Indian Journal of Pathology: Research and Practice

 Autoimmune oophoritis is a rare autoimmune disease leading to premature ovarian failure and frequently associated with or at an increased risk of development of other autoimmune diseases. Hence detail clinical examination, investigations and follow up are mandatory especially in infertile young women and to find out other autoimmune disorders.Herein, we report a case of autoimmune oophoritis as an incidental finding on hysterectomy in a  40-year-female.

 Odontomas are hamartomatous malformation of fully developed tooth structures like enamel, dentin and cementum.  These tumours are of two types, compound and complex depending on the basis of differentiation towards normal teeth. Of these complex odontomas are rare, asymptomatic and incidentally diagnosed on radiography. The tumours rarely present with large size causing facial asymmetry, inflammation and very rarely erupt into the oral cavity. Hence, herein we report the case of an unusual large complex composite odontoma erupting in the left posterior mandible of the oral cavity.

 Sarcoma-like mural nodule is a very rare occurrence in a mucinous tumour of the ovary. The sarcoma-like mural nodules occurred predominantly in middle-aged women, were multiple and sharply demarcated from the adjacent mucinous tumor, had small size, and exhibited a heterogeneous cell population. Distinction of these lesions from true sarcomatous nodules and foci of anaplastic carcinoma is important because of the worse prognosis of the two latter tumors compared with the favorable behavior of the sarcoma-like mural nodules.

 Lesch-Nyhan syndrome (LNS) is a rare, X-chromosome linked, genetically inherited disorder, present from the birth, but generally manifests itself in the first three to six months of life. The very first symptom, if observed carefully, is orange-coloured deposits of uric acid associated with blood in the diaper.  Eight day old male child presented with respiratory distress and progressive loss of pain sensation.  Radiological and hematological investigations were normal. Biochemically high urinary uric acid to creatinine ratio and uric acid crystals in urine helped diagnosis at an early day.    

Keywords: LNS; Red Sand Urine; Uric Acid.

 Desmoid tumor (musculoaponeurotic fibromatosis) is an aggressive monoclonal fibroblastic proliferation arising in musculo-aponeurotic structure at any site.  It is a distinct pathological entity which can locally infiltrate and recur posing therapeutic challenges  to a surgeon. We are reporting a rare case of abdominal desmoid tumor in a young patient.

 Introduction: Renal tumors comprise a diverse spectrum of neoplastic lesions with patterns that are relatively distinct for children and adults. A wide variety of both benign and malignant tumors arise from different components of the renal parenchyma, notably tubular epithelium. Methodology: In the retrospective analysis of cases, the descriptions of the gross  findings were taken from the records maintained in the department.  Following the receipt of nephrectomy specimen in 10% formalin, a detailed gross examination of the specimen was recorded. Results: Neoplastic lesions of kidney constituted 43.75% of the total nephrectomy specimen studied. They were three benign (8.57%) and 32 malignant tumuors (91.43%) of the renal tumours. Conclusion: Proper evaluation of nephrectomy specimens, a detailed clinical history, related laboratory and imaging findings are  necessary. 

Introduction: Renal diseases are responsible for a great deal of morbidity and mortality. Millions of people are affected annually by fatal and non fatal kidney diseases. Many of the diseases result in end stage renal disease showing typical gross and microscopic features. Thus the present study was undertaken to explore, elucidate and document the kidney lesions at nephrectomy. Methodology: The study was retrospective as well as prospective and included 80 nephrectomy specimens over a period of 3 yrs. The gross morphology and the microscopic sections were studied. Results: In the present study, a total of 80 cases of nephrectomy specimens were studied. Of these 80 cases, 45 were non-neplastic lesions (56.25%). Conclusion: Chronic pyelonephritis was most commonly found.

 Introduction: Type 2 diabetes mellitus accounts for more than 90% of all patients with diabetes worldwide. According to ADA, microalbuminuria is defined as levels of urinary protein from 30 to 300 mg/day or 20 mg/minute, or 30 to 299 mg/ mg creatinine. Methodology: 250 out patients of type 2 diabetes mellitus were selected at random. Based on levels of albuminuria the patients were categorized into normoalbuminuria with <30 mg/gm of creatinine, microalbuminuria with 30- 300mg/gm of creatinine, and macroalbuminuria with >300mg/gm of creatinine. Results: In the present study, Serum Triglyceride was 116+43.9mg/dl, Serum Total cholesterol 154±39.mg/dl, HDL was 45.4+10.8mg/dl, and LDL was 96.3+29mg/dl and there were  significant correlations of microalbuminuria with reference to duration (1-5 years since diagnosis) (p-value<0.10) and HbA1C >7%, total cholesterol >200 mg/dl, serum triglycerides >150 mg/dl, HDL <35 mg/dl and  hypertension (p value<0.05). Conclusion: Microalbuminuria is associated with various microvascular and macrovascular co-morbidities of diabetes. Microalbuminuria  in  itself  being a predictor of diabetic nephropathy showed positive association with diabetic neuropathy and diabetic retinopathy (microvascular complications).

 Context: India is the second largest global pool of chronic HBV infection. Despite the institution of mandatory screening for HBsAg, the issue of transfusion-associated HBV is still a major health problem plaguing most third world and resource poor countries. Transfusion medicine, apart from being important for the medical treatment of each patient, also has great public health importance. Objectives: The present study was conducted to estimate the prevalence of Hepatitis B infections in voluntary blood donors at a tertiary care teaching hospital in Mumbai. Materials and Methods: All voluntary donors reporting to the blood bank were screened for HBsAg  by using the appropriate enzyme-linked immunosorbent assay. The study was designed for duration of  seven years between  January 2008  to December 2014.  Medical reports of the donors were accessed from the blood bank records and analyzed. Results: A total of 5606 voluntary blood donors were screened, of which 5120 (91.33%) were males and 486 (8.67%) were females. The seroprevalence of Hepatitis B was 3.67%. Conclusion: Blood borne transmission of hepatitis B virus continues to occur despite implementation of highly sensitive screening tests for HBsAg, suggesting these assays are still not sensitive enough to prevent all infections.

 Introduction: The prevalence of  Diabetes mellitus is growing rapidly worldwide and is reaching epidemic proportions. It is estimated that there are 285 million people with diabetes worldwide and this number is set to increase to 438 million by the year 2030. Methodology: 250 out patients of type 2 diabetes mellitus were selected at random. Based on levels of albuminuria the patients were categorized into normo albuminuria with <30 mg/gm of creatinine, microalbuminuria with 30-300mg/gm of creatinine, and macroalbuminuria with >300mg/gm of creatinine. Results: In the present study it was noted that among 250 patients studied, microalbuminuria was common in males, prevalence of microalbuminuria was 20%. Conclusion: Testing for microalbuminuria should be standardized in type 2 diabetes mellitus patients from time of first diagnosis of diabetes because early intervention helps in delaying the progression of diabetic nephropathy.

 Context: WHO reports that the viral dose in HIV transmission through blood is so large that one HIV positive transfusion leads to death, on an average after two years in children and after three to five years in adults. Transfusion medicine, apart from being important for the medical treatment of each patient, also has great public health importance. Objectives: The present study was conducted to estimate the prevalence of HIV infections in voluntary blood donors at a tertiary care teaching hospital in Mumbai. Materials and Methods: All voluntary donors reporting to the blood bank were screened for HIV by using the appropriate enzyme-linked immunosorbent assay. The study was designed for duration of seven years between January 2008 to December 2014. Medical reports of the donors were accessed from the blood bank records and analyzed. Results: A total of 5606 voluntary blood donors were screened, of which 5120 (91.33%) were males and 486 (8.67%) were females. The seroprevalence of HIV was 1.37%. Conclusion: Blood is still one of the main sources of transmission of HIV infections. 

 Objectives: The aim of the study is to determine the   clinico-pathological features of primary esophageal l malignant   tumors and to compare with primary gastrointestinal malignancies. Materials and methods: 45 patients with primary   esophageal  malignant   tumors  diagnosed over a 5 year period  were studied clinically and histopathologically,  they were classified using the  WHO classification and  compared with  300 primary gastrointestinal tumors and the previous studies. Result: 45 patients (15% ) were esophageal  malignancies arising out of 300 primary gastrointestinal malignancies, with a male to female  ratio of  3.5:1. Majority  were males, majority were  non vegetarians and  most of the males were alcoholics and smokers. The youngest patient affected is 20 years old and the oldest patient is 78   years old with mean age of 52.17 and median age of 53 years. Tumor more common in the  sixth and  seventh  decade of life.In esophagus, the presenting symptoms in the decreasing order of frequency were dysphagia, weight loss, hematemesis  and abdominal pain. Malignant tumors were more common in lower one third with 25 cases (55.55%) followed by frequency in middle and upper one third of esophagus with a male preponderance. Ulcerative type of lesion was the most common gross presentation in  55.5% of the tumors followed by exophytic and infiltrative pattern.  The commonest malignant tumor of esophagus was squamous cell carcinoma constituting  71.8%, and rest  include adenocarcinomas, poorly differentiated carcinomas and a single case of adenosquamous carcinoma. Conclusion: Primary  esophageal  malignancy   constitute  about 15%  of all gastrointestinal malignancies, males commonly affected (3.5 :1) and more common in alcoholics and non vegetarians. dysphagia, weight loss, hematemesis and abdominal pain was the most common clinical presentations,  more common in lower one third with 25 cases (55.55%). Ulcerative type of lesion was the most common gross presentation in 55.5% of the tumors, Histologically 71.8% were sqamous cell carcinoma and few cased of  adenocarcinomas, poorly differentiated carcinomas and a single case of adenosquamous carcinoma.