Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a rare and aggressive extranodal T-cell lymphoma of the gastrointestinal tract with exceedingly poor prognosis. Its diagnosis and clinical management are complicated by a broad differential, frequently manifesting with non-specific clinical presentation. While recent studies have provided useful insights in regard to its molecular and genetic characteristics, its pathogenesis remains poorly understood. We present a case of an 81year-old female with T-cell lymphoma, showing MEITL morphologic features, involving the ileum. The patient presented with repeated episodes of nausea, decreased oral tolerance and abdominal pain. Amongst the many lymphoid markers studied, CD3, TIA-1, and bcl-2 were the only ones that were positive by immunohistochemistry (IHC) and T-cell receptors beta and gamma by molecular studies. Although positive in most reported cases, CD8 and CD56 were negative in our case. Recognition of various IHC and molecular markers of this rare neoplasm may elucidate a better understanding of its pathogenesis and eventual approach to therapeutic modalities.
Extranodal NK/T cell lymphoma, nasal type (ENKTLNT), is an angiodestructive T-cell non-Hodgkin’s lymphoma associated with latent Epstein Barr virus (EBV) infection.[7] On biopsy, it can present as a poorly differentiated necrotic lesion, requiring a methodical histopathological assessment. The final diagnosis is confirmed by the demonstration of a cytotoxic T-cell phenotype and the presence of EBV in the malignant cells.[7,3] We present the case of a 66-year-old male with an ulcerated maxillary lesion in which we review the histological features of these lymphomas and discuss the general histopathological approach to the diagnosis.
All the patients with a non-operative diagnosis of invasive breast cancer should have ipsilateral axillary ultrasound performed, preferably at the time of initial assessment. If this was not performed initially, it should be done as soon as possible following core biopsy diagnosis of the breast cancer. The number and morphology of any abnormal nodes should be documented1. No national guidelines are available to give the utility of FNA versus biopsy of axillary nodes. They are regarded as equal, however, we had a couple of difficult experiences in reporting of FNA results, and therefore we decided to do an audit while comparing the two techniques by keeping the histology as gold standard.
Background: Sigma is a quality management tool that helps in continuous monitoring and improvement of the performance of the analytes in the clinical laboratory. The present study evaluated the performance of our Quality Management System under optimal condition as well as during the adverse condition due to unexpected flooding in Chennai, India in the month of December 2015. Methods: The performance of the assays in the clinical laboratory was evaluated in sigma scale for 27 routine analytes under optimal condition, adverse condition during the disaster, and after restoring the optimal condition. Results: The performance of each analyte was analyzed to evaluate the quality of results released under all the three situations viz., optimal condition (Pre-disaster phase); adverse condition (Disaster phase) and after re-establishing the optimal condition (Post-disaster phase). Six analytes showed poor performance with a sigma 3 sigma. Alanine aminotransferase showed a <3 sigma performance at level 1 control and bicarbonate at both levels of quality control even after the optimal condition was restored. Conclusion: Even in adverse condition, the quality of the results released from VITROS 5600 integrated system was not much impacted except for a few analytes. Analysis using quality goal index (QGI) showed that imprecision was the reason behind the unacceptable sigma. Good clinical laboratory practices aided us in improving the quality of performance of these analytes.
