Indian Journal of Pathology: Research and Practice

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Background: Thyroid hormones play a vital role in the regulation of metabolism and the proliferation of blood cells. Thyroid dysfunction can lead to various effects on blood cell counts, including anemia, erythrocytosis, leukopenia, thrombocytopenia, and in rare instances, pancytopenia. Additionally, thyroid dysfunction can alter red blood cell indices such as mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC),red cell distribution width (RDW) and platelet distribution width(PDW). This study aims to assess the impact of hypothyroidism on blood cell parameters, determining the prevalence and severity of hematological abnormalities in this patient population. Methods: From January 1 to March 31, 2024, a cross-sectional study was conducted at a tertiary care hospital involving 200 patients, out of which 100 were diagnosed with hypothyroidism and 100 were euthyroid selected through systematic random sampling. Hematological data were gathered using data extraction sheets, while information on associated factors was obtained through structured questionnaires and data extraction sheets. Four milliliters of anticoagulated venous blood were collected for complete blood cell count analysis. Data were entered into Epidata version 3.1 and analyzed using Stata version 14. Both bivariate and multivariate logistic regression analyses were conducted to identify factors linked with hematological abnormalities. A P value of less than 0.05 was considered statistically significant. Results: Analysis of the collected data showed a statistically significant difference between two groups of patients in red blood cell (RBC) count, red cell distribution width (RDW), Mean corpuscular volume(MCV) and Platelet distribution width ( PDW ) (P-value < 0.05). However, there was no significant difference in hemoglobin, mean corpuscular hemoglobin concentration (MCHC), mean corpuscular hemoglobin(MCH), hematocrit(P-value > 0.05). Conclusion: The study revealed a variety of hematological abnormalities in patients with hypothyroidism.Altered RBC count, MCV, hematocrit, RDW and PDW were common findings in patients with hypothyroidism Consequently, early diagnosis and effective monitoring strategies are essential to minimize complications in these individuals.

Objectives: To evaluate and compare the diagnostic accuracy of Monocyte Distribution Width (MDW) in Beckman coulter DxH900 with sepsis biomarkers Procalcitonin and CReactive protein(CRP). Background: Early detection of sepsis is crucial for improving patient outcomes. Conventional biomarkers, such as Procalcitonin (PCT) and C Reactive protein(CRP), are frequently employed but have drawbacks, especially when it comes to early sepsis identification. Through the detection of morphological alterations in monocytes during inflammation, Monocyte Distribution Width(MDW), a novel haematological parameter, has become a promising early sepsis indicator compared with CRP and PCT. With this background, we aimed to evaluate the efficacy of MDW as an early indicator of sepsis and to compare its diagnostic accuracy with established biomarkers such as CRP and PCT. Methodology: We conducted a prospective observational study on patients suspected of sepsis with the age ranged from 1 to 90 years. MDW, CRP, and PCT levels were measured. Continuous variables are expressed in Mean & Standard deviation (SD) and the area under the curves (AUCs) obtained from receiver operating characteristic curves were used to evaluate and compare MDW with CRP and PCT. Results: Our study revealed that MDW is increased among sepsis patients along with biomarkers like CRP and PCT. The AUC for MDW comparable with PCT and CRP are 0.917 and 0.864 respectively. We found statistical significance for MDW with both PCT (0.001) and CRP (0.001). Conclusion: MDW outperforms conventional biomarkers like CRP and PCT as an early and accurate indication of sepsis, especially in the early stages of the illness. By adding MDW to routine blood tests, a quick, easy, and affordable way to increase early detection, which is essential for prompt intervention and better patient outcomes is provided.

Angioleiomyoma (ALM) is a rare soft-tissue tumour with an overall prevalence of fewer than 100 cases reported so far. ALMs are well-defined, painless, slow-growing lesions, making preoperative differentiation from leiomyomas or other mesenchymal tumorsdifficult. We present here a case of a 24-year-old female with an exophytic, cystic swelling in the nasal cavity clinically suspected to be a nasolabial cyst. Surgical excision is the primary treatment of ALM, with a low recurrence rate and only one reported case of malignant transformation to this date. This case highlights the importance of considering this rare benign lesion in the list of differential diagnoses for a fairly common complaint of sinonasal swelling and the definitive role of histopathology alongwith IHC for diagnosing such tumors.

Nevus lipomatosus cutaneous superficialis (NLCS) is a rare cutaneous hamartoma characterized by the ectopic presence of mature adipocytes in papillary and reticular dermis without connection to the subcutis. It usually has a predilection for buttocks, upper thigh and back. It presents itself as skin to yellow colored discrete or confluent papulo-nodular soft, fleshy sessile mass and has two clinical forms described in the literature, classical and solitary types. The classical form is usually composed of multiple and grouped skin-colored, pedunculated nodules. A second and more rare form is characterized by a solitary dome-shaped sessile papule or nodule. Microscopically it presents with the fat deposition in the dermis and is considered to be the consequence of the degenerative changes in the connective tissues. Its pathogenesis is unknown; however, several theories have been proposed. Some attribute it to the adipocyte metaplasia during the degenerative course and some to the development displacement of adipose tissue while others, as a consequence of maturation of adipocytes from mononuclear cells differentiation into lipoblasts in the perivascular zone. Histopathology shows clusters of ectopic presence of adipose fat among the desiccating collagen fibres in the dermis without any connection with the subcutaneous fat. Herein, we present a case of solitary NLCS over left flank associated with left upper thigh acrochordon in a 30 years female.