Indian Journal of Pathology and Oncology

7-13

Authors: Suryawanshi Kishor H., Damle Rajshri P., Dravid Nandkumar V., Tayde Yogesh

Background: Head and neck lesions encompass a multitude of congenital, inflammatory or neoplastic lesions including several anatomic sites and originating in different tissues and organs. Fine needle aspiration cytology (FNAC) is a simple, quick, feasible, cost effective and repeatable outpatient procedure with minimal risk of complication. Aim: 1. To evaluate the role of FNAC and its utility in diagnosis of palpable head neck masses. 2. To study the spectrum of head neck lesions in rural population. 3. To study diagnostic accuracy of FNAC by histopathological correlation wherever possible. Material and methods: The study included 288 patients presented with palpable head and neck swelling in a tertiary care hospital from January 2011 to December 2014. Detailed clinical history of patient was noted. Aspirations were done by using 10 ml syringe and 22/23 gauge needles. Smears were stained with PAP, Haematoxylin and eosin and Leishman stain. Cytomorphological diagnosis was given. Cyto-histopathological correlations were done wherever possible. Results: Out of 288 patients of head and neck lesions studied, lymph node (39.58%) was the predominant site aspirated with tubercular lymphadenitis being the commonest lesion. Thyroid lesions constituted 31.25 % followed by salivary gland (18.75%), soft tissue and miscellaneous (7.29%). FNAC was inconclusive in 3.12 % cases. Overall accuracy rate of FNAC was 93.02% with sensitivity of 81.81 % and specificity of 96.87 %. Conclusion: Though excisional biopsy is the gold standard for diagnosis of head and neck neoplastic lesion. FNAC is a rapid, cheap diagnostic tool now-a-days with overall accuracy rate more than 90 %.

25-30

Authors: Nirmala T, Vani B R., Murthy Srinivasa V., Deepak kumar B., Geetha R L, Kumar Pradeep L.

Background: Hypertension is one of the common medical complications of pregnancy and contributes significantly to maternal and perinatal morbidity and mortality. Hypertension is a sign of an underlying pathology which may be pre-existing or appear for the first time during pregnancy. Various haematological changes like numerical and functional platelet abnormalities, alteration in haemoglobin and erythrocyte parameters and increase in the procoagulant state of normal pregnancy are seen. Aims and Objectives: Evaluation of Platelet indices in PIH. To identify the early platelet parameters predictive of preeclampsia and HELLP syndrome. Materials and methods: A 2 year study was carried out in the Dept. of pathology ESIMC, Bangalore on 100 PIH cases. Platelet indices is done in all the cases. P values for all parameters were statistically derived and evaluated. Results: Total of 100 cases were included in the study. 37 were mild GH, 9 cases were severe GH, 29 cases were mild preeclampsia and 25 cases were in severe preeclampsia group. Thrombocytopenia was observed in 23 cases and elevated MPV in 49 cases. Conclusion: Thrombocytopenia is identified as the most common complications of PIH and at times may be life threatening. Therefore estimation of platelet indices can be considered as an early, simple and rapid procedure in the assessment of severity of pre-eclampsia and to prevent progression to HELLP syndrome and DIC.

37-40

Authors: Rita Kumari, Sindhu Sharma, Priya Gupta

Laryngeal squamous cell carcinoma tends to exhibit local spread with a low incidence of distal metastases. The majority of distant metastases are to the lungs and renal involvement is extremely rare. We present a rare case of metastatic renal tumour originating from Laryngeal squamous cell carcinoma. Fifty year old male diagnosed two years back as Laryngeal squamous cell carcinoma, underwent complete chemo radiation and was clinically free of disease for about two years, now presented with gross haematuria. Physical examination revealed left renal mass which was confirmed on CT scan as heterogeneously enhanced mass in upper part of kidney. Nephrectomy was done. On histopathological examination, well-differentiated squamous cell carcinoma of kidney was reported.

44-47

Authors: Prerna Sachdeva, Anitha Padmaanabhan, Priyanka Katke, N.M Gadgil

The primary leiomyosarcoma invading the spine is an extremely rare neoplasm .We report a case of 75 year old male with no significant medical history presenting with weakness in both lower limbs and incontinence of urine and faeces since 15 days. MRI confirmed the presence a lytic lesion causing collapse of D11-D12 vertebrae with involvement of paravertebral soft tissue and 11-12th ribs. Decompressive surgery was performed for the same and tumour was sent for histopathological examination. On histology, tumour was found to be low grade leiomyosarcoma which showed positivity for desmin and smooth muscle actin on Immunohistochemistry.

53-56

Authors: Hawaldar Ranjana, Sodani Sadhna

India is an ethnically diverse country with marked regional variation. This diversity is reflected in the presence of different Hb variants in different ethnic groups. Hb J Meerut is one such rare variant detected by HPLC as abnormal peak (25.4%) in P3 window with a retention time of 1.85 minutes. This clinically asymptomatic variant has been reported to interfere with HBA1C estimation in diabetic patients.HBA1C values are routinely done to assess glycaemic control in diabetic patients. HbA1C values may be falsely low due to presence of abnormal HB variants. As HbA1C is based on haemoglobin, both quantitative and qualitative, variants in haemoglobin can affect HBA1C values.Here we report a case of a 45 year old male diabetic patient who had a spuriously low HBA1C value on HPLC with an abnormal peak in P3 window .Hb electrophoresis done to detect variant haemoglobin showed an abnormal peak (25.4%) in P3 window at a retention time of 1.85 minutes. A provisional diagnosis of HBJ Meerut was made which was confirmed by capillary electrophoresis.