Indian Journal of Pathology and Oncology

110-112

Authors: Chaware SA, Ingole AS, Bahattare VN, Mangalkar S

Tuberculosis is the chronic infectious disease and for its diagnosis battery of investigations are done. Ziehl Neelsen staining for detection of causative Acid Fast Bacilli is one of them. Positive smears diagnose the disease but negative smears doesn’t exclude the disease. We here done attempt to diagnose the undiagnosed cases by modifying the conventional ZN staining method. Patients suspicious of having pulmonary Tuberculosis were included in the study. Sputum examination was done by Ziehl-Neelsen staining method. Acid Fast Bacilli positive sputum samples were excluded from the study. Total 120 confirmed smear negative cases by conventional Ziehl-Neelsen method were studied. Sputum samples were processed for Culture and sodium hypochlorite sedimentation technique. Smears were stained by ZN method after sodium hypochlorite sedimentation technique. Of 120 initial negative cases 8 cases were found to be positive. Culture was positive in 10 cases. Thus this study was an attempt to show the increase in sensitivity of conventional ZN staining with the use of sodium hypochlorite concentration.

118-120

Authors: Renuka Gahine, Aditi Das, Pratima Kujur, Chandrakala Joshi

Background and objectives: Due to increased requirement of blood, it is necessary to formulate action plans for its prudent use. This study had been conducted to evaluate ongoing transfusion services at a tertiary care centre. Method: This had been a prospective study of 7 months duration (June 2013 - December 2013). The data obtained, regarding the utilization of 10,203 units of blood component during that period, was compiled and analyzed further. Results: Total 10,203 units were cross matched and 9431 units were issued. The overall C/T ratio (Units crossmatched/ Units transfused) was 1.08:1. The transfusion probability & transfusion index obtained were 67.44 % and 1.17 respectively. Of 7328 units demand for whole blood and red cell concentrate, red cell concentrate demand was 43% (n= 3154) and whole blood demand was 57% (n= 4174). The maximum demand was received from Obstetrics & Gynaecology department (n= 1450) followed by Paediatrics (n=1434). Maximum utilization of blood units was noticed in Trauma unit (C/T ratio= 1.00:1) and minimum was observed in department of Surgery (C/T ratio= 1.20:1). Of 2875 units demand for fresh frozen plasma (FFP) & platelets, FFP demand was 42% (n= 1206) and platelet demand was 58% (n= 1669). 1206 units demand for FFP resulted in transfusion in 1084 patients (average 1.11 units/patient) with maximum demand from department of Surgery (36.3%) followed by Pediatrics (22.4%) and the commonest indication being burns followed by full term acute fetal distress (FTAFD)/ sepsis. Conclusion: This study highlights that every health care institute must develop distinct transfusion guidelines based on the nature of routine & emergency services and implement them through the institutional transfusion committee to assure effective blood utilization.

126-130

Authors: Rajeshwari K, Damle R, Dravid N, Karibasappa G.N

Aims and objectives: 1. To establish the role of AgNOR in differentiating the benign from the premalignant and the malignant lesions of the prostate. 2. To establish the significance of AgNOR count in differentiating the grades of malignancy. Materials and methods: A prospective study was conducted on 197 prostatic lesions from 2011- 2013. Two sections from each case were stained with haematoxylin and eosin and the other with AgNOR stain. The data was analysed by using SPSS-17.0. Results: The mean AgNOR count of prostatic adenocarcinoma was significantly higher than the benign and premalignant lesions of prostate with P<0.001. The mean AgNOR count in benign lesions is1.6 +/- 0.2 and the AgNOR dots tend to be large, regular and homogenously stained. The mean AgNOR count in malignant lesions was between 4.7 +/- 0.1 – 5.7+/- 0.9 and the dot appear large, irregular in size and shape with gaint and bizarre clusters. Conclusion: AgNOR staining can be considered as a useful adjunct to diagnostic pathology. The study was helpful in evaluating the importance of AgNORs in differentiating the benign, premalignant and malignant lesions of prostate can be considered as a valuable tool in analysing the proliferative activity of the cell.

141-149

Authors: Preeti Rihal Chakrabarti, Suvadip Chakravarti, Ajita Pandit, Purti Agrawal, Shilpi Dosi, Mukul Raj J

Background: Soft tissue sarcomas compared with carcinomas and other neoplasms are relatively rare and constitute less than 1% of all the cancer. Soft tissue sarcomas may occur anywhere in the body but most arise from large muscle of extremeties, the chest wall, the mediastinum and the retroperitoneum. Aims and objectives: To study the macroscopic and microscopic pathology of benign and malignant soft tissue tumour and there clinicopathological correlation. Materials and methods: The study was conducted in Dr .D .Y Patil School of Medicine, Navi Mumbai, from 1st of January 2008 to December 2010. A Cross sectional study of 150 cases of soft tissue tumors were carried out in details. A pretested proforma was used to classify each tumor and details like age, sex, clinical features, gross and microscopic findings were noted. Results: The most common soft tissue tumor in the study were benign tumors (140 cases), followed by malignant (9 cases) and one case was reported as borderline. Lipomas were the most common benign tumors accounting for 49 out of 140 cases. Benign smooth muscle tumors were the next most common tumor accounting for 44 cases.Benign vascular and benign peripheral nerve sheath tumor accounted for 19 cases in each category. Of 19 cases of benign vascular tumor, 16 cases were of haemangioma, 3 cases were of angiofibroma. Of 19 benign peripheral nerve sheethtumor, 12 cases were reported as neurofibroma and 7 schwannomas. Of 5 cases of fibrohistiocytictumor, 3 cases were benign, 1 case of borderline (Dermatofibrosarcoma protuberance) and 1 case of malignant fibrous histiocytoma (MFH). Of 7 cases of Fibrous tumor, 6 cases were of Benign and 1 cases of malignant variant (Fibrosarcoma). Out of 6 cases which were reported as benign, comprised of 2 cases each of fibroma, fibromxyoma, and palmar fibromatosis. 9 out of 150 cases were malignant tumors,3 cases were malignant peripheral nerve sheath tumor(MPNST) ,whearas Gastrointestinal stromal tumor(GIST),leiomyosarcoma, MFH, atypical lipomatoustumor, Fibrosarcoma, Embryonal rhabdomyosarcoma accounted for one case each. Conclusion: Benign soft tissue tumors outnumbered malignant tumors by a ratio of 14:1. Lipomas and leiomyomas of gynaec origin were the most common benign tumors and MPNST were the most common malignant tumor in the present study. Most patients with soft tissue neoplasm presented with painless mass. Sarcomas, for the most part develop as deeply located mass. Hematoxylin and eosin stained sections represented the mainstay of diagnosis, however ancilliary techinque like immunohistochemistry (IHC) plays a important role in diagnosis.

158-160

Authors: Shobha SN, Amita K, Narendra BR

Aim: The study aimed to evaluate the role of Fine Needle Aspiration Cytology (FNAC) in follicular patterned lesions of thyroid. Materials and methods: A prospective study was done in 30 cases in which FNAC showed follicular patterned lesions. Histopathological correlation was done wherever possible. Result: Out of 30 cases of follicular patterned lesions 17 cases were reported as follicular neoplasm, 12 cases were reported as adenomatous goiter and one case was reported as follicular variant of papillary carcinoma of thyroid in FNAC. Based on the FNAC diagnosis, surgery was done and histopathological correlation was available in nine cases. Conclusion: FNAC is quite accurate in follicular patterned lesions of thyroid with a sensitivity of 70.6%, specificity of 100% and diagnostic accuracy of 80%.

165-169

Authors: Vaddatti Tejeswini, Pidakala Premalatha, IV Renuka, R Krishna, PAVKrichnamacharyulu, G Vahini

Introduction: Pancytopenia refers to simultaneous presence of anaemia, leukopenia and thrombocytopenia. Multiple disorders either primarily or secondarily affecting bone marrow, manifest with various haematological derangements and is commonly presented as pancytopenia. Identification of the disease is of prime importance, since this is the key to appropriate management. Aim: The main aim of this study is to diagnose and evaluate various causes of pancytopenia. Materials and methods: Seventy five cases of pancytopenia were included in the study. Two millilitres of EDTA anticoagulated blood was collected and analyzed by automated haematology analyser ADVIA2120. Haematological parameters were recorded, peripheral smear and bone marrow smears studied. Results: Bone marrow aspiration was helpful in identifying the cause of pancytopenia. There was female preponderance and the age ranged between 2yrs to 75 yrs. The most common cause of pancytopenia was megaloblastic anaemia (68%) followed by hypoplastic/aplastic marrow (13.3%) and leukaemia/lymphoma (5.33%). Conclusion: This study showed that the most common cause of pancytopenia was megaloblastic anemia and that is reversible by therapy. Thus in pancytopenia, thorough evaluation has to be done to identify the cause at the earliest, so the treatable causes are identified without delay and the patient is benefited.

172-174

Authors: Rajeshwari K, Nikumbh D.B, Dravid NV, Akshay S

Basal cell carcinoma (BCC) is locally invasive, slowly spreading rarely metastasizing tumor, arising from the epidermis”. BCC are usually diagnosed on histopathology. There are very limited data on role of fine needle aspiration cytology (FNAC) in diagnosing pigmented BCC. The diagnosis of pigmented BCC on cytology is as accurate as histopathology. Herein, we report a case of pigmented BCC successfully diagnosed on FNAC. A 57 year old male patient with pigmented nodule on right side of the face. Cytological diagnosis of pigmented BCC was offered and subsequently confirmed on histopathology. Hence FNAC is rapid, simple and noninvasive and an outpatient procedure can be used in diagnosis of suspicious pigmented BCC and can lead to accurate diagnosis and proper management of the patient.

179-181

Authors: Kanthikar Shivraj N, Nikumbh Dhiraj B, Dravid N V, Akshay Surana

Basal cell carcinoma is the most common skin malignancy, often seen in elderly patient with the sun exposed areas, accounting for approximately 70-80% of cutaneous cancer. It can occur in sun protected areas among them genital involvement is very rare and it accounts for less than 1% of all cases. As the vulvar BCC is very rare accounting about less than 5% of all vulvar neoplasm, most of the time it is misdiagnosed due to its nonspecific characteristics. We report a case of vulvar basal cell carcinoma which was misdiagnosed for 2 years in a 39 years old middle-age female patient. Vulvar basal cell carcinoma is usually diagnosed late due to its asymptomatic and slow growth pattern. The cause is unknown, but chronic vulvar irritation is important factor that gives clue to early diagnosis.