Indian Journal of Pathology: Research and Practice

Introduction: Autopsy plays a crucial role in arriving at the cause of death. At the same time it also unravels a
multitude of findings which would not have clinically manifested. This study throws light on many such findings
which would have otherwise gone unnoticed.

Aim: This study aims at determining the spectrum of histopathological findings including inflammatory, non
neoplastic and neoplastic lesions which were found incidentally and were unrelated to the cause of death with
special emphasis on interesting lesions.

Materials and Method: A retrospective study of medicolegal autopsies for three years i.e., from January 2017 to
December 2019, was undertaken in a tertiary care centre to determine the spectrum of histopathological findings
unrelated to the cause of death.

Statistical Analysis: Individual lesions were expressed in numbers and incidence in percentage along with the
cause of death.

Results: The study consisted of a series of 288 autopsy cases out of which 116 cases had some incidental finding
unrelated to the cause of death. Atherosclerosis was the most common incidental finding (67 cases, 57.75%) followed
by fatty liver (41 cases, 35.34%).Neoplastic lesions accounted for 6.9% of all cases.

Conclusion: This study has elucidated common incidental findings on autopsy reflecting their prevalence in
general population along with afew neoplastic lesions that were discovered incidentally like psammomatous
meningioma, leiomyoma of kidney and serous cystadenofibroma of ovary.

Keywords: Medicolegal autopsies; Incidental finding; Atherosclerosis; Fatty liver
 

Cytsic lesions around joints are commonly encountered in clinical practice. Olecranon bursitis is one such
common condition where the bursal cavity, superficial to the olecranon, becomes inflamed with or without
superadded infection depending on the aetiology.Along with X ray and ultrasound, fine needle aspiration cytology
is a commonly asked procedure for this entity which also provides pain relief by reducing pressure on the bursa.
The thorough history taking supplemented by correlation of various findings in all these investigations can help
add rational to decision-making processes aiding targeted treatment and better patient care. We present a case of
olecranon bursitis to highlight the importance of history taking and to make the reporting cytologist aware of the
minor variations that can be seen on the aspirate smears.
Keywords: Olecranon bursitis; FNAC; Cytology
 

Context: Thalassemia is one of the most common hereditary disorders in Asia and most parts of the world and has drawn the attention of scientific research by many.It is accompanied with metabolic dysregulation, iron overload, chronic hypoxia and cell damage. All physiological changes result in ineffective erythropoiesis, hemolysis and
anemia. Most patients are dependent on either blood transfusion or bone marrow transplantation for survival. Regular transfusion has improved the span and quality of their lives but has been known to cause alterations in the hematological and biochemical parameters.

Aims: The present study was conducted to assess the changes in hematological and biochemical parameters in thalassemia patients for timely correction of any deranged parameters, to prevent any severe complications and to improve quality of life.

Methods and Material: The study was done on 35 thalassemia patients who were admitted for treatment and blood transfusions. Thirty-five healthy individual controls were matched by sex and age. Total iron binding capacity (TIBC), Serum Iron, Serum Calcium, Serum creatinine, Serum phosphorus (P), Serum Alkaline phosphatase (ALP) and Serum Ferritin were estimated. Hemoglobin (Hb), Hematocrit (HCT), Mean corpuscular volume (MCV), Mean corpuscular haemoglobin (MCH), Mean corpuscular haemoglobin concentration (MCHC), Platelet count, Red Cell Distribution Width-Standard Deviation and Coefficient of Variation (RDW-SD, RDW-CV) were measured. Statistical Analysis Used: Statistical analysis was performed using statistical package for the social sciences (Version 17). Results were compared using independent t-test and Mann Whitney U test.

Results: Hb, HCT, MCHC, TIBC, Serum Creatinine and Serum Phosphorous were significantly decreased (p<0.005) in thalassemia patients when compared with control group. RDW(SD), RDW(CV), Serum Iron and Serum Ferritin showed a statistically significant increase (p<0.005) in the thalassemia patients. MCV, MCH, Platelet count,
Serum Calcium and Serum ALP showed no significant difference.

Conclusion: Repeated blood transfusions in thalassemia cause derangement of many hematological and biochemical parameters. Regular monitoring of these parameters is important for better management of patients.

Keywords: Thalassemia; Blood transfusion; Hematological; Biochemical Parameters.

Key Messages: Regular blood transfusion in thalassemia patients causes derangement in their hematological and
biochemical parameters. It is important to monitor these parameters in all thalassemia patients undergoing repeated
blood transfusions. Regular assessment will help in providing timely correction of any deranged parameters,
prevent severe complications and improve the quality of life in these patients.
 

Introduction: Ascites is the pathologic accumulation of fluid within the peritoneal cavity. Accumulation of fluid in the peritoneal cavity resulting in ascites has many different mechanisms.The proper evaluation of ascitic fluidhelps in narrowing the diagnostic dilemma faced by the physicians and helps in better management of the patients.

Objectives: The present study aims to assess the value of ascitic fluid cytology in the differential diagnosis ofascites along with various biochemical parameters and its usefulness in the patient management.

Material and Methods: This prospective study was conducted in the Department of Pathology, at SNMC Bagalkot
over a period of 6 months from November 2019 to april 2020. This study included 120 patients who presentedwith ascites.Detailed examination – physical, cytological, biochemical and microbiological (wherever indicated)was done.

Results: Most common cause of ascitis was cirrhosis followed by tuberculosis,Malignant ascitis was noted in 8.3%
cases. Ascitic fluid cytology was useful not only in the diagnosis but also to assess the response to treatment in thesecases. The total protein content of ascitic fluid was significantly lower in cirrhotic cases as compared to tubercular,acute infective cases and malignant cases.

Conclusion: The exudative ascites is seen with tubercular acute infective and malignant ascites, with proteincontent >3.0 gm/dl and lower glucose levels while the transudative ascites as seen commonly with cirrhotic asciteshas protein content <3.0 gm/dl and a higher glucose levels.The careful cytomorphological examination of ascitic fluid is a valuable, simple, rapid, inexpensive and reliable
technique in the differential diagnosis of ascites.

Keywords: Ascitic fluid cytology; Transudate; Exudate; Cirrhosis.
 

Aims: To analyze clinical parameters, histomorphological features of Nasopharyngeal angiofibroma.Materials and Methods: The present study is a retrospective and prospective study conducted for 6 ½ yrs. durationin a total of 7222 head and neck cases operated, out of which 78 cases were diagnosed as juvenile nasopharyngeal
angiofibroma. All patients were evaluated with routine lab investigations and all clinical features noted. Thepatients were investigated with x-ray and CT head and neck.

Results: Incidence of juvenile nasopharyngeal angiofibroma was 1.08% of head and neck tumours. In all the cases were male incidence was high in second decade.The tumour tissue was lined by pseudostratified epithelium in 52 cases (66.66%) followed by squamous (metaplastic) in 14 cases (17.94%). Remaining 12 cases showed ulceration and
granulation tissue.The calibre of vascular channels was studied in detail showed 36 cases (48.71%) with small thin nonmacular followed by 29 cases which showed large thin nonmuscular vessels. Stroma was composed of plump cells, edematous and fibrous components. Out of 78 cases, 45 cases (57.69%) were composed of mixed pattern with
any of the two or all three components. Secondary changes like thrombus, hemorrhage and necrosis were observed in 17 cases.25 sections rich in stromal cells were selected and subjected to immunohistochemistry-C-kit. Out of 25 cases 23(92%) showed high to moderate immunoexpression and 2 cases (8%) showed weak positivity. C-kit expression was seen in all cases of nasopharyngeal angiofibroma with 92% of high expression.

Conclusions: Study showed new hope and promise of application of C-kit expression in nasopharyngeal angiofibromas to evaluate the response to imatinib therapy.

Keywords: Nasopharngeal; Angiofibroma and C-Kit.
 

Background: Skin adnexal tumors are a group of skin tumors which differentiate towards hair follicles, sebaceousglands, eccrine and apocrine sweat glands. These tumors are uncommon in routine practice and usually cause diagnostic problems. The aim of this study was to determine the incidence of skin adnexal tumors, its correlation
with age group and sex and to study detail histopathological characteristics of each tumor by light microscopy.

Material and Method: A prospective and retrospective study was conducted on 50 cases for four years period (2009to 2013) in department of pathology, ASCOMS, Jammu.

Result: Among the all types of skin appendageal tumors diagnosed 94% were benign and 6% were malignanttumors. Maximum benign tumor cases were seen in age group of 26-50 years and maximum malignant caseswere seen in age group 51-75 years. Tumors were observed most frequently on the scalp in both the sexes. As per
histopathological types of the benign skin appendageal tumors, benign follicular tumor was seen in 23 cases (46%),benign eccrine tumor in 20 cases (40%), benign apocrine in 3 cases (6%) and benign sebaceous tumor in one case(2%).As per histopathological types of malignant tumors, 2 cases of eccrine porocarcinoma and a case of sebaceous
carcinoma were seen.

Conclusion: The incidence of appendageal skin tumors is relatively uncommon. Histopatholgical study of
clinically suspected cases of skin appendageal tumor is a need of an hour.

Keywords: Skin appendageal; Benign tumors; Malignant tumors; Histopathological findings.
 

Background and Aim: Hypertensive disorders of pregnancy commonly known as Pregnancy Induced Hypertension (PIH), affects about 10% of all pregnant women around the world. A variety of haematological abnormalities may occur in women with PIH, thrombocytopenia being the most common. There is also a definite exaggeration of the
hypercoagulable state during PIH due to increase in coagulation factors like fibrinogen. A strong relationship exists between the two most important causes of maternal mortality and morbidity worldwide: Preeclampsia and Postpartum haemorrhage. The aim of this study was to find out the changes that occur in the coagulation profile and
platelet indices in PIH as compared to that in normal pregnancy and if they can be used as a reliable indicator of the onset and severity of Disseminated Intravascular Coagulopathy (DIC) and HELLP Syndrome.Method: A total of hundred pregnant women (50 PIH and 50 control) within the age group of 18 to 35 years after 20 weeks period of
gestation were admitted in the antenatal ward of the Department of Obstetrics and Gynaecology of Index Medical College, Indore. Their complete blood picture with platelets count and coagulation profile were done to compare with normal control pregnant women. Result: Bleeding time (BT), Clotting time (CT), one stage Prothrombin time
(PT), activated partial Thromboplastin time (aPTT) and Thrombin time (TT) was significantly higher amongst cases
than in controls. Conclusion:Thus, authors came to the conclusion that platelet indices and coagulation profile canbe used as a reliable early indicator of onset and severity of DIC and HELLP Syndrome.

Keywords: Pregnancy induced hypertension; coagulation profile; Disseminated Intravascular Coagulopathy; HELLP Syndrome.
 

Benign prostatic hyperplasia (BPH) and adenocarcinoma are common diseases that account for considerablemorbidity and mortality in the aging population. Prostatic intraepithelial neoplasia (PIN) refers to the preinvasive end of the continuum of cellular proliferations within the lining of the prostatic ducts, ductules and acini, with cytological changes mimicking cancer.Prostate cancer (PCa) is the most prevalent cancer found in men above the age of fifty years. Adenocarcinoma of the prostate range from well-differentiated gland forming cancers to poorly
differentiated tumors.

Aim: To evaluate the histopathological variants of prostatic lesions in prostatectomy specimens.

Materials and Methods: A prospective study was done to evaluate the various histological lesions in prostate specimens received in our institution. Statistical Analysis Used: The data collected was entered in MS Excel spreadsheet and analysed using SPSS version 20.
Results: Out of 90 prostate specimens studied, commonest pathology encountered was benign lesions constituting 94.5% and malignant lesions were 5.5%. Out of 84 cases of benign lesions, 51 cases (64.28%) were diagnosed as nodular hyperplasia only and NH was associated with 6 cases of basal cell hyperplasia (7.14%), 5 cases of squamous metaplasias (5.95%), 2 cases of transitional metaplasia (2.38%), and 20 cases (23.80%) of prostatitis. Diagnosis of
prostatic carcinoma was made in 5 cases (5.5%).

Conclusion: Histologically, all the malignant lesions encountered were adenocarcinoma of prostate. The commonest pattern seen was acinar followed by arrangement of tumor cells in cords, sheets and cribriform pattern.
Keywords: Benign prostatic hyperplasia (BPH); Prostatic intraepithelial neoplasia (PIN); Prostatic adenocarcinoma.
 

Benign prostatic hyperplasia (BPH) and adenocarcinoma are common diseases that account for considerable morbidity and mortality in the aging population. Prostatic intraepithelial neoplasia (PIN) refers to the preinvasive end of the continuum of cellular proliferations within the lining of the prostatic ducts, ductules and acini, with cytological changes mimicking cancer.Prostate cancer (PCa) is the most prevalent cancer found in men above the age of fifty years. Adenocarcinoma of the prostate range from well-differentiated gland forming cancers to poorly
differentiated tumors.

Aim: To evaluate the histopathological variants of prostatic lesions in prostatectomy specimens.
Materials and Methods: A prospective study was done to evaluate the various histological lesions in prostate specimens received in our institution. Statistical Analysis Used: The data collected was entered in MS Excel spreadsheet and analysed using SPSS version 20.

Results: Out of 90 prostate specimens studied, commonest pathology encountered was benign lesions constituting 94.5% and malignant lesions were 5.5%. Out of 84 cases of benign lesions, 51 cases (64.28%) were diagnosed as nodular hyperplasia only and NH was associated with 6 cases of basal cell hyperplasia (7.14%), 5 cases of squamousmetaplasias (5.95%), 2 cases of transitional metaplasia (2.38%), and 20 cases (23.80%) of prostatitis. Diagnosis of
prostatic carcinoma was made in 5 cases (5.5%).

Conclusion: Histologically, all the malignant lesions encountered were adenocarcinoma of prostate. The commonest pattern seen was acinar followed by arrangement of tumor cells in cords, sheets and cribriform pattern.

Keywords: Benign prostatic hyperplasia (BPH); Prostatic intraepithelial neoplasia (PIN); Prostatic adenocarcinoma
 

Background and Objective: Endometrial carcinoma is the most common gynaecologic malignancy in perimenopausal, and menopausal women. It is often preceded by endometrial hyperplasia. Estrogen appears to be involved in the development of endometrial carcinoma. Other mechanisms of endometrial carcinogenesis include mutations in
p53, PTEN, and proliferation markers like Ki-67. However, the pattern of Ki-67 expression is not well established in hyperplastic and neoplastic endometrium. Thus, objective of our study was to determine the immunohistochemical expression of Ki-67 in hyperplastic endometrium and endometrial carcinoma.

Methods: Immunohistochemical analysis of Ki-67 was done in 60 fixed, paraffin-embedded endometrial biopsy specimens and uterine resections obtained from patients. Specimens included simple hyperplasia, complex hyperplastic lesions, and endometrial adenocarcinoma.

Results: Ki-67 expression showed strong positivity in complex hyperplasia with atypia when compared to simple
hyperplasia, and complex hyperplasia without atypia. Though high grade endometrial carcinomas expressed more Ki-67 positivity, but there was no statistical significance found between expression of Ki-67 and tumour grading. Strong positivity was seen in advanced tumours with positive correlation between expression of Ki-67 and tumour stage.

Conclusion: Theexpression of Ki-67 may be used as diagnostic and prognostic marker in cases of endometrial carcinoma. Further studies with larger samples are needed to validate these findings.

Keywords: Endometrial Carcinoma; Immunohistochemistry; Ki-67.

Key Messages: Ki-67 expression was positive in 74.3% cases of endometrial hyperplasia. Statistical association  was observed between Ki-67 expression and simple hyperplasia, and between Ki-67 expression and complex hyperplasia with atypia. Ki-67 expression was positive in 80% cases of endometrial carcinoma. Statistical association was noted between tumor staging and Ki-67 exp
 

Background: Haematology analyser that determine Platelet indices, such as Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet-crit (PCT) and Platelet large cell ratio (P-LCR) may provide some valuable information regarding the underlying mechanism and pathogenesis of thrombocytopenia.

Methods: Prospective observational study of 200 thrombocytopenic samples, hemogram analysis done byautomated haematology analyser and Statistical analysis was done.

Results: Among the 200 cases of thrombocytopenia,66 cases were classified intohypo productive and 134 cases into hyper-destructive thrombocytopenia. Most common cause of hypo-productive and hyper-destructive was Megaloblastic anaemia(52%) and Dengue(42%) respectively. Both MPV and PDW were increased in hyperdestructive thrombocytopenia compared to hypo productive thrombocytopenia.
Conclusion: Increased MPV and PDW may provide a reliable positive diagnosis of Immune Thrombocytopenic Purpura in case of thrombocytopenic patients.

Keywords: Thrombocytopenia; Immune thrombocytopenia; Platelet indices; Mean platelet volume; Platelet
distribution width.
 

Granulomas are organized aggregates of macrophages and other immune cells often with characteristic morphological changes. Granulomas evolved as protective responses to destroy or sequester particles but are frequently pathological in the context of foreign bodies, infections, and inflammatory diseases. Cutaneous diseases occur in 60% to 70% of cases of granulomatous lesions. Present study aimed to study the morphology of cutaneous granulomatous lesions. Total 170 patients with clinical suspicion of granulomatous skin lesions were subjected for punch biopsy from skin lesion. Histopathological examination was done to study the morphology of lesion.
We found 148 cases of Leprosy, 11 cases of tuberculous of skin, 03 cases of actinomycosis and 8 cases were non infectious granulomatous lesions. Age group of the study population varies from 9 year to 69 years and had mean age 35.57 year. 106 were male and 64 were female. Upper limb (41%) followed by lower limb (19%) was the most
common site of biopsy. Clinically, hypopigmented patch (34%) followed by plaque (27%) was the most common presentation. Of the leprosy cases, borderline tuberculoid leprosy (BT- 45%) followed by tuberculoid leprosy (TT –14%) was the predominant lesion. Lupus vulgaris (56%) was the predominant tuberculous skin lesion.

Keywords: Actinomycosis; Biopsy; Borderline Tuberculoid; Granuloma; Leprosy; Lupus Vulgaris; Skin;Tuberculosis; Tuberculoid Leprosy.
 

Background: Thyroid hormones regulate metabolic rate and stimulate hematopoiesis via multiple mechanisms. Alterations in various hematological parameters have been reported in various thyroid disorders. Hypothyroidism is the most common thyroid disease. Objectives: To evaluate various erythrocyte indices and indices of iron metabolism in (subclinical and overt) hypothyroid cases and compare with control (euthyroid) group.  Materials and Methods: Laboratory data and medical records of patients were retrieved. Patients were grouped as   ‘overt   hypothyroid’    (TSH   >5.5   µIU/ml    and   reduced   serum   T4   and/or   T3);   ‘subclinical   hypothyroid’   (TSH   4.0- 5.5  µIU/ml  with   normal   thyroxin)   and    euthyroid    (control)    group   (TSH    0.03-4.0    µIU/ml    with  normal   serum    THs).    Complete blood count (CBC) and iron indices data of these cases were compiled. Statistical analysis was carried out using IBM SPSS version 25.0 statistical software.  Result: 158 euthyroid, 56 subclinical hypothyroid and 28 overt hypothyroid cases were included.>70% of hypothyroid and ~60% of control group was anemic. Normocytic anemia was reported in 80% (overt) and 60% (subclinical) hypothyroid anemics, rest were microcytic. Reduced levels of TIBC;all erythroid markers {hemoglobin, TRBC, color index (CI), MCV, MCH, MCHC and PCV}, and significant increase in serum iron were observed in both subclinical and overt hypothyroid cases compared to euthyroid. Reduction of Hb, PCV, MCH and CI were statistically significant. These four parameters exhibited significant negative correlation with serum TSH whereas serum iron showed a significant positive correlation. Conclusion: Anemia cases (particularly treatment resistant ones) should be screened for thyroid abnormality. CBC should be carried out in all overt and subclinical hypothyroid cases.

Introduction: Castleman disease (CD) is a rare lymphoproliferative disorder characterized by enlargement of lymph nodes. The aim of the study was to present an unusual presentation of the disease. Due to very limited number of cases the exact statistical data is not available. CD is classified into two clinical entities; unicentric presentation with the disease confined to a single lymph node and a multicentric presentation characterized by generalized lymphadenopathy and a more aggressive clinical course. It is also classified based on the Histological appearance of the lymph node mainly, hyaline vascular type and plasma cell type.
Case Report: A case report of a 30-year old male presenting with swelling in the right side of the neck, gradually increasing in size, associated with on and off mild pain for more than a year. Physical examination, coagulation tests, infectious disease screening (HIV, HCV and HBsAg), ESR test and chest X-ray were all normal. Both computed
tomography (CT) and Ultrasonography (USG) findings showed a well-defined solid enhancing mass lesion in the inferior part of the right posterior triangle, extending in the supraclavicular fossa, with a displacement of the right jugular vein. Reactive lymphadenopathy features were seen in FNAC. Microscopic examination of Biopsy showed a well-encapsulated lymphnode tissue with an expanded mantle zone (paler areas), regressed follicles with radially penetrating sclerotic blood vessels (lollipop-like appearance), indicating a Unicentric Castleman disease, hyalinevascular type. Conclusion:Unicentric Castleman disease is a rare benign condition, surgical resection is curative. Histopathological examination rules out lymphoma and concluded that it is Unicentric Castleman disease, hyaline-vascular type case.

Keywords: Castleman Disease; Lymphadenopathy; Hyaline-vascular; Cervical; Lymph node; HIV.
 

Background: Iron deficiency anaemia (IDA) and β thalassemia trait (βTT) are the two most common causes of microcytic hypochromic anaemia. βTT is an important differential diagnosis of IDA . It is important to distinguish between these two conditions for appropriate treatment. Red blood cells (RBCs) indices are a simple, easy and cost
effective method. Red cell distribution width index (RDWI) can be easily derived from these parameters helps in diagnosis. Objective: We aimed at finding out reliable and cost effective method in the differentiation of iron deficiency anaemia and beta thalassemia trait in the adult population. Methods: A total of 110 cases (age range 20–45 years) from the hospital record are taken into the study. Cases diagnosed as IDA and βTT on the basis of serum iron, ferritin levels and Hb electrophoresis. Haemoglobin, RBC count, MCV, MCH, MCHC and RDW was noted from Swelab Alfa analyser value, whereas RDWI was calculated for all the samples. Results: A total of 110 individuals with microcytic hypochromic anemia, 60 were diagnosed having IDA, whereas 50 were having βTT. There is female preponderance is seen in both types of anaemia. RBC count is higher in βTT. In both IDA and βTT haemoglobin and ranges from 6–7g/dl. The derived index RDWI showed better discriminative effect between βTT and IDA, as this index had both sensitivity and specificity equal or more than 85%. Conclusion: RDWI is simple cost effective and reliable index for differentiation of IDA and βTT.

Keywords: Iron deficiency anaemia; β thalassemia trait; RDWI.
 

Introduction: Bone marrow involvement is not very common in Hodgkin Lymphoma (HL) and when present has an implication on the treatment strategies and prognosis of the patient. This study evaluates the various bone marrow changes seen in Hodgkins Lymphoma. Methods: This is a one year retrospective study carried out in the cilinical laboratory of Kasturba Hospital, Manipal, India. All the patients diagnosed as HL on lymph node biopsy in whom bone marrow aspirate and biopsy were done were included in the study. Results: A total of 24 patients of HL were included in the study. Bone marrow infiltration was seen in only 2
patients (8.3%). 4 cases (16.6%) showed Hodgkin associated changes in the bone marrow whereas remaining 18 patients (75%) did not show any changes in the bone marrow. The cases with infiltration showed presence of mononuclear variant of Reed Sternberg cells with increased eosinophils and lymphocytes. Hodgkin associated changes included increased eosinophils, monocytes and histiocytes, dyspoeticmegakaryocytes, presence of atypical lymphocytes and increased activated histiocytes but absence of RS cells or its variants. 18 patients received the ABVD chemotherapy regimen whereas 6 patients did not receive treatment in our hospital. Out of the 18 patients
only one patient relapsed in one year follow up. Conclusion: The incidenceof BMI is rare in HL as compared to Non Hodgkin lymphoma. The BMI can be in the form of frank infiltration or non infiltrative Hodgkin associated changes. The relationship between Hodgkin associated changesand prognosis of the disease is not yet clearly understood. However bone marrow examination is a must in all cases of HL to aid in appropriate staging and to decide on treatment modifications required.

Keywords: Hodgkin lymphoma; Bone marrow; Reed Sternberg cell; Histiocytes.
 

Background: Tuberculosis is the ninth leading cause of death worldwide. India contributes to about one fifth of global TB burden. It is very important to diagnose early and treat Tuberculosis to cut down transmission of Tuberculosis. The sensitivity of smear microscopy and its inability to detect drug resistance limits its impact on TB control. We compared the cartridge-based nucleic acid amplification test (CBNAAT) results for diagnosis of pulmonary and extra pulmonary tuberculosis with the conventional methods like sputum smear. Material and Methods: We conducted a retrospective study in department of Microbiology to analyze the utility and yield of CBNAAT from Jan 2017 to December 2017. We included all patients who were subjected to CBNAAT
in the study period. Data was collected from DOTS centre and CBNAAT centre. We collected total number of samples tested for CBNAAT, indication for CBNAAT, result of smear microscopy for AFB and CBNAAT. The study population included all the pulmonary and extra pulmonary presumptive TB cases who were subjected for further
investigations. Conclusion: CBNAAT is one of the rapid diagnostic tests available in the country and it should be routinely used under the public and private health sector effectively to detect a tuberculosis case.

Keywords: Cartridge-based nucleic acid amplification test (CBNAAT); Tuberculosis; Sputum smear; AFB; Sensitivity; Specificity.
 

Background: Subcutaneous swellings clinically present as soft tissue mass, keratinous cysts or abscess and some follow trauma. Here we studied 26 forearm subcutaneous swellings of which, six cases of fungal lesions were diagnosed. Material and Methods: It is a prospective study conducted for a period of four months between October 2019 to January 2020 in Department of pathology, Government Siddhartha Medical College, Vijayawada. FNAC was done on all cases and stained with Haematoxylin and Eosin, special stains like Periodic Acid Schiff (PAS) was used where ever necessary. Data was analysed and tabulated based on the clinical and cytological features. Results: Six out of 26 were positive for fungal elements and maximum showed Candida Species.

Keywords: Fungal abscess; Forearm swelling; PAS.
 

Aims and Objectives: To study the hematological parameters and types of anemia in type 2 uncontrolled diabetes mellitus patients. To establish the role of this parameters (RDW, MPV, PDW) as predictive markers in type 2 uncontrolled DM.Methods and Materials: This case control study includes 70 cases of type 2 diabetic patients with HbA1c levels >9.0% and 30 cases of controls with HbA1c levels <6.5% was carried out for 6 months duration. Hematological parameters like Hb , RBC count, TC, MCV, RDW, Platelet count, PDW, MPV were done in the automated cell
counter (Sysmex XN330) and peripheral smear findings were studied.
Statistical Analysis: Data cleaning and data validation was done and analysed using Statistical Package for Social Sciences (SPSS-Version 20). Results: In the study, mean age of type 2 uncontrolled diabetics was 51.79±11.14 years and controls were 56.43±11.13years. RDW-CV in uncontrolled diabetics was 15.2 (13.3–17.2) and control were 12.2 (12.3–13.90). Leucocytosis was observed in uncontrolled diabetics as 9100 (7480–11900) and it indicates infections are more common in uncontrolled diabetics. MPV was (12.00±1.09) in uncontrolled diabetics and (10.05±0.97) in controls. PDW was 11.4 (10.3–12.9) in diabetics and control was 10.8 (9.8–12.5). MPV and PDW were significantly higher in uncontrolled diabetics. Conclusion: Hematological parameters such as RDW, PDW, MPV, and Platelet count were high in patients with
type 2 uncontrolled diabetes mellitus and they represent appropriate predictive markers for vascular complication due to diabetes mellitus. Present study recommends routine and regular screening for hematological parameters in diabetic patients to initiate early prevention strategies and to reduce the morbidity related to it.

Keywords: RDW; PDW; MPV.
 

Prostate Specific Antigen (PSA), a member of the human Kallikrein gene family, is a serine protease with chymotrypsin like activity, produced mainly by the epithelial cells that line the acini and duct of the prostate gland. Prostate specific antigen density (PSAD) calculation has been recommended as a more accurate and reliable method for differentiating benign and malignant lesions. Aims: The present study is undertaken to determine the PSA and PSAD levels in patients of BPH, PIN and carcinoma prostate, and to evaluate the diagnostic efficiency of PSAD in the management of carcinoma prostate and in differentiating patients of early prostate cancer (PIN) from those of BPH. Materials and Methods: The present study is a hospital based prospective study, undertaken in the department of pathology, Sri Siddhartha Medical College, Tumkur. This study was conducted on 90 transurethral resection of prostate (TURP) and prostate biopsy specimens obtained from patients presenting with complaints of enlargement of prostate in Department of Surgery, SSMC, Tumkur. Statistical Analysis Used: Data collected was entered in MS Excel spreadsheet and analysed using SPSS version 20. Results: In benign cases, SPSA was normal in 89.98% of cases. Modest elevation (4.1–10ng/ml) was seen is 10.71%
cases. In all the 84 cases, PSA density was within normal range (<0.15ng/ml/cc) and correlated well with the histological pattern.
In PIN cases, SPSA and PSAD were within normal range. All 5 malignant cases show SPSA values is significant zone (>10ng/ml) and PSAD in all the cases were above the cut-off value of 0.15ng/ml/cc.
Conclusion: PSAD offers a simple, readily acceptable, objective and economical approach to the detection of prostatic carcinoma. Further, immunohistochemistry and molecular genetic analysis are suggested.

Keywords: Prostate specific antigen (PSA); Prostatic carcinoma (PCa); Benign prostatic hypertrophy (BPH); Prostate specific antigen density (PSAD); Transurethral resection of prostate (TURP).
 

Introduction: Papillary carcinoma of the breast is very rare, constituting 1–2% of breast cancers with favourable prognosis. However cytohistopathologic features of these have not been studied in great detail. Aim and Objective: To analyze the clinical presentation, cytomorphological aspects, histopathological features and immuno histochemical study of papillary carcinoma. Material and Methods: The present study included 06 retrospective cases of papillary carcinoma of breast in a regional cancer centre in north eastern part of India during a period of 5 years. FNAC was carried out on all of them. Cytomorphological features were studied and correlated with clinico-histopathological features. In all cases Immunostaining for ER, PR and HER2neu was done. Results: This was a retrospective study of 06 cases of papillary carcinoma out of total 1250 cases of breast cancer
over a period of 5 years. On cytological examination, 2 cases were reported as papillary neoplasm suspicious of malignancy. Rest 4 cases reported as papillary carcinoma. Histopathological examination was done in all 6 cases and reported as intracystic papillary carcinoma in 2 cases and invasive carcinoma in 4 cases. 5 cases had strong staining for estrogen and progesterone receptors. One case was triple negative. Only one case was positive for HER2neu. Conclusion: Papillary carcinoma of the breast is very rare. The utility of FNAC is limited by the overlapping morphological features of benign and malignant neoplasm. Thus for papillary lesions diagnosed using FNAC, excision is required to facilitate accurate diagnosis.

Keywords: Intracystic; Invasive papillary carcinoma breast.
 

Introduction: Endoscopy is a commonly done procedure among the patients presenting to gastroenterology department. Of the biopsies taken from Upper GI tract, gastric lesions constitute the majority. The present study was undertaken to determine the prevalence of gastric lesions seen on endoscopic biopsies and to estimate the usefulness of these biopsies in patient care. Materials and Methods: The present study consisted of endoscopic biopsies from stomach received over a period of four years from May 2014 to June 2018 at the department of pathology, MNR Medical College, Sangareddy. The biopsies were fixed with 10% buffered formalin, tissue processing and H&E staining (and special stains where necessary) were done before reporting. Results: A total of 260 cases of endoscopic biopsies from stomach were received, among which non-neoplastic lesions were slightly higher than neoplastic lesions, seen affecting male more than female. Maximum cases were in
the 5th decade of life. Epithelial malignancies constituted the majority of neoplastic lesions and were categorized into various histological subtypes. Conclusion: Even though the non-neoplatic lesions were slightly higher, the majority of neoplastic lesions were malignant. Endoscopic biopsy in correlation with imaging carries a benefit of early detection of the malignancy and thus a better outcome.

Keywords: Endoscopic biopsies; Gastric neoplasm; Histopathology.
 

Introduction: Dengue is an arbo-viral disease of tropical areas. WHO estimates almost half the world’s population lives in countries where dengue infection is endemic. Various parameters have been used for assessing the severity, platelet are one such important predictors. Liver and kidney function abnormalities has also been noted in some patients.
Aims and Objectives: The present study aims to analyze the platelet counts and biochemical abnormalities of liver and renal involvement in dengue patients, also to see the correlation between platelet counts and LFT, RFT in predicting the disease course. Materials and Methods: A total number of 102 cases positive for Dengue NS1/ Ig M antibodies were included in the study from department of pathology, MNR Medical College over a period of 10 months from March 2019 to December 2019. Blood counts, LFT and RFT were evaluated. Statistical analysis with p value of less than 0.05 was considered significant. Results: A total of 102 confirmed cases of dengue were studied for various parameters. Patients from 15 years to 70 years of age with m:f ratio of 1.5:1, showed elevated Liver and renal function test parameters.
Conclusion: Alteration in AST, ALT levels was seen in all the cases. Renal function tests were elevated in only few people. Correlation between platelets count and LFT, RFT parameters showed inverse relation with statistical significance. Hence, these parameters can be utilized for monitoring the course of the disease.

Keywords: Biochemical abnormalities; Dengue; Platelet counts; Predictors of course.
 

Background & Objective: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is a universally accepted and standardized system to categorize thyroid fine needle aspiration (FNA) smears in patients with thyroid nodules. The system assigns a malignancy risk and gives recommendations for patient management in each category. The objective of the current study was to analyze the thyroid FNA by the Bethesda system, to correlate the cytopathology with histopathology and to assess the risk of malignancy in each category. Methods: The current study was conducted on 324 retrospective cases of FNA smears of thyroid nodules over a period of two years from October 2017 to September 2019. Cytohistopathological correlation was observed in 52
cases. Subsequently, cytomorphological features were further classified according to TBSRTC into six groups, and correlated with clinico histopathological features along with assessment of risk of malignancy.
Results: Diagnostic sensitivity and specificity of FNAC was 62.51% and 100%, respectively. The positive predictive value was 100% and negative predictive value was 92.6%. The number of cases in each diagnostic category and the risk of malignancy (ROM) were as follows: nondiagnostic – three cases (ROM – 0%), benign – 33 cases (ROM –
3.03%), atypia of undetermined significance – one case (ROM – 0%), follicular neoplasm – 3 cases (ROM – 33.33%), suspicious for malignancy – 2 cases and malignant – 4 cases (ROM – 100%) in both.
Conclusion: The Bethesda System is a uniform and effective modality in diagnosis and planning management of patients with thyroid gland lesions. Risk based stratification may guide the clinicians towards a more comprehensive approach to patient management.

Keywords: Bethesda system; Thyroid nodules; Follicular neoplasm.
 

Introduction: Castleman disease (CD) is a benign uncommon lymphoproliferative disorder requiring a high index of suspicion. Based on the clinical features and lymph node involvement, they can be categorized into unicentric (UCD) and multicentric (MCD) types. The rarity of this entity and infrequency of diagnosis accounts for the incomplete knowledge of this disease. Materials and Methods: This is a retrospective eight year study conducted in the department of pathology, cases of CD reported on histopathology were retrieved. The age, sex, clinical features site involved and the histopathological type, laboratory findings was noted and analysed. Results: Eighteen cases of CD were reported on histopathology over a period of 8 years. Majority were adults in the age group 30–50 years. There was no sex predilection. Majority of the patients (77.7%) showed features of UCD and four cases showed features of MCD. Most of these patients were asymptomatic and presented with painless lymph node enlargement. Patients with MCD had anaemia, hypoalbuminaemia and raised ESR levels. The
commonest site of involvement was cervical lymph node. Among the cases of CD, 14 cases were of hyaline vascular type, 2 cases were of plasma cell type and 2 cases were of mixed type. Conclusion: CD is a rare entity with a wide spectrum of benign and malignant mimics. Since the presentation is non-specific and CD is usually not suspected clinically, histopathology is the gold standard for diagnosis.

Keywords: Castleman; Hyaline-Vascular; Multicentric, Plasma-cell; Unicentric.
 

Background: Thrombocytopenia is defined as a decrease in peripheral blood platelet count less than 150,000 cells/μL. Immature Platelet Fraction (IPF) is simple non-invasive procedure to measure percentage of reticulated platelets in peripheral blood. Our study aimed at measuring the IPF percentage and evaluating its significance in
hyperdestructive, hypoproductive and megaloblastic thrombocytopenic groups. Methods: In present study a total of 73 cases of thrombocytopenia were studied, which included 43 cases of
hyperdestruction, 16 cases of hypoproduction and 14 cases of megaloblastic group. IPF% along with complete blood counts was estimated for all samples using Sysmex XN350. Cases not meeting the required criteria were excluded from study. Results: Of 73 patients, 56% were females and 44% were males. ITP was the most common clinical diagnosis in the study with 27% of cases followed by dengue and megaloblastic anaemia with 19% each. Out of 43 cases of Hyperdestructive group, 41 (95.3%) cases showed increased IPF in comparison to Hypoproductive group, in which only 01 (0.06%) case out of 16 cases showed increased IPF. Megaloblastic group were in between the both groups showing increased IPF in 06 (42.8%) cases of total 14 cases. Conclusion: Since bone marrow examination is invasive and expensive, platelet indices such as PDW, MPV and P-LCR lack significant sensitivity and specificity, Immature Platelet Fraction can be used as a simple non-invasive procedure for estimating the reticulated platelets percentage in peripheral blood to monitor the megakaryocytic
activity.

Keywords: Immature Platelet Fraction; Megaloblastic Anemia; Reticulated Platelets; Thrombocytopenia.
 

Introduction: The standard surgical procedure in urological practice that is performed in end stage/nonfunctioning kidney or in suspected malignant neoplasm is nephrectomy. It is indicated in patients who present with a wide range of clinical conditions that include obstruction, symptomatic chronic infections, calculus disease as well as severe traumatic injury to renal cell carcinomas. We conducted this study to assess the patterns of neoplastic and non-neeoplastic lesions in the nephrectomy specimen in a tertiary care hospital. Materials and Methods: This retrospective study was done over a period of twelve year where all nephrectomy cases were taken out from the records of the department and reviewed. Demographic details and the histopathological reports of the patients were recorded. Results: Total 111 cases were studied. There were 70 non-neoplastic lesions and 41 neoplastic lesions. Most common non-neoplastic lesion was chronic pyelonephritis. Majority of cases of chronic pyelonephritis belonged to
age group 21-30 years. Most common neoplastic lesion was RCC in adults. Most of the patients were in age group 41–50 years. Most common neoplastic lesion was wilm’s tumor in children. Rare renal pathologies were congenital mesoblastic nephroma in children and angiomyolipoma and squamous cell carcinoma in adult. Conclusion: A variety of non-neoplastic and neoplastic lesions present in the hospital which undergo nephrectomy. Many lesions can be clinically and radiologically misdiagnosed, so every nephrectomy specimen should be subjected to a detailed histopathological examination. In renal cell carcinoma, nuclear grade and staging of tumors are necessary for therapy and prognosis.

Keywords: Nephrectomy; Chronic pyelonephritis; Clear cell renal cell carcinoma; Congenital Mesoblastic nephroma; Angiomyolipoma and Squamous cell carcinoma.
 

Introduction: Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae, diagnosed based on clinical signs, histopathological findings and demonstration of acid fast bacilli on skin biopsy. But diagnosis becomes challenging in case of tuberculoid spectrum of leprosy where diagnosis is made on histological findings
like nerve destruction and granuloma. The histological findings like granuloma may simulate other granulomatous dermatosis like sarcoidosis. In such cases immunostaining with S-100 helps in differentiating leprosy from other granulomatous dermatosis on the basis of nerve staining. Materials and Method: This is a prospective descriptive study on 50 skin biopsy specimen diagnosed as leprosy
and other cutaneous granulomatous dermatosis. Histological examination was done using H&E and fite faracco. Immunohistological examination was done after staining with S-100. Diagnostic efficacy of test in terms of sensitivity were calculated using histopathological features as gold standard. Correlation between pattern of neutritis by S-100 staining and agreement between histological diagnosis were analysed. Result: Out of total 50 skin biopsies, 30 were diagnosed as leprosy and 20 cases were other granulomatous dermatosis. Maximum cases among leprosy were of tuberculoid leprosy (46.67%). Sensitivity of S-100 in nerve identification in tuberculoid leprosy was 100% whereas it was 85.71% with H&E. Fragmented (64.29%) and infiltrated (21.43%) pattern was most common in tuberculoid spectrum of leprosy whereas lepromatous spectra showed mostly fragmented pattern (80%). Intact nerves were seen in all the other cutaneous granulomatous lesions. Conclusion: Therefore, S-100 is an effective auxillary tool in early diagnosis and differentiation of leprosy from other granulomatous dermatosis.

Keywords: Granulomatous dermatosis; Leprosy; Nerve staining; S-100 immunostaining.
 

Context: Abnormal Uterine Bleeding is defined as bleeding that does not fall within the normal ranges of amount, frequency, duration or cyclicity of normal pattern of a menstrual cycle. It has a significant negative impact on the quality of life. Endometrial sampling is done to evaluate various lesions and rule out malignancy. Aims: To study the histopathological changes of endometrium in Abnormal uterine bleeding and to study incidence among different age groups. Settings and Design: This study is a retrospective descriptional study done in the Pathology laboratory for two years from January 2016 to December 2017. Methods and Material: All the Data regarding the patient is collected from the Pathology records. Cases with known structural causes were excluded from the study. Statistical Analysis used: Results were analysed in the form of percentages. Results: A total number of 184 cases were included in the study. The most common age group for abnormal uterine bleeding was 41–50 yrs. The most common finding was the proliferative phase, followed by simple hyperplasia and secretory phase. Conclusions: There is an age related incidence of Abnormal Uterine Bleeding, with a higher incidence in 41–50 year age group. Endometrial curettings and biopsy are essential diagnostic procedures in the evaluation of Abnormal Uterine Bleeding, which help in guiding the treatment.

Keywords: Abnormal uterine bleeding; Endometrium; Menorrhagia.

 

Introduction: Lymph node enlargement is frequent presentation in all age groups with a wide spectrum of diseases, ranging from infections to malignancy. Therefore, management of cases depends on lymph node pathology, which can be studied by collecting material through fine needle aspiration method that can be used as an outpatient
procedure. Objectives: To assess the cytomorphological features and incidence of various lymph node lesions on fine-needle aspiration cytology (FNAC) and to analyse the utility and importance of FNAC in diagnosing lymph node lesions. Material and Methods: A prospective study undertaken on 130 patients who had presented with lymphnode
enlargement at the Department of Pathology for a period of 20 months.
Results: Most common lesion observed in our study was reactive lymphadenitis, followed by tubercular lymphadenitis, metastatic malignancies, acute suppurative lymphadenitis, lymphomas and necrotizing lymphadenitis, respectively. Conclusion: Lymphadenopathy is most commonly superficial and palpable, and therefore easily accessible to sampling by palpation or ultrasound guided FNA, which usually results in a fast, reliable, and relatively in expensive diagnosis. In the current study, reactive lymphadenitis was recorded as the most common presentation of lymphadenopathy in the cervical region. It not only confirms the presence of metastatic diseases but also, in most
cases, gives the clue regarding the origin of the primary tumor.

Keywords: Fine-needle aspiration cytology; Lymph node; Lymphadenitis.
 

Introduction: Liver diseases are one of the important public health problems in the world and also in India. The tremendous amount of socio economic burden caused by these liver diseases, it is necessary to study the patho-physiological changes in the coagulation and the same attempt is made to review the normal physiology of haemostasis, the role of the liver in the haemostatic system and to discuss the coagulation abnormalities that may occur in patients with liver disease in this study. Aim: To study the coagulation profile in patients of liver disease.

Objectives:
1. To study the alteration in coagulation profile in various liver diseases which helps to evaluate the risk of bleeding in patients with liver disease.
2. To study the association of coagulation abnormality with the extent of liver disease.
3. To find out prevalence of patients admitted with liver disease.

Material and Methods: The materials for the present study included patients attending the Medicine outpatient department with liver disease may be acute or chronic and admitted in In–patient department of Medicine and I.C.U. of Dr. Shankarrao Chavan Government Medical College, Vishnupuri, Nanded a tertiary care centre. Result: A total of 120 cases were analyzed during the study period. Alcoholic liver disease was the most common pathology amongst the study subjects (44.17%). More than 2/3rd (70%) of the patients included in the study have deranged coagulation test. The total prevalence of liver disease in the hospital was 0.67%.

Keywords: Liver disease; Coagulation; Haemostasis.
 

Purpose: To study the ability of ADVIA 2120i, five part cell counter scattergrams by PANDA approach to accurately detect and classify leukemia and its comparison with final Flow Cytometric results. Methods: This is a retrospective analysis of 48 consecutive patients over a 6 months period from October 2018 to March 2019. The CBC was performed on ADVIA 2120i and the cell counter scatter diagrams were evaluated based on PANDA algorithm. The scatter diagram results were compared with final flow cytometric results. Results: The scatter diagram analysis showed PPV of 95% with accuracy of 79.16% (38). Out of total 48 leukemia patients, highest accuracy was observed that in CML (100%) and APML (100%) while it was 91.67% for ALL. The accuracy of the scatter diagram was more in patients with total leucocyte count of >50000 cells/cmm (86.36%) as compared to the ones with <50000 cells/cmm (76.92%). Conclusion: The timely identification and classification of leukemia is crucial for patient survival, and is essential to prompt further investigations to confirm the diagnosis and to initiate treatment as soon as possible.

Keywords: ADVIA 2120i scattergrams; PANDA algorithm; Scattergram analysis; Scattergram analysis comparison with flow cytometric results; Use of automated cell counters.
 

Introduction: Bone marrow study is a common procedure. It is highly informative procedure, though invasive, it is safe when performed with proper precautions. It is used routinely in medical institutions for the diagnosis and management of hematological disorders which often pose diagnostic challenge to physician and the knowledge of accurate etiologies is crucial in their management. Aim of the study: To study the morphology and spectrum of bone marrow in hematological diseases, in cases of Pancytopenias to determine the etiology and also to study the bone marrow morphology in isolated splenomegaly cases presenting as haematological disorder. Materials and Methods: This was a prospective study done over a period of two years. Peripheral blood smear examination and bone marrow aspirations were performed in 176 cases. The patient demographics, bone marrow findings and clinical findings were correlated. Results: There were total 176 patients. Majority of the cases were reported in the age group range of 21-30 years and the male to female ratio was 1.1:1. Disorders of RBC were most common with predominance of megaloblastic anaemia. Disorders of WBC were less with cases of Acute leukaemia. There were 2 cases of Idiopathic
thrombocytopenic purpura and 10 cases of Plasma cell dyscrasia. Normal marrow study was seen in 17 cases. Conclusion: Bone marrow aspiration is a safe, easy, cost-effective procedure. Bone marrow aspiration shows better cellular details when compared to bone marrow biopsy. The latter is required for confirmation and prognostication
of certain hematological diseases. The results and accuracy are highly dependent on the quality of samples and smears. Diagnosis is strengthened by correlating the marrow findings with peripheral smear, other relevant biochemical investigations and clinical features.

Keywords: Bone marrow study; Acute leukemias; ITP; Megaloblastic anemia.
 

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.