Indian Journal of Pathology: Research and Practice

Background: Pyogenic granuloma is an excessive proliferation of granulation tissue that usually develops after minor trauma or surgery. Ocular involvement usually happens on the external surface and cornea is rarely involved. The objective of our report is to describe the clinicopathological feature of this rare disease and give insight on clinical features that help in the diagnosis. Case Report: A 62 year old male came with the complain of loss of vision and pain, who had fleshy growth of one week duration on the right eye after development of pain and redness in ophthalmology department. Slit lamp examination showed vascularized central corneal mass with surrounding stromal infiltrates. The mass was excised, and histopathological examination confirmed pyogenic granuloma of the cornea. Conclusion: Pyogenic granulomata of the cornea are rare. However, the present case illustrates the importance of considering benign inflammatory causes in the differential diagnosis of a corneal mass lesion so as to avoid unnecessarily aggressive therapeutic intervention.

Keywords: Pyogenic granuloma; Cornea; Lesion. 

Background: There is some “grey zone” in thyroid cytology where the diagnostic efficacy declines sharply rendering it difficult to categorize the lesions resulting in discrepancy. So, a study was conducted to determine the accuracy of FNAC in diagnosis of thyroid lesions and to assess the correlation between preoperative cytological diagnosis and post operative histopathological diagnosis. It was observed that FNAC is reliable, safe and accurate method as a first line of evaluation in thyroid swelling before the surgery. Aim: To highlight probable causes of error in the cases showing discrepancy between cytological and histological diagnoses. Materials and Methods: A retrospective and prospective study was conducted from June 2013 to July 2015 in Pathology department of our hospital. Patient data were collected and details of their thyroid lesion, including clinicopathological features and FNAC findings were recorded. The cytology reports were compared with the histopathological diagnosis. Results: A total of 136 cases of thyroid lesions were aspirated. 131 cases are adequate for reporting. Remaining 5 cases were sample inadequate. Out of 131 cases, 40 cases were available for histopathological correlation. Age group of 3140 yrs is most effected group with thyroid disorders Adenomatous Goiter is the most common thyroid lesion in study. Statistical analysis of our data shows the diagnostic accuracy of FNAC to be 97%. FNA showed sensitivity and a specificity of 100%. Conclusions: FNAC is a rapid, efficient, costeffective, relatively painless procedure with a high diagnostic accuracy. Hence, it is a valuable tool in the diagnosis and management of patients.

Keywords: CytoHistopathological Correlation; Fine Needle Aspiration Cytology; Thyroid Lesions. 

Background: The purpose of this study was to analyze the trends in the incidence rates of major types of leukemia viz. acute myelogenous leukemia (AML), acute lymphocytic leukemia (ALL), chronic myelogenous leukemia (CML), chronic lymphocytic leukemia (CLL) and mixed phenotypic acute leukemia (MPAL), in the population of upper Assam who have visited Assam Medical College, Dibrugarh, during the period June 2012 to June 2016. Due to the lack of any leukemia screening program, the majority of the people are not aware of the disease. Epidemiological study can play a vital role in understanding the occurrence and outcome of the disease. The present study is carried out to see the pattern of leukemia in different ethnic population of upper Assam. Method: 204 cases of leukemias comprising of 120 males and 84 females were analysed focusing on their ethnicity. Result: The highest number of leukemia cases was found in Mongoloids 83 cases (40.69%) followed by Tea tribes 58 cases (28.43%). The highest number of AML (45.74%), ALL (39.13%) and CLL (72.73%) cases were found in Mongoloids while the highest number of CML (34.09%) was found in Tea tribes. Conclusions: Ethnicity is independent of disease type and severity at diagnosis and should be taken into consideration in the management of leukemia patients, especially in terms of social and psychological support. It reflects socioeconomic differences and must be taken into consideration for long time survival of patients with leukemia.

Keywords: Leukemia; Ethnicity and Race. 

Aim: Aim of the study is to review the cytomorphology of granulomatous lymphadenitis on FNAC and confirm with the final histological diagnosis in available cases. Materials and Methods: A retrospective study of 40 cases in a tertiary referral hospital, Mediciti Institute of Medical Sciences, was done for a one year period, i.e., from June 2015 to May 2016. Result: 6 cases out of 40 underwent surgery. 3 cases confirmed the original FNAC diagnosis of granulomatous lymphadenitis. The other 3 cases were diagnosed as metastatic squamous cell carcinoma, anaplastic large cell lymphoma and diffuse large cell lymphoma respectively. Conclusion: A significant number of cases of FNAC diagnosed as granulomatous lymphadenitis have an identifiable underlying causal pathology. FNAC combined with clinical correlation is the first line investigation that helps to single out those that need further investigation or biopsy. use of additional special stain like ZN stain for AFB and culture for AFB in addition to routine H&E. Use of appropriate stains like PAP stain in suspected metastatic carcinoma and Leishman stain in suspected lymphoma can aid in the diagnosis.

Keywords: Granulomatous Lymphadenitis; FNAC; Carcinoma; Lymphoma. 

Aim: The present study demonstrates the recent experiences in histopathological diagnosis of phyllodes tumor of breast. Material & Methods: Histopathological slides and medical records of eleven cases of phyllodes tumor of breast diagnosed at the Department of Pathology, SRMSIMS, Bareilly from January 2013 to December 2016 were reviewed. Cases were evaluated for degree of stromal cellularity and atypia, mitotic count, stromal overgrowth, and the nature of the tumour borders. Results: The median age at diagnosis was 45 years (range 30 years to 58 years). Mean tumor size was 10.2 cm (range 22cm to 6cm). Tumors predominated on the right side (54.5%). Wide tumorectomy was performed in seven patients and four patients underwent mastectomy. FNAC was performed in seven cases out of which 3 cases were diagnosed as phyllodes, 2 cases showed possibility of phyllodes and 2 cases were diagnosed as fibroadenomas. Histopathologically 10 cases were diagnosed as benign phyllodes and one case was diagnosed as borderline or low malignant potential. There were two cases of recurrent benign phyllodes tumor. Conclusions: The confrontation of our results to the data of the medical literature shows that histological confirmation is required for the diagnosis of phyllode tumors. The treatment of choice is surgery. The prognosis depends on the histological characteristics of these tumors.

Keywords: Phyllodes Tumor; Prognosis; Tumorectomy. 

Background: Several changes in platelet parameters have been reported in Iron deficiency anemia. But underlying mechanism between iron metabolism and megakaryopoiesis is not yet clear. Hence the aim of the study is to evaluate relation between iron and platelet parameters in women with IDA. Materials and Methods: Sixty women with mean age of 33 ± 11 (16 – 78) years with IDA were studied. The relationship between serum iron parameters such as iron, ironbinding capacity, iron saturation and ferritin and platelet parameters such as platelet counts, platelet crit, mean platelet volume (MPV), platelet distribution width (PDW) and large platelet (LPLT) were evaluated by using Pearson correlation and stepwise logistic regression tests. Results: Thrombocytosis and thrombocytopenia were noted about (77.46% and 22.54% ) respectively. Platelet counts were inversely correlated with serum iron and transferrin saturation (p<0.05). Other iron parameter revealed no significant relationship with any platelet parameters. There was a linear relationship between platelet counts and platelet crit (p<0.001) but inverse relationships betweenplatelet counts and both mean platelet volume and ironsaturation (p<0.001, for both). Also there were a linear relationship between platelet distribution width and mean platelet volume (p<0.001) and an inverse correlationbetween platelet distribution width, Mean platelet volume, Platelet crit with both mean corpuscular volume and Mean corpuscular hemoglobin concentration p<O.O01). Platelet crit was linearly correlated with platelet count mean platelet volume, and LPLT (p<0.05). There is no significant correlation between platelet crit with any iron parameter. Conclusion: This study concludes important iron parameter affecting the platelet was serum iron and transferrin saturation. Patient with severe anemia had higher platelet count, PCT and MPV. Changes in platelet parameter are due to low levels of tissue iron. Decrease iron saturation also stimulates megakaryopoiesis and iron has inhibitory effect on platelet counts.

Keywords: Iron Deficiency Anemia; Platelets; Women; Thrombocytosis. 

Background: Dysfunctional uterine bleeding (DUB) is characterized by abnormal bleeding that is unrelated to any identifiable cause. The aim of this study is to establish that, DUB is a disorder of angiogenesis by detecting vascular endothelial growth factor (VEGF) expression on immunohistochemistry(IHC) study of DUB endometria. Material and Methods: It was a cross section study, undertaken at Index Medical College, Indore over a period of 18 months from March 2015 to July 2016. The study includes 100 endometrial dilation and curettage (D&C) and hysterectomy specimen of clinically diagnosed DUB patients. These specimens were studied for histopathology and expression of VEGF. Results: VEGF expression in endometria of DUB patients was significantly higher than in endometria of control group. There was also significant higher expression of VEGF in endometrial hyperplasia. Conclusion: Significantly over expression of VEGF in the endometrial glands in cases of DUB suggest that VEGF plays an important role in the pathogenesis of DUB

Keywords: DUB; Angiogenesis; VEGF; Endometrium. 

Introduction: Ascites represents the pathological collection of fluid in the peritoneal cavity. Spontaneous bacterial peritonitis is the infection of the ascitic fluid. For its diagnosis, the number of polymorphonuclear cell count from the ascitic fluid obtained by diagnostic abdominal paracentesis should equal or exceed 250 cells/ cu.mm and from bacteriological cultures only one type of organism must be isolated. Biochemical analysis is also recommended. It is the most rapid and cost effective method for diagnosing cause of ascites. These patients must be treated with antibiotics aggressively as they have poor prognosis and high mortality if not treated early. Materials and Methods: Study was conducted at a tertiary care hospital, Haryana. All patients under went paracentesis within 24 hours of admission and were diagnosed before giving any antibiotics. Ascitic fluid was submitted in the Central Clinical Laboratory for total and differential leucocyte count, culture and biochemical investigations. Results: Present study included 38 patients of spontaneous bacterial peritonitis. Various clinical signs and symptoms were studied and followed by comparison statistics for all the variants. Statistical study was done to find the etiology for cirrhosis. Culture study revealed various organisms responsible for spontaneous bacterial peritonitis. Conclusion: Polymorphonuclear cell count in ascitic fluid without the need of positive culture is helpful in diagnosing spontaneous bacterial peritonitis. Mortality has decreased because of early diagnosis and effective treatment.

Keywords: Spontaneous Bacterial Peritonitis; Polymorphonuclear Cell Count; Serum/Ascites Albumin Gradient; Culture. 

Background: The past few years have witnessed a global increase in the prevalence of thyroid cancer, and it is the fifth most common cancer in women. The study intends to estimate the prevalence of thyroid malignancies, and the ageand genderwise distribution of thyroid cancer in a rural setting in India. Methods: The study was conducted on 158 subjects presented with thyroid swelling between January 2015 and December 2016. Demographic and clinical details were obtained from all the patients. Fine needle aspiration cytology (FNAC) was used for the diagnosis of thyroid lesions. The subjects were classified into various groups based on the age and gender, and the prevalences of various cytological diagnoses were studied. Results: Thyroid swelling was mostly reported in 2140 years age group for women, and in 4160 years age group for men. Out of the 158 smears studied, only 11 (6.96%) were neoplastic. The most commonly reported thyroid lesion was colloid goitre. Neoplastic lesions like papillary thyroid cancer and benign follicular neoplasm were noted in 2.53%, and 4.43% of the subjects respectively. The prevalence of papillary thyroid cancer was comparable in both males and females, whereas benign follicular neoplasm was more common in females. Conclusion: The common thyroid lesion noted was colloid goitre and the most common thyroid malignancy noted was benign follicular neoplasm.

Keywords: Colloid Goitre; Follicular Neoplasm; Papillary Thyroid Cancer; Thyroid Lesions. 

Background: Bone marrow examination is an important diagnostic tool in the evaluation of cases of myelophthisic anemia. Myelophthisis means replacement of bone marrow elements by the tumor tissue, granulomatous inflammations or fibrosis, which further leads to anemia. Methods: our study was retrospective study which reviewed bone marrow examination of 60 cases with myelophthisic anemia in Narayana Medical College and hospital, during a period of 5years (Jan 2011Jan 2016). Result: Our study of 60 cases revealed, 53 cases having neoplastic involvement of bone marrow and 7 cases having nonneoplastic pathology. 53 cases having neoplastic involvement showed 49 cases with haematological and 4 cases with secondary metastatic deposits. In our study 50% cases presented with anemia, 30% with leukoerythroblastic picture, 13.33% cases presented with pancytopenia & 6.66% cases with thrombocytopenia Conclusion: Our study reflected that the common causes of myelophthisic anemia was neoplastic (88.33%) and tuberculosis (42.86%) commonest among the nonneoplastic involvement.

Keywords: Myelophthisic Anemia; Bone Marrow. 

Introduction: Aim of the Study: To study the spectrum of lesions in cervical lymph nodes onFine Needle Aspiration Cytology. Materials and Methods: This was a prospective study done over a period of two and half yearsin the department of pathology at Kakatiya Medical College, Warangal, Telangana. A total of 330 patients with cervical lymphadenopathy were evaluated. The detailed clinical history was recorded before performing FNAC. Other relevant radiological investigations were also noted for correlation. Results: FNACs was done in 350 cases who presented with enlarged cervical lymph nodes. There were 20 inadequate aspirates which were excludedfrom the study. Age group ranged from1 to 70 years. Majority of the patients (33.3%) were in the age group 2130 years and male to female ratio was 2.3:1. Tuberculous lymphadenitis was the most common diagnosis. Conclusion: FNAC of lymph nodes is very useful and simple procedure in the initial diagnosis of cervical lymphadenopathies.

Keywords: Cervical Lymphnode; Fine Needle Aspiration Cytology; Tuberculosis. 

Introduction: India has high prevalence of HCV in blood donors, which is easily transmitted through infected blood. The aim of the present study is to determine the seroprevalence of HCV in 14727 blood donors in Davangere. Materials & Methods: The present study was conducted to detect Hepatitis C in blood donors (voluntary and replacement donors) for two years & screening done by ELISA (3rd generationUBIR, HCV EIA.40 kit). Results: Seroprevalence of HCV was 0.33%, among which 85% were males (13292) and the remaining were females donors (1435).Among 43 positive donors, one donor was illiterate and the remaining 42 were literate. Out of the total positive donors, married donors showed 0.42% and unmarried showed 0.18% seropositivity. Most of the seropositive individuals were in reproductive age group (1840) Highest prevalence was in age 1835 years. A, B and O group donors were almost equal in number with AB group constituting least number of donors. Conclusion: In conclusion, the present study has established the prevalence the HCV antibody in healthy donors was 0.29% in our area (Davangere). This proves that compulsory screening for HCV lowers the incidence of post transfusion hepatitis (PTH).

Keywords: HCV; Hepatitis C Virus; Sero Prevalence; Blood Donors.

Introduction: Red cell distribution width (RDW), a numeric measure of variability in the size of circulating erythrocytes is a routinely reported haematological parameter commonly part of complete blood cell count. RDW was found to be a strong independent predictor of poor outcome in a variety of cardiovascular disease states even after adjustment for potential confounders, including anaemia and renal dysfunction. The present study was undertaken to analyze the variation in RDW, Hb% and MCV in elderly patients with various illnesses. Aim and Objective: 1. To study the pattern of Red cell Distribution width (RDW) in elderly patients in different diseases. 2. To correlate increased RDW values with other RBC parameters like Hb% and MCV. Materials and Methods: Material for the study consisted of RBC parameters like Hb%, MCV of consecutive patients aged more than 65 years, who had increased RDW, irrespective of their sex and illness which were retrieved from laboratory records. These patients (both in patients and out patients) were referred to haematology laboratory whose Ethylene Diamine Tetra Acetic acid (EDTA) blood samples were analyzed by automated hematology analyser (Horiba Abxpentraxl 80.303pxl 5748 analyzer). Relevant clinical data of these patients like age, sex and clinical diagnoses were also obtained from the clinical records. Data analyzed was expressed in numerals and percentage. Results: Out of 196 patients, blood samples of 60(30.16%) patients had increased RDW, out of which 39(65%) were males and 21(35%) were females. IHD formed the major portion of patients with increased RDW comprising of 31(51.66%) patients. 36 patients had Hb<10gm %( 59.9%) and 40 (66.6%) patients had MCV <70fL. Conclusion: Most of the patients with increased RDW were those with IHD. Majority of them were males. The biologic mechanisms underlying the association of RDW with various diseases merit investigation. RDW is an inexpensive test routinely reported to physicians, further research is needed to determine whether RDW is an useful risk assessment tool in different clinical settings apart from the ones which are proved.

Keywords: RDW; Elderly Patients; IHD. 

Materials and Methods: Four months study was conducted at Index Medical college, Department of Pathology. The initial rapid diagnosis of diabetes was confirmed followed by homocysteine level by ELISA method. Results: Out of 45 diabetic patients enrolled in the study, 36 patients (80% of 36 patients) had blood sugars values <200 mg/dl and 9 patients (20% of 36 patients) had random blood sugar values >200 mg/dl. Out of 23 patients (100% of the 45 patients) with normal homocysteine values, 18 patients (78.26%) had random blood sugar values <200 mg/dl and 5 patients (21.74 Objective: Hyperhomocysteinemia is strongly associated with increased risk of type 2 diabetes mellitus. Patients %) had random blood sugar values >200 mg/ dl. Out of the 22 patients with abnormal plasma homocysteine values, 18 patients (81.82% of the 22 patients) had random blood sugar values <200 mg/dl and 4 patients (18. 18%) had random blood sugar value >200 mg/dl. Conclusion: A regular monitoring of homocysteine levels appears to be a useful strategy to reduce the morbidity and mortality in diabetic patients.

Keywords: Homocysteine; Diabetes; Cardiovascular Diseases. 

Background: Gastrointestinal tumors account for a large proportion of all neoplasms. Colorectal cancer ranks second and stomach cancer ranks fourth amongst the most common tumors of the world, according to the World Cancer Report of 2000. Aims: The present study was undertaken with a view 1) To determine the frequency of GIT tumors with respect to age, sex and site of lesion in our institute. 2) To classify the GIT tumor according to WHO classification. Material and Methods: This was a prospective study over three years period. Gross and histopathological examination of the specimens was done, for assessing appearance and extent of lesion. Stains used were routine hematoxylin and eosin stain. Special stains such as Periodic acid Schiff (PAS), Alcian blue, Mucicarmine were done wherever required. The clinicopathological data was analyzed and observations were noted. Results: Of 129 cases of GI tumours, 98% were malignant and 1.6% was benign. GI malignancies had a peak in 5160 years. M: F ratio was 1.1:1. Colorectal cancers occurred most commonly followed by oesophagus, stomach and small intestine in descending order. Conclusion: There is a need to conduct detailed studies before these societies are transformed into westernlike environments. Otherwise we may miss an unique opportunity to understand the factors that could prevent many cancers in the world.

Keywords: GIT; Tumor; Colorectal; Cancer; Oesophagus; Stomach; Histopathology; Small Intestine 

Introduction: Cytomorphologic features of benign breast lesions which encompasses majority of palpable breast lesions have not been studied in great detail. Aim and objective: To study the cytomorphological aspects of benign breast lesions in patients with an apparent breast lump and their histopathological correlation. To find accuracy of fine needle aspiration cytology (FNAC) in the diagnosis of benign breast lesions. Material and Methods: The present study included 200 prospective cases of benign breast lesions presenting with palpable breast lump in the outpatient department. FNAC was carried out on all of them. Cytomorphological features were studied and correlated with clinicohistopathological features. Results: The most common lesion in our study was fibroadenoma followed by fibrocystic disease. The diagnostic accuracy was 89.16%. Conclusion: FNAC is a simple, rapid, cost effective, highly sensitive and specific procedure in diagnosing benign breast lesions.

Keywords: Benign Breast Lesions; Fine Needle Aspiration Cytology (FNAC). 

Introduction: The present study of Urothelial carcinoma is intended to include: Retrospective hospital based observational study of paraffin section of old block and cases attending our hospital. Material Methods: The study is conducted in the Department of Pathology at SRMS IMS, during a period of 21 months, 1st January 201330th September 2014. Total 80 cases of Urothelial Carcinoma were included in the study. Tumour is classified according to WHO classification and all the 80 cases were subjected to Immunohistochemical study for p53 from the representative areas. Samples demonstrating at least 10% nuclear reactivity were considered positive for p53. Results: Out of 4 cases of PUNLMP, 1 case (25%) was positive for p53. Out of 27 cases of Low grade papillary urothelial carcinoma, 4 cases (14.8%) were positive for p53. Out of 48 cases of High grade papillary urothelial carcinoma, 28 cases (58.3%) were positive for p53. 1 case of Mucinous adenocarcinoma with signet ring change was positive for p53. Discussion: The present study results were in consistency with the other studies, i.e a higher rate of p53 protein positive staining was seen in high grade tumor. Conclusions: p53 alterations are significantly associated to clinicopathological features of poor prognosis, the inclusion of p53 mutation status into a predictive panel of tumor markers for bladder cancer is recommended.

Keywords: p53; Urinary Bladder Carcinoma; IHC.

Background: Micronucleus in buccal mucosa exfoliative cells is essential to have reliable and relevant minimally invasive biomarkers to improve the implementation of biomonitoring, diagnostics, and treatment of disease caused by, or associated with genetic damage. Methods: The present retrospective study was carried in 100 persons in which 25 persons were alcohol consumers, 25 persons were tobacco smokers, 25 persons were both alcohol consumers and tobacco smokers and 25 persons were control group, in the department of pathology, Narayana Medical College & Hospital, Nellore, Andhra Pradesh, India, during the period of January 2016 to December 2016. Cytological smears was fixed in ethyl alcohol and then stained with Hematoxylin & Eosin staining technique and assessed for micronuclei count. Result: The micronucleus count in “A” group was a mean count of 4.89 micronuclei, where as the mean micronucleus count in “S” group was 5.36. The “A+ S” group had the mean micronucleus count of 5.98 and the control group had a mean micronucleus count of 3.67. Conclusion: The present study was undertaken to observe the micronucleus count and micronucleus index among smokers (S group), alcoholics (A group) and smokers and alcoholics together (A+S group) and compare with controls (C group) that had no such life style habits. In this study there was a significant difference between smokers and controls which seem to be more prominent in cases of both smoking and alcoholic group when compared to controls and the significance of alcohol only, was not well proven.

Keywords: Buccal Mucosa; Micronucleus. 

Background: Intraoperative cytology preparation was first introduced by Eisenhart and Cushing in early 1930s. With the advent of CT and MRI guided stereotactic biopsies, smear technique has gained importance because of technical simplicity and good preservation of cytological and nuclear details at low expense. Aims: 1. To study various patterns of central nervous system [CNS] lesions in squash cytology and histopathology. 2. To correlate cytological diagnosis with histopathology. 3. To evaluate the diagnostic utility of intraoperative squash cytology. Settings and Study Design: Analytical study at tertiary care hospital. Material and Methods: Hundred cases were analyzed. Squash smears were prepared from biopsy samples sent in isotonic saline. The smears were stained by Hematoxylin and Eosin [H &E] and Papaniculaou [PAP] stain. Histopathological evaluation was done subsequently from biopsy samples sent in formalin. Special stains were performed in selected cases. Cytomorphological features were correlated with histopathology. Statistical Analysis: Frequencies, ChiSquare Test and Crosstabs were used for calculation. Results: Histopathological diagnosis of hundred cases included neoplastic lesions [90%] and nonneoplastic lesions [10%]. Correct diagnosis was achieved by squash cytology in 68 cases [73.11%] by complete correlation. However, diagnostic accuracy improved considerably [84.94%] after applying partial correlation criteria. For the detection of neoplastic lesions, squash cytology had sensitivity of 95.29%, specificity of 75% and efficacy of 93.54%. The p value, determining efficacy of squash cytology for detecting CNS neoplasms was statistically significant [p<0.005]. Conclusions: Squash cytology is a reliable, rapid and inexpensive intraoperative diagnostic tool. It has high sensitivity and is highly efficacious procedure.

Keywords: Neurosurgical; Squash Cytology; Histopathology; IntraOperative; Diagnostic Accuracy.

Background: Getting adequate exfoliated cells in serous fluids is not an easy task and diagnosis is in dilemma which not only hampers patient’s outcome but also confuses pathologists. Materials from patients submitted in the form of fluids for cytological examination can be evaluated in two fashions :1. Smear technique following centrifugation of the specimen 2. Cell block technique. The present study was done to 1. Evaluate the diagnostic efficacy of routine staining method and cell block technique 2. To diagnose the type of malignancy and to know primary site of malignant effusion by special stains and IHC wherever possible. Methods: Fluids from aspirates of body cavities i.e. pleural, pericardial, peritoneal were collected over a period of two years from September 2014 to July 2016. Fluids obtained were first examined by naked eye for physical characteristics and then processed in two halves. One portion was prepared as conventional method and the other was processed by Cell block technique. Smears obtained were studied and compared. Result: One hundred and four samples were subjected to diagnostic evaluation. Along with conventional smear, fluids were subjected to cell block technique. The age of the patients ranged from 5 to 92 years. Male: female ratio was 0.7:1. The samples were categorized into benign, malignant lesions and suspicious for malignant cells. Additional yield for malignancy was obtained by cell block method when compared to conventional smears. Conclusion: Cell block method provides an additional yield of malignant cells, and thereby, increases the sensitivity of the cytodiagnosis when compared to conventional smear method and use of IHC help to identify primary site of malignancy giving more definitive diagnosis.

Keywords: Cell Block; Conventional Smear; IHC. 

The study is a prospective study undertaken on endometrial curettings from clinically diagnosed cases of abnormal uterine bleeding (AUB). The objectives were to analyze the histomorhological patterns of endometrium in clinically diagnosed cases of AUB in different age groups in comparison with the other similar studies. Patients from all the age groups were included in the study and all types of pregnancy complications were excluded from the study. The endometrial biopsy material, fixed in 10% formalin was processed, sections were cut from blocks prepared from paraffin, stained with H&E and studied. A total of 100 endometrial biopsies from clinically diagnosed AUB patients were studied histopathologically. Out of these 46% were simple hyperplasia, 22% were proliferative endometrium, 9% were complex hyperplasia, 8%were secretory phase, disordered proliferative endometrium and endometrial polyp were 4% each, anovulatory endometrium and adenocarcinoma were 2% each, chronic endometritis , inadequate secretory phase and pillendometrium were 1% each. Majority of the patients in the present study were in the age groups of 4150yrs. Most common presenting complaint in the present study was menorrhagia. In conclusion it is observed that AUB is most common in perimenopausal age groups with histomorphological pattern of simple hyperplasia, followed by normal proliferative pattern, secretory pattern and endometrial carcinoma is seen in older age groups and most commonly presenting with post menopausal bleeding. Histopathological findings in the endometrial biopsies of these patients help to detect & differentiate between functional causes and organic lesions there by facilitating appropriate patient management.

Keywords: Abnormal Uterine Bleeding; Simple Hyperplasia; Menorrhagia.

Background: Papulosquamous skin diseases are amongst the most important dermatological lesions because of their high prevalence. Clinical and histopathological distinction of each of them is of paramount importance because of different treatment modalities and prognosis. Aim: To analyse and classify the cases with non infectious erythematous papulosquamous lesions; psoriasiform and lichenoid dermatitis based on histomorphological characteristics. Materials and Methods: In present study 100 cases of noninfectious erythematous papulosquamous skin disorders were histopathologically examined to analyse the characteristic features in psoriasis and lichenoid dermatitis. Study was done for a period of one and a half year from March 2015 to July 2016. Results: Out of 100 cases of papulosquamous lesions, we encountered 80 cases with histomorphological features consistent with Lichen planus (44%) and psoriasis (36%). These features were analysed and correlated with the clinical diagnosis. Conclusion: Psoriasis and Lichen planus comprise the bulk of papulosquamous skin disorders (80/100 cases). The age group of 2140 years was most frequently involved with both the disease showing male preponderance. The present study signifies the advantage of coherent use of clinical examination and histopathological study in making an accurate diagnosis.

Keywords: Papulosquamous; Erythematous; Lichen Planus; Psoriasis; Histopathology. 

Introduction: Thyroid gland is very often subjected to FNAC as thyroid enlargement is a common clinical problem and also due to its easy accessibility for the procedure. Hurthle cells are commonly encountered in thyroid aspirates from varied etiology. Aim of the Study: To find the significance of Hurthle cells in thyroid cytology and to note the cytological features that would differentiate reliably between different lesions containing Hurthle cells. Materials and Methods: This was a two yearstudy conducted in the Department of Pathology, at NRI Institute of Medical Sciences, Visakhapatnam. A total of 858 thyroid aspirates were done of which 240 cases showed Hurthle cells. These 240 cases consisted of the study group in which histopathology examination was done in 107 cases. There were 229 female and 11 male patients in the age groups of 10 to 70 years. Observations and Results: Hurthle cells were seen in 240 (11.6%) cases. Non neoplastic and neoplastic Hurthle cell lesions comprised 222 (92.5%) and 18 (7.5%) cases respectively.There was a female predominance with the male to female ratio being 1:20. There were 201 cases (83.7%) with non neoplastic and 39 (16.2%) with neoplastic etiology. Hashimoto’s thyroiditis, nodular goiter and follicular adenomas commonly showed Hurthle cells. For Hurthle cell lesions, important cytological features were predominantly monomorphic Hurthle cell population, macronucleoli and absence of inflammatory cells. There was good agreement between the cytology and histopathological examination. Conclusion: Hurthle cells are seen in various lesions of thyroid. The presence of>50% of Hurthlecells in an aspirate indicates a Hurthle cell neoplasm.Aspiration cytology in Hurthle cell lesions can differentiate non neoplastic lesions from neoplastic lesions with high accuracy, but differentiation between benign and malignant neoplasms is less reliable.

Keywords: Thyroid FNAC; Hurthle Cells; Hashimoto’s Thyroiditis; Thyroid Histopathology. 

Introduction: Brucellosis is a major zoonosis in the developing countries including India. The reported incidence of human brucellosis in endemic areas varies widely, from <0.01 to >200 per lakh population. Despite being endemic in many developing countries, brucellosis remains underdiagnosed and underreported. Interpretation of the serological tests is often difficult in endemic areas due to presence of antibodies against Brucella in high proportion of the population . Hence estimation of normal baseline titers of Brucella agglutinins in healthy individuals residing in endemic areas and the cutoff values are necessary for the serodiagnosis of brucellosis. AIM: To determine the baseline titre of brucella agglutinins, amongst apparently healthy blood donors in Dhule, Maharashtra, India. Materials and Methods: A total of 480 serum samples were analyzed by RBPT and STAT method for detection of Brucella Agglutinins over period of 6 months from July 2016 to December 2016. These agglutination tests were performed according to manufacturer‘s guidelines by using commercial kits containing stained Brucella abortus Antigen suspension. Result: Of these 480 samples 32 (6.7%) were positive for Brucella agglutinins by RBPT. Of these 32 RBPT positive samples 22(4.6%) showed agglutination by STAT. Amongst 22 STAT positive samples 15 samples were found positive for Brucella agglutinins at 1:40 and 7 samples were positive at 1:80. Conclusion: As RBPT is very sensitive test and its results should be confirmed by STAT. Since the base line titre of 1:80 by STAT was demonstrated in healthy individuals, titres 1:160 and above should be considered significant along with consistent clinical features.

Keywords: Brucellosis; Baseline Titre; RBPT; STAT; Agglutinins. 

Background: Platelet indices are potentially useful markers for the early detection of the thromboembolic diseases. Platelets are known to be implicated in the pathogenesis of cardiovascular disorders including atherosclerosis and myocardial infarction. Platelet hyperactivity and activation have been suggested to play a role in acute coronary syndrome. The degree of activation is indirectly measured by platelet indices viz. mean platelet volume (MPV), platelet distribution width (PDW) and platelet counts (PC). Hence the present study is undertaken to analyse these parameters in acute coronary syndrome (ACS). Objectives: To determine platelet indices and platelet count in cases and compare it with healthy controls. Materials and Methods: This was a comparative study which included 107 cases diagnosed with acute coronary syndrome and 100 age and sex matched healthy controls. The platelet indices and platelet count of both the groups were obtained by automated hematoanalyser. Plalelet counts thus obtained were confirmed by peripheral smear study. These data were entered in Microsoft excel and analysed using the EPI.INFO version 7.0. Results: The MPV & PDW were significantly higher in cases with ACS as compared to controls. Conclusion: Measurement of platelet indices and platelet count is a simple and cost effective tool that can be used as a marker of coagulation.

Keywords: Platelet Indices; Platelet Distribution Width; Mean Platelet Volume; Platelet Count; Acute Coronary Syndrome. 

Introduction: Cancer of the bladder and of prostate are commonmalignancies all over the world. In some cases it is difficult to point to the exact primary due to the anatomical location and morphology of the tumors from these two sites. Various immunohistochemical markers can be used to identify the primary site and p63 is one such marker. Aim of the study: To study the expression of p63 in urothelial carcinoma and prostatic adenocarcinoma so as to differentiate between the two carcinomas. Materials and Methods: In this study, formalin fixed paraffin blocks from 60 cases of urothelial carcinomas of urinary bladder and 20 cases of prostatic adenocarcinomas were examined on light microscopy and tissue sections from all 80 cases were studied for immunohistochemical staining with p63 marker. Observations and Results: The mean age of patients of urothelial carcinoma and of prostate carcinoma was 54.1 and 64.5 years respectively. There were 28 cases (46.6%) of low grade and 32 cases (53.3%) of high grade urothelial carcinomas. The Gleason score for prostatic carcinoma was 56 for 8 patients, 78 for 9 patients and 910 for 3 patients.In 60 urothelial carcinomas 90% of cases showed p63 positivity. All the 20 cases of prostatic adenocarcinomas were negative for p63. Conclusion: p63 is a reliable marker of urothelial differentiation and it can be used in morphologically difficult cases when the differential diagnosis is between poorly differentiated adenocarcinoma of prostate and high grade urothelial carcinoma of urinary bladder.

Keywords: Urothelial Carcinoma of Bladder; Prostatic Carcinoma; p63 Staining.

Dysfunctional uterine bleeding is irregular uterine bleeding that occurs in the absence of recognizable pelvic pathology, general medical disease, or pregnancy. Endometrial biopsy is often the first diagnostic tool in a case of dysfunctional uterine bleeding. A total of 161 cases were analysed during a period of two years, from January 2015 to January 2017 in the Department of Pathology, BGS Global Institute of Medical Sciences. The frequency of the various endometrial patterns with comparison of the patterns in different age groups was observed and documented.

Keywords: Dysfunctional Uterine Bleeding; Endometrium; Dilatation and Curettage. 

Introduction: Neonatal sepsis has always been a significant health problem worldwide, especially in developing countries. Since it is a treatable condition, it has to be diagnosed at the earliest to initiate treatment and to avoid abuse of antibiotics. Objectives: To study the various changes associated with platelets in neonatal sepsis, and to check the diagnostic value of these markers in the early diagnosis of sepsis in neonates. Study and Design: This is a crosssectional analytical study. Methods: This is a study on the evaluation of platelet count and platelet indices viz, Platelet Distribution Width (PDW) and Mean Platelet Volume (MPV) in neonatal sepsis on blood obtained from neonates with a clinical suspicion of sepsis. A total of 100 cases were included for the study. The platelet count and platelet indices were obtained using automated haematology analyser. Leishman stained smears were studied for platelet count and morphology and correlated with blood culture results. Results: PDW showed sensitivity and specificity of 82% and 73 % respectively. MPV showed sensitivity and specificity of 76% and 40 % respectively. Thrombocytopenia showed sensitivity and specificity of 64% and 82 % respectively. Conclusion: Platelet Distribution Width was the most sensitive marker (82%). Thrombocytopenia was the most specific marker (82%). Owing to the diagnostic confusion that usually surrounds Neonatal Sepsis due to the myriad of clinical features it presents, platelet studies could be used as easily accessible and inexpensive tools for the early detection and treatment of this condition.

Keywords: Platelet Indices; Thrombocytopenia; Neonatal Sepsis. 

Introduction: Carcinoma from almost all the organs has a tendency for regional metastasis. Nodal status is a key prognostic indicator in such patients, particularly with N0 stage. Occult metastasis in the form of micrometastasis (MM) and isolated tumor cells (ITCs), often goes undetected by routine hematoxylin and eosin (H&E) examination using 12 sections for analysis. This limitation could be overcome by combining serial sectioning (SS) with immunohistochemistry (IHC) for the detection of MM. Cytokeratin (CK7) is particularly a useful marker to detect these deposits as their presence has resulted in varied interpretations and different applications of the tumornodemetastasis system. The objective of the study was to detect micrometastases in lymph nodes reported negative on H & E staining by combining SS and IHC and to compare it with conventional H&E staining. Methods: The study was conducted on 181 LNs received from 77 patients which were negative on H &E. The lymph nodes (LNs) positive on H & E were not taken up for the study. IHS with CK7 was performed on these lymph nodes for detection of micrometastsis. Results: The application of combination of SS and IHC using CK7 in our study revealed the presence of MM in 14.36% of the LNs diagnosed as negative on routine H&E examination. Conclusion: In the view of crucial role of occult LN metastasis in prognosis and survival of patients, diagnostic tools such as IHC staining, particularly with CK7, combined with SS should be preferred over conventional methods as they result in upstaging, thus sparing the lowrisk patients the morbidity of unnecessary treatment.

Keywords: Micrometastasis; Lymph Nodes; Immunohistochemistry; Cytokeratin7; Serial Sectioning. 

Introduction: Numerous terminologies are used to describe abnormal uterine bleedingmenorrhagia, metrorrhagia, polymenorrhea, oligomenorrhea, intrmenstrual and postcoital bleeding [6]. The spectrum of cervical changes in perimenopausal age ranges from cervicitis to dysplasia to frank malignancy. Methodology: A total of 415 hysterectomy specimens of perimenopausal age group received at Department of Pathology, Hassan Institute of medical sciences, Hassan between the period of January 2015 and December 2016 were included. Results: The predominant histomorphological pattern in endometrium was proliferative phase (48.43%). Endometrial hyperplasia was seen in 72 cases, out of which atypia was seen in 6 cases. In 7 cases endometrial polyps were seen. 6 cases (1.44%) showed endometrial carcinoma. Conclusion: other than malignant lesions, benign neoplastic and nonneoplastic lesions should also be considered in the evaluation of abnormal uterine bleeding cases

Keywords: Hysterectomy; Histopathology; Endometrium. 

Not provided