International Journal of Clinicopathological Correlation

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Pregnancy induces hormone-related breast changes which pose diagnostic challenges in the evaluation of a breast lump. In particular, fine needle aspiration cytology of a lactating adenoma may mimic malignancy. The authors present a case of a woman with a right breast lump. Fine needle aspiration cytology demonstrated the presence of numerous single-occurring epithelial cells with large round nuclei, discrete nucleoli, and ample vacuolated cytoplasm. Taken in isolation, this finding would be suspicious for malignancy. However, the clinical history of recent pregnancy was duly noted as was the presence of a granular vacuolated background on cytology. An accompanying core biopsy confirmed the lesion to be a lactating adenoma. This case highlights lactating adenoma as a potential diagnostic pitfall on fine needle aspiration cytology.

A case of metastatic breast cancer with medication-related osteonecrosis of the jaws is described in a 42-year-old Hispanic female who was previously unaware of a preexisting breast carcinoma. Radiographic examination demonstrated the absence of visible lamina dura and periodontal ligament on teeth in the affected area; while clinical examination demonstrated a moderately diffuse swelling of the right mandible and vestibule without distinct masses. Microscopy revealed disordered lesional cells with moderate variations in nuclear size, shape, and chromaticity, with a low mitotic index. Also noted were segments of necrotic remodeled resorbed lamellar bone showing enlarged empty osteocytic lacunae, a serrated external surface, adherent granular basophilic bacteria, and a fibrinous exudate with neutrophils.

Background: Bone remodeling is a biologic process involving an acute inflammatory response in periodontal tissues during orthodontic tooth movement. The early response of periodontal tissues to mechanical stress involves metabolic changes that allow tooth movement. Aim of the Study: The aim of the present study was to evaluate the changes in alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) enzyme activity in gingival crevicular fluid (GCF) when forces are applied during initial alignment (P1) and retraction (P2). Settings and Design: The study was performed in a hospital-based population with an experimental design. Materials and Methods: Seventeen participants (11–21 years) included in the study, all requiring 1^st premolar extractions were undergoing fixed orthodontic treatment. Maxillary canine and mandibular 2^nd molar were used as test tooth (TT) and control tooth (CT) in each patient, respectively. On 14^th day after start of each phase, 2 μL of GCF was collected from mesial side of both TT and CT for ALP and LDH activity determination using spectrophotometer. Statistical Analysis: Statistical analysis was performed with SPSS (version 13, SPSS Inc., Chicago, USA) package. The significance of differences in both phases at test or, at control site for LDH and ALP enzyme activity was evaluated by performing student's paired t-test. The significance of differences in between test and control sites in each phase separately was evaluated by performing student's unpaired t-test. Results: There was a variation in enzyme activity during orthodontic tooth movement. At TT, there was statistically significant increase in ALP and LDH activity in P2 as compared to P1 with P = 0.005 and P ≤ 0.001, respectively. At CT, there was no statistically significant difference in ALP and LDH activity in P1 and P2 with P = 0.054 and P = 0.061, respectively. Conclusion: This study concluded that ALP and LDH activity could be successfully estimated in the GCF and ALP and LDH activity in GCF reflects the biologic activity in the periodontium during orthodontic tooth movements.

Objective: The objective of the study was to describe the clinical, histopathological, and immunohistochemical profile of glioblastoma in patients and to correlate these findings with patient survival. Materials and Methods: Thirty cases of histopathologically diagnosed glioblastomas were included in this study. These cases were analyzed in detail for certain clinical and histopathological parameters. Immunohistochemical staining for p53, epidermal growth factor receptor, vascular endothelial growth factor, mouse double minute 2 homolog (MDM2), and Ki67 was done, and scores were calculated. Results of these findings were correlated with patient survival. Results: A retrospective analysis of the histopathology records and clinical case files was done in thirty cases of glioblastoma (World Health Organization Grade IV). The mean age of presentation was 50.6 years with a male predilection. The most common involved site was the frontal lobe. Among the clinical parameters, age of the patient and extent of surgical resection showed a significant correlation with the patient survival. Histopathological parameters showed no significant correlation with the patient survival, while among the immunohistochemical parameters, expression of MDM2 showed a significant correlation with the patient survival. Conclusion: In this study incorporating clinical, histopathological, and basic panel of immunohistochemistry, age of the patient, extent of the surgical resection, and expression of MDM2 showed a significant correlation with the patient survival.

Schwannoma is a benign, slow-growing encapsulated tumor arising from schwann cells of the nerve sheath and believed to originate from the embryonic neural crest cells. They are common tumors of the head-and-neck region and extremities arising from the nerve sheaths of cranial and spinal nerves. We present two cases of schwannoma occurring at uncommon sites. The first case is a solitary intra-cranial schwannoma presenting in the frontal region which was radiologically diagnosed as meningioma. And, the second case presented as a polypoidal lesion in the right nasal cavity.

Primary malignant melanoma of the oral cavity is a rare neoplasm. Over 90% of melanoma occurs in skin, but they may also arise from the mucosal surfaces or other sites where neural crest migrates. Intraorally, the most common sites are the palate and gingiva followed by mandibular gingiva and lip mucosa. Oral melanoma is initially asymptomatic. It may develop as a slowly growing mass and be present for months or years before being noticed. Mucosal melanoma of the head and neck has poor prognosis, with the survival of a patient with mucosal melanoma being less when compared with cutaneous melanoma, so early diagnosis is important.

Online since 19^th September, 2016