Psammomatoid juvenile ossifying fibroma of maxilla

: An uncommon neoplasm p. 191
Jyotsna Naresh Bharti, Ashok Singh, Jitendra Singh Nigam
DOI:10.4103/ccij.ccij_8_18  
Juvenile ossifying fibroma (JOF) is a rare variant of ossifying fibroma. JOF is classified into two distinct clinicopathological variants: Trabecular and psammomatoid JOF. Based on the age group involved, most common site of occurrence and clinical behavior, JOF differs from the larger group of ossifying fibromas. We report a case of psammomatoid JOF of maxilla in a 10-year-old female who presented with a swelling over the right side of the face.
http://www.ccij-online.org/currentissue.asp?sabs=y

Carcinosarcoma of the submandibular gland with a rhabdomyosarcoma component

: A case report and review of the literature p. 187
Suma M Narayana, Smrita Singh, Rekha V Kumar
DOI:10.4103/ccij.ccij_83_18  
Carcinosarcoma of the salivary gland is a rare and aggressive malignancy with a poor prognosis. These neoplasms are composed of malignant epithelial and mesenchymal elements. This report describes a new case of carcinosarcoma arising in the submandibular gland, which had a rhabdomyosarcoma component, without clinical or histological evidence of a preexisting pleomorphic adenoma. Till date, only two case reports have described the occurrence of carcinosarcoma with a rhabdomyosarcoma component in the salivary gland, to the best of our knowledge. Histological and immunohistochemical results are presented. The literature is reviewed, and the possible histogenesis and pathogenesis of carcinosarcoma (true malignant mixed tumor) of the salivary gland are briefly discussed.
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Years with anxiety and headache

Recurrent pilocytic astrocytoma after 5 years with anxiety and headache p. 184
Mazaher Ramezani, Shima Jalalvandi, Zahra Torkchin, Masoud Sadeghi
DOI:10.4103/ccij.ccij_66_18  
Pilocytic astrocytomas (PAs) account for 25% of all pediatric brain tumors and commonly occur in the first two decades of life. Recurrence and/or regrowth of residual tumors are not common and mostly occur within 4–5 years of the first surgery. Herein, we reported a 16-year-old male adolescent with neurological symptoms and signs that pathologic specimens confirmed the diagnosis of PA. The patient underwent 27 sessions of radiotherapy without surgery. After 5 years, at the age of 21, the patient readmitted with anxiety and headache and the recurrence of the same tumor with the same grade. We suggest follow-up of the patient after initial treatment for at least 5 years with considering any neurological symptoms including behavioral changes.
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Apoptotic indices are useful in distinguishing between benign and malignant squamous lesions

Operational role of apoptotic index in premalignant and malignant squamous lesions: An apprise p. 180
Sheetal Arora, Deepshikha Rana, Indrani Dhawan, Rashmi Arora
DOI:10.4103/ccij.ccij_80_17  
Background: The aim of the study was to evaluate the role of apoptotic index (AI) in premalignant and malignant squamous lesions of different sites on light microscopy. Materials and Methods: Retrospective study of 75 cases of premalignant and malignant squamous epithelial lesions of different sites was done. All slides were H and E stained, screened for apoptosis under ×40. AI was calculated as the number of apoptotic cells and apoptotic bodies, expressed as percentage of total number of tumor cells counted in each case. Results: On statistical analysis, it was found that the difference in the apoptotic indices in all the subgroups of dysplasia was not statistically significant. However, the significant statistical difference was found within the malignant group, P value between well-differentiated squamous cell carcinoma (SCC) and moderately differentiated SCC (MDSCC) was <0.0001. P value obtained between MDSCC and poorly differentiated SCC was 0.0006. Conclusion: We conclude that apoptotic indices are useful in distinguishing between benign and malignant squamous lesions. Several indices such as proliferating index (Ki-67) and AgNOR count are not routinely available in various hospitals, especially in developing countries. The advantage of this technique is that it can be calculated in routine H and E stained sections, and so it saves time. Although it is labor-intensive, it is cost-effective method which can benefit the patient as it correlates well with tumor aggressiveness and thereby increasing the prognosis of the patients.
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Computed tomography-guided fine-needle aspiration and concurrent core biopsy

 in diagnosis of intrathoracic mass: An evaluation of 54 cases in a tertiary care hospital p. 176
Rajashree Pradhan, Sajeeb Mondal, Subrata Pal, Mrinal Sikder, Biswajit Biswas
DOI:10.4103/ccij.ccij_81_17  
Introduction: Fine-needle aspiration cytology (FNAC) is a simple, safe, and effective tool for cytological diagnosis of different neoplastic lesions. Computed tomography (CT)-guided core biopsy is also essential for tissue diagnosis. Aims and Objectives: The aim of this study is to assess the diagnostic value and limitations of fine-needle aspiration and core biopsy in diagnosis of intrathoracic lesions; we have done this retrospective study. Materials and Methods: In all 54 cases with mean age of 57.37 years, CT-guided FNAC and core biopsy were performed on same sittings. 20–22 G Chiba needle was used for FNAC, and core biopsy was performed by 18–20 G coaxial automated cutting needle. The cytological and histological evaluations were done in our cytology and histopathology laboratory. Complications were managed by pulmonologists. Results: On the evaluation of FNAC smears, diagnosis was done in 44 cases and 10 cases were inconclusive. In core biopsy, five cases were inconclusive. Most of the tumors were of epithelial origin (43 cases, 87.75%) and 95.59% cases were malignant in our series. Sensitivity and diagnostic accuracy of core biopsy (90.38% and 90.74, respectively) were higher than FNAC (84.62% and 85.18%, respectively). Conclusion: CT-guided core biopsy was more effective and accurate in diagnosis and tumor classification than FNAC in spite of higher complication rate.
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Ultrasound-guided fine-needle aspiration cytology of head and neck masses

: Experience in Ado-Ekiti, Southwestern Nigeria p. 171
Abidemi Emmanuel Omonisi, Olufunso Simisola Aduayi, John Adetunji Omotayo, Ganiyu Olusola Akanbi, Olusola Olusoga Akute
DOI:10.4103/ccij.ccij_87_17  
Background: A multidisciplinary approach to the evaluation of head and neck masses is crucial to achieving optimum patient care and enhancing diagnostic accuracy for definitive treatment. This is exemplified by the clinical and radiopathologic correlation of head and neck masses subjected to diagnostic evaluation using ultrasound-guided fine-needle aspiration cytology (FNAC) in a tertiary health institution. Subjects and Methods: A prospective study was carried out on 51 patients with head and neck lesions referred to the FNAC Clinic of the Department of Anatomic Pathology of Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. The study was conducted over a period of 2 years between February 2014 and January 2016. The FNAC was done under imaging guidance with a 7.5 MHz ultrasound probe. Clinical, radiological, and pathological findings were correlated. The data were analyzed using SPSS version 15. Results: The study population consisted of 12 (23.5%) males and 39 (76.5%) females. The age range was 2–80 years with a mean age of 44.7 ± 18.4 years. A significant proportion (80.4%) of the masses was located in the anterior neck. Multinodular goiter (n = 22, 43.1%) was the predominant clinical diagnosis. On ultrasonography, the predominant echotexture of the masses was heterogeneous (n = 29, 56.9%), only 4 (7.84%) of the masses had internal calcifications while the predominant composition of the masses was a mixture of solid and cystic portions (n = 30, 58.8%). There was a strong radiopathologic correlation (Spearman correlation value of 0.910). Conclusion: Ultrasound-guided FNAC of head and neck masses provides a synergistic approach to patient care and should be encouraged in our setting for optimum diagnostic yields.
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Latex-related symptoms and sensitization

Prevalence and associated factors of latex-related symptoms and sensitization at a multispecialty hospital: A cross-sectional study p. 122
Jandhyala Sridhar, Rahul Ray
DOI:10.4103/jmms.jmms_58_18  
Background and Aim: Upsurge in usage of latex gloves over the last few decades, coupled with the proliferation of medical latex products at the workplace, has led to a higher incidence of latex-related symptoms among health-care workers (HCWs). This study aimed to assess the prevalence and associated factors of latex glove-related symptoms and sensitization among HCW at a multispecialty hospital. Materials and Methods: The study included all the paramedical personnel and nurses employed at a multispecialty hospital where powdered latex gloves were in use. Consenting participants were evaluated by a questionnaire for symptoms of latex allergy, followed by a skin prick test (SPT) for evaluating sensitization to latex allergen. Statistical Analysis Used: Mean, standard deviation, and Student's t-test were used for continuous data. Categorical data were analyzed using the Chi-square test. Odds ratios and 95% confidence intervals were calculated. Results: Latex glove-related symptoms were present in 25 (10.91%) HCWs. Symptoms suggestive of Type I latex allergy were reported in 11 (4.8%), while those of contact dermatitis were reported in 17 (7.42%) HCWs. Of the 229 HCWs, 37 (16.16%) had a personal history of atopy; 14 (6.11%) were SPT positive to latex allergen. Conclusions: In this study among Indian HCW, there was a significant correlation of latex glove-related symptoms with the duration of glove use, personal atopy, and SPT positivity to latex allergen. Questionnaire-based evaluation of allergic symptoms along with SPT positivity was found to be a useful identifier of true latex allergy.
http://www.marinemedicalsociety.in/currentissue.asp?sabs=y