Indian Journal of Pathology: Research and Practice

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The diversity of presenting features of gastrointestinal (GI) carcinoids presents a major challenge in the diagnosis and treatment of these cases.  An increasing incidence of midgut carcinoids is being reported due to improved diagnostic modalities. Occult metastatic carcinoid in mesenteric nodes requires a diligent search for localisation of primary tumor in GIT which are often smaller in size than the metastasis and requires a high index of suspicion and meticulous examination for detection. Here we describe two cases presenting as metastatic carcinoid in mesenteric nodes of unknown origin, which on further investigation revealed primary of small size in the midgut.

Keywords: Neuroendocrine tumors; Midgut carcinoid; Metastatic carcinoid; Mesentric metastasis; Small sized carcinoid.

introduction: Transfusion of blood and blood components, as a specialized modality of patient management saves millions of lives worldwide each year and reduce morbidity. It is well known that blood transfusion is associated with a large number of  complications, some are only trivial and others are potentially life threatening, demanding for meticulous pre-transfusion testing and screening particularly for transfusion transmissible infections (TTI). The priority objective of blood transfusion screening (BTS) is thus to ensure safety, adequacy, accessibility and efficiency of blood supply at all levels.The objective of the present study was to assess the seroprevalence and trend of transfusion transmitted infections (TTI) among voluntary and replacement blood donors in the blood bank of Father Muller Medical College Hospital, Mangalore. Methods: A retrospective review of donors record covering the period between January 2008 to December 2012 was analysed and all samples were screened for HIV, HBsAg, HCV, syphilis and malaria. The data was analysed using Statistical Package for the Social Sciences (SPSS) software. Results: The overall prevalence of HIV, HbsAg, HCV, syphilis and malaria were 0.06%,0.30%,0.06%,0.12% and 0.01% respectively. With the implementation of strict donor criteria and use of sensitive screening tests, it may be possible to reduce the incidence of TTI in the Indian scenario. Conclusion: All blood donations should be screened for TTI’s ,thus ensuring safe blood supply to the recipients. With the implementation of strict donor selection criteria, use of sensitive screening tests and establishment of strict guidelines for blood transfusion it may be possible to reduce the incidence of TTI in the Indian scenario

Keywords: Transfusion transmitted infections; Seroprevalence; screening.

Background: Pure red cell aplasia (PRCA) is a rare disorder, characterized by reticulocytopenia (<1%) associated with a marked reduction of the bone marrow erythroid precursors (<5%) which is often clinically missed. Aim: To investigate the demographic profile and different causes of PRCA in the institution. Material and Methods: During a 5 year period, all cases which were reported as erythroid hyppolasia were reviewed. Based on the accepted criteria, 19 cases were included in the study. The cases were classified based on causes as primary and secondary. The clinical and laboratory profile of the cases were reviewed and followed up. Results: Among the 19 patients, two children were considered as primary PRCA as there was no other cause. The rest were secondary – 1 patient developing PRCA secondary to thymoma and 11 patients developed drug induced PRCA. 4 of them were on ART. The patient who had developed PRCA secondary to Thymoma was a 53 year old male presented with dyspnoea for more than a month. CT scan showed a mass in the anterior mediastinum which was diagnosed as thymoma and confirmed histopathologically. The four patients on ART had Zidoviduine in the regimen which is known to cause PRCA. Comments and Conclusions: The present study showed 19 patients with PRCA with diverse causes. Since PRCA is a rare disorder, haematologists should be alert to include PRCA in the differential diagnosis in cases of severe normochromic and normocytic anaemia combined with reticulocytopenia and normal production of the white blood cell and megakaryocytic lineages. The major goal in treating PRCA is to induce a remission with the recovery of erythropoiesis, thereby providing relief from transfusions and avoiding transfusion-related complications.

Keywords: Pure red cell aplasia; Thymoma; Teticulocytopenia.