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BACKGROUNDThe aim of the study is to assess the sensitivity and specificity of AMACR (P504S) in the diagnosis of prostatic carcinoma and to correlate serum PSA value in Carcinoma Prostate, atypia, PIN, prostatitis and nodular hyperplasia. This was an observational descriptive study carried out in Department of Pathology, Government Medical College, Kottayam. MATERIALS AND METHODSTotal of 120 cases of prostatic needle biopsies (processed routinely for H and E and IHC) during the period of 18 months from August 2014 to January 2016 were studied. Statistical analysis was done using SPSS version 16. Chi-square test was used to find if there was any statistically significant association between the levels of serum PSA and histopathological findings studied. RESULTSAmong 93/120 cases confirmed as carcinoma by H and E, 85 cases (91.3%) showed AMACR positivity. Among 5/120 cases confirmed as atypical glands suspicious for malignancy by H and E, 4 cases (80%) showed AMACR positivity. Out of 3/120 cases confirmed as PIN by H and E, 2 cases (66%) showed AMACR positivity. Out of 19/120 cases confirmed as benign prostatic hyperplasia by H and E, all the 19 cases (100%) showed AMACR negativity. High grade carcinoma (Gleason pattern 5) showed AMACR negativity. Sensitivity and specificity of AMACR in prostatic carcinoma were 90% and 100% respectively. Positive predictive value of AMACR in prostatic carcinoma was 100% and negative predictive value of AMACR in prostatic carcinoma was 65%; 99% of prostatic carcinoma showed high serum PSA value. CONCLUSIONH and E is the gold standard for diagnosing prostatic neoplasia. AMACR helps in confirming the diagnosis of carcinoma in the cases of atypical glands/suspicious of malignancy. But AMACR negativity does not exclude the possibility of carcinoma. So along with positive marker (AMACR), basal cell marker (negative marker, p63/HMWCK) is useful in diagnosing the morphologically suspicious cases. BACKGROUNDThe most common malignancy of prostate is adenocarcinoma, which accounts for more than 25% of all malignancies in men. 1 In developing countries even though prostatic carcinoma is less common, its incidence and mortality is on the rise. 2 It is a disease gaining importance worldwide. In Indian population, the incidence ranges from 5.39 to 6.58/1 lakh population. 3 Currently, the mainstay of detection of early prostatic carcinoma is by the triad of level of total serum PSA, digital rectal examination and TRUS-guided core needle

BACKGROUNDThere is an increased incidence of renal tumours every year in the last three decades, RCC being the most common. There is little published data on the spectrum of renal tumours in India, especially Southern parts like Kerala. Hence, this study is undertaken to analyse the relative frequencies of different types of renal tumours and their histopathological characteristics.The aim of the study is to find out the mean age of presentation, mode of presentation and gender predominance of renal tumours, the histopathological subtype of renal tumours and microvascular invasion. MATERIALS AND METHODSThis was a descriptive study carried out in the Department of Pathology, Government Medical College, Kottayam. 51 nephrectomy specimens of renal neoplasm received during the period of two years were studied. Statistical analysis was done using SPSS version 16. RESULTSAmong 51 nephrectomy specimens of renal neoplasm, 90.2% (46/51 cases) were of malignant tumours. Of 46 malignant cases 31/51 cases were of clear cell carcinoma, 7/51 cases were of papillary carcinoma, 5/51 cases were of chromophobe carcinoma, 1/51 were of multilocular cystic RCC and 2/51 were of unclassified RCC. Of 5 benign cases (9.8%) 2/51 were of oncocytoma, 1/51 were of solitary fibrous tumour, 1/51 were of clear cell sarcoma and 1/51 were of angiomyolipoma. Majority of renal neoplasms (90.2%) were RCC, seen predominantly in middle aged males (mean age is 52.41 years). They mostly presented with symptoms of abdominal pain (37.2%) and mass (31.3%). The classical symptom triad (macroscopic haematuria, palpable tumour and pain) was less commonly seen (8.7%). Clear cell carcinoma was the most common histological type of renal tumours (60.7%) and also had the most number of capsular (60%) and renal sinus invasion (72%), which may indicate bad prognosis. As the size, stage/ grade of the tumour increased, the symptoms did not increase. Therefore, relative paucity of symptoms does not mean that the tumour has not made much progression/ is completely curable/ resectable. CONCLUSIONIncidental tumours being in the lower stages and lower nuclear grades indicate that early detection of renal neoplasms by radiological screening may have some value. However, large scale case control studies are needed to make accurate analysis of renal neoplasms including the measurement of cancer specific survival and prognosis. The incidence rates of RCC have risen steadily each year during the last three decades in most parts of the world with an average increase of 2% to 3% per year. 1 The increased incidence is primarily due to two reasons. One is the increased detection via radiological methods like USG and CT. 'Financial or Other Competing Interest': None. Submission 24-10-2017, Peer Review 21-11-2017, Acceptance 27-11-2017, Published 11-12-2017. Corresponding Author: Dr. Lillykutty Pothen, Kaniankunnel House, Gandhinagar P. O, Kottayam. E-mail: glamskan@gmail.com DOI: 10.14260/jemds/2017/1453 Another reason is the increased prevalence of risk factors l...

True Dandy-Walker malformation [DWM]consists of cerebellar vermis hypoplasia, posterior fossa enlargement with elevation of the torcula and an enlarged 4th ventricle extending posteriorly as a retrocerebellar cyst. Other malformations with less severe cerebellar vermis hypoplasia and generally smaller posterior fossa fluid collections were categorized as ''Dandy-Walker variants''. We herein report a case of Dandy Walker Variant who presented in an unusual manner. CASE REPORT: Our patient, a 17 yrs. old adolescent male presented to the hospital with intractable vomit and unsteadiness x 3 days. On detailed elicitation of history, he was apparently asymptomatic till 3 days ago. There was no significant precipitating factor like fever, drug intake or trauma. He is not gainfully employed due to "lack of interest". He had been a poor performer at school and dropped out at 8 th Std. Patient is 3 rd born of consanguineous parents and has 2 elder siblings. Sister is mentally retarded and requires support for ADL; brother has normal mentation and physique. On Clinical Examination, patient was dehydrated, confined to bed, anthropometry was within normal limits. On detailed Neurological Examination, he had an average IQ 80-90, MMSE->18 and speech was staccato. He had evidence of cerebellar dysfunction like truncal ataxia, dysmetria, dyssynergia and nystagmus. Other parts of CNS examination were unremarkable. Laboratory Workup of Patient revealed normal blood counts and basic biochemical analysis. Patient had hyponatremia [Na+ 122MEq/L]. ECG revealed sinus bradycardia. CT scan brain revealed cerebellar vermis atrophy with posterior fossa cyst/ supra tentorial structures normal-features s/o Dandy Walker Variant. MRI Brain was s/o partial vermis aplasia, no displacement, posterior fossa cyst-Dandy Walker Variant. ECHO Cardiography was normal study. Karyotype analysis was carried out which showed normal male karyotype, trisomies ruled out. Since the patient's sister was also a retard we considered an inherited disorder and worked up the sibling sister. However, her laboratory tests, CR and MR imaging, Echocardiography and Karyotype analysis were all normal. Course in the Hospital: Patient was managed conservatively with intravenous fluids, labyrinthine stimulants. His general condition improved, electrolytes reverted to normal and he was able to resume normal activities in 2 days. His sinus bradycardia persisted though for unknown reasons. He got discharged from the hospital on day 7.

Introduction: Fungal Rhinosinusitis is broadly defined as any sinonasal pathology related to the presence of fungi and is increasingly recognized worldwide. This study aimed to assess and ascertain the need for histopathological examination in the management of fungal Rhinosinusitis. Materials and Methods:  This study was performed over two years, from April 2019 to April 2021, in the Department of Pathology, Vinayaka Missions KirupanandaVariyar Medical College and Hospital, Salem. A total of 383 cases of rhinosinusitis/nasal polyps were studied. Histopathological examination and categorization were done and compared with clinical diagnosis. Results: Only 4/18 cases of acute fungal Rhinosinusitis were correctly diagnosed(22.22%). Nineteen cases of the fungal ball were diagnosed, but none was correctly categorized. Clinical suspicion of fungal sinusitis was present in 10 cases of Rhinosinusitis, which turned out to be chronic Rhinosinusitis in histopathology. In AFRS, fungal elements were overlooked in Hematoxylin and Eosin stained slides and identified only by Grocottmethenamine silver in one-fourth of the cases. Conclusions: Though clinical diagnosis was made in 86% of fungal rhinosinusitis cases, correct categorization was done only in one-third of cases. CT scan could diagnose 60% of cases, but none was categorized. As treatment depends on the type of fungal Rhinosinusitis, histopathological examination is the gold standard for diagnosing and treating fungal Rhinosinusitis.