BACKGROUND:This study was performed to demonstrate the usefulness of horizontal and vertical sections of scalp biopsies in diagnosing various forms of primary alopecias and to highlight the importance of error-free grossing.MATERIALS AND METHODS:A retrospective analytical review of 228 scalp biopsies was done, noting down the diagnostic histopathological features evident in horizontal and vertical sections of each cases. The idealness of the sections, especially horizontal section, was also analyzed.RESULTS:Out of the 228 cases, 44 scalp biopsies were classified histologically as cicatricial alopecias and the remaining 162 as noncicatricial alopecia. 22 cases were inconclusive owing to erroneous grossing. We found horizontal sections to be more useful in cases of noncicatricial alopecias, whereas vertical sections proved superior in cicatricial alopecias.CONCLUSION:Combining both horizontally and vertically sectioned scalp biopsies maximizes the diagnostic yield. When a single biopsy is submitted, the choice between horizontal and vertical section should depend on clinical diagnosis/suspicion.

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Background:Mild perifollicular inflammation is seen in both androgenetic alopecia (AGA) cases and normal controls, whereas moderate or dense inflammation with concentric layers of collagen, is seen in AGA cases but only in very few normal controls, and may lessen the response to topical minoxidil. Moderate or dense lymphocytic inflammation and perifollicular fibrosis have poor hair growth following transplantation.Aim:The purpose of the study is to evaluate the perifollicular lymphocytic inflammation and fibrosis in AGA patients during follicular unit hair transplantation (FUT) and its comparison in normal controls.Materials and Methods:A total of 21 male patients with AGA and 7 matched controls participated in the study. Histopathological analysis of biopsy specimens from donor strip of patients during the hair transplantation and two 4 mm punch biopsies on controls were performed. Morphometric analysis was performed and perifollicular fibrosis was scored based on the width of the condensed collagen at the lower infundibulum and isthmus from 0 to 3. Perifollicular infiltrate was also scored 0-3 and a total score of 3 or more out of 6 was considered significant.Results:Nearly 76% of AGA patients had perifollicular fibrosis more than 50 μm at ×200 magnification. Almost 33.33% patients had moderate/dense perifollicular lymphocytic infiltrate whereas none of the controls had it. Total score in AGA cases was significantly higher than controls (P = 0.012) using Chi-square test. Out of 21 patients, 13 had a score of 3 or more and were followed-up with monthly treatment with intralesional steroids using a dermaroller.Conclusion:Histopathological evaluation of the donor area is a must during hair transplantation to evaluate the extent of perifollicular inflammation and achieve better results by following it up with treatment directed to decrease the inflammation.

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A 68-year-old male was admitted to Surgery department of the college with complaints of easy fatigability, pain abdomen & diarrhea since one year. He also complained of blood in stool, on and off, for last three months. His general physical and systemic examination & laboratory findings were normal except for an elevated ESR (=90 mm at the end of first hour) and anemia (hemoglobin 9.5 gm %). Chest X -ray was within normal limits. Colonoscopic biopsy was done at a different clinic, six months prior to his admission, and the microscopic examination showed "ulcerated colonic mucosa with granulation tissue, heavy mononuclear cell infiltrate and no evidence of malignancy." Subsequently, computer tomography of the abdomen was advised. It revealed circumferential wall thickening with intramural mass involving caecum & ascending colon along with multiple enlarged pericolonic lymph nodes. There was no hepatosplenomegaly. A provisional diagnosis of colonic carcinoma was made and the patient underwent right hemicolectomy.The resected specimen received in our pathology department was that of a colonic segment measuring 45cms in length, with the mucosal aspect being studded with a multitude of sessile polyps of varying sizes, largest measuring 3.5 x 2.5 x 1.8 cm [ ABSTRACTMultiple lymphomatous polyposis is considered to be a rare condition, with most of the cases being extranodal counterpart of mantle cell lymphomas. We report a rare case of multiple lymphomatous polyposis of the gastrointestinal tract in which the patient presented with abdominal pain and bloody diarrhea. Computer tomography of the abdomen showed circumferential wall thickening with intramural mass involving caecum & ascending colon with enlarged pericolonic lymph nodes. The patient underwent right hemicolectomy.Immunohistologic findings were characteristic of MALT lymphoma. Microscopic examination of polypoidal masses and mesenteric lymph nodes revealed infiltration by pleomorphic, atypical lymphoid cells which were CD20 positive and negative for CD3, CD10, Cyclin D1. Lymphoepithelial lesions were also noted. Careful endoscopic evaluation and histopathological review along with an immunohistochemical panel is extremely useful for accurately diagnosing such cases and avoiding unnecessary surgery and inappropriate therapy.