Indian Journal of Pathology: Research and Practice

 Introduction : Bilateral breast cancer is extremely rare presentation. Most of the cases of bilateral breast cancer are of lobular carcinoma type. Herewith we report a case of bilateral Invasive Breast Carcinoma (Not Otherwise specified). A case of a 47 year old female who presented with bilateral breast mass, right breast mass measuring 3.4 x 2 x 2 cm and left breast mass measuring 2.8x2.0x1.6 cm. Fine needle aspiration cytology of right breast mass was reported as positive for carcinoma cells. Patient was operated for left modified radical mastectomy 8.5 years back which was reported as Invasive Breast Carcinoma (IBC) - II and now, the patient was operated for right modified radical mastectomy which was reported as right sided Invasive Breast Carcinoma with medullary differentiation. The Richardson Bloom score was (3+3+3) =9 , Grade III. Conclusion: Metachronous bilateral breast cancer is an extremely rare presentation of breast cancer. Early detection of contralateral breast tumor is of utmost importance for appropriate management of these cases.

Keywords: Bilateral Breast Cancer; Invasive Breast Carcinoma; Breast Lump; Medullary Differentiation.

 Endometriosis is a benign condition characterized by the presence of endometrial tissue outside the endometrial cavity. It is usually confined to the pelvis and reproductive organs, but has been described in the omentum, gastrointestinal tract, peritoneum, operative scars, lymphnodes, umbilicus, skin, lungs, pleura, bladder and kidney. Endometrial cyst of Pancreas is extremely rare. To our knowledge only seven such cases have been reported in the literature [1]. Herein, we describe a patient with pancreatic endometrial cyst presenting as cystic mass in the tail of Pancreas.

Keywords: Endometrial Cyst; Pancreas; Endometriosis.

 A woman aged 40 years sought medical attention for bilateral breast swellings considered to be bilateral fibroadenomata or malignancy. Excised lump revealed to be Rosai-Dorfman disease with characteristic histology. Its incidence in the breast; a rare entity, is discussed in relation to available literature on the subject. One of the perplexing problems; particularly, the origin of the tumor cells is discussed against the background of unusual immunochemical data.

Keywords: Breast, Rosai-Dorfman Disease, Clinical and Pathologic Review, Significance of Immunochemical Findings.

 Background: Ovarian tumours are heterogenous neoplasms with a varied clinical, morphological and histological features. p53 overexpression has been associated with poor prognosis, poor overall survival and altered sensitivity to chemotherapy in patients with ovarian cancer. Aim and Objectives: To study the frequency, age distribution and the diverse histomorphological spectrum of ovarian tumors and to evaluate the frequency of immunohistochemical expression of p53 in different types of ovarian tumors. Materials and Methods: This is a retrospective study of 100 ovarian tumours diagnosed in the Department of Pathology, Kilpauk Medical college, Chennai, Tamilnadu, India. After gross examination of specimens, representative bits were taken, routinely processed and stained with H and E.Tumors were classified as per WHO classification. p53 expression was assessed immunohistochemically. Results: There were 14 malignant cases among 100 ovarian tumours of which commonest was Surface Epithelial tumours. p53 was found to be overexpressed in 85.7% of malignant tumours.

Keywords: Ovarian Tumours; p53; Immunohistochemistry.

 40 females aged between 25 to 65 years old having breast cancer were studied during 2016 and August 2018. 15 (37.5%) were tobacco chewers, 4 (10%) were smokers 3 (7.5%) were alcoholic and 18 (45%) were mal-nutritious. Expression of ki67 and its histopathological correlation was found to be 4(10%) patients had IDC grade I malignancy, 22 (55%) had IDC grade II malignancy, 14 (35%) had IDC grade – III malignancy, 5 (12.5%) axillary lymph nodes had negative expression, while 35 (87.5%) expressed positivity for ki67 bio marker. The size of tumour were 4 (10%) were <2 cm and 36 (90%) with > 2 cm in the correlative study of ki67 with PR score value was 0.58, with ER score value was 0.18 and with HER-2/ neu value was 1.0 and all three correlation were statistically insignificant. This study confirmed that increasein ki67 – positivity has poorer prognosis hence ki67 biomarker plays significant role inthe prognostic value in breast cancer

Keywords: Er = Estrogen Receptor; Pr = Progesterone Receptor; Her-2 = Human Epidermal Growth Factor Receptor -2.

Context: Pre-eclampsia is a complication of pregnancy causing both maternal and fetal morbidity and mortality. Changes in the placenta, which are a consequence of some maternal conditions have their bearing on fetal outcome. Studies on placenta from cases of pregnancy induced hypertension (PIH) have shown a spectrum of changes. Aim: To study pathological features of placenta in PIH and to correlate these changes with severity of PIH. Methodology: 100 placentas from cases of PIH and 20 normal placentas were subjected to Gross and microscopic examination. Weight of placenta, infarction, retroplacental hematoma (RPH) and calcification was noted on gross. On microscopy villous changes were quantitated. Statistical analysis: Comparison of parameters between different groups was done by ANOVA test and students "t" test. Categorical data was analysed by chi-square test and Fisher exact probability test. Results: The placental weight was reduced in cases of PIH and they had increased incidence of infarction and RPH compared to controls. There was significant increase in villous lesions like cytotrophoblastic proliferation (CP), syncitial knots (SK), vasculosyncytial membrane paucity (VSMP), thickening of basement membranes (TBM), fibrinoid necrosis (FN) and stromal fibrosis (SF) in cases of PIH. These changes increased with severity of PIH. Conclusion: PIH adversely influences the placenta. Significant gross findings include Infarction and RPH and villous lesions are Increased SK, CP, FN of villi, TBM, VSMP. These changes were proportional to the severity of disease.

Keywords: Pregnancy Induced Hypertension; Placenta; Syncitial Knots.   

 Background: Bethesda system of reporting thyroid cytopathology is a standardized system,improving communication between pathologists and clinicians,leading to more consistent management approaches.The aim of the research work was to study the efficacy of Bethesda System for reporting thyroid fine-needle aspirations in view of offering guidance for patients management and to evaluate the specificity of the system based on the cytology and histopathological correlation. Methods: All the patients referred for FNAC of thyroid lesions were studied for 2 years and classified them according to Bethesda system. Histopathological correlation was done for all cases which underwent surgical resection. Results: Out of 280 cases, 64 (22.86%) were of category I, 144 (51.43%) were of category II, 11 (3.93%) were of category III, 43 (15.35%) were of category IV, 09 (3.21%) were of category V, 09 (3.21%) were of category VI. Statistical analysis of this study showed that the sensitivity, specificity, diagnostic accuracy were 95.5%, 84.3%, 89.3%, respectively. The positive predictive value and negative predictive value were 83% and 95.8%, respectively. Conclusions: The six diagnostic categories of Bethesda system were beneficial for triaging patients for either clinical follow-up or surgical management. Each diagnostic category conveys specific risks of malignancy, which offers guidance for patients management.

Keywords: Bethesda; Cytology; Thyroid.

 Aims: To determine the histopathologic correlation of breast FNAC. Settings and Design: This is a two-year prospective study of breast lumps seen at Department of Pathology, Dr. S.N. Medical College, Jodhpur (Rajasthan) between June 2011 and June 2013. Methods and Material: A total of 526 FNAC cases were evaluated. Histologic follow up was available for 173 FNAC samples. Statistical analysis used: The cytological diagnoses were categorised into one of five diagnostic categories in accordance with the National Health Services Breast Screening Programme of Britain classification (C1, C2, C3, C4, & C5). Then cytological findings were correlated with histological findings and accuracy was assessed by calculating sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, predictive valve, false negative, false positive rates and accuracy. Results: Between June 2011 to June 2013 a total of approximately 526 FNAC breast cases were evaluated. Histologic follow up was available for 173 FNAC samples. Amongst all the cases (526) reported in cytology, maximum cases i.e., 417 (79.28%) cases had C2 lesions. Out of 526 FNAC cases, 173 were correlated in histology. So, in total there were 3 false positive cases and 4 false negative cases in this study. Results calculated were: sensitivity= 89.47%, specificity= 97.78%, positive predictive value= 91.89%, negative predictive value= 97.06% and accuracy= 95.95% Conclusions: A high sensitivity and a high positive predictive value proved that a positive FNAC in the breast means a definite diagnosis of the concerned pathology when compared with the final histology report. The high specificity and a high negative predictive value for malignancy illustrated the high accuracy of FNAC in the diagnosis of malignancy in the breast.

Keywords: FNAC; Histopathology; Correlation; Sensitivity; Accuracy.

Background: colonoscopy is the “gold standard” for diagnosis of colonic mucosal disease. Colonoscopy has greater sensitivity than barium enema or CT for colitis, polyps, and cancer Colonoscopy has the advantage of not only picking up primary cancer but also having the ability to detect synchronous polyps or even multiple carcinomas, which occur in 5% of cases. It tends to be used in patients whose main presenting symptom is bleeding, those with known polyps and those in whom there is doubtful radiology. Ideally, every case should be proven histologically before surgery. Aims: To establish a correlation between clinical diagnosis, colonoscopy and histological findings of colon lesions. Materials and Methods: The study was done at Department of Pathology, MGMCH, Jaipur it was a Hospital-based observational study consisting of 60 cases. The findings of clinical diagnosis, colonoscopy and histology were correlated. Statistical methods: sensitivity, positive predictive value, negative predictive value, and specificity was calculated Results: Among 60 cases, 41 cases were Nonneoplastic, 15 cases were Neoplastic and 4 cases were classified as biopsy specimen inadequate or unsatisfactory for evaluation. In our study, colonoscopy with biopsy was performed on patients of all age groups, ranging from 2 years to 87 years. Conclusion: Colonoscopy is a safe procedure and has a high diagnostic yield. The endoscopic evaluation of the large bowel has been greatly expanded by the availability of colonoscopy.A comprehensive histopathological study of the colonoscopy biopsy specimens should be done in constant correlation with the clinical and colonoscopy features.

Keywords: Colonoscopy; Histopathology; Clinical Diagnosis; Polyps; Adenocarcinoma.

 Malaria is an important public health concern especially in endemic nations like India. Hematologic changes play a major role in fatalities. The present study was conducted with an objective to assess blood cell counts in malaria and correlate them with parasite density, so as to enforce their role as indicators of disease severity. A total of 144 malaria positive cases diagnosed at JN Medical College and Hospital, Aligarh during the period from November 2014 to October 2015 were included in this study. Complete blood cell count was assessed along with peripheral blood smear examination of each patient for parasite identi cation and calculation of parasite density. The results were statistically analyzed using SPSS version 19. A signi cant decreasing trend of haemoglobin concentration, leukocyte count and platelets was noted with increasing parasite density (p < 0.001). Eosinophilia was also a key  nding. In conclusion, a spectrum of deranged blood parameters such as a low leukocyte count and eosinophilia along with anemia and thrombocytopenia may serve as a basis for immediate and aggressive treatment approach in severely febrile patients of malaria.

Keywords: Malaria Parasite Density; Anemia; Leucopenia; Eosinophilia.

Context: Smoking continues to be the single most preventable source of health hazards. A detailed analysis of impact of duration of smoking, intensity of smoking on the hematological parameters in current smokers, ex-smokers and non smokers is lacking. Aims: The objectives were to study the effect of smoking and its intensity on hematological parameters in chronic smokers and to compare it with that of in ex-smokers and non smokers. Materials and Methods: Adult male chronic smokers and exsmokers were interviewed about their smoking pattern and the results of their hematological parameters were collected. The results of the same hematological parameters from non smokers were also collected for comparison. The collected data were entered in excel and analyzed by statistical tests. Results: Out of 133 participants, 47 were current smokers, 45 were ex-smokers, and 41 were non smokers. Majorities (59%) of the current smokers were from the age group 31-50 and ex-smokers (53%) were from the age group 51-70. Majority (81%) of the current smokers were smoking 1-10 cigarettes per day for duration of 16- 30 years (62% of the smokers). On comparing the hematological parameters among current smokers, ex-smokers and non smokers, it was found that chronic smokers had statistically significant (P value < 0.05) elevated levels of MCH, MCHC, Neutrophils and Lymphocytes compared to that of non smokers. Conclusion: Chronic smoking causes altered hematological parameters. Abnormal parameters in current smokers return to near normal after quitting smoking.

Keywords: Smoking, Hematological Parameters; Current Smokers; Ex-Smokers; Non Smokers.   

 Aim: To delineate the histopathological pattern of prostate diseases and to correlate prostate speci c antigen values and histomorphological features. Methods and materials: A retrospective review was made of all prostate biopsy reports seen between January 2013 to December 2017 at Department of Pathology, Khaja Banda Nawaz Institute of Medical Sciences Kalaburagi, Karnataka. A total number of 164 biopsies was received at the department of pathology. All prostate biopsies were classi ed as In ammatory and neoplastic lesions which comprise benign prostatic hypertrophy and carcinoma. Prostate speci c antigen values were analyzed documented and correlated with histopathological  ndings. Hematoxylin and eosin stained sections were examined using paraf n embedded blocks. Results: Mean age of presentation was 60.5±12.5yrs with maximum incidence in 7th decade of life. Out of 164 biopsies examined 85.97% (141cases) were diagnosed as benign prostatic hyperplasia with or with out prostatitis, Two cases were diagnosed as High grade Prostatic intraepithelial neoplasia [1.23%] and 21 cases were adenocarcinoma [12.80%]. The most common gleason score was 7 (71.42%) followed by score 9 (19.04%). and score 4 (9.52) .Pattern 4 was most common predominant. Most adenocarcinoma is well differentiated to moderately differentiate with Gleason’s score of 4 to 9. Prostate speci c antigen [PSA] is used as screening test for prostate carcinoma with PSA value in range from 4 to 140ng/ml. Conclusions: In this study, 1. Benign Prostatic hyperplasia is commonest benign lesion and adenocarcinoma is histopathological type of prostate cancer. 2. Prostate speci c antigen [PSA] was in higher range in prostate cancer than in Benign Prostatic hyperplasia, hence PSA is good early indicator for malignancy 3. Histopathology examination remains the diagnostic test for con rmation of malignancy

Keywords: Prostate Adenocarcinoma; Benign Prostatic Hyperplasia; Prostate Specific Antigen.

 Background: The primary lung lesion includes both neoplastic and non-neoplastic conditions. However lungs can secondarily involved in almost all forms of terminal events. Many times clinical and radiological findings in respiratory diseases are nonspecific, so prompt pathological investigation and diagnosis is essential. Autopsy is an important tool for identifying and understanding respiratory diseases Aims & Objectives: To know the histopathological spectrum of Lung diseases and frequency of pulmonary lesions in respect to age and sex. Material & Methods: The study was done on 250 lung specimens from autopsy cases received in the Department of Pathology, Bangalore medical College for a period of 1year during January 2014 to January 2015. Gross findings and microscopic features were recorded. Results: The spectrum of lung lesions were seen, the commonest being edema and congestion 90 (36%) followed by pneumonia 80 (32%), Emphysema 20 (8%), Tuberculosis 18 (7.2%) , Acute respiratory distress syndrome 12 (4.8%), Amniotic fluid embolism 5 (2%), Pulmonary embolism 3 (1.2%) and Lymphoma 2 (0.8%). In 20 (8%) cases we saw normal lung histology. Conclusion: The present study is making an attempt to study the various spectrum of lung lesions, in where infectious lesions (nontubercular & tubercular pneumonias) are still the most common preventable causes of morbidity and mortality. Hence, autopsy study can be of great value in improving the vision and diagnostic setups for better clinical assessment, timely diagnosis and therapy.

Keywords: Lung Autopsy; Pneumonia, Tuberculosis; Histomorphological Pattern.

Background: Chikungunya is a mosquito-borne, viral, acute febrile illness that can be difficult to distinguish clinically. Since the incidence of this disease is increasing, it is necessary to study the prevalence and incidence of the disease to take the measures to stop the spread of the disease. The study was done as epidemiologically in Bharatpur region in all age group. Materials & Methods: This was a retrospective study conducted in the central lab of a Government Medical College Bharatpur (Rajasthan) during four years period (January 2015 to October 2018). In this study 589 patients having suspicion of Chikungunya of all age groups characterized by acute illness with painful myalgia, polyarthralgia, fever and skin rash were included. IgM antibodies of Chikungunya were detected by IgM capture ELISA in serum. Results: This study was done over suspected cases of chikungunya. 589 serum samples were collected and serum were tested for IgM antibody by Elisa method and in 122 it was found to be positive for Chikungunya. The number of suspected case were increased significantly over the study period. Number of samples were maximum in year 2016 and also positivity was (31.33%) in this year. Chickinguniya virus positivity was maximum in post monsoon season. Females were affected more 22.7% than males 18.5% of the total suspected. Majority of patients were in the age group of 21-60 years. Conclusions:The present was done to find out the prevelance and incidence of chinkungiya and to estimate the burden of disease in the district of bharatpur .The study concluded that chikinguniya is prevalent throughout the year with the maximum prevalence seen during the monsoon reason.All the age groups are affected with maximum morbidity and mortality seen in the vunrelable group like children and people with preexisting disease and old people. The incidence of chikinguniya can be minimized with educating people about vector born diseases and how to control the spread of mosquitoes. A community awareness based approach can minimize the morbidity and mortality associated with chikinguniya and minimize the economic impact on the poor and margnilased people of developing country like india.

Keywords: Chikungunya; Fever; Arthralgia; IgM ELISA.

 The metallothionein (MT) expression is used as a prognastic factor for tumor progression and drug resistance in a variety of malihgnancies particularly breast, hepatic, prostatic, ovarial, head and neck, non - small cell lung carcinoma, and soft tissues sarcoma. The latest research outcomes indicate that MT levels in cancerous cells indicate the clinical stage of the disease or response to therapy. MT plays a key role in transport of essential heavy metals, detoxification of toxic metals and protection of cells against oxidation stress. Aim: The goal of this study was to see the MT isoforms (MT1A, MT1E, MT1F, MT1H, MT1X, MT2A) expression in MN1 (human breast cancer epithelial cell line containing wild type – p53) and MDD 2 (derived from MCF7 cell line, containing mutated p53) and HEPG 2 cell lines. Materials and Methods: After designing all the above set of primes and adjusting the gradient temperature for the Polymerase Chain Reaction (PCR). The RNA is extracted and made complementary DNA from it. Results: After several numbers of polymerase reactions and number of repetitions our data suggest that MT isoforms are not expressed in MN and MDD2 cell line, but they are expressed in HEPG 2 cell lines.

Keywords: Metallothionein Ioforms; p53.

Background: Upper gastro intestinal (GI) endoscopy is an established mode of investigation and treatment of a wide range of upper gastro intestinal disorders, such as dysphasia, upper GI bleeding, persistent dyspepsia, heartburn, chronic acid reflux and in the surveillance of Barrett’s esophagus, gastric ulcer and duodenal ulcer. Upper gastrointestinal tract is a common site for neoplasm’s especially malignant tumors. Worldwide carcinoma stomach is the second most common cancer and carcinoma esophagus is the sixth leading cause of death. Aims & Objectives: To analyze the histopathological spectrum of diseases in upper GI tract, estimate the incidence of H. Pylori associated chronic gastritis, incidence of malignancy and to correlate clinical features with histopathological diagnosis. Materials and Methods: The present study was conducted in the Department of Pathology, MVJ Medical College and Research Institute, Hoskote over a period 2 years from September 2012 to August 2014. Total of 150 cases who underwent Upper GI Endoscopic Biopsy (esophageal, gastric, and duodenum (1st part) lesions) were studied. Results: Out of the 150 upper GI endoscopic biopsies, 47 (31.3%) were from the esophagus, 95 (63.3%) from stomach and 8 (5.3%) from duodenum. There were 87 male patients and 63 female patients making the male: female ratio of 1.4:1. The highest number of biopsies was done in patients between 41 to 50 years (25.3%). Dysphagia (38.6%) is the commonest presentation with esophageal lesions. Dyspepsia (61.3%) & pain abdomen (38%) were the commonest presentation in patients with gastric lesions. Out of 47 esophageal biopsies 28 (59.2%) were squamous cell carcinoma followed by chronic esophagitis 7 (14.8%). Majority of cases of carcinoma esophagus were in the middle 1/3rd of the esophagus, histologically these proved to be squamous cell carcinoma & adenosquamous carcinoma. Only 2 cases of adenocarcinoma were obtained and these were in the lower 1/3rd of the esophagus. Out of 95 cases of gastric biopsies 79 (83.1%) were Chronic gastritis, followed by 6 (6.25%) were tubular adenocarcinomas. Antrum was most common site of involvement. Among 79 cases of chronic gastritis 50 (63.2%) cases are positive for H pylori and 29 (36.7%) cases are negative for H pylori. Out of 8 cases of duodenal biopsies, chronic duodenitis was the comment lesion. Conclusion: Endoscopic biopsy provides an excellent opportunity for the clinician and histopathologist to study the morphology of the lesion using minimal tissue obtained by an endoscope, also it obviates laparotomies and excision biopsies.

Keywords: Duodenum; Esophagus; Stomach; Upper gastrointestinal Endoscopic Biopsy.   

 Introduction: Erythrocyte inclusions are elements that may be present in red blood cells (RBCs). The appearance, composition, and associated physiology of the inclusions are speci c for each type of inclusion. Identi cation and reporting of these inclusions are important because their presence may indicate diseases or disorders. Typically, inclusion bodies are nuclear or cytoplasmic aggregates of stainable substance, usually proteins. The inclusion bodies in red blood cells are almost always indicative of some sort of pathology, and thus it is useful to understand each inclusion body that can occur within a red blood cell. Aim: 1. To interpret inclusion bodies and correlate with smear  ndings. 2. To  nd out the uses of identifying them in day to day practice. Material and Methods: Present study is a retrospective study for 3 months. All the cases which came with request for peripheral smear study in the clinical central laboratory were included in the study. Results: There were total of 400 cases in 3 months, which included 130 microcytic hypochromic anemia, 33 macrocytic anemias, 30 dimorphic anemias and 207 normal smears. There were 4 cases of leukemia, 1 microangiopathichemolyticanemia and 42 eosinophelia. Of the 400 cases 58 presented with thrombocytopenia, 13 as pancytopenia and 7 showed parasites (malaria and borrelia). There were total of 32 (8%) cases which showed the RBC Inclusions, consisting of Howell jolly bodies- 20 cases (62.5%), Basophilicstippling-10 (31.25%), cabot ring 01(3.125%)and Pappenheimer bodies -01 (3.125%). Conclusion: Identi cation and reporting of these inclusions are important because their presence may indicate diseases or disorders. This article tells us the importance of smear study which is basic and a very important tool indiagnosing some conditions which would have been missed by CBC alone.

Keywords: Peripheral smear, RBC inclusions.

 Background: Cutaneous Granulomatous lesions comprises a heterogeneous group of diseases caused by the variety of infectious and non-infectious etiological factors and thus often poses a diagnostic challenge to histopathologist as they show similar histological features. Objective: The present study was aimed at studying the various histo-morphological patterns of cutaneous granulomatous lesions, to determine the relative frequencies and to compare our results with other studies. Materials and Methods: A retrospective analysis of skin biopsies received over a period of three years from January 2016 to November 2018 was performed and cases of cutaneous granulomatous lesions reported on histopathology were analyzed with respect to age, sex, site, and etiology and histomorphological pattern. Results: Out of a total of 516 skin biopsies 45 (8.7%) cases were diagnosed as cutaneous granulomatous lesions. It was common in males (60%) with most occurring in the third to fourth decades. Majority of the cases (28 cases, 62.2%) were categorized as infectious granulomatous lesions with the predominance of leprosy (18 cases, 40%) followed by tuberculosis (7 cases, 15.5%). Conclusion: The present study is a comprehensive, comparative study of cutaneous granulomatous lesions and leprosy is the most common cause of granulomatous skin lesions according to this study. This study concludes that histopathology is the gold standard investigation for diagnosis, categorization, and management of cutaneous granulomatous lesions. Special stains play a supportive role in the diagnosis of infectious granulomas.

Keywords: Cutaneous Granulomatous Lesion; Leprosy; Tuberculosis.

 Introduction: Suprarenal gland is a bipartite endocrine gland which is divided into adrenal cortex and adrenal medulla. Histopathological spectrum of adrenal lesions consist of adrenal cysts, adrenal myelolipoma, adrenal cortical adenoma, adrenal cortical carcinoma and pheochromocytoma. Aims and objectives: To study the histopathological spectrum of adrenal lesions diagnosed at Narayana Medical College & Hospital, Nellore for over a period of two years. Materials and methods: All the adrenal gland specimens submitted to the Department of Pathology, Narayana Medical College and Hospital, Nellore, from January 2016 to December 2017 were included in the study. Adrenalectomy specimens were fixed in 10% formalin, subjected to routine processing, embedding, cutting and then stained with Haemotoxylin and Eosin staining technique. Results: A total of 18 cases were noticed in the present retrospective study. Most of the tumors were noted in the age group of 21-40 years with female predominance. Most common adrenal lesion noted in our study was pheochromocytoma (55.55%). Conclusion: We diagnosed a total of 18 cases of adrenal lesions including adrenal cysts, adrenal cortical tumors and adrenal medulla tumors. Most of the adrenal tumors were noted in the age group of 21-40 years with female predominance. Most common adrenal lesions noted was pheochromocytoma.

Keywords: Adrenal Cysts; Adrenal Myelolipoma; Adrenal Cortical Tumors; Pheochromocytoma.