Correlation of Hormonal Receptors Estrogen Receptor, Progesterone Receptor and Her-2/Neu with Tumor Characteristics in Breast Carcinoma: Study of 100 Consecutive Cases

Introduction-Breast cancer is the most common cancer and leading cause of death in women. In India, its incidence is rapidly rising over last few decades. Present study is aimed to study the pattern of expression of hormonal receptors and Her-2/neu in invasive breast carcinoma and to correlate estrogen receptor (ER), progesterone receptor (PR) and Her-2/neu expressions with various clinicopathological parameters. Material and methods: The present study was carried out in Department of Pathology, S.C.B. Medical College, Cuttack in the year 2013 taking consecutive 100 cases. Routine H&E staining for histological diagnosis and IHC analysis for ER, PR and Her 2/neu was carried out in all 100 cases of breast malignancies. Results: 99% of cases are invasive breast carcinoma, not otherwise specify (IDC-NOS). The age ranges from 23 years to 72 years. Majority of tumors are of grade 2 (70%) followed by grade 3 (30%). ER PR and Her-2/neu expression are seen in 45%, 35% and 30% respectively. Triple negative cases comprise 35%. Higher number of grade 2 tumor shows ER, PR positivity as compared to grade 3 tumors. Her-2/neu expression does not show any significant correlation with age or lymph node status of the patient. Conclusion: ER and PR expression in breast cancers in the current study are found to be comparable to the findings of other authors, but the frequency of HER-2/neu expression is slightly higher. Significant correlation is observed between hormonal receptor status and the grade of the tumor. Inverse relationship is found between Her-2/neu expression and ER, PR receptor status. Her-2/neu expression is increased with size and high grade of tumor.

Undergraduate Pathology Education: Meeting the Challenge Ahead

Background: In India, undergraduate medical education has remained more or less static and for last so many decades no effective development has been done. Therefore this study is done for restructuring it and to meet the challenges faced thereby. Material and methods: Depending on the problems faced during undergraduate pathology teaching, questions were prepared and sent to pathology teachers of Odisha. In few aspects, suggestions were also asked for modification of the present system of medical curriculum including the problem of factual or information overload on students. Results: 18 questions were prepared and asked to 96 pathology teachers. The opinions mostly were to introduce small group teaching or problem based learning (PBL) and multidisciplinary integrated teaching. The opinion of students of 3rd and 4th MBBS were also taken into consideration for taking the decisions of modification. Conclusion: Efforts should be taken to bring the desired changes in undergraduate pathology education to produce need based human resources for health care in society.

Autopsy Findings in a Case of Ellis Van Creveld Syndrome with Review of Literature

Ellis Van Creveld (EVC) syndrome is one of the congenital anomalies not compatible with life. It is also known as chondroectodermal dysplasia. The most common manifestations of this syndrome are short ribs, postaxial polydactyly, growth retardation, and ectodermal and cardiac defects. It has an incidence of one in every 60,000 live births and equal sex predisposition. In our case, perinatal autopsy was performed in a stillborn baby of 32 weeks of gestation having syndactyly, polydactyly and short forearms to know the cause of death and the diagnosis emerged as EVC syndrome. It is important to diagnose EVC syndrome as it is transmitted as an autosomal recessive disorder, so genetic counseling is required to make parents aware of the risk of recurrence.

Use of Telemedicine in Postgraduate Pathology Education

Objective: Telemedicine is the use of telecommunication for medical diagnosis, treatment, health education and research. Telepathology is diagnostic pathology at a distance. It functions with images viewed on a video monitor rather than directly through a microscope. Many years have passed since the evolution of telepathology. But no study has yet been done to evaluate the benefits postgraduates got through this. Therefore this study is undertaken to analyse the different impacts of telepathology on the postgraduate learning. Material and Methods: The study was done in Telemedicine Center of S. C. B. Medical College, Cuttack over a period of 9 years. The telepathology service was carried out by store and forward method using a CCD, a large computer server and a huge bandwidth network service (VSAT). The sessions with SGPGI, Lucknow were analysed and the benefits of postgraduates were studied. Results: The number of sessions held was 95. Out of which 92 sessions were with SGPGI. It included 202 cases transmitted from Lucknow and 186 cases from S. C. B. Medical College, Cuttack. The postgraduates had a chance to exposure to rare cases in renal pathology, dermatopathology and hepatopathology. The overall concordance rate with glass slide diagnosis was 87%. Conclusion: The diagnostic expertise through light microscopy and tele-images are not the same. But the telepathology system increased the ability of image analysis, histopathologic diagnosis of our postgraduates and also exposed them to many rare and interesting cases.

Meckel-Gruber Syndrome:Autopsy Based Approach to Diagnosis

Meckel–Gruber syndrome(MGS)is a rare lethal congenital malformation affecting 1 in 13,250–140,000 live births.The classical diagnostic triad comprises multicystic dysplastic kidneys,occipital encephalocele,and postaxial polydactyly.It can variably be associated with other malformations such as cleft lip and palate,pulmonary hypoplasia,hepatic fibrosis,and anomalies of central nervous system.A 20 weeks fetus was diagnosed as MGS with classical features along with many other congenital abnormalities such as microcephaly,microphthalmia,hypertelorism,cleft lip and palate,neonatal teeth,and the right side club foot which were detected only after doing autopsy.This case is reported because of its rarity emphasizing the importance of neonatal autopsy in every case of fetal death,especially where the antenatal diagnosis has not been made previously.A systematic approach to accurate diagnosis of MGS based on autopsy will be described here which can allow recurrence risk counseling and proper management in future pregnancies.