Understanding Monoclonal B Cell Lymphocytosis: An Interplay of Genetic and Microenvironmental Factors

The term monoclonal B-cell lymphocytosis (MBL) describes the presence of a clonal B cell population with a count of less than 5 × 109/L and no symptoms or signs of disease. Based on the B cell count, MBL is further classified into 2 distinct subtypes: ‘low-count’ and ‘high-count’ MBL. High-count MBL shares a series of biological and clinical features with chronic lymphocytic leukemia (CLL), at least of the indolent type, and evolves to CLL requiring treatment at a rate of 1-2% per year, whereas ‘low-count’ MBL seems to be distinct, likely representing an immunological rather than a pre-malignant condition. That notwithstanding, both subtypes of MBL can carry ‘CLL-specific’ genomic aberrations such as cytogenetic abnormalities and gene mutations, yet to a much lesser extent compared to CLL. These findings suggest that such aberrations are mostly relevant for disease progression rather than disease onset, indirectly pointing to microenvironmental drive as a key contributor to the emergence of MBL. Understanding microenvironmental interactions is therefore anticipated to elucidate MBL ontogeny and, most importantly, the relationship between MBL and CLL.

Correlation of fetal hemoglobin in different cancer patients and sickle cell anaemia: A review

Fetal hemoglobin is the main hemoglobin during gestation period. But this globin chain is replaced and is taken over by adult hemoglobin. Sometimes this switch from fetal to adult fails to occur leading to production of fetal hemoglobin as in case of sickle cell anemia. It is also observed that fetal hemoglobin expression is also seen under malignant condition. In malignancy the spleen, liver as well as gut acquire its ability to produce fetal hemoglobin. Certain HbF cells inducing factor such as stem cell growth factor and interleukin -3 also promote HbF erythropoiesis. HbF cells are indicated as a biomarker of tumour cells implicated in many carcinomas observed by immunohisto chemical investigations.

Cervical Intraepithelial Neoplasia Managed With Classical Homeopathy: A Case Report

We present the case of 33-year-old woman diagnosed with low to high grade squamous intraepithelial neoplasia that benefited with individualized classical homeopathy. The outcomes were resolution of the pre-malignant condition and the HPV infection, preventing the use of invasive procedures that were otherwise deemed necessary.

Primary Cecal Squamous Cell Carcinoma: A Case Report of a Rare Tumor with Poor Prognosis

Squamous cell carcinoma of the colon is a rare tumor and primary cecal localization is unusual. This malignant condition is marked by a worst prognosis due to early local invasion. We report a case of a 46-year-old female patient admitted to the emergency department with symptoms of peritonitis. CT scan showed a cecal tumor perforated in the retroperitoneal space. The patient underwent right hemicolectomy with D2 lymphadenectomy without intestinal anastomosis. The diagnosis of squamous cell carcinoma was confirmed by histopathological examination. Squamous cell carcinoma is a malignant tumor with poor prognosis, hence, the interest of early diagnosis and management.

SIGNIFICANCE OF MAST CELLS IN BENIGN AND MALIGNANT CONDITIONS OF PROSTATE

Introduction: Mast cells are the one of the component of defense immunity of our body.Aims of the study:Role of mast cell in benign and malignant condition of prostate.Materials & methods:Total number of cases is 32.Out of 32 cases,24 cases are Benign (BPH) and 8 cases are malignant. Special stain ie.Toluidine blue has been done in all the 32 cases, as toluidine blue stain will highlight the mast cells accurately.The number of mast cells per 10 high power fields in both benign and malignant conditions was compared using statistical tools.Results: Proportion of mast cell in benign lesions is 0.58 while in malignancy is 0.63.Since the p-value was > 0.05,the results were considered as statistically insignificant. Discussion: In the present study, it is found that there is no statistical significant increase in the number of mast cells. Conclusion: Hence probably mast cells may not play any protumorogenic role in cases of prostatic malignancy.

Clonal hematopoiesis in sickle cell disease

Curative gene therapies for sickle cell disease (SCD) are currently undergoing clinical evaluation. However, the occurrence of several myeloid malignancy cases in these trials has prompted safety concerns. Individuals with SCD are predisposed to myeloid malignancies, but the underlying causes remain undefined. Clonal hematopoiesis (CH) is a pre-malignant condition that also confers significant predisposition to myeloid cancers. While it has been speculated that CH may play a role in SCD-associated cancer predisposition, no data addressing this issue have been reported. Here, we leverage 74,190 whole-genome sequences to robustly study CH in SCD. While we have sufficient power to detect increased rates of CH, we find no variation in rate or clone properties between individuals affected by SCD and controls. These results should help guide ongoing efforts that seek to better define the risk factors underlying myeloid malignancy predisposition in SCD and help ensure that curative therapies can be more safely applied.

AN OVERVIEW OF ENDOMETRIAL HYPERPLASIA

Endometrial Hyperplasia is referred as the endometrial cells of uterus, which keep on growing or multiplying instead of shedding because of high levels of estrogen and low or insufficient levels of progesterone. It is a pre-malignant condition but which are not invasive in nature. EH usually occurs in women between 50 – 55 yrs. Endometrium being a hormone dependent tissue depends on estrogen and progesterone for proliferation and shedding. Endometrial thickness gradually increases day by day. EH is caused by PCOS and chronic anovulation in premenopausal women. Obesity, lynch syndrome are other causes of EH. In 1994, WHO classified this EH into four groups. In 2014, WHO revised this classification into two types, one is endometrial Hyperplasia (without atypia) and second one is atypical endometrial hyperplasia or EIN. Patient with EH experiences abnormal uterine bleeding, bleeding in between periods etc… Age, nulliparity, obesity, smoking, diabetes mellitus are the risk factors and is diagnosed by endometrial biopsy, dilation, and curettage, a transvaginal ultrasound, hysteroscopy. Management of EH is based on its types. Hyperplasia without atypia is managed by the levonorgestrel-releasing intrauterine system (LNG-IUS), oral progestogens, and surgery. Atypical EH is managed by surgery hysterectomy

Frontal bone fibrous dysplasia in a 6-months-old boy: A distinctive entity

Fibrous Dysplasia (FD) is a non-malignant condition caused by post-zygotic, activating mutations of the GNAS gene that results in inhibition of the differentiation and proliferation of bone-forming stromal cells and leads to the replacement of normal bone and marrow by fibrous tissue and woven bone. The clinical behavior and progression of FD is variable. The management of this condition is difficult and in every case is strictly individualized. We report a case of frontal fibrous dysplasia in a 6month’s old boy who underwent a successfully resection of the lesion with an excellent cosmetic effect.

Cancer Prevention in Patients with GERD and Barrett’s Esophagus: Surgery

Barrett’s esophagus (BE) is an acquired pre-malignant condition that is the result of chronic damage to the esophagus mucosa caused by reflux. Gastroesophageal reflux disease (GERD) and BE are major risks factors for esophageal adenocarcinoma. Effective treatment for BE should control GERD symptoms but these patients frequently presents with other associated conditions that makes management more challenging. Laparoscopic antireflux surgery (LARS), restoring the gastroesophageal barrier, is a very effective treatment of patients with BE, but its role in cancer prevention remain controversial. There is strong evidence that surgery can promote regression, but less so for reducing progression. The aim of this article was to review the current role of antireflux surgery in preventing progression to dysplasia or cancer in patients with BE and GERD.