Indian Journal of Pathology: Research and Practice

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.