Indian Journal of Pathology: Research and Practice

Background: Neoplastic and non-neoplastic Gastrointestinal
tract (G.I) disorders are frequently encountered in clinical practice.
Upper gastrointestinal endoscopy is a common tool for diagnosis.
The common indication of upper gastrointestinal endoscopic biopsy
includes odynophagia, gastroesophageal reflux and dysphagia.
Endoscopic studies include biopsy for histopathological evaluation
in clinically suspicious lesions. Aims and Objectives: To study the
histopathological features in endoscopic biopsy of the gastric
lesions. To study the correlation between various histopathological
gastric lesions with age, sex and clinical presentation. To study
the association of H. pylori in various gastric lesions. Material and
Methods: The present study was done in the department of pathology
and Gastroenterology in Sri Manakula Vinayagar Medical College
and Hospital Pondicherry for 18 months. Detailed clinical history
was taken and endoscopic biopsies were obtained from the gastric
lesions. All the clinical and endoscopic findings of these cases
along with diagnosis were noted down. A total of 74 cases were
collected in the study period. Results: Average age of the patients in
the present study was 46.7 years with 65% males and 35% females.
The most common symptom reported by the patients in the present
study was upper abdominal pain (87.8%). Non-specific gastritis was
the most common diagnosis (48.7%) in the present study. H. pylori
was the second most common diagnosis (36.5%). Adenocarcinoma,
chronic gastritis and hyperplastic polyp/mucosa were diagnosed
in 8.1%, 4.1% and 2.7% of the patients respectively. Conclusion: Our
study confirms that non-specific gastritis and H. pylori gastritis are
the most common etiologies of dyspepsia.
Keywords: Histopathology; Gastrointestinal; Endoscopic biopsy;
H. pylori; Gastritis; Adenocarcinoma.

Introduction: Soft tissue is a non-epithelial extra skeletal tissue of
the body wherein reticuloendothelial system, glia and supporting
tissue of parenchymal organs are excluded. It is constituted by
voluntary muscles, fat, fibrous tissue and supplying blood vessels.
Aim of the study: To analyse the histopathological findings in various
soft tissue tumors and to study its distribution in relation to age, sex
and site. Materials and Methods: This is a retrospective observational
study carried out in the pathology department at tertiary care
academic institute for a period of two years. The specimen was
grossed, processed, sectioned, stained with haematoxylin and eosin.
It includes 106 cases of soft tissue tumors that were diagnosed at our
institute on both clinical and pathological basis. Results: Out of 106
cases, 102 cases (96.22%) were benign and three cases (2.83%) were
malignant in nature and only one case (0.94%) was of intermediate
grade. The commonest age group was 41–50 years and M:F ratio
was 2.52 :1. Among benign tumours, adipocytic tumours constituted
majority of the cases (75.47%), followed by vascular tumours
(12.26%). Extremities was the commonest site for soft tissue tumour
followed by back region. Conclusion: The most common age group
is 41–50 years and the incidence is higher in males than females.
Most common symptom was painless mass. The benign soft tissue
tumors outnumbered malignant tumors. Lipomas were the most
common benign tumours.
Keywords: Soft tissue tumors, lipomas, adipocytic tumors.

Context: Antiglobulin (Coombs) test is very important test in
the detection of incomplete (IgG) antibodies in the blood, either
in free form (Indirect coombs test) or bound to the red blood cell
(Direct coombs test). There is a possibility that anticoagulants like
Ethylenediaminetetraacetic acid (EDTA), Citrate, etc used for the
collection of blood sample, may effect the end result of the test.
Aims: The present study is aimed at comparison of the end result
(the clarity of agglutination) between the coombs test performed on
plain blood and anti- coagulated blood (EDTA and Citrate). Settings
and Design: Blood samples collected from blood donors at the time
of blood donation in plain and anti- coagulated blood (EDTA and
Citrate). Samples were subjected to coombs test at various dilutions
and agglutination was observed under the microscope. Methods and
Material: 6 ml. of blood samples will be collected from the 100 blood
donors at the time of blood donation in and 2 ml each transferred
into; EDTA bottle, Citrate bottle and Plain bottle. The sample thus
collected was used for performing the Anti-globulin test. 10% red
cell suspension was sensitized with Anti D IgG (as supplied by
Tulip Diagnostics) at different dilutions (1/10, 1/20, 1/30, 1/40).
The washed saline suspension of RBC’s is treated with Anti- human
globulin serum and agglutination is observed under a microscope
at 5X objective. Statistical analysis used: Friedman test. Results: The
degree of agglutination obtained by using plain blood samples at
various dilutions, tend to be higher compared to the same obtained
by using citrate and EDTA blood samples. The citrate blood samples
gives intermediate pattern between plain blood samples and EDTA
blood samples. Conclusions: The use of plain blood was found to give
better results compared to citrate and EDTA blood in performing the
antiglobulin test. The chances of missing the detection of low titres
of anti-D IgG is more with EDTA blood samples when compared to
citrate blood samples and least with plain blood samples.
Keywords: Antiglobulin; Coombs; Anticoagulants,
Ethylenediaminetetraacetic acid (EDTA), Citrate

Context: Breast cancer is the most common malignancy in
females. Advancement in cancer management had lead to early
detection and treatment of disease. Recently Immunohistochemistry
plays an vital role in the classification of breast cancer. Estrogen
Receptor/Progesterone Receptor and Human epidermal growth
factor receptor/neu (Her2/neu) status provides prognostic and
therapeutic information. Aims: This study is done to find the
association between Her2/neu by immunohistochemistry and
various clinicopathological factors in breast cancer. Study design: The
present study is a cross sectional study. Material and Methods: Forty
patients who were diagnosed to have carcinoma breast cancer patient
underwent Modified radical mastectomy were included in the study.
The surgical specimen were then evaluated histopathologically using
modified Bloom Richardsons grading and immunohistochemically
for Her2/neu markers. Results: In the present study most of the
cases were aged between 50–60 years. The mean age of presentation
was 52.4. The most common histological type were infiltrating ductal
carcinoma no special type, constituting 35 (87.5%). Grade II tumours
were seen in 57.5%. Her2 was positive in 16 cases (40%), and it
was negative in 26 (60%). Among the positive cases 14 cases were
of Grade III. Lymphovascular involvement was seen in 15 cases.
Conclusion: This study emphasize the need of Her2/neu in routine
histopathological report in breast cancers. Her2 positivity increased
as the tumour Grade increases and also had increased lymphnode
involvement, lymphovascular invasion with poor prognosis.
Keywords: Breast cancer; Human Epidermal Growth Factor
Receptor2/neu; Tumour grade.

Context: Fine needle aspiration cytology is an effective tool for
diagnosing and differentiating the nonneoplastic and neoplastic
salivary gland lesions. However, there are varied reporting formats
which hinders the effective management. The proposed Milan
system for reporting salivary gland cytology provides a platform for
uniform reporting and effective communication among pathologists
and clinicians. Aim: The aim and objectives of this study is to evaluate
and categorize the previously diagnosed salivary gland lesions under
Milan reporting system, to determine the risk of malignancy for each
diagnostic categories and to ascertain the diagnostic accuracy of FNA
in differentiating benign from malignant lesions. Material and Methods:
This retrospective study was conducted in a tertiary care center for 2
years from 2017 to 2019. The cytological diagnosis of salivary gland
lesions were recategorised as per Milan reporting system. The risk of
malignancy and diagnostic accuracy were evaluated by comparing
with histopathological diagnoses. Results: Of 106 cases, highest
number of cases were observed in nonneoplastic category (51.9%).
Histopathological follow-up was available for 51.8% cases. The risk
of malignancy was highest in malignant category (100%) and no risk
of malignancy were identified in nondiagnostic and nonneoplastic
categories. The diagnostic accuracy for differentiating benign and
malignant lesions was 94.55%. Conclusion: This study emphasizes the
need for utility of the proposed Milan classification system in routine
cytology reporting of salivary gland lesions. This six-tier classification
is useful particularly when difficulty arises due to overlapping
morphological features.
Keywords: Salivary gland; Milan system; Risk of malignancy.

The appendicitis is a very common surgical emergency and for
which appendicectomy is the treatment of choice. Appendicitis can
cause morbidity and mortality which is related to appendicular
perforation, gangrene, peritonitis, sepsis, etc. Aims and Objectives:
To study the histomorphological features of the appendicectomy
specimens and its clinical correlation. Materials and Methods: This is
prospective, observational type of study. The total 270 specimens of
appendicectomy received at pathology department of our tertiary
care hospital were studied over a period of 2 years from 1/1/2016 to
31/12/2017. Results: Total of 270 appendicectomy specimens were
studied. The common gross findings in appendicectomy specimens
were inflamed appendix, other were perforation, obliteration
gangrene. Among these 98.51% were involved by non -neoplastic
lesions and 1.49% by neoplastic lesions. Non-neoplastic lesions were
acute appendicitis 219 cases (81.19%), chronic appendicitis 29 cases
(10.74%), perforation in 04 cases (1.49%), gangrenous in 02 cases
(0.74%) etc. Neoplastic lesions includes 2 cases of low grade mucinous
neoplasm and 02 cases of carcinoid tumor. Conclusion: The careful
and systematic study of all the surgically removed appendicectomy
specimens are very important. The most common histopathological
finding in our study was acute appendicitis followed by chronic
appendicitis. The neoplastic lesions were very low. The clinical
diagnosis, relevant investigations and histopathological diagnosis
are important for patients of appendicular lesions in the treatment
and to reduce the morbidity and mortality.
Keywords: Histopathology; Appendicitis; Clinical features; Pain
abdomen.

Introduction: Infertility is an increasingly common problem
in recent times, affecting one in six couple, urging them to take
treatment even in young years of age. During the past few decades, it
is observed that semen volume, sperm count, percentage of motility
and number of sperms with normal morphology are declining
gradually. In this study, Semen Volume, Sperm Concentration,
Motility and Morphology were examined in men presenting with
infertility. Materials & Methods: This is a descriptive cross-sectional
study done after getting consent from patients presenting with
Infertility in a tertiary care hospital. 197 patients were included in the
study over a period of one year from April 2018 to March 2019. This
study included men between age group of 20–50 years. Collected
Semen samples were checked for semen volume, sperm count,
motility and morphology. Results: Out of 197 men included in the
study, Hypospermia is observed in 51% (n = 101). Oligozoospermia
seen in 44% (n = 87), Asthenozoospermia is seen in 49% (n = 95)
and Teratozoospermia is seen in 49% (n = 97). All 3 parameters
– Oligozoospermia, Asthenozoospermia and Teratozoospermia
incidence were increased in smokers and alcoholics as compared to
men without these habits. Conclusion: It was observed in this study
that men who came for infertility screening are having abnormalities
in various semen parameters and have to be treated, since infertility
due to male factors are not given importance especially in a rural
population. Further it is noticed that quality of seminal parameters
are affected in association with smoking and alcoholic habits.
Keywords: Infertility; Motility; Morphology; Sperm Count.

Oral cancer accounts for 3% of all malignant neoplasm’s and is
the eighth most common cancer in the world, with epidemiologic
variations among different geographic regions. It causes substantial
mortality and morbidity. Oral squamous cell carcinoma (OSCC)
is of significant public health problem in India, and it accounts
for approximately 30% of all cancers in the country. The objective
of the present study was to compare individual histopathology
parameters of malignancy between non-metastatic and metastatic
SCC of the tongue to contribute to the identification of morphologic
parameters associated with cervical metastasis that could serve
as indicators of aggressiveness. We carried out a retrospective
analysis of 69 patients with tongue cancer who had undergone wide
excision and neck dissection. The histopathological characteristics
of the tumour, such as, degree of tumour cell differentiation, depth
of invasion, pattern of invasion, perineural invasion, and local
host response were studied using standard statistical analysis to
determine their association with neck nodal metastasis. The goal is
to correlate these parameters with cervical metastasis to determine
the optimal treatment for tongue cancer.
Keywords: Oral cancer; Pattern of invasion (POI); Aggressiveness.

Background: Gastrointestinal tract malignancies (GIT) are on the
rise and it is imperative to identify individuals at risk of developing
relapse or metastasis and decide on management protocol
consequently. Accurate risk assessment is pivotal to balance benefit
versus overtreatment. Recently the tumour bud scoring has been
included as a marker in cancers. The present study was planned
to determine the association of tumour budding with various
clinicopathology parameters in GIT malignancies. Material &
Methods: This was a retrospective study conducted over a duration
of two years including 40 cases. Tumour budding was counted in
the maximum invasive area. Tumour budding was defined as the
presence of single tumour cells or small clusters of up to five cells
in the tumour stroma, Correlation between tumour budding and
various clinicopathological characteristics were tested by chi-square
test, with p < 0.05 significance. Results: There was a statistically
significant association between grade of tumour budding and
histologic type (p < 0.048), histologic grade (p < 0.000), lymph
vascular invasion (p < 0.000), TNM staging (p < 0.001) and tumour
interface (infiltrative versus expansile) (p < 0.004). Conclusion:
Astandardized information about presence of tumour budding in
routine histopathology reporting of GIT malignancies will help
clinicians in adopting an effective modality of treatment for better
patient care.
Keywords: Tumour budding; Gastrointestinal tract; Prognosis.

Introduction: Lesions of urinary bladder constitute an important
source of clinical signs and symptoms. Both neoplastic and nonneoplastic lesions do occur commonly, however the former being
the most common type. Majority of urinary tract tumors are
epithelial in origin, among which 90% of them are urothelial in
origin. Objective: To evaluate the histopathological spectrum of
urinary bladder lesions with emphasis on the neoplastic lesions
with reference to 2016 WHO classification of tumors of urinary
system. Materials and Methods: This was a prospective study and
includes all the urinary bladder specimens received. They were
examined grossly and processed completely as per the standard
procedure. Multiple sections of 3–5 microns were taken and
stained with H & E, followed by light microscopic examination
to study various non-neoplastic and neoplastic lesions. Results:
Total 65 cases were studied, 30 were cystoscopic biopsies and
35 were TURBT specimens. There were 40 males and 25 females
constituting up to 61.54% and 38.46% respectively. Chronic
non-specific cystitis was the common non-neoplastic lesion.
Among neoplastic lesion, Invasive urothelial carcinoma was
the predominant lesion constituting 22 cases (62.86%). These
neoplastic lesions were more common among males (74.28%)
with M:F ratio of 2.8:1. Conclusion: Urinary bladder lesions
are most frequently encountered by surgical pathologists and
are heterogenous. Both benign and malignant lesions are well
documented but latter being more common. Many of these are
more common in elderly people with male predilection and are
often associated with smoking. Identifying the extent of invasion
by microscopic examination constitutes an important aspect in
urothelial carcinomas.
Keywords: Urinary bladder; Cystoscopic biopsy; Transurethral
resection of bladder tumor; Invasive urothelial carcinoma.

Lymphomas are broadly classified in to Hodgkins lymphoma
(HL) and Non Hodgkins lymphoma. Immunohistochemistry
helps in better understanding of pathogenesis and also useful
in the characterization of immunophenotype in most of the
malignant lymphomas. Aims & Objectives: The current study
was undertaken to categorize malignant lymphomas based on
morphological and immunohistochemical findings. Materials
and Methods: Fifty cases of Lymphomas were diagnosed in the
Department of Pathology, at MVJ Medical College Research
Hospital, over a period of two year (between April 2015 and
April 2017). The data was analyzed with respect to age, sex,
histomophological and immunohistochemical characters.
Results: Out of 50 cases, 12 were of HL (24%) and 38 cases
(76%) were NHL. Among NHL, B-cell and T-cell lymphomas
were of equal incidence. Male’s outnumbered females (68%) &
maximum incidence of lymphomas including both sexes was
seen in age group 51-60 years followed by age group 41–50
years. Conclusion: IHC is a useful adjunct modality with H&E
stain in diagnosis and classification of malignant lymphomas.
Keywords: HL; NHL; T-cell; B-cell; RS cell.

Background: Hashimoto thyroiditis (HT) is the most commonest
form of autoimmune thyroiditis with heterogenous clinical
presentation. Recently a type of Hashimoto thyroiditis with dense
lymphoplasmacytic infiltration and marked fibrotic changes with
increased number of IgG4-positive plasma cells and serum IgG4
have been reported in the literature and they have a close relationship
to IgG4-related disease (IgG4-RD). On the basis of immunostaining
for IgG4, HT was divided into an IgG4 thyroiditis group and a
non-IgG4 thyroiditis group and their clinical and histopathological
features were studied. Aims and Objectives: To categorize Hashimoto
thyroiditis with reference to IgG4-positive plasma cell infiltration
and to study the histopathological characteristics of each group.
Materials and Methods: It was a retrospective cross sectional study for
a period of one and half year. Cases which were histopathologically
diagnosed as Hashimoto thyroiditis were included in the study.
Immunohistochemistry marker done for IgG4 and the foci with the
highest density of positive cells was evaluated. Results: Among the
13 cases of Hashimoto thyroiditis 8 cases were subtyped into IgG4
thyroiditis group and 5 cases into non IgG4 thyroiditis group based
on immunohistochemistry. All the cases were females in both the
groups and the age of presentation in IgG4 thyroiditis was younger
when compared to non IgG4 thyroiditis. Histopathologically,
IgG4 thyroiditis showed marked fibrosis and moderate to severe
lymphoplasmacytic infiltration with increased IgG4 positive plasma
cell infiltration when compared to non IgG4 thyroiditis. Conclusion:
Immunostaining of IgG4 can help in the subtyping of Hashimoto
thyroiditis and are closely related with IgG4 related diseases. IgG4
Hashimoto thyroiditis presents with a distinct histopathological
features when compared to non IgG4 thyroiditis.
Keywords: Hashimoto thyroiditis; IgG4; Immunohistochemistry;
Fibrosis; Histopathology.

Background: Psoriasis is a chronic proliferative and inflammatory
disease of genetic etiology. The clinical presentation of psoriasis
is varied and often results in incorrect interpretation and misdiagnosis. There is a need for histopathological confirmation for
effective case management. This study was carried out to evaluate
the clinicopathological presentation of psoriasis. Methods: This cross
sectional study was carried out among 100 clinically diagnosed
psoriasis specimens which were examined for histopathological
diagnosis. Hematoxylin and eosin staining was carried out for
histopathological evaluation. Results: Majority of the participants
were aged between 31-50 years and were adults. The most common
clinical presentation was silvery scaly plaques which were itchy and
pigmented (55%). Most of the patients (95%) had itchy nature of
the lesion. Of the 100 cases studied, 86 were diagnosed as psoriasis
clinically. Among the 86 cases, 80 were psoriasis vulgaris, 6 were
pustular psoriasis. By histological examination of skin biopsies,
96 cases were found to be psoriasis, three cases were psoriasiform
dermatitis, one case of psoriasiform hyperplasia. Conclusion:
Histological confirmation helps in ruling out diagnostic dilemma to
psoriasis like alterations in the skin, which often gives a confusion
to the clinician.
Keywords: Histopathology; Psoriasis; Plaques; Skin disorder.

Background: Hemangioblastomas are benign vascular tumors with
large majority of them arising within the cerebellum and produce the
neurologic manifestations. They can appear either sporadically or due
to an association with von Hippel-Lindau (VHL) disease. This study
was done with the aim of knowing the current spectrum of incidence,
varied locations, age and gender distribution in hemangioblastomas
and their association with von-Hippel-Lindau (VHL) disease. Methods:
A 5 year retrospective study was conducted in the Department
of Neuropathology, Institute of Neurosurgery from January 2014
to December 2018 and histopathologically confirmed cases of
Hemangioblastomas were compiled. Results: A total of 20 cases of
hemangioblastomas were identified during the study, all of which were
histopathologically confirmed. Among them 18 were intracranial and 2
were spinal hemangioblastoma. The most common age group affected
in sporadic cases were 41–50 years (7 cases) and in VHL associated
case was 11–20 years (1 case). Cerebellar location was the commonest
seen in 13 cases (65%), followed by medullary, cerebellopontine angle,
parieto occipital and cervical spine in decreasing order of frequency.
Male predominance was seen unlike previous studies. Conclusion:
The current spectrum of cases of hemangioblastomas with respect to
incidence, various locations encountered, age and gender distribution
were seen. The nature of presentation of paediatric hemangioblastomas
is different, genetic heterogenicity and association with VHL has to
be ruled out. Histological subtyping of the hemangioblastomas is
necessary, after ruling out the differentials. Proper follow-up of the
cases of hemangioblastomas are needed to look for recurrence.
Keywords: Hemangioblastomas; Cerebellar location; Von
Hippel-Lindau disease.

Background: Bethesda system of reporting thyroid cytology helps
in uniform reporting and clear communication among doctors for
further management. This also helps in clear cytopathological and
histopathological correlation. Aims and Objectives: This study was
undertaken to classify thyroid lesions under Bethesda category and
to correlate it histopathologically. Material and Methods: A total of 110
patients were studied in a prospective study of one year duration
from January to December 2019 at a tertiary care hospital care
hospital of eastern U.P. and the results were correlated cytologically
and histopathologically. Results: Based on the Bethesda system, out
of 110 lesions of thyroid, 79% were of Category II, least cases were
of Category V and Category VI. While no cases were under atypia
of undetermined significance. Out of these 52 cases were further
compared on histopathology and correlated. Conclusion: Review
of thyroid lesion by Bethesda system embarks better and uniform
categorization which facilitates and simplifies further management
of patients and also reduces unnecessary surgical procedure in
benign cases.
Keyword: Bethesda; FNAC; Cyto-Histopathological correlation.

Background: Acute Eosinophilic Appendicitis (AEA) is a rare entity
characterised by eosinophilic infiltration of muscularis propria with
accompanying edema separating the muscle fibres. It presents with
similar symptoms as classical appendicitis. Objective: The present
work aims to study the histomorphological features of AEA. Methods:
Total 178 cases of appendicectomy were studied in the department
of Pathology, MIMSR Medical college, Latur. Clinical features, gross
and microscopic features were studied in detail. Results: Out of 178
cases of appendicectomy, 4 were diagnosed as Acute eosinophilic
appendicitis. It included 1 male child, 2 adult males and 1 adult
female. Conclusion: AEA cannot be diagnosed before surgery, hence
Histopathology is the gold standard for diagnosis of AEA.
Keywords: Appendicitis; Eosinophilic; Histopathology.

Objective: To analyze the spectrum of Oral lesions detected in
a tertiary health care hospital, in Nanded, Maharashtra. Materials
and Methods: This is a 1 year prospective study from January 2018
to December 2018. All the oral cavity specimens received in the
Department of Pathology, Dr. Shankarrao Chavan Government
Medical College, Nanded) during the study period was included
for the study. Data regarding the age, sex, clinical complaints
of subjects, location and type of lesions were obtained for each
case. All the histological sections were stained in hematoxylin &
eosin stain mounted. All the histological sections were examined
microscopically & findings were recorded and tabulated. Results: A
total of 60 cases were analyzed during the study period. The age
group ranged from 3 to 70 years in the study. Overall males were
affected more than the females with male:female (M:F) ratio of 1.6:1.
Buccal mucosa (43.34%) was the commonest site involved followed
by tongue (30%). Maximum lesions were malignant: 40%, followed by
benign lesions: 35%, premalignant lesions: 15% and non-neoplastic
lesion: 10%. Among the neoplastic lesion, squamous cell carcinoma
(SCC) was seen in 75% cases; verrucous carcinoma in 20.83% and of
adenoid cystic carcinoma in 4.16% cases of neoplastic oral lesions.
Mild Dysplsia, 45.45% was the most common premalignant lesion,
hemangioma was the commonest benign oral lesions 54.16% and
Inflammatory lesions 50% were the most common non-neoplastic
lesion. Most common chief complaint was growth in oral cavity (42
cases, 70%). It was also noted that tobacco chewing was the most
prevalent habit amongst the patients with oral lesions, comprising
of 21 cases (35%). Conclusion: A variety of lesions were encountered
in the study with predominance of malignant lesions. Squamous
cell carcinoma was the commonest malignant lesion, and buccal
mucosa was the commonest site involved.
Keywords: Oral cavity lesions; Tobacco chewing; Buccal cavity;
Squamous cell carcinoma.

Introduction: Endometrium being a dynamic tissue undergoes
physiologic and morphologic changes in response to hormones
produced in ovary. Various patterns of subtle ovarian changes is
related to morphologic alterations in endometrium. Objective: To
correlate histopathological features of endometrium with those of
ovarian pathology in hysterectomy with salphingo-oophorectomy
specimens. Materials and methods: It was a retrospective study
of hysterectomy with salpingo-oophorectomy specimens from
January 2017 to June 2018. Histopathology slides were reviewed
and findings were documented. Various histopathological patterns
in endometrium and corresponding ovarian histopathological
features were documented, categorized and analyzed. Results: One
hundred and forty-three cases were analyzed. Endometrium showed
proliferative phase in 47 cases (32.87%) and constituted the most
common pattern. Right ovary was examined in 134 cases. Left ovary
was examined in 114 cases. Both the ovaries showed corpus albicans
as the most common non-neoplastic finding. Right ovary showed
benign serous cystadenoma [3.73%] as the most common neoplastic
lesion. Left ovary showed benign cystic teratoma [2.63%] as the most
common neoplastic lesion. Conclusion: Histopathological changes
in ovary and endometrium are complimentary. Ovarian tissue
findings may reflect histopathological patterns of endometrium.
Keywords: Hormones; Cystadenoma; Teratoma.

Context: The measurements of platelet count, mean platelet
volume (MPV), are routinely available nowadays. So this study
was designed to study the causes of reactive thrombocytosis. Aims:
To study the association of reactive thrombocytosis in different
underlying clinical conditions and its age dependent aetiology. Also
to study the relation between reactive thrombocytosis and platelet
volume. Settings and Design: Prospective study. Methods and Material:
This descriptive study was done on 500 patients with platelet count
> 450,000/l and the cause being reactive. Platelet count and MPV
were measured at the time of hospitalization. Statistical analysis used:
Cross tabulations for categorical data & correlation for continuous
data in the SPSS ver.19 programme. Results: Most common cause
of reactive thrombocytosis was Infections (28.8%), Tissue damage
(16.4%), Iron deficiency anemia (16.2%), Malignancy (9.6%) and
Inflammation (9.4%). In infections, bacterial infections (88%) were
found to be more common. In children, infections 24.7%, anemia
21.9 %, tissue damage 21.9, haemolytic anemia 5.7%, inflammation
(non-tuberculosis) 5.7%, poisoning 5.7% and tuberculosis 4.8% were
common causes studied. Conclusion: Thrombocytosis is not rare in
children. Causes of reactive thrombocytosis were almost similar
in both the paediatrics and adults. Secondary thrombocytosis is
common and predominatly attributed to infection. This study
demonstrated a higher level of platelet count and lower MPV in all
the patients having reactive thrombocytosis.
Keywords: Thrombocytosis; Mean platelet volume; Platelet
count.

Background: It is not uncommon for most women to suffer from
abnormal uterine bleeding (AUB) at some point of their lifetime
which results in anemia, interferes with daily activities and
raises concern about uterine cancer and they frequently undergo
hysterectomy in our country. Aim and Objective: 1. To evaluate the
prevalence of adenomyosis, leiomyomas and of their concomitance
in hysterectomy specimens. 2. To study the type of leiomyomas
on the basis of their location in uterus. Materials and Methods: A
retrospective study of 120 pathological specimens those underwent
hysterectomy during the period of January 2015 to December
2018. Data including age, symptoms and clinical indication for
hysterectomy was collected for the study. The specimens were
processed routinely and stained with haematoxylin and eosin
stain and examined microscopically. We looked for prevalence of
adenomyosis alone, of leiomyomas alone and of their concomitance
were evaluated. Results: Mean age of the patients was 45.2 years.
Pathological findings included adenomyosis in 25%, leiomyoma
in 60%, and both in 15%. 72 specimens had fibroid which were
evaluated for number and its location. Conclusion: leiomyoma
was the most common histopathological finding in hysterectomy
specimens and prevalence of adenomyosis in our study was nearly
equal. So gynecologist must pay attention to adenomyosis as one of
the common underlying causes of AUB.
Keywords: Hysterectomy; Abnormal Uterine Bleeding;
Adenomyosis Leiomyoma.

Acquired immunodeficiency syndrome (AIDS), one of the
most devastating infectious diseases to have emerged in recent
history is characterised by impairment of cellular immunity with
severe reduction in T-helper cells. Complications of AIDS include
opportunistic infections, unusual neoplasms and unexplained
lymphadenopathy. Hematological abnormalities “involving all
the three lineages of blood cells” are among the most common
complications of AIDS infection. Hundred cases of HIV patients
were studied for various cytopenias and bone marrow changes.
Cytopenias was seen commonly in HIV patients, most frequently
anemia (97%), followed by thrombocytopenia (40%) and leucopenia
(34%). Dyspoietic cells were seen in all lineages, in bone marrow
study. Megakaryocyte dyspoiesis was seen in 91% cases on bone
marrow biopsy (BMB), whereas bone marrow aspirate showed
erythroid dyspoiesis in 75% cases and myeloid dyspoiesis in 45.8%
cases. BMB showed atypical lymphoid aggregates in 11% cases and
abnormal cells were seen in 9% cases. Granuloma was seen in 22
cases on BMB, out of which 8 cases showed AFB positivity and one
case showed intracellular yeast form suggestive of histoplasma.
The study showed disparity between peripheral cytopenias
and marrow hyperplasia which suggests mechanisms of either
ineffective hematopoiesis, abnormal release or increased peripheral
destruction.
Keywords: HIV; AIDS; Hematological changes, Bone marrow
changes; Cytopenia; Dyspoiesis.

Background: Diabetes mellitus (DM) is a complex disease
characterised by chronic hyperglycemia that leads to long term
macrovascular and microvascular complications. Several studies
have shown that DM affects the morphology and functioning of
red blood cells, white blood cellsand platelets, which is reflected
as aberrations in routinehaematological parameters. Thus the
aim of this study was to determine the changes in haematological
parameters in diabetic patients in comparison to healthy controls.
Materials and Methods: A cross sectional study was conducted
from Jan 2019 till June 2019, in Department of Pathology, SNMC,
Bagalkoton 115 already diagnosed diabetic patientsand 115 age
and sex matched apparently healthy individuals. Haematological
indices, fasting blood glucose and glycated haemoglobin (HbA1c)
levelswere determined. p-value less than 0.05 were considered as
statistically significant. Results: Red cell distribution width was
significantly increased in diabetic patients as compared to the
control group (17.46 ± 1.75 vs 13.40 ± 1.69) with a p-value of 0.001.
Both, mean cell volume and mean cell haemoglobin were reduced
with average of 73.29 ± 7.36 and 27.18 ± 3.18 respectively in diabetic
patients, as compared to the control group (p = 0.000). There was
significant difference in red blood cell count between diabetics and
control group (4.63 ± 0.911 vs 4.29 ± 0.67). All biochemical parameters,
fasting blood sugar, post prandial blood sugar and HbA1c (149.55 ±
62.79, 234.77 ± 80.10 and 7.81 ± 2.35 respectively) were significantly
higher in diabetic patients. Though mean platelet volume was higher
in diabetic group (7.78 ± 0.953) as compared to control group (7.10
± 1.207), it was not statistically significant (p = 0.107). Analysis of
peripheral blood smear of diabetic patients showed changes in RBC
morphology. Hypochromia and anisopoikilocytosis were seen. Of
all the parameters, only MPV was statistically correlated with FBS
levels (r = 0.285, p = 0.002). Conclusion: The study showed statistically
significant difference in some haematological parameters of diabetic
patients compared to controls. Thus, routine haematological profile
checkup of diabetic patients is recommended as it may indicate
towards the impending vascular complications associated with
aberrations in haematological parameters.
Keywords: Type 2 Diabetes mellitus; Haematological indices;
Fasting blood sugar; Glycated haemoglobin.

Background: Fine needle aspiration cytology (FNAC) is a unique
first line of investigation for triaging patients with thyroid nodules.
It is a simple economical and minimally invasive procedure
reducing the rate of unnecessary surgery for patients with benign
nodules. Objective: The aim of this prospective study was to assess
the efficacy of The Bethesda System for Reporting Thyroid Cytology
(TBSRTC) in accurate prediction of thyroid lesions on fine needle
aspiration (FNA). Study design: In this prospective study of 110
FNAC of thyroid nodules referred to the Department of Pathology
at Sri Siddhartha Medical College, Tumkur and histopathological
report was correlated wherever it was available. Results: Of the
110 cases, 0.9% was nondiagnostic, 83.6% were benign, 0.9% were
atypical follicular lesion of undetermined significance (AFLUS),
3.6% were suspicious for follicular neoplasm (SFN), 3.6% were
suspicious for malignancy, 7.2% were malignant. Conclusion: The
Bethesda system of Reporting Thyroid Cytopathology (TBSRTC)
undoubtedly represents a major step towards standardization,
reproducibility and ultimately improves clinical significance,
usefulness and predictive value of thyroid FNAC.
Keywords: Thyroid nodule; Fine needle aspiration cytology; The
Bethesda system of reporting thyroid cytopathology.

Background: Fine needle aspiration cytology (FNAC) is considered
a superior and more cost-effective tool for diagnosis of chronic
lymphocytic thyroiditis. Chronic lymphocytic thyroiditis is an
autoimmune disorder where in which thyroid follicles are rapidly
destroyed. Aim: To assess cytomorphological spectrum of chronic
lymphocytic thyroiditis with respect to the clinical, biochemical,
ultrasonographic, and radionuclide parameters.Material and Methods:
Hospital based descriptive cross-sectional study was conducted on
172 cases of chronic lymphocytic thyroiditis. Results: Majority were
females presenting in 3rd to 4th decade. Cases diagnosed on FNAC
were 155 and on histopathology were 17. Among FNAC diagnosed
cases, commonest clinical presentation was diffuse (65.6%) followed
by Nodular (30.9%). Only 50% showed hypothyroidism followed by
hyperthyroidism (30%) and majority cases (73.55%) showed grade
2 follicular destruction. Cases diagnosed on histopathology mainly
presented as nodules. Cellular changes in follicular & hurthle cells
led to false positive diagnosis of neoplasia in 6 cases. Four cases
of papillary cancer with thyroiditis were misdiagnosed as goitre
and follicular neoplasm on FNAC. Conclusion: FNAC remains first
line diagnostic modality for thyroiditis. The cytological grades of
follicular destruction in thyroiditis can predict functional status.
Few cases might be missed due to inherent procedural limitations,
changing clinical presentation and associated neoplasms. On FNAC,
presence of colloid, follicular hyperplasia and neoplasm could lead
to diagnostic pitfalls, hence thorough cytological evaluation and
integrated approach is necessary.
Keywords: Hashimoto Thyroiditis; Hurthle cells; TMA; FNAC.