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Deepali Jain 5 Articles
Primary pulmonary epithelioid inflammatory myofibroblastic sarcoma: a rare entity and a literature review
Priyanka Singh, Aruna Nambirajan, Manish Kumar Gaur, Rahul Raj, Sunil Kumar, Prabhat Singh Malik, Deepali Jain
J Pathol Transl Med. 2022;56(4):231-237.   Published online July 7, 2022
DOI: https://doi.org/10.4132/jptm.2022.05.08
  • 1,610 View
  • 60 Download
AbstractAbstract PDF
Epithelioid inflammatory myofibroblastic sarcoma (EIMS) is an aggressive subtype of inflammatory myofibroblastic tumor (IMT) harboring anaplastic lymphoma kinase (ALK) gene fusions and is associated with high risk of local recurrence and poor prognosis. Herein, we present a young, non-smoking male who presented with complaints of cough and dyspnoea and was found to harbor a large right lower lobe lung mass. Biopsy showed a high-grade epithelioid to rhabdoid tumor with ALK and desmin protein expression. The patient initially received 5 cycles of crizotinib and remained stable for 1 year; however, he then developed multiple bony metastases, for which complete surgical resection was performed. Histopathology confirmed the diagnosis of EIMS, with ALK gene rearrangement demonstrated by fluorescence in situ hybridization. Postoperatively, the patient is asymptomatic with stable metastatic disease on crizotinib and has been started on palliative radiotherapy. EIMS is a very rare subtype of IMT that needs to be included in the differential diagnosis of ALKexpressing lung malignancies in young adults.
Correlation of TTF-1 immunoexpression and EGFR mutation spectrum in non–small cell lung carcinoma
Tripti Nakra, Varsha Singh, Aruna Nambirajan, Prabhat Singh Malik, Anant Mohan, Deepali Jain
J Pathol Transl Med. 2021;55(4):279-288.   Published online July 8, 2021
DOI: https://doi.org/10.4132/jptm.2021.05.10
  • 2,661 View
  • 112 Download
  • 3 Citations
AbstractAbstract PDF
Background
Thyroid transcription factor (TTF-1) is a diagnostic marker expressed in 75%–85% of primary lung adenocarcinomas (ACs). Activating mutations in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) gene is the most common targetable driver alteration in lung AC. Previous studies have shown a positive correlation between TTF-1 and EGFR mutation status. We aimed to determine the predictive value of TTF-1 immunoexpression for underlying EGFR mutation status in a large Indian cohort.
Methods
This retrospective designed study was conducted with medical record data from 2011 to 2020. All cases of primary lung AC and non–small cell lung carcinoma not otherwise specified (NSCLC, NOS) with known TTF-1 expression diagnosed by immunohistochemistry using 8G7G3/1 antibodies and EGFR mutation status diagnosed by quantitative polymerase chain reaction were retrieved, reviewed, and the
results
were analyzed. Results: Among 909 patient samples diagnosed as lung AC and NSCLC, NOS, TTF-1 was positive in 76.8% cases (698/909) and EGFR mutations were detected in 29.6% (269/909). A strong positive correlation was present between TTF-1 positivity and EGFR mutation status (odds ratio, 3.61; p < .001), with TTF-1 positivity showing high sensitivity (90%) and negative predictive value (87%) for EGFR mutation. TTF-1 immunoexpression did not show significant correlation with uncommon/dual EGFR mutations (odds ratio, 1.69; p = .098). EGFR–tyrosine kinase inhibitor therapy was significantly superior to chemotherapy among EGFR mutant cases irrespective of TTF-1 status; however, no significant differences among survival outcomes were observed.
Conclusions
Our study confirms a strong positive correlation between TTF-1 expression and common EGFR mutations (exon 19 deletion and exon 21 L858R) in advanced lung AC with significantly high negative predictive value of TTF-1 for EGFR mutations.

Citations

Citations to this article as recorded by  
  • Expression landscapes in non-small cell lung cancer shaped by the thyroid transcription factor 1
    Herdee Gloriane C. Luna, Marcelo Severino Imasa, Necy Juat, Katherine V. Hernandez, Treah May Sayo, Gloria Cristal-Luna, Sheena Marie Asur-Galang, Mirasol Bellengan, Kent John Duga, Bien Brian Buenaobra, Marvin I. De los Santos, Daniel Medina, Jamirah Sam
    Lung Cancer.2023; 176: 121.     CrossRef
  • Malignant pleural effusion cell blocks are reliable resources for PD-L1 analysis in advanced lung adenocarcinomas: a concordance study with matched histologic samples
    Swati Mahajan, Aruna Nambirajan, Ishan Gupta, Nalini Gupta, Parikshaa Gupta, Deepali Jain
    Journal of the American Society of Cytopathology.2022; 11(5): 253.     CrossRef
  • Clinicopathologic Features and Molecular Biomarkers as Predictors of Epidermal Growth Factor Receptor Gene Mutation in Non-Small Cell Lung Cancer Patients
    Lanlan Liu, Xianzhi Xiong
    Current Oncology.2021; 29(1): 77.     CrossRef
Endobronchial Smooth Muscle Tumors: A Series of Five Cases Highlighting Pitfalls in Diagnosis
Tripti Nakra, Aanchal Kakkar, Shipra Agarwal, Karan Madan, Suresh C Sharma, Deepali Jain
J Pathol Transl Med. 2018;52(4):219-225.   Published online July 11, 2018
DOI: https://doi.org/10.4132/jptm.2018.05.16
  • 4,589 View
  • 81 Download
  • 3 Citations
AbstractAbstract PDF
Background
Primary endobronchial smooth muscle tumors (SMTs), which are extremely rare, include endobronchial leiomyomas and leiomyosarcomas. Clinically, SMTs present with signs and symptoms of bronchial obstruction, and lack specific radiological findings. Thus, histopathological examination is required for accurate diagnosis as well as for tumor grading. We examined the histomorphological and immunohistochemical features of endobronchial SMTs and highlighted pitfalls in diagnosis, particularly when using small biopsies.
Methods
Cases of primary endobronchial SMTs diagnosed at our Institute over the last 6 years (2012–2017) were retrieved from the departmental archives. Histopathological features and immunohistochemistry performed for establishing the diagnosis were reviewed.
Results
Five cases of SMTs occurring in endobronchial locations were identified. These included three cases of leiomyoma, and two cases of leiomyosarcoma. The age distribution of patients ranged from 13 to 65 years. Leiomyomas showed more consistent staining with smooth muscle markers (smooth muscle actin, desmin, and smooth muscle myosin heavy chain), while tumors of higher grade showed variable, focal staining, leading to erroneous diagnosis, especially on small biopsies.
Conclusions
The diagnosis of endobronchial SMTs relies on histopathological examination, for both confirmation of smooth muscle lineage and determination of the malignant potential of the lesion. Appropriate immunohistochemical panels including more than one marker of smooth muscle differentiation are extremely valuable for differential diagnosis from morphological mimics, which is necessary for instituting appropriate management.

Citations

Citations to this article as recorded by  
  • Smooth Muscle Conditions of the Chest
    Matthew R. McCann, Lucas R. Massoth, Carlos A. Rojas, Yin P. Hung, John P. Lichtenberger, Gerald F. Abbott, Justin T. Stowell
    Journal of Thoracic Imaging.2021; 36(5): 263.     CrossRef
  • A Well-Defined Endobronchial Tumor in a 26-Year-Old Man
    Christina Triantafyllidou, Petros Effraimidis, Mirjam Schimanke, Simone Ignatova, Anders Ringman, Susann Skoog, Farkas Vánky, Miklós Boros, Karin Cederquist
    Chest.2021; 159(5): e313.     CrossRef
  • Primary Pulmonary Leiomyoma
    Mohammad Abu-Hishmeh, Gowthami Kobbari, Fouzia Shakil, Oleg Epelbaum
    Journal of Bronchology & Interventional Pulmonology.2020; 27(4): e54.     CrossRef
Thyroid Cytology in India: Contemporary Review and Meta-analysis
Shipra Agarwal, Deepali Jain
J Pathol Transl Med. 2017;51(6):533-547.   Published online October 5, 2017
DOI: https://doi.org/10.4132/jptm.2017.08.04
  • 7,830 View
  • 163 Download
  • 9 Citations
AbstractAbstract PDF
Fine-needle aspiration cytology (FNAC) is a screening test for triaging thyroid nodules, aiding in subsequent clinical management. However, the advantages have been overshadowed by the multiplicity of reporting systems and a wide range of nomenclature used. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was formulated in 2007, to give the world a uniform thyroid cytology reporting system, facilitating easy interpretation by the clinicians. Here, we review the status of thyroid FNAC in India in terms of various reporting systems used including a meta-analysis of the previously published data. An extensive literature search was performed using internet search engines. The reports with detailed classification system used in thyroid cytology were included. The meta-analysis of published data was compared with the implied risk of malignancy by TBSRTC. More than 50 studies were retrieved and evaluated. TBSRTC is currently the most widely used reporting system with different studies showing good efficacy and interobserver concordance. Ancillary techniques have, as of now, limited applicability and acceptability in thyroid cytology in India. Twenty-eight published articles met the criteria for inclusion in the meta-analysis. When compared with TBSRTC recommendations, the meta-analysis showed a higher risk of malignancy for categories I and III. Thyroid FNAC is practiced all over India. TBSRTC has found widespread acceptance, with most institutions using this system for routine thyroid cytology reporting. However, reasons for a high malignancy risk for categories I and III need to be looked into. Various possible contributing factors are discussed in the review.

Citations

Citations to this article as recorded by  
  • Evaluation of thyroid lesions by the bethesda system for reporting thyroid cytopathology
    SyedAsif Hashmi, Monika Aggrawal, Rahul Pandey, Deepika Gulati, InamDanish Khan
    Journal of Marine Medical Society.2023; 25(1): 73.     CrossRef
  • Cytomorphological categorization of thyroid lesions according to the bethesda system for reporting thyroid cytology and correlation with their histological outcome: An indian oncology centre experience
    Meenakshi Kamboj, Anurag Mehta, Sunil Pasricha, Gurudutt Gupta, Anila Sharma, Garima Durga
    Journal of Cytology.2022;[Epub]     CrossRef
  • Incidence and Malignancy Rates in Thyroid Nodules in North-East Indian Population by Bethesda System: A Single Institutional Experience of 3 Years
    Suvamoy Chakraborty, Manu C. Balakrishnan, Vandana Raphael, Prachurya Tamuli, Anuradha Deka
    South Asian Journal of Cancer.2022;[Epub]     CrossRef
  • Is surgery necessary in benign thyroid lesions?
    Pushkar Chaudhary, Naseem Noorunnisa
    Journal of Datta Meghe Institute of Medical Sciences University.2022; 17(3): 799.     CrossRef
  • Effect of the Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features (NIFTP) Nomenclature Revision on Indian Thyroid Fine-Needle Aspiration Practice
    Chanchal Rana, Pooja Ramakant, Divya Goel, Akanksha Singh, KulRanjan Singh, Suresh Babu, Anand Mishra
    American Journal of Clinical Pathology.2021; 156(2): 320.     CrossRef
  • The combination of ACR‐Thyroid Imaging Reporting and Data system and The Bethesda System for Reporting Thyroid Cytopathology in the evaluation of thyroid nodules—An institutional experience
    Shanmugasundaram Sakthisankari, Sreenivasan Vidhyalakshmi, Sivanandam Shanthakumari, Balalakshmoji Devanand, Udayasankar Nagul
    Cytopathology.2021; 32(4): 472.     CrossRef
  • Risk of malignancy in Thyroid “Atypia of undetermined significance/Follicular lesion of undetermined significance” and its subcategories – A 5-year experience
    Abha Thakur, Haimanti Sarin, Dilpreet Kaur, Deepak Sarin
    Indian Journal of Pathology and Microbiology.2019; 62(4): 544.     CrossRef
  • Thyroid FNA cytology in Asian practice-Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
    K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
    Cytopathology.2017; 28(6): 455.     CrossRef
  • The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
    Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
    Journal of Pathology and Translational Medicine.2017; 51(6): 571.     CrossRef
Acid-Fastness of Histoplasma in Surgical Pathology Practice
Madhu Rajeshwari, Immaculata Xess, Mehar Chand Sharma, Deepali Jain
J Pathol Transl Med. 2017;51(5):482-487.   Published online September 14, 2017
DOI: https://doi.org/10.4132/jptm.2017.07.11
  • 7,788 View
  • 138 Download
  • 6 Citations
AbstractAbstract PDF
Background
Histoplasmosis (HP) is diagnosed by visualizing intracellular microorganisms in biopsy and/or culture. Periodic-acid Schiff (PAS) and Gomori methenamine silver (GMS) staining methods are routinely used for identification. The acid-fast property of Histoplasma was identified decades ago, but acid-fast staining has not been practiced in current surgical pathology. Awareness of the acid-fast property of Histoplasma, which is due to mycolic acid in the cell wall, is important in distinguishing Histoplasma from other infective microorganisms. Here, we examined acid-fastness in previously diagnosed cases of Histoplasma using the Ziehl-Neelsen (ZN) stain and correlated those findings with other known fungal stains. Methods: All cases diagnosed as HP were retrieved and reviewed along with ZN staining and other fungal stains. We also stained cases diagnosed with Cryptococcus and Leishmania as controls for comparison. Results: A total of 54 patients ranging in age from 11 to 69 years were examined. The most common sites of infection were the skin, adrenal tissue, and respiratory tract. Of the total 43 tissue samples, 20 (46.5%) stained positive with the ZN stain. In viable cases, a significant proportion of microorganisms were positive while necrotic cases showed only rare ZN-positive yeasts. In comparison to PAS and GMS stains, there was a low burden of ZN-positive yeasts. Cryptococcus showed characteristic ZN staining and all cases of Leishmania were negative. Conclusions: Although the morphology of fungal organisms is the foundation of identification, surgical pathologists should be aware of the acid-fast property of fungi, particularly when there is the potential for confusion with other infective organisms.

Citations

Citations to this article as recorded by  
  • Histoplasma capsulatum var. duboisii : A KwaZulu‐Natal , South Africa public sector perspective
    Lerato Claudia Khathali, Gamalenkosi Bonginkosi Nhlonzi, Absalom Mwazha
    Journal of Cutaneous Pathology.2022; 49(2): 139.     CrossRef
  • Histologic features of colonic infections
    Maria Westerhoff
    Der Pathologe.2022; 43(1): 16.     CrossRef
  • Challenge of Ziehl-Neelsen stain for Basidiobolomycosis diagnosis in Indonesia: A unique case report
    Metta Octora, Arthur Pohan Kawilarang, Pepy Dwi Endraswari
    Annals of Medicine and Surgery.2022; 74: 103278.     CrossRef
  • Pulmonary Histoplasmosis Mimicking Metastatic Lung Cancer: A Case Report
    Gion Ruegg, Stefan Zimmerli, Maria Trachsel, Sabina Berezowska, Swantje Engelbrecht, Yonas Martin, Martin Perrig
    Diagnostics.2021; 11(2): 328.     CrossRef
  • Cutaneous Histoplasmosis in HIV Seronegative Patients: A Clinicopathological Analysis
    Arvind Ahuja, Minakshi Bhardwaj, Poojan Agarwal
    Dermatology.2021; 237(6): 934.     CrossRef
  • Challenges in the Diagnosis of Invasive Fungal Infections in Immunocompromised Hosts
    Spinello Antinori, Mario Corbellino, Carlo Parravicini
    Current Fungal Infection Reports.2018; 12(1): 12.     CrossRef

JPTM : Journal of Pathology and Translational Medicine