Indian Journal of Pathology and Oncology

173-177

Authors: Ankit Ojha1, Tanu Agrawal, Shubhanshu Gupta, Pragati Singh, Arushi Agarwal

Introduction: Gall bladder carcinoma accounts for 0.3-0.7% of all cancers and has a peak incidence among women aged 70 and 79 years. Recently many molecular markers like Ki-67, cyclin D1, MUC1 and p53 with prognostic impact on GBC have been described. Ki-67 is a proliferative marker which is expressed in all active phases of the cell cycle and it can be detected in the nucleus of tumour cells indicating its proliferative activity. The aim of this study is to evaluate the expression of Ki-67 in carcinoma of gall bladder by immunohistochemistry and to correlate the mean Ki-67 labelling index with the various histological grades of gallbladder carcinoma. Materials and Methods: All the histopathologically proven cases of gall bladder malignancy from July 2014 to June 2017 (n=44) were examined for Ki-67 expression immunohistochemically.Ki-67 labelling index was calculated. ANOVA test and independent ‘t’ test were applied to see correlation of Ki-67 expression with various grades of gall bladder carcinoma. Results: The Ki-67 labelling index was minimum in well-differentiated adenocarcinoma of gall bladder and maximum in poorly differentiated adenocarcinoma of gall bladder. The p value amongst these groups was found to be statistically significantly different. Conclusion: 88.64% of Gall bladder carcinoma was positive for Ki-67 and the Ki-67 labelling index increased significantly as the histological grade increased.

184-188

Authors: Komal Sawaimul, M. Banyameen Iqbal, Vijayalaxmi Sawaimul, Tusar Kambale

Introduction: Lymphadenopathy is one of the commonest clinical presentations in children and a common scenario for pediatrician. Unexplained lymphadenopathy often poses a great deal of anxiety and concern in parents. Fine needle aspiration cytology (FNAC) is a minimally invasive, cost effective and a well established technique as a high diagnostic efficacy tool. FNAC especially in benign inflammatory condition has aided in clinical practice by avoiding unnecessary excision biopsies also limiting its complications and psychological trauma to patient. The present study was conducted to evaluate FNAC as a diagnostic tool in pediatric lymphadenopathy and study spectrum of various cytomorphological patterns in paediatric age group. Materials and Methods: The present study was undertaken in the Department of Pathology, in a tertiary care hospital in Maharashtra. Reports of 312 pediatric FNAC (<16years) of various lymph nodes were studied from July 2014 to November 2017 retrospectively. Results: Maximum number of aspirates were found in 12-16 years (38.78%) i.e older age group and were of benign nature i.e. 96.80% with remaining (3.20%) malignant in nature. Anterior cervical lymph nodes predominate over other lymph nodes (41.02%) followed by posterior cervical lymph nodes (31.40%) when FNAC anatomical site subdivision was done. Maximum number of aspirates were found to be reactive lymphadenitis (61.53%) followed by tuberculous lymphadenitis (8.65 %). Conclusion: To conclude fine needle aspiration cytology has emerged as a reliable initial screening tool in all the lymphadenopathy cases in pediatric age group due to its cost-effectiveness and high diagnostic accuracy. A spectrum of different lesions can be evaluated by using FNAC. Pediatrician plays a very important role by taking initiative in referring all the pediatric patients for FNAC, in a resource limited settings like India.

195-201

Authors: Gorijavolu Durgaprasad

Introduction: There exists a wide variation in the response of tumors to radiotherapy and prognosis from individual to individual after radiotherapy to carcinoma of uterine cervix in all stages. Before embarking on treatment one would like to be forearmed with the knowledge that the treatment outcome would be good. Apoptosis is an important mechanism in predicting response to radiotherapy in squamous cell carcinoma of uterine cervix. Objective: Prospective study to correlate the relation between markers of cell proliferation (MI), cell death (AI), and MI to AI ratio as an independent prognostic factors in patients of carcinoma of uterine cervix treated by radical radiotherapy. Materials and Methods: 56 evaluable subjects of squamous cell carcinoma of uterine cervix during the period from May 1999 to December 1999 were enrolled in the study and patients were followed for 2 years. Measurement of Apoptotic index (AI) and Mitotic Index (MI) was done by microscopic method only. All subjects received radiation to a dose of 70 Gy using standard technique. Results: Patients with Apoptotic Index (AI) less than median value of 0.75% and Mitotic Index (MI) greater than median value of 0.2% showed better response to radical radiation therapy at 2 years. However the difference is not statistically significant (p = 0.20 and 0.25 respectively). Patients with AI/MI less than median value of 0.3 showed better local as well as overall control of disease when compared to patients with AI/MI ratio greater than median value of 0.3. The difference is statistically significant (p = 0.03). Conclusions: Besides traditional prognostic factors like stage, lympho-vasular invasion, AI/MI ratio will provide a guide for response to radiotherapy and prognosis.

208-211

Authors: Shweta Grover, Rani Bansal

Introduction: Basal cell carcinoma is the most common type of skin cancer and occurs mostly in the head and neck region in middle age to elderly people. It has varied clinical presentation and also many morphologic/histopathologic subtypes. Aim of the Study: To study the spectrum of basal cell carcinomas in our institute over a nine year period. Materials and Methods: This was a prospective study carried out at Subharti Medical College, Meerut, Uttar Pradesh, over a period of nine years. All the basal cell carcinomas reported during this period were studied for clinical presentation, demographic details, anatomical location of tumor, macroscopic and microscopic appearance. Results: A total of 28 cases of BCC were reported. The patient age ranged from 14 to 85 years and the male to female ratio was 2.1:1. Most of the cases occurred over 40 years and all the tumors occurred in the facial region. Clinically, ulcerative and nodular presentation was more common. One case of nevoid BCC syndrome was also seen. Conclusion: Basal cell carcinoma commonly occurs in the face region and its incidence increases with advancing age. It has varied clinical presentations and histologic subtypes. Early diagnosis gives better prognosis. Basal cell carcinoma in a young person or child should be evaluated for nevoid BCC syndrome.

216-220

Authors: Pradyumn Singh, Anurag Gupta, Namrata P Awasthi, Ashish Singhal, Gaurav Gupta

The WHO 2016 update on lymphoid neoplasms incorporates criteria independent of tissue architecture in the diagnosis and sub-classification of non-Hodgkin lymphoma. Thus, lymphoid neoplasms with characteristic immunophenotypes and/or cytomorphology could be classified with FNA material with appropriate use of ancillary methods. We analysed the efficacy of cytomorphology and cell block immunocytochemistry (CB-ICC) in in diagnostic workup of non-Hodgkin lymphoma diagnosis on FNA material. 65 clinically suspected cases of lymphoma presenting with lymphnode enlargements were analysed. FNAC and CB-ICC were performed and compared with the subsequent biopsy. The sensitivity, specificity, PPV and NPV of CBICC in the diagnosis of NHL were 84.6%, 75%, 95.6%, and 42.8%, respectively in our study. We also observed that use of CB-ICC can have significant logistic implications in patient management in terms of reducing the turn-around time to diagnosis and improving the accuracy in diagnosis on FNAC. ICC on cell blocks can easily be done on FNA material and is a very useful adjunct to FNAC in establishing the diagnosis in a suspected case of NHL especially when a biopsy is not available

230-236

Authors: Jenita Christiana Samson, Umamaheswari Karuppanan, Hemalatha Ganesan, Sudha Velusamy, Priya Thangara

Aim: To determine the prevalence of vitamin B12 deficiency in subjects with anaemia and elevated mean corpuscular volume. Materials and Methods: Blood samples from 119 subjects were selected for the study based on the inclusion and exclusion criteria laid down. Blood samples were analysed on sysmex KX 21 haematology analyser. Morphological evaluation of blood cells was done on peripheral blood smear. Serum vitamin B 12 assays were done. Qualitative and quantitative variables were analysed by statistical methods. Results: Out of 119 subjects taken for study 70 (58.8 %) were male and 49 (41.2 %) were female with mean age ± SD 40.5± 18. Vitamin B 12 deficiency was noted in 82 (69 %) of which 12 (10.1%) were in Borderline levels of deficiency, 31 (26.1%) were in deficient levels and 39 (32.8%) were in severely deficient group. Red blood cell indices were categorized as per different groups of vitamin B 12 levels. Pancytopenia was noted in 67.1% (54) of B 12 deficient individuals. Significant negative correlation was found between vitamin B 12 levels and mean corpuscular volume (r = - 0.215 .p = 0.019). A positive correlation was found between vitamin B12 and platelet count. (p= < 0.001) and also with leukocyte counts (p value < 0.001) These correlations were found to be statistically significant. Peripheral blood film examination shows macrocytosis in 76 (64%) smears and hypersegmented neutrophils in 66 (56%) smears

242-248

Authors: Ch. Geetha, M. Pavani, Shailaja Prabhala, A.K. Deshpande

Introduction: Colonoscopy and accompanying mucosal biopsy is the diagnostic tool of choice in the evaluation of patients with colo rectal pathologies. The objectives of this study were to study the histo morphological spectrum of colonoscopic biopsies, to find age, gender, site distribution of these lesions and to correlate them with clinical presentation and colonoscopic diagnosis. Materials and Methods: The study included all the colonoscopic biopsies received at Department of Pathology, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad from January 2015 to December 2016, over a period of two years. Results: There were 198 colonoscopic biopsies during this period. Two biopsies were inadequate for opinion and were excluded from the study. All the colorectal resection specimens, anal lesion were excluded from the study. Out of total 196 biopsies, 104 were non-neoplastic lesions, 92 were neoplastic lesions. Mean age of patients was 49.7 years with a male to female ratio of 1.6:1. Most common location of the lesion was rectum. The most common presenting complaint for both non-neoplastic and neoplastic lesions was bleeding per rectum. Non-specific colitis was commonest non-neoplastic lesion followed by ulcerative colitis. In the neoplastic lesions, adenocarcinoma was the commonest subtype followed by adenomatous polyps. Conclusion: Both neoplastic and non-neoplastic lesions equally affect colon. Non-specific colitis, ulcerative colitis, Crohns disease, tuberculosis, amoebic colitis, eosinophilic enteritis, hamartomatous and hyperplastic polyps were the various non neoplastic lesions encountered in our study. Adenocarcinoma was the most common malignancy on colonic biopsies. Carcinomas occurred at a later age than adenomas. Colonscopic diagnosis correlated well with histopathology diagnosis in carcinomas.

254-261

Authors: Amritha Malini. G, Mary Nandini Singh, K.A. Aisabi

Introduction: Breast carcinoma is the most common malignancy in women. Fine needle aspiration Cytology (FNAC) is an important component of triple approach for diagnosing breast lesions and is highly sensitive, specific, rapid and easy to perform. FNAC has an important role in the preoperative evaluation of breast lesions and deciding treatment. Materials and Methods: The present study was carried out among 350 patients who presented to a tertiary care hospital in North Malabar during a 4 year period from June 2013- June 2017. All cases that presented with breast lump were evaluated with FNAC and the lesions were categorised as C1- C5 as per National Health Service Breast screening programme (NHSBSP) reporting criteria. In 240 cases cytohistopathological correlation was obtained and diagnostic accuracy of FNAC was determined. Aims: To study the spectrum of benign and malignant breast lesions and the efficacy of FNAC as a diagnostic tool by correlating with histopathological findings. Results: Statistical analysis showed that sensitivity of FNAC was 99.46% in benign lesions and 96.2 % in malignant lesions. The specificity and positive predictive value of malignant lesions were 99.46% and 98.07% respectively and that of benign lesions were 96.2% and 98.93% respectively. Conclusions: FNAC serves as a rapid and reliable tool for evaluation of breast lumps with high sensitivity and specificity. However, grey zone lesions of breast which shows atypical / suspicious morphology needs confirmation by biopsy.

269-272

Authors: Sidhaling Reddy, Vinay Kumar .R, Anirudha V .Kushtagi, Hemavathi Reddey, Kazi Wajid Husain

Introduction: Fine needle aspiration cytology is fast becoming preoperative method of choice for diagnosis and management of various lumps and lesions since few decades. It helps clinician to decide mode of treatment in most cases in both non-neoplastic and neoplastic disorders. The aim of our study was to assess utility of FNAC in the diagnosis and management of lymph node disorders and distribution of these lesions according to different lymph node groups and age and sex distribution of these lesions. Materials and Methods: The present study was done during the period between December 2015 and May 2017 in the department of pathology (central clinical laboratory), Koppal Institute of medical sciences, Koppal. 10ml syringe and 23/24 gauge needles were used for the procedure. Material obtained was expressed on slide and smears were made by standard smearing technique. Both wet and air dried smears were made. Wet smears were stained with Haematoxylin and Eosin stain and dry smears with Lieshman stain and Giemsa stain. Ziehl-Neelson staining for acid fast bacilli was done wherever required. Results: We assessed 204 cases of lymphadenopathy cases. We got satisfactory aspirate in most (97.1%) cases. Cervical group of lymph nodes were most commonly (82%) involved. Granulomatous lesions were most common in young adults and reactive nonspecific lesions were most common in paediatric group. Metastatic carcinomas were most common type after 50yrs age group. Conclusion: Fine needle aspiration is simple, rapid and cost effective method to know the cause of lymphadenopathy. It significantly reduced unnecessary surgical biopsy for diagnosis of lymphadenopathies in our case

277-282

Authors: Anitha Padmanabhan, Sonali Rajesh Saraf, Vandita Singh, Nikita Anil Patel

Introduction: Fine needle aspiration cytology (FNAC) forms one of the first diagnostic tools in evaluation of soft tissue lesions. Aim of this study was to evaluate the role of FNAC in the primary diagnosis of soft tissue tumors and tumor like lesions and to assess the effectiveness of FNAC in the histological subtyping and grading of soft tissue tumors. Materials and Methods: We reviewed FNAC smears of 170 soft tissue tumors and tumor like lesions over a 3 years period and correlated with the histopathological features which were available in 117 cases. Conventional Papanicolaou (PAP) and Giemsa staining was done in all cases. Results: 152 out of 170 cases [89.41%] were neoplastic, of which 130 tumors were labelled as benign. Lipoma constituted 83.07% of benign tumors. Based on the predominant cytomorphological features and background, the tumors were classified into myxoid (4), spindle cell (20), pleomorphic (2), small round cell(4), epithelioid /polygonal cell (7), lipomatous (108) and miscellaneous (7). The non-neoplastic lesions included tuberculosis, filariasis, actinomycosis, scar endometriosis and calcinosis cutis. Conclusion: FNAC proved to be helpful in distinguishing between neoplastic and non-neoplastic soft tissue lesions, differentiating metastatic carcinoma and melanoma in soft tissue from primary soft tissue tumors and differentiating benign and malignant soft tissue tumors. Accurate subtyping was possible in many tumors of myxoid category and round cell tumors. Spindle cell tumors of intermediate grade were difficult to grade on FNAC. Pleomorphic sarcomas were of high grade and their subtyping could not be done on FNAC

286-289

Authors: D. Umesh, Arumugam P

Introduction: FFP contains the labile as well as stable components of the coagulation, fibrinolytic and complement systems. The use of plasma and its products has increased manifold over the four decades. In blood transfusion service, the primary goal of quality is 'transfusion of safe unit of blood.' Aim of the Study: To ensure that the prepared fresh frozen plasma (FFP) consistently met the requirements for quality and to find out the potency and possible extension of shelf life of fresh frozen plasma once thawed and refrozen within stipulated period. Materials and Methods: 66 units of FFP prepared by Platelet Rich Plasma (PRP) method were divided into two groups. Group 1 comprised of 33 samples, which were tested on 0 day, last week of 12th month and last week of 18th month. Group 2 comprised of remaining 33 units which were tested on 0 day, thawed and tested on 1st week of 12th month and were again refrozen within 12 hours of thawing. Later, the refrozen units were again retested on the last week of 12th month. All the FFP units were evaluated as per the DGHS Guidelines. Results: Group 1: The quality of fresh frozen plasma stored at -30OC for 12 months adhered to quality parameters but on extended storage period (-30OC for 18 months) showed non-compliance to the standardized quality control. Group 2: Refrozen thawed plasma complied with all quality parameters. Discussion: Fibrinogen and Factor VIII levels, which were representative of stable and labile factors respectively, were within normal limits in both the study groups when stored at standardized temperature and time, but showed non-compliance to the standardized quality control at extended time. Refrozen thawed plasma retained all coagulation factors. These findings were in concordance with the DGHS Standards and various other studies. Conclusion: Fresh Frozen Plasma should be used judiciously and if thawed plasma is not used for some reasons, it should not be discarded. The thawed FFP can be refrozen and added up to the inventory and hence, useful to the society

294-297

Authors: Archana Gupta, Swati Gupta, Aneeta Singh, Arvind Khajuria

Introduction: Microcytosis is a condition in which red blood cells are unusually small as measured by their mean corpuscular volume.1 The most common cause of microcytosis is iron deficiency anemia.2 In severe microcytosis, both thrombocytosis and thrombocytopenia may be seen although thrombocytosis is more frequently seen. Aim and Objectives: To study the values of platelet count and mean platelet volume in cases of severe microcytosis. Materials and Methods: A 1 year prospective study (1st January 2017 to 31st December 2017) of 200 patients was carried out in the Post Graduate Department of Pathology, Acharya Shri Chander College of Medical Sciences (ASCOMS) and Hospital, Sidhra after obtaining due clearance from Institutional Ethical Committee. Platelet count and mean platelet volume (MPV) of 200 patients with low mean corpuscular volume (MCV) was done. Results: A total of 200 patients with severe microcytosis (MCV <60 fl) were evaluated for platelet counts and mean platelet volume. Thrombocytosis was seen in 160 patients (80%), thrombocytopenia in 5 patients (2.5%), whereas normal platelet count was seen in 35 patients (17.5%). The mean platelet volume was low in 141 patients (70.5%), high in 4 patients (2.0%) and normal in 55 patients (27.5%). Conclusion: Both thrombocytosis and thrombocytopenia may occur in severe microcytosis although the incidence of thrombocytosis was very high (80%) in our study. There is an inverse relationship of mean platelet volume and platelet count in severe microcytosis.

302-307

Authors: M. Pavani, Ch. Geetha, L. Peter Ericson, Ashok Kumar Deshpande

Introduction: In this era, as the life expectancy is increasing, women are experiencing a long postmenopausal phase. Postmenopausal bleeding (PMB) is a sinister complaint and accounts for about 10% of postmenopausal complaints. Being a symptom of varied etiologies and its strong association with malignancy, it should be diligently evaluated. Aims and Objectives: 1. To evaluate the histopathological spectrum of lesions presenting as PMB. 2. To estimate the incidence of premalignant, and malignant lesions presenting as PMB. 3. To confirm the benign nature of the lesions to prevent unnecessary radical treatment. Materials and Methods: This prospective study done from January 2016 to September 2017 and included the endometrial biopsies/curettages and cervical biopsies sent for histopathological examination from clinically diagnosed cases of postmenopausal bleeding. Results: Out of all the samples majority were benign lesions (44%), followed by premalignant (25.7%), malignant lesions (18.3%). Conclusion: A variety of histopathological findings are seen in PMB. Benign pathologies were more common in our study but the collective proportion of premalignant and malignant lesions is considerably higher in this study. Accurate diagnosis makes it much easier to counsel the patient about further course of management, prevent unnecessary radical treatment for benign conditions, prompt treatment, and vigilant follow up for malignant lesions.

314-317

Authors: Lawrence D’Cruze, Susruthan M, G Barathi, Leena D Joseph, Suresh Varadarajan, Sandhya Sundaram

Introduction: The term “small round-cell tumors” (SRCT) describes a group of highly aggressive malignant neoplasms composed of small, monotonous cells with high nucleocytoplasmic ratios. Microscopic tumor burden, pre and post therapy tumor necrosis quantification and mitotic index may help as an alternative method of assessing the prognosis in these patients. Aims: Morphometrical analysis of the spectrum of small round cell tumors over a period of five years and its role in grading the tumors with respect to microscopic tumor burden, tumor necrosis and mitoses. Materials and Methods: This study included 39 cases of small round cell tumors (19 NHL, 6 Ewings/PNET, 3 atypical carcinoid, 3 olfactory neuroblastoma, 2 cases each of rhabdomyosarcoma, wilms tumor, neuroblasoma and monophasic synovial sarcoma across all age groups. The study was confined to bone and soft tissues. The microscopic tumor burden and tumor necrosis was assessed using computer assisted morphometric analysis by digital processing. Concurrently the number of mitosis were studied and correlated. Results: Thirty nine cases of small round cell tumors were morphometrically analyzed using image pro-plus analysis soft ware 5.0. The mean of microscopic tumor burden / necrosis / mitoses were compared among the four commonly encountered small round cell tumors namely atypical carcinoid, non-Hodgkins lymphoma (NHL), olfactory neuroblastoma, Ewings/PNET using Kruskal-Wallis Test. The difference was significant with respect to necrosis (p=0.003) and mitoses (p=0.003). Similarly inter group comparison of mitoses and necrosis were done for atypical carcinoid, NHL, olfactory neuroblastoma and Ewings/PNET using Mann-Whitney U Test. Inter group comparison of necrosis showed that the mean tumor necrosis of Ewings/PNET was more when compared with NHL, atypical carcinoid and olfactory neuroblastoma, showing a significant p value of 0.002, 0.020 and 0.018 respectively. The mean mitotic figures of Ewings/PNET when compared with atypical carcinoid and olfactory neuroblastoma were statistically significant (p0.020 and 0.020 respectively). Similarly, mitotic figures of NHL were more when compared with atypical carcinoid and olfactory neuroblastoma (p0.006 and 0.006). Conclusion: The above results reveal that Ewings/PNET have relatively more tumor necrosis, mitosis compared to other SRCT. In the forthcoming years, it will be extremely useful to find out the reversal of these patterns as the tumors are subjected to chemotherapy and radiotherapy

326-331

Authors: Vidya Vasudev, Geetha S, Rejani K., Bharthi. M

Introduction: Postmenopausal bleeding is regarded as an omnious and serious alarm of genital pathology. It is a symptom having various etiology and has a strong association with malignancy, which demands its thorough evaluation. Aims and Objectives: The present study was carried out to know the causes of postmenopausal bleeding based on histopathology and the percentage of various benign premalignant & malignant lesions in postmenopausal bleeding. The association with age was also studied. Methodology: This study included 139 specimens received in in Department of Pathology MMC & RI Mysore, with history of postmenopausal bleeding, from January 2013 to December 2014. Results: Mean age of the patients in the study was 57 years. Cervical biopsy was most common biopsy received (43.8%). Benign cases were 51.6%, malignant cases 36.07% and premalignant lesions were 9.27%. Among the benign lesions atrophic endometrium was most common (11.2%). Cervical cancer was most common (33%) among malignancy. Conclusion: Any patient presenting with history of postmenopausal bleeding should be investigated thoroughly to determine the cause of bleeding. Cervical lesions are still the most common cause postmenopausal bleeding so screening programme should be effectively implemented.

338-340

Authors: Mandakini Patel, Mala Jain, Ravi Lotlikar

Introduction: The aim of the study is to find out various cervical lesions with histopathological correlation and age. Materials and Methods: This is a retrospective study conducted at department of Pathology in Tertiary care center from January 2015 to October 2015. The data of 208 patients were retrieved from past records who were diagnosed with various cervical lesions. Cervical biopsies were available for 119 cases and specimens of uterus with cervix were found in 88 cases and vault biopsy in one case. Results: Out of 208 cases, 67 cases (32.2%) were that of Chronic non-specific cervicitis, 33 cases (15.86%) were papillary endocervicitis, 24 cases (11.5%) were Cervical intraepithelial neoplasia (CIN), 72 cases (34.6%) were cervical cancer, 6 cases(2.8%) were hyperplasia, One case (0.9%) showed squamous metaplasia with koiliocytic changes, 4 cases (1.9%) did not show any remarkable pathology. Most common age group from squamous cell carcinoma were 41-50 years. Conclusion: Most common cervical lesion is Squamous Cell carcinoma and most common age group is 41-50 years

345-348

Authors: Afnan Gul, Sandhyalakshmi B.N, Srinivasa Murthy V

Carcinoma of breast is rare in men with an estimated incidence of one per 100,000 per annum. Of all the histological types of breast cancer, Intra-cystic papillary carcinoma (IPC) of the breast is rare accounting for less than 1% of all breast malignancies. A 61 year old gentleman presented with painless, progressively enlarging lump in his left breast since 3 years associated with serosanginous nipple discharge of 3 months duration. On examination, a single 8 x 3 cm well defined cystic swelling in the retro-areolar region was felt with normal overlying skin and nipple-areola complex. No axillary lymph nodes were palpable. FNAC of the lump showed features of infiltrating ductal carcinoma. Patient was taken up for modified radical mastectomy under general anaesthesia. Histopathological examination of the specimen revealed a cyst measuring 7x4 cm containing hemorrhagic fluid. On gross examination, the cyst wall exhibited grey white papillary excrescences that protruded into the lumen. Histopathological diagnosis of intracystic papillary carcinoma was given. Being a rare entity, there is no definite guideline for the treatment of IPC; however, a surgical excision with a clear resection margin forms the mainstay of the treatment. These patients have very good outcome. The addition of hormonal treatment does not appear to have an impact on the patient outcome

352-353

Authors: Smita Masamatti, Vijaya. C.

Apocrine hidrocystoma (AHC) are benign adnexal cystic tumours of the skin. They are uncommon and are usually found in the head and neck area. Nevus sebaceous (NS) is a hamartoma which is present since birth and is associated with many benign and malignant tumours such as trichoblastoma, trichilemmoma, sebaceoma, nevocellular nevi, keratoacanthoma, basal cell carcinoma etc. Apocrine hidrocystoma arising from a nevus sebaceous located over scalp region is extremely rare with less than five cases being reported till date. We report an interesting case of a 55 year old male who presented with a nodule over the scalp. A clinical diagnosis of sebaceous cyst was made. On histopathological examination, it turned out to be apocrine hidrocystoma arising in the background of nevus sebaceous

357-359

Authors: Ranjan Agrawal, Miti Gupta, Jagdamba Sharan, Parbodh Kumar

Lipomas may occur anywhere within the body. However, their occurrence in the digits is very rare. We report 2 cases of lipoma in the digits. The first case is of a 70 years lady who had a soft painless swelling in the left thumb while the second case was of a 40 years lady who presented with a swelling over the medial aspect of right foot. Excision biopsy in both the cases proved them to be lipoma. The cases are presented due to the rarity of their sites as only 14 cases of lipoma in the digits have been reported earlier.