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Prabhat Malik



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    P1.14 - Thymoma/Other Thoracic Malignancies (Not CME Accredited Session) (ID 946)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.14-14 - Histotyping of Indian Thymomas: A Comprehensive Clinicopathologic Study (ID 11242)

      16:45 - 18:00  |  Author(s): Prabhat Malik

      • Abstract
      • Slides

      Background

      Thymomas are rare, but most common anterior mediastinal lesions. The WHO 2015 classification has defined criteria of classifying these into various subtypes. The histomorphologic spectrum of thymic epithelial tumors (TET) in Indian population has not been explored. We aimed to study the histomorphology of TETs in the Indian patients with clinico-pathological correlation.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      It was a retrospective, tertiary referral centre, study. All cases of morphologically confirmed, surgically resected specimens and small biopsies diagnosed as TETs since 2009 were included. Clinical details and histology slides were reviewed using the Modified Masaoka-Koga staging system and WHO 2015 classification. Clinico-pathological correlation and survival analysis was done. Comparative review from other published Indian studies was performed.

      4c3880bb027f159e801041b1021e88e8 Result

      We identified 219 cases of TETs (138 resections and 81 biopsies). Most common histo-morphologic type was B2 and most frequent stage was I. Clinically, higher stage tumors were found mostly in men (P=.008) and these were type B thymomas (P=.01). Association of myasthenia gravis was prevalent in women (P=.02) and in lower stages (P=.04). Survival analysis revealed significant association between recurrence and tumor stage. Although thymic carcinoma was diagnosed on biopsy, no resectable case was identified.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Literature lacks detailed histotyping of TETs from India. Indian thymomas are most commonly stage I tumors of B2 and AB histotypes. Resected thymic carcinomas are conspicuously absent in Indian cohort. We hope that broadening the spectrum of recognized pathologic manifestations of Indian thymomas will help global database for future studies.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P3.09 - Pathology (Not CME Accredited Session) (ID 975)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.09-22 - Correlation Between Maximum Tumour Diameter Measurement on CT-Scan and Histopathological Specimen: An Indian Experience (ID 13431)

      12:00 - 13:30  |  Author(s): Prabhat Malik

      • Abstract
      • Slides

      Background

      Lung cancer is staged according to TNM classification, which encodes the anatomic extent of the disease. This is the most important prognostic factor in patients diagnosed with lung cancer. CT scan is a basic imaging modality used for pre-treatment tumour staging (T staging). Each centimetre increase in size leads to worsening of prognosis. Adjuvant treatment decisions are based upon the final histopathological tumour size. Accurate clinical and pathologic correlation has been an important focus of research in many cancers. The objective of our study is to see for any discordance with respect to tumour size calculated by CT scan and final histopathological specimen in patients of carcinoma lung undergoing upfront surgery.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      All patients of lung cancer operated upfront between 2012 to 2017 were included in the study. Any patient with chest wall involvement, significant pleural effusion and tumours of main bronchus were excluded. CT scans were acquired from the supraclavicular region through the adrenal glands using a 1.25 mm slice thickness with 1.25 mm spacing following deep inspiration. Based on tumour perimeter maximum tumour size was calculated. The largest diameter of resected lung tumour was recorded using a standard ruler by the pathologist. A mean, median and range for both the CT diameter and pathology diameter were obtained. A paired t-test was used to examine the measurement difference between CT and pathology.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 109 patients were included in the study. Most common histology was Squamous cell carcinoma (n=40,36%), followed by Adenocarcinoma (n=32,29.3%), Neuroendocrine tumour(n=27,24.77%) and other histologies(n=10,9.17%). Among these patients, 22 tumours were located in right upper lobe (20.18%), 10: right middle lobe(9.17%), 25:right lower lobe(22.93%), 31: left upper lobe(28.44%) and 21: left lower lobe(19.26%). The mean size of tumour on CT scan is 4.92cm (SD=1.852cm, range:1-10 cm) and mean size on grossing is 4.5cm(SD=1.774cm,range:0.5-9.5cm)(p<0.05). The difference between the CT diameter and histopathological size is statistically significant. Tumour location and histology did not add any difference to tumour shrinkage.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Our study demonstrates that there is a statistically significant difference between tumour diameter as measured by CT and its pathologic size. These differences could have implications in the treatment and prognosis of patients with lung cancer.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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