Indian Journal of Pathology: Research and Practice

 Dermatofibrosarcoma protuberance is a histiocytic tumor of intermediate malignant potential. We are presenting a case of myxoid variant of dermatofibrosarcoma protuberance in a 37 year female patient having large 15 x 6 x 5 cm soft tissue mass on back region, over right paraspinal area of 8 years duration which suddenly increase in size in last 3 months. This case of dermatofibrosarcoma protuberance myxoid variant is presented for its rarity and clinico-histopathological findings.

Keywords: Soft Tissue Tumor; Fibrohistocytic Tumor; Histological Types.

 Disseminated angioinvasive aspergillosis is a rare fatal disease seen in immunocompromised hosts. Invasive pulmonary aspergillosis have been reported in immunocompetant patients with preexisting COPD having bulla, tuberculous cavity or bronchial cyst. A 22 years aged male patient was hospitalized after consumption of ratol, a rodenticide poison. Investigations revealed altered liver function,leukocytosis of 16,600cells/mm3, HIV and HbsAg negative status. Clinical diagnosis was fulminant hepatocellular failure.On fifth day, he suddenly developed massive haematemesis and dyspnea and succumbed to death. Autopsy revealed disseminated angio-invasive aspergillosis involving the lungs, heart and kidney. On histopathology, Invasive pulmonary aspergillosis, myocarditis, endocarditis, angioinvasion and renal aspergillosis showing septate hyphae branching at acute angle were seen. We report this case of invasive aspergillosis occurring in a non immunocompromised person, diagnosed on autopsy.Our case upholds the significance of autopsy.

Keywords: Aspergillosis; Autopsy; Disseminated; Hyphae.

 Krukenberg tumor is a rare tumour and accounts for 1% to 2% of all ovarian neoplasms. It is an uncommon metastatic signet ring cell adenocarcinoma of the ovary, originating in the stomach in the vast majority of cases. On occasions, the gastric cancer may be small and remains undetected for several years after oophorectomy. Much less frequently, the primary tumor is in the large intestine, breast, gallbladder, uterine cervix, appendix, or urinary bladder. Tubular variant of Krukenberg tumour with an occult primary can cause diagnostic dilemma on histopathological examination by mimicking primary ovarian tumours like SertoliLeydig cell tumour, endometrioid carcinoma (primary or metastatic) or clear cell carcinoma. Distinction from primary ovarian tumours is very important as misdiagnosis of Krukenberg tumour as primary ovarian tumour can lead to suboptimal treatment of the patient. We report a case of tubular variant of Krukenberg tumour with occult primary in a 42 year old female and discuss the diagnostic dilemma that arise in such situation. Gross examination of the specimen revealed asymmetricallly enlarged bilateral ovaries having bosselated outer surface with few cysts. Histopathological examination of both the ovaries revealed mucin laden cells in tubular configuration as well as diffusely scattered signet ring cells in a cellular ovarian stroma.The primary site of tumour could not be identified even after through radiographic and endoscopic examination of the patient. The prognoses for patients with this type of metastatic tumor are poor, most die within the first year of evolution. There are rare cases in which patients survive several years.

Keywords: Krukenberg Tumour; Tubular Variant; Ovary.

 Leiomyoma is a benign soft tissue tumor that arises from the smooth muscle, commonly occurs in Uterine Myometrium. Extrauterine Leiomyoma are rare. Smooth muscle tumors may arise from the erector pili muscle, the erectile tissue, insertion of the round ligaments and are usually well circumscribed .Vulval Leiomyomas are rare in occurrence with as few as 300 cases reported in the literature. In our institution this is the first case of Vulval Leiomyoma among the 37 Extrauterine Leiomyoma during January 2013 to june 2016. Hence we report a case of Vulval Leiomyoma,clinically diagnosed as Bartholins cyst .

Keywords: Vulval Leiomyoma; Extrauterine Leiomyoma; Leiomyoma.

 Olanzapine is among one of the widely used antipsychotics. Weight gain and metabolic side effects of this drug have been discussed through numerous literature. However, edema due to Olanzapine is not a typical issue. Here we are delineating a case of Olanzapine-induced edema.

Keywords: Olanzapine; Edema; Naranjo Scale.

 Primary ovarian pregnancy is one of the rarest types of ectopic pregnancies. Patients may complain of abdominal pain and bleeding per vaginum. Likely risk factors are intrauterine devices and assisted reproductive technology (ART). A pre-operative diagnosis is challenging but transvaginal sonography may be helpful. A diagnostic delay may lead to rupture, secondary implantation or operative difficulties. Therefore, awareness of this rare condition is important in reducing the associated risks. Here, we report three cases of primary ovarian pregnancies presenting with acute abdominal pain. Transabdominal ultrasonography could not be done in one, while in the second TVS could not particularly pin-point the site of the ectopic pregnancy. Both cases were confirmed by histopathological examinations.

Keywords: Primary; Ovarian; Pregnancy.

 Breast lesions are one of the most commonly encountered lesions in women. All physicians accept the necessity of obtaining prompt pathological confirmation of nature of mass in the breast suspected as benign or malignant. In recent years, mammary cytology has been considered as an effective means of early diagnosis of breast masses. 476 aspirates from breast lesions were studied and categorized as inflammatory (9 case), benign (418 cases) and malignant (49 cases). Youngest case was of 14 years old with juvenile fibroadenoma and oldest was 80 years with malignant lesion. Among the 476 cases, 38 were male patient. Benign lesions were most common in the age group of 21 ýÿ 30 years, while malignant lesions were most common in the fifth and sixth decades of life. Fibroadenoma was the commonest benign lesion followed by fibrocystic disease. Among the malignant lesions, invasive carcinoma was found to be more common. Of these, cyto-histopathological correlation was done in 111 cases. Cytology had the diagnostic accuracy with sensitivity of 94%, specificity of 99% and accuracy rate of 97%.

Keywords: Breast; Benign; Malignant; Cytology; Histopathology.

 Introduction: The morphologic pattern in the various granulomatous diseases may be sufficiently different, to allow reasonably accurate diagnosis by an experienced pathologist, however there are so many atypical presentations, that it is always necessary to identify the specific etiologic agent by special stains for organisms, by culture methods and by serological studies to exclude an infectious cause. Methodology: The clinical assessment of the patients were done by the Dermatologists. The skin biopsies were taken from the most prominent lesion or from the anaesthetic area depending on clinical diagnosis. Results: Leprosy formed the largest population, of the total 58 cases were Leprosy. The next in frequency was fungal granulomas. Out of the total 13 cases, in 9 cases (69.2%), a diagnosis of chromoblhomycosis was made, in one case the diagnosis was Histoplasmosis (7.7%). Conclusion: A detailed evaluation of good H&E stained sections could offer many diagnostic points for the accurate aetiological classification

Key words: Granulomatous; Histopathology; Leprosy.

 Introduction: Diagnostic evaluation of Intra-abdominal masses has always remained an enigma in surgical practice. Fine needle aspiration cytology (FNAC) is an alternative for exploratory laprotomy to provide documentary evidence of the nature of pathology before institution of therapy and also prognosis. The objective of the study was to assess the diagnostic accuracy of FNAC in evaluation of Intra-abdominal mass lesions. Methods: Study included 128 intra-abdominal mass lesions detected clinically and radiologically which was further classified into palpable and non palpable masses. Image guided FNAC was performed in non palpable lesions. Smears were made with routine stains and special stains were done wherever required. Histopathological correlation was done wherever possible. Results:The mean age was 45.17 years, with Male: Female ratio of 1:1.3. The diagnostic yield was 95.2% under direct aspiration and 91.8% under Ultrasonography (USG) guidance. There were 74(57.8%) malignant, 30(23.4%) benign, 14(10.9%) inflammatory, 1(0.78%) suspicious lesions and 9(7.03%) unsatisfactory smears. The liver and the ovary were the most common sites. Adenocarcinoma and hepatocellular carcinoma were the most common malignant lesions. This study showed 97.3% sensitivity, 100% specificity, 100% positive predictive value, 93.3% negative predictive value and 98.07% diagnostic accuracy. Conclusion: FNAC is a highly sensitive, reliable, accurate method for rapid provisional pre-operative evaluation of intra-abdominal mass lesions. This has a major impact on the management of patients, avert diagnostic surgical procedures and accelerate the planning for therapy.

Keywords: Guided FNAC; Abdomen; Histopathology; Diagnostic Accuracy.

 Introduction: The histopathology of lepromatous skin varies according to the cell-mediated immunity of the host against Mycobacterium leprae. In tuberculoid and borderline tuberculoid leprosy, epithelioid noncaseating granulomas predominate, and acid-fast bacilli (AFB) are absent or only rarely present. In borderline lepromatous and lepromatous leprosy, the infiltrate is composed of macrophages with a vacuolar cytoplasm, lymphocytes, and plasma cells. Methodology: A Descriptive study was carried out at a Tertiary care Hospital to know the in depth features of Leprosy. Totally 58 cases were recruited based on non probability purposive sampling technique. Results: Borderline tuberculoid (BT) comprised 33 cases (56.8%), Tuberculoid leprosy (TT) 20 cases (34%), Borderline leprosy 1 case (1.7%) and Borderline lepromatous (BL) 4 cases (7.3%). One case of BT was in reaction and three were of relapses. Conclusion: There is no independent gold standard for diagnosis of leprosy.

Keywords: Leprosy; Histopathology; Laprae.

 Background and Objectives: Fallopian tubes are the common specimens received in the histopathology laboratory. The recent concept of fallopian tube epithelium as a main source for tubal, ovarian and pelvic carcinoma is becoming common, hence proper examination of fallopian tube is essential. The aims and objectives of this study is to describe various histomorphological aspects of lesions of fallopian tubes. Materials and Methods: Present study is a prospective descriptive study. A total of 361 fallopian tubes specimens were included, these were routinely processed and sections of 5 micron thickness were taken and stained with Hematoxylin and eosin. Detailed gross and microscopic examination was done. Special stains like PAS and modified ZN stain were done wherever necessary. Results: Total of 361 fallopian tubes were analyzed, 49.045% (n=177) cases were unremarkable on both gross and microscopic examination. Salphingitis was seen in 16.36% (n=59) cases which includes acute, chronic, tuberculous and foreign body granulomatous salphingitis. Ectopic pregnancy in 2.78%(n=10) cases, endometriosis in 0.58%(n=2) cases, Salphingitis isthimica nodosa in 0.84%(n=3) cases, primary fallopian tube carcinoma in 0.27%(n=1) and metastatic deposits in 1.1%(n=4) cases. Conclusion: In the present study most patients (86.89%) had the fallopian tubes removed as a part of hysterectomy which was done for other causes rather than tubal pathology. It was observed that almost half of them had tubal pathology. The present study has made a meticulous attempt and studied the gross and microscopic features and categorized the lesions into various groups. Early and correct diagnosis of these diseases will definitely help clinicians in initiation of prompt therapy against the disease.

Keywords: Fallopian Tubes; Salphingitis; Endometriosis; Salphingitis Isthimica Nodosa

 Introduction: Influenza-like illness (ILI) is defined by the CDC as fever (temperature 100°F or 37.8°C) and either cough or sore throat in the absence of another known cause. Methodology: The patients with clinical features of Influenza like illness were enrolled. A complete clinical examination was carried out and relevant investigations done and documented in the proforma. Results: Fever was the most common symptom and was seen in all cases (100%), followed by cough (94.3), sore throat (74.3%), nasal catarrh (22.9%), difficulty in breathing (8.6%), vomiting (11.4%), diarrhea( 2.8%). Conclusion: The clinical manifestations of influenza A H1N1 virus infection range from self- limited uncomplicated subfebrile respiratory illness to severe and even fatal respiratory disease and extrapulmonary disease. Gastrointestinal symptoms include vomiting, diarrhea and abdominal pain.

Keywords: Influenza; Laboratory Profile; Clinical Manfestations.

 Introduction: Separation of perivascular neoplasms from the “waste basket” category of hemangiopericytomas has obviated a need for more detailed look at this newly formed category of neoplasms.The lesions now remaining in perivascular tumor category are ones showing evidence of differentiation towards myoid / contractile perivascular cell and all share a characteristic tendency to grow in a circumferential perivascular fashion. Aims: To delineate the morphological features that characterise perivascular tumors and outline the morphological features seen in them. Methods and Materials: Perivascular tumors diagnosed in our institution over a period of five years were collected, we utilised H&E stained glass slides along with special stains to characterise and delineate the perivascular tumors. Results: 16 cases of perivascular tumors included 1case of glomus tumor, two cases of myopericytoma and thirteencases of myofibroma. One myopericytoma was of classical type while the other was an angioleiomyoma - like myopericytoma. 13 myofibromas could be sub classified into leiomyoma - like, vascular, nodular and multinodular type. Conclusions: Common features highlighted in the study indicate that perivascular tumors are part of a morphologic continuum, with categories defined by researchers being arbitrary. It would be suitable to merge them into a single entity, thus paving the way for use of the term hemangiopericytoma to denote all perivascular tumors, but only after morphological parameters for the usage of the term are clearly defined.

Keywords: Hemangiopericytoma; Myofibroma; Myopericytoma; Glomus Tumor; Angioleiomyoma.

 Background: Rectal carcinomas are one of ten leading causes of death in India. There is gradual rise in their incidence which has prompted the greater research into their behavior. Now world wide all locally advanced rectal carcinomas are treated with preoperative chemo or radiotherapy. Aims and objectives: To observe the post chemotherapy histopathological changes in pretreated rectal carcinoma. Material and Methods: the present was both prospective and retrospective study conducted at Department of Pathology, on the 36 cases who had received pre-operatives NACT (Neoadjuvant chemotherapy). Results: Out of these 36 cases none showed complete remission of tumor. Both cytoplasmic and nuclear changes were observed and documented. The most common findings was cytoplasmic eosinophilia (98% of cases) and stromal dense fibrosis was seen in TRG3 tumors. The residual tumors were classified as TRG 0,1,2,3 as according to Dworak, Rodel and AJCC TNM system. The Rodel system was better as it was more objective and reducing the subjective bias in resected specimens. Conclusion -Hence the pathologist awareness towards the assessment of therapeutic response including the evaluation of residual tumor burden or tumor response grading (TRG) and cytomorphology including the stromal changes has become the hour of need.

Keywords: Rectal Carcinoma; Neoadjuvant Chemotherapy; Post Chemotherapy Changes; Tumor Regression Grading (TRG).

 Introduction: Traditional models of breast cancer development are based on morphological studies and suggest the transition from a normal epithelial cell via hyperplasia and atypical hyperplasia to ductal carcinoma in situ. The risk for carcinoma increased with the rate of proliferation and atypia in breast biopsies. Methodology: In this study, collection of family history and interrogation with the patient forms an integral part. This was done by direct communication with the patient at the Pathology and Surgery departments, collection of details from the radiotherapy department records and by collecting filled up proforma from the patients by post. Results: It is clearly seen that nearly 78% of the tumours belonged to the higher grade –Grade 2 and 3, whereas low-grade tumours constituted only 22%.Conclusion: The lymph node positivity is a strong indication to make the public aware of this disease and to intensify the screening and surveillance programmes

Keywords: Breast Carcinoma; Clinical Profile; Pathological Profile.

 Introduction: Nephrotic syndrome (NS) is caused by increased permeability of the glomerular capillary wall for proteins. Aims and Objectives: To Study biochemical status of serum and urine in patients of Nephrotic Syndrome. Methodology: The present study was carried out in department of Pathology, ACPM Medical College Dhule. The period of study was one year. Diagnosed cases of nephrotic syndrome of different age and sex in the hospital during one year period were included in study. Diagnosis of nephrotic syndrome was recommended by international study of kidney disease for diagnosis.Result: Age and sex wise distribution of 84 cases of nephrotic syndrome is tabulated in table. Maximum number of patient 54(64.28%) were-observed in 0-10 years age groupthe prevalence of nephrotic syndrome decreases as age advanceThe various Biochemical serum values were (Mean ±SD) i.e. Total proteins (g/dl) were 3.32 ± 2.6 and Albumin (g/dl) was 1.52 ± 0.9; Sr. Cholesterol (mg/dl) was 235 ± 1.2 and Total antioxidants (mmol/L) were 1.77 ± 0.92; Homocysteine (umol/L) was 18.11 ± 4.12 and Vit.C (mg/L) was 0.52 ± 0.42.The majority of the Patients were having Urine Protein values i.e. Total urine protein g/24 hrs. in 2-2.9 range were 33(39.28%) followed by 3-3.9 were 33. (39.28%); 4- 6 were 17(20.23%) and >6 were 1(1.19%). Conclusion: In Nephrotic Syndrome, various serums biochemical values like total Proteins, Total antioxidants and Vit.C levels were decreased while Homocysteine level was increased and in urine there was proteinuria.

Keywords: Total Proteins; Total Antioxidants; Homocysteine; Proteinuria.

 Context: The plethora of pathologies makes diagnosis of dermal lesions challenging. Though, benign lesions are common, malignant conditions need to be ruled out. Clinical and radiological modalities result in inconclusive diagnosis due to overlapping features. Aims: The objectives of the present study are to collocate and organize dermal lesions based on anatomical location and distribution. We also highlight light microscopic features of these dermal lesions. Methods and Material: All cases clinically presenting with a dermal lesions were collected from histopathology archives. Relevant clinical details and histopathological slides were retrieved. The diagnosis was confirmed by review of the slides. Results: Out of 125 cases, only eight cases constituted pathologies with intermediate and/or malignant behavior. Non-neoplastic pathologies such as calcinosis cutis, ganglion cyst, keloid too were encountered. Lipoma accounting for 49.6% cases was the most common pathology. Most malignant lesions were located on extremities and were seen in elderly. Conclusions: It is prudent to consider even non-neoplastic lesions in differentials of dermal lesions. Age and location among other clinical details help in listing the differentials. Adequate sampling and recognisition of characteristic histological pattern helps in accurate pathological diagnosis.

Keywords: Dermal Lesions; Soft Tissue Tumors; Histopathology.

 Introduction: The Nephrotic syndrome aptly termed “the syndrome of Proteinuria” by the lord platt has stimulated provoked and puzzled doctors for years or more. The characteristic toad face, be if “Caucasian Negriod” or “ Mongoloid” is so pathognomic that together with bloated belly, legs and genitalia it has been recognized as a spectacular and specific since the time interest in thedisease of children began. Aims and Objectives:To Study Urinary Protein Pattern Using Polyacrylamide Gel Disc Electrophoresis in Nephrotic Syndrome. Meterials and Methods: This is a retrospective study. The study was carried out in department of ACPM Medical College, Dhule. Diagnosed cases of Nephrotic syndrome of different age and sex admitted to hospitals during one year were included in study. Clinical diagnosis of Nephrotic syndrome was recommended by international study of kidney disease for diagnosis used were as follows (more than 3 gm in 24 hrs/1.73 m2 /more than 40 mg/hr/m2 ) (serum cholesterol more than 200 mg/dl) (hypoalbuminaemia-serum albumin less than 2.5 g/dl. Result: Maximum number of patient 54(64.28%) were-observed in 0-10 years age group. Of this 54 patients, 28(51.85%) were male and 26 (48.14%) were female. So male female ratio is 1.07:1 The prevalence of nephrotic syndrome decreases as age advance. Male female ratio is 1.5:1. Oedema was the most common presenting symptom and it was observed in all patients (100%). The next common presenting symptom was fever which was observed in 47(55.95%) patients. Associated diseases were found in 23 cases of nephrotic syndrome the most common disorder associated with nephrotic syndrome was glomerulonephritis which was observed in 15(65.22%) patients. The next common associated systemic disorder was tuberculosis which was observed in 5 cases (21.74%) Commonest pattern observed was presence of albumin and transferrin (II) among 36 patient (42.85%) followed by presence of albumin, transferrin, post albumin and post transferrin (IV) in 15 patients (17.85%). Albumin, transferrin and post albumin (III) was observed in 9 patients (10.71%) and only albumin (I) in seven patient (8.33%). Whereas presence of all proteins (VI) was noted in 3 patients (3.57%) and presence of albumin, transferrin, post albumin and post transferrin and 7S (V) in 14 patients (16.66%). Pattern ‘I’ protein in range of 2 -2.9 g/24hours, in thepattern II protein in range of 2-2 g/24 hours . Type ‘III’ protein levels of 2-2.9gm/24 hours- pattern ‘IV’ -3-3.9gm/24 hours. Pattern ‘V’- 3-3.9 gm/24 hours . Pattern VIin 3-3.9. Conclusion: Polyacrylamide Gel Disc Electrophoresis in Nephrotic Syndrome is useful of quantification and identification of the nephrotic syndrome.

Keywords: Nephrotic Syndrome; Polyacrylamide Gel Disc Electrophoresis.

 Aim: To determine the spectrum of various bone tumors as observed on fine needle aspiration cytology and to correlate the same with histopathological examination. Materials and Methods: 20 cases were studied over a period of 3 years.Patients of both sexes and all age groups with clinico radiological suspicion of bone tumors were subjected for FNAC.Histopathological examination was carried out in patients who subsequently underwent biopsy and tumor excision.Finally correlation of FNAC findings with histopathology was done. Results: The age group affected ranged from 13-80 years.Males (60%) were affected more than females (40%) with M:F ratio of 1.5:1.Pain and swelling were the most common clinical features. Benign tumors (65%) were documented more than malignant tumors (35%).Giant cell tumor was most common tumor. Histopathological correlation was done in 14 out of 20 cases and out of 14 cases positive correlation seen in 13 (92.8%). Conclusion: FNAC should be considered as a diagnostic tool in the initial workup of skeletal tumors used for the preliminary diagnosis of bone tumors. Great diagnostic aid especially in developing countries like India. Alleviates the need for open biopsy and helps in initiating appropriate therapy faster. FNAC of bony masses have a high diagnostic accuracy especially when sampling is adequate.

Keywords: FNAC; Bone Tumours; Histopathology

 Introduction: Infections of the kidney are the common indication for the nephrectomy. Nephrectomy is a common urological procedure done for a variety of conditions like chronic infection, obstruction, injury and neoplasms. Aim and objectives: To study the various non–neoplastic lesions of Nephrectomy specimens. Material and Methods: The prospective study from the period of January 2013 to December 2015 was conducted in the Department of Pathology, Santhiram medical college, Nandyal. All the Nepherectomy specimens were analysed. Results: A total of 72 cases were studied. 62 cases were non neoplastic and 10 cases were neoplastic lesions. Chronic pyelonephritis was the predominant lesion in female. Conclusion: Infections in the kidney were common cause of chronic pyelonephritis in females. The chronic pyelonephrtis is the common indication for the nephrectomy.

Keywords: Chronic Pyelonephritis; Nephrectomy; Non – Neoplastic Lesions

 Background: A wide knowledge about the distribution of blood grouping in any population will help in the successful management of the blood banks. Aim: This study was conducted to find the distribution of ABO blood grouping and Rh typing in a tertiary care hospital in South India and to compare it with previous literature from India and other parts of the globe. Materials and Methods: This was a retrospective study done at the blood bank of a tertiary care hospital for a period of 5 years and 6 months ( January 2012 to June 2016). Forward blood grouping (Cell grouping) was done by both slide and tube agglutination method and Reverse grouping (Serum grouping) by tube agglutination method using daily freshly prepared known pooled A, B and O cells. Rh typing was done using antiglobulin technique. The results were recorded, analysed, tabulated and compared with previous similar studies. Results: Amongst the 9992 donors, O blood group formed the most common one - 3618 numbers (36.2%), followed by B blood group -3328 (33.3%) and A blood group - 2305 numbers (23.06%). AB was the least common blood group with 739 numbers (7.39%). 2 numbers (0.02%) of the rare Bombay blood group was present during the study period. In the Rh typing, majority, 9074 (90.8%) were Rh positive and only 918 (9.2%) were Rh negative. Conclusion: Regional blood group studies will provide a wide knowledge about the distribution of blood grouping in the population and will help in the successful management of the blood banks. A knowledge about the distribution of blood groups may also be useful to take preventive measures against certain diseases which have possible relationship with specific ABO groups.

Keywords: ABO Grouping; RH Typing; Blood Groups; Blood Bank; Transfusion.

 Background: There is a rising trend of oropharyngeal cancer, but a easy, safe and non –invasive test to differentiate the benign from malignant lesion is still at an early stage. Bulk fluorescence is an important step in this regards. Auto-fluorescence from biological agents like collagen and NADH (Nicotinamide adenine dinucleotide-reduced form) tissues involves evaluating the biomolecular environment through optical spectroscopy. Aim of Study: To study the role of optical spectroscopy in differentiating the benign from the malignant oral lesions by detecting the change in the bulk fluorescence, especially of collagen and NADH. Method: A study of 28 patients with oropharyngeal lesion was done. In all 28 freshly excised tissues, bulk fluorescences were measured by optical spectroscopy. Later the same excised tissues were processed for histopathology as gold standard. Results: This study showed that bulk fluorescence of collagen is a good method of investigation with 64.29% sensitivity than bulk fluorescence for NADH, which is only 35.70%. Conclusion: Optical spectroscopy has a bright future in differentiating the benign and malignant oropharyngeal lesion. Furthermore, it can detect cancer at an early stage.

Keywords: Bulk Fluorescence; Collagen and NADH (Nicotinamide Adenine Dinucleotide-Reduced form); Oropharyngeal Lesions.

 Pancytopenia and Bicytopenia are hematological findings which can occur from various etiological factors mainly involving the bone marrow. In our study of 106 cases of Pancytopenia (63 cases, 59.43%) and Bicytopenia (43 cases, 40.56%), megaloblastic anemia was the commonest finding which reflects the nutritional anemia in our country which can be corrected easily, followed by hypoplastic marrow, erythroid hyperplasia and HIV infection. Most of the patients were in 21-30 yrs of age group 26 cases (24.52%). Males were more 61 cases (57.54%) than females 45 cases (42.45%). In our study, HIV infection was found in 13 cases and 1 case of HBs Ag positive. HIV infection is emerging as another leading cause for Pancytopenia and Bicytopenia. Thrombocytopenia cases were more in our study because of ITP and Infection associated thrombocytopenia (IAT), due to Dengue out break during our study period. Final diagnosis requires morphological examination of marrow by doing bone marrow aspiration along with bone marrow biopsy, clinical examination in association with Vit B12 and folic acid levels, enzyme assays, serology, electrophoresis, markers etc along with radiological evaluation is needed for optimization of results & proper diagnosis in relevant cases.

Keywords: Bicytopenia; Bone Marrow; HIV; Megaloblastic Marrow; Pancytopenia.

 Background: Plasmodium vivax is the predominant cause of clinical malaria in India. Though infection of plasmodium vivax is historically believed to be a benign form of malaria, recent reports suggest that Plasmodium vivax can also lead to several complications. The study was undertaken to document the urinary abnormalities by dipstick method in Plasmodium vivax malaria patients and to know its usefulness and correlation with level of parasitaemia. Method: This study was performed on patients suffering from plasmodium vivax malaria, diagnosed by peripheral smear examination. Urine samples from Plasmodium vivax infected patients and healthy controls were analysed by dipstick method and compared. Parasite grading was done semi quantitatively by examining the stained thick smears. Proteinuria in positive cases are graded semi quantitatively as trace, +,++,+++ as per kit manufacture’s guidelines. Result: In our study out of 100 patients 97 (97%), showed protein in urine, which is significant, compared to control group (p value<0.05). Other urinary constituents like bilirubin and urobilinogen were also higher in these patients in comparison to control group. Also current study showed a positive correlation between proteinuria and plasmodium vivax parasitaemia and thus highlighted its usefulness as one of the diagnostic indices in identifying patients with severe plasmodium vivax malarial infestation. Conclusion: This study has documented proteinuria in significant number of patient with plasmodium vivax infestation. Study also showed a positive correlation between proteinuria and plasmodium vivax malaria parasitaemia. Even though urinalysis is not an alternative diagnostic tool for malaria, these urinary findings can be used as one of the diagnostic indices in identifying patients with severe plasmodium vivax malarial infestation. But further extensive researches involving large number of cases needs to be undertaken to support and justify the real benefits of these findings.

Keywords: Urine; Plasmodium Vivax; Malaria; Proteinuria; Dipstick.

 Background: Image Guided Fine Needle Aspiration Cytology (Image Guided FNAC) has become routine procedure for any lesion which is deep seated or inaccessible by conventional FNAC. It is an established, simple, rapid, less-invasive and economical procedure for cytological diagnosis of various benign as well as malignant lesions. Aims & Objectives: To study the sensitivity, specificity and diagnostic accuracy of image guided FNAC and to correlate its diagnosis with histopathology (HP) in intra-abdominal lesions. Materials & Methods: Image guided Fine Needle Aspirations (FNA) were performed in 80 patients with various intraabdominal lesions during May 2009 to December 2011. Among which, 73 were USG guided (91.3%) and 7 were CT guided (8.7%). Their cytological diagnosis was compared to HP diagnosis. True and false (positive and negative) data was analyzed to measure sensitivity, specificity and diagnostic accuracy of image guided FNAC. Results: Out of 80 cases, adequate material was aspirated in 75 cases (Sample adequacy 93.6 %.) so remaining 5 cases were excluded from study. Maximum cases were from Liver (24) followed by Ovary (19), Gall bladder (13), Gastro Intestinal Tract (GIT) (10), Lymph nodes (5) and Omentum (4). FNAC was diagnostic in all 75 cases which had adequate material. Among which, 55 (73.3 %) cases were malignant, 9 (12%) were benign and 11 (14.7%) were non-neoplastic. HP correlation was available in 58 (77.3%) cases. HP diagnosis was different from FNAC diagnosis in only 2 (3.4%) cases. Diagnostic accuracy of image guided FNAC was 96.6% with sensitivity of 95.9% and 100% specificity. Conclusion: Having high sensitivity, specificity and diagnostic accuracy, image guided FNAC is an OPD based rapid, reliable and accurate diagnostic procedure for various intra-abdominal lesions which are inaccessible by conventional FNAC. It is much economical to the patient as compared to costly surgical biopsies which have high morbidity.

Keywords: Image Guided FNAC; Intra-Abdominal; Ultrasonography; CT Scan, Histopathological Correlation.

 Introduction: The silent killer disease-Ovarian carcinoma ranks 6th among carcinomas in women. Surface epithelial tumours constitute 90-95% of them. Vascular Endothelial Growth Factor is a Tumour angiogenesis factor. Bevacizumab-anti VEGF antibody shows promise in the treatment of ovarian cancer. Compared to benign ovarian lesions,early stage ovarian cancer patients showed raised levels of VEGF. When used in combination with CA 125, sensitivity increased upto 96%, specificity increased upto 77%. Aims: To study the expression of VEGF (Vascular Endothelial Growth Factor) in epithelial ovarian neoplasms which could thence be, used as therapeutic targets in future. Methods and Material: In the 3 year study from June 2012 to june 2015, out of 92 surface epithelial ovarian neoplasms received, 26 ovarian malignancies and 4 borderline tumors were randomly selected for VEGF immunohistochemistry and statistical analysis was done. Results: Maximum number of patients presented only at an advanced stage of ovarian carcinoma. Among malignancies, 84.02% showed VEGF positivity. Carcinomas showed higher degree of VEGF positivity compared to borderline tumors. Higher the stage and grade, greater was the expression of VEGF and these were found to be statistically significant. Conclusions: VEGF has both diagnostic and therapeutic implications. There is a wide arena of community based studies and research activities being carried out with this marker - opening up newer dimensions and horizons in the early diagnosis and chemotherapeutic approaches with anti VEGF antibodies in the battle against this silent killer called Cancer Ovary.

Keywords: Vascular Endothelial Growth Factor; Tyrosine Kinase; Tumor Angiogenesis.

 Background: Computed Tomography (CT) guided Fine Needle Aspiration Cytology (FNAC) is an established, safe, reliable and accurate procedure for cytological diagnosis of any intra-thoracic lesion which is deep seated and inaccessible by Ultrasonography (USG). Aims & Objectives: To study the sensitivity, specificity and diagnostic accuracy of CT guided FNAC and to correlate its diagnosis with histopathology (HP) in intrathoracic lesions. Materials & Methods: CT guided Fine Needle Aspirations (FNA) were performed in 63 patients with various intra-thoracic lesions during May 2009 to December 2011. Their cytological diagnosis was compared to HP diagnosis. True and false (positive and negative) data was analyzed to measure sensitivity, specificity and diagnostic accuracy of CT guided FNAC. Results: Out of 63 cases, adequate material was aspirated in 59 cases (Sample adequacy 93.7 %.) so remaining 4 cases were excluded from study. Maximum cases were from Lung (39) followed by Mediastinum (9), Pleura (6) and Vertebral & Para-spinal region (5). FNAC was diagnostic in all 59 cases which had adequate material. Among which, 40 (67.8 %) cases were malignant and 19 (32.2%) were benign. HP correlation was available in 37 (62.7%) cases. HP diagnosis was different from FNAC diagnosis in only 3 (8.1%) cases. Diagnostic accuracy of CT guided FNAC was 91.8% with 90.3% sensitivity and 100% specificity. Conclusion: Having high sensitivity, specificity and diagnostic accuracy, CT guided FNAC is an OPD based safe, reliable and accurate diagnostic procedure for various intrathoracic lesions which are inaccessible by USG. It helps the clinician to select the treatment modality avoiding costly surgical biopsies and unnecessary thoracotomy for diagnostic purposes.

Keywords: CT Guided; FNAC; Intra-Thoracic; Sensitivity; Specificity; Accuracy

 Context: Papulosquamous lesions are a broad variety of dermatological disorders that encompass non infectious papular and squamous lesions known to have a varied distribution of mast cells. The role of mast cells in the pathogenesis of skin lesions like lichen planus is evident by the increase in their number and morphological alterations of these cells as noted by few authors. Aims: To quantify and evaluate mast cells in various papulosquamous diseases. Methods and Material: A total of 50 cases of papulosquamous skin lesions were retrieved from archives. H & E sections were reevaluated to confirm the diagnosis. Sections from representative blocks were cut to stain with Toluidine blue. They were evaluated for mean number of mast cells by evaluating three 40X high power fields. The mast cells were assessed for mean mast cell number, location, granularity and morphology. Results: Among 50 cases selected 3 were rejected due to insufficient block material. 17 cases of lichen planus(LP), 10 cases of psoriasis vulgaris (PV), 6 cases of discoid lupus erythematosus (DLE), 2 each of pityriasis lichenoid rosaeca, lichen plana pilaris, lichen simplex chronicus and 1 each of 8 other miscellaneous lesions. Mean mast cell number for LP, PV and DLE were 7.5, 8.7 and 5.8 respectively. Degranulation and spindled morphology was observed in 88%, 50% and 100% in LP, PV and DLE. Conclusions: The mast cells present in the lesions can bear influence on the pathogenesis of papulosquamous lesions by release of mediators to induce histological alteration characteristic of these lesions.

Keywords: Mast Cells; Papulo-Squamous Lesions; Skin.

 Introduction: Colorectal cancer (CRC) is a significant cause of morbidity and mortality and population based time trend studies have shown a rising trend in incidence of CRC in India. As the literature on the issue in India is limited, we undertook the study with the objective of evaluating the histopathological features of CRC and correlating these with certain clinicopathological variables. Material and Method: All the cases of colectomy and abdominoperineal resection specimen, received in the Pathology Department, over a period of three years (between July 2012 and July 2015) were evaluated. Statistical Analysis: Continuous data and qualitative variables were summarised using descriptive statistics and frequency respectively. Fisher’s exact test was used to compare the tumour grade with other clinicopathological variables. Results: The study included 51 cases of CRC with male: female ratio of 2.2:1. The mean patient age was 52.3± 13.2 years, with most of the cases occurring in the 5th decade (33.3%). Majority of the cases were located in the rectum (39.2%) and the commonest gross tumour morphology was ulceroinfiltrative (45.1%). Conventional adenocarcinoma (ACa- NOS) was the commonest histologic type (74.5%) followed by mucinous adenocarcinoma (MACa) (19.6%) and signet ring cell carcinoma (SCa) (5.9%). The most frequent grade observed was G2 (45.1%). Majority of the patients were in stage III (52.9%). Conclusions: Our age and sex distribution is comparable, to a larger extent, with other related nationwide studies. As many previous studies worldwide have consistently demonstrated, we found positive correlation between tumour grade and nodal metastasis, extent of local tumour spread and TNM stage.

Keywords: Adenocarcinoma; Colorectal Carcinoma; Mucinous Adenocarcinoma; Tumour Grade; TNM Stage.

 Objective: 1. To study the mucin spectrum in cholelithiasis, 2. To study the histomorphology of calculous cholecystitis, 3. To correlate mucin histochemistry with the histopathological findings. Materials and Methods: Histopathologically diagnosed cases of chronic calculous cholecystitis were taken. The study included 30 cases. Special stains like PAS (for neutral mucin), alcian blue-ph2.5(for sialomucin) and alcian blue pH 1(sulfomucin) were done on all 30 cases. Slides were assessed as per proforma. Results: The gall stone disease showed female preponderance. There was increase in sialomucin and neutral mucin in contrast to normal gall bladder(where sulfomucin predominates). Pigment stones seen more common than cholesterol stones. Gastric metaplasia is more common than intestinal. Conclusion: In chronic calculous cholecystitis, intraepithelial sulfated mucin reduces and sialomucin and neutral mucin increases. Cases with severe inflammation(grade III) showed the maximum decrease in sulfomucin and increase in sialomucin scores.The sialomucin showed increasing scores with degree of fibrosis. Gastric metaplasia had highest incidence(53.8%) in severe inflammation and was associated with increase in sialomucin.

Keywords: Alcian Blue; Cholecystitis; Metaplasia; Mucins; Periodic Acid Schiff.

 Introduction: Lung carcinoma stands among one of the most common malignancies causing higher mortality. Like other parts of the world, there is an increase in the incidence of lung carcinoma in India as well. Lung malignancy has been categorized into non-small cell (NSCLC) and small cell (SCLC) lung carcinoma. Lung malignancy has been categorized into non-small cell (NSCLC) and small cell (SCLC) lung carcinoma. These histological types of lung malignancies have an importance lying on the clinical presentation, prognosis, and response to treatment. Material and Methods: This descriptive retrospective study was performed using the records of 110 patients with lung cancer proved by histo-pathological examination. The demographic information was obtained from their requisition form for cytology and histopathalogy examination of specimens. Results: The results of this study were based on the analysis of 110 case-records of patients who had proven to have lung cancer. The age of the patients ranged between 22-95 years. Smoking habit was found in the majority of the male patients, 81 patient out of total 91 male were smoker which constitute about 89% were smoker. Our revealed that the adenocarcinoma is the most common type in our center, it was found in 63 patients (57.3%) common in both male and female, followed by squamous cell carcinoma in 31 patients (28.2%). Large cell carcinoma was the least commonly found only in a single case in our study. Discussion: The mean age of lung cancer patients has remained nearly constant over the years. The present study showed a smoker: non-smoker ratio of 2.8:1 in patients of lung cancer. The present study has observed that adenocarcinoma accounted for 57.3% of lung carcinoma, squamous cell carcinoma for 28.2%, small cell carcinoma for 3.6%, undifferentiated carcinoma for 10.9% and large cell ca 0.9%. In our study, we found adenocarcinoma to be the commonest histological subtype, accounting for 57.3% of all lung carcinoma cases . Over the last few years there has been a shift of histological profile towards adenocarcinoma worldwide. Conclusions: Lung carcinoma is a very serious public health problem and a preventable disease. With an increasing incidence and cigarette smoking is responsible for at least 90% of lung carcinoma.

Keywords: Lung Malignancy; Adenocarcinoma; Squamous Cell Carcinoma; NSCLC; SCLC.

 Introduction: Dengue is a major public health problem in tropical countries like India. The role of novel platelet indices is not well established for routine clinical use in dengue infection. Our study was undertaken to compare the platelet indices PLT count, MPV, PDW and PCT in serologically positive Dengue cases with that of control group and to assess the differences in platelet indices, if any between serologically antigen and antibody positive Dengue cases. Methods: Serologically NS1 antigen, IgM, IgG antibody positive 521 dengue cases detected by rapid ICT card test and 158 serologically dengue negative controls with normal platelet counts were studied. The PLT count, MPV, PCT and PDW in both case and control groups were measured by Beckman LH780 hematology analyzer and compared by statistical analysis. Results: PLT count and PCT were significantly lower (P< 0.005), MPV and PDW were significantly higher (P<0.005, 0.384 respectively) in dengue cases when compared to controls. Low PLT count, high MPV and low PCT were significantly associated with NS1 antigen, IgM, IgG antibody positivity. PLT count <150x109 /L was sensitive, MPV >8.5FL and PCT <0.14% were specific for dengue infection. PDW was not an accurate marker.Conclusion: Low PLT count, high MPV and low PCT were significantly associated with NS1 antigen, IgM and IgG antibody positivity. Platelet count <150x109 /L showed sensitivity, MPV > 8.5FL and PCT <0.14% showed specificity for dengue infection.

Keywords : Dengue; Mean Platelet Volume; Platelet Count; Plateletcrit; Platelet Distribution Width.

 Background: Tuberculosis is one of the major public health problems in India and other developing countries.Tuberculosis is still considered a social disease; it reflects the standard of living in the community. The bacilli in the lymphnode can be detected microscopically by ZN stain and fluorochrome stain and culture methods. Objectives: To study the utility of Papanicolaou stain as a screening tool in detection of tubercle bacilli by microscopic method. Method:The prospectively study carried out at Department of Cytology, JJM Medical college Davangere, Karnataka between from September 2013 to February 2014. A total 104 cases of the lymph node FNAC were studied and stained by PIF, AO and Ziehl-Neelsen stained smears. Mycobacterial culture was used as the gold standard to compare the results. Results: Out of 100 specimens, 30%, 56% and 53 % were found positive by ZN, PIF and AO respectively. PIF was found to be superior to ZN on several aspects. Culture was positive in 19.04%. Conclusion: The efficacy of fluorescence microscopy proved to be much higher than conventional light microscopy and comparable to that of culture. Pap-induced fluorescence of lymph node smears is a safe, reliable and rapid method, which can prove as a valuable diagnostic tool for diagnosis of TB.

Keywords: Fluorescence Microscopy; Papanicolaou Stain; Fine Needle Aspiration; Tuberculosis.

 Not Provided.