BACKGROUND:Thyroid swellings are common in surgical and endocrine practice, and accurate preoperative discrimination of benign from malignant nodules guides surgical decision-making and avoids unnecessary intervention. Preoperative work-up typically combines fine-needle aspiration cytology (FNAC), ultrasonography (USG) with Thyroid Imaging Reporting and Data System (TI-RADS) scoring, and serum thyroid-stimulating hormone (TSH) measurement, with histopathological examination (HPE) as the reference standard. OBJECTIVES:To evaluate the diagnostic performance and correlation of FNAC (Bethesda System), the American College of Radiology (ACR) TI-RADS USG, and serum TSH status against histopathological examination as the reference standard. METHODS:In this single-center, prospective, cross-sectional study conducted from June 2024 to May 2025, 178 consecutive patients underwent clinical evaluation, serum TSH measurement, USG using ACR TI-RADS, and FNAC, with results reported according to the Bethesda System. Sixty-eight patients (38.20%) underwent surgery, with HPE as the reference standard. Diagnostic performance estimates were calculated only in this surgically verified subgroup, with 95% Wilson score confidence intervals (CIs). RESULTS:The mean age was 44.88 ± 15.34 years. Of the 178 patients, 108 (60.67%) were female (female-to-male ratio, 1.54:1). Hypothyroidism was the most common thyroid functional state, occurring in 103 (57.87%) patients. Among the 68 operated patients, malignant or borderline histopathology, including non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), was confirmed in 36 (52.94%) patients. FNAC showed sensitivity of 58.33%, specificity of 100.00%, positive predictive value (PPV) of 100.00%, negative predictive value (NPV) of 68.09%, and accuracy of 77.94% (κ = 0.57). USG showed sensitivity of 75.00%, specificity of 78.12%, PPV of 79.41%, NPV of 73.53%, and accuracy of 76.47% (κ = 0.53). The Bethesda category correlated strongly with HPE (χ² = 50.43, P < 0.0001); thyroid functional status did not (P = 0.309). CONCLUSIONS:Within the surgically verified subgroup, FNAC and USG TI-RADS provided complementary diagnostic information. FNAC showed high specificity and PPV but limited sensitivity, whereas USG TI-RADS showed higher sensitivity with lower specificity. Interpretation is limited by partial histopathological verification.

The carcinomas of the breast being the worldwide most regular cancers of the breast in women are the consequence of clonal expansions of cells that have amassed a variety of genetic mutations, impacted by hereditary susceptibility genes and hormonal variables. These mutations aid in the initiation, progression, immune system evasion, and angiogenesis of cancer.β-galactosidebinding lectin galectin-3 (Gal 3) is entangled in transcription control, removal of the introns and cell viability. Gal-3 controls how cells and the extracellular matrix interact. Excess Gal-3 is frequently linked to greater angiogenesis and higher resistance to apoptosis, according to in vitro research.It has been observed that Gal-3 has a role in altering the tumor microenvironment, which leads to immunological suppression, tumor development, and distant metastasis. In this study which was performed on the histopathological sam Summary: ples of carcinoma breast of 57 patients we found notable association of Gal 3 with clinical staging where strong expression declined and low expression increased with advanced stages (p < 0.001). however it was not signicantly linked to age or lymph node status .Thus according to the observations in this study,monitoring Gal-3 levels might be helpful in predicting the progression and severity of breast cancer, guiding treatment decisions.Also , drugs that inhibit Gal-3 might reduce tumor progression and improve patient outcomes. The ndings can stimulate further research into Gal-3's mechanisms in breast cancer, potentially leading to new discoveries in cancer treatment options.

Gastrointestinal (GI) carcinomas is a term for group of cancers that affect the digestive system. This includes oesophageal, gallbladder, liver, pancreatic, stomach, and bowel cancers. Young-onset colorectal cancer (CRC) is defined as CRC that manifests in people under the age of 50 years. The incidence of CRC in young people has increased by 2% to 8% annually. Small bowel cancer is one of the rare types of cancer as its incidence accounts for less than 1% of all other types of cancer in the United States. Most of these tumors occur in older adults; > 90% of cases occur in people older than 40 years. Here, we are presenting four cases of young onset GI carcinomas. GI carcinomas is now being reported in younger population, therefore it is important to be aware of symptoms and risk factors in them. Here, we are presenting four cases of young onset GI carcinomas in female patients aged 22 and 24 and two male patients aged 21 and 32.

Seborrheic keratosis in axilla is a very rare finding. Here, we describe the case of a 46-year-old woman who visited a dermatology Opd and complained of a lesion over her left axilla that had been there for six years. On examination single pedunculated cerebriform nodules black-tan in color surrounded by hyperpigmented halo at its base, firm to palpate, painless present over left axilla, it was non-bleeding. The histopathological examination revealed seborrheic keratosis which is a very rare in axilla.

Lichen scrofulosorum, other name “tuberculosis cutis lichenoides” which is present as lichenoid eruption of minute papules, a rare tuberculid commonly seen in children and adolescents with tuberculosis. Mostly positive tuberculin reaction strongly associated with eruption. Diagnosis can be difficult in this type of lesion which is closely resemble to other type of dermatological conditions that are often primarily considered. Here we report a case of lichen scrofulosorum in a twenty year- old female having typical grouped lichenoid papules on the neck, hand and leg associated with itching.

Objectives: Tubercular lymphadenitis accounts for the large majority of extrapulmonary tuberculosis (TB) worldwide. The available means for their diagnosis are often time-consuming, tedious, and costly. Adenosine deaminase (ADA) level estimation in body fluids has emerged as a popular method of diagnosing tuberculous infection. Very few studies have examined serum ADA levels in TB lymphadenitis and fewer such studies have used controls. The objective of the present study was to find any correlation between serum ADA and fine-needle aspiration cytology-confirmed tubercular lymphadenitis and, if a correlation existed, whether there existed any diagnostic cutoff for clinical utility. Material and Methods: This prospective study was done over 2 years. The patients were grouped into tubercular lymphadenitis (group 1, cases) and non-tubercular lymphadenitis (group 2, controls). Serum ADA level was estimated using the spectrophotometric method. Statistical methods were employed to examine the intergroup differences in serum ADA levels. The receiver operating characteristic curve (ROC curve) was used to assess the overall accuracy and corresponding diagnostic accuracy at different cutoff values of serum ADA. Results: Tubercular lymphadenitis (Group I) has a strong female predilection (M: F = 0.56:1, P = 0.017), a significantly late clinical presentation (P = 0.002), and a significantly higher incidence of cervical lymph node involvement (P = 0.019). A positive treatment history was significantly and more commonly found in patients of group 1 (P < 0.001) than patients of group 2. The mean serum ADA level was 43.14 IU/L. A significantly higher serum ADA level was detected in group 1 patients than in group 2 (56.81 ± 12.42 vs. 32.07 ± 6.84, P < 0.001). On ROC, the area under the curve was 97.2%, indicating a very good discriminating capability of serum ADA levels between groups 1 and 2. A cutoff value of 41.90 IU/L had the best sensitivity and specificity (93.15% and 92.1%, respectively) for detecting a tubercular etiology. Conclusion: Serum ADA level of 41.90 U/L can differentiate tubercular from non-tubercular lymphadenitis with a very high sensitivity and specificity. Therefore, serum ADA estimation can facilitate an early clinical diagnosis and institution of treatment.

A rare yet distinct testicular germ cell tumor is spermatocytic seminoma which represent less than 1% of testicular cancers. It was first recognized by Masson et.al in 1946. It is between 25 and 40 times less frequent than the typical seminoma. An older presentation age and a decreased propensity to metastasis are the clinical characteristics that set out spermatocytic seminoma from classical seminoma. Spermatocytic seminoma never arises in any location other than the testis that is unrelated to other varieties of germ cell cancers, in contrast to the typical seminoma, which develops in the extragonadal sites as a primary tumor (where it is known as a germinoma) and typically occurs with other forms of germ cell tumor. It has a better prognosis.. The preferred treatment is orchidectomy. Radiotherapy is not required to be given after it.

A Duplication cyst of the oesophagus is the 2nd most common congenital anomaly of the Gastrointestinal tract. It has an estimated prevalence of 0.012% with a higher predominance in males, representing the 10- 15% of all gastrointestinal duplication defects. Although it is a common nding in children, diagnosis of an oesophageal duplication in adults is rare. They are often asymptomatic but they may experience symptoms such as stridor or dysphagia corresponding to the lesion within the neck or mediastinum or be complicated by intracystic haemorrhage, rupture & infections. Here we present a case of an adult patient presenting with an oesophageal duplication cyst

Vulvar fibroadenoma is a rare entity presenting at an unusual location. Here we present a case of a 45-year-old female, with painless, well-defined mass in the left labia majora for one year. On radiological examination, ultrasonography showed a well-defined rounded heterogeneously hypoechoic space occupying lesion. The mass was excised under local anesthesia. The histopathological examination revealed vulvar fibroadenoma.

Neurofibroma are benign tumour of peripheral nerve sheath that are mostly sporadic. Solitary neurofibromas of breast are uncommon. In this study, a case of 21-year-old female was referred with complaint of hyper pigmented lump in left breast since birth with recent increase in size for 5 months. Ultrasonography revealed a well-defined hypoechoic Space occupying lesion in subcutaneous plane at 11’o clock position of left breast along with a large ill-defined hypoechoic area with normal vascularity noted extending from 11’o clock to 2’o clock areas in left breast. Microscopically, the underlying stroma showed proliferating spindle cells with interspersed collagen bundles. Spindle cells show bland serpentine (wavy dark) nuclei and scant cytoplasm.

CONTEXT:Oral cancer is highly prevalent in India. Lack of awareness and delay in diagnosis and treatment of patients with oral cancer leads to high mortality and poor survival of patients. Salivary endothelin-1 is proposed as a prospective biomarker for oral squamous cell carcinoma. AIMS:Aim of the study was to evaluate salivary level of endothelin-1 in oral cancer and precancer as a biomarker. SETTINGS AND DESIGN:We planned a case control study to evaluate salivary level of Endothelin-1 in oral cancer and precancer as a biomarker. MATERIALS AND METHODS:A total of 72 subjects were taken in study out of which 24 cases were of histopathologically confirmed premalignat oral lesion (oral leukoplakia and oral submucous fibrosis), 24 cases were of histopathologically confirmed oral squamous cell carcinoma, and 24 cases of healthy age and gender matched controls without any addiction to tobacco in any form from a tertiary care hospital were taken. Saliva was collected from all following standard guidelines and estimation of salivary endothelin-1 was done by ELISA. STATISTICAL ANALYSIS USED:SPSS software version 15. RESULTS:Salivary endothelin-1 values of controls ranged between 0.09 and 1.88 pg/ml while that of premalignant cases ranged between 1.16 and 16.135 pg/ml and of SCC cases ranged between 2.567 and 22.98 pg/ml. CONCLUSIONS:Salivary endothelin-1 is raised in oral squamous cell carcinoma compared to premalignant and controls therefore, shows capability to differentiate between premalignant lesion and oral cancer. So, it could be used as a biomarker for early diagnosis.

Gliomas are the tumor of glial cells found in Central nervous System. High Grade Gliomas are rare in pediatric age group. Definitive diagnosis is made by histopathological examination. A 2 ½ year old male admitted with the complaint of abnormal tonic-clonic body movements along with headache, nausea, vomiting and fever. CT scan showed a poorly circumscribed hypodense lesion involving frontoparietal region. Surgery was performed and specimen sent for histopathological examination. Histopathological examination showed mfeatures of high grade glioma like microvascular proliferation, necrosis and haemorrhage. Cerebral tumors are the most common childhood neoplastic tumors. Gliomas are generally classified into low grade glioma and high grade glioma. High Grade glioma is rare in pediatric age group. Most commonly they present in supra tentorial compartment. The most common cerebral cortex involved are frontal lobe followed by parietal and temporal. Clinical signs and symptoms of High grade gliomas are seizure, headache, nausea, vomiting and visual disturbances. CT scan showed a poorly circumscribed hypodense lesion involving left frontoparietal region mainly. Definitive diagnosis of high grade glioma is by histopathological examination. Histopathological examination showed hypercellular heterogeneous tumor lying on a fibrillary background. Areas of microvascular proliferation along with necrosis and haemorrhage are also seen. Surgical resection followed by chemotherapy and local radiotherapy are the present recommendation. High grade gliomas are rare pediatric tumor associated with poor outcome. Surgery was performed due to neurological worsening, which was unsuccessful and patient died. Diagnosis was confirmed on histopathological examination. Poor prognosis and high morbidity even after evolution of treatment, demands further research to improve the prognosis and reduce morbidities.

Amelanotic melanoma is an uncommon type of of melanoma which lacks melanin pigment (1). Of all the melanoma cases, approximately 2-8% cases represents amelanotic melanoma. The exact prevalence of this malignancy is more due to misdiagnosis. Due to lack of clinical criteria and pigmentation, the condition often detected late (2). Amelanotic melanomas are commonly found on the face, which shows microscopically the characteristics of desmoplasia (desmoplastic melanoma), but other body parts can also be involved (4).

Pyloric gland adenoma is an uncommon precancerous polypoidal growth. Pyloric gland adenoma of stomach accounts for 2.7% of all gastric polyp. Mostly Pyloric gland adenoma are found in stomach but can be found in other anatomical sites. Pyloric gland adenoma of stomach occur in elderly population and having female predominance. Pyloric gland adenoma of stomach is commonly seen in chronic gastritis patients, autoimmune gastritis but can also occur in some genetic disease like familial adenomatous polyposis and Lynch syndrome. Early identification and therapeutic polypectomy by endoscopically and histopathological evaluation and confirmation of pyloric gland adenoma may reduce the chances of transformation of invasive adenocarcinoma.

Rhabdoid tumor is relatively rare highly malignant tumor in adult older than 40 years, therefore treatment regimens often throwing from pediatric age group. It is characterized by extremely aggressive behavior, rapid metastasis to other organ, low survival rate and no targeted therapy. So, early diagnosis is necessary for better treatment and reduce mortality outcome. A 42 years male suffering from a right side cheek mass of 5x3cm associated with tongue displacement to left side and difficulty in swallowing. After complete removal of lesion for histopathological examination, revealed grossly the tumor is well defined gray-white, round, lobulated 5x3cm in size having infiltrating borders. Cut surface shows gray-white to gray-brown, solid areas. Microscopically H&E stained section revealed, sheets of tightly packed large, discohesive, polygonal cells having abundant eosinophilic cytoplasm with eccentrically placed round nuclei showing distinct prominent vesicular nucleoli separated by thin fibrous septae with blood vessels. These cells lie in myxoid background. These tumor cells have deeply acidophilic having finely granular abundant cytoplasm with small, peripherally placed nuclei and abundant intra-cytoplasmic vacuoles along with nuclear pleomorphic, no mitotic figure seen. Histologically, the adult type tumor proliferating as sheet of tightly packed large, discohesive, polygonal cells having abundant eosinophilic cytoplasm with eccentrically placed round nuclei showing distinct prominent vesicular nucleoli separated by thin fibrous septae with blood vessels lie in fibromyxoid background. These tumor cells have deeply acidophilic, finely granular cytoplasm with small, peripherally placed nuclei with occasional intra-cytoplasmic vacuoles along with cross striations, no mitotic figures seen. Study concludes that adult type Rhabdoid tumors have extremely aggressive behavior, rapid metastasis spread to other organs, low survival rate and no targeted therapy. Usually males older than 40years of age are affected. It is crucial to make a rapid correct diagnosis and early treatment may improve the outcome.

Eccrine spiradenoma is one of the rare, benign dermal neoplasm showing eccrine sweat gland differentiation. The literature search accounts for less than 100 reported cases of eccrine spiradenoma. Clinically, the lesion presents as solitary, intradermal, circumscribed, round or oval, firm, painful or tender nodule measuring from 0.3 - 5 cm in diameter. Rarely if ES, presents as multiple lesions, in combination with other types of adnexal tumors such as cylindromas & trichoepitheliomas, it can be considered as a part of the Brooke-Spiegler syndrome. Majority of these tumours appear on the head/face & upper trunk region of the body. Spiradenomas arise in early adulthood in most instances with few reports also of congenital cases and no sex predilection seen. The definitive diagnosis is made by excisional biopsy of the tumour. Complete tumor excision with clear surgical margins is considered the primary treatment for these cases. Here, we present a rare case report of a 58 years old male presenting with a soft, cystic lesion in the left lumbar region of the abdomen for past 2 years duration. Surgical excision of the tumour was done with clear margins and the specimen was sent for histopathological examination. Due to the overlapping histomorphological features, this tumour is often confused with cylindromas and trichoepitheliomas along with other vascular tumours. Eccrine Spiradenoma, although a benign tumour, but malignant transformation has been described especially in long-standing cases or multiple lesions. So, early diagnosis is very important to prevent recurrence and to identify any onset of malignant transformation.

Angiokeratoma shows dilatation of capillaries in the upper dermis and it also shows some epidermal changes, like- hyperkeratosis, papillomatosis, and thickening of epidermis or acanthosis .Clinical presentation of angiokeratoma includes plaques over the skin of lower limbs, mostly on the buttocks or thigh. It is usually identified clinically but a definitive diagnosis is made only on histopathological examination.Adeeper biopsy of the lesion is empirically essential to make a concrete diagnosis as the characteristic changes seen in angiokeratoma, are limited to superficial dermis. Our case report has a 24 years old female presenting with unilateral, linear, bluish-black verrucous plaque on the back of left elbow.

This study’s objective is to evaluate the expression of Octamer-binding transcription factor 4 (OCT-4) as a prognostic biomarker for urinary bladder cancer (UBC) along with its histological grade and tissue invasiveness. It is also called the POU domain, class 5, transcription factor I(POU5FI). OCT-4 protein is a transcription factor and a well-known marker of cancer stem cells. This study aimed to validate the OCT-4 value in urinary bladder cancer. FFPE tissue blocks from ten patients of different grades and invasiveness of urothelial carcinoma were studied and correlated with the degree of OCT-4 expression by immunohistochemistry. The mean histochemical expression score in seven high-grade urothelial carcinoma cases was 8.4 as compared to 5.0 in three low-grade urothelial carcinoma cases. Similarly, the mean histochemical expression score in seven lamina invasive urothelial carcinoma was 5.9 as compared to 7.5 in detrusor muscle-invasive urothelial carcinoma. There was a positive correlation between OCT-4 expression and high grade and invasive urinary bladder cancer.

Carcinoma colon ranks third among the commonest cancer in the world, while seen less common in the Asian countries however lately an increasing trend has been observed. Majorly the elderly population is at an increased risk of colon cancer however early onset of the disease has also been observed in past few years. Various histologic subtypes with different prognoses are present, but the most common histological type is Adenocarcinoma (1). Signet-ring cell carcinoma (SRCC) is a known rare subtype of colorectal carcinoma (< 1%) officially recognized by the WHO, mucinous types are aggressive with poor outcomes and are most commonly diagnosed around the fourth to fifth decade of life comprising only 1% of colorectal cancers. So we report a case of a 40-year-old male with adenocarcinoma colon of signet ring cell type. The patient presented with localized abdominal discomfort with only generalized weakness and fatigue which was later evaluated to be a near-obstructing right-sided colonic mass. Patient was taken up for surgery and was found to have diffuse carcinomatosis.

Context: Role of cancer stem cells in the esophageal carcinogenesis is not clear. Aim:To assess the expression of CD44 and CD133 cancer stem cell markers in esophageal squamous cell carcinoma (ESCC) and its predisposing lesions by immunohistochemistry. Setting and Design:Prospective study as a part of an intramural research project. Materials and Methods:Tissues samples were obtained with endoscopic biopsy and from surgically resected esophageal specimens. Fifty cases each of histopathologically diagnosed cases of esophageal squamous cell carcinoma and its predisposing lesions (mild, moderate, and severe dysplasia and esophagitis) were evaluated for stem cell marker CD44 and C133 by immunohistochemistry using a scoring system. Statistical Analysis:Chi-square test, analysis of variance (ANOVA), post-hoc tests (Tukey-HSD) were used as appropriate for data analysis. Two sided P < 0.05 was considered as significant. Results:CD44 expression was significantly higher in ESCC as compared to dysplasia and esophagitis (mean IS 7.92 ± 1.45 vs. 6.34 ± 0.80 vs 5.15 ± 0.86 respectively, P < 0.001). CD133 expression was also significantly higher in ESCC as compared to dysplasia (mean IS 6.82 ± 1.57 vs. 1.00 ± 0.00 respectively, P < 0.001) while esophagitis showed no expression. CD44 and CD133 expressions were significantly higher in poorly differentiated ESCC than moderately differentiated and well differentiated lesions (CD44 mean IS 6.94 ± 1.44 vs 8.17 ± 1.38 vs. 8.63 ± 1.02 respectively, P < 0.001 and CD 133 mean IRS 5.63 ± 0.81 vs 6.00 ± 00 vs. 9.0 ± 00 respectively, P < 0.001). Conclusion:Significantly higher expression of CD44 and CD133 cancer stem cell markers in ESCC as compared to its predisposing lesions (esophagitis and dysplasia) suggests its role in esophageal carcinogenesis.