Objectives: To study the sensitivity and specificity of IHC markers AMACR and ERG in prostatic ad... more Objectives: To study the sensitivity and specificity of IHC markers AMACR and ERG in prostatic adenocarcinoma. Methods: The study was a prospective one and samples were collected from August 2014 to June 2016. A total of 186 samples were obtained from the Department of Urology, in which 112 of these were benign prostatic hyperplasia (BPH), and 71 were prostatic adenocarcinoma. The adenocarcinoma cases were evaluated by two histopathologists, and appropriate Gleason score was given according to the modified ISUP Gleason grading system (2016). IHC markers AMACR & ERG were performed on the adenocarcinoma cases and their sensitivity and specificity were calculated. Results: AMACR was a highly sensitive and specific marker for detecting prostatic carcinoma with a sensitivity and specificity of 95.8% and 96.5% respectively. ERG was a very specific marker with poor sensitivity in detecting prostate cancer. The sensitivity and specificity of ERG were 35.2% and 100% respectively. ERG expression decreased with increasing Gleason grade, PSA level, and tumour volume, which was statistically significant while the association of AMACR with Gleason grade or with tumor volume was not significant. Conclusion: ERG is a marker of early prostatic carcinogenesis and tumors may be positive or negative subtypes. Special histomorphologic features like perineural invasion, glomerulations, and intraluminal blue mucin were also studied. AMACR was a highly sensitive marker for detecting prostatic adenocarcinoma, while ERG was highly specific.
Sertoliform endometrioid carcinoma (SEC) is a rare epithelial ovarian cancer which may be mistake... more Sertoliform endometrioid carcinoma (SEC) is a rare epithelial ovarian cancer which may be mistaken for sex cord tumour on microscopy. Immunohistochemistry and extensive sampling of tumour to look for areas of conventional endometrioid carcinoma are important to confirm the diagnosis of SEC. We report a case of SEC of ovary in a postmenopausal lady who presented to us with abdominal wall abscess in epigastric region.
https://www.monaldi-archives.org/ Publisher's Disclaimer. E-publishing ahead of print is increasi... more https://www.monaldi-archives.org/ Publisher's Disclaimer. E-publishing ahead of print is increasingly important for the rapid dissemination of science. The Early Access service lets users access peer-reviewed articles well before print / regular issue publication, significantly reducing the time it takes for critical findings to reach the research community. These articles are searchable and citable by their DOI (Digital Object Identifier). The Monaldi Archives for Chest Disease is, therefore, e-publishing PDF files of an early version of manuscripts that have undergone a regular peer review and have been accepted for publication, but have not been through the typesetting, pagination and proofreading processes, which may lead to differences between this version and the final one. The final version of the manuscript will then appear in a regular issue of the journal. E-publishing of this PDF file has been approved by the authors. All legal disclaimers applicable to the journal apply to this production process as well.
Malakoplakia is a chronic xanthogranulomatous condition that affects the genitourinary tract repo... more Malakoplakia is a chronic xanthogranulomatous condition that affects the genitourinary tract reported earlier as urinary granulomas and pelvic masses. We report a different clinical manifestation of malakoplakia presenting as postmenopausal pyometra. A 64-year-old postmenopausal female presented with foul-smelling vaginal discharge with a past history of induced abortion, followed by dilatation and evacuation. On examination, abdomen was soft, vaginal examination revealed pus discharge, parous size uterus with free fornices, and pap smear ruled out malignancy. Ultrasonography revealed linear, echogenic structures in the endometrial cavity suspicious of bony spicules with fluid around. Hysteroscopy revealed congested endometrium with multiple pieces of shredded bone-like structures that were removed followed by curettage. Histopathological examination was suggestive of malakoplakia with osseous metaplasia. Retained bony spicules can cause chronic granulomatous inflammation that may become symptomatic postmenopause due to absent cyclical shedding. This is the first reported case of malakoplakia of uterus following retained bony spicules.
Endosalpingiosis is a benign condition characterized by the presence of tubal-type epithelial cel... more Endosalpingiosis is a benign condition characterized by the presence of tubal-type epithelial cells outside the Fallopian tube. It may rarely involve the uterus and present as a cystic or tumor-like mass. We report an unusual case of cystic uterine endosalpingiosis in a postmenopausal female with carcinoma endometrium. Preoperative and intraoperative diagnosis of this condition is challenging. Awareness about this condition in clinicians may help in preventing misdiagnosis and overtreatment.
Title: Rhabdomyosarcoma of urinary bladder in a young male suspected and confirmed on urine cytol... more Title: Rhabdomyosarcoma of urinary bladder in a young male suspected and confirmed on urine cytology.
Objectives: Membranous nephropathy (MN), also called membranous glomerulopathy, is one of the lea... more Objectives: Membranous nephropathy (MN), also called membranous glomerulopathy, is one of the leading causes of nephrotic syndrome in adults which is defined by the presence of subepithelial immune complex deposits with a spectrum of changes in the glomerular basement membrane (GBM). It is known that C4d is a byproduct of the classic and lectin pathway. There is deposition of C4d noted in the cases of immune complex-mediated glomerulonephritis involving the classical/lectin pathway including MN. The main objective of this study is to assess the utility C4d as an immunohistochemical (IHC) stain in MN. Materials: A total of 43 cases of MN (primary & secondary) were taken, and 39 cases of minimal change disease (MCD)/focal segmental glomerulosclerosis (FSGS) were used as the control group. All the relevant data were retrieved from the hospital database. C4d immunohistochemistry was performed in the cases as well as the control group. Results: A diffuse continuous staining pattern in the glomeruli was observed in cases of primary MN whereas a discontinuous staining in the glomerulI favors a secondary MN. 26/29 cases of MCD showed positivity in the podocytes. Among the cases of FSGS, 7/10 cases showed positivity in the podocytes with 3 cases showing an associated mesangial blush pattern of staining. Conclusion: Very few studies are available demonstrating the importance of C4d IHC in MN. C4d IHC can be a useful adjunct for immunofluorescence, especially in cases of early MN.
A 12‐year‐old male child presented with complaints of a slow growing swelling in the right parast... more A 12‐year‐old male child presented with complaints of a slow growing swelling in the right parasternal region noticed since one month. On examination, the lump was 2 × 2 cm firm, mobile nontender located in the subcutaneous plane which was also confirmed radiologically. Fine needle aspiration cytology was attempted showed small to medium sized monotonous round cell morphology, nuclear molding and mitotic figures were frequent. Few cells exhibiting rosettoid arrangement. No definite epithelial or mesenchymal component was evident. No glio‐fibrillary matrix or lymphoglandular bodies were evident in the smears. Based on morphology, a small round cell tumor was considered with possibilities of Wilm's tumor and Ewing's family of tumor. Based on morphological differentials ICC was requested, tumor cells were positive for strong nuclear WT1 staining while CK and FLI1 were negative. The cytomorphology along with the ICC confirmed the diagnosis of metastatic wilm's tumor. Seven y...
The diagnosis of myositis ossificans onfine needle aspiration cytology is a challenge due to vari... more The diagnosis of myositis ossificans onfine needle aspiration cytology is a challenge due to variation in clinical, radiological and pathological findings in its three stages. A case is described with particular attention to the cytological features and diferential diagnosis.
Medullary carcinoma of thyroid is a relatively uncommon malignancy, which can be sporadic and syn... more Medullary carcinoma of thyroid is a relatively uncommon malignancy, which can be sporadic and syndromic in nature. It commonly spreads to regional lymph nodes followed by spreading to distant sites. Breast is an uncommon site of metastasis of this malignancy. Our case is a 38-year-old woman married parous woman presenting to the outpatient department with complaints of lump in both the breasts. Fineneedle aspiration (FNA) was attempted, which revealed a malignancy more suggestive of a metastasis, which was confirmed on CT scan. A detailed history revealed
Columnar cell variant of papillary thyroid carcinoma (PTC) is a rare subtype which is difficult t... more Columnar cell variant of papillary thyroid carcinoma (PTC) is a rare subtype which is difficult to predict on cytology and is usually identified histologically. Nevertheless this case highlights the features that allowed the diagnosis to be made pre‐operatively.
An intraosseous ganglion is a rare lesion which can be confused clinically and radiologically wit... more An intraosseous ganglion is a rare lesion which can be confused clinically and radiologically with bony neoplasms. This lesion can be accurately diagnosed on FNAC when biopsy may not be very useful.
The phagocytic property of mesothelial cells has rarely been reported. This letter describes the ... more The phagocytic property of mesothelial cells has rarely been reported. This letter describes the presence of haemosiderin‐laden mesothelial cells in an ascitic fluid sample.
Orbital hematolymphoid lesions are rare and usually encountered in elderly patients. Orbital lesi... more Orbital hematolymphoid lesions are rare and usually encountered in elderly patients. Orbital lesions are not easy to biopsy: hence fine needle aspiration cytology (FNAC) can be a very good diagnostic modality for these lesions.
A 48year old HIV positive male presented with shortness of breath at rest for 2 days. He reported... more A 48year old HIV positive male presented with shortness of breath at rest for 2 days. He reported having experienced fever, a dry cough and shortness of breath on exertion for the previous 2 months with gradual worsening. There was a 3 × 3 cm palpable lymph node in the inguinal region which was tender and fluctuant. No cutaneous lesions were seen. Fine needle aspiration cytology (FNAC) of the inguinal swelling was performed, with clinical suspicion of tuberculosis. It yielded purulent material, and smears stained with May Grunwald Giemsa (MGG) and Papanicolaou (Pap) stain showed suppurative inflammation, with sheets of neutrophils and scattered lymphocytes in a necrotic background. No granulomas or atypical cells were seen (Figure 1). Periodic acidSchiff (PAS) stain did not highlight any fungal organisms, and modified ZiehlNeelsen (ZN) stain with 1% acid alcohol showed few slender, slightly beaded, filamentous, rightangled branching acidfast bacilli, morphologically resembling Nocardia. They were also seen in Gramstained smears. Blood agar inoculated with the inguinal aspirate also grew tiny chalky white colonies of Nocardia farcinica (Figure 2). Imaging did not reveal any significant brain or lung lesions, and a no organisms grew in a sputum culture. The absence of cutaneous lesions revealed the lymph node as the only site of Nocardia involvement. Since primary nocardiosis of lymph node is not known, there could have been clinically unrecognised or healed cutaneous lesions, making this lymphocutaneous nocardiosis. Given the patient’s predisposition, another explanation is that, though the blood culture did not yield Nocardia, there could still have been a disseminated infection.
Rhinosporidiosis is a chronic mucocutaneous granulomatous disease caused by Rhinosporidium seeber... more Rhinosporidiosis is a chronic mucocutaneous granulomatous disease caused by Rhinosporidium seeberi, commonly affecting the nose and nasopharynx. Endobronchial involvement is of rare occurrence but can pose challenging problems for diagnosis, surgical excision and anaesthetic management. We report a 40-year-old man with a history of recurrent nasal rhinosporidiosis who presented with unilateral nasal obstruction, cough, shortness of breath and a radiological feature of left lung collapse. Eight years since the last surgery, he presented with a recurrent lesion in the nose with concurrent endobronchial involvement. The patient underwent excision of the nasal and the endobronchial lesion successfully under general anaesthesia without any complication and good symptomatic improvement. The clinical presentation and the management of endobronchial rhinosporidiosis are discussed here. The surgical difficulties faced during the procedure are highlighted.
Sino-nasal tract tumours constitute 3% of the head and neck malignancies. Among these tumours, ne... more Sino-nasal tract tumours constitute 3% of the head and neck malignancies. Among these tumours, neuroectodermal tumours are rare with histo-morphological and immunohistochemical overlap making them a challenge for the pathologist. We included Ewing’s/PNET, olfactory neuroblastoma (OFN), mucosal malignant melanomas (MMM), Melanotic neuroectodermal tumour of infancy (MNTI), small-cell neuroendocrine carcinoma (SNEC), and the newest entity Adamantinoma like Ewing’s sarcoma (ALES) as part of the neuroectodermally derived tumours of the sino-nasal tract. The last three entities were added to the existing ones, which also has been emphasized in this paper. A comprehensive analysis was done on all neuroectodermally derived tumours from 2016 to 2020. A total of 18 cases were collected, which included OFN (10 cases), SNEC (2 cases), MMM (2 cases), Ewing’s/PNET (2 cases), MNTI (1 case), and ALES (1 case). The most common presentation in NE tumours was nasal obstruction (80–100%). Except for OFN, all other tumours were confined to the nasal and paranasal sinuses. 4/10 cases of OFN showed orbital extension. Cervical lymph-node metastasis was seen in 50% of cases of SNEC and MMM groups. An array of relevant immune-histochemical markers were performed. The marker expression was very subtle among the groups. On follow-up, recurrence was seen in the OFN and MMM groups in 30 and 50%, respectively. Metastasis was seen in SNEC group (100%) and OFN group (10%). As sino-nasal neuroectodermal tumours pose a diagnostic challenge and have different therapies and are prognostically different, the pathologist must be aware of the subtle morphological, immunohistochemical clues which have been dealt with in-depth in this study.
Objectives: To study the sensitivity and specificity of IHC markers AMACR and ERG in prostatic ad... more Objectives: To study the sensitivity and specificity of IHC markers AMACR and ERG in prostatic adenocarcinoma. Methods: The study was a prospective one and samples were collected from August 2014 to June 2016. A total of 186 samples were obtained from the Department of Urology, in which 112 of these were benign prostatic hyperplasia (BPH), and 71 were prostatic adenocarcinoma. The adenocarcinoma cases were evaluated by two histopathologists, and appropriate Gleason score was given according to the modified ISUP Gleason grading system (2016). IHC markers AMACR & ERG were performed on the adenocarcinoma cases and their sensitivity and specificity were calculated. Results: AMACR was a highly sensitive and specific marker for detecting prostatic carcinoma with a sensitivity and specificity of 95.8% and 96.5% respectively. ERG was a very specific marker with poor sensitivity in detecting prostate cancer. The sensitivity and specificity of ERG were 35.2% and 100% respectively. ERG expression decreased with increasing Gleason grade, PSA level, and tumour volume, which was statistically significant while the association of AMACR with Gleason grade or with tumor volume was not significant. Conclusion: ERG is a marker of early prostatic carcinogenesis and tumors may be positive or negative subtypes. Special histomorphologic features like perineural invasion, glomerulations, and intraluminal blue mucin were also studied. AMACR was a highly sensitive marker for detecting prostatic adenocarcinoma, while ERG was highly specific.
Sertoliform endometrioid carcinoma (SEC) is a rare epithelial ovarian cancer which may be mistake... more Sertoliform endometrioid carcinoma (SEC) is a rare epithelial ovarian cancer which may be mistaken for sex cord tumour on microscopy. Immunohistochemistry and extensive sampling of tumour to look for areas of conventional endometrioid carcinoma are important to confirm the diagnosis of SEC. We report a case of SEC of ovary in a postmenopausal lady who presented to us with abdominal wall abscess in epigastric region.
https://www.monaldi-archives.org/ Publisher's Disclaimer. E-publishing ahead of print is increasi... more https://www.monaldi-archives.org/ Publisher's Disclaimer. E-publishing ahead of print is increasingly important for the rapid dissemination of science. The Early Access service lets users access peer-reviewed articles well before print / regular issue publication, significantly reducing the time it takes for critical findings to reach the research community. These articles are searchable and citable by their DOI (Digital Object Identifier). The Monaldi Archives for Chest Disease is, therefore, e-publishing PDF files of an early version of manuscripts that have undergone a regular peer review and have been accepted for publication, but have not been through the typesetting, pagination and proofreading processes, which may lead to differences between this version and the final one. The final version of the manuscript will then appear in a regular issue of the journal. E-publishing of this PDF file has been approved by the authors. All legal disclaimers applicable to the journal apply to this production process as well.
Malakoplakia is a chronic xanthogranulomatous condition that affects the genitourinary tract repo... more Malakoplakia is a chronic xanthogranulomatous condition that affects the genitourinary tract reported earlier as urinary granulomas and pelvic masses. We report a different clinical manifestation of malakoplakia presenting as postmenopausal pyometra. A 64-year-old postmenopausal female presented with foul-smelling vaginal discharge with a past history of induced abortion, followed by dilatation and evacuation. On examination, abdomen was soft, vaginal examination revealed pus discharge, parous size uterus with free fornices, and pap smear ruled out malignancy. Ultrasonography revealed linear, echogenic structures in the endometrial cavity suspicious of bony spicules with fluid around. Hysteroscopy revealed congested endometrium with multiple pieces of shredded bone-like structures that were removed followed by curettage. Histopathological examination was suggestive of malakoplakia with osseous metaplasia. Retained bony spicules can cause chronic granulomatous inflammation that may become symptomatic postmenopause due to absent cyclical shedding. This is the first reported case of malakoplakia of uterus following retained bony spicules.
Endosalpingiosis is a benign condition characterized by the presence of tubal-type epithelial cel... more Endosalpingiosis is a benign condition characterized by the presence of tubal-type epithelial cells outside the Fallopian tube. It may rarely involve the uterus and present as a cystic or tumor-like mass. We report an unusual case of cystic uterine endosalpingiosis in a postmenopausal female with carcinoma endometrium. Preoperative and intraoperative diagnosis of this condition is challenging. Awareness about this condition in clinicians may help in preventing misdiagnosis and overtreatment.
Title: Rhabdomyosarcoma of urinary bladder in a young male suspected and confirmed on urine cytol... more Title: Rhabdomyosarcoma of urinary bladder in a young male suspected and confirmed on urine cytology.
Objectives: Membranous nephropathy (MN), also called membranous glomerulopathy, is one of the lea... more Objectives: Membranous nephropathy (MN), also called membranous glomerulopathy, is one of the leading causes of nephrotic syndrome in adults which is defined by the presence of subepithelial immune complex deposits with a spectrum of changes in the glomerular basement membrane (GBM). It is known that C4d is a byproduct of the classic and lectin pathway. There is deposition of C4d noted in the cases of immune complex-mediated glomerulonephritis involving the classical/lectin pathway including MN. The main objective of this study is to assess the utility C4d as an immunohistochemical (IHC) stain in MN. Materials: A total of 43 cases of MN (primary & secondary) were taken, and 39 cases of minimal change disease (MCD)/focal segmental glomerulosclerosis (FSGS) were used as the control group. All the relevant data were retrieved from the hospital database. C4d immunohistochemistry was performed in the cases as well as the control group. Results: A diffuse continuous staining pattern in the glomeruli was observed in cases of primary MN whereas a discontinuous staining in the glomerulI favors a secondary MN. 26/29 cases of MCD showed positivity in the podocytes. Among the cases of FSGS, 7/10 cases showed positivity in the podocytes with 3 cases showing an associated mesangial blush pattern of staining. Conclusion: Very few studies are available demonstrating the importance of C4d IHC in MN. C4d IHC can be a useful adjunct for immunofluorescence, especially in cases of early MN.
A 12‐year‐old male child presented with complaints of a slow growing swelling in the right parast... more A 12‐year‐old male child presented with complaints of a slow growing swelling in the right parasternal region noticed since one month. On examination, the lump was 2 × 2 cm firm, mobile nontender located in the subcutaneous plane which was also confirmed radiologically. Fine needle aspiration cytology was attempted showed small to medium sized monotonous round cell morphology, nuclear molding and mitotic figures were frequent. Few cells exhibiting rosettoid arrangement. No definite epithelial or mesenchymal component was evident. No glio‐fibrillary matrix or lymphoglandular bodies were evident in the smears. Based on morphology, a small round cell tumor was considered with possibilities of Wilm's tumor and Ewing's family of tumor. Based on morphological differentials ICC was requested, tumor cells were positive for strong nuclear WT1 staining while CK and FLI1 were negative. The cytomorphology along with the ICC confirmed the diagnosis of metastatic wilm's tumor. Seven y...
The diagnosis of myositis ossificans onfine needle aspiration cytology is a challenge due to vari... more The diagnosis of myositis ossificans onfine needle aspiration cytology is a challenge due to variation in clinical, radiological and pathological findings in its three stages. A case is described with particular attention to the cytological features and diferential diagnosis.
Medullary carcinoma of thyroid is a relatively uncommon malignancy, which can be sporadic and syn... more Medullary carcinoma of thyroid is a relatively uncommon malignancy, which can be sporadic and syndromic in nature. It commonly spreads to regional lymph nodes followed by spreading to distant sites. Breast is an uncommon site of metastasis of this malignancy. Our case is a 38-year-old woman married parous woman presenting to the outpatient department with complaints of lump in both the breasts. Fineneedle aspiration (FNA) was attempted, which revealed a malignancy more suggestive of a metastasis, which was confirmed on CT scan. A detailed history revealed
Columnar cell variant of papillary thyroid carcinoma (PTC) is a rare subtype which is difficult t... more Columnar cell variant of papillary thyroid carcinoma (PTC) is a rare subtype which is difficult to predict on cytology and is usually identified histologically. Nevertheless this case highlights the features that allowed the diagnosis to be made pre‐operatively.
An intraosseous ganglion is a rare lesion which can be confused clinically and radiologically wit... more An intraosseous ganglion is a rare lesion which can be confused clinically and radiologically with bony neoplasms. This lesion can be accurately diagnosed on FNAC when biopsy may not be very useful.
The phagocytic property of mesothelial cells has rarely been reported. This letter describes the ... more The phagocytic property of mesothelial cells has rarely been reported. This letter describes the presence of haemosiderin‐laden mesothelial cells in an ascitic fluid sample.
Orbital hematolymphoid lesions are rare and usually encountered in elderly patients. Orbital lesi... more Orbital hematolymphoid lesions are rare and usually encountered in elderly patients. Orbital lesions are not easy to biopsy: hence fine needle aspiration cytology (FNAC) can be a very good diagnostic modality for these lesions.
A 48year old HIV positive male presented with shortness of breath at rest for 2 days. He reported... more A 48year old HIV positive male presented with shortness of breath at rest for 2 days. He reported having experienced fever, a dry cough and shortness of breath on exertion for the previous 2 months with gradual worsening. There was a 3 × 3 cm palpable lymph node in the inguinal region which was tender and fluctuant. No cutaneous lesions were seen. Fine needle aspiration cytology (FNAC) of the inguinal swelling was performed, with clinical suspicion of tuberculosis. It yielded purulent material, and smears stained with May Grunwald Giemsa (MGG) and Papanicolaou (Pap) stain showed suppurative inflammation, with sheets of neutrophils and scattered lymphocytes in a necrotic background. No granulomas or atypical cells were seen (Figure 1). Periodic acidSchiff (PAS) stain did not highlight any fungal organisms, and modified ZiehlNeelsen (ZN) stain with 1% acid alcohol showed few slender, slightly beaded, filamentous, rightangled branching acidfast bacilli, morphologically resembling Nocardia. They were also seen in Gramstained smears. Blood agar inoculated with the inguinal aspirate also grew tiny chalky white colonies of Nocardia farcinica (Figure 2). Imaging did not reveal any significant brain or lung lesions, and a no organisms grew in a sputum culture. The absence of cutaneous lesions revealed the lymph node as the only site of Nocardia involvement. Since primary nocardiosis of lymph node is not known, there could have been clinically unrecognised or healed cutaneous lesions, making this lymphocutaneous nocardiosis. Given the patient’s predisposition, another explanation is that, though the blood culture did not yield Nocardia, there could still have been a disseminated infection.
Rhinosporidiosis is a chronic mucocutaneous granulomatous disease caused by Rhinosporidium seeber... more Rhinosporidiosis is a chronic mucocutaneous granulomatous disease caused by Rhinosporidium seeberi, commonly affecting the nose and nasopharynx. Endobronchial involvement is of rare occurrence but can pose challenging problems for diagnosis, surgical excision and anaesthetic management. We report a 40-year-old man with a history of recurrent nasal rhinosporidiosis who presented with unilateral nasal obstruction, cough, shortness of breath and a radiological feature of left lung collapse. Eight years since the last surgery, he presented with a recurrent lesion in the nose with concurrent endobronchial involvement. The patient underwent excision of the nasal and the endobronchial lesion successfully under general anaesthesia without any complication and good symptomatic improvement. The clinical presentation and the management of endobronchial rhinosporidiosis are discussed here. The surgical difficulties faced during the procedure are highlighted.
Sino-nasal tract tumours constitute 3% of the head and neck malignancies. Among these tumours, ne... more Sino-nasal tract tumours constitute 3% of the head and neck malignancies. Among these tumours, neuroectodermal tumours are rare with histo-morphological and immunohistochemical overlap making them a challenge for the pathologist. We included Ewing’s/PNET, olfactory neuroblastoma (OFN), mucosal malignant melanomas (MMM), Melanotic neuroectodermal tumour of infancy (MNTI), small-cell neuroendocrine carcinoma (SNEC), and the newest entity Adamantinoma like Ewing’s sarcoma (ALES) as part of the neuroectodermally derived tumours of the sino-nasal tract. The last three entities were added to the existing ones, which also has been emphasized in this paper. A comprehensive analysis was done on all neuroectodermally derived tumours from 2016 to 2020. A total of 18 cases were collected, which included OFN (10 cases), SNEC (2 cases), MMM (2 cases), Ewing’s/PNET (2 cases), MNTI (1 case), and ALES (1 case). The most common presentation in NE tumours was nasal obstruction (80–100%). Except for OFN, all other tumours were confined to the nasal and paranasal sinuses. 4/10 cases of OFN showed orbital extension. Cervical lymph-node metastasis was seen in 50% of cases of SNEC and MMM groups. An array of relevant immune-histochemical markers were performed. The marker expression was very subtle among the groups. On follow-up, recurrence was seen in the OFN and MMM groups in 30 and 50%, respectively. Metastasis was seen in SNEC group (100%) and OFN group (10%). As sino-nasal neuroectodermal tumours pose a diagnostic challenge and have different therapies and are prognostically different, the pathologist must be aware of the subtle morphological, immunohistochemical clues which have been dealt with in-depth in this study.
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