Sclerosing stromal tumor is an uncommon subtype of sex cord–stromal tumor of the ovary. It occurs in young females who present with pelvic pain and menstrual irregularities. We present a case of an 18-year-old female who was brought to emergency room with a history of blunt trauma abdomen after road traffic accident. A diagnosis of hemoperitoneum was made, and the patient underwent emergency exploratory laparotomy. An incidental right ovarian mass was found which was removed and sent for histopathological examination. Histomorphology of this lesion showed variable findings with extensive edema and paucicellularity. Few thin wall blood vessels were also observed. The possible differential diagnosis on gross and microscopic examination included sclerosing stromal tumor, fibroma, thecomas, granulosa cell tumor, and edema of the ovary. In view of diagnostic dilemma, special stains for collagen and reticulin were done. In addition, immunohistochemistry (IHC) for CD99, smooth muscle actin, and desmin was put up. A diagnosis of sclerosing tumor of the ovary was made based on histomorphology and findings of ancillary tests. In general, ancillary tests are not required to diagnose sclerosing ovarian tumor as it has characteristic histological features. This case highlights the usefulness of special stains and IHC in sex cord tumors with overlapping microscopic features.
A 56-year-old male presented with vague and non-specific scrotal pain, on and off for the past eight months. He also noticed two nodular swellings, one on either side of the lower pole of the testes for the past three months. Both the swellings were insidious in onset, painless and synchronously affecting bilaterally. He gave no history of trauma, fever, dysuria or haematuria. He is hypertensive for the past five years. He had undergone bilateral hernioplasty and haemorrhoidectomy in the past.
Background: Histological grading is the most important prognostic factors and the best indicator of metastatic risk in adult soft tissue sarcomas. It has been shown that Ki67 immunohistochemical (IHC) staining is an effective method of assessing the prognosis in a number of tumor types. Ki67 is a cell cycle antigen which is elevated in proliferation states. High level of Ki67 expression is an independent prognostic indicator that correlates with poor outcome in patients with sarcomas. Methods:In this study 53 cases of soft tissue tumor were selected and were classified according to FNCLCC system. IHC staining of Ki-67 was done in all the 53 samples. Diagnosis was made mainly based on histopathological pattern analysis and with the use of IHC.Results: By using FNCLCC grading soft tissue tumor cases were graded as grade I, II and III. The correlation between the FNCLCC grading and Ki67 was done and it was observed that there was statistically significant positive correlation between Ki67 and the grade of the tumor, as evidenced by P-values of 0.002, 0.005 and 0.004. The correlation between the FNCLCC grading and Ki67 index was also assessed. Statistically significant positive correlation between Ki67 index and the grade of the tumor was observed. Conclusion:There was significant correlation noted between FNCLCC grading and Ki-67 index. Thus it can be recommended that Ki-67 IHC stain should be done on routine basis to accurately grade the sarcomas so that it will be beneficial for the management of the patient.
Introduction and Aim: Aberrant over expression of PD L1 by tumours and tumour infiltrating lymphocytes provide an immune shield to the tumours. The present study aims to evaluate the effect of over expression of PD L1 in tumour cells and tumour infiltrating lymphocytes on various clinicopathological aspects of gastric carcinoma including the follow up and survival analysis. Materials and Methods: Paraffin blocks were retrieved from 100 cases of primary gastric carcinoma who underwent curative resection. Immunostaining was done using a qualitative immunohistochemical assay from Ventana Roche with rabbit monoclonal anti PD-L1 clone SP142 intended for use in the assessment of the PD-L1 protein in formalin -fixed, paraffin -embedded (FFPE) tissue. Results: Out of 100 cases 65 were males and 35 were females. PD-L1 expression is observed in tumour cells in 17 cases and tumour infiltrating immune cells in 44 cases. Statistically significant correlation of expression of PD-L1 was observed with the clinicopathological characteristics like, larger tumour size (p value 0.03), lymphovascular invasion (p value 0.01), lymph node metastasis (p value 0.01) and higher tumour stage (p value 0.02). Two years follow up did not show any statistically significant correlation between PD-L1 expression in tumour cells and tumour infiltrating immune cells and survival (p value 0.27). Conclusion: Present study shows a substantial expression of PD-L1 in patients with gastric carcinoma. Hence PD-L1 immunohistochemistry can be potentially helpful in screening candidates for anti PD-L1 therapy.
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