North Kerala is a high risk area for carcinoma stomach. Therefore, 'intestinal type' carcinoma of Lauren is more prevalent here and the disease occur even in people below the age of 40. An attempt is made to analyse various risk factors in 70 patients who had undergone gastrectomy for carcinoma stomach in Medical College Hospital, Calicut. The population study revealed no relationship between the disease and the various religious communities. Diet is found to be the most important potential environmental influence. Even though both males and females share the same type of diet, males are found to be more affected by the disease. The high frequency of female population in North Kerala with a low frequency of carcinoma stomach in them, suggests the possible role of smoking and alcohol abuse in males. The blood group profile of healthy population in North Kerala and that of the patients show that people with blood group A have a differential susceptability to gastric carcinoma. Age and chewing of tobacco were the other factors involved.

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Commercial Vira Pap and Vira Type kits of Life Technologies Inc., U.S.A., were used to determine prevalence and type specific distribution of human papilloma viruses (HPV) in 18 biopsy samples of cervical carcinomas and 26 specimens of exfoliated cervical cells (swabs). The women were either attending out-patient's department of a suburban hospital or a cancer hospital in Calcutta, India. HPV DNA was detected in 9 biopsy specimens but not in any of the cervical swabs. Five of the 9 HPV positive biopsies had HPV DNA type 16/18. Neither HPV 6/11 nor HPV 31/33/35 DNAs were detected in any of these 9 specimens. Results indicated possible presence of HPV DNAs of types other than the above in at least 4 specimens.

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A 40 year old male patient presented with jaundice. The patient had a small periumbilical nodule. He was referred to the department of Pathology for FNAC of the nodule. A diagnosis of metastases from adenocarcinoma was made. Further investigations revealed carcinoma of stomach with metastatic deposits in liver. The present report highlights the utility of F N A C in diagnosis and to decide on further investigations to arrive at a final diagnosis in a given case. A brief review of historical aspect is also given.

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This is a clinicopathological study of 114 cases of metastatic carcinomas of bone accessioned between 1979 and 1988 at a large cancer hospital. The cases were divided into two groups. The first group comprised of 68 cases (59.64 percent), which included those where the primary was either known (Ia-12 cases), detected after simple investigations (Ib - 18 cases) or detected after extensive investigations (Ic - 38 cases). The lung emerged as the primary source of the metastases in almost half the cases. Hence an X-ray chest should be the basic essential investigation in the workup of skeletal metastasis. The second group comprised of 46 cases (40.35 percent), where the primary remained unknown; 56.5 percent of these were adenocarcinomas. When the histological diagnosis is adenocarcinoma in cases of an occult primary, it is often difficult to pinpoint the primary site after exclusion of organs like breast, prostate, thyroid and kidney.

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Nucleolar organizer regions (NORs) have been identified by means of an argyrophilic technique (AgNOR) in routinely processed formalin-fixed paraffin sections of breast lesions. 85 cases of different breast lesions were examined. The AgNOR counts were, normal breast 1.2 (1.0-1.5) Fibroadenoma 1.74 (1.6-2.7), purely cystic disease 1.6 (1.5-1.82) adenosis 2.1 (1.7-2.8), Epitheliosis 2.4 (1.9-3.2) gynaecomastia 3.7 (3.6-4.7), Noninvasive caccinoma 2.8 (2.6-4.4) invasive carcimomas 3.89 (2.7-9.9) i.e. mean AgNOR counts between benign and malignant lesions. Also gynaecomastia, a benign condition had a high mean AgNOR count. There was no significant difference in the mean AgNOR count of various types of invasive breast caninoma. Higher the histological grade, higher was the AgNOR count. To conclude, AgNOR technique does not enable a clear distinction between benign & malignant lesions. But, it could be used with other prognostic indices to predict the behaviour of breast malignancy.

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Primary malignant tumours of the body of the uterus are less common in India compared to carcinoma of the cervix. This study analyzed 86 primary malignant tumours of the body of the uterus over a 5 year period with regard to incidence of the various tumours, age group, gravidity, any predisposing factor, and the incidence of carcinoma of the cervix in the same period. Adeno-carcinomas were found to be the most common type of tumour. Tropho-blastic malignancies and mixed mullerian tumours also formed a significant number of cases. Compared to Western studies our patients with adenocarcinoma, adenosquamous carcinoma, squamous cell carcinoma and mixed mullerian tumour, were younger. Patients with adeno-carcinomas had a higher parity and patients with choriocarcinoma had a lower parity. Diabetes, hypertension and obesity were not as common as in the West. Carcinoma of the cervix was found to be commoner than primary malignant tumours of the body of the uterus.

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Malignant peripheral nerve sheath tumours of orbit is rare entity. Only sixteen cases are reported in world literature. Bengin schwannomas of the orbit are found in 1.5 to 18 percent of patients with von Recklinghausen's disease (VRD) and form 1 percent of all orbital tumours1. The incidence of malignant transformation in VRD is varies from 5-15 percent of all the cases1.

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A patient with pancreatic carcinoma who developed disseminated cutaneous and scalp metases is reported. To the authors knowledge scalp metases have hitherto not been reported with pancreatic carcinoma.

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We prospectively evaluated serum concentrations of beta 2-microglobulin in twenty healthy controls and fifty cases of CT scan proven and operated intracranial tumours. The later group comprised of twenty subjects of benign and thirty cases of malignant tumours respectively. Mean serum beta 2-microglobulin in healthy subjects was 1.80 +/- 0.5 mg/ litre, none had value of more than 3.0 mg/ltr. On the contrary 75% of benign and 63.3% of malignant tumour cases had statistically significant rise in the beta 2-microglobulin. Elevated serum level of beta 2-microglobulin may prove to be a reliable tumour marker.

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Silver staining Nucleolar organizer regions (AgNORs) were studied in fine needle aspirates of 48 benign and 36 malignant lesions and correlations with histological types, menstrual status, tumor size and lymph node involvement were looked for. A semiquantitative scoring system (AgNOR Score) reflecting total AgNOR area was applied to each of these parameters and compared with the standard counting method. The objectives were to examine the pattern of distribution and discriminating capacity of AgNORs in fine needle aspirates of different breast lesions and to evaluate the AgNOR scoring system as an alternative to the standard counting method. Mean AgNOR count was significantly higher in malignant (5.4; 95% CI 5.0-5.9) than benign (2.8; 95% CI 2.7-3.0) lesions. For AgNOR scores the corresponding values were: malignant 11. 2; 95% CI 10.2-12.2 and benign 5.3;95% CI 4.9-5.7. For malignant lesions, the counts and scores tend to be more in ductal carcinomas than lobular, more in premenopausal women, in tumors more than 5 cm in diameter and in cases with more than 3 lymph nodes involved. For all parameters the scoring system showed better discriminating capacity. The differences in AgNOR scores were statistically significant for tumor size and lymph node status. Multiple stepwise regression shown tumor size to be best correlated with AgNORs.

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Twenty five cases of Wilms' tumour were studied with special reference to their morphological variations. Wilms' tumour constituted 7.6% of all the malignant tumours of childhood and 50% of renal malignancies. Male/female ratio was 4:1; the mean age being 3.5 years. Left side was commonly involved (60.9%) center dot bilateral involvement in one case (4.3%). Morphologic study revealed triphasic pattern in 60% cases, biphasic (epithelial + stromal) in 12% and monophasic pattern in 28%. Other features observed were myxomatous degeneration, rhabdomyoblasts, calcification and squamous epithelial pearls seen in 20%, 12%, 8% and 4% respectively.

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Study of the argyrophilic nucleolar organizer regions (AGNORS), which was used extensively in cytogenetics, has been identified as a reliable indicator of cell proliferation and in turn, the malignant potential of a lesion. Premalignant and malignant lesions of the cervix are analysed for their AGNOR counts in this study. Statistically significant difference in AGNOR counts was noted in different sets of lesions. This technique can serve as a useful adjunct to routine histopathology.

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The number type and results of test done before biopsy were analyzed in patients with gastrointestinal, and lung cancers, adenocarcinoma of unknown primary site and lymphomas in an attempt to investigate the degree and type of delays in performing a diagnostic biopsy. In the 181 patients evaluated a 9 to 14 days delay diagnostic before a biopsy was done and was consistent across the four malignancies studied. In 59% delay be attributed to continued, frequently low yield, noninvasive tests.

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In this study, thirty-two non-functional and eighteen functional pituitary adenomas were analysed for the presence of argyrophilic nucleolar organizer regions (Ag-NORs) in paraffin sections, using an one-step silver-colloidal staining method. Differences in the mean Ag-NOR numbers of functional pituitary adenomas were statistically significant than those of non-functional pituitary adenomas. It is being emphasised that evaluation of Ag-NOR count is a more reliable index than the presence of mitotic figures in predicting the proliferative activity as well as possibility of recurrence in a patient with pituitary adenoma.

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