Journal of Current Oncology and Medical Sciences

An examination of the cytomorphological trends in tuberculous lymphadenitis at a tertiary care hospital of southern Assam

Sukanya Choudhury — 2025-03-31

Introduction: Tuberculous lymphadenitis is a leading cause of lymph node enlargement accounting for 195 per 1,00,000 population in India. Fine needle aspiration cytology (FNAC) is rapid and economical compared to other tests and thus plays a crucial role in diagnosing this condition. It prevents unnecessary biopsy of lymph nodes and it can be used for collection of material for cytomorphological and bacteriological examination. This study aimed to assess the cytomorphological patterns of tuberculous lymphadenitis and correlate them with Ziehl-Neelsen (ZN) staining.

Primary aim is to assess the cytomorphological patterns of tubercular lymphadenitis and to correlate with the bacteriological results using ZN staining.

Materials and methods: The FNAC results of 100 cases diagnosed with tuberculous lymphadenitis over a period of one year were analyzed from the cytopathology section of Silchar Medical College and Hospital. The findings were classified into three patterns: pattern A - epithelioid granuloma in absence of caseous necrosis, pattern B - epithelioid granuloma with caseous necrosis, and pattern C - caseous necrosis in absence of epithelioid granuloma. The cytomorphological patterns were then correlated with acid-fast bacilli (AFB) positivity.

Results: In individuals between the ages of 21 and 30, tuberculous lymphadenitis was predominantly observed. The cervical lymph node (92%) was the most frequently affected area. Among the different patterns of the condition, Pattern B, which is characterized by the presence of epithelioid granuloma along with caseous necrosis, was found to be the most common (53%). In contrast, Pattern C, which is marked by caseous necrosis without the presence of epithelioid granuloma, exhibited the highest positivity for acid-fast bacilli (80%). The difference in AFB positivity among the patterns was statistically significant (P-value= 0.0003).

Conclusion: FNAC is an effective and economical diagnostic tool for tuberculous lymphadenitis, particularly in resource-limited settings. The study found that Pattern B (epithelioid granuloma with caseous necrosis) was the most common, while Pattern C (caseous necrosis without epithelioid granuloma) exhibited the highest AFB positivity. FNAC, combined with ZN staining, enhances the accuracy of tuberculosis diagnosis, minimizing the need for invasive biopsies. Given the high prevalence of tuberculosis, FNAC should be the first-line investigation for patients presenting with superficial lymphadenopathy, ensuring timely diagnosis and treatment.

A rare case of bronchial glomus tumour of uncertain malignant potential

Sharanya Sathish — 2025-03-31

Introduction: Glomus tumours are typically benign pericytic mesenchymal neoplasms, occurring in the soft tissues of distal extremities, and rarely seen in deep soft tissues and visceral locations. Malignant glomus tumours are exceedingly uncommon. Here, we present a rare case of glomus tumour with uncertain malignant potential, arising in the bronchus of a young female patient. This case report highlights the clinical, radiological, and pathological aspects of this unusual entity, discussing the challenges in diagnosis and management and reviewing relevant literature on its behavior and treatment options.

Case Presentation: A 35-year-old lady with progressive breathlessness and cough, was found to have an obstructive mass lesion in the right upper lobe bronchus on CT scan. Check bronchoscopy and biopsy revealed features of a low-grade spindle cell lesion, with the possible differentials of a Glomus tumour and low-grade myofibroblastic tumour. She underwent right upper lobectomy; the final histopathological exam with the aid of immunohistochemistry confirmed the diagnosis of a Glomus tumour of uncertain malignant potential. Post-operatively, due to localised disease with negative surgical margins, she was kept on regular follow-up and was asymptomatic 6 months post-surgery.

Discussion: The possibility of a Glomus tumour must be considered for tumours with plump spindle to round cell morphology on a bronchoscopic biopsy. Immunohistochemistry helps to exclude most differentials. The assessment of malignant potential in Glomus tumour requires thorough examination of a completely resected tumour sample. Molecular studies have shown NOTCH1 gene rearrangements in both benign and malignant Glomus tumours. However, it does not help to predict malignant potential in benign-appearing tumours.

Conclusion: Bronchial Glomus tumours of uncertain malignant potential are rare tumours requiring more research on molecular markers for prognostication and treatment. This case is presented for its rarity, diagnostic and prognostic challenges.

Management of oligometastatic triple-negative breast cancer with lung metastasis using 4DCT: a case report

Siddharth Arora — 2025-03-31

Introduction: Breast cancer remains the most prevalent disease in women. Oligometastatic breast cancer (OMBC), is defined by a limited disease burden. 40% of Triple negative breast cancer are associated with Lung metastasis. Stereotactic body radiotherapy is used for lung metastasis. We report a case of oligometastatic triple-negative breast cancer with lung metastasis treated with the deep inspiratory breath hold technique via four-dimensional (4D) respiratory correlated CT imaging (4DCT).

Case presentation: A 77-year-old Asian Indian female patient presented with breathing difficulty. Evaluation revealed it as Oligometastatic breast carcinoma with solitary lung metastasis. She was treated with SBRT to her lung lesion using 4DCT after her primary management.

Discussion: 4DCT has revolutionized the radiotherapy planning for gated radiotherapy delivery. Retrospective 4DCT allows the reconstruction of a number of breathing phases that demonstrate the motion of the tumor and surrounding tissue. Despite its limits, the addition of this technology has been beneficial to the overall sector.

Conclusion: A total dose of 50 Gy in 5 fractions (BED10: 100 Gy) via volumetric modulated arc therapy (VMAT) was delivered to solitary lung metastasis. During surveillance imaging with PET/CT, there was no sign of progression or distant failure, and the treated lesion responded almost completely after 3 months beyond evidence of pneumonitis.

Isolated intraperitoneal urinary bladder rupture following blunt trauma abdomen: a case study

Parampreet Singh Sandhu Param — 2025-03-31

Introduction: Urinary bladder injuries present in emergencies in the set up of road traffic accidents with blunt trauma to the abdomen. Bladder injury can be extraperitoneal, intraperitoneal, or mixed. Intraperitoneal bladder ruptures comprise 15% of all bladder injuries. The most common feature of bladder rupture is hematuria, which can be either microscopic or gross. We hereby present a case of isolated urinary bladder intraperitoneal rupture following a roadside accident due to its rarity.

Case presentation: The 29-year-old male was brought to emergency with an alleged history of Roadside accidents with a distended abdomen. Hematuria is present on Foley’s catheterization. X-ray of the pelvis was normal. Contrast-enhanced computerized tomography whole abdomen showed bladder rupture. The patient was taken up for exploratory laparotomy and bladder repair. The postoperative period was uneventful.

Discussion: In blunt abdominal trauma, up to 90% of bladder injuries are often associated with pelvic fractures. Isolated traumatic bladder rupture is rare. In intraperitoneal bladder rupture, urine gets collected in the peritoneal cavity. Intraperitoneal bladder rupture requires exploratory laparotomy and the site of rupture is treated by suturing the bladder in two layers with absorbable sutures. Postoperative care is focused on preventing urinary catheter-associated infections.

Conclusion: This case report highlights the rare occurrence of isolated bladder rupture in cases of Road traffic accidents. Our patient recovered uneventfully after exploratory laparotomy and surgical repair.

Recurrent diffuse tenosynovial giant cell tumour of knee joint with emphasis on treatment trends: a case report

Siddharth Arora — 2025-03-31

Introduction: Tenosynovial giant cell tumor is a benign lesion that frequently recurs locally. The recurrence rate is quite high for diffuse tenosynovial giant cells. Complete surgical excision remains the standard of treatment, yet radiotherapy can be delivered in cases of recurrence. Here we present a case of recurrent diffuse tenosynovial giant cell treated with Image Guided-Intensity modulated radiotherapy. The case report also highlights and discusses other potential treatment options available or under investigation.

Case presentation: A 32-year-old female presented to us as a recurrent case of Diffuse tenosynovial giant cell tumor (DTGCT). She was offered above-knee amputation, which she refused. The role of systemic therapy was explored. She was taken for Image-guided; intensity-modulated radiotherapy (IG-IMRT).

Discussion: DTGCT shows a widespread morphological spectrum. Though Surgery remains the standard of care, Post op radiotherapy can be delivered in incomplete synovectomy or recurrence cases. The potential use of agents targeting CSF1/ CSF1R in D-TGCT has been explored.

Conclusion: Post operative radiotherapy with advanced External beam radiation therapy techniques IG-IMRT, after surgery produced acceptable functional status and excellent local control with few side effects. Our patient post radiotherapy phase was uneventful. His 6-month evaluation was suggestive of no recurrence.

Anti-cancer activities of eugenol and potential immunomodulatory effects: a comprehensive review

Fathima Hafsah Haleem — 2025-03-31

Diseases such as cancer and inflammatory conditions are on the rise in patients despite advances in early detection methods. Conventional therapeutic techniques such as chemotherapy and common synthetic drugs are facing problems such as serious side effects and drug resistance development which hinders the overall treatment. Traditional medicine involving the use of herbal based products is able to combat against these issues. Eugenol, the major bioactive constituent found in clove has been shown to possess various pharmacological properties that can be used to treat various diseases. This review aims to evaluate the current findings on the therapeutic properties of eugenol against cancer and immune-related conditions. The research has shown that eugenol exerts anti-cancer activities against various cancer cell lines such as colon, breast, lung, skin and cervical cancer, by targeting molecular pathways and genes, such as proto-oncogenic signaling pathways and pro-apoptotic gene expressions, that trigger apoptosis and inhibit cell proliferation and migration. Eugenol has also been shown to affect the immune system by targeting specific immune cells such as T cells and dendritic cells, and pro-inflammatory cytokines including TNF-alpha, IL-6 and PGE2, that leads to an immunosuppressive effect and reduced inflammation, preventing cellular damage which can lead to oncogenesis. The findings support the idea of using eugenol as a therapeutic drug against cancer and inflammation. Further studies focusing on its mechanisms of action and toxicity must be conducted to pave the way to clinical trials to provide more efficient and safer treatment options to cancer and immune related conditions.

Exploring the role of the psychedelic alkaloid psilocybin in alleviating cancer-related distress

Fejzić Dino — 2025-03-31

Cancer is one of the leading causes of death worldwide, ranking alongside cardiovascular diseases. A cancer diagnosis is often perceived as a profound and life-altering event, bringing psychological distress not only to patients but also to their families and close friends. While advances in cancer treatment have significantly improved survival rates over the past five decades, progress in addressing the emotional and psychological burden of the disease has been slower. Oncology patients require ongoing medical care both in clinical settings and at home, which can contribute to persistent distress for both patients and their families. Studies indicate that 20–40% of relatives of cancer patients experience anxiety and depression, as they must adjust to the shifting realities of serious illness. Given the limitations of conventional treatments for cancer-related depression, novel therapeutic approaches are needed. One particularly promising candidate is the psychedelic alkaloid psilocybin, which has shown potential in multiple controlled studies. Psilocybin is a naturally occurring compound found in various species of mushrooms, commonly referred to as psychedelic mushrooms. Its mind-altering effects have been recognized for centuries, often playing a central role in religious and spiritual ceremonies. Modern research, however, has shifted the focus from its historical use to its therapeutic potential. Research suggests that psilocybin may be highly effective in treating depression spectrum disorders, especially in cases where traditional treatments have proven inadequate. If granted regulatory approval, psilocybin could transform the management of end-of-life depression, offering rapid symptom relief. Notably, a single dose appears to provide significant and lasting improvements in depressive symptoms—an essential benefit for cancer patients with limited life expectancy who require immediate psychological relief.

Comparative analysis of hypofractionated vs. conventional radiation therapy with concurrent chemotherapy in advanced inoperable non-small cell lung cancer: a retrospective study

Shambodeep Chatterjee — 2025-03-31

Introduction: Traditional fractionated radiation therapy is commonly used for patients with inoperable stage III non-small cell lung cancer. This study hypothesizes that accelerated hypofractionated radiotherapy could offer comparable effectiveness without increasing toxicity risks.

Materials and methods: This retrospective analysis included patients diagnosed with stage III non-small cell lung cancer between January and September 2020 who were medically or surgically inoperable, free of metastatic disease and did not receive simultaneous chemotherapy. Two treatment arms were compared: Arm A received hypofractionated radiotherapy (55Gy in 20 fractions), and Arm B received conventional fractionation (60Gy in 30 fractions). Both groups adhered to specific dose constraints for critical organs, including the spinal cord, esophagus, heart, and lungs.

Results: The study cohort consisted mainly of individuals aged 56 to 60 years, with a significant smoking history in both groups. The most common symptoms were cough, chest pain, and respiratory distress. Lesions were predominantly located in the right and left upper lobes, and adenocarcinoma was the most common histology. Despite similar performance status, differences in tumour and nodal staging affected treatment response and toxicity profiles. Acute toxicities were comparable across both treatment regimens.

Conclusion: Hypofractionated radiotherapy may be a viable treatment option for patients with inoperable stage III non-small cell lung cancer, especially those with limited performance status. These findings support the need for further research to explore the potential benefits of advanced radiation techniques in this patient population.