Head and Neck Pathology

Histopathological findings of solitary thyroid nodule: An institutional retrospective analysis Harendra Kumar Gautam, Suredrendra Kumar Kanaujia, Vinod Kumar, Devendra Maurya, Shiromani Singh International Journal of Head and Neck Pathology 2018 1(2):37-40 Background: Thyroid swellings are commonly encountered in the surgical practice and accurate preoperative evaluation of thyroid disorder becomes mandatory for the proper management of the patients. Aims and Objectives: The aim of this study was to study the histopathological finding in patients of solitary thyroid nodule at tertiary center of Kanpur region. Materials and Methods: A total of 100 patients with solitary thyroid nodules were thoroughly examined clinically after taking detail history and fine-needle aspiration cytology. All the patients were subjected to surgery after preoperative preparation and anesthesia checkup. Thyroidectomy specimen was evaluated by histopathological examination. Results: Majority of the patients were between the age group of 21 and 40 years. Female:male ratio was about 5.6:1. Swelling in front of the neck was the most common presentation. Most common solitary thyroid swelling was the colloid goiter. The most common surgery performed was hemithyroidectomy. On histopathological examination, a total of 98 out of total 100 patients presented with benign lesions which included 66 patients of colloid goiter, 16 with follicular adenoma, 4 with lymphocytic thyroiditis, and 12 with adenomatous goiter. Two out of total 100 patients had malignant lesions. Among malignant lesions, papillary carcinoma was found in one patient and anaplastic carcinoma in one patient. Conclusion: The most common histopathological findings of solitary thyroid nodule were colloid goiter followed by follicular adenoma, adenomatous goiter and thyroiditis. Thyroid malignancy was very rare histopathological finding.

BRAF status in the variants of papillary thyroid carcinoma Daphne Fonseca, Sudha S Murthy, Ravindranath Tagore, Vishal Rao, Chandrashekar S Rao, K V. V N. Raju, Hemant Kumar Nemade, Sundaram Challa International Journal of Head and Neck Pathology 2018 1(2):41-47 Aim: The aim was to study the BRAF status by immunohistochemistry (IHC) in the variants of papillary carcinoma thyroid and compare it with the clinicopathological parameters. Materials and Methods: All the thyroid carcinomas diagnosed during the period of January 2015–June 2018 were reviewed and classified according to the WHO 2017 criteria. The demographic and clinicopathological features were noted. Microarrays were prepared on 27 cases, including classic and variants of papillary thyroid carcinoma (PTC), poorly differentiated thyroid carcinoma (PDTC), and medullary thyroid carcinoma (MTC). IHC was performed with BRAF V600E by automated staining. The BRAF status was correlated with known prognostic markers. Results: There were 23 PTC, 3 PDTC, and one MTC. The PTC included seven classic, three solid, two each of microcarcinoma, infiltrative and encapsulated follicular variant, tall-cell variant (TCV), oncocytic and one each of diffuse sclerosing, nodular fasciitis-like stroma, and Warthin-like variants. BRAF positivity was seen in 44.44%, including 11 PTC and one PDTC. The positivity was 85.71% in classic and 31.25% in variants. The age (>45 vs. <45 years), gender (male vs. female), number of lesions (unifocal vs. multifocal), type of tumor (PTC vs. other tumors), subtype of PTC (classic PTC vs. variants), invasion (capsular vs. lymphovascular), and aggressive features (extrathyroidal extension vs. lymph nodal involvement) between BRAF positive and negative tumors were not statistically significant (Fisher's exact test at P < 0.05). Conclusion: BRAF status did not show correlation with known prognostic variables in classic as well as variants of PTC.

Oral mucosal melanoma: An enigma to the clinician Krishna Sireesha Sundaragiri, Shikha Saxena, Chandni Shekhawat, Bharat Sankhla International Journal of Head and Neck Pathology 2018 1(2):48-51 Oral mucosal melanoma is a rare oral malignancy with well defined clinical presentation of a pigmented brown macular to nodular lesion. The careful histopathological examination along with immunohistochemistry of the biopsy specimen was helpful in identification of this noxious lesion. A clear distinction between management and prognosis of benign gingival lesions and rarer lesions exists. Thus every general dental practitioner should advocate a mandatory histopathological examination of the each and every gingival growth. We present a unique case of oral mucosal melanoma masquerading as a benign gingival growth without any clinical presence of pigmentation in a 58-year-old male patient.

Oral squamous cell carcinoma with myiasis Sakshi Gupta, Arjun Agarwal, Cheena Garg, KY Giri, Archana Chaurasia International Journal of Head and Neck Pathology 2018 1(2):52-54 Myiasis is a rare condition that occurred with advanced ulcerated lesions of the oral cavity caused by the larvae in human tissue that evolve to a parasite and is commonly found in tropical countries. Poor oral hygiene is a primary cause for the growth of maggots leading to the development of myiasis. These cases are reported with chief complaint of pain and irritation in a localized area and diagnosed clinically based on the presence of the maggots. Treatment option is manual removal of maggots to cure the inflammatory process and prevent secondary infections. Here, we present a case of oral squamous cell carcinoma with myiasis diagnosed in a 50-year-old female patient.

A rare case of isolated retro-orbital fungal granuloma Mahmood Dhahir Al-Mendalawi International Journal of Head and Neck Pathology 2018 1(2):55-55