Sudeep Khera

The most common primary malignant tumors of the central nervous system are gliomas, and the most frequent isocitrate dehydrogenase (IDH) mutation in gliomas is IDH1 R132H, rather than IDH2 mutations. The proliferative marker Ki-67 has been widely studied in gliomas; however, its relationship with IDH1 status and clinicopathological parameters remains incompletely understood. This study evaluated the immunohistochemical expression of IDH1 and Ki-67 labeling index (LI) in astrocytic tumors and their correlation with clinicopathological parameters. The present study is an ambispective hospital-based observational study that included 56 histologically diagnosed glioma cases evaluated over a 5-year period. Immunohistochemical expressions of IDH1 and Ki-67 LI were assessed and correlated with clinicopathological parameters. There was a significant positive correlation between Ki-67 LI and age (Pearson's r = 0.306, p = 0.022) and histopathological grade (p < 0.001). Advanced age at diagnosis, male gender, and absence of IDH1 immunoexpression were associated with higher Ki-67 LI. The observed association between IDH1 status and proliferative activity warrants further investigation in larger studies with multivariate analysis and outcome data.

Vitamin B12 deficiency is a worldwide public health issue, with its prevalence high in the developing countries. It is a micronutrient synthesized by microorganisms and obtained through diet and its deficiency can lead to megaloblastic anaemia and neurological deficits. The elderly are more prone to it. Pernicious anaemia is a prevalent cause of megaloblastic anaemia, which is associated with autoimmune destruction of parietal cells and intrinsic factor deficiency by APCA and AIFA antibodies. These antibodies can cause mucosal damage and hinder vitamin B12 absorption. The present prospective observational study included 166 patients with severe vitamin B12 deficiency (defined by Vitamin B12 levels ≤ 150 pg/mL) who were treated at a tertiary care centre in western Rajasthan. Expression of AIFA and APCA were assessed and their association with different parameters were evaluated. The present study didnot find any significant association between APCA and AIFA impressions, indicating that the absence or presence of one antibody did not strongly predict the presence or absence of the other antibody. This suggests that these autoantibodies may have distinct roles or mechanisms in PA and further research is needed to understand their relationship.

Primary soft tissue sarcomas of the breast are rare aggressive neoplasms. These often are misdiagnosed with other more common neoplasms like fibroepithelial malignancies, namely phyllodes tumour and metaplastic carcinoma. Being uncommon, chances of being misdiagnosed are higher leading to early mortality. A multidisciplinary team incorporating surgery, pathology, chemotherapy and radiotherapy is required to formulate an approach to primary soft tissue sarcoma. Generally, these tumours may show single or dual phenotype; we present one rare case report showing multiphenotypic differentiation.

Sujata Sarangi, Balamurugan Thirunavukkarasu, Sudeep Khera, Selvakumar B, Taruna Yadav. Ann Hepatobiliary Pancreat Surg 2023;27:329-41. https://doi.org/10.14701/ahbps.23-046

Pleomorphic adenoma is the most common and well-studied salivary gland neoplasm. It is a benign tumor most commonly occurring in the parotid gland although it can be seen in other major and minor salivary glands. There is a variety of metaplasia seen in Pleomorphic adenoma most commonly squamous metaplasia, others noted are osseous metaplasia, oncocytic metaplasia, sebaceous metaplasia, and adipocytic metaplasia. Also, at times tyrosine crystalloids are seen. This study discusses a few of the metaplasia and the presence of tyrosine crystals in pleomorphic adenoma. Indeed, this tumor proves true to its name.