Indian Journal of Pathology: Research and Practice

Background: Breast cancer remains one of the most prevalent cancers affecting women worldwide, with early detection and accurate biomarker evaluation playing pivotal roles in prognosis and treatment planning. Immunohistochemical analysis of biomarkers such as Estrogen Receptor (ER), Progesterone Receptor (PR), and Human Epidermal Growth Factor Receptor 2 (HER-2/neu) on tissue samples is standard practice. However, the use of fine needle aspiration (FNA) cytology as a minimally invasive method for evaluating these biomarkers is gaining attention for its potential diagnostic utility and advantages. Aims and objectives of this study were to study the expression of biomarkers ER, PR, HER2 in FNAC smears of breast carcinoma and core needle biopsy, to evaluate whether there is a concordance or discordance in expression of these biomarkers in FNAC smears as compared to that of core needle biopsy and to assess the utility of FNAC in preoperative assessment of biomarker status in breast carcinoma. Methods: It was a hospital based prospective study. Forty cases of breast carcinoma of which both FNAC and core needle biopsy were performed were included in our study. Results: We studied 40 patients of histopathologically proven Breast Carcinoma. When compared to Immunohistochemistry, there was 82.5% diagnostic accuracy of Immunocytochemistry (ICC) done on FNAC for ER. For PR and HER2 diagnostic accuracy of ICC was 87.5% and 77.5% respectively. Conclusion(s): ICC done on alcohol fixed smears shows high concordance with IHC done on CNB and may be routinely performed in all suspected cases of breast cancer.

The emergence of AI in medical practice is revolutionizing clinical practices, specifically for the separation of blood components from apheresis. There is growing evidence that AI enhances the accuracy and effectiveness of apheresis through real-time data analytics, predictive modeling and advance decision support systems. Machine learning algorithms use patient-specific characteristics to improve working conditions, personalize treatment routines and predict potential side effects; since they provide the necessary preventative care. Artificial intelligence helps to improve medical service by automatically monitoring and documenting data, which can help relieve the mental burden of clinicians and administrative pressure. Enhanced pattern recognition and anomaly detection helps with quality control and early detection of equipment failures or biological irregularities. In therapeutic apheresis, AI modalities augment evidence-based medicine by combining clinical datasets, laboratory results, procedural measures, and patient outcomes. This combination raises evidence-based recommendations to help guide treatment decisions and improve patient outcomes. Despite these accomplishments, many challenges persist such as data privacy concerns, interfacing with legacy systems, and the need for tight regulatory oversight. However, gradual convergence of AI and apheresis has significant potential to improve patient care, organization productivity, and therapeutics effectiveness. Expected developments will further extend AI’s role in diagnostics, prediction, and apheresis process automation and remote monitoring. In this talk we emphasize the potential of AI for advancing safety, personalization, and efficiency in state-ofthe-art apheresis.

Adenoid cystic carcinoma (ACC) of the vagina arising from Bartholin’s glands is a rare type of female malignancy. ACC of the vulva is rare, and treatment protocols are often based on experience with similar tumours in other locations (e.g. head and neck) and case reports. Here, we report a case of a 52-year-old female patient who presented with a pain above perineum and lower end of vagina leading to a diagnosis of ACC of the vagina after biopsy and confirmation on immunohistochemical analysis. Often, such lesion is clinically misdiagnosed as a cyst or inflammation. The present case was clinically suscpected to be either a bartholin cyst or lipoma or parasitic fibroid or calcification. The possibility of cancer should be considered in any female older than 40 years of age with a lesion near the Bartholin’s glands.

Cervical cancer continues to be a significant global health burden, particularly in low and middle-income countries, despite being largely preventable through effective screening and early intervention strategies. Among the various screening modalities, the Papanicolaou (PAP) smear has been pivotal in reducing both the incidence and mortality associated with cervical carcinoma. This article comprehensively reviews the Pap smear’s history, clinical utility, methodologies, and evolving significance in modern gynecological practice. Additionally, it presents a case study involving a 56-year-old woman diagnosed with cervical carcinoma, detected via Pap smear, thus emphasizing the test’s critical role in routine gynecological assessments. The review further explores the integration of newer screening modalities such as HPV DNA testing and liquid-based cytology (LBC), which have augmented the sensitivity and specificity of cervical cancer screening. The article highlights the need for continued public health efforts to enhance awareness, improve access to screening, and incorporate advanced diagnostic techniques for effective cervical cancer control.