Epidemiology and Clinicopathologic Study of Nonneoplastic Cystic Lesions of the Central Nervous System at a Tertiary Care Center

Background Nonneoplastic cysts of brain are a diverse group of benign lesions with variable etiopathogenesis. Due to different site and histogenesis, these lesions have wide clinicopathologic spectrum. Objective The study was performed to evaluate epidemiology and clinicopathologic spectrum of nonneoplastic central nervous system (CNS) cysts highlighting the role of histopathology in the diagnosis as well as to compare the data with other institution’s data available in literature. Materials and Methods All nonneoplastic CNS cysts reported from January 2013 to June 2020 in the Department of Pathology of Sawai Man Singh Medical College, Jaipur, were retrieved and reviewed. The data were evaluated for age, site, cyst wall lining, nature of cyst contents, and location (intracranial and spinal), using SPSS software version 20.0. Results A total of 255 cases were reviewed with an incidence of 4.96% and an age range of 2 to 74 years with slight male preponderance. Among them there were 157, 34, 26, 24, and 2 cases of epidermoid, arachnoid, dermoid, colloid, and glioependymal cysts, respectively, and 1 case of perineural cyst. Infective cysts were much less common than noninfective cysts, accounting for two cases of neurocysticercosis and hydatid cysts each. All cyst types mainly presented with signs and symptoms of a mass lesion. Conclusion Nonneoplastic cyst mainly presented like a CNS mass lesion with overlapping clinical features, and image finding revealing the key role of histopathological analysis. Epidermoids were the most common type of these cysts in the present series followed by the arachnoid cysts.

Spindle cell variant of medullary thyroid carcinoma: a clinicopathologic study of four cases

Background Medullary thyroid carcinoma (MTC) is a malignant tumor derived from C cells. It accounts for about 10% of all thyroid malignancies. More than 14 histological variants have been described. Among them, spindle cell variant is extremely rare. Case presentation Here we describe 4 cases of spindle cell variant of MTC collected from 2012 to 2019. Ultrasound showed solid and hypoechoic nodules. Three patients underwent total thyroidectomy and regional lymph node dissection, and 1 patient underwent thyroid mass resection. Histologically, the tumors showed spindle shaped cells in bundles or interlaced arrangement, separated by hyalinised fibrous stroma that contained amyloid deposits. Immunohistochemistry showed that the tumor cells were positive for calcitonin, chromogranin A, synaptophysin, CD56, and TTF-1, but negative for other lineage-specific markers. Conclusions We report 4 rare cases of spindle cell variant of MTC. Due to its rarity and special morphology, the diagnosis of spindle cell variant MTC relies on its morphology and immunohistochemical markers to avoid misdiagnosis.

Neuroendocrine Carcinoma of the Cervix: Clinicopathologic Study and Review of the Literature

BackgroundNeuroendocrine carcinoma of the cervix (CNECC) is a rare variant of cervical cancer. The prognosis of women with CNECC is poor and there is no standardized therapy for this type of malignancy. To discuss the clinical and pathological features and prognosis of CNECC.MethodsTwenty one patients diagnosed as CNECC of cervix from May 2008 to September 2021 were retrospectively analyzed at Peking University people's hospital, were analyzed retrospectively including hematoxylin-eosinstaining （HE）slides review, immunohistochemistry results,Thinprep cytology test(TCT) and human papillomavirus (HPV) Hybrid Capture 2(HC2) assay. and their data were analyzed retrospectively. Telephone and medical records were followed up for 3-160 months with an average follow-up time of 49.8 month.ResultsThe patient's average age was 48.6 years old (range: 33–69 years). The first symptoms of 11 cases had vaginal bleeding, 2 cases had vaginal discharge, and the others were asymptomatic. Among the 21 patients, 17 cases were diagnosed as neuroendocrine carcinoma by biopsy. There were 9 cases with TCT examination and HC2 tests before biopsy, TCT results of 4 cases were positive. High-risk HPV of 7 cases were positive. The morphology of cancer cells were relatively consistent, the cytoplasm was sparse, the nuclei were obviously blue stained, and accompanied by extensive neoplastic necrosis. 13 cases were pure CNECC(61.9%), 8 cases were mix types of CNECC(38.1%).There were 3 cases accompanied by squamous cell carcinoma,5 cases accompanied by adenocarcinoma.The positive detection rate of Syn, CgA, CD56,p16 and TTF1 were 85.7%(18/21), 42.9%(9/21), 85.7% (18/21), 81%(17/21) 52.4%(11/21),respectively.The overall survival rate of 21 NECC cases was 71.4%(15/21).ConclusionsCNECC was a extremely rare primary tumor.The tumor was associated with HPV infection. Combined examination of TCT and HPV could significantly improve the detection rate of neuroendocrine carcinoma before biopsy.Pthology diagnosis was based on histological and immunohistochemical examination. It was considered to be highly aggressive malignancy with very poor prognosis.