Barani Karikalan

Endometrial epithelial metaplasia is described as transition of the normal endometrial epithelial cells by benign complex proliferation of cells. These metaplastic changes have been frequently reported as associated changes in endometrial hyperplasia and adenocarcinoma more than non-neoplastic samples and are also known to appear atypical occasionally, and hence can be a diagnostic challenge. Eosinophilic cell change is one of the most frequently encountered endometrial metaplasias. Eosinophilic syncytial change is a form of eosinophilic endometrial metaplasia, and is known to mimic endometrial serous carcinoma, again posing a diagnostic challenge. In this article, we have presented a case of endometrial eosinophilic metaplasia in a 47-year-old patient along with a brief discussion on immunohistochemical characteristics of eosinophilic syncytial change that could help pathologists to differentiate them from malignancies in challenging scenarios.   Keywords: Eosinophilic, Metaplasia, Endometrium, Immunohistochemistry.

Metastasis to Pituitary gland is an extremely rare condition. Patients are usually asymptomatic and imaging studies often miss the lesion. Pituitary metastases so far reported are largely from autopsies done for unrelated reasons. Here, we describe a case of pituitary metastasis, presented with diabetes insipidis, underwent surgery for removal of pituitary tumor and diagnosed as metastatic lung cancer using immunohistochemical studies. Keywords: Pituitary, Metastasis, Lung carcinoma.

Introduction: Solid Pseudopapillary tumor (SPT) is a tumor with low malignant potential and comprises around 1-2% of all tumors occurring in Pancreas. Pseudocyst of Pancreas, Microcystic adenoma, neuroendocrine tumor and mucinous cystic neoplasm are considered as challenging differentials of SPT. High suspicion followed by accurate diagnosis is key to management because SPT is known for its good prognosis and successive cure rate on surgical resection. Case Presentation: 21-year-old female patient presented with complaints of abdominal pain and dyspnoea. Imaging studies revealed a retroperitoneal tumor. Surgical resection carried out. Gross examination of the specimen showed circumscribed lobular brown mass weighing around 468 gm with a measurement of 15x12x10 cm. On sectioning, the tumor had a variegated appearance containing multiple cysts varying from 1 - 3 cm in size. Microscopic examination revealed an encapsulated cellular neoplasm with individual tumor cells arranged in solid, pseudopapillae and cystic patterns. Tumor cells were round to oval with no distinct nucleoli. Mitotic figures were very few in number. Hyaline globules were noted. Mucinous changes were seen focally. Occasional areas exhibited clear cell change of tumor cells. Cystic areas were filled with heamorrhage. Vascular areas were unremarkable. Normal Pancreatic parenchyma was noted at the tumor edge. Conclusion: Morphology of SPTs are varied ranging from solid to cystic appearance. No definitive morphology is identified to differentiate benign from malignant SPT. SPT are known to mimic a wide range of pancreatic and retroperitoneal lesions that may pose a challenge to diagnostic pathologists as seen in this case. Keywords: Calcified tooth, Dental operating microscope, Maxillary central incisor.

Small cell glioblastoma (SCGBM) is a rare variant with monomorphous cells and deceptively bland nuclei and are often misdiagnosed. Here, we present a case of small cell GBM in a 39-year-old male involving bilateral basal ganglia diagnosed as primary central nervous system lymphoma on MRI. After excision, the tumor showed features of small cell glioblastoma. Clinical features, morphological characteristics and immunohistochemical features of this rare lesion is hence discussed. Keywords: Small cell glioblastoma, Basal ganglia.

Chronic wounds are wounds that fail to progress through the normal stages of healing and remain open for an extended period of time. These wounds often require specialized treatment approaches. While the genes involved in wound healing play important roles in chronic wound treatment as well, the specific genetic factors contributing to chronic wounds are still being studied. Some of the genes and genetic factors that have been implicated in chronic wound healing and their potential for treatment include Transforming Growth Factor-Beta (TGF-β) Family, Matrix Metalloproteinases (MMPs), Transforming Growth Factor-Alpha (TGF-?), Hypoxia-Inducible Factor-1 (HIF-1), Vascular Endothelial Growth Factor (VEGF), Nitric Oxide Synthase (NOS) and Wound-Healing-Associated microRNAs. It's important to note that chronic wounds are multifactorial, and their treatment requires a comprehensive approach addressing various factors beyond genetic factors alone. Other aspects such as underlying medical conditions, infection, local wound environment, and patient-specific factors also play crucial roles in chronic wound management.   Keywords: Matrix Metalloproteinases, Transforming Growth Factor-Alpha, Nitric Oxide Synthase

Nur77, also known as NR4A1 (nuclear receptor subfamily 4 group A member 1), is a transcription factor belonging to the NR4A subfamily of nuclear receptors. Emerging evidence suggests its involvement in modulating macrophage polarization states.Macrophages are versatile immune cells that can adopt distinct functional states depending on the signals they receive from their microenvironment. Two main polarization states are commonly recognized: the classically activated (M1) phenotype, associated with pro-inflammatory responses, and the alternatively activated (M2) phenotype, linked to tissue repair and immunoregulation. The balance between M1 and M2 polarization is critical for maintaining immune homeostasis in the lung.Several studies have indicated that Nur77/NR4A1 may influence macrophage polarization towards the M1 phenotype. Also, other studies have also indicated a potential role for Nur77 in regulating M2 polarization of macrophages. Research findings suggest a dual role for Nur77 in modulating macrophage polarization, potentially promoting both M1 and M2 phenotypes depending on the context and specific signaling cues.It's important to note that the exact mechanisms underlying Nur77's regulation of macrophage polarization in the lung are still being elucidated. Further research is needed to fully understand the complex interplay between Nur77, other transcription factors, and the signaling pathways involved in lung macrophage polarization. Nonetheless, the current evidence suggests that Nur77/NR4A1 is a key player in orchestrating the immune responses of lung macrophages and may have a role in regulating their polarization towards both M1 and M2 phenotypes.   Keywords: Molecular, Gene, Therapy, Immunomodulation, Chemokines, Cytokines