Indian Journal of Pathology: Research and Practice

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Introduction: Thyroid Fine Needle Aspiration (FNA) has been widely used as a first­line investigation to assess thyroid nodules, as it is rapid, cost effective, safe and reliable.To bring uniformity and standardization in thyroid cytology reporting, “The Bethesda System for Reporting Thyroid Cytopathology” (TBSRTC) was introduced and it is gaining acceptance. This study has been undertaken to evaluate the reproducibility using TBSRTC system while reporting thyroid FNACs and to find out the utility of Bethesda system after correlating with the histopathology. Methods: A retrospective study was conducted in which 506 cases of thyroid aspirates were reclassified according to TBSRTC in to six categories by two cytologists separately and reproducibility of the system was assessed. In 97 cases histopathological correlation was available and risk of malignancy in all these TBSRTC categories was calculated. Results: ategory wise distribution of aspirates was non diagnostic (ND) 1.38%, Benign(BN) 88.15%, Follicular neoplasm (FN) 2.38%, follicular lesion of uncertain significance(FLUS) 2.96 %, suspicious of malignancy(SM) 1.38% and malignant category (3.75%). Overall Percentage of agreement between the two cytologists was 97.5% and rate of disagreement was more in follicular lesion of undetermined significance, follicular neoplasm and suspicious category. On cytohistological correlation, malignancy rate in different categories are ND 0%, BN 1.4%, FLUS 20%, FN 28.6%, SM 60% and MGT 100%. Conclusions: It was observed that standardized nomenclature of the Bethesda system has brought much needed clarity in thyroid FNAC reporting. Substantial interobserver agreement was found for thyroid cytological lesions using Bethesda reporting. Along with MGT category, the FLUS, FN and SM categories carry higher malignancy risk. 

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 Kikuchi­Fujimoto disease (KFD) is a self­limited, usually benign condition of unknown etiology characterised by fever and cervical lymphadenitis. Multisystem involvement is not very common.We report a case of a 14 year old boy who presented with prolonged fever, rashes, cervical lymphadenitis, oral ulcers, and weight losseventually diagnosedwith kikuchi’s disease. This case is interesting as the child subsequently developed multisystem involvement secondary to Kikuchi disease. Child recovered and remains well on follow up clinic visits. KFD may have to be differentiated from many other infective, inflammatory and malignant disorders. Diagnosis is confirmed by characteristic histopathological findings on excision lymph node biopsy. Long term careful monitoring of these patients for signs and symptoms of evolving SLE or other autoimmune disorders is required.

Keywords: Kikuchi’s Disease; Fever; Lymphadenitis; SLE; Multisystem

 Filaria are usually classified according to the final habitat of the adult worms in the human host are The cutaneous group, The lymphatic group, The body cavity group. Onchocerca volvulus and Loa loa are most common organisms reported in subcutaneous tissue, and Wuchereria bancrofti and Brugia malayi are the 2 most common species in lymphatic. In the present case microfilaria of Wuchereria bancrofti was seen in subcutaneous nodule.Fine­needle aspiration cytology (FNAC) is not commonly used for its detection . It has always been detected incidentally, while doing FNACs for evaluation of other lesions. Here we found a rare cases of cutaneous filariasis by Wuchereria bancrofti at lateral aspect of arm diagnosed by fine needle aspiration cytology is reported in 25 yr old.

Keyword: Wuchereria Bancrofti; FNAC; Cutaneous Filariasis; Complete Blood Count (CBC).

 Parapharyngeal space is one of the potential facial planes of head and neck that may be involved by various pathological processes:infectious, inflammatory andneoplastic. Neoplastictumours seen at the parapharyngeal space represent less than 1% of all head and neck tumours. Both benign and malignant tumours may arise in this location, majority appears to be benign. Mostparapharyngealspace tumours are salivary gland tumours, neurogenictumours and lymphoreticular lesionswhich comprise nearly 75­80% of all parapharyngeal space tumours. We report a case of Pleomorphic adenoma arising de novo in the parapharyngeal spacewhich is a very rare site of its occurrence. World literature suggests parapharyngeal space lesions account for only 0.5% head and neck tumours and the majority of the minor salivary gland tumours are malignant. Pleomorphic adenoma arising de novo in the parapharyngeal space is of rare occurrence. High index of suspicion and an adequate clearance of the tumour with a cuff of surrounding dispensable normal tissues is the key to successful treatment of such tumours.

Keywords: Parapharyngeal; Salivary Gland Tumour; Pleomorphic; Adenoma.

 Introduction: Osteosarcoma is by far the greatest histological imitator of bone tumours. Both radiologically and histologically, osteosarcoma mimics many other benign and malignant bone lesions.Accurate diagnosis of bone­forming tumors, including correct subclassification of osteogenic sarcoma is critical for determination of appropriate clinical management and prediction of patient outcome. Methodology: All patients with clinical and radiological suspicion of primary and secondary tumours and tumour like lesions of the bone which require biopsy or surgical excision. Biopsy specimens were fixed in 10% formalin for 24 hrs after recording the gross morphological features. Specimen was sampled carefully and bone tissue was cut with hand and electrical saw in to thin slices. Samples containing bone tissue were decalcified before routine processing and paraffin embedding. Results: Among the bone forming tumours, benign tumours were four which constituted one osteoma and two osteoid osteoma and one osteoblastoma.. Malignant bone forming tumours were 3 which constituted conventional osteosarcoma. Among the cartilage forming tumours benign tumours were 11 amongst which osteochondromas were 8, chondromas were 2 and 1 chondroblastomas. The malignant cartilage tumour. was conventionally chondrosarcoma. Marrow origin tumours constituted 2 cases of Ewing’s sarcoma Conclusion: Knowledge of radiological appearances of various bone tumours and tumour like lesions is essential for the pathologist in evaluating the bone tumours.

Keywords: Bone Tumours; Radiology; Osteosarcoma.

 Introduction: Though bone tumours are infrequently encountered compared to the occurrence of other neoplastic lesion, they are of great significance because majority of them affect adolescents and young adults with a tendency of aggressive course. Methodology: The study was prospective and there was need to study various bone tumours and tumour like lesions of bone in the experience of the department of pathology, and hence study was conducted. All patients with clinical and radiological suspicion of primary and secondary tumours and tumour like lesions of the bone which require biopsy or surgical excision. Results: Out of 50 lesions studied, malignant bone tumours were 27 (54%) , benign tumours 16 (32%) and tumour like lesions 7 (14%). The ratio of benign to malignant bone tumours was 1 to 1.68. Conclusion: Benign bone tumours though common in general population are less often biopsied. Tumour like lesions more commonly present clinically as neoplastic lesion and also appear as tumours on X­rays.

Keywords: Bone Tumours; Histopathology; Tumour Like Lesions.

 Objective: Blood transfusion is an important mode of transmission of infections to recipients. With every one unit of blood transfusion there is 1% chance of transfusion related complications including Transfusion Transmissible Infections (TTIs). This study was designed to determine the prevalence of Human Immunodeficiency virus (HIV), Hepatitis B, Hepatitis C and syphillis infections among blood donors. Materials and Methods: Total number of 26617 units of blood were collected from healthy voluntary donors and tested for HIV I & II Hepatitis B surface Antigen, Hepatitis C and Syphilis. This study was done during the period of 2011 to 2015 at SBHGMC hospital blood bank, Dhule. Results: It was observed that 33(0.12%) tested positive for HIV, 360(1.35%) were positive for HBsAg,17 (0.06%) were positive for HCV and 13(0.05%) were positive for syphilis. Total 423 Units (1.59%) of blood were discarded due to presence of infective agents. Conclusions: Strict quality control, selection of donors by proper counseling and training of blood transfusion personnel including deferring of suspected donors may help in improving the blood safety.

Keywords: Voluntary; Replacement; Transfusion Transmissible Infections.

 Context: Capillary hemangiomas are fairly common benign tumors encountered across all age groups.Even though they consist of number of clinicopathologically distinct entities, clinicians and pathologists alike have traditionally tended to lump these tumors, under overly generic terms like capillary hemangioma which do little to guide proper clinical management. Aims: To delineate various lesions with capillary hemangioma pattern and outline the morphological features that distinguish each of them. Results: We characterised a collection of 93 cases with capillary hemangioma pattern received over a period of 60 months. Mast cells were counted in 10 fields of high density and mast cell density per square millimetre area was calculated. Statistical Analysis: Pearson correlation coefficient was used to analyse the relationship between mast cell numbers and the age of the lesion. Conclusions: Pathogenesis of capillary hemangiomas remains a hot topic receiving widespread attention of researchers. For a pathologist to distinguish a lobular capillary hemangioma from an Infantile hemangioma or a congenital hemangioma based on morphology is important, pointing to a need for looking beyond using a generic term of capillary hemangioma, and study of a large cohort of cases.

Keywords: Congenital Hemangioma; Epithelioid Hemangioma; Infantile Hemangioma; Lobular Capillary Hemangioma.

 Context: Malaria is endemic in tropics and subtropics with India contributing to 75% of the cases in South East Region. The early diagnosis of malaria is essential to treat patients and to prevent complications especially in cerebral malaria. Aims: To evaluate the diagnostic accuracy of different techniques available like Peripheral smear, Quantitative Buffy coat (QBC), and Rapid Diagnostic tests (RDT) in the diagnosis of malaria. Settings and Design: Prospective study for duration of one year. Methods and Material: Blood samples from all clinically suspected cases of malaria were routinely subjected to peripheral smear examination, QBC & RDT for the presence of malaria parasite. Statistical analysis used: Sensitivity, Specificity, Positive predictive value and Negative predictive value were analyzed using standard formulae. Results: Sensitivity, specificity, Positive Predictive value and Negative predictive values were 100%, 99.6%, 97% and 100% for QBC and 100%, 99.2%, 95% and 100% for RDT respectively. Conclusions: RDTs are equally or more sensitive and specific than peripheral smear and QBC. Newer Pf /Pv specific antigen card can distinguish mixed and PF infections unlike old Pf/ Pan RDTs. However further studies are required to assess cost effectiveness and efficiency of different RDTs.

Keywords: Malaria Diagnosis; Rapid Diagnostic Test; QBC.

 Introduction: Clinical studies have shown the detrimental effects of tuberculosis on the course of HIV infection. The risk of death in HIV­infected patients with tuberculosis was reported to be twice that in HIV­infected patients without tuberculosis, independent of the CD4 count. Methodology: The standard procedure was followed making use of 10 ml syringe with 23 gauge needle and as many as possible smears were prepared. Procedure was performed wearing disposable surgical gloves. Hands were washed with soap under running tap water after the procedure. The smears obtained were routinely fixed with ethyl alcohol or air dried according to type of stain to be used. If the smears were inadequate, aspiration was repeated. Smears were then stained by Haematoxylin and Eosin (H & E), May Grunwald Giemsa and ZN stain for acid fast bacilli (AFB). Results: In the present study, smears showing both caseous necrosis and epithelioid cell granuloma (CN­ECG) constituted predominant pattern with 19 cases (65.51%), followed by smears showing only epithelioid cell granuloma (ECG) 5(17.24%) and smears showing only caseous necrosis (CN) 5 (17.24%). Conclusion: Lymph node cytology is useful for segregating lymphadenopathy cases that needs further evaluation.

Keywords: TB Lymphadenitis; HIV; FNAC.

 Background and Objectives: FNAC play a vital role in evaluating pulmonary lesion. Its diagnostic accuracy is high in diagnosing lung cancer. From therapeutic view it is essential to categorize small cell lung carcinoma(SCLC) from Non small cell lung carcinoma. However recent targeted therapy emphasizes classification of NSCLC into different categories like squamous cell carcinoma(SQC), adenocarcinoma(AC) and Poorly differentiated carcinoma(PDC). The present study highlights utility of FNAC in diagnosing and categorizing lung cancer into various groups on which patient management is based. Materials and Methods: Present study is a prospective descriptive study. A total 25 FNAC of lung lesions under therapeutic guidance were included in the study. FNA smears were further stained and detailed cytomorphological study was done. Cytological parameters which were were studied include cellularity, cell arrangement, cell morphology and background material. Results: Mean age of the patients was 60.08years, 88% were males and 12% were females. Imaging technique used in 88% cases was ultrasonography and in 12% cases CT was used. In 8% cases aspirate was inadequate to comment. FNA diagnosis in 80% cases was positive for malignancy. Among malignant cases 35% were adenocarcinoma, 30% were squamous cell carcinoma, 25% were poorly differentiated carcinoma and 10% cases were metastasis. Conclusion: FNA is highly reliable method in not only distinguishing SCLC from NSCLC, but also categorizes NSCLC into SQC, AC and with the help of ancillary techniques one could even know the line of differentiation of PDC which really helps in patient management.

Keywords: Squamous Cell Carcinoma; Lung Cancer; Adenocarcinoma; Small Cell Carcinoma.

 Introduction: HIV­1 probably originated from one or more cross­species transfers from chimpanzees in central Africa. HIV­2 is closely related to viruses that infect sooty mangabeys in western Africa.Genetically, HIV­1 and HIV­2 are superficially similar, but each contains unique genes and its own distinct replication process. HIV­ 2 carries a slightly lower risk of transmission, and HIV­2 infection tends to progress more slowly to acquired immune deficiency syndrome. Methodology: Based on the selection criteria HIV positive patients with lymph node enlargement underwent clinical examination and the history was taken. Laboratory findings were carried out for these patients like routine haematological tests, CD4 T cell count. Fine Needle Aspiration Cytology was carried out. In patients with more than one group of lymph node enlargement, representative nodes (larger in the group) were chosen from each group and were subjected to FNAC. Results: In this study 50.67% had reactive lymphadenitis followed by tubercular (38.67%), granulomatous lymphadenitis (8%), non Hodgkin’s lymphoma (1.33%) and secondary metastases (1.33%). Conclusion: Most infectious causes of HIV lymphadenopathy can be correctly identified, in which the patients can commence prompt treatment for lifethreatening infections.

Keywords: FNAC; Lymph Nodes; HIV.

 Background and Objectives: The Bethesda system for reporting thyroid cytopathology (TBSRTC) is a standard method for analyzing thyroid smears, there by communicating clear and relevant information to the clinician. Objective of the study is to classify the cytological features of different thyroid lesions according to TBSRTC and compare them with histopathology wherever possible and to determine the diagnostic accuracy. Materials and Methods: A prospective fine needle aspiration (FNA) study is conducted in the department of pathology VIMS Ballari on all cases of thyroid lesions between January 2015 and June 2016. The smears are classified using the Bethesda system and distribution in each category is done. The malignancy risk for each category is calculated by follow up histopathology wherever possible. Results: Of the 300 FNA of thyroid swelling 10.66% were nondiagnostic, 77% were benign, 5.6% were atypical follicular lesions of undetermined significance(AFLUS), 4% were suspicious for follicular neoplasms, 1.33% were suspicious for malignancy and 1.33% were malignant. Follow up histopathological examination(HPE) are available in 70 cases. The distribution of malignancy risk rates in various Bethesda category were 11.11% in nondiagnostic, 2.08% in benign. 66.67% in atypical FLUS, 0% in follicular neoplasms, 100% in suspicious of malignancy and 100% in malignant category. Conclusion: The implementation of TBSTRC which stands for a unique, international and a universal terminology for the reporting of the thyroid cytology should be encouraged because of its relative ease of reproducibility. The classification is directly related to the risk of malignancy in each category which in turn prompts the recommended clinical management of that category.

Keywords: Bethesda System; Fine Needle Aspiration; Histopathology; Thyroid Lesions

 Introduction: The p53 tumor suppressor gene undergoes mutations in many diverse human cancers. It is commonly mutated in colorectal adenocarcinomas and can be studied by mutational analysis or by immunohistochemical methods. It has been correlated with poor prognosis and treatment outcomes in colorectal cancers. Aims and Objectives: To perform and interpret p53 immunostaining on all colorectal lesions and infer the rate of p53 positivity and to correlate it with the type of lesion and grade of tumor. Materials and Methods: This was a retrospective hospital based study done in two years (October 2009 to October 2011) at MGM Hospital, Warangalin collaboration with Biogene Quest, a research laboratory based in Hyderabad. Tissue from colorectal lesions from 65 patients was studied for histopathology and for p53 by immunohistochemistry (IHC). Observations and Results: p53 IHC was done on all the cases. 25/65(38.4%) cases were positive for p53 immunostaining. In these 25 cases, 21 (84%) were colorectal adenocarcinomas,2 (8%) were adenomatous polyps,1 (4%) were hyperplastic polyps and 1(4%) were ulcerative colitis.2/4(50%)adenomatous polyps were positive. Among these positive cases one was adenomatous polyp with highgrade dysplasia and other was tubulo­villous polyp. 21/35 (60%) adenocarcinomas including mucinous adenocarcinoma were positive.61%(13/21) well differentiated adenocarcinoma, 55%(5/9)moderately differentiated adenocarcinomas, 66%(2/3) poorly differentiated adenocarcinomas showed overexpression of p53. 40% (8/21) cases were located in right colon, 30% (6/20) cases were located in left colon, and 30% (6/20) positive colorectal adenocarcinomas were located in rectum. Conclusion: In our study, p53 overexpression was seen in 60% of colorectal adenocarcinomas and in 50% of adenomas. As p53 mutations are known to have a role in adenomacarcinoma sequence, we recommend testing of all colorectal adenocarcinomas and adenomatous adenomas for p53 mutation.

Keywords: P53; Colorectal Lesions; Adenocarcinomas; Histopathology; Immunohistochemistry.

 Chagas disease is a potentially fatal condition that presents high capacity to infect cardiac muscle cells and frequently evolves to dilated cardiomyopathy and congestive heart failure. The treatments available nowadays has low efficacy and several side effects, thus homeopathic medication is being studied as an alternative. Studies showed a decrease in the number of amastigotes in the heart of animals treated with Lycopodiumclavatum, a medication with anticholinesterasic, anti­inflammatory, antibacterial, antiviral and antifungal actions; and treated with Conium maculatum, a medication that acts in the nervous system by binding to nicotinic receptors. Therefore, the objective of this study was to describe the alterations verified in cardiac muscle cells of 12 Swiss male mice, 8 weeks old, infected with 1,400 trypomastigotes forms of T. cruzi (Y strain) and treated with Lycopodiumclavatum, 13cH –1:10 [26]dilution (GLy) and Conium maculatum 13cH –1:10 [26] dilution (GCo). The results showed that the mean relative heart weight of the animals in group GCO (0.76g) was significantly higher than the mean relative heart weight of the animals in group GCI ­ control group (0,52g) (p=0,01). The animals in group GLy presented a mean relative weight of 0,62g, showing no statistic difference compared to group GCI.

Keywords: Trypanosomacruzi; Chagas Disease; Heart.

 Context: Platelet counts from automated haematologyanalysers are crosschecked in peripheral smears by counting the number of platelets in ten oil immersion fields and multiplying their average by 15000. Since different microscopes have different field diameters, the area viewed and the number of platelets counted in ten fields differs between microscopes. Hence it is inappropriate to use the same multiplication factor of 15000 in all microscopes. Aims: To determine whether the multiplication factor of 15000 should be modified in a microscope with field number 20. Settings and Design: Platelet counts were estimated by two different methods from peripheral blood smears by using a microscope with field number 20. Multiplication factor used was 12000 in method A and 15000 in method B. Results of the two methods were compared with automated platelet counts. Methods and Material: Automated platelet counts were obtained from Sysmex XT1800i for 200 blood samples and compared with the manual counts estimated from Leica microscope with field number 20 by the two methods mentioned above. Statistical analysis used: ANOVA, student’s t test, correlation coefficient. Results: Results from method A correlated strongly with automated platelet counts (correlation coefficient of 0.978) and did not differ significantly from them (p value of 0.28). Method B results differed significantly from automated counts (p < 0.001). Conclusions: Modifications to multiplication factor are essential when microscopes of different field diameters are used for platelet count estimation. We have suggested those modifications needed for various types of microscopes in this article.

Keywords: Automated Analysers; Haematology; Microscopes; Platelet; Platelet Count.

 Background: Nutritional anemia, particularly iron deficiency, continues to be a major public health problem worldwide, particularly in the developing countries like India. Although mass spectrometry has been recently used to give a definitive determination of iron in tissue, microscopic examination of Prussian blue­stained bone marrow aspirate has been considered the practical “gold standard” for determining iron depleted states. Aim: To assess the bone marrow iron stores among the various haematological disorders. Materials and Methods: A cross sectional observational study was conducted by the department of pathology at Shri B.M. Patil Medical College, Hospital and Research centre, Vijayapur for a period of one year. A total of 110 cases of various hematological disorders were studied to assess the bone marrow iron stores. Bone marrow aspirate was obtained after written informed consent from the posterior superior iliac spine observing strict asepsis, spread onto slides, air dried, fixed with methanol, and stained with Giemsa Stain, observed microscopically and also simultaneously one smear stained with Prussian blue stain. Equal volumes of 2% of potassium ferrocynide and 2% hydrochloric acid solution are mixed in staining jar and slides are immersed in the solution for 15­20 min. Then removed and rinsed with tap water. Counterstaining was done with 1% neutral red for 30 seconds. Results: Of the various haematological disorders 61.7% of the RBC disorders and 60% of the combined disorders had shown decreased bone marrow iron store, whereas among WBC disorders and platelet disorders it was 45% and 33.3% respectively and there was no statistically significant association (p=0.461) between any of the haematological disorder and the reduced bone marrow iron stores. Conclusion: Performing a bone marrow study in all patients with haematological disorders should be made routine before starting iron replacement therapy.

Keywords: Bone marrow; iron stores; haematological disorder.

 Introduction: Dengue is the most important arthropod borne viral infection of humans. As there is an alarming rise in Dengue Fever and its complications (i.e, Dengue Hemorrhagic Fever/Dengue Shock Syndrome), rapid and accurate diagnosis is of paramount importance. Aims/Objectives: 1. To study the prevalence of dengue in different age groups and sex distribution. 2. To study the spectrum of clinical symptomatology in endemic population. 3. To evaluate the clinical, hematological, biochemical, serological and coagulation profile in different stages of confirmed Dengue cases. 4. To correlate clinical, hematological, biochemical, serological and coagulation findings with disease severity and clinical outcome. Methods: A prospective study from June 2014 to June 2015 was done among 100 serologically confirmed cases of dengue by rapid immunologic tests. Evaluation of clinical data, hematological and biochemical parameters with peripheral smear study were carried out. Results: A total of 100 serologically positive cases were studied with adults (63%) and children (37%). The commonest clinical presentation was fever (100%), headache (80%), retro­orbital pain (48%), vomiting (18%), myalgia (64%), arthralgia (52%), hemorrhagic manifestation (18%) and shock (06%). The Hematological profile observed were decrease in Hemoglobin (62.5%), Hemoconcentration (35%), Leukopenia (57.5%) with presence of atypical lymphocytes (43.7%). and Thrombocytopenia of varying degree (62%). Liver enzymes were elevated in 25 % of cases and markedly elevated APTT level in 18% of cases of DHF/DSS. Conclusion: Early and prompt diagnosis by rapid diagnostic kits along with clinical features and serial measurements of hematological and biochemical parameters helps in reducing the morbidity and mortality associated with Dengue.

Keywords: Dengue; Dengue Fever; Dengue Hemorrhagic Fever; Dengue Shock Syndrome; Severe Dengue.

 During survey for the foliicolous fungi from diversified habitats of Bahraich (U.P.) India the authors came across an important crop for the locality Pennisetum typhoidis (L.) R. Br. which belongs to Plantae, Tracheobionta, Spermatophyta, Magnoliophyta, Lijiopsida, Commeliinidae, Cyperales, Poaceae­ the grass family is commonly called pearl millet, bulrush millet, cattail millet, candle millet, bajra, bajri etc. On critical study of pearl millet plants, we found the living leaves to be infected with Alternaria and Drechslera sp.. On critical morphotaxonomic study it was found to be new species and the same taxon has been described and illustrated as Alternaria penneseti sp. nov. and Drechslera rajendralla sp nov. The review of available literatures reveals that there has been no record of these fungus from India on this host so far. Therefore, this host for the two new species is a new record to Indian mycoflora from Bahraich (U.P) India.

Keywords: Foliicolous; Fungi; Pearl Millet; North Central; Bahraich; Uttar Pradesh; India.

 Background: Hydatid disease or echinococcosis is an important zoonosis, and a serious public health problem both globally, and especially in endemic country like India. This disease is usually found in liver and lungs, but unusual sites in the body can pose a diagnostic challenge. The aim of this study was to evaluate the epidemiology, clinical picture and different localisations of hydatid cyst and to suspect this disease in any cystic lesion affecting any organ in the body , especially in endemic areas of the world. Material and Methods: Total of 72 cases were analysed and a retrospective descriptive study was carried out in our institute over a period of 6 years from 2010 to 2015. We screened all the histopathology records diagnosed with hydatidosis and details are collected from their case sheet. Results: Out of 72 patients, the dominant sex affected by the disease were females 45(62.5%) and 27(37.5%) males. Hydatidosis more commonly affect in the second decade of life followed by third decade. Overall pain in abdomen was the most common presenting complaint. Among the unusual sites most common presentation was solitary, cystic swelling. Liver was the most commonly affected organ. We reported 11 cases of hydatidosis in unusual localisations. Conclusion: Hydatid disease is still a problem and burden in rural regions of India. A high index of suspicion, radiological investigations as well as histopathological examination is necessary in establishing the diagnosis of hydatid disease at unusual sites in the body.

Keywords : Hydatid Disease; Echinococcosis; Unusual.

 Background: Cytological tools, imprint and crush smear techniques are simple and rapid techniques in diagnosis of various lesions. Aims and Objectives: 1. To evaluate the utility of imprint, scrape and crush cytology as diagnostic modality. 2. To study the advantages and limitations of cytological techniques. 3) To correlate, compare and contrast with histopathology examination. Material and Methods: A prospective study, comprising of 200 cases of various specimen, submitted in histopathology department. Smears by different cytological techniques were stained by rapid H&E , PAP stain and Giemsa stains. Results: Imprint and crush smears showed cent percent diagnostic accuracy in diagnosing CNS lesion, Genitourinary, Bone, Testis and skin and soft tissue lesions. Lesions from Breast, Gastrointestinal lesions, Tumor resection margins , also showed high diagnostic concordance between cytological methods and histopathological examination. Conclusion: Imprint, scrape and crush smear methods are rapid cost effective techniques of obtaining accurate diagnosis of benign and malignant lesions.

Keywords: Imprint Cytology; Crush Cytology; Scrape Cytology; Histopathoogy.

 Background: Carcinoma of the Pancreas is one of the leading causes of mortality due to malignancy. Most of the cases present with advanced stage because of subtle clinical manifestation. With a curative resection, the five year survival rate reaches to 25­30%. Aims and Objective: Aim of this study is to correlate Cathepsin D expression with pancreatic adenocarcinoma grade, perineural and lymphovascular invasion. Materials and method: Total of 50 Whipple pancreato duodenectomy specimens were selected for this study. Sections from pancreatic carcinoma were graded according to their degree of differentiation. Perineural invasion and lymphovascular invasion was noted. Immunohistochemical study using Cathepsin D antibody was performed in 50 cases and degree of antibody expression was scored in each case. Results: Tumor grading based on Histopathological examination and Cathepsin D expression was done. 12% cases were well differentiated, 42% were moderately differentiated and 46% cases were poorly differentiated carcinoma. Cathepsin D expression was scored. Score 1 was given to 8% cases, 2 to 44% cases and 3 to 48% cases. Lymph node metastases were present in 70% of cases and absent in 30% of cases. Perineural invasion was present in 56% of cases and absent in 44% of cases. Conclusion: Our study shows that increased expression of Cathepsin D was associated with higher grade of pancreatic adenocarcinoma and poor survival rate.

Keywords: Pancreatic Carcinoma; Cathepsin D; Perineural Invasion.

 Post­menopausal uterine bleeding is the cause of discomfort and inconvenience, affecting millions of women. Endometrial sampling is the effective means of evaluating the women with post­ menopausal uterine bleeding. Objectives: To study the histopathological pattern of the endometrial biopsies of patients with post­menopausal uterine bleeding and to correlate the abnormal endometrial pattern with different clinical presentations and age groups. Methods: The present study included evaluation of 60 cases of post­menopausal uterine bleeding diagnosed in the Department of Pathology, Vijayanagar Institute of Medical Sciences, Ballary, over a period of 1 year, from June 2015 to June 2016. The specimens were processed, embedded and cut into sections of 3­5 microns. The histopathological patterns of the endometrial biopsies were studied. Results: Atrophic endometrium formed the bulk of post­menopausal bleeding (50.0%). Non­neoplastic and benign neoplastic lesions including endometritis, polyp and hormone induced lesions formed 25.0%. 11 cases of endometrial hyperplasias (18.3%) and 4 cases of adenocarcinoma (6.7%) were encountered. The incidence of postmenopausal bleeding decreased with increasing age while the probability of cancer as the underlying cause increased. The peak incidence of endometrial carcinoma was found in women between 65 and 69 years of age. Conclusion: Endometrial biopsy is a valuable means for differentiating various benign lesions of uterine cavity, including atrophic endometrium, endometritis, endometrial polyp, and hormone­induced changes. Microscopic assessment of postmenopausal bleeding has great value in the identification of endometrial hyperplasia and carcinomas. Endometrial biopsy should be a part of diagnostic work up of the patients with postmenopausal bleeding to ensure accurate diagnosis and correct management.

Keywords: Post­Menopausal Bleeding; Endometrial Biopsy; Histopathology; Patterns.

 Introduction: Hypertension (HT) and Ischemic Heart Disease (IHD) are two pandemic cardiovascular health problems. The alarming feature of 1HD is that majority of burden is now shifting to developing and deprived economies. This includes India also. The present paper highlights the Lipid Profile, Oxidative Stress (OS) Nutrient Antioxidants and Endogenous Antioxidants Enzymes in Tribals, who represent deprived community, and non­tribals who represent developing community. Methods: This study included 353 subjects (Normal; tribals – 62, nontribals­52: HT­tribals­10 non­tribals­169: 1HD­tribals­4, non­trbal­41; HT+1HD­tribal­1 and non­tribal 14). All the subjects were investigated for lipid profile (Total Cholesterol, HDL­Cholesterol, LDLCholesterol, VLDL­Cholesterol, Triglyceride),Total Protein and Hb; antioxidant enzymes (SOD, GPx and Cat) and TBARS levels in blood and urine.Creatinine was also estimated in urine. Results: The total plasma cholesterol was almost touching the upper limit of normal in both tribals and non­tribals, was significantly higher iin IHD patients in both the communities. The LDL­ cholesterol (LDLC+VLDLC) was one of the important risk factors. OS (plasma TBARS) was significantly raised in IHD patients. Urine TBARS levels did not provide any conclusive trend. Vitamin A and beta­carotene levels were almost normal in both control and patient groups but vitamin C and E level and were low in both control and patients groups. SOD and GPx were low in patients group but catalase did not provide any regular trend. Conclusion: Cumulatively data suggest: I­ LDLCholesterol and triglyceride are risk factors, II ­Lop­sided redox status in patients.

Keywords: Lipid Profile; Oxidative Stress; Nutrient Antioxidants; Antioxidant Enzymes; Hypertension; Ischemic Heart Disease; Tribals; Non­Tribals.

 During survey for the foliicolous fungi from diversified habitats of Bahraich (U.P.) India the authors came across an important crop for the locality Zea mays Linn. which belongs to Poaceae­ the grass family is commonly called as zea, corn, silk corn, makka, barajowar. It is most widly distributed world’s crop with short lifecycle which requires warm weather, appropriate apprension and management It is a valuable livestock feed, as a human food and raw material for several industries. On critical study of maize plants, we found the living leaves to be infected with Alternaria, Curvularia and Drechslera sp. On critical morphotaxonomic study it was found to be new species and the same taxon has been described and illustrated as plurivorus hyphomycetus fungi Alternaria ziamaydis sp. nov.; dematiaceous hyphomycetous fungi Culvularia zeae sp nov. and Drechslera indiana sp nov. The review of available literatures reveals that there has been no record of these fungus from India on this host so far. Therefore, this host for the three new species is a new record to Indian mycoflora from Bahraich (U.P) India.

Keywords: Foliicolous Fungi; Zea mays; North Central; Bahraich; Uttar Pradesh; India.

 Background: Gastrointestinal tract (GIT) is the important site for wide variety of lesions especially malignant tumors. GIT cancers constitute 15­25% of all cancer burdens. Lower gastrointestinal tract disorders are one of the most commonly encountered problems in clinical practice. The definitive diagnosis of upper gastrointestinal disorders rests on the histopathological confirmation and is one of the bases for planning proper treatment. We undertake this study to determine spectrum of the neoplasms of lower gastro intestinal tract, make definite histopathological diagnosis of various neoplastic and non­neoplastic lower GI tract lesions and to correlate them age, sex and and to know the incidence of lesions with reference to age and sex in rural tertiary care hospital. Method: A prospective descriptive study of eighty endoscopic biopsies and surgically resected specimens of lower GIT tumors were carried out at a Narayana Medical College in Nellore, during 2014 to 2015. Breif clinical history was noted when the specimen is received. The biopsy samples were subjected to histopathological studies to determine the neoplastic and non neoplastic incidence. Results: Amongst 80 cases, 34 cases were benign and 46 cases (57.5%) were malignant. The peak age distribution was in 4­6th decade. Males out numbered females with a male to female ratio of 2.2:1 in benign lesions, however a slight female preponderance was observed in colorectal cancer. The most common benign lesion was adenoma, followed by juvenile polyp. The occurance of gastrointestinal tumors were highest in the colon and rectum. Majority of adenocarcinomas were Moderately differentiated. The most common age group affected is 3rd decade (42.85%) followed by 5th decade(28.57%),and 4th and 2nd decade(14.28%). Females(57.14%) are more commonly affected than males(42.85%) with male to female ratio of 0.73 : 1. Majority of the adenomas was found in age group of 51­80 years 9 cases(75%). Peak incidence was seen in 41­50 years; with 11 cases in this age group. Conclusion: The tumors of gastrointestinal tract show a wide variation in the histological type making the histopathological examination a must in the diagnosis of these tumors. Our study of gastrointestinal tract lesions throws a light on early diagnosis by histopathology beneficial for the patients in the rural area.

Keywords: Neoplastic; Biopsy; Gastrointestinal Tumors; Adenoma; Malignancy

 Introduction: Cervical cancer is the leading cause of mortality and morbidity among women with nearly four lakh new cases diagnosed annually worldwide, of which 80 % cases are in developing nations. Cervical Pap smear is a sensitive test for early screening of cervical lesions. Materials and Methods: A two year retrospective study of pap smears was conducted in the Department of Pathology from December 2013 – December 2015. A total of 5,464 pap smears were studied from patients in the age group of 17 ­80 years. Conventional pap smears were prepared according to standard procedures and were reported according to 2014 Bethesda system. Result: Out of 5,464 patients screened, 5,158(94.39 %) cases were benign, 157 (2.87%) were pre­malignant, 8 (0.14%) were malignant and 141 (2.58%) were unsatisfactory. The pre­malignant lesions were highest between 41­50 years and malignant cases between 51­60 years. Conclusion: Pap smear screening for cervical cancer is a highly effective tool for early detection of cervical premalignant lesions to prevent their progression to overt malignancy. Pap smear screening must be made mandatory after 30 years of age.

Keywords: Pap Smear; Screening; Intraepithelial Malignant Lesions.

 Introduction: Haemoglobinopathies and thalessemias are inherited disorders of haemoglobin synthesis.It is estimated that at least 5.2% of the world population and more than 7% of pregnant women are carriers of abnormal haemoglobins.The aim of the present study was to evaluate capillary electrophoresis method for the detection of thalessemias and haemoglobinopathies in patients visiting our haemotology department for Hb electrophoresis. Materials and Methods: The present retrospective study was carried out in our haematology department between September 2015 to August 2016 . A total of 500 patients in both the sexes registered for Hb electrophoresis were included in the study. Blood samples were collected intravenously in K3 EDTA tubes using standard protocols.A complete blood count was performed on each sample on LH 750 (Beckman coulter) fully automated haematology analyser within 12 hours of blood collection. All the blood samples were later run on capillary electrophoresis system (Sebia)as per standard protocols. Results: There were 38.6% males and 61.4% females .The male to female ratio was 0.6:1. 311 patients(62.2%)had normal Hb electrophoretic pattern .Sicle cell trait was detected in 68(13.6%) patients.Thalessemia minor was detected in 51(10.2%) patients, Sickle cell disease in 47(9.4%)patients,.17 patients (3.4%) were detected to have Thalassemia major.Two cases (0.4%) had HbD. One each(0.2%) case was observed for Hb Barts, HbE, HbH and hereditary persistence of foetal haemoglobin (HPFH). Conclusion: Detection of haemoglobinopathies and Thalessemias have become easier due to rapid technical advances in the field of haematology. Capillary electrophoresis has an edge over other methods currently in use because it is rapid, precise and has high resolution and is extremely useful in screening population for haemoglobinopathies and thalessemias and can be used in conjunction with HPLC method for detection of new and rare Hb variants.

Keywords: Capillary Electrophoresis; Haemoglobinopathies; Thalessemia; HPLC.

 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 fallopian tube tumors and tumor like lesions. 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. Results: Total of 361 fallopian tubes were analyzed, pathological lesions were seen in 50.96%(n=184) cases. Out of which 1.38%(n=5) cases showed features of malignancy with primary fallopian tube carcinoma(PFTC) accounting for 0.27%(n=1) cases and metastatic carcinoma accounted for 1.11%(n=4) cases. Tumor like epithelial lesion included salpingitis isthmica nodosa(SIN) which was seen in 0.85%(n=3) 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 of fallopian tube tumors and tumor like lesions and categorized the lesions into various groups.

Keywords: Primary Fallopian Tube Carcinoma(PFTC); Salpingitis Isthmica Nodosa(SIN); Metastatic Carcinoma.