Background: More than half of Central Nervous System tumors are benign; however, they can cause substantial morbidity. The classification of central nervous system is vital for their varied outcomes and management. The objective of this study is to provide the histopathological spectrum of central nervous system tumors in a central hospital in Nepal.Methods: The present study is a retrospective cross-sectional study conducted at Department of Pathology, Kathmandu Model Hospital, Kathmandu, Nepal from January 2010 to December 2017 of 162 cases of clinically diagnosed cases of central nervous system tumors. All patients were classified according to the World Health Organization classification of central nervous system tumors. Results: Nine of these162 patients did not have any tumor. The most common categories of tumors were astrocytic and oligodendroglial tumors (39.2%), meningiomas (21.5%), cranial and para spinal tumors (15%), tumors of sellar region including pituitary adenoma (4.5%), and metastatic tumors (3.2%). Glioblastoma(51.6%) and diffuse astrocytoma (21.6%) were the most common astrocytic and oligodendroglial tumors. The most common site of tumors in the brain was frontal (14.37%) followed by temporal (10.45%) region in the brain and dorsal region in spine.Conclusions: This study gives the current scenario of the epidemiology and clinicohistopathological aspects of different brain tumors as encountered in a tertiary level hospital in Kathmandu.Keywords: Astrocytoma; central nervous system; cranial; meningioma; tumors.
Adenolipoma of the breast is a rare tumor classified as a hamartomatous lesion. It is a well-circumscribed lesion composed of adipocytes and other breast tissues. The characteristic feature is a well-circumscribed mass containing radiolucent fat admixed with dense fibrous connective tissue surrounded by a thin radiopaque pseudo capsule. Microscopically, there is a mixture of ducts and lobules with adipose tissue. Ductal hyperplasia, adenosis, calcification, and apocrine metaplasia may occur within the hamartoma. These are rarely associated with malignancies and excision is considered curative. If these lesions are not detected clinically or radiologically, these remain unrecognized. Awareness of this poorly recognized benign entity would help avoid an incorrect diagnosis and unnecessary intervention. Here we present a case of a 35-year-old female diagnosed histologically as adenolipoma of the breast.
Glassy cell carcinoma of the cervix is a rare subtype of adenosquamous carcinoma associated with aggressive course and poor prognosis. It is considered to originate from the subcylindrical reserve cells of the cervix and has been associated with human papillomavirus. Histologically glassy cell carcinoma is composed of nestes of large cells with ground glass cytoplasm and large vesicular nuclei with prominent nucleoli. Nuclear pleomorphism and tumor giant cells are frequently seen. Mitotic activity is brisk. Infiltration by eosinophils and plasma cells with admixture of lymphocytes is a characteristic feature. Focal squamous and glandular differentiation may be seen. The immunohistochemistry markers are positive for squamous cell carcinoma (p63, CK34) and adenocarcinoma(MUC1, MUC2, CEA).Here we present a case of 49 year old female diagnosed as glassy cell carcinoma histologically and immunohistochemically.
Introduction: Chronic gastritis is a chronic inflammation of the gastric mucosa characterized by infiltration of the superficial mucosa by chronic inflammatory cells and with progressive spread to involve the whole mucosa leading to atrophy and intestinal metaplasia and may even progress to the development of carcinoma. Chronic infection with Helicobacter pylori (H. Pylori) is believed to be the major causative agent in the pathogenesis of chronic active gastritis, duodenal and gastric ulcer along with gastric carcinoma. Sydney system classifies gastritis by the intensity of mononuclear inflammatory infiltrates, activity of polymorphs, atrophy, metaplasia and dysplasia and presence of H. pylori. Methods: Observational, descriptive, cross-sectional retrospective study conducted at Department of Pathology, Kathmandu Model Hospital, Kathmandu, Nepal from January 2015 to December 2015. Record of computerized histopathology reports of all cases of endoscopic gastric biopsies were retrieved from the laboratory. The biopsy samples obtained from both body and antrum were included in the study. The grades of mononuclear cells infiltration, neutrophilic activity, metaplasia, dysplasia and glandular atrophy were determined using the Sydney system classification. The presence or absence of H. pylori was noted in the slides stained with Giemsa stain. Data analysis was done using a Microsoft Excel file. Results: Of 128 samples studied, the most common endoscopic findings were erythematous lesions and mononuclear infiltrate was seen in all cases. 61.7% showed moderate inflammation. The activity was seen in 35.9% of cases. H. pylori organism was noted in 48.4% of cases. Conclusion: The severity of chronic inflammation and neutrophilic activity are significantly associated with infection by this microorganism.
Introduction. Kimura’s disease is a rare inflammatory disorder of unknown cause, commonly seen in young Asian males. Case Report. A 61-year-old male patient presented with a history of right tonsillar mass and cervical lymphadenopathy. The patient underwent hematological investigation and imaging followed by resection of tonsillar mass. Based on histopathological and subsequent immunohistochemistry reports, the case was diagnosed as Kimura’s disease of the tonsil. Discussion. Kimura’s disease commonly presents as painless subcutaneous masses in the head and neck region or cervical lymphadenopathy. Kimura’s disease presenting as a tonsillar mass is a very rare condition. Patients usually have peripheral eosinophilia and elevated levels of serum IgE. The diagnosis is based on the clinical and histopathologic findings in a biopsy of the mass and/or lymph node along with elevated peripheral eosinophil and serum IgE level. Conclusion. The clinical presentation of Kimura’s disease is highly variable. Kimura’s disease should be considered as a differential diagnosis in patients presenting with a tonsillar mass. A high index of suspicion along with histopathological examination helps in the early diagnosis and management. Surgical excision is the treatment of choice.
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