bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of serum anti-phospholipase A2 receptor antibody as a biomarker in membranous nephropathy
Authors: Mukherjee Sriranjan , Kumar Abhishek , Maity Priyanka , Sengupta Moumita , Basu Keya , Chaudhury Arpita Ray , Bandopadhyay Manimoy , Chakraborty Bidhan Chandra 
Published: May 2024

Background:
Membranous nephropathy (MN) is a pattern of glomerular injury. Exact categorization into primary membranous nephropathy (PMN) or secondary membranous nephropathy (SMN) is essential for treatment. An endogenous podocyte antigen, M-type phospholipase A2 receptor (PLA2R) has been discovered to be involved in the pathogenesis of PMN.

Aims and Objectives:
In this article, we aimed to analyze renal tissue PLA2R and serum anti-PLA2R antibodies in MN cases and determined the diagnostic utility.

Materials and Methods:
The study was of prospective type carried out from March 2019 to August 2020. Analysis of cases of MN was performed with PLA2R paraffin immunoflourescence and serum anti-PLA2R antibody ELISA.

Results:
Overall sensitivity, specificity, PPV, and NPV of serum anti-PLA2R ELISA for PMN was 91.3%, 80%, 75%, and 93.3%, respectively, and of tissue PLA2R staining for PMN was 91.67%, 81.08%, 75.86%, and 93.75%, respectively. There was strong concordance between two methods. In the patients that were followed up, we found baseline serum anti-PLA2R antibody was less in complete remission group than that in non-remission group and the reduction in serum anti-PLA2R antibody was more in complete remission group than that in non-remission group.

Conclusion:
Routine light and immunofluorescence examination are incapable of giving exact categorical opinion regarding PMN and SMN. Serum anti-PLA2R antibody detection and renal tissue PLA2R analysis are sensitive and specific in detecting PMN. Baseline serum anti-PLA2R antibody and anti-PLA2R antibody quantification trends are related to prognosis of PMN. So they can be incorporated as additional biomarker.
Expression of VEGF-A, HER2/neu, and KRAS in gall bladder carcinoma and their correlation with clinico-pathological parameters
Authors: Singh Pomilla , Jain Shyam Lata , Sakhuja Puja , Agarwal Anil 
Published: May 2024

Background:
Gall bladder carcinoma (GBC) is a multi-factorial disease, involving multiple genetic alterations. The present pilot study aims to explore some of the molecular pathways, by studying immunohistochemical (IHC) expression of biomarkers (HER2/neu, KRAS, and VEGF) in GBC with their correlation with various clinicopathological parameters.

Aim of the Study:
To study the expression of prognostic biomarkers (HER2/neu, KRAS and VEGF-A) in GBC and their correlation with clinico-morphological parameters. Materials and

Methods:
This prospective study was conducted over a period of 2 years. The study group included tissue of GBC (29) reported as malignant on histopathology and cholecystitis as a control group (29) for histopathological evaluation and IHC expression of above markers.

Results:
HER2/neu was expressed in 27.5% cases, and KRAS in 51.6%; however, both showed no association with tumor type, stage and grade. No association was found in KRAS expression and dysplasia. Vascular Endothelial Growth Factor - A (VEGF-A) was expressed in 86.1% cases, of which strong positivity was seen in 48.27%; it showed significant association with tumor stage (P value-0.027, Fishers' exact test), hence possibly suggesting its role in tumor progression; though no association was found in VEGF expression with tumor type and grade. No significant association was seen with vascular and tumor invasion also.

Conclusion:
The results suggest that the VEGF-A expression may be used as a potential prognostic biomarker in GBC.
Multicentric Castleman's disease in India – Does EBV rather than HHV8 play a role?
Authors: Bhanvadia Viral , Shet Tanuja , Rao Vidya , Epari Sridhar , Gujral Sumeet , Jain Hasmukh , Bagal Bhausaheb , Sengar Manju 
Published: May 2024

Background and Aim:
Multicentric Castleman's disease (MCD) is a rare lymphoproliferative disorder manifesting as multiple lymphadenopathy, multiorgan involvement, and inflammatory symptoms. This study aims at highlighting some unique features of MCD in Indian patients.

Materials and Methods:
These 17 patients from review of 78 cases of Castleman's disease (CD) diagnosed. Besides routine tissue sections were stained for Human Herpes Virus 8 latency associated nuclear antigen (HHV8-LANA) by immunohistochemistry (IHC) and Epstein Barr virus latent membrane protein (EBV-LMP) or Epstein Barr Virus by in situhybridization (EBER-ISH).

Result:
The cases included Plasma cell variant (11 cases), mixed MCD (4 cases) and two concurrent MCD with large B cell lymphoma in HIV positive patients. Median age of disease onset was 47 years and female predominance was seen. Out of 15 MCD uncomplicated by lymphoma, 5 had POEMS (Polyneuropathy, organomegaly, endocrinopathy, myeloma protein, skin changes) and one also had TAFRO (Thrombocytopenia, anasarca, fever, marrow reticulin fibrosis, organomegaly, normal or slightly elevated immunoglobulin) syndrome. Out of 10 MCD without lymphoma, 2 cases showed few EBV positive large cells, both have features of POEMS. All 17 MCD cases were negative for HHV8-LANA IHC. Two HIV patients with MCD had large cell lymphoma, intrasinusoidal pattern, of which one was EBV positive. Though four relapses were seen, none died from disease. One of the two patients complicated by lymphoma died from disease.

Conclusion:
Indian patients with MCD show female preponderance and are negative for HHV8 but show EBV positive cells. This makes a case for role of EBV in etiopathogenesis of MCD in India.
A study of Human Epidermal Growth factor receptor-2 [HER-2] in Carcinoma Oesophagus [Single Institutional Tertiary cancer centre study from North-East part of India]
Authors: Kalita Deepjyoti , Bannoth Srinivas , Purkayastha Joydeep , Talukdar Abhijit , Das Gaurav 
Published: May 2024

Background:
Oesophageal cancer both squamous cell [SCC] and adenocarcinoma have poor outcomes with high morbidity and mortality. Our hospital-based registry for year 2017–2018 showed that oesophageal cancer constituted 22.7% of annual case load. The main objective of this study was to determine the presence of HER-2 receptors in patients with oesophageal carcinoma in our region.

Methodology:
From September 2018 to September 2019, data regarding expression of HER-2 receptors was analysed in 133 patients of oesophageal carcinoma. Data were statistically described as frequencies (number of cases) and percentages where appropriate. Chi-square and Fischer's exact test was used to find out the association between categorical variables. A Pvalue less than 0.05 was considered as statistical significant at 95% confidence interval. The statistical analysis was performed using SSPS [statistical package for the social sciences] software version 17.0.

Results:
A total of 133 patients were taken into study. Majority of patients were males (96) with mean age of 52 years. Squamous cell carcinoma was predominant histology. HER-2 receptor positivity was seen in 6.01% of patients. Patients with HER-2 receptor positivity presented in advanced stage with poor functional status and poor grades of differentiation. Statistically significant correlation of Her-2 expression was seen with stage (p = 0.001) and pathology of tumour (p = 0.0001).

Conclusion:
Squamous cell carcinoma of oesophagus still predominates in North-eastern part of India. For studying the role of effective targeted therapies knowledge of frequency of HER-2 receptor positivity is of utmost importance in our population, and our study aims to answer this question. The present study shows low prevalence of HER-2 neu overexpression in our community, probably due to disproportionately high incidence of SCC compared to adenocarcinoma. Patients with HER-2 receptor positivity presented in advanced stage with poor functional status and poor grades of differentiation.
Oro-facial tuberculosis - Is it still an enigmatic entity?
Authors: Gupta Latika , Bhatt Anusha S. , Mallya Varuna , Rana Deepika , Khurana Nita , Singh Ishwar 
Published: May 2024

Background and Aims:
The objective of this study was to analyze and review the clinical and histopathological aspects of oro-facial tuberculosis.

Methods:
Sixteen cases of oral mucosal biopsies diagnosed as granulomatous pathology consistent with tuberculosis were retrieved from the data base and clinical information and histopathological findings were analyzed retrospectively.

Results:
Of the total 16 cases, 12 were males while 4 were females. The age ranged from 15-70 years (mean of 39.6 years). Buccal mucosa, as an involved site, was seen in 31% of cases, while tonsil and soft palate constituted 3 cases each. Duration of symptoms ranged from 01-12 months (mean of 5.3 months). Oral examination revealed ulceroproliferative lesions in majority of the cases. Of sixteen cases, six cases (37.5%) each primarily as well as secondarily involved oral cavity while in 25% (4/16) of cases the status could not be evaluated. On histopathology, caseating granulomas were seen in 7 of 16 cases (43.75%) and non-caseating granulomas were seen in rest 56.25% of cases. Ziehl Neelsen stain for acid fast bacilli was positive in 31.25% (5/16) of cases.

Conclusion:
Though unusual, tuberculosis should always be included in the differentials of oral lesions in a country endemic to tuberculosis like India. Histopathological evaluation of the biopsy remains the indispensible tool to diagnose oro-facial tuberculosis.
Mature teratoma of liver in an adult male patient
Authors: Saba Firdos , Hamid Tahira , Alrawashdeh Hamzeh Younes M , Iqbal Mohammad Shahid , Tabassum Aisha 
Published: May 2024

ABSTRACT
Teratomas are germ cell tumors occurring usually in gonadal organs. They are neoplasms composed of one or more of the three germ layers. Extragonadal teratomas are uncommonly reported in the literature. The liver is an extremely rare site for teratoma, constituting < 1% of all teratomas. The majority of the liver teratomas are found in the pediatric population with only a dozen cases reported in adults to the best of our knowledge. We present a case of a 27-year-old male with a history of abdominal pain of 5 months duration. CT scan revealed liver mass suggesting teratoma. The patient underwent cholecystectomy and segmental liver resection. Histopathology revealed mature cystic teratoma. Complete resection remains the best treatment option. Teratomas of the liver are extremely rare, constituting < 1% of all teratomas. An extensive review of the literature yielded < 50 cases of primary hepatic teratomas with only a dozen cases in adults and only two cases in males.
Elastin remodeling
Authors: Prabhudesai Sonal A. , Carvalho Karla , Dhupar Anita , Spadigam Anita 
Published: May 2024

Background:
The extracellular matrix (ECM) is a dynamic tissue that provides nutrition and support to overlying epithelium. During tumorigenesis, the tumor microenvironment (TME) dysregulates the ECM. This is reflected by morphological changes seen in collagen and elastic fibers and is thought to facilitate metastasis.

Aim:
To study the degradation of elastic fibers in different grades of oral squamous cell carcinoma (OSCC) and in oral epithelial dysplasia (OED) using histochemistry and to correlate it to the TNM stage of OSCC.

Materials and Methods:
Tumor cores from 38 cases of OSCC (well-differentiated[15], moderately differentiated[14], and poorly differentiated[9]) and 15 incisional biopsies of OED were analyzed. Hematoxylin-eosin and Verhoeff's–Van Gieson (VVG) stains were used. The stained sections were assessed for morphological changes in elastic fibers.

Statistical Analysis:
Data were analyzed using Statistical Package for Social Sciences (SPSS) version 22 software. Fisher's exact, Kruskal–Wallis, one-way ANOVA, and Turkey post hoc tests were used to establish significance (P ≤ 0.05). Spearman's correlation test was used to correlate elastin fiber degradation with TNM stage of OSCC.

Results:
All grades of OSCC showed absence of elastic fibers around the tumor islands. Elastic fiber degradation (fragmented and clumped type fibers) increased proportionately with the grade and TNM stage of OSCC. In OED, A significant reduction in the amount of elastic fibers with increasing grade was noted.

Conclusion:
A positive correlation was noted between elastin degradation and grade and stage of OSCC. Therefore, it may be implicated in tumor progression of OSCC.
The hormone receptor status in breast cancer and the relationship of subtypes with clinicopathological features
Authors: Senel Fatma 
Published: May 2024

Aim:
We aimed to determine the hormone receptor status in breast cancers and to investigate the relationship between single hormone receptor-positive, double hormone receptor-positive, double hormone receptor negativity, and human epidermal growth factor receptor 2 (HER2) status and some clinicopathological features.

Materials and Methods:
The study includes 85 patients who were diagnosed in our center between 2018 and 2019 and having surgical specimens were included in the study. Data of the cases, such as estrogen receptor (ER), progesterone receptor (PR), HER2 status, silver in situhybridization (SISH) evaluation results, age distribution, histopathological findings were recorded.

Results and Conclusions:
We investigated the relationship between age, grade, tumor size, lymph node metastases and ER, PR, and HER2. However, there was not a significant association between ER, PR, and HER2 and age, tumor size, lymph node metastases (P > 0.05). On the other hand, we found a significant association between grades and ER (P = 0.02) and PR (P = 0.004), but not between grades and HER2 (P > 0.05). High-grade tumors were tumors with the lowest ER, PR positivity rate. Considering the four subtypes, cases aged above 45 years were at most double hormone receptor-positive (75%) and ER-positive/PR-negative (56%), respectively (P < 0.001). High-grade tumors were mostly double hormone receptor-negative and at least double hormone receptor positive. The ER-positive/PR-negative subtype was between these two groups (P < 0.001). The increased tumor size (T3) and increased metastatic lymph node number (N2 and N3) were observed at least in the ER-positive/PR-negative subtype. The majority of cases are in the older age group and invasive ductal carcinoma (IDC) is the most common tumor type. Older cases are most frequently double hormone receptor-positive and ER-positive/PR-negative, respectively. The ER, PR positivity rate is low in high-grade tumors. ER-positive/PR-negative tumors are of a higher grade than double hormone receptor-positive tumors, but they are of a lower grade than double hormone receptor-negative tumors. The increased tumor size and increased lymph node metastasis number are at most in the double hormone negative subtype and at least in the ER-positive/PR-negative subtype. The ER-negative/PR-positive subtype is observed very rarely, which raises the question of whether ER-negative/PR-positive tumors really exist. Further studies are needed to investigate this subtype and its properties.
Validation of Whole Slide Imaging for primary surgical pathology diagnosis of prostate biopsies
Authors: Rao Vidya , Subramanian Pavitra , Sali Akash P. , Menon Santosh , Desai Sangeeta B. 
Published: May 2024

Context:
Whole slide imaging (WSI) is an important component of digital pathology which includes digitization of glass slides and their storage as digital images. Implementation of WSI for primary surgical pathology diagnosis is evolving, following various studies which have evaluated the feasibility of WSI technology for primary diagnosis.

Aims, Settings and Design:
The present study was a single-center, observational study which included evaluation by three pathologists and aimed at assessing concordance on specialty-specific diagnosis and comparison of time taken for diagnosis on WSI and conventional light microscopy (CLM).

Materials and Methods:
Seventy prostate core biopsy slides (reported between January 2016 and December 2016) were scanned using Pannoramic MIDI II scanner, 3DHISTECH, Budapest, Hungary, at 20× and 40×. Sixty slides were used for validation study following training with 10 slides.

Statistical Analysis Used:
Intraobserver concordance for diagnosis between the two platforms of evaluation was analyzed using Cohen's κ statistics and intraclass correlation coefficient (ICC); observation time for diagnosis was compared by Wilcoxon signed-rank test.

Results:
Interpretation on WSI using 20× and 40× was comparable with no major discordance. A high level of intraobserver agreement was observed between CLM and WSI for all three observers, both for primary diagnosis (κ = 0.9) and Grade group (κ = 0.7-0.8) in cases of prostatic adenocarcinoma. The major discordance rate between CLM and WSI was 3.3%–8.3%, which reflected the expertise of the observers. The time spent for diagnosis using WSI was variable for the three pathologists.

Conclusion:
WSI is comparable to CLM and can be safely incorporated for primary histological diagnosis of prostate core biopsies.
Ataxia-telangiectasia and combined hepatocellular-cholangiocarcinoma: A case report
Authors: Singh Tej P. , Patkar Shraddha , Goel Mahesh , Menon Munita Bal 
Published: May 2024

ABSTRACT
Ataxia-telangiectasia (A-T) is a rare autosomal recessive disease characterized by ataxia, cutaneous and ocular telangiectasia, impaired immunity with susceptibility to sino-pulmonary infections, radiation sensitivity, and cancers particularly of hemato-lymphoid origin. Liver function tests abnormalities and elevated alfa feto-protein have been reported in A-T; however, there is no reported case of combined hepatocellular-cholangiocarcinoma (cHCC-CC) in literature. These tumors should be treated in similar fashion as in general population; however, reduction of chemotherapy dose might be helpful in decreasing chemo-toxicity.
Correlation of cyclin D1, HER2, and AMACR expressions with histologic grade in bladder urothelial carcinomas
Authors: Karakaya Yeliz Arman , Oral Esin 
Published: May 2024

Background and Objective:
Bladder cancer is the ninth most common type of cancer worldwide. We aimed to investigate the relationship between tumor grade, lamina propria invasion, muscularis propria invasion, and lymphovascular invasion and human epidermal growth factor receptor 2 (HER-2), cyclin D1, and alpha-methyl-CoA racemase (AMACR) expressions in bladder cancer.

Materials and Methods:
The study included patients who underwent complete TURBT. In total, 72 cases of bladder cancer diagnosed by two pathologists were selected. AMACR, HER-2, cyclin D1 expressions were detected immunohistochemically.

Results:
The study population comprised 80% (57) males and 20% (15) females (mean age, 68 years). Further, 35 cases were noninvasive and 37 invasive urothelial carcinoma and 38 patients had low-grade tumor and 34 high-grade tumor. Intense immunostaining was observed with cyclin D1 for 75% tumors, AMACR for 39%, and HER-2 for 86%. High expressions of cyclin D1 and AMACR were observed in high-grade tumors (P < 0.05 and P < 0.005, respectively). High expression of HER-2 (2 and 3 positive) was found both at low- and high-grade tumors (84% and 88%, respectively).

Conclusion:
Cyclin D1, AMACR expressions were found to be significant predictive factors of high-grade tumors. High Her-2 expression in patients with bladder carcinoma may indicate that they are potential targets for treatment. These markers may be important in determining prognosis of tumors and may be valuable for guiding treatment options.
A randomised control trial to assess the efficacy of platelet rich fibrin in type 1 tympanoplasty
Authors: Mathew Nikhil V. , Menon Shalini Sandeep , Ramaswamy Balakrishnan , Nayak Dipak Ranjan 
Published: May 2024

Objective:
The objective was to assess the efficacy of platelet-rich fibrin in increasing graft uptake and improved hearing outcome following Type I tympanoplasty by postauricular underlay technique.

Materials and Methods:
Adult patients without any comorbidities in the age group 20–40 years with chronic otitis media-mucosal (inactive) enrolled for type I tympanoplasty were included in this randomized control study. Sixty eligible patients were randomly grouped by lottery method into test (application of platelet-rich fibrin, n = 30) and control groups (without application of platelet-rich fibrin, n = 30). Postoperative closure of the perforation was compared on 1st month and 3rd month follow-up. Postoperative graft uptake was compared in both the study groups. Pre- and postoperative comparison of pure tone average (PTA) and air-bone gap (ABG) closure were measured in all patients.

Results:
The graft uptake rate in the test group was 100%, and for the control group was 86% on 3rd month follow-up. PTA and ABG closure in patients did not show any comparable improvement in either group. The results were not statistically significant for graft uptake (P = 0.112), PTA (P = 0.221) and ABG (P = 0.931).

Conclusion:
The use of platelet-rich fibrin did not have significant improvement in postoperative outcome both in terms of tympanic membrane closure and hearing improvement statistically. However, we did notice better graft closure in patients where we used platelet-rich fibrin.
A Study on Clinical Presentation of Pseudocyst, Dermoid Cyst, and Sebaceous Cyst of Pinna and its Management at a Tertiary Care Center
Authors: Sinha Vikas , Parmar Bhagirathsinh D. , Chaudhary Nitin , Jha Sushil G. , Yadav Sandeep Kumar 
Published: May 2024

Introduction:
Swellings of pinna are common but various cystic lesions encountered in clinical practice are not reported too often. Management of these lesions if not done at the earliest may lead to disfigurement and change the entire appearance of the face.

Aim and Objective:
The aim and objective of the study was to determine the clinical presentation, relevant investigations, appropriate treatment, timing of surgical intervention, and prevention of complications.

Materials and Methods:
Our study comprised 38 cases; male and female patients presented with different types of pinna swellings.

Results:
A total number of pseudocyst patients were 30 and of which only four were females. Recurrence seen in pseudocyst was 13.33%. Complete resolution was seen after excision in all cases of dermoid and sebaceous cyst.

Conclusions:
Aspiration and drainage followed by splinting is a simple, safe, and effective surgical treatment of pseudocyst. Simple excision is the most effective surgical treatment of dermoid cyst and sebaceous cyst.