Indian Journal of Pathology: Research and Practice

Introduction: Chronic kidney disease, a leading cause of end-stage renal failure, is a growing concern globally. Diabetes and hypertension are the leading causes of this disease, with prevalence expected to double in the next 25 years, particularly in developing countries. The Kidney Disease Outcomes Quality Initiative defines chronic kidney disease as evidence of structural or functional kidney abnormalities persisting for at least 3 months, with or without a decreased glomerular filtration rate (GFR). Anemia, a closely related condition, is associated with chronic renal failure (CRF) and has public health importance in developing countries. Objective: This study aims to determine the incidence of different types of anemia in CRF cases, changes in haematological parameters with renal failure severity, and evaluate bone marrow iron status to exclude other cases of anemia. Results & Observation: This study analyzed the prevalence of uremic conditions in patients aged 41-60 years. The majority of cases were diabetic nephropathy, with a significant male preponderance. The majority had normocytic normochromic anemia, with a significant percentage of cases having low hemoglobin, hematocrit, red blood cell count, reticulocyte count, bone marrow iron store, and platelet count. The study found that most cases had blood urea levels between 91-120 mg/dl, with the highest level being 270 mg/dl. The study also found that uremic patients had a decline in Hb levels below 6 g/dl and high creatinine levels. The study also found that 40% of cases had Grade III scoring, with the highest percentage observed in Grade III. The study analyzed the prevalence of uremic kidney disease (ESRD) in patients aged 41-60 years, with diabetes mellitus being the most common cause. Most patients had normocytic normochromic anemia (54%), followed by normocytic hypo-chromic (23.8%) and microcytic hypochromic (19.04%) anemia. Anemia was an important determinant of CRF, with blood urea levels ranging from 6.l-9gm/dl. Low platelet count (18%) was found in 9 cases, while abnormal bleeding of more than 9 minutes was found in 6 cases. Abnormal prothrombin time (20%) was found in 10 cases, and abnormal activated partial thromboplastin time (14% of cases) was found in 7 cases. Conclusion: The present study highlights the importance of anemia and bone marrow iron status in managing patients with chronic kidney disease. The research aims to evaluate these parameters using common laboratory methods.

Introduction: Endometrial hyperplasia (EH) is a pathological condition characterized by the proliferation of endometrial glands, which can range from simple hyperplasia to complex atypical forms with a significant risk of progression to endometrial carcinoma. Histopathological evaluation of endometrial samplings plays a crucial role in the diagnosis, classification, and management of EH. Aim: This study aims to evaluate the histopathological spectrum of endometrial hyperplasia in endometrial samplings, assess the prevalence of various subtypes, and determine their association with clinical and demographic factors to aid in early diagnosis, risk assessment and appropriate management. Material & Methods: A cross sectional descriptive study was conducted on endometrial samples obtained from patient with suspected endometrial hyperplasia. The specimens received for histopathological evaluation at histopathology section in Tertiary care hospital from October 2020 to September 2022. Relevant clinical data, including age, symptoms, and associated risk factors, were analysed. Results: The study findings highlight the distribution of different EH subtypes, including EH with atypia and EH without atypia. Out of total 147 cases of EH; 9 cases (6.1%) were histopathologically classified as EH with atypia and 138 cases (93.8%) were EH without atypia. The commonest age group of EH with atypia was 41 to 50 years followed by 51 to 60 years and EH without atypia was 31 to 40 years. The most common clinical presentation was abnormal uterine bleeding. Conclusion: Histopathological evaluation remains the gold standard for diagnosing and classifying endometrial hyperplasia. Accurate assessment of endometrial samples aids in risk stratification and guides appropriate clinical management, thereby preventing the progression to endometrial carcinoma.

Fine needle aspiration cytology (FNAC) is an essential tool for diagnosing salivary gland tumors. Here we present a case involving a 45-year-old woman with an eight-year history of a slowly growing, painless swelling in her right parotid gland. FNAC showed clusters of polygonal cells with vacuolated cytoplasm, round nuclei, and prominent nucleoli in a bromuscular background, suggestive of acinic cell carcinoma (ACC). Surgical excision and histopathological analysis firm the diagnosis. This case highlights FNAC’s crucial role in the early detection and diagnosis of rare salivary gland malignancies.

Histopathology, the microscopic examination of tissues, is a keystone of the autopsy examination, providing critical understandings outside what can be observed with the gross examination. In medicolegal autopsies, where the cause and manner of death may be unclear or contested, histopathology plays an especially vital role. This case series emphasizes the important role of histopathological examination in medicolegal autopsies. We present three cases where microscopic tissue exploration through histopathology provided essential information that significantly impacted the final determination of the cause and/ or manner of death. In the first case, histopathology revealed subtle myocardial changes indicative of a previously unsuspected cardiac event. The second case demonstrated the utility of histopathology in distinguishing death due to rupture of hepatic cyst from alleged death due to blunt trauma. Finally, the third case highlights how microscopic evaluation identified a lethal but grossly undetectable disease process related to amniotic fluid embolism in a postoperative case. These cases illustrate that histopathology is a crucial tool in medicolegal investigations, often providing critical evidence that macroscopic gross examination alone cannot.

Colorectal cancers (CRC) are predominantly adenocarcinomas, accounting for the majority of cases. Rarer variants include neuroendocrine carcinoma, squamous cell carcinoma, adenosquamous carcinoma, spindle cell carcinoma, and undifferentiated carcinomas. Rectosigmoid squamous cell carcinoma is an exceedingly rare diagnosis, with only 150 cases reported in medical literature. We present a case of rectosigmoid squamous cell carcinoma (SCC) in a 50-year-old female who presented in the emergency department with left lower abdominal pain, fever, non-passage of stools, and flatus for two days. The diagnosis was challenging due to its unusual location and atypical presentation. The patient underwent rectosigmoidectomy, and the specimen was sent for histopathological examination. After a thorough gross and microscopic examination, the diagnosis of moderately differentiated squamous cell carcinoma of the rectosigmoid colon was made. This case highlights the importance of considering rarer malignancies in the differential diagnosis of colorectal malignancies. A thorough gross and microscopic examination is needed to diagnose rarer malignancies of the colorectal region. A multidisciplinary approach is required for accurate diagnosis and treatment.