Vasculitis may be due to various causes, including connective tissue disorders, medications, and infections. Histopathology shows similar features in different diseases so DIF (direct immunofluorescence) helps to categorize these vasculitic lesions on basis of positivity of different immunoglobulins. In this study, 40 cases of suspected vasculitis were confirmed by histopathology. Females were more commonly affected and the age range was from 9 to 71 years. Among these cases, 21 were immune complex mediated vasculitis of which c3 and IgG were the most commonly found immunoglobulins. Two of these cases were IgA mediated vasculitis. DIF was of great importance for the diagnosis of the disease for appropriate treatment.

Colorectal carcinomas (CRC) are associated with several histopathological and molecular factors of prognostic and hence therapeutic implications, including for epithelial mesenchymal transition (EMT) and angiogenesis. Downregulation of E-cadherin is a crucial step in EMT, directly related to tumor progression, invasion, and metastasis. Vascular endothelial growth factor (VEGF) induces angiogenesis and thereby tumour progression and metastases. Our objective was to analyse VEGF and E-cadherin expression in patients with CRC and to effectively assess the relationship of these with histopathological factors. 50 cases of CRC obtained over eighteen months duration, were included in the study. Haematoxylin and Eosin-stained sections were studied for histopathological factors. Immunohistochemistry with E-Cadherin and VEGF were performed on representative sections and evaluated. Histopathological features of importance noted were low grade tumour budding (55.5%), Infiltrative invasive front (83%), lympho-vascular invasion (50%). Preserved expression of E-Cadherin was seen in 66% of the cases, and 34% reduced expression, predominantly noted in patients above the age of 50, increased tumour size, mucinous variants, advanced TNM stage, lymph node involvement and high-grade tumour budding. VEGF staining was seen in 64% of the cases with varying intensity. Increased VEGF expression was noted in poorly differentiated tumours, advanced Duke’s stage and with lymph node metastasis. Colorectal carcinomas with high grade tumour budding were associated with lymph vascular invasion, infiltrative invasive front and significantly correlated with TNM stage. High grade tumours and adverse histopathological prognostic factors revealed a reduced E-cadherin expression and increased VEGF expression.

Marjolin ulcer is a rare malignancy that arises in previously traumatised or chronically inflamed skin, particularly after burns, with an average latency period of 36 years. Nearly 75-90% marjolin ulcers are diagnosed as squamous cell carcinoma but other neoplasms like basal cell carcinoma, melanoma, fibrosarcoma etc have also been rarely reported. In this case, a 52-year-old male presented with a painless bleeding mass over lower chest wall rapidly increasing in size from last 2 years. He had suffered burn at the same site 20 years ago. Biopsy was reported as spindle cell neoplasm. Wide local excision revealed a poorly circumscribed subcutaneous spindle cell neoplasm exhibiting variable cellularity, fascicular to storiform architecture, mild to moderate nuclear atypia and scattered gaping thin-walled blood vessels. The neoplastic cells showed diffuse strong staining with CD34 in the less cellular area and patchy positivity in the cellular more mitotically active areas. The tumor cells were immunonegative for EMA, p63, SMA, CD99 and STAT6. The final diagnosis rendered was Dermatofibrosarcoma Protuberans dedifferentiating in to fibrosarcoma. Although sarcoma presenting as a Marjolin ulcer is exceedingly rare, it should be kept in mind in differential diagnosis of spindle cell malignancy arising at a burn site.

Background: The occurrence of metastatic colon lesions in various organs has been documented extensively in the literature. The liver, lungs, and bones are the most frequently affected sites. Metastasis in the duodenum due to colon cancer is an infrequent occurrence. Case Presentation: We present a detailed case report of a 65-year-old female patient diagnosed with metastatic colon cancer to the duodenum. The patient initially underwent extended right hemicolectomy for stage III low-grade adenocarcinoma of the colon. Adjuvant chemotherapy was administered, resulting in a period of apparent remission. However, in 2020, the patient experienced elevated tumor marker levels, prompting further investigations. Endoscopy revealed an irregular mass infiltrating the muscle layer in the duodenum, confirming malignant involvement. The patient underwent curative distal gastric duodenectomy, with pathology results indicating a colonic origin of the tumor. The patient received first-line palliative chemotherapy with FOLFOX rechallenge and the addition of AVASTIN. Several cycles of chemotherapy were completed, with satisfactory tumor response observed in follow-up PET scans. Maintenance therapy was initiated after achieving disease-free status on CT scans. However, in October 2022, the patient exhibited increasing tumor marker levels and new findings on PET scan, leading to the initiation of second-line palliative therapy with FOLFIRI and ramucirumab. The patient has received multiple cycles of second-line therapy, with the most recent PET scan in February 2023 showing a favorable treatment response, including a decrease in the size of existing nodes and no identification of new lesions. Conclusion: In conclusion, this case exemplifies the journey of a patient with stage 3 colon cancer who initially responded well to surgery and adjuvant chemotherapy, but experienced subsequent relapse in the duodenum. Despite surgical intervention and palliative chemotherapy, the patient developed metastasis in the liver, lung, and multiple lymph nodes.

Endometrioid endometrial carcinoma (EEC) is most common invasive malignancy of female genital tract. In spite of advances in diagnosis and treatment, incidence of EEC has been rising because of increasing aging population and prevalence of obesity. Therefore, there is need of research exploring the underlying molecular mechanism of EEC and its precursors. Wnt/ β-catenin signaling are involved in the progression and invasion of EEC. However, the potential role of Wnt/ β-catenin signaling and its effectors in endometrial cancer and precursor lesions remains to be investigated. In the present study a total of 95 samples of endometrial biopsies were assessed histopathologically along with β-catenin expression by immunohistochemistry and promoter methylation of adenomatous polyposis coli (APC) gene by bisulfite method. Women age ranged from 35 to 70 years whose endometrial biopsy and resected samples were obtained. Expression of β-catenin was observed in 28/39; 72% of EEC, 23/37; 62% of precancer cases and 4/19; 21% of normal proliferative endometrium. APC promoter was completely unmethylated in all controls (14/14) and precancer (10/10) groups, however, only one case (1/13, 8%) of cancer was methylated. The present study showed that expression of β-catenin was upregulated in EEC and precursor lesions suggesting involvement of Wnt/ β-catenin signaling from an early stage of development of cancer from precancer. The information might offer a potential therapeutic target for EEC and could also be used as a screening tool in endometrial hyperplasia (EH) cases for detecting potentially precancerous lesions.