kolkata, India
| | - Deepak K Mishra
- Department of Molecular Genetics, Tata Medical Centre, Kolkata, India
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Mukherjee R, Halder A, Das SK, Mukherjee S, Chatterjee U. Biliary atresia with splenic malformation with associated ductal plate malformation and duodenal atresia: A case report. INDIAN J PATHOL MICR 2023:00004270-900000000-99966. [PMID: 38394407 DOI: 10.4103/ijpm.ijpm_182_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
ABSTRACT Biliary atresia (BA) is the most common cause of the obstructive type of neonatal cholestasis that requires prompt surgical intervention. About 10% of neonates with BA have other congenital anomalies, of which splenic malformation (BASM) is a well-known distinct sub-group. There is sparse literature on the association of duodenal atresia and ductal plate malformation (DPM) in patients of BASM. We describe a BASM associated with DPM and duodenal atresia in a 35-day-old infant, who succumbed at 40 days, before portoenterostomy could be performed. Duodenal atresia can be one of the associated malformations associated with BASM and ductal plate abnormalities. In our case, the child did not survive.
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Affiliation(s)
- Raktim Mukherjee
- Department of Pathology, Institute of Postgraduate Medical Education and Research (IPGME and R), Kolkata, West Bengal, India Department of GI Pathology, Institute of Postgraduate Medical Education and Research (IPGME and R), Kolkata, West Bengal, India Department of Neonatology, Institute of Postgraduate Medical Education and Research (IPGME and R), Kolkata, West Bengal, India
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Debnath R, Das M, Mandal B, Mukherjee S, Chatterjee U. Holoprosencephaly: Syndromic or Non-syndromic is the question. INDIAN J PATHOL MICR 2023:00004270-900000000-99967. [PMID: 38394408 DOI: 10.4103/ijpm.ijpm_183_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Affiliation(s)
- Rajarshi Debnath
- Department of Pathology, IPGME&R, Kolkata, West Bengal, India Department of Neonatology, IPGME&R, Kolkata, West Bengal, India
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Mohin M, Ghosh SK, Datta G, Chatterjee U. Cytological features of chordoid glioma: A case report with summary of prior published cases. Diagn Cytopathol 2023; 51:E314-E316. [PMID: 37540041 DOI: 10.1002/dc.25207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/23/2023] [Indexed: 08/05/2023]
Abstract
Chordoid glioma is an uncommon low-grade glioma and is a CNS WHO grade 2 tumour in the current WHO 2021 classification. Predominantly it is seen in the third ventricle and in young adults. Although the histological features of chordoid glioma are well documented, there is sparse literature describing its cytological features. Here we describe the squash cytological features of a case of chordoid glioma along with summary of prior published cases. The smears tend to be quite cellular, the cells show mild pleomorphism, anisonucleosis, and absent mitotic activity. The background shows a distinctive bluish myxoid stroma. It can be mistaken for high grade glioma on squash cytology.
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Affiliation(s)
- Md Mohin
- Department of Pathology, IPGME&R, Kolkata, India
| | - Sudip Kumar Ghosh
- Department of Neurosurgery, Bangur Institute of Neuroscience/IPGME&R, Kolkata, India
| | - Gitanjali Datta
- Department of Neurosurgery, Bangur Institute of Neuroscience/IPGME&R, Kolkata, India
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Jain K, Datta C, Sengupta M, Pal DK, Chatterjee U. Quest to develop a standard screening method for urothelial carcinoma using liquid-based cytology (The Paris System) and CK20. INDIAN J PATHOL MICR 2023; 66:720-726. [PMID: 38084522 DOI: 10.4103/ijpm.ijpm_95_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Background Bladder cancer, the most common malignancy of the urinary tract is a leading cause of morbidity and mortality. But cystoscopy, which is till now the mainstay of screening, is an invasive, high-cost method with low sensitivity especially for flat lesions. Aim To find a non-invasive and effective screening method with liquid-based cytology (LBC) using The Paris System (TPS) and CK20 immunocytochemistry. Materials and Methods It was a prospective study including the patients with clinical or cystoscopic diagnosis of urinary bladder space occupying lesions (SOL). Both conventional (CC) and liquid-based cytology slides were prepared from urine samples. Slides were evaluated by two trained pathologists and categorized according to TPS guidelines. CK20 immunocytochemistry (ICC) was also performed. Consequent formalin-fixed paraffin embedded sections were blindly examined by another pathologist and was taken as gold standard for comparison. Statistical Analysis All the statistical analysis were done using MedCalc version 15.8 [Mariakerke, Belgium: MedCalc Software 2015]. Results The study included 150 cases with a mean age of 62.4 years. Five cases revealed unsatisfactory smears. Rest of the cases were categorized as the following: 18.1% as NH-GUC, 8% as LGUN, 22.1% as AUC, 15.4% as SH-GUC, 32.9% as HGUC. Kappa value of CC and LBC were strong (0.854). LBC alone showed very low specificity (58%) and PPV (74.8%) which improved on application of ICC (specificity: 97.4%, PPV: 96.3%). Conclusion We conclude that CK20 ICC offers potential for accurate, non-invasive detection and surveillance of bladder cancer and is a better tool when combined with liquid-based cytology, reported using The Paris System.
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Affiliation(s)
- Kavita Jain
- Department of Pathology, IPGME&R, Kolkata, West Bengal, India
| | - Chhanda Datta
- Department of Pathology, IPGME&R, Kolkata, West Bengal, India
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Halder A, Patra S, Mandal B, Ray G, Ghosh R, Mukherjee S, Chatterjee U. Differentiating biliary atresia from other causes of infantile cholestasis: An appraisal of the histomorphological changes on liver biopsy. INDIAN J PATHOL MICR 2023; 66:790-798. [PMID: 38084534 DOI: 10.4103/ijpm.ijpm_215_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Background Cholestatic disorders are a significant cause of morbidity and mortality in infants. Characterization of these disorders and differentiating biliary atresia (BA) from other causes of intrahepatic cholestasis is an age-old problem. Objectives To study the spectrum of different infantile cholestatic disorders in our population, to differentiate BA from other causes of neonatal cholestasis (NC) on a liver biopsy, and validation of the available scoring system for the characterization of these disorders. Materials and Methods This is an observational cross-sectional study performed over a period of 3 years between 2018 and 2021, done on neonates and infants presenting with cholestatic jaundice. The changes on liver biopsy were evaluated by different histological parameters and available scoring systems to differentiate BA from non-BA causes. Correlation with clinical, biochemical, and imaging findings was done in all cases. Results This study included 87 cases of NC, of which BA comprised 28 cases (32%), whereas idiopathic neonatal hepatitis (INH) comprised only 12 cases (14%). Portal neutrophilic inflammation (P = 0.000053), ductal cholestasis (P < 0.001), neoductular bile plugs (P < 0.001) and bile ductular proliferation (P < 0.0001) were significantly more in BA, whereas lobular lymphocytic inflammation (P = 0.001) and giant cell transformation of hepatocytes (P = 0.0024) were more frequent in the non-BA group. Using the Lee and Looi scoring system, a histologic score ≥7 was helpful in identifying BA with 85.7% sensitivity, 92.6% specificity, and 90.6% accuracy. Conclusion BA is the commonest cause of NC in neonates, whereas the frequency of INH is declining. Detailed histomorphologic analysis of liver biopsy, aided with IHC, is the cornerstone for the diagnosis of these disorders.
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Affiliation(s)
- Aniket Halder
- Department of GI Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Sabita Patra
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Bappa Mandal
- Department of Neonatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Gautam Ray
- Department of Pediatric Gastroenterology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Ranajoy Ghosh
- Department of GI Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Suchandra Mukherjee
- Department of Neonatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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Karan S, Mukherjee R, Roy PS, Mohin M, Firdous W, Chatterjee U. Yolk Sac Tumour Arising in the Glans Penis an Achondroplasic Child: A Case Report with Summary of Prior Published Cases. Fetal Pediatr Pathol 2023; 42:820-824. [PMID: 37534583 DOI: 10.1080/15513815.2023.2242941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/26/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Yolk sac tumors (YST) are commonly encountered gonadal germ cell tumors in children, especially in the prepubertal age group. In addition to gonadal primary, it can occur in multiple extragonadal sites, of which sacrococcygeal, retroperitoneum, gastric and mediastinum are the commonest. There are 4 previous reports of primary penile YST. CASE REPORT We describe a primary penile yolk sac tumor in a child with achondroplasia. CONCLUSION Yolk sac tumor can occur in the penis during the prepubertal period. Penile yolk sac tumor associated with achondroplasia has not been previously reported, but this could be incidental.
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Affiliation(s)
| | | | | | - Md Mohin
- Department of Pathology, IPGME&R, Kolkata, India
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Mukherjee R, Bhattacharyya S, Chatterjee U. Labial Lipoblastoma in an Infant: An Uncommon Tumor at an Uncommon Site. J Indian Assoc Pediatr Surg 2023; 28:431-432. [PMID: 37842210 PMCID: PMC10569278 DOI: 10.4103/jiaps.jiaps_70_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 10/17/2023] Open
Abstract
Lipoblastoma and lipoblastomatosis are benign fatty tumors of soft tissues that are unique to childhood. Occurrence of lipoblastoma in the labial region is infrequent and can cause diagnostic dilemma. Awareness about this entity is important to avoid hazardous treatment in young children. Here, we present a case of labial lipoblastoma in a 2-year-old child along with its differential diagnosis.
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Affiliation(s)
- Raktim Mukherjee
- Department of Pathology, IPGME and R, Kolkata, West Bengal, India
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Dey S, Chatterjee U. A case of superficial CD34 positive fibroblastic tumor: Diagnostic challenges and pitfalls. INDIAN J PATHOL MICR 2023:00004270-990000000-00069. [PMID: 38391337 DOI: 10.4103/ijpm.ijpm_812_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 03/05/2023] [Indexed: 02/24/2024] Open
Abstract
ABSTRACT Superficial CD34 positive fibroblastic tumor (SCPFT) is a recently described soft tissue tumor of intermediate grade with predilection for subcutaneous and superficial fascial planes. Morphological diagnosis of these tumors can be challenging because of overlapping features with other benign and malignant soft tissue tumors of fibroblastic and myofibroblastic origin. A middle-aged man came with a subcutaneous mass in the left thigh. Microscopic examination showed features of an SCPFT comprised of a circumscribed spindle cell tumor with focal striking pleomorphism and bizarre hyperchromatic nuclei. Immunohistochemically (IHC), the tumor cells showed diffuse positivity for CD34 and focally for cytokeratin. Diagnosis of SCPFT on the basis of morphology alone can be challenging. A constellation of clinicoradiological profiles, IHC features, and sometimes molecular studies clinch the definitive diagnosis which can be helpful in avoiding overtreatment and chemotherapy. Here we highlight the diagnostic challenges and pitfalls in a case of SCPFT.
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Affiliation(s)
- Soumya Dey
- Department of Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
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Ghosh R, Halder A, Nim RK, Ray S, Chatterjee U. Primary hepatic leiomyosarcoma masquerading as focal nodular hyperplasia of liver: A wolf in sheep's clothing. INDIAN J PATHOL MICR 2023:00004270-990000000-00115. [PMID: 38391343 DOI: 10.4103/ijpm.ijpm_735_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 11/14/2022] [Indexed: 02/24/2024] Open
Abstract
ABSTRACT Primary hepatic leiomyosarcoma is a rare hepatic malignancy which requires exclusion of other primary site of origin. Clinical presentation and imaging of this tumor is nonspecific and mimics many other hepatic neoplasms. A 62-year-old female patient presents here with right hepatic mass with insidious onset and radiological features favoring a benign solid lesion suggestive of focal nodular hyperplasia. On right hepatectomy, an encapsulated mass identified about 11 cm in maximum dimension with pushing margin and central scar-like area. Histopathological examination reveals a spindle cell tumor and panel of immunohistochemical markers is required to distinguish it from other morphological mimickers. Diagnosis of primary hepatic leiomyosarcoma requires histopathology along with immunohistochemical examination. It is thus advisable to do preoperative biopsy with immunohistochemistry in all patients having atypical imaging and clinical features.
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Affiliation(s)
- Ranajoy Ghosh
- Department of GI Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Aniket Halder
- Department of GI Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Ranjit K Nim
- Department of Hepatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Sukanta Ray
- Department of GI Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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Mukherjee S, Basu K, Basu KS, Chatterjee U. MiT family translocation-associated renal cell carcinoma: A report of two cases in children. INDIAN J PATHOL MICR 2023; 0:00004270-990000000-00025. [PMID: 38391376 DOI: 10.4103/ijpm.ijpm_385_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/16/2022] [Indexed: 02/24/2024] Open
Abstract
ABSTRACT Renal cell carcinoma is uncommon in children and must be distinguished from the more common Wilms' tumor. Here, we present two cases of renal cell carcinoma in children both of whom presented with hematuria. Accurate diagnosis is essential in order to differentiate it from epithelial predominant Wilms' tumor which has vastly different prognosis and treatment. Immunohistochemistry for TFE3 is useful in establishing the diagnosis.
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Affiliation(s)
| | - Keya Basu
- Department of Pathology, IPGME&R, Kolkata, West Bengal, India
| | - Kalyani S Basu
- Department of Pediatric Surgery, NRS Medical College, Kolkata, West Bengal, India
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Kumar A, Roychowdhury A, Sengupta M, Basu K, Abraham A, Chatterjee U, Mukherjee S. Heavy chain deposition disease in a case of clear cell renal cell carcinoma- A jack in the box. INDIAN J PATHOL MICR 2023; 66:587-590. [PMID: 37530345 DOI: 10.4103/ijpm.ijpm_397_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
Renal cell carcinoma (RCC) is the most common subtype of adult renal tumors, and its detection rate in the early stages has been increased in the dawn of advanced imaging modalities. Nephrectomy is the mainstay of treatment; determination of tumor category and staging is the primary concern of oncopathologists. Non-neoplastic renal parenchyma is overlooked majority of times and thus misses the opportunity to detect concomitant medical renal diseases which also predict the renal outcome in the postoperative era. Although any kind of glomerular or extraglomerular pathology may be encountered, vascular changes in the form of arterionephrosclerosis are the commonest one. Here, we take the opportunity to report an unusual association of heavy chain deposition disease (HCDD) with clear cell subtypes of renal cell carcinoma in a 48-year-old male of Indian ethnicity.
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Affiliation(s)
- Abhishek Kumar
- Department of Nephrology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
| | - Arpita Roychowdhury
- Department of Nephrology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
| | - Moumita Sengupta
- Department of Pathology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
| | - Keya Basu
- Department of Pathology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
| | | | - Uttara Chatterjee
- Department of Pathology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
| | - Sriranjan Mukherjee
- Department of Pathology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
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Mukherjee R, Das O, Chakravorty S, Mohanty S, Chatterjee U. Extralobar Pulmonary Sequestration in Adrenal Mimicking Neuroblastoma: A Case Report. Fetal Pediatr Pathol 2023; 42:310-314. [PMID: 35796300 DOI: 10.1080/15513815.2022.2094513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background: Extralobar pulmonary sequestration (ELS) is a malformation composed of bronchopulmonary tissue outside the lungs that is discontinuous from the main tracheobronchial tree. ELS can present as a suprarenal space occupying lesion. Case Report: A 1-day old girl presented with a right supra-adrenal mass, first detected in-utero at 34 weeks. The differential included congenital neuroblastoma, but the urinary VMA was normal. At resection, there was lung tissue composed of dilated and tortuous bronchioles lined by columnar epithelium present in a back- to- back arrangement along with thick-walled vessels, features of an ELS with congenital pulmonary airway malformation type II. Conclusion: ELS enters the differential diagnosis of neonatal suprarenal masses with normal urinary catecholamines, and can have the morphology of a type II congenital pulmonary airway malformation.
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Affiliation(s)
- Raktim Mukherjee
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Oindrila Das
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Subhankar Chakravorty
- Department of Neonatology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Suravi Mohanty
- Department of Pathology, Kalinga Institute of Medical Sciences, Bhubaneswar, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
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Mandal AP, Das R, Sengupta M, Chatterjee U. Leukemia cutis - A case of cutaneous manifestation of acute monoblastic leukemia. J Cancer Res Ther 2023; 19:826-828. [PMID: 37470620 DOI: 10.4103/jcrt.jcrt_350_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Leukemia cutis is a comprehensive terminology for dermal manifestations of any type of leukemia either with accompanied or antecedent blood or bone marrow involvement. Although both myeloid and lymphoid neoplastic leukocytes can infiltrate the skin, the frequency is higher among children with congenital myeloid leukemia. However, the underlying pathogenesis of dermal tropism is not yet established. Clinical manifestation varies regarding appearance, site, and numbers. Skin biopsy is essential for the early establishment of the diagnosis and to guide for further testing and categorical management. We report the case of acute myeloid leukemia-cutis in a 22-year-old female where cutaneous manifestation preceded the hematological diagnosis of systemic leukemia.
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MESH Headings
- Female
- Child
- Humans
- Young Adult
- Adult
- Leukemia, Monocytic, Acute/complications
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/pathology
- Skin Neoplasms/diagnosis
- Skin Neoplasms/pathology
- Leukemia, Myeloid, Acute/complications
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/pathology
- Skin/pathology
- Biopsy
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Affiliation(s)
| | - Rhituparna Das
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Moumita Sengupta
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Uttara Chatterjee
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
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20
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Butta S, Khatun F, Mohin M, Chatterjee U. Pitfalls in the cytological diagnosis of nodular fasciitis: A report of two cases. Cytopathology 2023; 34:161-164. [PMID: 36401790 DOI: 10.1111/cyt.13191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/26/2022] [Accepted: 11/10/2022] [Indexed: 11/21/2022]
Abstract
Cytological diagnosis of nodular fasciitis can be challenging. The main features on cytological smears are bland, round to ovoid cells with fuzzy cytoplasmic processes in a background of focal myxoid change. The cytological features of two cases of nodular fasciitis are described here, along with the cytological differentials.
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Affiliation(s)
| | | | - Md Mohin
- Department of Pathology, IPGME&R, Kolkata, India
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21
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Sen A, Sarkar M, Das RN, Paul SS, Chatterjee U. The Bethesda system for reporting thyroid fine needle aspirates: A study of 1763 patients; with histopathological correlations, in eastern India. Diagn Cytopathol 2023; 51:174-181. [PMID: 36409469 DOI: 10.1002/dc.25080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 11/02/2022] [Accepted: 11/02/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Fine-needle aspiration cytology (FNAC) is an important test for triaging patients with thyroid nodules. The 2007 National Cancer Institute Thyroid Fine-Needle Aspiration State-of-the-Science Conference helped instigate the recent publication of The Bethesda System for Reporting Thyroid Cytopathology (TBS). AIMS AND OBJECTIVES Terminology and therefore the probability of malignancy vary between pathologists and institutions. The purpose of this study was to evaluate a single institution's experience to determine if sub-classification (neoplasm versus lesion) aids in identifying patients at higher risk for malignancy. Also, an effort in regional and worldwide variation of significance of adoption of Bethesda classification has been evaluated. MATERIALS AND METHODS From 2018 to 2021, all patients with thyroid lesions' were evaluated for FNAC correlation with the surgical diagnosis. During this period, 1763 thyroid FNACs were reported. Histopathological examination (HPE) outcome data was available in 444 (25.2%) cases. RESULTS The cytologic-histologic diagnostic discrepancy rate was 11.5%. The sensitivity and specificity of thyroid FNA for the diagnosis of malignancy were 71.4% and 49.5%, respectively. In our study, the maximum cases were benign (84.5%). The malignancy risk for the different categories in our study, as seen by follow-up HPE, has corroborated well with the Bethesda System. CONCLUSION The current results indicated that FNAC provides an accurate diagnosis of thyroid malignancy. The classification is directly related to the risk of malignancy in each category and this helps in accurate clinical management of that category.
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Affiliation(s)
- Ankita Sen
- Department of Hematology, NRS Medical College, Kolkata, India
| | - Manisha Sarkar
- Department of Pathology, Dr. B C Roy PGIPS, Kolkata, India
| | - Ram Narayan Das
- Department of Pathology, MJN Medical College & Hospital, Cooch Behar, India
| | - Shib Shankar Paul
- Department of ENT, Eves Clinic Nursing Home & Polyclinic, Kolkata, India
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22
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Sengupta R, Mitra S, Dighal A, Moulik S, Chaudhuri SJ, Das NK, Chatterjee U, Chatterjee M. Does immune dysregulation contribute towards development of hypopigmentation in Indian post kala-azar dermal leishmaniasis? Exp Dermatol 2023. [PMID: 36760064 DOI: 10.1111/exd.14760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/05/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
Post kala-azar dermal leishmaniasis (PKDL), a sequel of apparently cured visceral leishmaniasis (VL) presents with papulonodular (polymorphic) or hypopigmented lesions (macular) and is the proposed disease reservoir. As hypopigmentation appears consistently in PKDL, especially the macular form, this study aimed to delineate immune factors that singly or in combination could contribute towards this hypopigmentation. At lesional sites, the presence of melanocytes and CD8+ T-cells was assessed by immunohistochemistry and mRNA expression of melanogenic markers (tyrosinase, tyrosinase-related protein-1 and MITF) by droplet digital PCR, while plasma levels of cytokines and chemokines were measured by a multiplex assay. In comparison with skin from healthy individuals, macular PKDL demonstrated a near total absence of Melan-A+ cells at dermal sites, while the polymorphic cases demonstrated a 3.2-fold decrease, along with a dramatic reduction in the expression of key enzymes related to the melanogenesis signalling pathway in both forms. The levels of circulating IFN-γ, IL-6, IL-2, IL-1β, TNF-α and IFN-γ-inducible chemokines (CXCL9/10/11) were elevated and was accompanied by an increased lesional infiltration of CD8+ T-cells. The proportion of CD8+ T-cells correlated strongly with plasma levels of IFN-γ (r = 0.8), IL-6 (r = 0.9, p < 0.05), IL-2 (r = 0.7), TNF-α (r = 0.9, p < 0.05) and IL-1β (r = 0.7), as also with CXCL9 (r = 0.5) and CXCL10 (r = 0.6). Taken together, the absence/reduction in Melan-A suggested hypopigmentation in PKDL was associated with the destruction of melanocytes, following the impairment of the melanogenesis pathway. Furthermore, the presence of CD8+ T-cells and an enhanced IFN-γ-associated immune milieu suggested the generation of a pro-inflammatory landscape that facilitated melanocyte dysfunction/destruction.
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Affiliation(s)
- Ritika Sengupta
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Sneha Mitra
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Aishwarya Dighal
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Srija Moulik
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | | | - Nilay Kanti Das
- Department of Dermatology, College of Medicine & Sagore Dutta Hospital, Kolkata, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Mitali Chatterjee
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, India
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23
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Dey S, Mandal B, Chatterjee U, Mukherjee S. Infantile Myofibroma: A Report of Two Cases with Differential Diagnoses. J Indian Assoc Pediatr Surg 2022; 27:756-759. [PMID: 36714483 PMCID: PMC9878528 DOI: 10.4103/jiaps.jiaps_14_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/28/2022] [Accepted: 03/26/2022] [Indexed: 11/12/2022] Open
Abstract
Infantile myofibromas (IMs) are benign soft-tissue tumors of children. They are of fibroblastic-myofibroblastic origin and show considerable morphological overlap with other spindle cell neoplasms. Here, we present two cases of solitary myofibromas, one in a neonate and one in a 2-year-old girl. A 2-day-old girl presented with severe respiratory distress and died during intubation. At autopsy, a myofibroma involving the oropharynx with extension up to the larynx was noted. Second case was a 2-year-girl with a myofibroma in the hard palate. IM must be differentiated from other benign and malignant spindle cell tumors of infancy and childhood. Oropharyngeal myofibroma should be considered in the differentials of neonatal respiratory distress.
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Affiliation(s)
- Soumya Dey
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Bappa Mandal
- Department of Neonatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Suchandra Mukherjee
- Department of Neonatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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24
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Ma S, Yu H, Yu B, Gill J, Khan M, Chatterjee U, Iovoli A, Farrugia M, Singh A. Optimal Threshold of Smoking in Pack-Years and its Association with Survival Outcomes Among Patients Treated with Chemoradiation for Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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25
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Basu T, Das M, Bandyopadyay A, Chatterjee U. Acral metastasis as the primary presentation of colon carcinoma. INDIAN J PATHOL MICR 2022; 65:953-955. [PMID: 36308220 DOI: 10.4103/ijpm.ijpm_276_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Affiliation(s)
- Tista Basu
- Department of Pathology, IPGME&R, Kolkata, West Bengal, India
| | - Mou Das
- Department of Pathology, IPGME&R, Kolkata, West Bengal, India
| | - Anis Bandyopadyay
- Department of Radiotherapy, NRS Medical College, Kolkata, West Bengal, India
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26
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Maity P, Mondal A, Das R, Sengupta M, Gargari P, Kar A, Sarkar D, Mukhopadhyay S, Chowdhury S, Chatterjee U. Diagnostic and prognostic utility of SF-1 in adrenal cortical tumours. INDIAN J PATHOL MICR 2022; 65:814-820. [PMID: 36308186 DOI: 10.4103/ijpm.ijpm_153_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND AND AIMS Superior imaging techniques have increased the recognition of adrenal pathology. Distinguishing benign from malignant adrenocortical tumors is not always easy. Several criteria and immunohistochemical markers have been discovered which help to differentiate between adrenocortical adenoma (ACA) and adrenocortical carcinoma (ACC). Our aim here was to evaluate the diagnostic and prognostic role of steroidogenic factor-1 (SF-1) in adult adrenocortical tumors (ACT) diagnosed using the Weiss criteria. In this cohort, we have also analyzed Ki67 and p53 expression and the extent of agreement between SF-1 and Ki-67. METHODOLOGY This was a retrospective, observational study comprising 24 cases of adult ACT over 10 years. Immunohistochemical staining for SF-1, Ki67, and p53 was done in all the cases, and the results correlated with the morphological diagnosis made using Weiss criteria. RESULTS SF-1 was 100% sensitive and 80% specific as a marker of malignancy. Increased SF-1 expression correlated with worse survival. There was a moderate degree of agreement between Ki-67 labeling-index and SF-1 as a marker of malignancy with the kappa coefficient being 0.75. The sensitivity of p53 was lower than Ki67 in diagnosing ACC. CONCLUSION In adult ACTs, SF-1 has diagnostic significance and prognostic implication. SF-1 is a crucial, dosage-dependent survival factor in ACC. There is a moderate extent of agreement between Ki-67 and SF-1 as a marker of malignancy.
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Affiliation(s)
| | - Akash Mondal
- Department of Pathology, IPGME&R, Kolkata, India
| | | | | | - Piyas Gargari
- Department of Endocrinology, IPGME&R, Kolkata, India
| | - Anish Kar
- Department of Endocrinology, IPGME&R, Kolkata, India
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27
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Khatun F, Das A, Sengupta M, Chatterjee U, Sarkar R. Fine-needle aspiration cytology of juvenile granulosa cell tumour: A case report with summary of prior published cases. Diagn Cytopathol 2022; 50:E373-E376. [PMID: 35942608 DOI: 10.1002/dc.25037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/02/2022] [Accepted: 07/25/2022] [Indexed: 11/12/2022]
Abstract
Juvenile granulosa cell tumours (JGCT) are uncommon tumours of the ovary and can present diagnostic difficulty both on histology and cytology because of its rarity. Here we present the fine-needle aspiration cytology (FNAC) findings of a 4 year-old girl who came with a large abdominal mass and bleeding per vaginum. FNAC from the mass showed features suggestive of granulosa cell tumour (GCT) and which was later confirmed on histology to be of juvenile type. Only two cases of cytological findings of JGCT have been described earlier, both of which were recurrent cases and at metastatic sites. The main cytological feature in our case was presence of thick colloid like fluid containing apparent bubbles along with small clusters of uniform cells with eosinophilic cytoplasm and fine vacuolation. The presence of these secretions corresponding to the macrofollicles on histology has not been reported earlier.
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Affiliation(s)
| | - Anirban Das
- Department of Pediatric Surgery, IPGME&R, Kolkata, India
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28
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Abstract
BackgroundNeuroblastoma can arise from extra-adrenal sites in the paraspinal sympathetic chain, including the presacral region, where they must be differentiated from an immature or malignant neural lesion arising from a teratoma.Case ReportWe describe two congenital presacral neuroblastomas. The main clinical differential diagnoses were sacrococcygeal teratoma and meningomyelocele. Pathologically, they lacked teratomatous tissues, lacked germ cell serum markers, were localized without metastases, and were MYCN non-amplified. Both patients have done well without chemotherapy at 18 and 15 months of follow-up.ConclusionCongenital presacral neuroblastoma should be differentiated from teratomatous lesions, and in general have a good prognosis.
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Affiliation(s)
- Soumya Dey
- Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Arindam Ghosh
- Nilratan Sircar Medical College and Hospital, Pediatric Surgery, Kolkata, India
| | - Kaushik Sil
- Neonatology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Kalyani Saha Basu
- Nilratan Sircar Medical College and Hospital, Pediatric Surgery, Kolkata, India
| | - Uttara Chatterjee
- Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, India
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Dey S, Khatun F, Ray R, Barman S, Chatterjee U. Infantile Myofibroma: A Series of 2 Cases with Special Reference to Cytological Features. Fetal Pediatr Pathol 2022; 41:689-697. [PMID: 34193017 DOI: 10.1080/15513815.2021.1945173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BackgroundInfantile myofibromas (IM) are benign soft tissue lesions of childhood and represent a significant portion of the benign spectrum of fibroblastic-myofibroblastic tumors. Cytological diagnosis of these tumors can be challenging because of overlapping morphology and limited case report descriptions. We describe the cytological features and the cytological differential diagnoses.Case reportWe describe cytological features of two IMs. The main features were the presence of loose clusters and dispersed bland myofibroblasts in varying stages of maturation with traversing blood vessels and myxoid stroma. The cells typically lacked features of atypia, mitoses and significant pleomorphism.ConclusionDiagnosis of IM on the basis of cytology alone can be tricky and definitive diagnosis should be made only after correlating the cytological features with histology. However, bland morphology of differentiating myofibroblasts can aid in cytological diagnosis and help to exclude other malignant spindle cells neoplasms needing preoperative chemotherapy.
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Affiliation(s)
- Soumya Dey
- Department of Pathology, IPGME&R, Kolkata, India
| | | | - Raktim Ray
- Department of Pathology, IPGME&R, Kolkata, India
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30
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Ray R, Agarwal N, Sadique SI, Das M, Chatterjee U. Cytological Features in Pilomyxoid Astrocytoma: A Case Report with Summary of Prior Published Cases. Cytopathology 2022; 33:742-745. [PMID: 35774027 DOI: 10.1111/cyt.13162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 11/27/2022]
Abstract
Pilomyxoid astrocytoma is a subtype of pilocytic astrocytoma described as grade 1 tumour in the WHO classification of CNS tumors, 2022. It occurs preferentially in the hypothalamic region in infants. Although the histological features of pilomyxoid astrocytomas are well documented, there is sparse literature available on the cytological findings of the same. Here we describe the squash cytological features of a case of pilomyxoid astrocytoma along with a summary of prior published cases. The smears of this tumour tend to be more cellular with piloid cells arranged in an angiocentric pattern without Rosenthal fibres or eosinophilic granular bodies. The background can have blue myxoid substance.
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Affiliation(s)
- Raktim Ray
- Department of Pathology, IPGME&R, Kolkata, India
| | - Nitish Agarwal
- Department of Neurosurgery, Bangur Institute of Neuroscience/IPGME&R, Kolkata, India
| | | | - Mou Das
- Department of Pathology, IPGME&R, Kolkata, India
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31
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Das RN, Mandal B, Das M, Sil K, Mukherjee S, Chatterjee U. Perinatal and Fetal Autopsies in Neuropathology: How I do it. INDIAN J PATHOL MICR 2022; 65:S207-S217. [PMID: 35562151 DOI: 10.4103/ijpm.ijpm_977_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Fetal and perinatal autopsies are useful to identify the accurate cause of death and in the process recognize disorders which may require counselling for future pregnancies. Abnormalities of the CNS are an important cause of fetal loss and perinatal deaths. Most of these are structural abnormalities of the CNS, however a smaller portion show changes pertaining to prematurity, infections and even congenital tumors. In this review we evaluate CNS abnormalities of the fetus and the newborn as detected in autopsy series. We also describe our experience in a tertiary care hospital with a specialized neonatology unit over the last 8 years and discuss some of the newer methods like virtual autopsy.
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Affiliation(s)
- Ram Narayan Das
- Department of Pathology, MJN Medical College and Hospital, Cooch Behar, West Bengal, India
| | - Bappa Mandal
- Department of Neonatology, IPGME&R, Kolkata, West Bengal, India
| | - Mou Das
- Department of Pathology, IPGME&R, Kolkata, West Bengal, India
| | - Kaushik Sil
- Department of Neonatology, IPGME&R, Kolkata, West Bengal, India
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Abstract
Background Gliomatosis peritonei (GP) is characterized by widespread implants of mature glial tissue in the peritoneum. It is most often associated with immature or mature ovarian teratomas. Case Report: A 6-month old infant developed isolated gliomatosis involving the tunica vaginalis following excision of an immature sacrococcygeal teratoma in the neonatal period. Conclusion: Tunica vaginalis gliomatosis can occur in the setting of a retroperitoneal extragonadal congenital immature teratoma.
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Affiliation(s)
- Sabita Patra
- Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Subhankar Chakravorty
- Department of Pediatric Surgery, Nilratan Sircar Medical College and Hospital, Kolkata, India
| | - Uttara Chatterjee
- Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Koushik Saha
- Department of Pediatric Surgery, Nilratan Sircar Medical College and Hospital, Kolkata, India
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33
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Maity P, Das N, Chatterjee U, Basak D. Sex-Cord Tumor with Annular Tubules with Unusual Morphology in an Infant with Peutz-Jeghers Syndrome. Fetal Pediatr Pathol 2022; 41:306-311. [PMID: 32609034 DOI: 10.1080/15513815.2020.1786200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background Peutz-Jeghers syndrome (PJS) is characterized by hamartomatous gastrointestinal polyposis, mucocutaneous pigmentation and cancer predisposition. The clinical features of PJS manifest in first two decades of life; however, neonatal presentation is uncommon. Case report: We present a five day old girl with PJS that presented with obstructive hamartomatous polyps in the sigmoid colon. At colostomy closure at six months, an incidental ovarian sex-cord tumor with annular tubules (SCTAT) was detected. It showed predominantly a solid pattern with limited tubule formation and was composed of lipid-rich cells. She had no hormonal symptoms. Conclusion: SCTAT can occur as young as six months of age in PJS, and may show histologic overlap with lipid-rich Sertoli cell tumors.
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Affiliation(s)
- Priyanka Maity
- Department of Pathology, Institute of Post Graduate Medical Education & Research, Kolkata, India
| | - Nandini Das
- Department of Pathology, Medical College and Hospital Kolkata, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Post Graduate Medical Education & Research, Kolkata, India
| | - Dhananjay Basak
- Department of Pediatric Surgery, Park Clinic, Kolkata, India
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Ma S, Khan M, Gill J, Santhosh S, Chatterjee U, Iovoli A, Farrugia M, Wooten K, Gupta V, Mcspadden R, Yu H, Kuriakose M, Markiewicz M, Hicks W, Platek M, Seshadri M, Ray A, Repasky E, Singh A. Optimal Threshold of Pre-Treatment Hemoglobin Level as a Prognostic Biomarker for Survival Outcome in Patients with Head and Neck Cancer in the Era of Human Papillomavirus. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ma S, Khan M, Gill J, Santhosh S, Chatterjee U, Iovoli A, Farrugia M, Wooten K, Gupta V, Mcspadden R, Yu H, Kuriakose M, Markiewicz M, Hicks W, Platek M, Seshadri M, Ray A, Repasky E, Singh A. Optimal Threshold of Neutrophil-Lymphocyte Ratio and its Association with Survival Outcome Among Patients with Head and Neck Cancer in the United States. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Islam N, Das RN, Chatterjee U, Sengupta M, Sarkar R, Saha K. Utility of tru-cut biopsy in diagnosis of palpable pediatric soft tissue neoplasms. INDIAN J PATHOL MICR 2022; 65:374-380. [PMID: 35435374 DOI: 10.4103/ijpm.ijpm_1074_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
CONTEXT Soft tissue neoplasms are infrequent in children with sarcomas accounting for approximately 7% of all pediatric malignancies. Morphologic diagnosis is challenging due to overlapping features. Subtyping and categorization of these lesions are difficult on fine-needle aspiration cytology (FNAC) alone owing to tumor heterogeneity and limited material in some cases. Tru-cut biopsies obtain adequate tumor tissue for ancillary studies besides conventional histology. AIM The study aims to explore the role of tru-cut biopsy to arrive at a definitive diagnosis. The study also highlights the correlation between FNAC and histopathology on tru-cut biopsy besides explaining the significance of a panel of immunohistochemistry (IHC) markers for histological categorization and subtyping. MATERIALS AND METHODS A total of 61 children from infancy to 18 years were included in the study. Closed biopsy procedures like FNAC and tru-cut biopsy were performed, and the tru-cut biopsy specimen was subjected to a panel of immunohistochemical markers. RESULTS Fisher's exact test for sensitivity and specificity towards detection of malignancy was 83% and 86%, respectively for FNAC. For tru-cut biopsy, sensitivity was 94% and specificity was 91%. The two-sided P value (<0.0001) was extremely significant. Cohen's Kappa coefficient value for tru-cut biopsy was 0.772 suggesting a substantial strength of agreement. Tru-cut with IHC had a Kappa value of 0.866 suggesting greater agreement with histopathology. CONCLUSION Tru-cut biopsy is a simple, safe, and reliable adjunct to the FNAC. Instead, immunohistochemistry enhances the diagnostic accuracy.
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Affiliation(s)
- Nelofar Islam
- Department of Pathology, IPGME&R, Kolkata, West Bengal, India
| | - Ram N Das
- Department of Pathology, MJN Medical College, Coochbehar, West Bengal, India
| | | | | | - Ruchirendu Sarkar
- Department of Pediatric Surgery, IPGME&R, Kolkata, West Bengal, India
| | - Kaushik Saha
- Department of Pediatric Surgery, NRS Medical College, Kolkata, West Bengal, India
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Dey S, Chatterjee U, Datta C. Intramyofiber skeletal muscle invasion: An unusual pattern of muscle infiltration in breast cancer. INDIAN J PATHOL MICR 2022; 65:478-479. [PMID: 35435401 DOI: 10.4103/ijpm.ijpm_1371_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
Skeletal muscle infiltration in carcinoma is a rare entity. Intramyofiber skeletal muscle invasion is the rarest type of muscle infiltration. Here we present one such case of intramyofiber skeletal muscle invasion in a case of breast carcinoma.
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Affiliation(s)
- Soumya Dey
- Department of Pathology, IPGME and R, Kolkata, West Bengal, India
| | | | - Chhanda Datta
- Department of Pathology, IPGME and R, Kolkata, West Bengal, India
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Mondal A, Das RN, Chatterjee U, Majumdar A, Sengupta M, Bhattacharyya S, Sarkar R. Histoplasmosis masquerading as tuberculosis: A report of three cases in immunocompetent children. INDIAN J PATHOL MICR 2022; 65:406-409. [PMID: 35435380 DOI: 10.4103/ijpm.ijpm_1070_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
The most common cause of granulomatous lymphadenitis in countries like ours is mycobactrium tuberculosis followed by atypical mycobacterial infection, fungal infections, parasitic infection, cat scratch disease, lymphogranuloma venereum (inguinal lymphadenopathy), and leprosy Here, we present three cases of lymphadenopathy due to histoplasmosis in immunocompetent children. Two of them presented with fever, lymphadenopathy, initially diagnosed as granulomatous lymphadenitis consistent with tuberculosis on FNAC and were put on antitubercular drugs. However, their condition gradually became worse. As the patients continued to deteriorate, subsequent lymph node biopsies were done and diagnosed as histoplasmosis. Third case presented with acute loss of vision with hepatosplenomegaly and lymphadenopathy. Initially considered as acute leukemia, but eventually established as histoplasmosis. Histoplasmosis should be considered as one of the possible causes of granulomatous lymphadenitis in children.
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Affiliation(s)
- Anindita Mondal
- Department of Pathology, IPGMER, Kolkata, West Bengal, India
| | - Ram N Das
- Department of Pathology, CGMCH, Coochbehar, West Bengal, India
| | | | - Arijit Majumdar
- Department of Pathology, Dr. B. C. Roy PGIPS, Kolkata, West Bengal, India
| | | | | | - Ruchirendu Sarkar
- Department of Pediatric Surgery, IPGMER, Kolkata, West Bengal, India
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Jain K, Sengupta M, Maity P, Chatterjee U, Chaudhuri S, Rajyalakshmi E, Datta C, Ghosh S, Chatterjee S. Comparison of Frozen Section and Squash Cytology as Intra-Operative Diagnostic Tool in Pediatric CNS Tumors. Neurol India 2022; 70:714-720. [PMID: 35532645 DOI: 10.4103/0028-3886.344656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Pediatric central nervous system (CNS) tumors have a different histological spectrum as compared to adults with the infantile group having even more varied and distinct histological profiles. Intra-operative diagnosis is especially important as it guides the neurosurgeon to tailor an approach which is best suited for a particular case. The aim of the study was to evaluate the diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value of frozen section (FS) and squash cytology and to find out the degree of correlation (kappa value) between the two procedures. MATERIALS AND METHODS A prospective study was conducted on 55 pediatric patients with clinicoradiologically diagnosed CNS lesions for a period of 2.5 years. Intra-operative squash smears and FS were made and stained with hematoxylin and eosin stain. Diagnosis made subsequently on paraffin embedded sections was taken as the gold standard. RESULTS Although the specificity (90%) and positive predictive value (96%) were comparable between the two procedures, sensitivity (91.4%) and negative predictive value (75%) of FS was more as compared to squash cytology. Both the diagnostic modalities showed substantial agreement (k = 0.728). CONCLUSION Even though the histological spectrum of pediatric CNS tumors is more varied than adults, FS gives a reasonable intra-operative diagnosis and better results when compared to squash alone.
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Affiliation(s)
- Kavita Jain
- Department of Pathology, IPGME and R, Park Clinic, Kolkata, West Bengal, India
| | - Moumita Sengupta
- Department of Pathology, IPGME and R, Park Clinic, Kolkata, West Bengal, India
| | - Priyanka Maity
- Department of Pathology, IPGME and R, Park Clinic, Kolkata, West Bengal, India
| | - Uttara Chatterjee
- Department of Pathology, IPGME and R, Park Clinic, Kolkata, West Bengal, India
| | | | - E Rajyalakshmi
- Department of Neurosurgery, BIN, Park Clinic, Kolkata, West Bengal, India
| | - Chhanda Datta
- Department of Pathology, IPGME and R, Park Clinic, Kolkata, West Bengal, India
| | - Subhashish Ghosh
- Department of Neurosurgery, BIN, Park Clinic, Kolkata, West Bengal, India
| | - Sandip Chatterjee
- Department of Neurosurgery, Park Clinic, Kolkata, West Bengal, India
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Maity P, Halder A, Ghosh R, Chatterjee U, Barman S, Sarkar R. Immunohistochemistry as a Surrogate Marker of Underlying Molecular Derangements in Sporadic Colorectal Carcinoma in Children - A Series of Three Cases. Fetal Pediatr Pathol 2022; 41:98-106. [PMID: 32441577 DOI: 10.1080/15513815.2020.1765918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Colorectal carcinomas (CRCs) are uncommon tumors in children. Here, we elucidate three cases of childhood CRCs with their underlying molecular derangements using immunohistochemistry (IHC) with emphasis on BRAF mutation. Case summary: All three CRCs were sporadic tumors involving the left colon with two of them having a mucinous phenotype. We performed IHC for BRAF, p53 and β-catenin along with markers of microsatellite instability (MSI) in all three tumors. All the tumors had diffuse strong cytoplasmic BRAF positivity, with focal p53 positivity in two cases and cytoplasmic β-catenin staining in one case. One case showed CpG island hypermethylation with isolated loss of PMS2 staining. None of the cases had any family history of CRC. Conclusions: IHC can be used as a surrogate marker for determining the underlying molecular derangements in CRC. Sporadic CRCs in children are a cumulative effect of multiple mutations, of which BRAF mutation is significant and critical for planning targeted therapy.
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Affiliation(s)
- Priyanka Maity
- Department of Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Aniket Halder
- Department of GI Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Ranajoy Ghosh
- Department of GI Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Shibsankar Barman
- Department of Pediatric Surgery, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Ruchirendra Sarkar
- Department of Pediatric Surgery, Institute of Postgraduate Medical Education and Research, Kolkata, India
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Maity P, Chatterjee U, Das M, Patra S. Recurrent Giant Cell Fibroblastoma in an Infant: A Diagnostic Challenge. Fetal Pediatr Pathol 2022; 41:171-178. [PMID: 32511045 DOI: 10.1080/15513815.2020.1775733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Giant cell fibroblastoma (GCF) shows a wide spectrum of morphological patterns which may lead to a misdiagnosis of sarcoma. Case Report: This 14- month- old baby was referred to us for recurrent left scrotal embryonal rhabdomyosarcoma (ERMS), first diagnosed at 8 months, status post chemotherapy. Review of previous histology, cytology (with frequent multinucleated floret type giant cells but without cross striations) and immunohistochemistry resulted in the change of diagnosis to GCF. It was re-excised, recurred at 20 months of age, and was again re-excised. The morphology was the same in both recurrences as the original. Conclusion: Despite chemotherapy, the histology of multiple recurrences for GCF remained the same as the original. Cytologically, identification of the multinucleated floret like giant cells without cross striations was helpful in differentiating this lesion from embryonal rhabdomyosarcoma.
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Affiliation(s)
- Priyanka Maity
- Department of Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Mou Das
- Department of Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Sabita Patra
- Department of Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, India
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Bhattacharya S, Roy P, Chatterjee U, Bhattacharyya A. Kaposiform hemangioendothelioma in an unusual site: A report of two cases in children. INDIAN J PATHOL MICR 2022; 65:167-169. [PMID: 35074987 DOI: 10.4103/ijpm.ijpm_489_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
Kaposiform hemangioendothelioma (KHE) is a locally aggressive vascular tumor usually seen in children. It is frequently associated with Kasabach-Merritt phenomenon. Here we report two cases of KHE: the first case being an 11-month-old boy who came with massive swelling on the face and violaceous discoloration. The second case was a 7-year-old boy who presented with respiratory distress and bleeding manifestations. CT scan chest showed a large mass involving the anterior mediastinum. Histologic examination of resected masses from both these cases showed features of KHE involving subcutaneous tissue and thymus, respectively. Although cutaneous and subcutaneous location is common, thymic involvement is unusual. It is important to distinguish KHE from infantile haemangioma, tufted angioma, spindle-cell haemangioma, verrucous malformation and Kaposi sarcoma. Histologic features, supportive immunohistochemistry and the clinical profile together are helpful to differentiate KHE from other vascular lesions.
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Affiliation(s)
- Sumanta Bhattacharya
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Paromita Roy
- Department of Pathology, TMC, Kolkata, West Bengal, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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Ray R, Dey S, Khatun F, Barman S, Das M, Chatterjee U, Sarkar R, Saha K. Adrenal and Mesenteric Teratomas in Infants: Common Tumors in Uncommon Sites. J Indian Assoc Pediatr Surg 2022; 27:354-356. [PMID: 35733597 PMCID: PMC9208687 DOI: 10.4103/jiaps.jiaps_26_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/28/2021] [Accepted: 09/14/2021] [Indexed: 11/10/2022] Open
Abstract
Teratomas are common tumors in children. The most common sites are gonads, however, several extragonadal sites are well known such as sacrococcygeal region, mediastinum, head and neck, stomach, and vagina. Occasionally, teratomas occur in unusual sites which pose diagnostic difficulties. Here, we describe two cases of infantile teratomas with unusual presentation. The first case was a 6-month-old girl who presented with a mass in the right side of the abdomen. Computed tomography (CT) scan showed a solid-cystic mass in the right suprarenal region. The second was a 4-month-old boy who came with a huge abdominal mass. Contrast-enhanced CT showed a tumor arising from the jejunal mesentery. On microscopic examination, they were diagnosed as mature and immature teratoma, respectively. Although neuroblastoma is the most common infantile adrenal neoplasm, the possibility of teratoma should be considered for cystic adrenal lesions. Mesenteric teratoma can be difficult to distinguish radiologically from the more common lymphangioma; however, accurate diagnosis is important in view of long-term follow-up for teratomas because of the possibility of malignant transformation.
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Affiliation(s)
- Raktim Ray
- Department of Pathology, IPGME and R, Kolkata, West Bengal, India
| | - Soumya Dey
- Department of Pathology, IPGME and R, Kolkata, West Bengal, India
| | - Farjana Khatun
- Department of Pathology, IPGME and R, Kolkata, West Bengal, India
| | - Shibsankar Barman
- Department of Pediatric Surgery, IPGME and R, Kolkata, West Bengal, India
| | - Mou Das
- Department of Pathology, IPGME and R, Kolkata, West Bengal, India
| | - Uttara Chatterjee
- Department of Pathology, IPGME and R, Kolkata, West Bengal, India,Address for correspondence: Prof. Uttara Chatterjee, Department of Pathology, IPGME and R, 244 AJC Bose Road, Kolkata - 700 020, West Bengal, India. E-mail:
| | - Ruchirendu Sarkar
- Department of Pediatric Surgery, IPGME and R, Kolkata, West Bengal, India
| | - Koushik Saha
- Department of Pediatric Surgery, NRS Medical College, Kolkata, West Bengal, India
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Basu T, Das M, Ghosh A, Chaudhuri S, Chatterjee U, Ghosh S. Squash cytology of clear cell meningioma: Report of a case. Cytopathology 2021; 33:261-265. [PMID: 34860435 DOI: 10.1111/cyt.13084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/21/2021] [Accepted: 12/01/2021] [Indexed: 11/26/2022]
Abstract
Clear cell meningioma (CCM) is a rare histological variant of meningioma. It is commonly located at the cerebellopontine angle and the spine particularly around the cauda equina. Squash cytology finding of meningioma is well-established, however there is sparse literature available on squash cytology of CCM. Here we describe a case of CCM occurring in the lumbar spine in a young woman. Initially, on squash cytology a diagnosis of a low grade glioma favouring an ependymoma was considered. Eventually histopathological examination along with immunohistochemistry helped us reach the diagnosis of a CCM. In this article we discuss the cytomorphology of CCM along with its cytological differentials and the hurdles to an accurate diagnosis.
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Affiliation(s)
- Tista Basu
- Department of Pathology, IPGME&R, Kolkata, India
| | - Mou Das
- Department of Pathology, IPGME&R, Kolkata, India
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Ghosh M, Sengupta M, Barman S, Chatterjee U, Mukhopadhyay M, Sarkar R, Saha K, Basu AK. Clinicopathological Study of Primary Pediatric Gastrointestinal Lymphomas. J Indian Assoc Pediatr Surg 2021; 26:327-333. [PMID: 34728919 PMCID: PMC8515530 DOI: 10.4103/jiaps.jiaps_201_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/11/2020] [Accepted: 07/21/2020] [Indexed: 11/08/2022] Open
Abstract
Background: Primary gastrointestinal lymphomas (PGIL) are uncommon in children and account for <5% of all pediatric malignancies. The objective of our study was to analyze the prognostic factors of pediatric PGILs with reference to its histological subtypes, stage, and outcomes using immunohistochemistry. Materials and Methods: Twenty cases were studied over 11 years. Clinicopathological profiles, histological details, and immunohistochemical (IHC) profiles were analyzed. Results: The mean age at the presentation was 6 years. Using IHC stains (CD CD10, CD19, CD20, CD3, terminal deoxynucleotidyl transferase, BCL 2 and 6, PAX 5, and MUM1), diffuse large B-cell lymphoma (DLBCL) was most prevalent (45%), followed by Burkitt lymphoma (35%) and lymphoblastic lymphoma (20%). DLBCLs (9) were classified using the Han's algorithm. Six were activated B-cell and 3 were germinal center B-cell subtypes. The cases of lymphoblastic lymphoma and those in Stage I disease had the best prognosis. Conclusion: Pediatric PGILs have variable presentation, outcomes, and diverse treatment modalities depending on the histological subtypes. A panel of IHC stains can be a useful adjunct for the categorization and prognosis of pediatric PGILs.
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Affiliation(s)
- Moupali Ghosh
- Department of Pathology, IPGME&R, Kolkata, West Bengal, India
| | | | - Shibsankar Barman
- Department of Pediatric Surgery, IPGME&R, Kolkata, West Bengal, India
| | | | | | - Ruchirendu Sarkar
- Department of Pediatric Surgery, IPGME&R, Kolkata, West Bengal, India
| | - Koushik Saha
- Department of Pediatric Surgery, NRS Medical College, Kolkata, West Bengal, India
| | - Ashoke Kumar Basu
- Department of Pediatric Surgery, Institute of Child Health, Kolkata, West Bengal, India
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Mondal A, Mandal B, Das RN, Chatterjee U, Mukherjee S. Thanatophoric dysplasia type 1 with temporal lobe dysplasia: Report of a case along with differential diagnosis. INDIAN J PATHOL MICR 2021; 64:776-779. [PMID: 34673602 DOI: 10.4103/ijpm.ijpm_917_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Thanatophoric dysplasia type 1 (TD1) is a lethal form of osteochondral dysplasia due to mutation of FGFR3 gene. In addition to severe shortening of the limbs there is temporo-occipital lobe dysplasia along with a range of other CNS anomalies. In this report we describe the radiological and anatomical features at autopsy in neonate with TD1 along with the CNS anomalies. We have also summarized the key distinguishing features of TD1 from other common types of osteochondral dysplasia. An accurate diagnosis is important for genetic counseling and impact on future pregnancies.
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Affiliation(s)
- Akash Mondal
- Department of Pathology, IPGME&R, Kolkata, West Bengal, India
| | - Bappa Mandal
- Department of Neonatology, IPGME&R, Kolkata, West Bengal, India
| | - Ram N Das
- Department of Pathology, Coochbehar Government Medical College, Cooch Behar, West Bengal, India
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Alphones S, Chatterjee U, Singh A, Das A, Zameer L, Achari R, Bhattacharya A, Roy P. Immunohistochemical screening for mismatch repair protein deficiency in paediatric high-grade gliomas - institutional experience and review of literature. Childs Nerv Syst 2021; 37:2521-2530. [PMID: 34097097 DOI: 10.1007/s00381-021-05229-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Immunohistochemical (IHC) testing for mismatch repair (MMR) deficiency (MMRD) is used as a screening tool to identify microsatellite instability in various cancers (especially colon). This not only identifies hereditary cancer syndromes like Lynch and constitutional mismatch repair deficiency (CMMRD) but also aids in prognostication and prediction of sensitivity to checkpoint inhibitor drugs. There are very few reported studies on MMRD status of pediatric high-grade gliomas (pHGG) and none from the Indian subcontinent. The aim of this study is to evaluate the frequency of MMRD in pHGG and to assess if there is a need for universal screening with immunohistochemistry. METHODS Paraffin blocks of consecutive cases of pHGG (< 18 years) were retrieved from 2 centres, and IHC with four MMR antibodies - MLH1, PMS2, MSH2 and MSH6 - was performed using tissue microarray-based technique. RESULTS Three out of nine cases (33%) studied showed loss of staining. One case had loss of MSH2 and MSH6 confirmed by gene sequencing. Eight of the cases were glioblastoma. One case of IDH1-mutated anaplastic astrocytoma showed loss of MLH1 and PMS2 staining. Isolated PMS2 loss was noted in 1 case, where the non-tumour cells also showed loss of staining, indicative CMMRD syndrome. This patient had prior colon cancer with isolated PMS2 loss and responded to check-point inhibitor therapy with nivolumab. CONCLUSION Our study shows that the frequency of MMRD to be about one-third of pHGG. Universal IHC screening for MMRD in all pHGGs may benefit early diagnosis and play a role in therapeutic decisions. A larger multi-institutional study will help better assess the prevalence and treatment implications in MMRD tumours.
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Affiliation(s)
- Sheena Alphones
- Department of Pathology, Tata Medical Center, Kolkata, India
| | | | - Angad Singh
- Department of Pathology, Tata Medical Center, Kolkata, India
| | - Anirban Das
- Department of Pediatric Oncology, Tata Medical Center, Kolkata, India
| | - Lateef Zameer
- Department of Pathology, Tata Medical Center, Kolkata, India
| | - Rimpa Achari
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | | | - Paromita Roy
- Department of Pathology, Tata Medical Center, Kolkata, India.
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Das D, Datta C, Chatterjee U, De A. A case of eccrine porocarcinoma: A treacherous mimic and diagnostic challenge. INDIAN J PATHOL MICR 2021; 64:186-188. [PMID: 33433439 DOI: 10.4103/ijpm.ijpm_427_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Eccrine porocarcinoma is a rare malignant dermal appendageal tumor notorious for its varied morphology, both clinically and histologically; and it can pose a considerable diagnostic dilemma to both the dermatologist and the pathologist. Herein, we present a case of a 74-year-old woman with slow-growing nodular masses on both buttocks, reaching a fairly large size over a course of 3 years. Although atypical morphologic features posed significant diagnostic difficulty to both the surgeon and the pathologists, it was eventually diagnosed as eccrine porocarcinoma with focal squamoid features, using immunostains. To our knowledge, this is the second reported case of bilateral eccrine porocarcinoma which highlights the need for awareness of the morphological variations that this entity is capable of producing.
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Affiliation(s)
- Diya Das
- Department of Pathology, Calcutta National Medical College, Siliguri, West Bengal, India
| | - Chhanda Datta
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Siliguri, West Bengal, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Siliguri, West Bengal, India
| | - Abhishek De
- Dermatology, Calcutta National Medical College, Siliguri, West Bengal, India
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Ghosh K, Ghosh S, Chatterjee U, Bhattacharjee P, Ghosh A. Dichotomy in Growth and Invasion from Low- to High-Grade Glioma Cellular Variants. Cell Mol Neurobiol 2021; 42:2219-2234. [PMID: 33978861 DOI: 10.1007/s10571-021-01096-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 04/28/2021] [Indexed: 11/29/2022]
Abstract
Glial dysfunction outraging CNS plasticity and integrity results in one of the most dangerous cancers, namely glioma, featuring little median survival period and high recurrence. The hallmark properties of proliferation, invasion and angiogenesis with the infiltrated macrophages in glioma are expected to be tightly coupled or cross-linked, but not properly related so far. The present study is aimed to find a relationship between this featured quadrangle from lower to higher grades (HG) of post-operative glioma tissues and their invading subsets. Elevated Ki67-associated proliferation in lower grades (LG) was supported with VEGF dependent angiogenic maintenance which found a decrease unlikely in HG. In contrast, MMP 2 and 9-associated invasions augmented high in HG with the dominant presence of CD204+ M2 polarized macrophages and a general increase in global DNMT1-associated methylation. Marked differences found in ECM invading cellular subsets of HG showing high proliferative capacity indicating rationally for recurrence, contrasting the nature of gross tumor tissue of the same grade. Thus in LG, the neoplastic lesion is more inclined to its growth while in higher grade more disposed towards tissue wreckage in support with cellular environmental milieu whereas the cellular variants and subsets of invaded cells showed different trends. Therefore, some operational dichotomy or coupling among cellular variants in glioma is active in determining its low- to high-grade transition and aggressive progression.
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Affiliation(s)
- Krishnendu Ghosh
- Immunobiology Laboratory, Department of Zoology, Panihati Mahavidyalaya, Kolkata, West Bengal, India.,Environmental Epigenomics Laboratory, Department of Environmental Science, University of Calcutta, Kolkata, West Bengal, India
| | - Samarendranath Ghosh
- Department of Neurosurgery, Bangur Institute of Neurosciences (BIN), Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, West Bengal, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, West Bengal, India
| | - Pritha Bhattacharjee
- Environmental Epigenomics Laboratory, Department of Environmental Science, University of Calcutta, Kolkata, West Bengal, India
| | - Anirban Ghosh
- Immunobiology Laboratory, Department of Zoology, Panihati Mahavidyalaya, Kolkata, West Bengal, India. .,Department of Zoology, School of Sciences, Netaji Subhas Open University, DD-26, Salt Lake, Sector-I, Kolkata, West Bengal, 700064, India.
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Roy S, Chatterjee U, Sengupta M, Ray S. Primary hyperoxaluria: An unusual cause of renal failure in a neonate. INDIAN J PATHOL MICR 2021; 64:606-607. [PMID: 34341288 DOI: 10.4103/ijpm.ijpm_319_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sudip Roy
- Department of Pathology, IPGME&R, Kolkata, West Bengal, India
| | | | | | - Suchandra Ray
- Department of Pathology, IPGME&R, Kolkata, West Bengal, India
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