Indian Journal of Pathology: Research and Practice

CMF is said to be the most uncommon benign tumors in the oral cavity. Very few cases in the oral cavity have been reported so far. Its uniqueness & rare occurrence in the Head & Neck area has made us report the dental image of the same.

Keywords: Chondromyxoid Fibroma; Benign Tumor; Giant Cell Tumor. 

Introduction: The skin is the largest organ of the body. Skin tumors are abnormal growths of tissues that can be malignant or benign. Tumors of cutaneous appendages are uncommon, classified into tumors of sweat gland, hairfollicle and sebaceous gland. Aim: To study the spectrum of skin and adnexal tumors with respect to age, sex, and histopathological pattern. Materials and Methods: Present study is a retrospective study from Jan 2016 to June 2017 at department of pathology Shimoga institute of medical sciences, shimoga. All the specimens of skin /cutaneous adnexal tumors were analyzed and lesions were categorized according to WHO classification system. Results: out of 50 skin tumors, 38 were benign and 12 were malignant with benign to malignant ration of 3.16:1. Incidence of benign epidermal/keratinocytic tumors were highest 29 cases (58%), followed by adnexal tumors 13 cases (26%) and melanocytic tumors 8cases (16%). Maximum number of benign tumors was seen in 3rd and 4th decade of life and malignant tumors in 6th and 7th decade of life. Conclusion: Benign tumors were common in middle age where as malignant tumors showed an ascending trend in age. Most of the tumors were male predominant .Melanocytic tumors were female predominant. Keratinocytic tumors were the commonest lesion which included warts, seborrheic keratosis and fibroepithelial polyps (8% each). Among the malignant tumors squamous cell carcinoma (SCC) was commonest (66.6%) followed by basal cell carcinoma (22.2%).

Keywords: Skin/ Adnexal Tumors; Age; Sex Distribution. 

Background: Soft tissue tumors are defined as non epithelial, extra skeletal tissue of the body exclusive of the reticulo-endothelial system, glia, and supporting tissue of various parenchymal organs. Soft tissue tumours constitute a large and heterogenous group of neoplasms. WHO has classified soft tissue tumors in different categories like Adipocytic tumors, Fibroblastic/Myofibroblastic, Fibro-histiocytic, Smooth muscle, Pericytic, Skeletal muscle, Vascular, Chondro-osseous & tumors of uncertain differentiation. These are further subdivided into benign, intermediate & malignant. This study aims to analyze the histopathological findings of soft tissue tumors and their distribution according to age, sex and site of occurrence in patients. Aims and Objectives: To study the macroscopic and microscopic pathology of benign and malignant soft tissue tumour and there clinico-pathological correlation at rural set up. Materials and Methods: The study was conducted in Indian Institute of Medical Sciences Medical College, Warudi Dist. Jalna, from 1st of January 2017 to November 2017. A Cross sectional study of 151 cases of soft tissue tumors were carried out in details. A pretested proforma was used to classify each tumor and details like age, sex, clinical features, gross and microscopic findings were noted. Results: The most common soft tissue tumor in the study were benign tumors (139 cases), followed by malignant (8 cases) and four cases were reported as intermediate. Lipomas were the most common benign tumors accounting for 99 out of 139 cases. Benign peripheral nerve sheath tumors were the next most common tumor accounting for 22 cases. Benign vascular tumors (10) and benign Fibroblastic-Myofibroblastic tumors (5) accounted for 15 cases. Of 10 cases of benign vascular tumor, all cases were of hemangioma. Of 22 benign peripheral nerve sheath tumors, 12 cases were reported as neurofibroma and 10 schwannomas. Of 7 cases of Fibrohistiocytic tumor, 3 cases were benign, 2 cases of intermediate (Dermatofibrosarcoma protuberance) and 2 cases of malignant fibrous histiocytoma (MFH). Of 8 cases of Fibroblastic/Myofibroblastic tumor, 5 cases were of Benign and 3 cases of malignant variant (Two Fibro sarcoma and one low grade fibromyxoid sarcoma). 8 out of 151 cases were malignant tumors, 2 cases were malignant fibrous histiocytoma (MFH) and 2 were fibrosarcoma whereas malignant peripheral nerve sheath tumor (MPNST), Liposarcoma, low grade fibromyxoid sarcoma and Embryonal Rhabdomyosarcoma accounted for one case each. Conclusion: Benign soft tissue tumors outnumbered malignant tumors by a ratio of 17:1. Lipomas were the most common benign tumors and Malignant fibroblastic/Myofibroblastic tumors were the most common malignant tumors in the present study. Most patients with soft tissue neoplasm presented with painless mass. Sarcomas, for the most part develop as deeply located mass. Hematoxylin and eosin stained sections represented the mainstay of diagnosis.

Keywords: Tumors; Hematoxylin; Fibrosarcoma; Parenchymal Organs. 

Background: Micronuclei (MN) scoring has been used as a biomarker of chromosomal damage, genome instability and cancer risk. Micronuclei scoring can be exploited in the screening of high risk population of a specific cancer. Aims: 1. to score the micronuclei in the fibroadenomas and infiltrating ductal carcinoma (IDC). 2. To compare the micronuclei scores in fibroadenomas and various grades of infiltrating ductal carcinomas. Methodology: A retrospective study was done in the Department of Pathology including thirty cases of fibroadenoma and thirty cases of infiltrating ductal carcinoma. Micronuclei scoring was done on Papanicolaou and Hematoxylin and Eosin stained smears of these cases. Carcinoma were graded by Robinson cytological grading. Statistical analysis was done to assess the difference in MN scoring between the Fibroadenoma group and IDC. Results: Mean micronuclei score range was 1.9±1.7 in Fibroadenoma and 25.1±11.7 in Infiltrating duct carcinoma. It was 20.2±10.3, 23.1±9.5 and 29.9±12.4 in IDC cytological grades 1,2 and 3 respectively. Statistical analysis showed significant increase in MN score in ductal carcinoma when compared with fibroadenoma.

Keywords: Micro Nuclei; Fibroadenoma; Infilreating Ductal Carcinoma.

Introduction: Computed Tomography (CT) guided percutaneous fine-needle aspiration cytology (FNAC) of suspicious lung lesions is a widely accepted diagnostic method with relatively low cost, negligible mortality and limited morbidity. CT guided FNAC is helpful in distinguishing between benign and malignant lesions and confirming the diagnosis which would help the clinicians in deciding the therapeutic management. Aims and Objectives: The purpose of this study is to evaluate the pathological spectrum of lung lesions through CT guided FNAC. Material and Methods: This is a retrospective study which was carried out in the department of Pathology, Yenepoya Medical College, Mangalore. Fifty patients having lung space occupying lesion (SOL) on chest X-ray and CT scan were selected for the procedureand were included in the study. Results: Out of 50 cases, 37 were males and 13 females. Age range was from 25 to 80 years with mean age of 58.8 yrs. Majority were Non Small Cell Lung Carcinoma (NSCLC) (13 cases, 26%), of which 3 were suggestive of primary adenocarcinoma and one was a case of squamous cell carcinoma(SCC), followed by 8 cases of adenocarcinoma (16%) (Figure 1) , 2 cases of squamous cell carcinoma (4%), 2 cases of small cell carcinoma (4%), 4 cases of poorly differentiated carcinoma(8%) and one case each of metastatic carcinoma, neuroendocrine origin and fungus (Aspergillosis). Conclusion: There is increasing role of cytology in diagnosing both neoplastic and nonneoplastic lesions of lung. Performing FNAC is much easier and helps in prompt diagnosis and management of patients.

Keywords: Lung; Aspiration; Adenocarcinoma; Aspergillosis. 

Objective: To determine the prevalence of low sperm count (oligozoospermia) & azoospermia (absence of sperms) in seminal plasma infertile male & to assess the pattern & distribution of abnormal sperm parameters in infertile men. Methods: The descriptive cross-sectional study was carried out at the Department of Pathology R.D.Gardi Medical College, Ujjain from August 2016 to August 2017. A total of 100 consecutively consenting male partners of women fulfilling the inclusion criteria between 20 and 45 years of age were approached. Semen analysis was performed according to methods and standards defined by the World Health Organisation (WHO). Samples were categorised into normozoospermia, oligozoospermia and azoospermia on the basis of sperm count. Results: Out of the 120 males approached, 20 (20) had to be left out either because of their unwillingness or inability to pass semen. The study sample comprised of 100 response rate (83.33%) normozoospermia was observed in 47 (47%) males, azoospermia in 9 (9%), and oligozoospermia in 44(44%) The oligozoospermic samples had low ejaculated volume, but significantly higher percentage of non-motile sperms 62% ( normal 33%) and abnormal morphology 43% (Normal 31%) in comparison to normozoospermic samples. Conclusion: Semen analysis is the basic diagnostic test that should be performed on all couples or singles that are suffering from infertility and or are concerned about having infertility. The purpose of the test is to detect possible abnormalities and/or “weaknesses “within the sperm. Sperm concentration, motility and morphology are related to each other, factors that cause deterioration of one of them usually also have negative impact on the other two as well.

Keywords: Infertility; Semen; Sperm; Motility; Normozoospermia Oligozoospermia; Azoospermia; Asthenozoospermia; Teratozoospermia. 

Background: Breast cancer is 2nd most common malignancy in Indian women. FNAC is first line of investigation for breast lump. Aims: 1)To diagnose and classify breast lesions on cytology according to probabilistic approach. 2) To evaluate accuracy of probabilistic approach by correlating with Histopathological diagnosis wherever possible. Study Design: Prospective study of FNACs classified into positive, suspicious, proliferative with atypia, proliferative without atypia and unremarkable categories. Results: Total 237 cases were studied. The probability of finding carcinoma on histopathology from positive, suspicious and proliferative with atypia categories were 100%, 80% and 43.75% respectively. All the lesions from proliferative without atypia and unremarkable categories were benign on histology. There were no false positive cases. The specificity and sensitivity were 100% and 90.54%. Conclusion: The probabilistic approach with defined diagnostic criteria is an accurate, uniform and reduces inter-observer variability. It minimizes false positives without compromising sensitivity for detecting carcinoma. This scheme of reporting breast FNA provide the rational basis for guidelines for management of breast lesions.

Keywords: Probabilistic Approach; Breast FNAC; Positive for Carcinoma. 

Introduction: The prevalence of hormone receptor positive breast cancer in Asian countries is found to be lower than the western world where more than 50% of the tumors express hormone receptors. Studies have found consecutive decrease of ER, PR expression as a measure of differentiation of the tumour with low grade having the highest and high grade having the lowest ER/PR expression. Detection of vascular invasion in the primary tumor is a marker of metastatic potential and has prognostic significance, particularly in the lymph node negative group and helps to predict both recurrence and long-term survival. Aims and Objectives: To study the expression of ER, PR and HER2/neu status by immunohistochemistry and correlation of clinicopathological parameters with hormone receptor status and HER2/neu expression. Results: In the present study the age range of the patients was between 35-80 years. Out of 53 cases, majority (72%) of them were invasive ductal carcinoma. Other tumors included medullary carcinoma, lobular carcinoma, metastatic carcinoma and poorly differentiated carcinoma. Nineteen out of 53 tumors (36% of the cases) showed triple negativity and only one tumor showed triple positivity. Of the total cases 32% of the tumors were ER+/PR+, 17 % ER+/PR- and 4% showed ER-/PR+. Conclusion: This study highlights the importance of various prognostic factors and hormone receptor status evaluation that will aid in therapeutic intervention.

Keywords: Breast Cancer; ER; PR; HER2/neu; Lymphovascular. 

Background: The pathological bone lesions are wide array from inflammatory to neoplastic conditions. The X-ray helps in exact location of lesion, but most often times it is very difficult to diagnose and differentiate. This problem can be overcome with the help of histopathological study. Objective: To study histopathological spectrum of bone lesions and correlate them with age, gender, site and type of lesion. Materials and Methods: The present Descriptive, Cross sectional study was carried out at Dr. PSIMS and RF from December 2014 to November 2016. A total of 82 bone biopsies were received. Histopathological examination of the bone specimens was performed after detailed clinical and radiological examination. After fixation, decalcification, processing and H&E staining, histopathological diagnosis was made. This study was approved by the institutional ethical committee. Result: Total 82 cases of bone biopsies were analyzed. Out of 82 bone lesions 65(79.3%) were Non-neoplastic, 16(19.5%) cases were Neoplastic and 1 (1.2%) case was inadequate for diagnostic evaluation. Benign bone lesions were more preponderant than malignant with 13(15.5%) and 3(3.7%) cases respectively. Chronic osteomyelitis was the most common non- neoplastic lesion. Osteochondroma and Osteosarcoma were most common benign and malignant lesions respectively. Tibia was most common bone involved in benign lesions and femur for malignant lesions. Maximum number of bone lesions present in the age group between 40-60 years, with male preponderance. Conclusion: An integrated use of clinical, radiological, and histopathological findings were recommended to increase accuracy of diagnosis and for better management of the patient

Keywords: Bone Lesions; Osteochondroma; Chronic Osteomyelitis; Histopathology; Osteosarcoma; Chondrosarcoma. 

Background: Gastrointestinal polyps are proliferative or neoplastic mucosal lesions, projecting into gastrointestinal lumina. Certain polyps like adenomatous polyps have more clinical importance because they have the risk of malignancy. Aim: The aim of our study is to determine the age and sex distribution, location, histological type and also to assess the benign or malignant potential of gastrointestinal polyps. Materials and Methods: This study was done in the Department of Pathology, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India, over a period of two years from October 2015 to September 2017. Total 160 Cases of Gatrointestinal polyps were studied. Results: Gatrointestinal polyps were more common in males (60%) than females (40%) and were common in the age group between 51-60 years (40%). Commonest clinical symptom was malena (28.12%). Rectum was the commonest site (28.75%), followed by sigmoid colon (18.75%). The most prevalent type of gastrointestinal polyp was adenomatous polyp (50%). The commonest subtype of adenomatous polyp was tubular variant (82.5%). Conclusion: High grades of dysplasia was commonly observed in villous and tubulovillous types of adenomatous polyps. As adenomatous polyps have more risk of malignant transformation, early diagnosis and removal is a highly effective method in preventing colorectal cancer.

Keywords: Adenomatous Polyp; Dysplasia; Gastro Intestinal Polyps; Rectum; Tubular Variant. 

Background: Endometrial cells are rarely seen in pap smears. Their presence in postmenopausal women > 45 years may suggest endometrial pathology. Aims: To evaluate the pap smears of cases with significant endometrial histopathology for the presence of endometrial cells; its association with age and menopausal status and its sensitivity in detection of endometrial pathology. Settings & Design: Cross sectional retrospective case control study. Meterials and Methods: Endometrial biopsies grouped as cases (significant endometrial pathology hyperplasia, carcinoma, polyps, carcinoma) and control (basal, proliferative, secretory) were collected for a period of two years. Their pap smears were evaluated for the presence of endometrial cells. Statistical Analysis: Descriptive statistics was used. Results: Among the 58 cases and 58 controls, endometrial cells were present in 31% (18/58) of cases and 17% (10/58) of controls. Age >45 years, menopausal status and postmenopausal bleeding had no association. 25% of simple hyperplasia, 50% of complex hyperplasia, 37.5% of endometrial polyp and 50% of endometrial carcinoma cases had endometrial cells. The sensitivity of detection of significant endometrial pathology by endometrial cells was 31%; specificity 82%; positive predictive value 64% and negative predictive value 54%. The average number of clusters were >2 in the cases and <2 in the control. The clusters had papillae/club like/swirl morphology or atypical in cases. Conclusion: We conclude from our study that we should document the presence of endometrial cells in patients with any symptom of irregular bleeding irrespective of age and menopausal status especially when there are more than two clusters with distinct morphologies like papillae/ club/swirls.

Keywords: Endometrial Cells; Pap Smears; Significant Endometrial Pathology. 

Background: Thyroid lesions are common, presenting mostly as enlargement of thyroid gland. Fine needle aspiration cytology (FNAC) of the thyroid is an easy procedure providing rapid and accurate diagnosis. Terminology for reporting has varied amongst pathologists. Bethesda system provides guidelines for cytological reporting category and management. Aim: To classify the thyroid lesions according to Bethesda system for reporting thyroid cytology, compare with conventional system and correlate cytological diagnosis Material and Methods: A prospective study was conducted over a period of 2 years on 202 consecutive patients. FNAC of thyroid gland was done and smears prepared.Smears were reviewed and cytological reporting was done according to both conventional and Bethesda systems. Result: Most of the patients were females (177, 87.6%) with a mean age of 37.4 years. 4.0% were non diagnostic, 91.1% were benign, 1.5% were atypia/follicular lesion of undetermined significance, 1.0% were suspicious for follicular neoplasm/ follicular neoplasm and 2.4% were malignant. Radiological findings were available in 100cases and showed diagnostic deviation in 2 cases with cytological findings. Histopathological correlation was present in 16 cases and revealed minor deviation in one case. Conclusion: The Bethesda System for Thyroid Cytology is a useful method in reporting different thyroid lesions. In our study a definite interpretation for lesions in category I and III was provided by following specific criteria. Standardising the reporting methodology increases the reproducibility of diagnosis.

Keywords: Cytology; Correlation; Conventional; Bethesda System; Radiological; Biochemical; FNAC. 

Background: Hematological abnormalities are quite frequent in cirrhotic patients and commonly include various types of anemias, thrombocytopenia and increased PT/INR. Some of these parameters are used as prognostic markers in scoring systems like Child-Pugh and Model for End Stage Liver Disease (MELD). Aim: We aimed to assess the various hematological parameters in cirrhotic patients and correlate them with disease severity based on Child-Pugh and MELD scoring systems. Materials and Methods: 87 patients diagnosed with cirrhosis irrespective of etiology were studied over a period of 2 years. Complete blood count, peripheral smear and coagulation parameters were noted along with relevant clinical history. Variations in these were compared with Child-Pugh and MELD scoring systems. Results: Macrocytic anemia and spur cell anemia were seen in 33 and 7 patients respectively. Thrombocytopenia was noted in 33 patients. 67 patients had prolonged PT. According to Child-Pugh classification, 65.5% of patients came under Grade C, 27.6% under Grade B and 6% under Grade A respectively. According to MELD score, 24% of patients had a score < 15 and 76% had a score of 15. Hematological parameters like MCH, MCHC and Total count showed a significant positive correlation with both Child-Pugh and MELD scoring systems with p < 0.05. Hemoglobin, RBC count and RDW showed a negative correlation with both Child-Pugh and MELD scoring systems with p value < 0.05. Coagulation parameters PT and PT/INR showed a significant positive correlation with both Child-Pugh and MELD scoring with p value < 0.001. Conclusions: Although a number of hematological abnormalities are seen in cirrhotic patients, only few of them show significant correlation with disease severity. Hence it is suggested that these parameters be used for prognostication in cirrhotics.

Keywords: Child-Pugh; Cirrhosis; Hematological; MELD. 

Background: The diagnosis of early Mycosis Fungoides (MF) is quite challenging because of its overlapping clinicopathologic findings with various reactive dermatoses. A comprehensive assessment of clinical history is absolutely essential as pathologic criteria alone are insufficient. Aim: We aimed to diagnose early MF seeking an algorithm proposed by the International Society for Cutaneous Lymphoma (ISCL), define various significant diagnostic criteria and describe the associated clinical and histological mimics. Materials and Methods : Formalin fixed, paraffin embedded and H&E stained sections of forty skin biopsies from thirty nine clinically suspected early MF patients (n = 39) were studied initially. Various clinical and histopathological parameters were recorded followed by immunohistochemistry (IHC) with selected markers to arrive at a proper diagnosis. Results: Early MF was diagnosed in 9 patients (23.1%), parapsoriasis in 5 patients (12.8%), psoriasiform dermatitis in 7 patients (17.9%) and spongiotic dermatitis in 5 patients (12.8%). Remaining 13 patients (33.3%) were grouped under miscellaneous category comprising of other reactive dermatoses. Atypical lymphocytes were seen in 8 patients with early MF (n = 9) and 2 patients with parapsoriasis (n = 5). No statistical significance was observed between the two groups (P > 0.05, Fisher’s exact test). Conclusions: Some patients with early MF fail to show the typical histological features of the disease. In such instances, multiple biopsies from different lesions are highly useful and the algorithm developed by ISCL is a valid tool in diagnosis. Epidermotropism is considered as histological hallmark. IHC is not needed in all cases, particularly when the clinical and histopathological features are quite obvious.

Keywords: Algorithm; Early MF; Epidermotropism; ISCL; Reactive Dermatoses. 

Background: The incidence of clinically evident thyroid nodules is 4-5% in the general population. Fine needle aspiration cytology of thyroid can be used as diagnostic test along with ultrasonography for evaluation of thyroid lesions. Aims and Objective: To study cytological profile of thyroid lesions and correlate the results with Ultrasonography findings and clinical features. Material and Methods: This prospective study was carried out in department of pathology on 250 patients with thyroid swelling who came from surgical departments from the period of October 2016 to October 2017 at Narayana medical college and hospital, Nellore. Results of FNAC were correlated with those of USG reports and clinical features of the patient. Results: Out of 250 cases, 227 [90.8%] cases were benign, 8 [3.2%] cases were malignant on FNAC. About 220 cases (88%) were females and (12%) were males (male to female ratio 1:733). On USG 68% cases were diagnosed as benign and 2.8% cases were malignant. Out of which on cytology 90.8% were benign & 3.2% cases were malignant. On FNAC Multinodulargoitre (47.2%), colloidgoitre(6%), Thyroiditis((34%), diagnosed. Follicular neoplasm (4%), suspicious of malignancy 5 cases (2%) diagnosed under indeterminate category on FNAC. On USG nodular goitre (52.4%), colloid goitre(5.6%), Thyroiditis 73 cases(29.2%), Follicular adenoma 16 cases (6.4%) and malignancy 7 cases (2.8%). Thyroglossal cyst (2.8%), Graves disease (0.68%) diagnosed on FNAC and USG as well. Conclusion: Ultra sound and Fine needle aspiration cytology are advocated as first line examination for the assessment of thyroid lesions along with clinical examination and helps to come to the proper diagnosis

Keywords: Fine Needle Aspiration Cytology; Ultrasonography; Thyroid Lesions; Benign; Malignant. 

Background: Fibroepithelial polyps are common small protuberant benign lesions primarily developing in areas where the skin forms creases such as neck, axillae, and groin. They may also arise on the face, usually on the eyelids. It occurs predominantly with advancing age, typically painless, and do not grow or change over time. An important triggering factor seems to be frequent irritation of the skin, especially in persons who are obese. Diagnostic problem is faced when it is located at unusual site and huge size. Materials and Methods: Retrieval of all cases of fibroepithelial polyp were made from August 2014 to May 2017. A retrospective analysis of all cases of fibroepithelial polyps reported in histopathology section of department of Pathology, AIIMS, Patna weredone with patient’s details, site of lesion, gross and microscopic findings. Conclusion: Fibroepithelial polyp is a common entity but their occurrence at unusual site pose a diagnostic challenge to both the clinicians and pathologists.

Keywords: Fibroepithelial; Polyp; Neoplasm; Intertriginous; Histopathology; Pedunculated. 

Introduction: Skin diseases are one of the most common health problems in India. Histopathological examination of skin biopsy is the gold standard for most dermatological diagnosis. Our medical college being the only govt tertiary institute in north Maharashtra this work has been undertaken, to study the spectrum of various skin disorders that affect the north Maharashtra population. Methods: The study was undertaken in the department of Pathology, S.B.H. Govt Medical College and Hospital, Dhule the only tertiary care centre in North Maharashtra region. It included all the skin biopsies received by the department of pathology for histopathological examination during January 2013- December 2015. Histopathological classification of skin diseases based on the site, pattern and cytology of the histological changes seen in the biopsy was used. According to which we divided skin diseases in VIII groups. Results: Out of 175 patients highest no of patients (n=39) were observed in 21 to 30 yrs with majority being females (50.28% n=88). Maximum no of cases belonged to group V disorders (n=75; 42.86%) i.e. perivascular, diffuse and granulomatous infiltrates of reticular dermis followed by, Group VI disorders (n=30; 17.14%) i.e. tumors and cysts of dermis and subcutis. In the group V leprosy was the most prevalent skin disease (n=57). Pemphigus vulgaris (2.86%) was the most common vesiculobullous lesion. Conclusions: Leprosy is the most common (42.86%) skin problem seen in the present population. This emphasizes the need for the rigorous measures to be implemented for prevention, diagnosis and treatment of leprosy in the present region.

Keywords: Leprosy; Skin Biopsy; Skin Tumor; Vesiculobullous. 

Introduction: Tuberculosis is a chronic infectious disease caused by mycobacterium tubercular bacilli. It primarily affects lung and it can involve any organ system in the body. There are various methods for detection of acid fast bacilli in the sputum examination for the diagnosis of tuberculosis. Material and Method: Our study was done clinically suspected tubercular patients in the tertiary care hospital. On all received samples ZN stain was applied by two method (conventional and bleach). Result: 682 cases out of 3962 total cases are positive both in conventional method and bleach method and the 188 cases are positive only in bleach method. Conclusion: The majority of positive cases in bleach method showed easily visible and detectable. AFB morphology was observed to be better preserved to in the bleach method. The bleach method is safe, inexpensive and easy to perform and requires no additional equipment.

Keyword: Tuberculosis (TB); Mycobacterium Tubercular Bacilli (MTB) Acid Fast Bacilli (AFB); Ziehl- Neelsen (ZN Stain) and Bleach (Sodium Hypochlorite). 

Background: Cancer of uterine cervix is a leading cause of mortality and morbidity among women worldwide Papanicolaou cytological (Pap) test is, in many respects, the ideal screening test. Cervical cancer has a defined premalignant phase of many years, which allows repeated tests to significantly reduce the impact of individual false negative test results. Cervical cytology is inexpensive and readily accepted among Indian women.This is a retrospective study aimed to evaluate all previously conducted cervical smears examined at a teaching tertiary hospital during a two and half year period to find out the prevalence of abnormal pap smears. Materials & Methods: Detailed clinical data and Pap smear cytology reports were obtained from June 2014 to December 2016 and data noted in a structured Performa. All the smears were reported as per the revised 2014 Bethesda system. Prevalence of epithelial abnormalities was calculated in percentages. Results: Out of 1671 cases, 1635(97.8%) were negative for intraepithelial lesion/malignancy, 36 cases (2.15%) were positive for intraepithelial lesion. Conclusion: Pap smear provides supportive evidence as a tool for screening for cervical cancer. There is a need to increase the awareness among women to know the utility of this test to prevent precancerous changes in cervix can be detected before they progress to frank malignancy.

Keywords: Cervical Cancer; Screening; Bethesda System; Pap Smear; Papanicolaou. 

Introduction: 70% of clinical decision making is predicted upon, or confirmed by, or documented by medical laboratory test results. Accurate laboratory services are required for diagnosis, to identify causative factors, staging, treatment initiation, monitoring drug efficacy and toxic effects in cancer patients. Purpose: 1. to provide accurate, early, reliable and universally acceptable results to patients in a Cost-effective way. 2. To improve operational efficiency and safety of laboratory personnel 3. Encourage other laboratories to apply for National Accreditation Board for Testing and Calibration Laboratories (NABL). Methods: A quality manager was appointed to supervise the implementation of accreditation. Quality manual was prepared and from it Standard Operating Procedures (SOPs), registers and formats were made according to International Organization for Standardization (ISO) 15189 guidelines. Results: Quality of our laboratory services and reports are improved thereby gaining the confidence of clinicians and patients in our institute. Our technicians are more efficient in their work. Conclusions: Although accreditation is a time consuming and laborious process, it is a doable process. It provides early warning signs and identifies lacunae in our system. We encourage all the teaching hospitals and laboratories to apply for accreditation.

Keywords: Accreditation; Hematology Laboratory; ISO 15189; NABL. 

Not Provided.