Primary Cutaneous Amyloidosis: A Clinical, Histopathological and Immunofluorescence Study
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Abstract:
Primary Localized Cutaneous Amyloidosis (PLCA) is a relatively rare chronic condition characterized by amyloid deposition in dermis without associated deposits in internal organs. Histopathology of cutaneous amyloidosis using Haematoxylin and Eosin (H&E) stain shows eosinophilic hyaline material in papillary dermis, which can be further confirmed by Congo Red (CR) staining or Direct Immunofluorescence (DIF) Test or immunohistochemistry.To assess the concordance between the clinical, histo pathological and DIF findings in various subtypes of (PLCA).Data was collected from patients attending the Outpatient Department (OPD) at a tertiary care centre in Karnataka, India, over a period of one and half years. A total of 50 patients with clinical features suggestive of cutaneous amyloidosis were subjected to histopathological examination with H&E, CR stain and immunofluorescence.Among 50 clinically suspected patients, the most common subtype was macular amyloidosis (70%) and lichen amyloidosis seen only in 16%. A biphasic pattern comprising of both macular and lichen amyloidosis was seen in 14% cases. Extensor aspect of the arm was the most frequently (76%) involved area. All the cases had multiple site involvement. Immunofluorescence positivity was 88% as compared to 86% on histopathology using CR stain. Amyloid deposits were detected in 80% of clinically diagnosed macular amyloidosis cases by histopathology using CR stain and in 85.7% by DIF, whereas in 5.7% cases, it was not detectable by both CR stain and DIF. Both immunofluorescence and CR staining were able to detect amyloid in all the cases of lichen amyloidosis. In biphasic amyloidosis, amyloid was detected in 100% cases on histopathology versus 85.7% cases on immunofluorescence.CR stain and DIF are complimentary to each other for detection of macular amyloidosis. In case of lichen and biphasic amyloidosis, both CR and DIF are comparable modalities.Keywords:
Histopathology
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Haematoxylin
Immunofluorescence
Amyloid (mycology)
Papillary dermis
Hyaline
Objective:-1)To compare the intensity of light green stain as cytoplasm and nuclear fast red as nuclear stain compare with routine haematoxylin and eosin stain.2)To evaluate the accuracy of light green stain and nuclear fast red as an alternative stain used in cytology. Materials and methods: 30 buccal smears were collected from 10 healthy patients. they were categorized into 3 groups according to type stains were used. Result: this present study showed statically significant, p value >0.001.Conclusion:Several modifications have been made to improve their efficiency, There has been a rising need for efficient, accurate and less complex staining procedures is required
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Two very rare cases of a lipid-secreting carcinoma of the breast are reported, and a review of the pertinent literature. The patients were both women, aged 70 and 81, respectively. Both of their clinical stagings were T2aN1aM0, stage II., and radical mastectomies were performed. On examination of the resected specimens, the tumors did not differ from the general findings of breast cancer. Microscopically, H-E stain showed the tumor cells to have a foamy and vacuolated eosinophilic cytoplasm. Lipid stain and an electron microscopic study were performed and showed that the tumor cells contained large amounts of neutral lipid droplets in their cytoplasm.
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Alpha2u-globulin is an adult male rat-specific protein that accumulates spontaneously or inductively in the renal proximal tubular epithelium and forms microscopically observable deposits, which are generally referred to as "hyaline droplets," whereas a specific type of deposits is referred to as "eosinophilic bodies" by Japanese toxicologic pathologists. We compared hyaline droplets and eosinophilic bodies using special stains including immunostaining for α2u-globulin and lysosome-associated membrane protein in spontaneously occurring and d-limonene-induced cases. Eosinophilic bodies appeared simultaneously and increased in parallel with the hyaline droplets in the induced case. In both of the spontaneous and induced cases, hyaline droplets and eosinophilic bodies were associated with α2u-globulin and lysosomes, although there were differences in the forms and staining properties that probably reflected the purity or density of α2u-globulin. According to the results, it is not necessary for eosinophilic bodies to be strictly distinguished from hyaline droplets, and it is reasonable to identify eosinophilic bodies as hyaline droplets in α2u-globulin nephropathy in routine toxicity studies, as they have been recognized to be a sequence of changes associated with accumulation of α2u-globulin.
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A retrospective study evaluating haematoxylin basic fuchsin picric acid stain (HBFP) on necropsy material from 60 patients (1963 to 1970) has been undertaken. All had died of presumed myocardial infarction. Time before death varied between 30 minutes and 5 hours –too short for diagnostic histological appearances to develop. Results show that this stain is consistent and reliable.
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Developmental Biology
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Signet ring cell carcinoma is a poorly differentiated adenocarcinoma in which the tumour cells invade singly or in small groups. Early stages of the disease can be missed easily when using regular haematoxylin and eosin staining. This is a report of a case in which routine screening of gastric biopsies with the Genta stain was responsible for rapid identification of signet ring carcinoma. The patient, a 29 year old woman, had a large portion of the antrum excised surgically for signet ring cell gastric carcinoma. Follow up endoscopy six years later showed no evidence of tumour. Twenty six large cup biopsies were obtained and a single focus of signet ring tumour cells infiltrating the surface mucosa in single files was seen. The diagnosis was missed on haematoxylin and eosin stain by three senior pathologists but owing to the Alcian blue component of the Genta stain the tumour cells were recognised easily. Thus, the Genta stain not only facilitates detection of Helicobacter pylori but also allows for simultaneous visualisation of gastric morphology as well as signet ring carcinoma that can be missed with conventional stains.
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Micrometastasis to the lymph node is an important prognostic factor in survival and recurrence and even in making critical decisions regarding postoperative radiation treatment. Methods like Immunohistochemistry (IHC), serial sectioning and Polymerase Chain Reaction (PCR) are very sensitive; however, they are expensive and time consuming. Hence, there is a need for the detection of micrometastasis by method which is easily feasible and inexpensive.This study was undertaken to identify if special stains (Modified Papanicolaou stain and Ayoub Shklar stain) are valuable in detecting micrometastasis which are routinely missed in Haematoxylin and Eosin stain and also to compare their efficacy over Haematoxylin and Eosin stain in detection of metastatic tumour cells in non-metastatic lymph nodes.This study constituted a total of 300 histopathologically proven non metastatic lymph node sections. Other than Haematoxylin and Eosin stain, Modified Papanicalaou and Ayoub Shklar stain were used for identification of micrometastatic deposit.Papanicolaou stain was the only stain useful in detecting micrometastasis which accounted to 7% of non metastatic lymph node sections used in our study.Papanicolaou stain has definitely proved valuable in detecting micrometastasis over routine Haematoxylin and Eosin and Ayoub Shklar stain with an added advantage of being economical, easily available and technique insensitive.
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Burn is an injury which is caused by application of heat or chemical substances to the external or internal surfaces of the body causing destruction of tissues [1].However, severe burn injury is the most devastating injury; a person can sustain it and yet hope to survive.Every year more than 2 million people sustain burns in India; most of them (around 500,000 people) were treated as outdoor patients.About 2,00,000 were admitted in hospitals while 5,000 died [2].The exact cause of death in many mortally burned patients is not known.Tests of blood, serum electrolyte values, and other laboratory determinants may be normal, yet sometimes patient succumbs to death.In such cases exact reason behind his/her death remains unsolved.Many explanations have been offered including electrolyte imbalance, shock, and infection, renal, hepatic or adrenal insufficiency.The major cause of death in the burn patients includes multiple organ failure and infection.It is suggested that they can be understood better with a pathological study of the victim's organs [3].In many cases, young married women die due to burns and in such cases IPC 304 (B) may become applicable.Similarly, burns may be used to cause homicidal death [1].In modern era, commonly a big hue and cry in media (Print & Electronics) is made over such deaths and their investigations.This puts immense pressure on workers including autopsy surgeons.There are instances that post mortem reports in such cases are referred to second to multiple opinions.In some cases
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Forensic examination
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