A Clinicopathological Analysis of Melanocytic Nevi: A Retrospective Series

Purpose: Melanocytic nevi are common cutaneous lesions. This study aimed to demonstrate the concordance and discordance between clinical and histopathological diagnoses of melanocytic nevi and the importance of histological evaluation in differentiating malignant lesions from diseases with similar clinical manifestations.Patients and Methods: We studied 4,561 consecutive patients with a clinical diagnosis of melanocytic nevi from 2014 to 2019. We compared the clinical diagnosis with the histopathological diagnosis to establish a histopathological concordance rate and then investigated the effects of clinical characteristics and the reasons for removal on misclassification.Results: Among 4,561 patients who were clinically diagnosed with melanocytic nevi, the overall histopathological concordance rate was 82.11% (3,745 of 4,561 patients), while the histopathological discordance rate was 17.89% (816 of 4,561 patients). The histopathological concordance included 90.25% common acquired melanocytic nevi (3,380 of 3,745 patients) and 9.75% other benign melanocytic neoplasms (365 of 3,745 patients). The most common diagnostic change was to seborrheic keratosis (n = 470, 10.30%), followed by basal cell carcinoma (n = 64, 1.40%), vascular tumor (n = 53, 1.16%), fibroma (n = 43, 0.94%), epidermoid cyst (n = 34, 0.75%), wart (n = 30, 0.66%), melanoma (n = 24, 0.53%), Bowen's disease (n = 16, 0.35%), squamous cell carcinoma (n = 4, 0.09%), keratoacanthoma (n = 2, 0.04%), and other neoplasms (n = 76, 1.67%). Male sex, old age, location of the lesion, and the reasons for removal have a potential effect on misclassification. The percentages of misclassified lesions on the trunk and limbs and the perineum and buttocks were higher than those in lesions without a change in diagnosis. Importantly, locations of lesions on the head and neck were significantly related to a change in diagnosis to non-melanoma skin cancer, while locations on the hands and feet were significantly related to a change in diagnosis to melanoma. In addition to a typical clinical features, removal due to lesion changes or repeated stimulation was significantly associated with a change in diagnosis to melanoma.Conclusions: Our study emphasizes the clinical differential diagnosis of melanocytic nevi, especially the possibility of malignant tumors. The occurrence of clinical features associated with clinicopathological discordance should raise the clinical suspect and be carefully differentiated from malignant tumors.

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HISTOPATHOLOGICAL SPECTRUM OF SKIN LESIONS: A TWO YEAR RETROSPECTIVE STUDY.

10.36106/ijsr/6201091 ◽

2021 ◽

pp. 26-29

Author(s):

Shruti Shemawat ◽

Sakshi Apurva ◽

D.P Soni ◽

Saurabh Soni

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Relative Frequency ◽

Malignant Tumors ◽

Skin Lesions ◽

Benign Tumors ◽

Histopathological Diagnosis ◽

Neoplastic Lesions ◽

Skin Biopsies ◽

Age And Sex

INTRODUCTION: The skin being largest organ of the body has vast spectrum of disorders which can be difcult to diagnose correctly solely on the basis of clinical features. Hence histopathological examination is necessary to categorise skin lesions. The aim was to study relative frequency of various skin lesions and distribution of these lesions according to age and sex. METHODS: This is a retrospective descriptive hospital based study. The skin biopsies samples which came in the duration of two years from January 2019 to December 2020 at the Department of Pathology, Sardar Patel Medical college and associated group of hospitals, Bikaner, Rajasthan were taken in this study. All skin biopsies that showed denite histopathological diagnosis were included. After proper xing and staining procedures these lesions were examined under light microscopy and categorized as non-neoplastic and neoplastic. Relative frequency of various lesions, distribution of lesions according to age and sex was analyzed. The data collected was tabulated, interpreted and compared with other similar studies. RESULTS: Out of 346 patients, incidence of neoplastic lesions 259 (74.9%) were higher than non-neoplastic lesions 87(25.1%). Males were affected more compared to females with male to female ratio 1.45:1. Non-neoplastic lesions were mostly caused because of infectious etiologies among which leprosy was the most common infection. Keratinocytic tumors 99(52.2%) constituted most common type of neoplastic lesion. Benign tumors 191(73.7%) outnumbered malignant tumors 68(26.3%). The cases of benign tumors were seen more in younger population while that of malignant tumors were seen in older age groups. Among the keratinocytic type of malignant skin tumors squamous cell carcinoma (63.5%) was the most common variant which was followed by basal cell carcinoma 19(36.5%). Male predominance was observed in both squamous cell carcinoma and basal cell carcinoma. CONCLUSION: A wide heterogenesity of skin lesions was observed in the present study . These skin lesions were mostly affecting age group of 10-30 years. Inspite of extensive programmes and research, leprosy and tuberculosis remains a rampant cause of infectious non-neoplastic skin lesions. Sometimes ignorance by patient for a very small appearing skin lesions becomes life threatening. Hence early clinician consultation with proper examination and accurate histopathological diagnosis becomes the mainstay in early treatment and recovery.

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Different Faces of Sinonasal Mass Lesions

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2020.v28i3.288 ◽

2021 ◽

Vol 28 (3) ◽

pp. 193-197

Author(s):

Devika T ◽

Shubha P Bhat ◽

Vadisha Srinivas Bhat ◽

Rajeshwary Aroor ◽

Satheesh Kumar Bhandary B ◽

...

Keyword(s):

Nasal Cavity ◽

Clinical Diagnosis ◽

Clinical Features ◽

Histopathological Examination ◽

Nasal Discharge ◽

Histopathological Diagnosis ◽

Appropriate Treatment ◽

Sinonasal Mass ◽

Wide Range ◽

Neoplastic Lesions

Introduction Mass in the nasal cavity presents with a wide range of symptoms, when a presumptive diagnosis is often made with the help of imaging and endoscopy. This study focussed on correlating clinical diagnosis with the histopathological diagnosis so that appropriate treatment can be offered to improve the quality of life of the patient. Materials and Methods The study included 120 cases who presented with symptoms and signs of mass in the nasal cavity, undergoing surgery or diagnostic biopsy. They were evaluated with a detailed history and clinical examination, diagnostic nasal endoscopy, and relevant radiological investigations. Histopathological examination of the biopsy of the excised specimen was performed by Haematoxylin and Eosin stain. Special stains and Immunohistochemistry (IHC) were performed whenever indicated. The clinical diagnosis was correlated with histopathological diagnosis. Results Nasal obstruction was the most frequent symptom followed by nasal discharge. Non-neoplastic lesions made up 85% of cases, while16% of cases were proved as neoplastic lesions. Among neoplastic lesions, 7% were benign, and 9% were malignant. The inflammatory polyp was the most common non-neoplastic lesion. Fischer's exact test showed a correlation between clinical diagnosis and histopathological diagnosis. Non-neoplastic lesions were common in the 4th decade of life; benign lesions were common in the 3rd decade of life, while malignant lesions were common in the 5th decade of life. Conclusion Sinonasal masses present with overlapping clinical features, and sometimes the definite diagnosis is possible only by histopathological examination of the specimen. However, in the presence of characteristic clinical features, accurate clinical diagnosis is possible in most cases, and appropriate treatment can be performed without delay, pending histopathological examination.

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Histological and immunohistochemical evaluation of epithelial and mesenchymal tumors of psittacines

Medycyna Weterynaryjna ◽

10.21521/mw.6377 ◽

2020 ◽

Vol 76 (03) ◽

pp. 6377-2020

Author(s):

OZGE ERDOGAN BAMAC ◽

SECKIN ARUN S.

Keyword(s):

Cell Carcinoma ◽

Malignant Tumors ◽

Smooth Muscle Actin ◽

Anaplastic Carcinoma ◽

Histological Evaluation ◽

Control Panel ◽

Immunoperoxidase Method ◽

Mesenchymal Tumors ◽

Gland Carcinoma ◽

Von Willebrand

This study describes histological and immunohistochemical evaluation of 50 epithelial and mesenchymal tumors of psittacines that were found in the archives of the pathology departments of veterinary faculties at Utrecht University and Istanbul University Cerrahpasa. In each case, cellular morphological features, tumoral pattern and mitotic activity were evaluated histologically, and immunohistochemistry was performed by the streptavidin-biotin immunoperoxidase method using a panel of commercially available antibodies raised against pan-cytokeratin, vimentin, muscle-specific actin, desmin, smooth muscle actin and Factor VIII/von Willebrand Factor. The histological evaluation revealed that 30 epithelial tumors were squamous cell carcinoma (n: 20), renal adenocarcinoma (n: 3), basal cell carcinoma (n: 2), abdominal carcinoma (n: 2), uropygial gland carcinoma (n: 1), cloacal carcinoma (n: 1) and cholangiocarcinoma (n: 1). Out of the 50 tumors, 13 had a mesenchymal origin and were diagnosed as fibrosarcoma (n: 4), hemangioma (n: 3), hemangiosarcoma (n: 4) and leiomyosarcoma (n: 2). Histological diagnosis could not be made for 7 tumors, and they were evaluated as undifferentiated malignant tumors (UDMT). Two tumors diagnosed as fibrosarcoma and three tumors diagnosed as UDMT showed strong SMA staining and were re-diagnosed as leiomyosarcoma. In view of the IHC findings, two other UDMTs were re-diagnosed as fibrosarcoma and anaplastic carcinoma. Although only a limited number of antibodies were used in the control panel, they were useful in establishing a definite diagnosis in some cases

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CLINICO PATHOLOGICAL CORRELATION OF EYELID TUMORS AND THEIR SURGICAL OUTCOME

Journal of medical pharmaceutical and allied sciences ◽

10.22270/jmpas.v10i3.1126 ◽

2021 ◽

pp. 2890-2895

Author(s):

Sumit Thakur

Keyword(s):

Clinical Diagnosis ◽

Malignant Tumors ◽

Histopathological Examination ◽

Detailed Examination ◽

Lymph Node Excision ◽

Excision Biopsy ◽

Histopathological Diagnosis ◽

Presenting Symptoms ◽

Eyelid Tumors ◽

Lid Reconstruction

Eyelid tumors are the most common neoplasm in daily ophthalmology practice and encompass a wide variety of benign and malignant tumors. The most common presenting symptoms for skin cancer on the eyelids include a mass or tumor, ulceration, or soreness. It is an institution-based study and the patients were recruited from the OPD and Indoor-wards of Aravind Eye Hospital. Each patient was examined by the slit lamp bio-microscope. The size of the tumor is measured with a detailed examination of the tumor-like margin, the involvement of the other adnexal structure, and the lymph node. Excision biopsies were done and send for histopathological examination. Wound closure with lid reconstruction done according to the size and site of the tumor. Out of 66 patients, the clinical diagnosis of 56(85%) patients was correlated with the histopathological diagnosis but in the remaining 10(15%) patients no correlation was found between histopathological and clinical diagnosis. Proper knowledge of the tumor, anatomy of the lid, and history will help in the appropriate diagnosis of eyelid tumor which can be confirmed by histopathological examination. In the present study, tumors were managed with excision biopsy and lid reconstruction was done depending upon the location and extent of the tumor.

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Pigmented Lesions of Skin: A Histopathologic Experience at a Tertiary Care Center in Central Nepal

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v17i1.28276 ◽

2021 ◽

Vol 17 (1) ◽

pp. 1-9

Author(s):

Binita Goyal ◽

Suman Rai ◽

Mamata Sedhain ◽

Pratigya Subedi

Keyword(s):

Cell Carcinoma ◽

Malignant Tumors ◽

Histopathological Examination ◽

Care Center ◽

Tertiary Care ◽

Skin Lesions ◽

Histopathological Diagnosis ◽

Female Ratio ◽

Pigmented Lesions ◽

Pigmented Skin Lesions

Introduction Pigmented skin lesions refer to lesions that are brown, black or blue in color. These are not always melanocytic in origin. Keratinocytic, vascular or reactive pigmentation in other lesions can also appear pigmented. The main aim of the study was to see the histopathological spectrum and objective was to compare clinical and histopathological diagnoses in pigmented skin lesions. Methods This descriptive study was carried out on 43 pigmented skin lesions that were biopsied over a 1 and half year period from Jan 2018 to June 2019 in College of Medical Sciences and Teaching Hospital. Results Age of the patient ranged from 10 to 88 years and mean±SD was 42.02±19.73 years. There were 21 (48.8%) males and 22 (51.2%) females with a male female ratio 0.9:1. Melanocytic nevus was the most common histopathological diagnosis (11 cases, 25.6%). Reactive pigmentation was seen in 20 (46.5%) cases. Malignant cases comprised 6 (14.0%) cases which included 2 (4.7%) cases of melanoma, 2 (4.7%) cases of pigmented basal cell carcinoma and 1 (2.3%) case each of basaloid squamous cell carcinoma and trichoblastic carcinoma each. Clinicopathological agreement could be seen in 32 (74.4%) cases. However, malignancy was clinically suspected in only half of histologically diagnosed cases. Conclusions Melanocytic nevi were the most common pigmented lesions diagnosed. Not all pigmented lesions are melanocytic in origin. Malignant tumors can sometimes appear deceptively benign and also tumors other than melanoma can be pigmented. Hence, histopathological examination remains the gold standard in diagnosing these conditions and guiding appropriate management. Keywords: melanocytic; melanoma; nevus; pigmented.

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Clinical features of primary multiple eyelid basal cell carcinoma

Kazan medical journal ◽

10.17816/kmj1973 ◽

2013 ◽

Vol 94 (4) ◽

pp. 568-571 ◽

Cited By ~ 1

Author(s):

I E Panova ◽

I S Suslo ◽

I A Kuchenkova ◽

A E Arakelyan

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Clinical Features ◽

Basal Cell ◽

Malignant Tumors ◽

Abdominal Cavity ◽

Control Group ◽

Younger Age ◽

Neoplastic Process ◽

Outer Canthus

Aim. Identification of clinical and epidemiological features of primary multiple eyelid basal cell carcinoma. Methods. 53 patients with multiple eyelid basal cell carcinoma were included in the main group, the control group included 98 patients with solitary forms of eyelid basal cell carcinoma, who were not diagnosed with primary multiple lesions during 7 years of follow-up. Diagnosis of a malignant disease of the eye was based on the disease history, complex ophthalmic clinical and instrumental examinations, the diagnosis of multiple eyelid basal cell carcinoma was verified by cytological and histological examination. Magnetic resonance imaging and computed tomography of the orbit, brain, abdominal cavity were used to assess the area of malignancy. Results. Primary multiple eyelid basal cell carcinoma was diagnosed mainly in elderly patients over 70 years old (58.49% of patients), whereas a solitary basal cell carcinoma was significantly more common in patients of the younger age group - from 30 to 59 years old (24.49% of patients). Neoplastic process in primary multiple eyelid basal cell carcinoma was mainly localized on the skin of the outer canthus (13.20%), presenting mainly as nodular form (64.15%), with differentiated tumor dominating morphologically. Primary multiple eyelid basal cell carcinoma is diagnosed in 1.64% of patients with tumors of organ of vision, with two metachronous tumors in most of the cases (69.81%), associated with skin epithelial malignant tumors, breast, uterine, kidney and rectal cancer. Conclusion. The clinical features of primary multiple eyelid basal cell carcinoma are the following: age of 70 years and over, verification at T1N0M0 cancer stage, predominantly nodular form (64.15%), with differentiated tumor dominating morphologically.

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Clinicopathological correlation of uterine cervical lesions with focus on premalignant and malignant lesions

Journal of Pathology of Nepal ◽

10.3126/jpn.v9i2.26447 ◽

2019 ◽

Vol 9 (2) ◽

pp. 1560-1563

Author(s):

Ramesh Makaju ◽

Binod Dhakal ◽

Rachana Dhakal

Keyword(s):

Cell Carcinoma ◽

Clinical Diagnosis ◽

Clinical Examination ◽

Pap Smear ◽

Precancerous Lesions ◽

Demographic Data ◽

University Hospital ◽

Histopathological Diagnosis ◽

Cervical Lesions ◽

Common Diagnosis

Background: Cervical cancer ranks as the most frequent cancer among women in Nepal and the first most frequent cancer among women between 15 and 44 years of age. The objectives of the study are to find the incidence of premalignant and malignant cervical conditions and to correlate histopathological diagnosis with that of clinical diagnosis. Materials and Methods: This was a retrospective study carried out at Kathmandu University Hospital. All cervical biopsy done from January 2009 to December 2018, were included in the study. A proforma was created in which relevant demographic data like age, sex along with clinical findings, gross and histopathological findings were collected. Results: Mean age of patients with cervical intraepithelial lesion- 1, 2 and 3 was 43.5 years, 48 years and 43.4 years respectively. The most common diagnosis was cervical polyp were (38.65%) followed by 52 cases (15.9%) of unhealthy cervix which bleeds easily on touch and 42 (12.8%) cases of inflammatory condition. Clinical diagnosis of carcinoma of cervix comprised of 42 cases (12.8%). On histopathology, 51(15.6%) cases had invasive carcinoma of which 48 (94.1%) were squamous cell carcinoma, two (3.92%) were adenocarcinoma, and one (1.9%) was of small cell carcinoma. In 33 cases (78.57%), clinical examination was correctly able to identify the invasive cancer. The sensitivity rate of diagnosing cancerous and precancerous lesions by clinical examination and cervical pap smear was 80.95 percent. Conclusions: Proper clinical history, examination, pap smearing and biopsy report helps through appropriate clinical intervention and prevents development of advanced stage of cervical carcinoma

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COMMON PIGMENTED SKIN LESIONS

The Professional Medical Journal ◽

10.29309/tpmj/2018.25.01.542 ◽

2018 ◽

Vol 25 (01) ◽

pp. 78-83

Author(s):

Amjad Ali Khan ◽

Abdul Shaheed Asghar ◽

Israr Ahmed Akhund ◽

Muhammad Ishaq

Keyword(s):

Clinical Diagnosis ◽

Malignant Tumors ◽

Skin Lesions ◽

Melanocytic Nevus ◽

Seborrheic Keratosis ◽

Melanocytic Nevi ◽

Medical College ◽

Hematoxylin And Eosin ◽

Pigmented Skin Lesions ◽

Year 2013

Objectives: The purpose of this study is; firstly, to study the histopathologicalspectrum of the pigmented skin lesions in the community, to signify that not all pigmented skinlesions are malignant melanomas; secondly, to assess the age-wise distribution of the commonpigmented skin lesions; and thirdly, to determine the commonly affected body sites by thesepigmented skin lesions. Study Design: Retrospective/Observational study. Setting: CharsadaTeaching Hospital affiliated with Jinnah Medical College Peshawar. Period: 100 consecutivecases with clinical diagnosis of pigmented skin lesion, starting in the year 2013. Methods: Inthis study, 100 consecutive surgical pathology cases with clinical diagnosis of pigmented skinlesion were retrieved from the archives of Charsada Teaching Hospital affiliated with JinnahMedical College Peshawar. All the specimens were incisional biopsies of skin, fixed in 10%formalin, embedded in paraffin, and stained with Hematoxylin and Eosin stains. Results: Onanalyzing 100 consecutive pigmented skin lesions (n=100) starting from the year 2013, it wasfound thatthe large majority of these lesions were benign. The most common pigmented skinlesion was melanocytic nevus. Moreover, majority of pigmented skin lesions were seen infemales. Seborrheic keratosis and malignant tumors, like basal cell carcinoma and squamouscell carcinomas, were more commonly seen in males in the 6th and 7th decades of life; whereas,dermatofibroma and post-inflammatory pigmentation were more common in females in the 4thand 5th decades of life. Overall, the pigmented skin lesions were more common in the 3rd, 4th, and5th decades of life with peak in the 4th decade. Skin of face was the most common site affectedby melanocytic nevi and malignant epidermal skin tumors. Conclusions: In conclusion, mostof the pigmented skin lesions are benign, encountered in the 4th decade of life, and commonlyaffect the skin of face. Also, most of the melanocytic nevi are encountered in females, whilemost of the malignant epidermal neoplasms are encountered in males affecting the skin of face.

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An analysis of the clinical features of children with early congenital Syphilis and Syphilitic Hepatitis

BMC Pediatrics ◽

10.1186/s12887-021-02932-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hongling Yang ◽

Huimin Zhang ◽

Caiying Wang ◽

Lin Pang

Keyword(s):

Liver Function ◽

Clinical Diagnosis ◽

Clinical Features ◽

Congenital Syphilis ◽

Clinical Manifestations ◽

Physical Symptoms ◽

Abnormal Liver Function ◽

Whole Body ◽

Syphilis Infection ◽

Before And After

Abstract Background The infection rate of congenital syphilis is gradually increasing, the clinical manifestations of some children with congenital syphilis are abnormal liver function, which is given the clinical diagnosis of syphilitic hepatitis. At present, there are few studies on the clinical features of children with early congenital syphilis combined with syphilitic hepatitis, so we set out to do such a study. We compared the liver function indicators before and after the treatment of syphilis to find the clinical features that can provide guidance for clinical diagnosis and treatment. Methods This study collected clinical data on 51 children with early congenital syphilis combined with syphilitic hepatitis in Beijing Ditan Hospital, affiliated with Capital Medical University, between April 2014 and October 2019. We observed their age, gender, clinical symptoms, and physical symptoms, as well as the pregnancy and childbirth history of their mothers. We also compared the liver function indicators before and after the treatment of the syphilis and analyzed the children’s clinical features. Results The results of this study showed that the clinical manifestations in children with early congenital syphilis combined with syphilitic hepatitis were diverse. The most common clinical manifestation was anemia (56.9 %), followed by syphilitic rash (54.9 %), hands, feet, and whole-body peeling (35.3 %), and splenomegaly (29.4 %). Liver damage caused by a syphilis infection tends to result in elevated alanine aminotransferase, aspartate aminotransferase, and bilirubin, while albumin decreases. After the syphilis treatment, the liver function indexes were significantly improved compared with before treatment, and the difference was statistically significant (all p < 0.05). Conclusions A child with abnormal liver function, especially with anemia, skin rash, peeling, abdominal distension, and hepatosplenomegaly should be highly suspected of having a syphilis infection. Once the diagnosis is made, the appropriate standard penicillin treatment should be started as soon as possible to improve the condition and prognosis of the child.

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An Atypical Case of Renal Mass - A Case Study

Bangladesh Journal of Urology ◽

10.3329/bju.v15i2.45921 ◽

2020 ◽

Vol 15 (2) ◽

pp. 56-58

Author(s):

Shafiqur Rahman ◽

B Ahmed ◽

ATM Mowladad Chowdhury ◽

Mirza M Hasan ◽

Sayedul Islam

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Clinical Diagnosis ◽

Renal Cell ◽

Renal Mass ◽

Clinical Presentation ◽

Atypical Case ◽

Renal Tuberculosis

A forty eight year old woman with the clinical diagnosis of renal mass due to renal cell carcinoma was found to have renal tuberculosis. The clinical presentation and management are being discussed. Bangladesh Journal of Urology, Vol. 15, No. 2, July 2012 p.56-58

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