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  1. Article: The Great Mimicker of Gastric Cancer: A Case Report of Ménétrier's Disease.

    Roy, Sarmista / Neogi, Sushanto / Chaturvedi, Anubhuti / Tomar, Reena

    Cureus

    2024  Volume 16, Issue 2, Page(s) e55076

    Abstract: This is the case of a 52-year-old Indian lady who presented with hematemesis, severe anemia, and an abdominal lump in cardiac failure. On radiographic evaluation, the lesion appeared to be gross circumferential asymmetric proximal gastric wall thickening, ...

    Abstract This is the case of a 52-year-old Indian lady who presented with hematemesis, severe anemia, and an abdominal lump in cardiac failure. On radiographic evaluation, the lesion appeared to be gross circumferential asymmetric proximal gastric wall thickening, with suspicion of gastric lymphoma or tubercular hypertrophic gastritis. After stabilization with multiple transfusions, she underwent proximal D2 gastrectomy with esophago-gastric anastomosis and a total splenectomy. Grossly, the gastric rugae appeared to be hypertrophied and firm. No growth was identified grossly; however, necrotic areas were identified at the distal end. Microscopic examination of multiple sections studied showed significant foveolar hyperplasia, tortuous glands, and a few cystically dilated foveolar glands, which were limited up to the muscle layer. Mild serosal congestion was seen. No atypia or invasion was seen. An impression to consider is the possibility of Ménétrier's disease (MD). MD is an acquired protein-losing enteropathy with giant gastric rugal folds, decreased acid secretion, and increased gastric mucous production. Radiographically, endoscopically, and grossly, the condition can be confused with malignant lymphoma or carcinoma. It is difficult to diagnose, and histopathological confirmation of the resected specimen is needed for a definitive diagnosis. Our intention in presenting this case is to emphasize that MD can present as massive hematemesis and should be considered in a differential diagnosis. Surgical treatment by total or partial gastrectomy is recommended for cases with persistent, debilitating symptoms or a risk of cancer.
    Language English
    Publishing date 2024-02-27
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.55076
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Schwannoma-like pleomorphic adenoma: A pathological quandary.

    Gautam, Rashmi / Tomar, Reena / Rana, Deepika / Khurana, Nita / Singh, Ishwar

    Indian journal of pathology & microbiology

    2024  

    Abstract: Abstract: Pleomorphic adenoma usually presents as a painless growing mass in locations of the salivary glands and is notorious for local recurrence if previous surgical resection is incomplete. Schwannoma is a benign peripheral nerve tumor with ... ...

    Abstract Abstract: Pleomorphic adenoma usually presents as a painless growing mass in locations of the salivary glands and is notorious for local recurrence if previous surgical resection is incomplete. Schwannoma is a benign peripheral nerve tumor with microscopic features of sheets of spindle-shaped cells with nuclear palisading. However, when a pathologist encounters a salivary gland tumor with microscopic morphological features of biphasic components with areas of schwannoma-like morphology, it is crucial to make a prudent diagnosis by differentiating Schwannoma-like pleomorphic adenoma and its differential diagnosis as they have remarkably different outcome in patients. We herein present a case of Schwannoma-like pleomorphic adenoma and discuss its approach to diagnosis and literature search.
    Language English
    Publishing date 2024-02-19
    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_552_23
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: An Unusual Painless Lesion on the Shin.

    Goel, Aakanksha / Shrivastava, Prabhat / Gupta, Varsha / Tomar, Reena

    Oman medical journal

    2023  Volume 38, Issue 3, Page(s) e518

    Language English
    Publishing date 2023-05-31
    Publishing country Oman
    Document type Journal Article
    ZDB-ID 2571431-4
    ISSN 2070-5204 ; 1999-768X
    ISSN (online) 2070-5204
    ISSN 1999-768X
    DOI 10.5001/omj.2023.24
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Bizarre parosteal osteochondromatous proliferation Nora's lesion: Case report of two cases with review of the literature.

    Hegde, Vindhyaprabha / Mallya, Varuna / Tomar, Reena / Khurana, Nita / Maini, Lalit

    Journal of cancer research and therapeutics

    2023  Volume 19, Issue 7, Page(s) 2090–2093

    Abstract: Abstract: Bizarre parosteal osteochondromatous proliferation (BPOP) is also known as Nora's disease. It is a benign lesion. Even though recent studies showed probable neoplastic etiology, the exact cause is unknown. BPOP commonly involves small bones of ...

    Abstract Abstract: Bizarre parosteal osteochondromatous proliferation (BPOP) is also known as Nora's disease. It is a benign lesion. Even though recent studies showed probable neoplastic etiology, the exact cause is unknown. BPOP commonly involves small bones of hands and feet. This condition is rare and very few cases are reported. In this report, two cases are presented with clinical, radiological, and histopathological findings. The first case was a 38-year-old female presented with 3-year history of mild painful swelling in the left middle finger and the second case was a 28-year-old male with the left leg swelling for 8 years. On radiology, both cases showed surface lesion with uninvolved medullary cavity. Excision specimen of both the lesions subjected for histopathological examination. Microscopically, there was irregular maturation of the bone and cartilage. Cartilage showed purplish-blue color (blue bone) with bizarre chondrocytes. BPOP is a rare benign condition. Awareness of clinical radiological and microscopic findings is needed for correct diagnosis and to differentiate it from other mimicking benign and malignant conditions.
    MeSH term(s) Female ; Male ; Humans ; Adult ; Soft Tissue Neoplasms ; Bone Neoplasms/diagnostic imaging ; Bone Neoplasms/surgery ; Hand ; Leg ; Cell Proliferation
    Language English
    Publishing date 2023-04-26
    Publishing country India
    Document type Review ; Case Reports ; Journal Article
    ZDB-ID 2187633-2
    ISSN 1998-4138 ; 0973-1482
    ISSN (online) 1998-4138
    ISSN 0973-1482
    DOI 10.4103/jcrt.jcrt_1897_21
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Histopathological response to denosumab in giant cell tumours of bone - A review of 11 cases.

    Kumar, Rabish / Mallya, Varuna / Mandal, Shramana / Tomar, Reena / Khurana, Nita / Maini, Lalit

    Journal of cancer research and therapeutics

    2023  Volume 19, Issue 3, Page(s) 768–772

    Abstract: Background: Giant cell tumor (GCT) of the bone is a locally aggressive primary bone tumor, that can rarely metastasize. Arising mostly in epiphysis of the long bones in young adults, the tumor is composed of mononuclear cells that are admixed with ... ...

    Abstract Background: Giant cell tumor (GCT) of the bone is a locally aggressive primary bone tumor, that can rarely metastasize. Arising mostly in epiphysis of the long bones in young adults, the tumor is composed of mononuclear cells that are admixed with osteoclastic giant cells(OLGCs), which express RANK ligand and RANK respectively. Denosumab a monoclonal antibody against RANK ligand has been shown to reduce the tumor by causing bone lysis by inhibiting RANKL. Histological changes in 11 patients of GCT who were treated with denosumab are presented here.
    Materials and methods: Clinical records and slides of 11 patients of GCT who had been administered neoadjuvant denosumab were included in the study. Evaluation of pre and post therapy GCT specimens was performed by two pathologists (RK and VM). There were 4 males and 7 females. Their mean age was 30 years. All the patients received 120 mg denosumab subcutaneously every week with additional 120 mg on days 8 and 15 of therapy. The histological slides were reviewed and following points noted: 1) degree of ossification,2) fibrosis,3) loss of osteoclastic giant cells,4) proliferation of mononuclear cells,5) atypia,6) Permeation of osteoid by malignant cells.
    Results: Out of 11 cases, 2 cases did not show any significant histological improvement. 7 cases showed reduction in giant cells, increased fibrosis, enhanced mononuclear cell proliferation and ossification consistent with a pathological response. Atypia and osteoid permeation were noted in 2 cases which showed transformation to osteosarcoma.
    Conclusion: Denosumab treated giant cell tumor show dramatic histological changes. The post therapy lesions may bear no resemblance to pretherapy lesion. There may be complete resolution or may be confused with benign or malignant lesions Rarely they may show sarcomatous transformation. It is imperative that the pathologist is aware of these changes to prevent diagnostic pitfalls as it poses therapeutic and prognostic implications.
    MeSH term(s) Male ; Female ; Young Adult ; Humans ; Adult ; Denosumab/pharmacology ; Denosumab/therapeutic use ; RANK Ligand/therapeutic use ; Giant Cell Tumor of Bone/drug therapy ; Giant Cell Tumor of Bone/pathology ; Bone Neoplasms/drug therapy ; Bone Neoplasms/pathology ; Fibrosis ; Bone Density Conservation Agents/therapeutic use
    Chemical Substances Denosumab (4EQZ6YO2HI) ; RANK Ligand ; Bone Density Conservation Agents
    Language English
    Publishing date 2023-07-20
    Publishing country India
    Document type Review ; Journal Article
    ZDB-ID 2187633-2
    ISSN 1998-4138 ; 0973-1482
    ISSN (online) 1998-4138
    ISSN 0973-1482
    DOI 10.4103/jcrt.jcrt_1777_21
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Mucinous carcinoma of the gallbladder- two rare case reports.

    Sharma, Mitakshara / Rath, Ashutosh / Tomar, Reena / Khurana, Nita / Ghuliani, Deepak

    Journal of cancer research and therapeutics

    2022  Volume 18, Issue 4, Page(s) 1192–1194

    Abstract: Gallbladder carcinomas are uncommon with female predominance in the sixth or seventh decades. Mucinous carcinomas of the gallbladder are rare with few cases documented in the literature. We present two cases of mucinous carcinoma of the gallbladder one ... ...

    Abstract Gallbladder carcinomas are uncommon with female predominance in the sixth or seventh decades. Mucinous carcinomas of the gallbladder are rare with few cases documented in the literature. We present two cases of mucinous carcinoma of the gallbladder one of which was incidentally detected. The first case is a 65-year-old female who was diagnosed clinically with a suspected case of carcinoma of the gallbladder with the help of contrast-enhanced computed tomography. Microscopy showed extensive areas of mucin pools (>90% of the tumor), atypical cells in three-dimensional clusters, and scattered singly in the mucin pools. Immunohistochemistry revealed a strong expression of MUC2 by the tumor cells. The second case is a 60-year-old female who was diagnosed clinically with a case of chronic cholecystitis; however, the cholecystectomy specimen showed a mucinous growth in the fundus and body of the gallbladder, microscopy of which showed extensive mucin pools (>90% of the tumor) along with scattered signet-ring cells. Both the cases were reported as mucinous carcinoma of the gallbladder. Mucinous carcinoma of the gallbladder exhibit more aggressive behavior than conventional gallbladder carcinomas. Documentation of these rare cases will encourage further research to find out their true incidence and adequate management of the patient.
    MeSH term(s) Adenocarcinoma, Mucinous/diagnosis ; Adenocarcinoma, Mucinous/surgery ; Aged ; Female ; Gallbladder Neoplasms/diagnostic imaging ; Gallbladder Neoplasms/surgery ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Mucins/metabolism
    Chemical Substances Mucins
    Language English
    Publishing date 2022-09-16
    Publishing country India
    Document type Case Reports
    ZDB-ID 2187633-2
    ISSN 1998-4138 ; 0973-1482
    ISSN (online) 1998-4138
    ISSN 0973-1482
    DOI 10.4103/jcrt.JCRT_646_19
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Metaplastic breast carcinoma: Analysis of clinical and pathologic features, a five-year study.

    Chaudhary, Dimple / Balhara, Kirti / Mandal, Shramana / Mallya, Varuna / Tomar, Reena / Khurana, Nita / Bains, Lovnish

    Journal of cancer research and therapeutics

    2023  Volume 19, Issue 5, Page(s) 1226–1230

    Abstract: Background: Metaplastic carcinoma breast (MCB) is a rare tumor comprising of both glandular and non-glandular patterns with epithelial and or mesenchymal components. Due to their varied clinicomorphological features, diagnosis has been challenging.: ... ...

    Abstract Background: Metaplastic carcinoma breast (MCB) is a rare tumor comprising of both glandular and non-glandular patterns with epithelial and or mesenchymal components. Due to their varied clinicomorphological features, diagnosis has been challenging.
    Aim: To study the clinicopathological and histomorphology of cases of metaplastic carcinoma breast diagnosed in a tertiary care hospital along with literature review.
    Materials and methods: This is a retrospective study including data of 11 patients who were diagnosed with MCB either on trucut or mastectomy specimens conducted between January 2014 and December 2018.
    Results: The study includes 11 patients, out of which 10 were diagnosed on mastectomy while one on trucut specimen. All the patients were women with the mean age of presentation being 43.8 years. The most common presentation was palpable breast lump with mean tumor size of 7.3 cm in greatest dimension. Skin involvement was seen in 36.3% of cases. While eight cases (72.7%) were classified as epithelial, three (27.2%) were classified as mixed. Amongst epithelial variety, in eight cases, squamous component was seen along with infiltrating ductal carcinoma (IDC) while one was pure squamous type. In mixed variety, one case showed spindled areas along with squamous areas and areas of IDC. Other two showed focal sarcomatous and cartilaginous areas in one and angiosarcomatous, bone and cartilage formation admixed with areas of IDC in other case.
    Conclusion: MCB are rare breast tumors with aggressive course and are characterized by their large size and rapid growth rate. Recently, there has been an upsurge in the cases of MCB due to increase in recognition of this entity. It has to be distinguished from other tumors by the pathologists so as to guide proper treatment.
    MeSH term(s) Adult ; Female ; Humans ; Breast/surgery ; Breast/pathology ; Breast Neoplasms/diagnosis ; Breast Neoplasms/surgery ; Breast Neoplasms/pathology ; Carcinoma, Squamous Cell/pathology ; Mastectomy ; Metaplasia/pathology ; Retrospective Studies
    Language English
    Publishing date 2023-10-03
    Publishing country India
    Document type Journal Article ; Review
    ZDB-ID 2187633-2
    ISSN 1998-4138 ; 0973-1482
    ISSN (online) 1998-4138
    ISSN 0973-1482
    DOI 10.4103/jcrt.jcrt_1229_21
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: A Rare Case of Extragonadal Mixed Germ Cell Tumor of the Sacrococcygeal Region with Mature Thymic Tissue in the Teratoma Component.

    Chaturvedi, Anubhuti / Tomar, Reena / Balhara, Kirti / Khurana, Nita / Ratan, Simmi K / Mitra, Aparajita

    Journal of Indian Association of Pediatric Surgeons

    2023  Volume 28, Issue 6, Page(s) 541–543

    Abstract: A rare extragonadal mixed germ cell tumor of the sacrococcygeal area presenting with mature thymic tissue in the teratomatous component, a rare finding and the first reported case of such an association. ...

    Abstract A rare extragonadal mixed germ cell tumor of the sacrococcygeal area presenting with mature thymic tissue in the teratomatous component, a rare finding and the first reported case of such an association.
    Language English
    Publishing date 2023-10-06
    Publishing country India
    Document type Case Reports
    ZDB-ID 2164528-0
    ISSN 1998-3891 ; 0971-9261
    ISSN (online) 1998-3891
    ISSN 0971-9261
    DOI 10.4103/jiaps.jiaps_150_23
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Endometrial stromal tumors: A clinico-histomorphological spectrum of endometrial stromal tumors with review of literature.

    Verma, Ankita / Tomar, Reena / Chaturvedi, Anubhuti / Dhankar, Nimisha / Mallya, Varuna / Khurana, Nita

    Journal of cancer research and therapeutics

    2023  Volume 20, Issue 1, Page(s) 150–155

    Abstract: Background: Endometrial stromal tumors (ESTs) are rare subset of mesenchymal uterine neoplasms. There are heterogeneous morphological, immunohistochemical, and genetic features. Approximately 50% of ESTs occur in perimenopausal women. In 2020, WHO sub- ... ...

    Abstract Background: Endometrial stromal tumors (ESTs) are rare subset of mesenchymal uterine neoplasms. There are heterogeneous morphological, immunohistochemical, and genetic features. Approximately 50% of ESTs occur in perimenopausal women. In 2020, WHO sub-categorized ESTs into four groups: endometrial stromal nodule (ESN), low-grade endometrial stromal sarcoma (LGESS), high-grade endometrial stromal sarcoma (HGESS), and undifferentiated uterine sarcoma (UUS).
    Objective: To review the morphological spectrum of endometrial stromal tumors.
    Method: This retrospective study reviewed the histomorphological features of 15 endometrial stromal tumors with respect to atypia, necrosis, mitosis, collagen bands, whorling around vessels, myometrial invasion, and inflammatory cells. Immunohistochemistry markers (CD10, SMA, and ER) along with special stains (Masson's trichrome, toluidine blue) were also studied.
    Results: The age of the patients ranged from 32 to 60 years. Three patients were postmenopausal. The most common presenting symptom was vaginal bleeding. Five patients were operated with a clinical diagnosis of uterine fibroid. One patient presented with prolapse with no other complaint. All the 15 patients had total abdominal hysterectomy and salpingo-oophorectomy. One case showed necrosis, eight cases showed collagen bands, all the 15 cases showed whorling around vessels, one case showed vascular emboli, and seven cases showed inflammatory cells. In low-grade cases, one case showed focal atypia and one case showed focal coagulative necrosis indicating infarction. Thirteen cases were LGESS, and one case of ESN and HGESS. All cases were positive for ER and CD10.
    Conclusion: Endometrial stromal tumors demonstrate extensive permeation of the myometrium as irregular islands with frequent vascular invasion, whorling around vessels, collagen bands, and inflammatory cells. All these features should be observed thoroughly on microscopy by pathologists to clearly differentiate the low-grade and high-grade endometrial stromal tumors, and to understand the overlapping gray areas morphologically as it affects the prognosis of the patient.
    MeSH term(s) Humans ; Female ; Adult ; Middle Aged ; Endometrial Stromal Tumors/diagnosis ; Endometrial Stromal Tumors/pathology ; Sarcoma, Endometrial Stromal/diagnosis ; Sarcoma, Endometrial Stromal/surgery ; Endometrial Neoplasms/diagnosis ; Endometrial Neoplasms/surgery ; Endometrial Neoplasms/genetics ; Retrospective Studies ; Uterine Neoplasms ; Collagen ; Necrosis
    Chemical Substances Collagen (9007-34-5)
    Language English
    Publishing date 2023-04-07
    Publishing country India
    Document type Review ; Journal Article
    ZDB-ID 2187633-2
    ISSN 1998-4138 ; 0973-1482
    ISSN (online) 1998-4138
    ISSN 0973-1482
    DOI 10.4103/jcrt.jcrt_741_22
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Role of CD44 as cancer stem cell marker in triple-negative breast cancer and its association with histological grade and angiogenesis.

    Tomar, Reena / Rakheja, Garima / Verma, Nidhi / Thakur, Shruti / Khurana, Nita / Ghuliani, Deepak

    Indian journal of pathology & microbiology

    2023  Volume 66, Issue 2, Page(s) 258–263

    Abstract: Introduction: Cancer stem cells (CSC) within the tumors play a central role in tumorigenesis. It is, thus, of utmost importance to identify these cells to develop effective cancer therapy. Triple-Negative Breast Cancer (TNBC) is an aggressive molecular ... ...

    Abstract Introduction: Cancer stem cells (CSC) within the tumors play a central role in tumorigenesis. It is, thus, of utmost importance to identify these cells to develop effective cancer therapy. Triple-Negative Breast Cancer (TNBC) is an aggressive molecular subtype of breast cancer associated with poor patient outcomes. The role of CD44 immunohistochemistry (IHC) as a putative CSC in breast carcinomas, particularly of the TNBC-subtype is ambiguous, with equivocal results.
    Aims and objectives: The present study aims to assess the role of CSC in breast carcinoma by immunohistochemical analysis of CD44 expression in TNBC. The association of TNBC expressing CSC with histological grade as well as with angiogenesis (using CD34 IHC) has been studied.
    Materials and methods: Biopsy samples from 58 patients with infiltrating ductal carcinoma, NST were studied. The histology of the tumor was sub-classified into grades 1-3. Based on immunohistochemical analysis (ER, PR, HER2/Neu), the cases were divided into TNBC and NTNBC groups. The tissue sections were also subjected to analysis for CD44 to identify the CSC-phenotype and CD34 to evaluate angiogenesis, to determine the microvascular density (MVD).
    Results: Out of the 58 cases in the study, 28 were TNBC and 30 were NTNBC. CSC phenotype (CD44 positive) was expressed significantly higher in the TNBC (78%) versus the NTNBC (53%) (p-value 0.043). The MVD estimated using CD34 IHC was lower in the TNBC group in our study, though the difference was not statistically significant. A larger proportion of cases in TNBC showed a higher histological grade (35%) in comparison to NTNBC (27%). However, statistically, it was not significant.
    Conclusion: Our study demonstrated that CD44 as a CSC marker is seen significantly more in the TNBC category of invasive ductal carcinomas. Further large-scale studies, to confirm these findings, will be of potential therapeutic and prognostic value.
    MeSH term(s) Humans ; Female ; Triple Negative Breast Neoplasms/pathology ; Biomarkers, Tumor/analysis ; CD24 Antigen/metabolism ; Prognosis ; Neoplastic Stem Cells/pathology ; Breast Neoplasms/pathology ; Hyaluronan Receptors
    Chemical Substances Biomarkers, Tumor ; CD24 Antigen ; CD44 protein, human ; Hyaluronan Receptors
    Language English
    Publishing date 2023-04-18
    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_437_21
    Database MEDical Literature Analysis and Retrieval System OnLINE

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