Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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On Sep 2018

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Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

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"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

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On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Images in Medicine
Year : 2022 | Month : November | Volume : 16 | Issue : 11 | Page : ZJ01 - ZJ02 Full Version

Perplexity in Diagnosing Pleomorphic Adenoma of Minor Salivary Gland with Plasmacytoid Cell

Published: November 1, 2022 | DOI:
Cheshta Walia, Sudip Roy

1. Assistant Professor, Department of Oral Pathology, Buraydah Private Colleges-College of Dentistry and Pharmacy, Al-Qassim, Saudi Arabia. 2. Assistant Professor, Department of Orthodontics, Buraydah Private Colleges-College of Dentistry and Pharmacy, Al-Qassim, Saudi Arabia.

Correspondence Address :
Dr. Cheshta Walia,
7, Subhash Park, Roy Nagar, Bansdroni, Kolkata, West Bengal, India.


Keratin pearls, Labial mucosa, Salivary gland neoplasm

A 46-year-old male reported to the Outpatient Department with the chief complaint of slow growing swelling in relation to upper front tooth region since one year. The swelling was gradual in onset with no history of pain, paresthesia or discharge. His personal history revealed that he was a cigarette smoker (4-5 times per day for 8 years), left his habit since a month. Medical history and family history were non contributory. The patient was moderately built with all vitals within normal limits.

Extraoral examination showed the presence of diffuse, mobile, non tender swelling surrounded within the boundary of right nasolabial fold superiorly, vermillion border of upper lip inferiorly, right commissural area laterally and philtrum mesially. There was no regional lymphadenopathy noted and overlying skin was free with no evident change in colour and texture. Intraorally, well defined, single, firm, non tendered, non ulcerated swelling was noted in relation to 12, 13 and 14 resulting in the obliteration of the right maxillary labial vestibule. The swelling was dome shaped measuring 1.5×2 cm showing pale pink superficial mucosa with prominent vascular markings (Table/Fig 1).

Keeping the clinical features in view, the provisional diagnosis of benign salivary gland neoplasm was made. Differential diagnosis including fibroma, lipoma, canalicular adenoma, Pleomorphic Adenoma (PA) and abscess were considered. The excisional biopsy was performed under local anaesthesia after obtaining informed consent from the patient. The gross specimen comprised of an encapsulated soft tissue mass measuring 1.5×2×1.5 cm with rubbery consistency (Table/Fig 2).

The tissue sections were stained with Haematoxylin and Eosin (H&E) for microscopic evaluation showed the presence of thick capsule. Neoplastic glandular epithelial cells were arranged in the form of sheets with numerous ductal structures containing eosinophilic coagulum. The lumen of the ducts was lined by cuboidal cells surrounded by abluminal myoepithelial cells. Wide spread squamous metaplasia was observed with multiple cystic spaces filled with whorls of keratin. Few areas showed presence of plasmacytoid cells with eccentric nuclei and eosinophilic hyalinised cytoplasm (Table/Fig 3). These microscopic features were suggestive of PA with extensive squamous metaplasia. The patient is under follow-up since two years and no recurrence is observed till date.

Pleomorphic Adenoma (PA) is the most common benign salivary gland tumour that rarely involves minor salivary glands. The term PA was first described by Willis in 1953 to address diverse clinical and histological appearance of the tumour. The onset is usually reported in third to fourth decade with twice common female preponderance compared to the males. Total 50-60% cases are usually seen in the palate followed by upper lip (15-20%), buccal mucosa (8-10%) and tongue with few sporadic cases reported in maxillary sinus and pterygopalatine space. Benign tumours of salivary glands are six times more common in upper lip while malignant tumours have more frequency of occurrence on lower lip. Clinically, small lesions of the upper lip are asymptomatic, sessile, mobile rubbery mass with smooth surface. However, larger tumours are firm with bosselated appearance that may cause noticeable swelling with asymmetry of face (1),(2),(3). In the present case, PA affecting upper lip was found in male patient in 4th decade with single, ovoid firm swelling with superficial vascular marking.

Pleomorphic adenoma of minor salivary gland may present as well circumscribed, encapsulated mass but incomplete pseudocapsule or pseudopodia and extracapsular extensions are not rare in tumours with expansive growth. The acinar, ductal and myoepithelial cells are often arranged in ductal and cystic pattern undergoing aberrant metaplastic changes. The most classical feature is the presence of admixture of polygonal epithelial and spindle-shaped myoepithelial elements in a mucoid, myxoid, cartilaginous, or hyaline background stroma. Few plasmacytoid cells with eosinophilic cytoplasm and eccentrically placed nuclei may be present. Though, these cells are ectodermal in origin, yet smooth muscle expression is observed in the desmosomes, intermediate size filaments, endocytic vesicles, and microfilaments of myoepithelial cells (4).

The histopathology of present case showed the metaplastic squamous epithelium-lined cystic spaces containing numerous keratotic lamellae and some solid squamous cell islands with keratin whorls. Literature suggests that only 25% of PA may manifest squamous metaplasia posing considerable challenge in diagnosing such lesions. Ischaemia may induce epithelial morphogenesis in myoepithelial cells, thereby producing increased amounts of tonofilaments and desmosomes with loss of myofilaments at acinar-intercalated duct cell complex (4),(5). Other neoplasms showing squamous differentiation include mucoepidermoid carcinoma, adenosquamous cell carcinoma, keratocystoma and conventional squamous cell carcinoma. However, absence of cellular and nuclear atypia, lack of invasion, minimal cellular activity with presence of intact fibrous capsule eliminates the diagnosis of malignancy (6).

The exact pathogenesis behind PA still remains controversial and has created a way for the researchers to intrude into the molecular level of genes. The complex process of morphogenesis of salivary gland is tightly regulated by growth molecules and transcription factors. The presence of chromosomal abnormalities due to translocation t(9;13)(p13;q12),) or reciprocal translocation t(9:12)(p13-21;q13-15) related to PLAG1 are regarded as major responsible event that may cause homeostatic errors. Therefore, loss or alteration of these factors increases the probability of progression to malignant PA (2).

The treatment modality of PA arising from minor salivary glands was complete surgical excision with clear margins followed by uneventful healing.


The salivary glands may show a diverse range of lesions involving spectrum of cells affecting its overall biological presentation. It also mandates the inclusion of PA in differential diagnosis of swelling involving upper lip region. The heterogeneity of tissue in PA and potential neoplastic transformation demands meticulous approach in differentiating it from malignant lesions. The present case revealed cystic spaces resembling cribriform pattern with areas showing metaplastic squamous cells and plasmacytoid cells. The conspicuous nature of myoepithelial cells to mimic plasmacytoid cells or squamous cells accentuates the risk of misdiagnosis. This type of lesions demands early diagnosis with complete excision for optimal management along with regular follow-up.


Taiwo AO, Akinshipo A, Braimah RO, Ibikunle AA. PA of the upper lip: A case report. Saudi J Med Med Sci. 2018;6:32-35. [crossref] [PubMed]
Maruyama S, Cheng J, Shingaki S, Tamura T, Asakawa S, Minoshima S, et al. Establishment and characterization of pleomorphic adenoma cell systems: An in-vitro demonstration of carcinomas arising secondarily from adenomas in the salivary gland. BMC Cancer. 2009;9:247. Doi:10.1186/1471-2407-9-247. PMID: 19622142; PMCID: PMC2722671. [crossref] [PubMed]
Singh AK, Kumar N, Sharma P, Singh S. Pleomorphic adenoma involving minor salivary glands of upper lip: A rare phenomenon. J Can Res Ther. 2015;11:1025. [crossref] [PubMed]
Savera AT, Zarbo RJ. Defining the role of myoepithelium in salivary gland neoplasia. Adv Anat Pathol. 2004;11:69-85. [crossref] [PubMed]
Urs AB, Augustine J, Negi D, Kumar RD, Ghosh S. Pleomorphic adenoma: A rare presentation in buccal salivary gland with extensive squamous and mucous metaplasia. Pan Afr Med J. 2019;33:147. Doi: 10.11604/pamj.2019.33.147.17550. PMID: 31558944; PMCID: PMC6754833. [crossref] [PubMed]
Nonitha S, Yogesh TL, Nandaprasad S, Maheshwari BU, Mahalakshmi IP, Veerabasavaiah BT, et al. Histomorphological comparison of pleomorphic adenoma in major and minor salivary glands of oral cavity: A comparative study. J Oral Maxillofac Pathol. 2019;23:356-62. [crossref]

DOI and Others

DOI: 10.7860/JCDR/2022/59087.17099

Date of Submission: Jul 14, 2022
Date of Peer Review: Aug 09, 2022
Date of Acceptance: Sep 14, 2022
Date of Publishing: Nov 01, 2022

• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes

• Plagiarism X-checker: Jul 16, 2022
• Manual Googling: Sep 08, 2022
• iThenticate Software: Sep 13, 2022 (18%)

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