Jornal de Citologia e Histologia

Background: Lymphadenopathy accounts for one of the most common lesions encountered in HIV positive patients. The cytopathology of these masses encompass a variety of changes that provide insight into the underlying condition associated with HIV. Aim of the present study was to analyze the cytological patterns of lymph node lesions in HIV/AIDS patients by Fine Needle Aspiration Cytology (FNAC) and correlate its findings with serum CD4 counts.
Method: A total 75 cases of all genders and age, already diagnosed as seropositive by ELISA and presented with lymphadenopathy of ≥1 cm were studied in the Department of Pathology by FNAC during the period of 1 and half year. Smears were fixed in 95% ethyl alcohol for PAP staining. Air dried smears were kept for MGG and AFB. The serum CD4 count was assessed by BD FACS Count System.
Results: Male predominance observed with male to female ratio of 1.3: 1. Maximum cases (80%) had involvement of cervical lymph nodes followed by axillary 6 (8%). The commonest cytological diagnosis was chronic granulomatous lymphadenitis 30 cases (40%), followed by tuberculous lymphadenitis 27 (36%). Most common cytomorphological pattern in cases of tuberculous lymphadenitis was caseous necrosis with epithelioid cells (55.5%). Most of the cases (20 cases) of chronic granulomatous had a serum CD4 count between 200-499 cells/μL with a mean of 330.2. The least mean value of serum CD4 count was seen in tuberculous lymphadenitis and it was 118.29 cells/μL.
Conclusion: FNAC is the simple and very effective diagnostic modality for HIV lymphadenopathy patients. It guides identification of majority of the granulomatous, reactive, and opportunistic infections. It therefore, helps in guiding subsequent management of these patients. 

Introduction: Haemoglobin is a widely studied protein due to its important roles in physiology and pathology. Aberrant expression of haemoglobins, including primitive globins, have been reported in various sites and disease states and may have utility in some instances as diagnostic and/or prognostic markers. Despite this, robust detection of haemoglobin epsilon in the placenta during development by immunohistochemistry has not been well documented.
Aim: To evaluate a polyclonal antibody against human haemoglobin subunit epsilon (HBE) by immunohistochemistry during primitive erythropoiesis in the developing mouse placenta.
Methods and results: An immunohistochemistry protocol was developed using a commercially available antihuman haemoglobin subunit epsilon antibody on the mouse placenta at embryonic day 11.5. Strong and specific cytoplasmic staining was observed in primitive erythroid cells within the blood cell islands. By contrast, the placenta endothelium, mesothelium and mesoderm were all immunonegative for epsilon haemoglobin.
Conclusions: An immunohistochemistry protocol for the specific detection of epsilon haemoglobin was successfully developed using mouse placenta tissue. This assay has utility as a tool for the study of erythropoiesis during development and/or detecting the ectopic expression of epsilon globins in disease states such as cancer.

Objective: Immunotherapy is a promising treatment option for a subset of lung cancers as it utilizes the host’s own immune system to attack tumors cells. Selection of patients who are likely to respond to immunotherapy is based on PD-L1 expression, a specific biomarker. Clinic-pathological correlation of PD-L1 status and NSCLC has been explored in several studies and large clinical trials. However, there is discrepancy of data as several antibodies are available. We looked at a series of lung tumors to study the association between PD-L1 expression and patient characteristics in our daily setting to improve the selection of patients more likely to express this marker. Results were compared to those available in literature using the same antibody.
Methods: We analysed PD-L1 status (using Dako clone 22C3) in 170 non-small cell lung cancers and correlated their PD-L1 status with clinical, pathological and molecular characteristics focusing in particular on EGFR and ALK status.
Results: We found a statistically significant association between PD-L1 status, histological pattern in the
adenocarcinomas subtype and stage of the disease.
Conclusion: Our results support the current findings that PD-L1 expression more frequently occurs in advanced stage disease and certain histological pattern. Our data also confirmed longer survival in PD-L1 positive patients.
Highlights
• Immunotherapy is a promising option for the treatment of NSCLC
• PD-L1 status detected by immunohistochemistry is linked to immunotherapy response.
• There are many clones available but only 22C3 is approved as companion diagnostic
• Patient selection can be affected by the antibody used.

Malignancies metastasizing to thyroid are a very rare phenomenon. Out of them all, diagnosis of metastatic squamous cell carcinoma in thyroid can be difficult to establish as in thyroid there can also be a primary thyroid squamous cell carcinoma SCC.

We herein report a rare case of a 28-year old man with metastasis of oral SCC the thyroid gland. He was operated six months back, took incomplete cycles of adjuvant chemo-radiotherapy. On FDG-PET CT was found to have metabolically active lesions in right lobe of thyroid along with right paratracheal and bilateral cervical nodes.

Fine needle aspiration cytology (FNAC) smears from thyroid showed malignant squamous cells. Considering various factors like previous history, histopathology, present FDG-PET scan findings and present cytology diagnosis was concluded to be metastatic over primary thyroid SCC.

It is necessary to differentiate between primary or metastatic SCC in thyroid as they are different in clinical and prognostic behaviour. Primary squamous cell carcinoma is very aggressive with a poor prognosis.