Background: Breast cancer is arising as the most common cancer among women. Axillary lymph node status is considered as one of the most important predictors of survival in breast cancer and a very important component to the staging system. The tumors under the skin have abundant access to the dermal lymphatic and have an increased chance of metastasizing to draining lymph nodes. Aim of the Study: To evaluate whether distance of tumor to skin can be considered as a predictor for lymph node metastasis. Materials and Methods: This was a retrospective study on all operated cases of infiltrating mammary carcinoma from January 2013 to December 2016. Both lumpectomy and mastectomy specimens with invasive carcinoma component were included in the study. The distance of the tumor was measured from the base of the epidermis of the skin to the anterior margin of the tumor on gross examination or microscopically the closest invasive carcinoma component. The distance was measured, tabulated, and correlated with the nodal status on axillary node dissection. Also, compared are the other parameters such as size, site, and grade of the tumor. Results: : Out of 200 patients enrolled, positive nodes were seen in 67.5% (135) of cases, of which tumor with distance from skin <0.3 cm show maximum nodal positivity (64.4%) and maximum cases with N2 and N3 disease (48.8%). Most important and significant finding was that 100% cases with tumor size corresponding in T2 size with skin invasion either grossly or microscopically and T3 size tumor with microscopically involving epidermis was positive for metastatic deposits in axillary nodes and 10/11 cases (90%) in T4 stage were positive. Conclusion: The distance of tumor from skin is an important predictor for Axillary lymph nodal metastasis in invasive breast cancers. Closer the tumor, the incidence of axillary nodal metastasis increases. Hence, distance of tumor from skin should be considered while evaluating a breast cancer patient.

The X-linked inherited coagulation disorders, hemophilia A (Factor VIII deficiency) and hemophilia B (factor IX deficiency), together with Von Willebrand disease comprise 95 to 97 percent of all the Inherited deficiencies of coagulation factors. (1,2) Replacement of the deficient factor is the mainstay of treatment; it may be "on demand" or "prophylactic" to prevent hemarthrosis in severe deficiency. The prevalence of hemophilia A is 1 in 5000 and that of hemophilia B is 1 in 30,000 (3,4) male live births and Von Willebrand disease with over all prevalence in the general population being 1:100. (4) Clinically both the deficiencies present as a lifelong bleeding disorder with considerable morbidity due to crippling arthropathy. Most common cause of death in these patients is Intra Cerebral Hemorrhage. Hemophilia A and B can only be distinguished on the basis of specific coagulation Factor VIII or IX assays. AIM: The present study was conducted with the aim to study the clinico-hematological profile of Persons With Hemophilia(PWH), their clinical presentations, incidence of inhibitors, estimating the burden of transfusion related complications at our hemophilia care center and to compare the findings with other studies of similar nature MATERIAL & METHOD: This retrospective study was conducted in the Department of Pathology in collaboration with Hemophilia Care Centre at Gandhi Medical College, Bhopal during the period of August 2003 to July 2013. Diagnosis was made on the basis of history, physical examination and laboratory investigations such as bleeding time (BT), Prothrombin time (PT), Activated Partial Thromboplastin Time (APTT),correction studies(factor VIII and factor IX estimation whenever possible). CONCLUSION: Bleeding after injury is obvious in healthy people but difficult to decide, when it is due to bleeding disorder. Serious congenital conditions e. g. severe hemophilia becomes obvious in early childhood but may be misdiagnosed as non-accidental injury, whereas mild cases may go undetected till later years especially those who have not undergone surgery in early adult life. Presence of hemarthrosis, bruises, hematoma either spontaneous or traumatic in an otherwise normal child should warrants for investigating in the line of hemophilia. Repeated episodes early in life show severe hemophilia. Most common cause of death was found Intra Cerebral Hemorrhage (ICH).

Lipids have a key role in the maintenance of cell integrity. Hypolipidemia is related with increased risk of cancer and mortality. Elevated calcium and alkaline phosphatase has also been seen in cancer patients having metastasis. Alteration in serum proteins also has been reported. Hence present study was undertaken in 100 histopathologically confirmed head and neck cancer patients, in Department of Pathology Gandhi Medical College Bhopal, after taking informed written consent and ethical clearance. Lipid Profile, Serum Calcium, Alkaline Phosphatase, Serum Protein with Albumin were estimated and compared with age and sex matched healthy controls. Statistical analysis was done using chi square test. Total cholesterol (TC), high density lipoprotein-cholesterol (HDLC), low density lipoprotein-cholesterol (LDLC), Very low density lipoprotein-cholesterol (VLDLC) all decreased in head & neck cancer patients. Hypercalcemia was seen in 35% of patients. Raised Alkaline phosphatase (ALP) was seen in 8 % cancer patients. Serum calcium was found to be increasing with advancing stage. Further studies should be carried out in large number of patients to confirm the role of these parameters with special attention to modifiable ones and their relation with staging and grading of cancer, which can be used as prognostic markers.

Background: Follicular dendritic cell sarcoma (FDCS) is a rare neoplasm arising from follicular dendritic cells of germinal centers. The most common site of origin is lymph nodes and it may mimic a variety of tumors at that location, including carcinomas and sarcomas. Diagnosis is frequently missed on cytology as there are very few case reports describing the cytological characteristics of the lesion. Even on histology, a high degree of suspicion is required for an appropriate diagnosis. Case: A 60-year-old male presented with a gradually increasing left submandibular mass that had been present for 3 months. Fine-needle aspiration cytology (FNAC) was performed, showing many clusters as well as scattered epithelioid cells with spindled to oval nuclei, nuclear pleomorphism, grooves, inclusions, and uniformly dispersed mature lymphocytes throughout the smears. The diagnosis of FDCS was suspected and was confirmed on histopathology and immunohistochemistry. Conclusion: FNAC can be a cheap, easy, and helpful tool in obtaining a diagnosis of FDCS as there are few characteristic cytological features that are better recognized than histology.

Neurohypophysis granular cell tumor (NGCT) is a rare entity and is classified under thyroid transcription factor 1 (TTF‐1) expressing tumors of pituitary. It is considered as an uncommon differential during sellar and suprasellar mass evaluation. Its intraoperative squash cytology is distinct and has rarely been reported in literature. A 65‐year‐old female presented with reduced vision of right eye and history of seizures. Radiological findings revealed a sellar/suprasellar mass with mass effect on optic chiasma. Intraoperative squash neurocytology examination showed a spindle cell lesion with abundant granular cytoplasm in tumor cells. Subsequent histopathology and immunohistochemistry confirmed the diagnosis of granular cell tumor. Granular cell tumor remains one of the sellar/suprasellar surprises. Its intraoperative neurocytology is unique and should be considered while evaluating a sellar/suprasellar mass. A case of sellar granular cell tumor with its intraoperative squash cytology, histopathology along with a review of literature is being presented with special emphasis on cytological differential diagnosis in pituitary region.