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  1. Article ; Online: Enteroblastic gastric cancer subtype holds therapeutic clues.

    Deshpande, Vikram / Bal, Munita

    Journal of clinical pathology

    2024  

    Language English
    Publishing date 2024-03-27
    Publishing country England
    Document type Editorial
    ZDB-ID 80261-x
    ISSN 1472-4146 ; 0021-9746
    ISSN (online) 1472-4146
    ISSN 0021-9746
    DOI 10.1136/jcp-2023-209346
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  2. Article: Advancements in diagnosing IgG4-related disease of the head and neck: Navigating diagnostic pitfalls.

    Bal, Munita / Deshpande, Vikram

    Seminars in diagnostic pathology

    2024  Volume 41, Issue 2, Page(s) 54–65

    Abstract: IgG4-related disease (IgG4-RD) is an immune-mediated condition affecting nearly any organ. This review focuses on the nuances of diagnosing IgG4-RD affecting the head and neck. Salivary gland involvement, especially of the submandibular glands, often ... ...

    Abstract IgG4-related disease (IgG4-RD) is an immune-mediated condition affecting nearly any organ. This review focuses on the nuances of diagnosing IgG4-RD affecting the head and neck. Salivary gland involvement, especially of the submandibular glands, often permits a definitive diagnosis on biopsy. However, elevated IgG4+ plasma cells are nonspecific and can be seen in chronic sialadenitis, lymphoma, and other mimics. Careful correlation of clinical and pathological findings is essential. Given the significant overlap with chronic sinusitis, IgG4-RD of the sinonasal region is difficult to diagnose histologically. Laryngeal and pharyngeal involvement appears rare as an isolated finding of IgG4-RD. Mastoid disease is uncommon and remains a diagnosis of exclusion. Thyroid manifestations pose challenges given unclear diagnostic criteria - Riedel's thyroiditis likely represents IgG4-RD, but the fibrosing variant of Hashimoto's thyroiditis as a form of the so-called 'IgG4-related thyroiditis' requires better characterisation. Eosinophilic angiocentric fibrosis, despite histologic similarities, only partially overlaps with IgG4-RD. This review aims to guide diagnosing IgG4-RD in the head and neck through a systematic, organ-focused discussion of the clinical context, the utility of immunostaining, histological mimics, and controversial issues that pose diagnostic pitfalls. Increased awareness of the nuances and difficulties diagnosing IgG4-RD affecting the head and neck will improve recognition of this protean disease.
    MeSH term(s) Humans ; Immunoglobulin G4-Related Disease/diagnosis ; Hashimoto Disease/diagnosis ; Hashimoto Disease/pathology ; Thyroiditis/pathology ; Immunoglobulin G
    Chemical Substances Immunoglobulin G
    Language English
    Publishing date 2024-01-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 605834-6
    ISSN 1930-1111 ; 0740-2570
    ISSN (online) 1930-1111
    ISSN 0740-2570
    DOI 10.1053/j.semdp.2023.12.003
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  3. Article ; Online: Top 10 Histological Mimics of Neuroendocrine Carcinoma You Should Not Miss in the Head and Neck.

    Juhlin, C Christofer / Bal, Munita

    Head and neck pathology

    2023  Volume 17, Issue 1, Page(s) 66–84

    Abstract: Background: The spectrum of neuroendocrine neoplasia (NEN) of the head and neck region is wide-ranging and diverse, including a variety of diagnoses stretching from benign and low-malignant tumor forms to highly proliferative, poor prognosis ... ...

    Abstract Background: The spectrum of neuroendocrine neoplasia (NEN) of the head and neck region is wide-ranging and diverse, including a variety of diagnoses stretching from benign and low-malignant tumor forms to highly proliferative, poor prognosis neuroendocrine carcinoma (NEC). Moreover, there are several non-neuroendocrine differential diagnoses to keep in mind as well, displaying various degree of morphological and/or immunohistochemical overlap with bona fide neuroendocrine lesions.
    Methods: Review.
    Results: While the growth patterns may vary, well-differentiated NEN usually display a stippled "salt and pepper" chromatin, a granular cytoplasm, and unequivocal expression of neuroendocrine markers such as chromogranin A and synaptophysin. However, these features are often less pronounced in NEC, which may cause diagnostic confusion-not the least since several non-NEC head and neck tumors may exhibit morphological similarities and focal neuroendocrine differentiation.
    Conclusion: As patients with NEC may require specific adjuvant treatment and follow-up, knowledge regarding differential diagnoses and potential pitfalls is therefore clinically relevant. In this review, the top ten morphological and/or immunohistochemical mimics of NEC are detailed in terms of histology, immunohistochemistry, and molecular genetics.
    MeSH term(s) Humans ; Biomarkers, Tumor/metabolism ; Carcinoma, Neuroendocrine/diagnosis ; Carcinoma, Neuroendocrine/pathology ; Neuroendocrine Tumors/pathology ; Head and Neck Neoplasms/diagnosis ; Immunohistochemistry
    Chemical Substances Biomarkers, Tumor
    Language English
    Publishing date 2023-03-20
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2407834-7
    ISSN 1936-0568 ; 1936-055X
    ISSN (online) 1936-0568
    ISSN 1936-055X
    DOI 10.1007/s12105-022-01521-x
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  4. Article ; Online: REFCOR study - An important study with certain limitations that should not be overlooked.

    Thiagarajan, Shivakumar / Bal, Munita

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

    2021  Volume 47, Issue 10, Page(s) 2706–2707

    MeSH term(s) Carcinoma, Mucoepidermoid ; Humans
    Language English
    Publishing date 2021-08-06
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 632519-1
    ISSN 1532-2157 ; 0748-7983
    ISSN (online) 1532-2157
    ISSN 0748-7983
    DOI 10.1016/j.ejso.2021.07.029
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  5. Article ; Online: Primary Pancreatic GIST - A-Single Centre Case Series and Systematic Review of Literature.

    Gupta, Vipul / Chopde, Amit / Chaudhari, Vikram / Bal, Munita / Shrikhande, Shailesh V / Bhandare, Manish S

    Journal of gastrointestinal cancer

    2024  

    Abstract: Purpose: GISTs arising from organs outside GI tract are defined as extragastrointestinal GISTs (EGIST). The majority of EGISTs arise from small intestinal mesentry, mesocolon, omentum, retroperitoneum, abdominal wall, liver and pancreas with pancreas ... ...

    Abstract Purpose: GISTs arising from organs outside GI tract are defined as extragastrointestinal GISTs (EGIST). The majority of EGISTs arise from small intestinal mesentry, mesocolon, omentum, retroperitoneum, abdominal wall, liver and pancreas with pancreas comprising less than 5% of it. Due to limited data, it is unknown if the results of GIST can be generalised for EGISTs. We thereby present the largest single-centre case series of primary pancreatic GIST so far with review of existing literature.
    Methods: A total of 9 patients of primary pancreatic GIST were treated at our institute from September 2016 to February 2023. After literature search for all studies published before February 2023, 51 articles including 57 patients were identified. Their clinicopathological data and survival analysis were assessed.
    Results: The median age of patients treated at our centre was 53 years with a female predominance. The most common epicentre was pancreatic head with abdominal pain as the most common presenting symptom. All 57 patients documented in literature belonged to a similar age group with similar gender predilection. The factors impacting DFS were histologic type, mitotic index, NIH risk category and adjuvant therapy. The median DFS was 74 months with a 5-year DFS being 71.9%, while the 5-year OS was 90.4%.
    Conclusion: Pancreatic GIST is a rare entity. Due to limited evidence and evolving literature, results cannot be generalised to a larger population. Larger case series with longer follow-up data are required to further understand the disease biology and long-term outcomes of pancreatic GIST.
    Language English
    Publishing date 2024-02-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2452514-5
    ISSN 1941-6636 ; 1559-0739 ; 1941-6628 ; 1537-3649
    ISSN (online) 1941-6636 ; 1559-0739
    ISSN 1941-6628 ; 1537-3649
    DOI 10.1007/s12029-024-01024-8
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    Zs.A 2184: Show issues Location:
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  6. Article ; Online: Intrahepatic Cholangiocarcinoma in a Background of Biliary Adenofibroma: A Rare Entity.

    Agarwal, Jasmine / Patkar, Shraddha / Rabade, Katha / Bal, Munita / Goel, Mahesh

    Journal of gastrointestinal cancer

    2023  Volume 54, Issue 4, Page(s) 1359–1361

    MeSH term(s) Humans ; Cholangiocarcinoma/diagnosis ; Cholangiocarcinoma/surgery ; Cholangiocarcinoma/pathology ; Bile Ducts, Intrahepatic/pathology ; Liver Diseases/pathology ; Bile Duct Neoplasms/diagnosis ; Bile Duct Neoplasms/surgery ; Bile Duct Neoplasms/pathology ; Adenofibroma/diagnosis ; Adenofibroma/surgery ; Adenofibroma/pathology
    Language English
    Publishing date 2023-03-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2452514-5
    ISSN 1941-6636 ; 1559-0739 ; 1941-6628 ; 1537-3649
    ISSN (online) 1941-6636 ; 1559-0739
    ISSN 1941-6628 ; 1537-3649
    DOI 10.1007/s12029-023-00931-6
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    Zs.A 2184: Show issues Location:
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  7. Article ; Online: Langerhans cell histiocytosis of thyroid: Case report with review of literature.

    Yadav, Subhash C / Bal, Munita / Patil, Asawari

    Indian journal of cancer

    2022  Volume 59, Issue 1, Page(s) 115–118

    Abstract: Langerhans cell histiocytosis (LCH) is a rare monoclonal disease of antigen presenting cells. Involvement of thyroid gland by LCH is exceedingly rare. Herein, we present a case of LCH involving the thyroid in a 38-year-old woman. Our patient presented ... ...

    Abstract Langerhans cell histiocytosis (LCH) is a rare monoclonal disease of antigen presenting cells. Involvement of thyroid gland by LCH is exceedingly rare. Herein, we present a case of LCH involving the thyroid in a 38-year-old woman. Our patient presented clinically as a case of primary thyroid neoplasm. Presence of elongated, epithelioid neoplastic cells with grooved nuclei along with presence of background eosinophils were seen on fine-needle aspiration cytology (FNAC) and histopathology. Positive staining for CD1a and S100 immunohistochemistry confirmed the diagnosis of LCH. Patient was given combination chemotherapy and has responded well to the same without any complaints for last 6 months. With this report, our goal is to expand awareness of this rare tumor in the thyroid. Consideration at the time of FNAC and its correct diagnosis on subsequent excision is imperative for patient management.
    MeSH term(s) Adult ; Biopsy, Fine-Needle ; Cytodiagnosis ; Female ; Histiocytosis, Langerhans-Cell/diagnosis ; Histiocytosis, Langerhans-Cell/drug therapy ; Histiocytosis, Langerhans-Cell/pathology ; Humans ; Thyroid Neoplasms/diagnosis ; Thyroid Neoplasms/pathology
    Language English
    Publishing date 2022-05-25
    Publishing country India
    Document type Case Reports ; Review
    ZDB-ID 410194-7
    ISSN 1998-4774 ; 0019-509X
    ISSN (online) 1998-4774
    ISSN 0019-509X
    DOI 10.4103/ijc.IJC_608_20
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    Zs.B 581: Show issues Location:
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  8. Article ; Online: Striated duct adenoma of the parotid: A potential diagnostic pitfall.

    Chandwani, Sneha / Shah, Aekta / Mittal, Neha / Bal, Munita

    Indian journal of pathology & microbiology

    2022  Volume 65, Issue 1, Page(s) 198–199

    Language English
    Publishing date 2022-01-24
    Publishing country India
    Document type Journal Article
    ZDB-ID 197621-7
    ISSN 0974-5130 ; 0377-4929
    ISSN (online) 0974-5130
    ISSN 0377-4929
    DOI 10.4103/IJPM.IJPM_566_20
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    Zs.B 862: Show issues Location:
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  9. Article ; Online: A Rare Case of A Low-Grade Inflammatory Leiomyosarcoma/Histiocyte-Rich Rhabdomyoblastic Tumor in the Neck of An Adolescent Male.

    Rekhi, Bharat / Bal, Munita / Dharavath, Bhaskar / Dutt, Amit / Pai, Prathamesh

    Turk patoloji dergisi

    2022  Volume 39, Issue 2, Page(s) 154–160

    Abstract: Inflammatory leiomyosarcoma (LMS) is a newly included rare tumor entity in the group of smooth muscle tumors in the recent WHO classification. Recent studies have shown skeletal muscle expression within this tumor and its proximity with histiocyte-rich ... ...

    Title translation A Rare Case of A Low-Grade Inflammatory Leiomyosarcoma/Histiocyte-Rich Rhabdomyoblastic Tumor in the Neck of An Adolescent Male.
    Abstract Inflammatory leiomyosarcoma (LMS) is a newly included rare tumor entity in the group of smooth muscle tumors in the recent WHO classification. Recent studies have shown skeletal muscle expression within this tumor and its proximity with histiocyte-rich rhabdomyoblastic tumor (HRRT). A 17-year-old male presented with a soft tissue lump over the back of his neck of one-year duration. Radiologically, a lesion measuring 5.9 cm in the largest dimension was seen, extending from the skull base up to the C2 vertebral level, abutting the occipital bone. The initial biopsy was reported as a fibrohistiocytic tumor at the referring laboratory. A microscopic review of the sections from the initial biopsy and subsequent resection revealed a well-circumscribed, cellular tumor composed of plump spindle and polygonal-shaped tumor cells with relatively bland nuclei, moderate to abundant eosinophilic cytoplasm and numerous interspersed histiocytes, including foam cells and lymphocytes. Immunohistochemically, the tumor cells were positive for desmin, MYOD1 and SMA, focally positive for myogenin, while negative for h-caldesmon, SOX10 and S100P. A diagnosis of inflammatory leiomyosarcoma/HRRT was offered. Subsequently, the tumor was tested for MYOD1 (L122R) mutation and was found to be negative. The patient underwent adjuvant radiation therapy and is free-of-disease at 12 months post-treatment. This case constitutes an extremely rare case of an inflammatory LMS/HRRT, identified in the neck region. This tumor should be differentiated from its close mimics, such as a spindle cell/sclerosing rhabdomyosarcoma, as the latter is treated more aggressively, including with chemotherapy, given its relatively poor prognosis.
    MeSH term(s) Humans ; Male ; Adolescent ; Leiomyosarcoma/genetics ; Leiomyosarcoma/pathology ; Histiocytes/pathology ; Rhabdomyosarcoma/genetics ; Rhabdomyosarcoma/pathology ; Muscle, Skeletal/pathology ; Diagnosis, Differential ; Biomarkers, Tumor/genetics ; Biomarkers, Tumor/metabolism
    Chemical Substances Biomarkers, Tumor
    Language English
    Publishing date 2022-05-27
    Publishing country Turkey
    Document type Case Reports ; Journal Article
    ZDB-ID 2515899-5
    ISSN 1309-5730 ; 1309-5730
    ISSN (online) 1309-5730
    ISSN 1309-5730
    DOI 10.5146/tjpath.2022.01577
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  10. Article ; Online: Extragenital endometrial stromal sarcoma of transverse mesocolon: A diagnostic conundrum.

    Sharma, Aishwarya / Bal, Munita / Menon, Santosh

    International journal of surgical pathology

    2021  Volume 30, Issue 5, Page(s) 551–556

    Abstract: Endometrial stromal sarcoma (ESS) is a rare uterine neoplasm infrequently arising in extra-genital sites. Herein, we report an extremely rare case of primary extra-genital ESS of transverse mesocolon occurring in a 51-year-old female presenting with ... ...

    Abstract Endometrial stromal sarcoma (ESS) is a rare uterine neoplasm infrequently arising in extra-genital sites. Herein, we report an extremely rare case of primary extra-genital ESS of transverse mesocolon occurring in a 51-year-old female presenting with gradually increasing abdominal mass. The clinical diagnosis considered was a gastrointestinal stromal tumor. Intra-operatively, the mass was confined exclusively to the transverse mesocolon. Microscopy revealed a cellular tumor composed of oval to elongate neoplastic cells with hyperchromatic nuclei, inconspicuous nucleoli and were immunoreactive for CD10, progesterone receptor (PR), estrogen receptor (ER), and PAX8; negative for KIT, CD34, SMA, S100, synaptophysin, chromogranin, WT1, and calretinin. A distinct arborizing network of arterioles along with foci of endometriosis was also seen. We present this case for its extreme rarity and the challenges entailed in its diagnosis.
    MeSH term(s) Biomarkers, Tumor ; Endometrial Neoplasms/diagnosis ; Endometrial Neoplasms/pathology ; Endometrial Neoplasms/surgery ; Female ; Humans ; Immunohistochemistry ; Mesocolon/pathology ; Mesocolon/surgery ; Middle Aged ; Sarcoma, Endometrial Stromal/diagnosis ; Sarcoma, Endometrial Stromal/pathology ; Sarcoma, Endometrial Stromal/surgery
    Chemical Substances Biomarkers, Tumor
    Language English
    Publishing date 2021-12-31
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 1336393-1
    ISSN 1940-2465 ; 1066-8969
    ISSN (online) 1940-2465
    ISSN 1066-8969
    DOI 10.1177/10668969211070485
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