Indian Journal of Pathology: Research and Practice

 Background: Intraoperative squash cytology is a simple and reliable technique for rapid intraoperative diagnosis of neurosurgical specimens. Intraoperative squash cytology is a fairly accurate diagnostic modality which can be used in place of frozen sections. Aim: To assess the diagnostic accuracy of the squash preparation and to compare it with the histopathology sections. Materials and Methods: This study was conducted over a period of eight 8 years (May 2010 to June 2018) which included 131 patients with CNS lesions. The cytological preparations were stained by the rapid H & E method. The squash interpretation was compared with the paraffin section diagnosis. Results: Of the 131 patients, Squash cytology diagnosis was offered in all the cases. With hematoxylin and eosin-stained histopathology sections as the gold standard, the diagnostic accuracy of squash cytology was 95.4% (125/131). Among these cases, gliomas formed the largest group comprising of 50 cases (38.1%). The accuracy of squash cytology in this group was 94% (47/50). Conclusions: CNS squash preparations can be used for rapid and reliable intraoperative diagnosis for CNS lesions. 

Keywords: Central Nervous System Lesions; Intraoperative  Diagnosis; Squash Preparation.

 L-lactate is the end product of anaerobic glycolysis. It is derived predominantly from white skeletal muscle, brain, skin, renal medulla and erythrocytes. Lactate dehydrogenase catalysis the reduction of pyruvate to lactate. There are two major clinical settings in which lactic acidosis occur: (1) Conditions associated with hypoxia e.g. shock, congestive heart failure, myocardial infarction, blood loss and pulmonary edema. (2) Metabolic or drug/toxin related disorders like diabetes mellitus, hepatic disease and neoplasia. Objective of study is to find out the variation of lactate level in diabetic patient taking hypoglycemic drugs and also the correlation between fasting blood glucose and lactate in diabetic patients. It is an observational study in which 50 control subjects (fasting blood sugar 110 mg/dl) considered as case, all diabetics irrespective of treatment (OHA/Insulin). Age group 35-70 yrs. Lactate level ≤1.9 taken as normal. Lactate level among control group found to be 1.12±0.18 (mean±SD) with fasting blood sugar level found to be 92.99±5.64 (mean ± SD). In control group lactate level among control group found to be 2.03±0.23 (mean±SD) with fasting blood sugar level found to be 115.28±2.83 (mean±SD). The two-tailed pvalue is less than 0.0001. By conventional criteria, this difference is considered to be extremely statistically significant. In this, the lactate level found to be 2.03±0.23 among case group. This study also shows that after using metformin some individuals have fasting blood sugar more than 110 mg/dl 115.28±2.83.There is slight increase in lactate level among case group 2.03±0.23 These observations suggest that accumulation of metformin may not be as significant with respect to high arterial levels of lactate. 

Keywords: Diabetes Mellitus; Blood Sugar Level; Metformin; Lactate Level; Lactic Acidosis.

 Introduction/Background: The aim of the present study is to determine the expression of p16INK4a and its prognostic utility in the head and neck squamous cell carcinomas (HNSCC). Squamous cell carcinoma of the head and neck is a major public health problem in developing countries. A subset of head and neck cancer is associated with the human papillomavirus (HPV) [1]. Viral infection is closely correlated with expression of p16INK4a in these tumours. p16INK4a is the strongest independent prognostic marker in HNSCC and is associated with favourable prognosis [1]. Materials and Methods: The present study is retrospective study done during the period from June 2016 to July 2017. A total of 52 cases were taken and histological grading was done according to WHO criteria. p16INK4a expression was determined by immunohistochemical staining on the paraffin embedded tissue sections. Results: Out of 52 cases, 41/52 cases (78.8%) were positive for p16INK4a and remaining 11/52 cases (21.2%) were negative for p16INK4a. Expression of p16INK4a was graded accordingly. Conclusion: p16INK4a is an independent prognostic marker for HNSCC. p16 protein overexpression is very sensitive for the presence of transcriptionally active HPV and is widely available and also easy to interpret the test result. Expression of p16INK4a has major impact on treatment response and survival in patients with HNSCC. 

Keywords: Head and Neck Squamous Cell Carcinomas (HNSCC) 

 Introduction: Breast lump is the commonest presentation of breast diseases. Diagnosis of breast diseases can be made out based on history, physical examination and investigations, like cytology, histology and radiology. Several studies have shown that triple tests consisting of clinical, cytopathological and radiological examinations are more accurate, when all the three are positive; the accuracy approaches almost 100% for malignancy. Materials and methods: A 3 years retrospective study was performed in the Department of Pathology in a tertiary care centre. The cytological slides and corresponding histological slides were retrieved from the archives, and the cytological smears of palpable breasts were assessed. Statistical analysis: concordance study between conventional, MMSI and comparison with Histopathology.

Results: A total 226 patients with palpable breast lump were included in the study. A total of 18 cases were diagnosed by histopathology and there was 100% correlation between conventional and post MMSI diagnosis. A total of 144 cases were diagnosed in this category by histopathology 134 (94.4%), cases showed correlation, whereas 2 (1.4%) were under diagnosed as non proliferative breast diseases and 6 (4.2%) were over diagnosed as carcinoma by conventional cytology. Proliferative breast diseases with atypia. Out of 6 cases diagnosed on histopathology, MMSI showed 100% correlation, whereas conventional cytology 2 cases were under diagnosed as category 2 and 2 cases were correctly categorized as category 3, and 2 cases were over diagnosed as category 4. Carcinoma in situ/ Carcinoma. Out of 58 cases diagnosed by histopathology, 52 (89.7%) showed correlation with MMSI and conventional smears. 6 (10.3%)cases were under diagnosed and categorized as category 3 by MMSI. 4 cases (6.9%) were under diagnosed and categorized as category 2 and 2 cases (3.4%) were under diagnosed and categorized to category 1 by conventional cytology. Conclusion: The present study concludes that Masood’s modified scoring index has better diagnostic accuracy than conventional cytology method in diagnosing proliferative breast diseases without atypia and proliferative breast diseases with atypia, which is very useful in management of patents. 

Keywords: Breast Carcinoma; Fine Needle Aspiration Cytology; Tumor Grading; Proliferative Breast Diseases; Atypia.

 Background: Soft tissue tumors are mesenchymal proliferation, that occur in extraskeletal, non-epithelial tissue of the body, excluding the viscera, covering of brain and lymphoreticular system. Benign tumors are more common than malignant soft tissue tumors. Histopathological examination of soft tissue tumor is gold standard method for initial diagnosis and management of patient accordingly. Aims & Objectives: 1) To study the occurrence of soft tissue tumors in relation to age, sex and anatomical site distribution. 2) To study histopathological spectrum of soft tissue tumors. 3) To study frequency of occurrence of benign and malignant soft tissue tumors. Material and Methods: This retrospective study include total 97 soft tissues biopsy specimens which were received from January 2015 to July 2018. After processing and microscopic examination of tissue sections histopathological diagnosis given and tumors were classified according to WHO classification and result were correlated with clinical details of patient. Result: Peak age of incidence of soft tissue tumors was between 2nd to 5th decades. Male: Female ratio was 1:1. Benign tumors (97.93%) were more common than malignant tumors (2.06%). Most common soft tissue tumor was adipocytic tumors. Conclusion: Proper gross examination of the specimen and adequate sampling of the tumors and histopathological diagnosis of tumor by light microscopic evaluation of H&E stained sections remain the gold standard technique for initial diagnosis and further management of soft tissue tumors and is sufficient for the majority of cases. 

Keywards: Soft Tissue Tumor; Histopathology; Benign; Malignant