Indian Journal of Pathology: Research and Practice

Background: Gall bladder (GB) adenomatous polyps are uncommon and are usually an incidental finding. Infections serve as a fertile soil for gall bladder polyps. Risks for GB polyps are seen in patients with hepatitis B viral (HBV) infection with HBsAg serving as a risk factor. Hepatitis C viral (HCV) infection facilitates GB stone formation and the incidence is seen more in middle aged females. Case Description: Hereby, we present a case of 40 year old female presenting with long term intermittent abdominal pain. Patient was found to have, positive HCV serology (HCV genotype 3) with high viral load. USG and CT showed multiple gall bladder polyps. Histology revealed multiple adenomatous polyps of gall bladder with focally dysplastic epithelium. Final diagnosis of adenomatous polyp with dysplasia was given. Literature Review: Gall bladder polyps are usually single and a rare occurrence. The risk of malignancy in an adenomatous polyp increases in solitary and sessile polyps. The primary goal of management of Gall bladder polyp is to prevent the development of gall bladder adenocarcinoma. The literature is short of case reports where HCV infection has been associated with GB polyps. Clinical Significance: In our case, multiple GB polyps were seen in a HCV positive female. This association of multiple GB polyps with HCV infection is a rare association and to the best of our knowledge has not been previously reported in the literature.

Keywords: Gall Bladder; Adenomatous Polyps; Hepatitis C. 

We present an interesting case of acquired cutaneous lymphangiectasia of vulva following tubercular lymphadenitis. It was a 35 year old lady who initially had cervical lymphadenitis proven positive for Tuberculosis and received Anti- Tubercular treatment about thirty years ago. She developed multiple raised lesions over the vulva and left upper thigh of one year duration. On examination, the patient had a large polypoidal growth involving both sides of the vulva, left upper thigh and over pubic area. She underwent simple vulvectomy and left thigh growth excision. Histopathological examination of the vulvectomy specimen confirmed the clinical diagnosis of vulval lymphangiectasia.

Keywords: Acquired Vulval Lymphangiectasia; Vulval Lymphangiectasia; Tuberculosis. 

Lymphatic filariasis is caused by a haemo-parasite Wuchereria bancrofti . It is an endemic parasitic infection in the tropical and subtropical countries of the world. As such it is a major health problem in India with many patients being asymptomatic. The common presentation of genital filariasis in India is secondary vaginal hydrocele with associated epididymo-orchitis. Lymphatic filariasis may also present as lymphoedema with lymphadenopathy, genital lymphoedema and swelling of the lower limbs. Here we present a case of filariasis with a rare presentation of a penile nodular swelling mimicking a sebaceous cyst and without genital or limb lymphoedema.

Keywords: Filariasis; Wuchereria Bancrofti; Penile; Sebaceous Cyst. 

Introduction: It is critical that cytopathologists should communicate thyroid FNA interpretations to referring physicians in terms that are succinct, unambiguous, and clinically helpful. Historically, terminology for thyroid FNA has varied significantly from one laboratory to another, creating confusion in some cases and hindering the sharing of clinically meaningful data among multiple institutions. Methodology: Patients with thyroid lesions referred to the Department of Pathology, Medical College, Hospital & Research Centre for FNAC and histopathological evaluation were taken. Results: Total no of benign follicular lesion were 82 .Out of which 11 were Adenomatoidgoiter, 56 were MNG (colloid nodule), Lymphocytic (Hashimotos thyroiditis) were 14 and 1 case was Granulomatous thyroiditis. Conclusion: Histopathological follow up was available in 56 cases, out of which 50 cases were reported as benign thyroid lesion. Follicular carcinoma and malignant tumors were reported in 2 cases each.

Keywords: Thyroid; Histopathology; FNAC. 

Background: Given that the clinical and radiological examinations of lateral cervical masses are not always sufficient for deciding on appropriate management, the cytological examination of the material obtained by fine-needle aspiration might be an efficient tool in the preoperative investigation of these lesions. Aim: To assess the usefulness of FNAC in the diagnosis of cervical lymph node masses and study the cytological features of common pathological conditions affecting the lymph nodes,in correlation with histopathological examination. Materials and Methods: A retrospective study of enlarged cervical lymph nodes is undertaken &evaluated between the period from 2013 to 2016 .Cervical lymph node biopsieswere received from 90 patients out of a total of 100cases of previous FNACs and were subjected to unbiased histopathological examination, after fixing in 10% formalin. Results: All 90 cases correlated well with the histopathological diagnosis.Two of the AFB positive cases were subsequently diagnosed to be HIV positive. Epitheloid cell granulomas were observed in all cases of tuberculosis with or without caseation and/or AFB. Two cases of granulomatous lymphadenitis did not show caseation,both cytologicallyand histologically, and were labelled negative for AFB,both on smear and culture. They were further followed up, and subsequently diagnosed as Sarcoidosis and toxoplasmosis respectively. Cytological diagnosis for Non –Hodgkins lymphoma was rendered as lymphoproliferative disease,suspicious for malignant lymphoma,which on histopathological examination confirmed the diagnosis of NON –Hodgkins lymphoma. Conclusion: Fineneedle aspiration cytology (FNAC) is an accurate, reliable, cost effective, minimally invasive, and pain free, first line diagnostic technique to investigate both superficially palpable&deep seated masses.

Keywords: FNAC; Cervical Lymphadenopathy; Metastatic Carcinoma; Infectious Granulomatous Lymphadenitis

Background: Benign lesions of breast are most common cause of breast problems. Up to 30% of females suffer from benign diseases of breast, requiring treatment at some time in their lives. Benign lesions of breast are 5 to 10 times more common than breast cancer. Many of these lesions are clinically suspected as malignancy but diagnosed as benign after histopathological examination. Aim: To study the spectrum of benign lesions of breast & their age and sex distribution. Inclusion Criteria: All benign lesions of breast diagnosed on histopathology are included. Exclusion Criteria: Malignant lesions of breast. Materials and Methods: A retrospective study of 5 years is conducted from 31st December 2015 to 1st January 2011 to determine the spectrum of histopathological patterns in breast lesions received at Department of Pathology, Raichur institute of medical sciences, Raichur, Karnataka. Data for retrospective study is obtained from departmental records, tissue blocks, slides and requisition forms submitted along with specimens. Results: A total of 128 breast specimens were received during study period in our deparment. Benign to malignant ratio was 5.54:1; male to female ratio was 1:20.33. Highest incidence of benign lesions in females was seen between 21-30 years of age. Most common benign lesion was Fibroadenoma (64%), followed by fibrocystic disease (12.5%). All breast lesions in males were diagnosed as Gynaecomastia with the peak incidence in the age group between 21-30 years. Conclusion: The benign breast lesions constituted 85.3%. Benign to malignant ratio was 5.54:1 in females. Fibroadenoma was the most common lesion in the benign group followed by fibrocystic disease. This histopathological sublassification of benign breast lesions was useful in the management of patients and also carried prognostic value. Identification of benign breast lesions is important as some of them mimic malignancy clinically. Histopathological diagnosis plays an important role in the diagnosis of benign breast diseases.

Keywords: Benign Lesions of Breast; Fibroadenoma; Inflammatory Lesion. 

Context: The lower GI tract is a site for various infectious, inflammatory, idiopathic and polypoidal conditions along with neoplasms. Aims: To study the spectrum, histological patterns and clinico-pathological aspects of various lower gastrointestinal tract lesions in rural population and to compare the findings with data available in existing literature. Settings and Design: This is a prospective and observational study of 70 patients having lower gastrointestinal tract lesions, studied over a period of 18 months from Jan 2016 to June 2017 in Department of Pathology of a rural hospital. Methods and Material: We received samples in form of biopsies and intestinal resection specimens, which were processed and stained to make slides to reach to a definitive histopathological diagnosis. Statistical Analysis Used: Data was analysed with the help of simple statistical tables and charts. Result & Conclusions: Our study throws a light on the pattern of lower gastrointestinal tract lesions seen in our institute.

Keywords: Lower Gastrointestinal Tract Lesions; Histopathological Diagnosis; Non-Neoplastic; Neoplastic.

Introduction: Skin is involved in a number of pathological conditions and affects all age groups and both the sexes, ranging from mild to severe skin problems such as dry skin,wrinkling ,disfigurement ,itching, painful and sometimes fatal life threatening conditions like toxic epidermal necrolysis and malignancies like lymphoma. Skin biopsy is one of the most frequently used ancillary aids to confirm clinical diagnosis.The tissue reaction pattern and pattern of inflammation aid in the diagnosis. Objective: The purpose of the present study was to evaluate the skin biopsies in relation to age and sex and the pattern of histological diagnosis of skin biopsy specimens in the department of histopathology in our centre. Materials and Methods: The present retrospective study of skin biopsies was conducted in the department of histopathology of Sampurna Sodani diagnostic clinic over a period of one year from January to December 2016.A total of 173 skin biopsies were taken into consideration. All biopsies were fixed in 10% formalin for 24 hours and later 3-4 micron thick sections were made from the blocks and stained with H and E stain. Wherever necessary, PAS and AFB staining and immunohistochemistry was performed to aid in the diagnosis. Results: A total of 173 skin biopsy specimens were received from January 2016 to December 2016 . There were 76 (43.9%) males and 97 (56.1%) females. Leg was the most common site involved. Non-malignant lesions were more common comprising of 110/173 (65.3%). Borderline tuberculoid Leprosy was the most common finding among the granulomatous skin lesions (38.8%)Among the malignancies,Basal cell carcinoma was the most frequent finding (29.6%). Conclusion: Skin diseases present with a variety of patterns and severity. A definite histopathological diagnosis along with clinical presentation is mandatory for proper treatment and prognosis of the disease.

Keywords: Skin Biopsy; Leprosy; Non Malignant Skin Lesions. 

Background: Trichomonas vaginalis infection is a common sexually transmitted protozoal infection in HIV women among all reproductive age group and is associated with several adverse health outcomes such as, preterm delivery, delivery of a low–birth weight infant, and facilitation of sexual transmission of human immunodeficiency virus. Patients and Methods: Total of 100 women from 20-40 years who participated in the study from 28 th December 2015 to July2016.Collection of vaginal swab specimens were done after taking consent from each patient. The vaginal fluids extracted from these swabs were evaluated for the presence of Trichomonas vaginalis & perinuclear halo (presumptive diagnosis of Trichomonas) by staining with Papanicolaou method. Results: Over all, 10 women (10%) of the total of 100 women were positive for Trichomonas infection & 12 women (12%) were positive with demonstration of perinuclear halo (12%) Total 22% had shown the infection with Trichomonas. Conclusions: With Positive history of HIV & supported by positive HIV test & clinical examination, women with abnormal vaginal discharges, burning sensation and genital itches should be checked for Trichomoniasis using high sensitive and specific tests: papanicolaou stain for the detection of trichomonas & perinuclear halo.

Keywords: Trichomonas; Discharge; HIV; Vulva; Vagina; Urethra; Papanicolaou. 

Introduction: Fine needle aspiration cytology (FNAC) plays a vital role in the management of thyroid lesions. Historically terminologies used for reporting thyroid FNAC has varied significantly from one laboratory to another, creating confusion in some cases. A uniform reporting system for thyroid FNAC will facilitate effective communication among cytopathologists, endocrinologists, surgeons, radiologists and other health care providers. Present study is done to evaluate the efficacy of The Bethesda system for reporting thyroid cytopathology. Methodology: Patients with thyroid lesions referred to the Pathology Department, Medical College, and Hospital & Research Centrefor FNAC are taken. Interpretation of these cases was done as Per the Bethesda System. Results: Total numbers of cases studied on FNAC were 104. Out of 104 cases 82(78.8%) were benign lesions, 10(9.6%) were unsatisfactory/ nondiagnostic, 6(6.20%) were Follicular Neoplasm/ suspicious for neoplasm, 4(4.16%) were suspicious of malignancy, 3(3.12%) were Malignant and 1case was reported as Atypia of undetermined significance. Conclusion: Bethesda system of reporting thyroid cytopathology is beneficial for clinical follow up and surgical management. It helps to reduce the rate of unnecessary thyroid surgery for benign thyroid lesion and helps to plan the surgical management in malignant thyroid lesion.

Keywords: Thyroid; Fine Needle Aspiration Cytology; the Bethesda System. 

The aim of this study was correlation of skin adnexal tumors with age, sex, and location and determining its incidence in the Department of Pathology government medical college and Hospital, Nanded, Maharashtra. All cases of skin adnexal tumors diagnosed during 2015-2017 are included in this study. Total 27 cases were of adnexal tumour out of received 13057 biopsy specimens in our department.70.36% were benign and 29.6% were malignant Lesions. The sweat gland tumors constituted the largest group (including both apocrine and eccrine differentiation) followed by the hair follicle tumors and sebaceous gland tumors. Overall male: female ratio was 1:2.89. The commonest age group was 41–60 years and the commonest affected body part was head, neck and face region. Pilomatricoma were commonest benign tumors and sebaceous carcinoma was the most common malignant tumor seen. The incidence of benign skin adnexal tumors was more as compared to the malignant tumors.

Keywords: Adnexal Tumours; Pilomatricoma; malignant Lesions.

Introduction: Platelet plays an important role in atherosclerosis, the major cause of unstable coronary syndromes. Despite an increasing volume of literature which suggests that platelet volume measurement might be useful in the diagnosis of disorders of thrombopoisis, platelet parameters have not been utilised by the clinicians. The clinical utility of newer haematological parameters such as platelet indices has been explored in recent years. Mean platelet volume (MPV) is an indicator of platelet activation and it has been reported to increase in acute myocardial infarction and acute coronary syndromes Material & methods: The present study is to determine the relationship between mean platelet volume and platelet count, and also to assess the normal range for mean platelet volume in 500 healthy adults in Indian population. Result: The range of platelet count in the normal subjects was 26 – 490*103/ul with a mean of 194*103/ul . The range for platelet volume was 6 – 10.9fl with a mean of 7.4fl. . It was found that the platelet count and mean platelet volume were found to be inversely proportional to each other. Conclusion: Hence from our study we found the mean volume to be 7fl and mean platelet count was 194*103/ul. The count and volume showed an inverse relationship. Patients having a low platelet count had a higher MPV and patients with high platelet count had a low MPV. The patients having a MPV beyond 11.7 fl should be evaluated carefully especially for occlusive arterial diseases.

Keywords: Mean Platelet Volume; Platelet Count; Healthy Population. 

Breast cancer is a leading cause of mortality and morbidity among women worldwide.The high mortality associated with breast cancer is linked to the aggressiveness of the tumor which depends to a large extent on the histopathological subtypes. It is a heterogeneous disease, comprising multiple entities associated with distinctive histological and biological features, clinical presentations and behaviours and responses to therapy. Histological grade has been incorporated in multiple, validated, prognostic algorithms to determine breast cancer therapy, such as the Nottingham PrognosticIndex. Many studies have tried to identify prognostic factors for breast cancer with nodal status and histopathologic subtypes featuring prominently as prognostic indices. This study was a retrospective analysis of all consecutive breast cancer specimens study from January 2011 to September 2016 biopsysubmitted to the Pathology Department of Hassan Institutional Medical Sciences, Hassan. Prominent histomorphological features, grading, typing, Lymphovascular invasion, lymph node involvement and involvement of the surgical margins were studied in detail. The aim of this study was to know the age incidence patterns for different histopathologic types of carcinoma and to know the involvement of deep resected margin and number of lymph nodes by malignant cells.

Keywords: Breast Cancer; Histopathology Grading; Resected Margin; Nottingham Prognostic Index. 

Introduction: Abnormal uterine bleeding is the most common presenting complaint among women of all age groups attending the gynaecology out patient department. Abnormal uterine bleeding is a term used to describe any type of bleeding that does not fall within the normal ranges for amount, frequency, duration and cyclicity. Dysfunctional uterine bleeding is a clinical term used to describe abnormal uterine bleeding not attributable to any underlying organic lesions like Leiomyoma, Inflammation and Polyps. The causes of abnormal uterine bleeding vary with age. The present study was carried out to study the histomorphological spectrum of uterine lesions in women of all age groups presenting with abnormal uterine bleeding and to classify the lesions as Dysfunctional uterine bleeding or Organic causes. Materials and Methods: The retrospective study included a total of 163 specimens received either as endometrial curettings or hysterectomy specimens belonging to all the age groups (reproductive, perimenopausal and post menopausal), presenting with complaints of abnormal uterine bleeding was carried out in the Department of Pathology at a tertiary care centre in rural Haryana. Results: Maximum cases (39.26%) presenting with abnormal uterine bleeding were seen in the age group 31-40 years. Out of total 163 cases, there were 91 (55.82%) DUB cases, 69 (42.33%) were organic lesions and 3 (1.84%) cases were inadequate for opinion. Proliferative phase was seen in maximum cases of dysfunctional uterine bleeding (36/91 cases) and leiomyoma was the commonest pathology in organic lesions category (24/69 cases). Conclusion: Study of histomorphological pattern of the endometrium in patients of all the age groups presenting with abnormal uterine bleeding helps to diagnose and categorize the lesions as Dysfunctional uterine bleeding or Organic causes, to plan specific treatment modality, to assess therapeutic response and to rule out carcinoma.

Keywords: Abnormal Uterine Bleeding; Dysfunctional Uterine Bleeding; Hyperplasia; Leiomyoma; Normal Cyclical Endometrium. 

Introduction: Thyroid is the endocrine organ situated in the midline of the neck.Its pathology varies from nutritional disorders like multinodular goiter to high grade malignancy like anaplastic carcinoma. Since the thyroid is superficially located and easily palpable, Fine needle aspiration cytology (FNAC) becomes the most common modality of investigation done for diagnosing thyroid lesions. The Bethesda system for reporting of thyroid cytology is most commonly used method for reporting FNAC of thyroid. Material and methods: It includes 100 cases of thyroid lesions. Results: All cases on FNAC reported as category II according to Bethesda system. On biopsy, all show features of multinodular goiter. Discussion: Category II should be sub categorized into IIA, IIB, IIC accordingly for Nodular, Lymphocytic thyroiditis and others respectively, as they have different pathogenesis, diagnostic modality and treatment protocol. Conclusion: Subcategorisation helps the clinicians to have distinct and well defined work up protocol for early diagnosis and treatment.

Keywords: Bethesda; Thyroid; Lymphocytes; Colloid. 

Introduction: Perinatal mortalityworldwide accounts for about 53/1000 total births [1], in which preterm births contribute to a major proportion, followed by other fetal, placental and maternal factors [2]. Hence, analyzing the perinatal deaths by a detailed postmortem examination is indispensable in identifying the specific disorder for which targeted strategies could be implemented for prevention in further pregnancies and counseling regarding the risk of recurrence. Aims: 1. To analyze the spectrum of etiologies which account for the fetal death. 2. To study the various congenital anomalies 3. To correlate the pathological diagnosis with antenatal ultrasound findings and karyotyping wherever feasible. Materials and Methods: Fetal autopsies were performed on all deceased fetuses received in the Department of Pathology over a period of 4 years from June 2012 to June 2016. A total of 65 cases were included in this retrospective study. The findings were correlated with available antenatal ultrasound findings and with karyotyping reports wherever feasible. Results: Of the 65 cases, the predominant cause of fetal loss was found to be due to MTP following congenital anomalies in 26 cases ( 40% ), then by intrauterine deaths in 24 ( 36% ), ARDS with perinatal asphyxia in 8 (12%), spontaneous abortionsin 5 ( 7%) and miscellaneous conditions in 2 cases ( 5% ). Male fetuses were found to be more affected (62%) than females (38%). A 90% correlation between antenatal USG and pathological diagnosis was found. In 6 out of 65 cases which had karyotyping reports, 66% correlation was noted. Conclusion: The present study proves that an organized postmortem examination of the fetus helps in identifying the cause of death which along with appropriate antenatal history, radiological findings and karyotyping would give a definitive diagnosis and aids in estimating its risk of recurrence.

Keywords: Congenital Anomalies; Karyotyping; Perinatal Death. 

Background: In a developing country like India, Oral cancer is a major health issue, representing the leading cause of death. Objective: Study the spectrum of premalignant and malignant lesions with grading of malignant lesions of oral cavity and to study the incidence of malignant and premalignant lesions of the oral cavity in relation to age, sex, and site of the lesion. Methods: The study was conducted for a period of 2 years, in the Department of Pathology, KVG Medical College and Hospital, Sullia. 100 oral biopsies received from the Surgical, Medical and Dental outpatient departments were studied. Clinical details were obtained from the requisition form. Biopsies received were processed and stained with H&E. Histopathological diagnosis regarding type and differentiation was made. Data was entered and analyzed using Microsoft excel 2007 and SPSS Version 17. Quantitative data was expressed as mean and standard deviation, Qualitative data was expressed as percentage and proportions. Results: Among 100 oral cavity lesions studied, 16% were premalignant and 84% were malignant lesions. Peak incidence was seen in 6th decade with a male preponderance. 43% of patients were smokers, 30% were habituated to smokeless tobacco. The commonest site in both the premalignant and malignant lesions were Buccal mucosa. Majority of cases (50%) of leukoplakias were associated with mild dysplasias, one case of erythroplakia showed mild dysplasia. Amongst the 84 malignant lesions, 78 cases were Squamous cell carcinoma and majorities (60.25%) were well differentiated. Maximum number of cases (63.63%) were seen in Stage I and II. Nodal metastasis was seen in 36.36%, perineural invasion in 27.2% and microvascular invasion was seen in 18.18% cases. Negative surgical margins were seen in 100% cases. Conclusion and Interpretation: A detailed clinical work up with histology can help in early detection of dysplastic and malignant changes and thus reduce morbidity and mortality due to malignant lesions.

Keywords: Erythroplakia; Leukoplakia; Squamous Cell Carcinoma; Verrucous Carcinoma. 

Background: Fine needle aspiration cytology has been shown to be simple, safe, cost effective and quick to perform procedure with excellent patient compliance. It is a well established technique for preoperative investigation of thyroid gland swellings with high sensitivity, specificity and accuracy. The aim of this study was to determine the accuracy of fine needle aspiration cytology of thyroid swellings performed at our institution. Materials and Methods: This study was carried out at American International Institute of Medical Sciences and Hospital Udaipur, department of Pathology over a period of 2 years (May 2015 to May 2017). One hundred and ninety patients of all age groups and both sexes who underwent fine needle aspiration cytology for thyroid swelling were evaluated. Out of 190 patients, histopathological diagnosis was carried out in 69 patients. Results: Fine needle aspiration cytology result revealed 156 cases (82.10%) as non-neoplastic, 20 cases (10.52%) as neoplastic and 14 cases (7.38%) inadequate due to lack of cellularity. The commonest lesion in the thyroid gland was colloid goiter. Among the malignant neoplasms the commonest was papillary carcinoma. Out of 176 patients, histopathological diagnosis was available in 69 patients. Statistical analysis of our data shows the diagnostic accuracy of fine needle aspiration cytology to be 91.30%. Fine needle aspiration cytology showed a sensitivity of 90.90% and a specificity of 91.37%. Conclusion: Fine needle aspiration cytology is a well established technique for pre operative investigation of thyroid gland swellings with high sensitivity, specificity and accuracy.

Keywords: FNAC; Sensitivity; Accuracy. 

Context: Fine needle aspiration cytology (FNAC) is one of the important components of cytology. The main purpose of FNAC is confirmation of benign thyroid lesions and thereby reducing unnecessary surgeries for the same. Aims: The main aim of the study is to study the correlation ship between cytological findings of thyroid lesions with clinical history and histopathological examination (Wherever available). Settings and Design: It is a prospective study of 150 patients having thyroid enlargement carried out in a tertiary care centre over a period of 3 years. Methods and Material: A total 150 patients having thyroid enlargement were thoroughly studied and subjected for FNAC. Histopathological examination, ultrasonography (USG) findings and thyroid function tests (TFT) were studied wherever available. Correlation of FNAC finding with clinical diagnosis and histopathological examination was done. Statistical analysis: Specificity, Sensitivity, Diagnostic accuracy, Positive predictive value and Negative predictive value of FNAC of thyroid lesions were calculated. Results: Predominant age group in the study was 21-40yrs and Male: Female ratio was 1:9. Most common cytological diagnosis was colloid goiter followed by thyroiditis. Correlation between clinical diagnosis and FNAC was high in thyroiditis. Sensitivity of test for diagnosis of malignancy=90%. Specificity of the test for diagnosis of malignancy=100%. Positive predictive value=100%. Negative predictive value=96.8%. Diagnostic accuracy=87.5%. Conclusions: FNAC found to be simple, minimally traumatic, accurate, cost effective office technique for diagnosis of thyroid lesions. The positive influence of FNAC on the management of thyroid lesions is perhaps best highlighted in the low rate of surgical intervention, 26.66% in this study.

Keywords: FNAC; Histopathology; TFT; Thyroid Lesions; USG. 

Aim: To determine prevalence & age and gender distribution of HIV among blood donors and to study the trend of incidence of HIV positive Cases among them. Materials and Methods: This is a retrospective study conducted from from January 2001 to Dec 2015 for 15 years at RIMS, Teaching Hospital Blood Bank, Raichur. Serum Samples from Replacement and Voluntary Donors were tested for prevalence of HIV. Donors were selected by taking history, clinical examination (strictly following donor’s selection criteria) to eliminate professional donors, The donors were apparently healthy adults of the age group 18-60 yr. The donor blood samples were collected at the time of blood donation from the primary bag and tested for the presence of HIV using enzyme linked imunosorbent assay (ELISA). Inclusion Criteria: All blood donors (including voluntary and replacement blood donors) coming to donate blood either at Blood Bank, RIMS, Raichur as well as at various blood donation camps organised by blood bank were included in this study. Exclusion Criteria: Donors who did not fulfil the general criteria for blood donation, commercial and paid donors and also those with a history of high risk behaviour were excluded. Results: A total of 39090 blood donors were screened for HIV over a period of 15 years between January 2001 to December 2015. Out of which 38261 (97.88%) were males and 829 (2.12%) were females (Table 1). Age of the donors ranges from 18-52years. Out of 39090 donors screened for HIV, 148 donors were found to be reactive, comprising 0.37%. Out of 148 positive donors, 147 were males and one was female comprising 99.32% and 0.68% respectively. Conclusion: Prevalence of HIV among blood donors in our study showed 0.37%. Strict selection of blood donors with emphasis on getting healthy voluntary donors and comprehensive screening of blood donors for Human immunodeficiency virus and other transfusion transmissible infections using standard methods are highly recommended to ensure the safety of blood for receipients.

Keywords: HIV Prevalence; Blood Donors; Blood Bank. 

Background: Iron deficiency and lipid metabolism disorders are common health problems but the number of published studies investigating lipid alterations in Iron Deficiency Anemia (IDA) is relatively low and the results of these studies are inconsistent. Some of these studies show that lipid parameters in iron deficient patients are higher in value than those of healthy control patients, whereas others indicate that lipid parameters fall to lower levels in iron deficiency, but improve to normal range following the rise of hemoglobin (Hb) after iron replacement or transfusion. Therefore, in the present study, we investigated the changes in serum lipid concentrations that occur in patients of IDA. Materials and Methods: This is a cross-sectional study carried out in SRM Medical College Hospital and Research Centre, Chennai. Totally 200 subjects, both men and women aged >18yrs [100 patients with IDA (cases) and 100 patients without IDA (controls)] were included in our study and tested for lipid profile. Statistical Analysis: The data were analyzed by SPSS version 21 using Independent samples unpaired‘t’ test. ‘p’ value <0.05 was considered as statistically significant. Results: The baseline hematological parameters of the IDA patients were found to be significantly different from controls (Table 1). The levels of serum TG and serum VLDL were significantly (P <0.05) higher in the IDA group, whereas the levels TC, LDL and HDL were significantly (P = 0.01) lower in IDA. In our study mean serum TC and LDL levels was statistically significant (P < 0.05) between mild, moderate and severe anemia whereas mean serum TG, HDL, VLDL was not statistically significant. Except LDL in mild and severe anemia there was no significant difference between male and female in other lipid parameters among varying degrees of anemia. Conclusion: We conclude that, serum lipid profile is altered in the presence of IDA. But the role of iron in blood lipid metabolism has received little attention, especially in India, and must be explored to establish if IDA is a contributing factor in the etiology of cardiovascular disease in humans which must be considered seriously and hence all attempts should be made to treat this micronutrient deficiency promptly.

Keywords: Iron Deficiency; Anemia; Serum Lipid Profile. 

Atherosclerosis accounts for a large proportion of cardiovascular system associated morbidity and mortality. The aim of the study is to know the relationship between atherosclerosis of various arteries and anthropometric indices with the help of simple indicators of obesity such as body weight, body length, body mass index, waist circumference, hip circumference, waist-hip ratio, abdominal subcutaneous fat thickness and wrist circumference. The study included 100 autopsies conducted in the Government Medical College, Thrissur during a one and a half years period. The heart was dissected following standard autopsy protocol. A 5 cm section of the right coronary artery (RCA) in the atrio-ventricular groove from its origin, a 5 cm segment of the left anterior descending artery (LADA) distal to the origin of the circumflex artery (including the region of origin of the circumflex branch) and left coronary artery (LCA) from its origin till the circumflex branch were excised, marked for identification and histopathologically analysed. The study showed a positive correlation of age, body weight, body mass index, waist circumference, waist-hip ratio and abdominal subcutaneous fat thickness with atherosclerotic changes in the various arteries. No significant relation was observed between the grade of atherosclerosis and anthropometric indices of height, hip circumference and wrist circumference.

Keywords: Atherosclerosis; Body Mass Index; Hip Circumference; Waist Circumference; Waist Hip Ratio. 

Background: Breast carcinoma is the leading cause of death due to cancer in women. It is difficult to determine whether a lump is benign or malignant from clinical assessment. Fine needle aspiration cytology (FNAC) is a convenient and rapid procedure. Hence the present study was carried out to correlate fine needle aspiration cytology and histopathology of breast lesions. Aims and Objectives: To Correlate between FNAC and histopathology of breast lesions. Material and Methods: The present study is a retrospective study on 92 patients in Department of Pathology, Meenakshi Medical College and Research Institute, Kanchipuram from the period of March, 2014 to March2017. Patients were referred from department of surgery who has presented with breast lesions and pain in the breast. Hematoxylin and eosin slides of the breast cases were taken and FNAC slides were collected for the same patients and then correlation was done. Results: Statistical analysis showed sensitivity, specificity, positive predictive value, and negative predictive value of FNAC to be 93.3%, 100%, 100%, and 98.7%, respectively. Conclusion: FNAC is an effective modality for the diagnosis of breast lesions. It is a safe, simple, and cost effective outpatient procedure associated with negligible complications. In the present study it has a high sensitivity and specificity. It helps the clinicians for early diagnosis and specific management thus reducing morbidity and mortality.

Keywords: Fine Needle Aspiration Cytology; Histopathology; Sensitivity; Specificity; Positive Predictive Value and Negative Predictive Value. 

Background: Although malignant bone tumours are infrequently encountered compared to the occurrence of other neoplastic lesions, they are of great significance because majority of them affect adolescents and young adults with a tendency of aggressive course. Morphological diagnosis of these tumours can be highly challenging. Objectives: 1. to know the incidence of malignant tumours of bone in this institute. 2. To study the histomorphological features of these lesions. 3. To classify these lesions by WHO classification and study the incidence of different lesions with respect to age, sex and site. Methodology: Biopsies and specimens received at the department of Pathology, KIMS, Hubli from July 2006 to June 20111 were subjected to routine fixation, processing and sectioning. Results: Out of the total 115 tumour and tumour like lesions of bone that were encountered during the study period, malignant bone tumours were 31 (26.9%), benign bone tumours 71 (61.73%), and tumour like lesions 13 (11.3%). Peak incidence of the malignant tumors was seen in third decade of life (34.7%). Osteosarcoma was the commonest malignant tumor (58%) followed by Ewing’s sarcoma (16.2%) and chondrosarcoma (9.6%). There were 3 cases of secondary tumors - one of renal cell carcinoma and the other two were adenocarcinomas of unknown primary. Conclusion: Malignant bone tumours form an important group of neoplastic lesions during the period of active growth spurt in adolescents and young adults. Adequate sampling of histopathological specimen with analysis of clinical details and radiological pictures can help in diagnosing the lesion with certainty.

Keywords: Malignant Bone Tumours; Osteosarcoma; Ewing’s Sarcoma; Chondrosarcoma. 

Background: Non neoplastic salivary gland lesions have to be differentiated from neoplastic lesions that mandates preoperative evaluation by aspiration cytology. Objective: To evaluate the diagnostic accuracy of the non neoplastic salivary gland lesions by fine needle aspiration. Materials and Methods: This is a cross sectional study was conducted in the Department of Pathology, at two tertiary care centres. The clinical details and examination findings were recorded. The aspirates were studied by two pathologists. The cytology smears were subsequently correlated with histopathology. The collected data were analyzed statistically for sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy of FNAC. Data analysis was done with SPSS. Results: A total of 135 patients studied of which 58 were non – neoplastic lesions. Most common age of presentation was 3-4th decade. Chronic sialadenitis was commonest (45%) followed by Benign cystic lesion (26%), Acute sialadenitis (16%), lymphoepithelial lesion (12%) and Granulomatous sialadenitis (1%). The sensitivity, specificity and diagnostic accuracy of non-neoplastic lesion was 96%, 100% and 96.6% respectively. The positive and negative predictive value is 100% and 75% respectively. Conclusion: The salivary gland lesions constitutes only a small proportion of head and neck cytology, however cytology poses difficulty in arriving at lesion specific diagnosis. Our study eliminated the risk of surgery in 20% of patients and were managed conservatively. Hence fine needle aspiration holds good for the initial evaluation of patients with major salivary gland lesions especially in experienced hands.

Keywords: Salivary Gland, Fine Needle Aspiration Cytology, Histopathology, Non-Neoplastic Lesions. 

Background: The commonest clinical presentation in any out patient department is lymphadenopathy. Fine needle aspiration cytology (FNAC) is a simple, reliable, rapid and inexpensive method to diagnose various cause lymph node enlargement. Aim: 1. To report the incidence and to describe the various causes of lymphadenopathy. 2. To evaluate the usefulness of FNAC in etiological diagnosis of lymph node enlargement. Materials and Methods: We retrospectively analyzed 306 cases of lymph node enlargement in our study from Jan 2015 to August 2016. Patients who had minimum four smears from each aspiration site were included in our study and the smears were routinely stained with Papanicolaou stain and special stains where ever necessary. Results: Out of 306 cases, there were 170 (55.56%) males and 136 (44.4%) were females. Cervical lymph node enlargements were found in 245 cases (80%). In our study, 85% cases were benign and 15% cases were malignant with tuberculous lymphadenitis was the commonest presentation in 166 cases (63%). Accuracy of diagnosis was more than 90% in most of the cases. Conclusion: FNAC is an excellent first line method in diagnosing causes of lymphadenopathy and it serves as an easy alternative to open biopsy as it can be done as an outpatient procedure.

Keywords: FNAC; Lymphadenopathy; Tuberculous Lymphadenitis; Papanicolaou Stain. 

Introduction: Surgical removal of testis is indicated in testicular tumors, male breast carcinoma, and prostate cancer as well as in many non-neoplastic lesions like-undescended testis, torsion, epididymo-orchitis, hematocele and testicular atrophy. Testicular atrophy secondary to testicular injury and infections are common next to cryptorchidism. Testicular tumors comprise only 1% of all cancers in men. Aims and Objectives: Study of histomorphological spectrum of lesions in orchidectomy specimens and to determine the frequency of various testicular tumors. Materials and Methods: This is a retrospective study of orchidectomy specimens received from January 2009 toJanuary 2013. The specimens were grossly examined, fixed in 10% neutral buffered formalin. All H & E sections were reviewed. Results: Out of the 63 orchidectomy specimens received, 46 (73.01%) were non-neoplastic while 17 (26.98%) were neoplastic lesions. Among the non-neoplastic lesions, chronic epididymo orchitis was the commonest, followed by atrophic testis, organized hydrocele, acute epididymo-orchitis, pyocele and others. Whereas, neoplastic lesions ranged from seminoma being the commonest followed by mixed germ cell tumors, lymphoma, pure germ cell tumors, spermatocytic seminoma and metastatic prostatic adenocarcinoma. Conclusion: Testicular pathology is a nosologically complex subjectbecause of the spectrum of histologic subtypes and variableclinical behaviour. Currently, treatment for most of the testicular neoplasms is orchiectomy, surveillance and radiation to the affected testis. Hence present study was undertaken to study thehistomorphological spectrumof lesions in orchidectomy specimens.

Keywords: Epididymo-Orchitis; Metastatic; Orchidectomy; Seminoma; Testicular Tumours. 

Objective: The objective of the present study is to compare values of platelet count on automated coulter with different manual platelet counts and also to ascertain the better methodology to do the same, particularly when coulters are not available in remote areas. Materials &Methods: Platelet count was estimated by four different methods in 75 blood samples(25 each with low, high and normal platelet count) received in Department of Pathology, Dayanand Medical College & Hospital, Ludhiana and compared with platelet count obtained from automated analyzer Beckman coulter LH750. Methods A and B were based on counting the average number of platelets per oil immersion field (OIF) in 10 fields multiplied by factor of 2 and 3 respectively and to yield a platelet count estimate per 109/l. Methods C and D were based on multiplying the total number of platelets counted under 2 high power fields by factor of 2 and 3 respectively. All cases had a normal mean platelet volume (MPV). Statistical Analysis: The agreement between the manual methodologies with each other and each method with the automated count was assessed using the unpaired T-test and correlation coefficient analysis done. Results: Method A and Method C showed no significant differences in platelet values in all the three groups and were comparable to those obtained by automated analyser. Conclusion: Manual methods give reliable and accurate results similar to automated analyser and can be used in rural settings and also automated counts should be counter checked by manual method especially in cases of thrombocytopenia.

Keywords: Platelet; Manual Count; Automated Analyser. 

Background: Thyroid Swellings are most common in routine clinical practice. Fine needle aspiration cytology (FNAC) gives quick results with good sensitivity and specificity. It minimize further investigations and surgeries. Combined approach of Thyroid functions test (TFT), FNAC and Histopathological findings will increase the specificity for the diagnosis of thyroid lesions. Aims & Objectives: Study aims to correlate cytological findings, TFT and Histopathological findings. Materials and Methods: The present study was undertaken in Department of Pathology, KBN institute of Medical Sciences, Kalburagi from June 2016 to May 2017. Total of 100 cases presented with Thyroid swellings, who underwent FNA and TFT . Among 100 cases, 25 cases had Histopathological Follow Up. Results: Total of 100 patients with thyroid swellings were included in this study. 90 females and 10 were males. Maximum patients were in age group of 21–30 years. Most Common Lesions were Non-Neoplastic accounting 88 % of cases, among these Colloid Goitre was commonest. 12% cases were found to be neoplastic, among these, Follicular Neoplasm were the most common, followed by Papillary Carcinoma. 70 % were Euthyroid, 2 % were Subclinical hyperthyroid, 16% were hypothyroid, 5% were hyperthyroidism and 7 % were subclinical hypothyroidism. Among these 25 cases had histopathological Examinations, 21 were correlated with cytological studies, 2 were false Negative and 1 was False positive . So, the sensitivity of FNAC was 83.3%, Specificity was 91.6% and Accuracy was 84%. Conclusion: FNAC gives High accuracy and specificity for further management of Thyroid lesions. All the FNA diagnosis must be viewed in the light of the clinical picture and thyroid hormone profile to minimize the risks of false negative reports.

Keywords: FNAC; Thyroid Function Tests; Thyroid Swelling

Although histological study is one of the most valuable means of diagnosis in dermatology, it has its own limitations. Often no definitive diagnosis can be made. The reason for this is often very few dermatoses, aside from tumors are regularly associated with a diagnostic histopathological picture. Materials and Methods: This study is a prospective cross sectional study done at Adichunchanagiri Medical College, BG Nagar, Karnataka, India, over a period of 2 years from March 2015 to 2017 march comprising of 120 cases of papular lesions of the skin. Results: 120 cases of papular lesions were divided into 11 groups and subgroups. The infectious disease constituted the majority of cases and degenerative disease and tumors of vascular tissue was the least. Conclusion: From this study is that histopathological diagnosis although is one of the valuable means of diagnosis in dermatology, it has been shown to have its own limitations as often no differential diagnosis is made. In many instances the chief value of histopathology lies in corroborating the clinical diagnosis or in ruling out the possible diseases. Inspite of that histopathology has a major investigative role in papular lesions of the skin.

Keywords: Papular Lesions; Inflammation; Diagnosis.