Indian Journal of Pathology and Oncology

57-60

Authors: Amita K, Nithin Kumar H, Shobha SN, Vijay Shankar

Aim: To compare platelet count, mean platelet volume and platelet distribution width in preeclampsia and normal pregnant females in diagnosis and assessing the severity preeclampsia. Materials and Methods: Case control study comprising of 50 preeclamptic females between 20 to 24 weeks of gestation as cases and 50 normotensive pregnant females matched for age and gestation as controls. Preeclamptic patients were separated into three groups as mild (25), moderate (13) and severe preeclampsia (12).Platelet count, mean platelet volume and platelet distribution width measured by automated hematology analyzer sysmex KX 21 was recorded in all the groups and analyzed. Results: Platelet count decreased significantly in patients with preeclampsia as compared to normotensive healthy females. (Mean platelet count in lakhs/cumm ± SD - 1.6688 ±.71890 vs 2.5888 ±.66881, p < 0.0001) Among preeclamptic patients there was significant decrease in platelet count with the increasing severity (mild, moderate and severe preeclampsia - 2.2044 + 0.594, 1.176 + 0.267, 1.0917 + 0.385, p < 0.0001). There was significant increase in PDW in preeclampsia when compared to normotensive pregnant females. (PDW in fl - 15.488 ± 2.4685, 11.755 ± 1.4206, p < 0.0001) There were no significant differences in MPV in normal and preeclampsia and between severities of preeclampsia. Conclusion: Platelet count emerges as a reliable indicator for diagnosing preeclampsia and predicting the severity of disease. Though, PDW is also another reliable marker for diagnosis of preeclampsia, its role in assessing the severity of preeclampsia need to be explored. Also increased MPV is not a significant predictor of preeclampsia in pregnancy.

69-72

Authors: Sily Sreedharan, Prema N S

Background: Intestinal obstruction in the neonate or infantile period poses problem in the management. The diagnosis and the management can be resolved by taking rectal biopsy and proving them as Hirchsprung’s or Pseudohirchsprung’s disease by histo-pathological examination. It helps in better patient management by avoiding unnecessary surgeries in cases of Pseudohirchsprung’s disease. Aim: To study the pathology of Pseudohirchsprung’s disease and its staining pattern in immunohistochemistry with Neuron specific enolase (NSE) and S- 100. Material & methods: Study included all cases with clinical diagnosis of Hirchsprung’s disease, received in the department of pathology of a Govt. Medical college. Duration of study was 2 years from 2005-2007. A total of 90 cases were studied. Results: Out of the 90 cases, 61(67.7%) were diagnosed as Hirchsprung’s disease, 23 cases (25.60%) as Pseudohirchsprung’s disease. Of the 23 cases of Pseudohirchsprung’s disease, 7 cases showed hyperganglionosis, 7 cases showed hypoganglionosis and 9 cases showed normal ganglionic segment. Immunohistochemistry with NSE & S-100 in selected cases showed increased staining of sub mucosal nerve trunks. Conclusion: One fourth of clinically diagnosed cases of Hirchsprung’s disease were actually Pseudohirchsprung’s disease. No definite IHC pattern could be clearly defined. Further studies are recommended for setting up standards for diagnosis of Pseudohirchsprung’s disease, which will aid in better management of the cases.

76-80

Authors: Hawaldar Ranjana, Sodani Sadhna

Evaluation of LH 750 VCS parameters and lymph Index in identifying Dengue fever Background: Dengue is an acute viral infection which affects nearly 50-100 million people across many countries of the world. It is now threatening to become a major health problem across the globe. There is no specific treatment for Dengue and diagnosis depends mainly on serological testing and virus isolation from blood of patients. The major problem physicians face is to distinguish self-limiting Dengue fever from Dengue haemorrhagic fever. Aims and objectives: The present study aims to evaluate the utility of VCS (volume, conductivity, scatter) parameters and lymph index in accurately predicting dengue fever. We retrospectively analysed data from 193 febrile patients coming to our diagnostic centre between August 2014 and October 2014 and calculated the lymph index in the patients positive for dengue infection by serological methods. Materials and Methods: In this retrospective case control study, blood samples were collected from 193 febrile patients between August 2014 and October 2014. A simplified lymphocyte CPD(cell population data), the lymph index, was calculated as LV(lymphocyte volume) X LV- SD (standard deviation of lymphocyte volume) ÷ LC(lymphocyte conductivity). Results: We observed a significant increase in the lymph index in dengue patients (≥13.6) as compared to controls (mean lymph index 10.32). The Sensitivity and Specificity in predicting dengue infection was 71.17% AND 78.05% respectively with a cut off of ≥13.6. Conclusion: These results indicate that lymph index is a good hematological parameter for predicting dengue infection.

84-86

Authors: Preeti R Chakrabarti, Amit Varma, Priyanka Kiyawat, Kapil Gupta

Malignant melanoma is an aggressive tumor with potential to metastasize anywhere within the body. Herein, we report a 51 year male patient clinically diagnosed as diabetic foot ulcer that developed enlarged right inguinal lymph node during treatment. FNAC of right inguinal lymph node was performed. Initial cytological diagnosis of metastatic melanoma was made which lead to clinical suspicion of melanoma masquerading as diabetic foot. Cytomorphological features of metastatic melanoma are described with brief review of literature and value of cytological diagnosis is emphasized.

90-92

Authors: Jyotsna Suri, Rita Kumari, Bhavneet Kour

Eccrine spiradenoma is an uncommon benign tumor of sweat glands. The clinical presentation in majority of cases is as solitary painful dermal nodule less than 5 cm in diameter, with equal incidence in both sexes. The nodule develops most usually on head, neck and dorsal aspect of the trunk and is many times recurrent. Malignant transformation is rare. Differential diagnosis includes other sweat gland tumours, sebaceous cysts and various benign subcutaneous connective tissue disorders. Exact diagnosis and radical surgical excision can avoid recurrence. We here report a case of eccrine spiradenoma, clinically diagnosed as cervical lymphadenitis and stress the importance of role of fine needle aspiration cytology in its diagnosis along with documentation of the cytological diagnostic criteria of the same.

96-97

Authors: Prashant Vijay Kumavat, Urmi S Chakravarty, Shailesh S Vartak, Pankti Hemant Haria

Fine needle aspiration cytology (FNAC) is an important diagnostic tool in the diagnosis of soft tissue nodules around joint. Our patient was a 55 year old man a known hypertensive, diabetic with history of multiple skin coloured nodular lesions on both feet involving ankle, malleoli, Achilles tendon and dorsum of the forth toe associated with discharging sinuses since two years. He did not have any other clinical symptoms. The X ray of both feet showed osteolytic lesions. FNAC of the lesions revealed, monosodium urate crystals (MSU) which are birefringent needle shaped crystals under polarising microscopy. Diagnosis on FNAC was given as gouty tophi. Further investigations done revealed high levels of serum uric acid (10.4mg %) and a confirmed diagnosis of gout was given. It is important that pathologist should be conversant with the cytomorphological features of gout and also should be aware that FNAC can play an important role in the diagnosis of these lesions.

101-104

Authors: Majethia Nikhil Kantilal, Mohd. Unzer Khan, Haria Pankti, Felice Faizal

With the continuing rise in the number of immune-compromised patients, the incidence of invasive mycoses has increased. There are various patterns of fungal infections. Because of limitations in ante mortem clinical diagnosis owing to lack of sensitive diagnostic tools, information regarding frequency and pathogenesis of fungal infections is largely dependent on autopsy. We report a case of 50 year old diabetic female with lower limb cellulitis died of subarachnoid haemorrhage which showed mixed cirrhosis and fungal endocarditis. This presence of fungal endocarditis in a non diseased heart with no major risk factor like previous cardiac surgery or illicit drug abuse, but along with cirrhosis and diabetes is rare. Also fungal endocarditis is commonly associated with hemorrhagic stroke but subarachnoid haemorrhage is very rare.

109

Authors: Hira Mir, Limci Gupta

Indian Journal of Pathology and Oncology (IJPO) is an interdisciplinary journal at the interface of pathology and oncology, including the preclinical and translational research, diagnostics and therapy. The journal covers studies related to pathology including morbid anatomy, surgical pathology, clinical pathology, diagnostic cytopathology including gynecologic cytology. Furthermore, IJPO offers an international forum for the rapid communication of reviews, original research, critical and topical reports with excellence and novelty. Published quarterly, IJPO is dedicated to keeping scientists informed of developments in its focused biomedical fields which span the gap between basic research and clinical medicine.