Indian Journal of Pathology: Research and Practice

Primary Fallopian tube carcinomas are very rare in incidence. They occur in a wide range of age group ranging from 17 to 88 years. The etiology of these tumours is unknown. Sometimes the tumour presents clinically like an ovarian malignancy and that only rarely the diagnosis of tubal malignancy is made preoperatively. Both the ovarian and Fallopian tube malignancy have similar age of occurrence being more common in nulliparous women and are of serous papillary morphology. Tumours of uncertain origin arising from ovary and tubes have generally been put under ovarian origin since ovarian tumours occurs at a greater frequency than that of the tubes. Here with presenting a case of Primary Fallopian tube carcinoma which was incidentally diagnosed in a case with a preoperative diagnosis of leiomyoma.

Keywords: Primary Fallopian Tube Carcinoma; Papillary Serous Carcinoma. 

In the present study of outpatient settings, pyelonephritis was diagnosed in pregnant women by the history and physical examination & supported by urinalysis result. After a clinopathological confirmation of pyelonephritis, 50 pregnant women were selected. The urine sample was subjected for routine examination & urine sediment was examined for the evidence of pyelonephritis & particularly attention was given to the presence of white blood cell cast. A total of 13% of these patients had WBC cast in urine. Acute pyelonephritis is a bacterial infection of the kidneys that affects 1 to 2 per cent of pregnant women. In most cases, the infection first develops in the lower urinary tract. If it’s not diagnosed and treated properly, the infection may spread from your urethra and genital area to bladder and then to one or both of kidneys.

Keywords: Urine; Pyelonephritis; White Blood Cell Cast. 

Context: Meningiomas are one of the most common primary central nervous system neoplasms. They occur most commonly in female patients being most common in the fourth and fifth decades of age. They may be of intraspinal or intracranial and extraaxial location. Aims: The aim of this study is to highlight the importance of histopathological features in analyzing the behaviour of meningiomas. Settings and Design: This is an analytical study undertaken at the department of pathology in a tertiary care hospital for a period of three years from may 2013 to june 2016. Materials and Methods: All the clinical data of the meningioma cases were obtained from the patient files in the pathology registers. The hematoxylin and eosin stained and mounted slides were retrieved and reviewed from the archives of pathology laboratory. Statistical Analysis: Statistical analysis was carried out using SPSS software version 17. Various tests used in the study were the chi square test and the T test. Results: Out of the 250 cases of meningiomas analysed in this study, 92% of the cases belonged to grade I. Features such as small cell change, hypercellularity, sheet like pattern, nuclear pleomorphism, macronucleoli, vesiculous nuclei, necrosis, hypervascularity and brain invasion were seen predominantly in higher grades ( GRADE II and III) of Meningiomas thereby proving their association with aggressive behaviour of tumour and their association was statistically significant with a P value of <0.0000001. Conclusion: Proper histopatholgical analysis is very important for the diagnosing, grading and prognostication of meningiomas.

Keywords: Meningioma; Atypical Meningioma; Anaplastic Meningioma; Meningioma Histopatholgy. 

Background: Varicocele is the most common treatable cause of male infertility affecting the young couple’s Varicocele is associated with increased incidence of abnormal sperm abnormalities including sperm count, sperm concentration, motility & abnormal morphology of sperm. Abnormally shaped sperm are not capable of fertilising the egg, because they do not function properly leading to male infertility. In testing for teratozoospermia, (abnormal sperm) sperm are collected, stained and analyzed under a microscope to detect abnormalities. These abnormalities may include heads that are large, small, tapered, or pyriform or tails that are abnormally shaped. Patients & Method: The study was conducted at R.D. Gardi Medical College, Ujjain between 8th January 2015 to 30th July 2015. Total of 50 patients in age group of 1845 with clinically proved cases of varicocele from surgical outpatient department were included in the study. The semen sample was evaluated by routine examination including total count, motility & emphasis done on sperm morphology by staining the smear by Paponicolaou method. Results: Over all of the total 50 cases the most prounced abnormality was in head 33 (16.5%) followed by abnormality of tail 27 (13.5%) & mid piece constitute (12%).

Keywords: Male Infertility; Semen Parameters; Varicocele; Teratozoospermia.

Background: In India cervical cancer is the leading cause of morbidity and mortality. Cancer of cervix ispreventable, and can be diagnosed at the premalignant/ preinvasive stage with adequate and repetitive cytological screening by Papanicolaou (Pap) smears. Methods: This retrospective study includes total 820 patients who were presented with various gynaecological problems. Clinical data was obtained by hospital records and smears were revived. Reporting was carried out as per Bethesda system 2014. Results: Total 820 patients were screened. Majority of cases (812 of 820) were negative for intraepithelial lesion (NIL) and there were 7 abnormal Pap smears which includes 3 cases of high grade intraepithelial lesions (HSIL), 2 cases of low grade intraepithelial lesions LSIL(0.2%) and each case of atypical glandular cells(AGUS) and Squamous cell carcinoma (SCC)and 1 case was unsatisfactory for evaluation. Among NIL, 763 (93%) were of non specific inflammatory smear, 16 cases Candidal inflammatory smear and 33 cases were of Trichomonal inflammatory smear. Conclusions: Pap smear cytology is a useful screening tool to detect preinvasive cervical epithelial lesions hence, the incidence of invasive cervical malignancy can be prevented if Pap screening program is effectively implemented in target population.

Keywords: Pap smear; Epithelial Cell Abnormality; Negative for Intraepithelial Lesions. 

Background: Oral cavity lesions are usually squamous cell in nature. These lesions can present as both malignant and premalignant conditions. Premalignant lesions are usually dysplastic lesions which can be mild, moderate and severe, leukoplakias or erythroplakia. 1020% of premalignant lesions have a tendency to progress into malignancy. Hence it becomes important to identify these lesions to prevent progression. Apoptotic index can be used as a simple tool to assess the progression of the disease and identify individuals who have a tendency to development malignancy. Aims: The aim of this study is to assess the apoptotic index in premalignant oral squamous cell lesions and evaluate its usefulness in assessing disease progression. Material and methods: 33 cases were studied. 5 were normal and used as control and the rest of 28 from varying degrees of dysplasia’s. Apoptotic index was assessed on H&E stained sections using oil immersion lens. Apoptotic bodies were counted in 10 oil immersion fields and expressed as a percentage. Results: The results showed that apoptotic index increased with the grade of dysplasia’s, showing a peak in moderate dysplasia. Conclusion: From this study we can conclude that apoptotic index can be used as a simple tool to evaluate patients with oral premalignant lesion. It can also help in identifying patients who will progress to malignancy and can be used as a prognostic marker.

Keywords: Dysplasia; Apoptotic Bodies; Apoptotic Index. 

Background: DowlingDegos Disease (DDD) is a rare genetic disease of the skin having an autosomal dominant inheritance. It is grouped under reticulated pigmented anomalies and manifests as symmetric, progressive, pigmented macules over flexures, scattered comedolike lesions and pitted acneiform scars. Histopathology is required for definitive diagnosis and to distinguish it from other reticulate pigmentary genodermatoses. Aims: 1. To show the existence of this rare disease in the local population. (2) To stress on the clinicopathological correlation for the definitive diagnosis of the disease. Materials & Methods: Punch biopsies of skin received by the Department of Pathology over a span of two years with Dowling Degos Disease as one of the differential diagnosis, were included in the study. The biopsies were processed as per standard protocol. Diagnosis was confirmed by the histopathological examination. Result: A total of six cases were included in the study, out of which four were histologically confirmed as DDD and one case had features overlapping with Reticulate Acropigmentation of Kitamura (RAPK). The study showed female preponderance. Four cases had family history. The clinical and histopathological findings of each case are discussed. Conclusion: Dowling Degos Disease may not be a rare entity. It should be considered as one of the differential diagnoses for pigmentary disorders. With combined clinical and histopathological evaluation, more cases may come into light in the future and DDD may not remain as a rare disorder.

Keywords: DowlingDegos Disease; Genodermatoses; Reticulate Pigmented Disorders. 

Background: Neonatal sepsis remains an important clinical syndrome despite advances in neonatology. Early diagnosis and adequate antibiotic treatment are required because of high rates of mortality and morbidity, especially in developing countries. Early diagnosis of neonatal sepsis is difficult because of nonspecific signs and symptoms, and noninfectious diseases may mimic neonatal sepsis. Hence this study evaluates the role of certain new parameter in neonatal sepsis. Material and method: Before antibiotic therapy, blood samples for VCS parameters i.e. Volume, conductivity and scatter parameters of neutrophils and for culture were taken from patients with a diagnosis of sepsis. Data was analyzed by descriptive statistics. Student t test was used to compare 2 groups. Data included total WBC counts, percentage of neutrophils, and the VCS parameters of neutrophils, which were generated by each individual cell passing through the aperture and were optically and electronically measured by the Coulter LH 780 (Beckman Coulter, Fullerton, CA). VCS parameters were evaluated on the same day of sepsis diagnosis. Results: There were 55 cases and 10 controls. For each case total WBC counts, percentage of neutrophils, and the VCS parameters of neutrophils, CRP were noted. After the statistical analysis there was no statistically significant difference among cases and controls in relation to any of the parameters except for conductivity (C) of neutrophils. Conclusion: A high index of suspicion with or without lab evidences of infection is the key for early diagnosis. Prompt institution of antibiotic therapy and supportive care will save most of the cases of neonatal sepsis.

Keywords: Neonatal Sepsis; VCS Parameters; CRP. 

Introduction: Anemia is major public health problem. Diagnosis of anemia and its correction needs crucial intervention. Peripheral blood smear examination plays an important role in classifying anemais based on morphology of RBCs. Nutritional deficiency is a major risk factor for anemias. Aim of the study: The aimof the study is to look at the morphological patterns and prevalence of anemias in a teaching hospital in rural Telangana. Materials and Methods: It is a hospital based observational study done in the department of Pathology at RVM Institute of Medical Sciences and Research Center, Siddipet district, Telangana State for a period of two months from August 2017 to September 2017. A total of 560 cases attending a rural medical camp were screened for anemia. All the cases were sent to department of Pathology (central laboratory) for routine investigations for anemia. Investigations advised were Hemoglobin estimation, complete Hemogram, Peripheral smear examination and Reticulocyte count. Observations and Results: In the present study all the 560 cases were screened for anemia. 230 (41%) cases were normal and 330 (59%) cases showedanemia.157/330 cases were among 2130 years followed by 3140 years 62/330 cases. Female preponderancewas seen 339/560 (60.5%) compared to males 2 21/560 (39.4%). Clinically about 53.5 % cases presented with pallor. Among 560 cases screened, about 330 (59 %) cases showed features suggestive ofanemia.Microcytic hypochromic anemia was observed commonly among 55.3% cases (310/560) and normocytic normochromic in 230 cases (41%). Conclusion: Microcytic hypochromic anemia was the most common type of anemia identified. Females were commonly affected than males.

Keywords: Anemia Prevalence; Iron Deficiency; Microcytic Hypochromic Anemia; Medical Camp Study. 

Breast disease are one of the commonly encountered condition in females. For the diagnostic work –up of these lesions, clinical examination was followed by FNAC preoperatively and for confirmation histopathological examination has been done. Aims: to study cytology of breast lesions followed by cytohisto correlation, to validate the accuracy of FNAC and histopathology. Materials and Methods: Data was collected from 68 cases during feb 2016 to jan 2017. Results: Out of 68 cases, 4 were unsatisfactory, 10 were nonneoplastic lesion, 40 were benign, 3 were atypical, 3 suspicious for malignancy and 8 were malignant categories as per cytology. Histologically 10 were nonneoplastic and 44 were benign and 10 were malignant. Conclusion: Cytohistological correlation is the diagnostic tool in classifying the breast lesion and helps in overcoming the pitfalls of cytology.

Keywords: Breast; Ductal Carcinoma. 

Introduction: Leprosy is a major public health problem in developing countries including India. It is caused by Mycobacterium leprae and predominantly affects skin and peripheral nerves. It is a chronic disease having varied clinical and also varied biopsy findings. Aim of the study: (a) To analyse the histopathological spectrum of Hansens’s disease based on the histopathological and clinical features. (b) To study clinicohistopathological correlation. Materials and Methods: This was a retrospective and prospective study carried out at Subharti Medical College, Meerut, Uttar Pradesh, over a period of four and half years. All the skin biopsies obtained from patients clinically diagnosed or suspected as having leprosy were studied by way of histopathological examination and Fite stain. The age and gender distribution, sites of lesions, types on histopatholgy, Fite stain positivity and the types of reactions were studied. Results: A total of 216 (17.2%) cases of leprosy were diagnosed among 1255 total skin biopsies. The male to female ratio was 2.27:1. The most common age group was 2130 years, the most common sites were the extremities and most common presentation was as hypopigmented macules. The lepromatous type was the most common on histopathology and the midborderline was the least common. All lepromatous cases were positive for Fite stain. Erythema nodosum leprosum was seen in 30 (13.8%) cases. Conclusion: All cases of clinically suspected leprosy should undergo skin biopsy for histopathological examination and special stain to demonstrate the acid fast bacillus. The indeterminate type shows nonspecific findings on skin biopsy. Reversal reactions and Erythema nodosum leprosum are quite common in leprosy requiring hospital admission to prevent complications.

Keywords: Hansen’s Disease; Histopathology; Bacillary Index; Skin Biopsies; Leprosy Reactions. 

 Background and Objectives: Fine need aspiration cytology (FNAC) has become a rapid, cost effective investigative method for obtaining reliable tissue diagnosis especially for the site like head and neck where considerable overlapping of various structures makes it difficult to reach exact diagnosis. The present study is taken up to evaluate role of FNA in management and diagnosis of various head and neck lesions and to study the spectrum of various lesions encountered. Materials and Methods: Present study is a retrospective descriptive study. A total of 570 cases of palpable head and neck masses were subjected to FNAC at cytology OPD using 2324 gauge needle and 10 ml syringe. Detailed cytological assessment was done. Results: Out of 570 cases, thyroid lesions accounted for 38.07%, lymph node lesions were 33.19%, salivary gland lesions were 9.29% and skin/soft tissue and miscellaneous were 19.47%. Among thyroid lesions goitre (66.8%) accounted for maximum number of cases, metastatic carcinoma(33.86%) was the commonest lymph node lesion followed by tubercular lymphadenitis (19.57%) and pleomorphic adenoma (38.07%) was the commonest among salivary gland lesions. Conclusion: This study concludes that FNAC is quite effective, simple investigative procedure with very good patient compliance. Use of FNAC should be encouraged as an investigation for initial diagnostic evaluation of head and neck lesion and as a tool to avoid unnecessary surgical procedure and its complications.

Keywords: Head and Neck Lesions; Diagnostic Tool; Thyroid Lesions; Tubercular Lymphadenitis.

Introduction: Bladder cancer is the 7t hmost common cancer worldwide and constitutes for 90% of all primary tumors of the same. The current study was undertaken to study the histopathological lesions of the bladder and to determine the association of age and sex, histopathological variants and tumor grading and staging. Objectives: To study the histomorphological patterns of various lesions in bladder biopsies and to analyze the frequency of different urothelial lesions. Methods: The study was conducted from June 2015 to July 2017, in department of Pathology, at DY Patil Medical College, DPU, Pimpri, Pune. Related clinical history of all the cases was recorded. Results: Total of 73 bladder biopsies were analyzed. Clinical symptoms of hematuria, abdominal pain and an increased frequency of micturition were the usual presenting symptoms. Male dominance was noted as compared to females with M: F ratio of 2:1. Maximum incidences of cases were noted in the age group of 61 to 80 years. Neoplastic lesions comprised a total of 74.28% in contrast, the benign lesions were 27.3%. Amongst the malignant lesions majority were of urothelial carcinoma (54.7%) followed by papillary urothelial neoplasm of low malignant potential, low grade papillary urothelial carcinoma and sarcomatoid urothelial carcinoma (2.7%) and urothelial dysplasia (8.21%). Conclusion: Neoplastic lesions were more common than nonneoplastic, most common being urothelial carcinoma and their histopathological variants. Significant male predominance was noted with hematuria being the most common presenting symptom and advanced age had an overall poor survival rate. Pathological grading plays a key role in the prognosis of these tumors.

Keywords: Urothelial Lesions; Hematuria; Urothelial Carcinoma; Histological Variants. 

Fine needle aspiration cytology (FNAC) is a valuable adjunct to preoperative screening in the diagnosis of thyroid nodules and has emerged as one of the wellestablished firstline diagnostic techniques. In most cases, it can distinguish between benign and malignant lesions. FNAC is a rapid, efficient, costeffective, relatively painless procedure with a high diagnostic accuracy. It has high rate of sensitivity and specificity in diagnosing thyroid neoplastic lesions. Purpose of this study was to evaluate the effectiveness of FNAC in the diagnosis of neoplastic thyroid lesions and confirmation of the diagnosis by histopathological study and report the malignancy risk for FNA of thyroid lesions. The present study was carried out in our institute during the January 2012 to September 2016. This study was a retrospective study and a comparison was drawn between FNAC results and final histological diagnosis. In our study, 745 cases of thyroid FNAC smears were analyzed and cytohistopathological correlation was done in 39 cases of neoplastic lesions. 33 cases werediagnosed as neoplastic lesions by FNAC. The overall surgical yield of malignancy by FNAC was 26.84%. In our study, FNAC diagnosis had 79.84% sensitivity, 97.6% specificity, 6.06% false positive rate, 8.9% false negative rate, and 91.86% accuracy. Hence, FNAC has been proven to be an efficient and guide the clinical treatment of patients with thyroid nodules.

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

Background: Buccal mucosa cancer is the most common oral subsitewhichis aggressive in nature, had high rate of locoregional recurrence and mortality in India. Objective: The aim of study was to evaluate prognostic factors for buccal mucosa cancer by univariate and multivariate analysis. Materials and Methods: A retrospective study was performed by reviewing medical records between 2013 and 2016. Results: A total 198 buccal mucosa cancer were selected within the study criteria which includes125 (63.1%) male and 73 (36.9%) femaleparticipant with mean age of 54 years. Of 198 patients, 24 (12%) recurrence and 7 (3.5%) diseasespecific death was reported during followup period of 34 months (Median, 24 months).The KaplanMeier analysis shows 1st, 2nd and 3rdyear overall survivals were 90%, 72% and 48%, respectively. In univariate analysis,patients age, socioeconomic status, risk habits, clinicalTNM stage, tumor depth and cell differentiation were significant at 95% confidence interval (CI), p<0.05 and further validated by multivariate analysis.The multivariate coxregressionhazard risk (HR) revealed, age [HR, 0.593 (0.974 0.361), p=0.039], socioeconomic status [HR, 1.82 (1.432.55), p=0.048], risk habits [HR, 2.08 (2.1684.39), p=0.027], TNM stage [1.27 (1.183.15), p=0.037], tumor depth [HR, 4.08 (1.2213.58); p=0.021] and cell differentiation [HR, 2.45 (1.274.73); p=0.007]astrue independent prognostic factor at 95CI, p<0.05. Conclusion: Although several factors related to disease, the present study revealed that age, socioeconomic status, risk habits and clinical characteristics of TNM stage, tumor depth and cell differentiation may influence the survival outcome of patients.

Keywords: Clinical Stage; Multimodality Treatment; Oral Cancer; Prognostic Factor; Risk Habits. 

Background: Pathologists can quickly transmit the microscopic images photographed in a certain location to remote centers for analyzing the images. Gleason scoring system forms an important prognostic parameter for therapeutic decision and in the overall management of prostate cancer patients. Aims: 1. To study various histopathological patterns of prostatic carcinoma. 2. To evaluate the reproducibility of modified Gleason scoring system and Grade group in prostate carcinoma on microphotographs. Material and Methods: A retrospective study of invasive prostate cancer cases was conducted from January 2014 to October 2016. It was an analytical type of study at a rural tertiary care institute. Histopathology slides of prostate adenocarcinoma slides were retrieved, reviewed, scored and graded according to World Health Organization [WHO] 2016. The representative images captured by 13 megapixel mobile camera were sent to two pathologists by Email and were evaluated separately. The primary Gleason pattern, secondary Gleason pattern, total Gleason score and Grade groups were documented. Concordance and kappa statistics was applied. Results: Twelve cases were analyzed. Concordance was better in secondary Gleason pattern when compared with primary Gleason pattern, total Gleason score and Grade group. The present study showed substantial agreement in primary Gleason pattern; and substantial to almost perfect agreement in secondary Gleason pattern, Gleason total score and grade group. The overall performance of both the pathologists was satisfactory. Conclusions: Modified Gleason scoring system and grade group has good reproducibility in prostate carcinoma on microphotographs. The analysis of representative images is a feasible and time saving exercise.

Keywords: Adenocarcinoma; Gleason Score; Histopathology. 

Background: Blood transfusion is a critical and lifesaving procedure as even a unit of blood can save a patient in need [1]. Safe and adequate supply of blood and blood products is a major public health issue faced globally. One of the important step to warrant blood safety is by properly following the guidelines of criteria for blood donor selection.A large number of donors are deferred from donating blood for several reasons either temporarily or permanently. Hence it is important to understand the various causes of donor deferral so that preventive measures can be undertaken to reduce the deferral rate in future. The aim of this study is to provide safe blood to patients and to understand pattern of donor deferral in our demographic area. Materials and Methods: A retrospective study was conducted to evaluate the profile of deferred blood donors for a period of 3 years from January 2014 to December 2016. Data of different deferral patterns were obtained from donor deferral register.Every donor was thoroughly evaluated by physical examination, hemoglobin estimation, weight, age, blood pressure, pulse rate, temperature. Donors who did not meet the required criteria were deferred and recorded in the donor deferral register. The deferred donors were analysed based on the causes of deferral. Results: A total of 11831 people came to donate blood during the period of study, out of whom 11675 (98.6%) were males and the rest 156 (1.3%) were females. Common causes of donor deferral included low hemoglobin (43%), hypertension (16.5%), alcohol consumption (13.7%), vaccinations (5.2%), Tatooing (4.4%), underweight (2.8%) and medications (2.2 %). Conclusion: Deferral is a form of rejection and it could represent loss of time for both blood donors and blood bank and the importance of explaining the status of deferral cannot be ignored. Efforts must be taken to increase awareness among deferred donors and encouraging them for future donation by donor education helps to reduce much of the loss of precious units of blood.

Keywords: Deferral; Donor; Low Hemoglobin. 

Background: Papulosquamous disorders assume considerable importance because of their frequency of occurrence. As all the lesions are characterized by scaling papules and plaques, clinical confusion may occur in their diagnosis and hence these lesions are commonly misdiagnosed. Separation of each of these lesions becomes important because, for each disease, the treatment and prognosis is disease specific. Aim: To analyse various papulosquamous disorders of skin, to study the histopathological features and also to know the correlation between clinical and histopathological diagnosis. Materials and Methods: This study was done in the Department of Pathology, Narayana medical college and hospital, Nellore, Andhrapradesh, India for a period of 1 year from June 2016 to June 2017. Total 108 cases of papulosquamous skin disorders were studied. Results: Psoriasis was the commonest lesion (53.70%), followed by Lichen planus (29.63%), Pityriasis rubra pilaris (7.41%), Lichen nitidus (5.55%) and Parapsoriasis (3.70%). Papulosquamous skin lesions were common in 2140years age group (38.9%). Papulosquamous skin lesions were more common in males, than females with a male:female ratio of 1.7:1. Both age and sex distribution of cases showed significant p value < 0.001. In our study, histopathology confirmed the clinical diagnosis in 42.6% of cases. Histopathology gave the diagnosis when differential diagnosis were there in 51.85% of cases and in 5.55% of cases, histopathological diagnosis was different from clinical diagnosis. Conclusion: Our study concludes that histopathology is the gold standard investigation for diagnosis, categorization and clinicopathological correlation of papulosquamous skin disorders.

Keywords: Histopathology; Lichenplanus; Papulosquamous Disorders; Psoriasis; Skin. 

Background and AIM: Blood transfusion services aim at providing adequate, safe and quality blood to meet the demands for clinical blood transfusion. The aim of the blood utilization management system is to optimize the utilization of blood products and minimize wastage of blood resources. The present study aims to highlight the services that are provided in our blood bank and special focus on utilization of blood components. Materials and Methods: Present study is a retrospective descriptive study. All the data related to blood donation, blood grouping and Rh (Rhesus) typing, TTI (Transfusion transmitted infections) testing, blood component separation, blood issue and discard details of 2016 were collected from the blood bank. Detail analyses of type of blood donation, TTI results, components issue and discard rates were done. Results: A total of 7,433 blood units were drawn, out of which 98.3% were voluntary blood donation. On TTI testing prevalence of HIV, HbsAg, HCV and Syphilis among blood donors was 0.17%, 0.87%, 0.04% and 0.12%. A total of 9,954 transfusions were done and most common component utilized was RCC (Red cell concentrate) in 46.35% followed by FFP (Fresh frozen plasma) in 29.37% cases. Discard rate was 2.89% cases. The most common reason for discard was found to be TTI positivity followed by expiry. Conclusion: Despite the current advances in technology in healthcare delivery, access to safe blood and blood products and their judicious use remains a big challenge. The study demonstrates transfusion services and trend of utilization of blood and its components. The results allow the identification of blood requisition practices that can be improved, help appraise the effects of blood safety measures and assist in planning future blood supply.

Keywords: Blood Component; Blood Transfusion; Blood Utilization. 

Population explosion has posed a serious threat to the progress and survival of mankind. The Oral contraceptive pills (OCPs) quickly have become the most effective, acceptable and reversible contraceptive. OCPs contain an estrogen and progesterone. Serious side effects of OCPS are cardiovascular diseases such as myocardial infarction, thrombosis, cerebral hemorrhage, and arteriosclerosis. Many epidemiological studies have clearly indicated that arteriosclerosis and myocardial infarction are closely linked to an impaired lipid and lipoprotein metabolism and from such studies it’s also documented that treatment of the lipoproteinemia will reduce the risk of coronary heart disease.

Keywords: Oral Contraceptive Pills (OCPs), High Density Lipoprotein Cholesterol (HDL); Low Density Lipoprotein Cholesterol (LDL); Total Cholesterol (TC) and Triglycerides (TG). 

Context: The classification of breast cancers into subgroups on the basis of gene expression patterns is often regarded as the gold standard, but its use remains limited due to the expense involved. Consequently there is interest in using Immunohistochemical (IHC) markers to classify tumors into subtypes that are surrogates for those based on geneexpression profiling. Aims: To classify molecular subtypes of breast carcinomas based on the surrogate IHC markers and to evaluate the correlation between these subtypes and other clinical parameters Settings and Design: The study was done from January 2014 to June 2016 on 70 cases of modified radical mastectomy specimens diagnosed as invasive breast cancer on histopathological examination. Methods and Material: The Immunohistochemical evaluation of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2/neu) were done on formalin fixed paraffin embedded tissue sections and are compared with the age of the patients, histological grade and tumor stage. Statistical analysis used: Analysis of variance for continuous variables and chisquare test for categorical variables. Results: The surrogate classification consisted of 36 cases of luminal A, 16 cases of luminal B, 13 cases of triple negative/basallike tumors and 05 cases of HER2/neu subtype. The subjects of luminal A subtype were older, had a well/ moderately differentiated histological grade, presented with small tumor size, less number of lymph nodal metastasis and had Early stage breast cancer. Subjects with triple negative tumors were younger, had moderately/ poorly differentiated histological grade, presented with large tumor size, high lymph nodal metastasis and advanced stage breast cancer. Conclusions: IHC markers of breast cancer can be used as surrogate markers for molecular classification and are comparable with other prognostic markers.

Keywords: Breast Carcinoma; Immunohistochemical Markers; Molecular Classification; Progesterone Receptor; Estrogen Receptor. 

Aim/Objective: The objective of this study was to evaluate the diagnostic accuracy of FNAC in various salivary gland lesions and it’s correlation with histopathology, which helps in the appropriate management of the patient. Materials and Methods: A total of 65 FNA were performed on salivary gland lesion from September 2016 to August 2017 at department of pathology of a Tertiary care centre. Surgically resected, formalin fixed specimen were received, they were processed and slides were prepared. The cytological and histopathological stained slides were studied, analysed and correlated clinically. Results: The cytological features of 65 cases were studied and following lesions were observed in FNAC study of 65 cases: 28 were pleomorphic adenomas (43%), 15 were of chronic sialadenitis (23%), 4 were Warthin’s tumours (6%), 4 were mucoepidermoid carcinomas (6%), 4 were benign parotid tumour( 6%), 2(3%)were carcinoma ex pleomorphic adenomas, 2 were metastatic deposits(3%), 4 were cystic lesions (6%) and 2 were malignant tumours (3%)(unclassified). The sensitivity, specificity, positive predictive value and negative predictive value of present study is 78.5%, 75%, 72.4%, 91.6%, 40.9% respectively. Conclusion: FNAC of the salivary gland is a safe and reliable technique in the primary diagnosis of salivary gland lesions. Though the rate of characterization of specific type of tumor is lower, due to variable cytomorphology in case of FNAC, histopathological examination may prove to be accurate and gold standard for diagnosis. This study implies that FNAC of the salivary gland tumours is safe, simple, rapid and costeffective diagnostic method for the patient.

Keywords: FNAC; Sensitivity; Specificity; Cytology; Histopathology. 

Background: Ophthalmic pathology is a distinct branch of pathology that deals with various ocular lesions excised by ophthalmologists. They fall into various categories such as inflammatory, benign, premalignant and malignant and show varied clinical presentations. The definitive diagnosis depends on histopathological study of these lesions. Material and Methods: The present study was conducted as a cross sectional study in the department of pathology, of our tertiary care institute. Total 124 cases included in the study during a period of 2 and half years, i.e. January 2015 to August 2017. Results: Out of total 6301 cases in 2 and half years, ocular lesions were 124 cases (1.96%), maximum cases were in the age group of 3140 years. Among ocular lesions, maximum cases received were eyelid lesions followed by the lesions of conjunctiva. Among total ocular lesions, Nonneoplastic lesions comprised of 32.26%, benign lesions were 54.84%, premalignant lesions were 4.03 % and malignant lesions were 8.87%. Conclusions: Most common ocular malignancy was squammous cell carcinoma and most common nonneoplastic condition found was chronic dacryocystitis. Every lesion presents in a variety of clinical forms in different patients. Hence each lesion must be excised and proper histopathological diagnosis must be made to exclude malignancy.

Keywords: Dacryocystitis; Eyelid; Ocular Lesions. 

Background: Carcinoma breast is the one of the most common causes of cancer death among women. Early diagnosis and effective treatment of the disease are immensely important. The increasing number of options for treatment of carcinoma breast has made the prognostic evaluation of the disease even more important. Proliferation plays an important role in clinical behaviour of invasive carcinoma breast. Ki67 binding, is an objective measurement of cell proliferation which significantly aids in the management of the patients with carcinoma breast. Objectives: 1. Study of expression of Ki67 in primary breast carcinomas. 2. Correlation of Ki67 expression with the histopathological grade of breast carcinomas. Methodology: Forty modified radical mastectomy specimens received at the department of pathology, MIMS, Mandya from January 2015 to June 2016 were examined for gross and microscopic features. Immunohistochemistry was used to study the Ki67 expression. Ki67 status was correlated with tumour grade according to Nottingham modification of Scarff Bloom Richardson grading (NSBR grading. Results: Of 40 cases of carcinoma breast, 97.5% of the cases were positive for Ki67. The range of Ki67 score was 095%. Mean Ki67 in the study was 32.85%. Majority of the cases (62.5%) had high Ki67 expression. There was a significant statistical association between Ki67 expression with grade of the tumor(p value = 0.032). Conclusion: Our study data indicates that, high Ki67 expression is associated with high tumour grade. Conclusively, proliferative activity determined by Ki67 expression may reflect the aggressive behaviour of breast carcinoma. Ki67 detection provides valuable information about proliferative activity of cells therefore, it is necessary to combine this with other prognostic parameters for better evaluation of patient’s outcome as well as treatment decision.

Keywords: Immunohistochemistry; Ki67; Breast Carcinoma; Nottingham Modification of Scarff Bloom Richardson Grading (NSBR Grading).

 Not provided.

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.