Video clip of the child. Child at the age of 5Â year 10Â months showing ataxic gait, nystagmus, t... more Video clip of the child. Child at the age of 5Â year 10Â months showing ataxic gait, nystagmus, tremors and requiring assistance during ambulation. (MP4 50864 kb)
Background: Urinary bladder tumors are the second most common tumors affecting males. The aim of ... more Background: Urinary bladder tumors are the second most common tumors affecting males. The aim of the study was to evaluate the various histopathological findings in various bladder tumors and their correlation with exfoliative urine cytology. Design: This is an observational study carried out over a period of 7 years at a tertiary care hospital between January 2010 and January 2017. Materials and Methods: Tumors were divided into invasive and noninvasive urothelial carcinoma and were further classified into high-grade or low-grade urothelial cancer. Urine cytology smears from all these patients were also were studied. Cytological findings were correlated with histopathological findings. Result showed that bladder tumors were commonly seen in males with average age of presentation being the sixth decade. The most common type of carcinoma seen was low-grade urothelial carcinoma-noninvasive type. Urine cytology was positive in 47.46% patients. Sample Size: In our study, 113 cystoscopic biopsies were included over a period of 7 years (85 males and 28 females). Conclusion: Accuracy of diagnosing malignancy in urine cytology varies, and it depends on the presence of diagnostic yield in the urine cytology, processing of the sample, and experience of the cytopathologist. Urine cytology should be reported in a background of detailed clinical information and should always be followed by histopathological examination.
Background: Breast lesions are always a diagnostic challenge and range from benign to malignant. ... more Background: Breast lesions are always a diagnostic challenge and range from benign to malignant. Fine-Needle Aspiration Cytology (FNAC) is done in patients with breast lesions. However, to get an accurate and diagnostic yield is difficult at times. Aims: The aim of this study is to highlight the role of triple approach in diagnosing breast lesions. Design and Setting: This is an observational prospective study carried out in the Department of Pathology at a tertiary care hospital over 2 years. Materials and Methods: One hundred and fifty cases of breast lump were studied. Clinical findings, imaging findings, and cytology along with histopathological findings were correlated. Results: Cytological findings were benign in 102 out of 107 patients, who were otherwise clinically and radiologically benign. In rest five patients, Breast Imaging Reporting and Data Systems (BIRADS) BIRADS II category was given on mammography. In four of these five patients, there was cytological atypia. Biopsy in these four patients showed features of fibroadenoma with mild cytological atypia and one patient showed infiltrating duct carcinoma. Mammography was suggestive of malignant breast lump in 43 patients. In three patients, breast lump was diagnosed as benign on cytological examination. However, histopathological examination confirmed the mammography findings of malignancy. Conclusion: FNAC is a well-established procedure for diagnosing breast lesion but has got many pitfalls. Hence for diagnosis a breast lesion, the triple approach consisting of histopathological examination in addition to mammography and FNAC, should be considered.
Introduction: The spectrum of mediastinal masses comprises of lesions of various origins. Althoug... more Introduction: The spectrum of mediastinal masses comprises of lesions of various origins. Although the clinicoradiological findings and the location of these lesions within different mediastinal compartments help narrow down the differentials, tissue diagnosis remains the gold standard for diagnosis. The image-guided percutaneous transthoracic fine-needle aspiration cytology (FNAC) and/or core-needle biopsy (CNB) of the mediastinal lesions are considered to be cost-effective and safe diagnostic procedures. CNB of mediastinal lesions is found to provide better yield with the accuracy of 75%–90% and is more precise as compared to FNAC. In this article, we study the role of CNB in cases of mediastinal masses as a primary diagnostic modality as compared to FNAC. Materials and Methods: A retrospective observational study was conducted at a tertiary care hospital in Mumbai. All cases with mediastinal mass lesions diagnosed by FNAC and/or CNB over a period of 1 year in a tertiary care hospital were analyzed. Cases were divided into FNAC group or CNB group depending on the primary diagnostic procedure undertaken. Comparisons were made between the two groups. Results: CNB group was found to have better diagnostic yield in benign as well as malignant lesions in comparison with the FNAC group. The time taken to reach the definitive diagnosis was found to be shorter in the CNB group as compared to the FNAC group. Conclusion: The use of CNB as a primary diagnostic modality may provide faster and accurate tissue diagnosis in cases of mediastinal masses of both benign and malignant nature as compared to FNAC.
Mediterranean journal of hematology and infectious diseases, 2018
Dengue is a major health issue with seasonal rise in dengue fever cases imposing an additional bu... more Dengue is a major health issue with seasonal rise in dengue fever cases imposing an additional burden on hospitals, necessitating bolstering of services in the emergency department, laboratory with creation of additional dengue fever wards. To study the clinical and hematological profile of dengue fever cases presenting to a hospital. Patients with fever and other signs of dengue with either positive NS1 antigen test or IgM or IgG antibody were included. Age, gender, clinical presentation, platelet count and hematocrit were noted and patients classified as dengue fever without warning signs (DF) or with warning signs (DFWS), and severe dengue (SD) with severe plasma leakage, severe bleeding or severe organ involvement. Duration of hospitalization, bleeding manifestations, requirement for platelet component support and mortality were recorded. There were 443 adults and 57 children between 6 months to 77 year age. NS1 was positive in 115 patients (23%). Fever (99.8%) and severe body a...
4H syndrome is a congenital hypomyelinating leukodystrophy characterized by hypodontia, hypomyeli... more 4H syndrome is a congenital hypomyelinating leukodystrophy characterized by hypodontia, hypomyelination and hypogonadotropic hypogonadism belonging to the Pol III-related leukodystrophies which arise due to mutations in the POLR3A or POLR3B gene. The clinical presentation is of neurodevelopmental delay or regression with ataxia, dystonia, nystagmus, delayed deciduous dentition and abnormal order of eruption of teeth. MRI brain shows a characteristic hypomyelination pattern. Several mutations have been described in the implicated genes but there are no reports on mutations seen in patients from India. We report a 1½ year old girl, only child of a non-consanguinous couple who presented with delayed developmental milestones and delayed dentition. On physical examination she had downward slanting palpebral fissures, low set ears, smooth philtrum, hypodontia, prominent body hair and clitoromegaly. There was prominent horizontal nystagmus, hypertonia of both upper and lower limbs, exagger...
The ileum is one of the most common sites of intestine to undergo endoscopic biopsy. However, eve... more The ileum is one of the most common sites of intestine to undergo endoscopic biopsy. However, even with the experienced histopathologists, a definite diagnosis can be achieved only in 18% cases. Lack of knowledge about proper tissue handling, tissue orientation, overlapping histological findings, and lack of a standard algorithm based approach results in this low diagnostic yield. In this review article, we have tried to discuss these aspects and give a clear picture how to approach the ileal lesions. It would help the surgical pathologists in effectively interpreting the lesions and to identify the common pitfalls.
The American Journal of Gastroenterology is published by Nature Publishing Group (NPG) on behalf ... more The American Journal of Gastroenterology is published by Nature Publishing Group (NPG) on behalf of the American College of Gastroenterology (ACG). Ranked the #1 clinical journal covering gastroenterology and hepatology*, The American Journal of Gastroenterology (AJG) ...
Video clip of the child. Child at the age of 5Â year 10Â months showing ataxic gait, nystagmus, t... more Video clip of the child. Child at the age of 5Â year 10Â months showing ataxic gait, nystagmus, tremors and requiring assistance during ambulation. (MP4 50864 kb)
Background: Urinary bladder tumors are the second most common tumors affecting males. The aim of ... more Background: Urinary bladder tumors are the second most common tumors affecting males. The aim of the study was to evaluate the various histopathological findings in various bladder tumors and their correlation with exfoliative urine cytology. Design: This is an observational study carried out over a period of 7 years at a tertiary care hospital between January 2010 and January 2017. Materials and Methods: Tumors were divided into invasive and noninvasive urothelial carcinoma and were further classified into high-grade or low-grade urothelial cancer. Urine cytology smears from all these patients were also were studied. Cytological findings were correlated with histopathological findings. Result showed that bladder tumors were commonly seen in males with average age of presentation being the sixth decade. The most common type of carcinoma seen was low-grade urothelial carcinoma-noninvasive type. Urine cytology was positive in 47.46% patients. Sample Size: In our study, 113 cystoscopic biopsies were included over a period of 7 years (85 males and 28 females). Conclusion: Accuracy of diagnosing malignancy in urine cytology varies, and it depends on the presence of diagnostic yield in the urine cytology, processing of the sample, and experience of the cytopathologist. Urine cytology should be reported in a background of detailed clinical information and should always be followed by histopathological examination.
Background: Breast lesions are always a diagnostic challenge and range from benign to malignant. ... more Background: Breast lesions are always a diagnostic challenge and range from benign to malignant. Fine-Needle Aspiration Cytology (FNAC) is done in patients with breast lesions. However, to get an accurate and diagnostic yield is difficult at times. Aims: The aim of this study is to highlight the role of triple approach in diagnosing breast lesions. Design and Setting: This is an observational prospective study carried out in the Department of Pathology at a tertiary care hospital over 2 years. Materials and Methods: One hundred and fifty cases of breast lump were studied. Clinical findings, imaging findings, and cytology along with histopathological findings were correlated. Results: Cytological findings were benign in 102 out of 107 patients, who were otherwise clinically and radiologically benign. In rest five patients, Breast Imaging Reporting and Data Systems (BIRADS) BIRADS II category was given on mammography. In four of these five patients, there was cytological atypia. Biopsy in these four patients showed features of fibroadenoma with mild cytological atypia and one patient showed infiltrating duct carcinoma. Mammography was suggestive of malignant breast lump in 43 patients. In three patients, breast lump was diagnosed as benign on cytological examination. However, histopathological examination confirmed the mammography findings of malignancy. Conclusion: FNAC is a well-established procedure for diagnosing breast lesion but has got many pitfalls. Hence for diagnosis a breast lesion, the triple approach consisting of histopathological examination in addition to mammography and FNAC, should be considered.
Introduction: The spectrum of mediastinal masses comprises of lesions of various origins. Althoug... more Introduction: The spectrum of mediastinal masses comprises of lesions of various origins. Although the clinicoradiological findings and the location of these lesions within different mediastinal compartments help narrow down the differentials, tissue diagnosis remains the gold standard for diagnosis. The image-guided percutaneous transthoracic fine-needle aspiration cytology (FNAC) and/or core-needle biopsy (CNB) of the mediastinal lesions are considered to be cost-effective and safe diagnostic procedures. CNB of mediastinal lesions is found to provide better yield with the accuracy of 75%–90% and is more precise as compared to FNAC. In this article, we study the role of CNB in cases of mediastinal masses as a primary diagnostic modality as compared to FNAC. Materials and Methods: A retrospective observational study was conducted at a tertiary care hospital in Mumbai. All cases with mediastinal mass lesions diagnosed by FNAC and/or CNB over a period of 1 year in a tertiary care hospital were analyzed. Cases were divided into FNAC group or CNB group depending on the primary diagnostic procedure undertaken. Comparisons were made between the two groups. Results: CNB group was found to have better diagnostic yield in benign as well as malignant lesions in comparison with the FNAC group. The time taken to reach the definitive diagnosis was found to be shorter in the CNB group as compared to the FNAC group. Conclusion: The use of CNB as a primary diagnostic modality may provide faster and accurate tissue diagnosis in cases of mediastinal masses of both benign and malignant nature as compared to FNAC.
Mediterranean journal of hematology and infectious diseases, 2018
Dengue is a major health issue with seasonal rise in dengue fever cases imposing an additional bu... more Dengue is a major health issue with seasonal rise in dengue fever cases imposing an additional burden on hospitals, necessitating bolstering of services in the emergency department, laboratory with creation of additional dengue fever wards. To study the clinical and hematological profile of dengue fever cases presenting to a hospital. Patients with fever and other signs of dengue with either positive NS1 antigen test or IgM or IgG antibody were included. Age, gender, clinical presentation, platelet count and hematocrit were noted and patients classified as dengue fever without warning signs (DF) or with warning signs (DFWS), and severe dengue (SD) with severe plasma leakage, severe bleeding or severe organ involvement. Duration of hospitalization, bleeding manifestations, requirement for platelet component support and mortality were recorded. There were 443 adults and 57 children between 6 months to 77 year age. NS1 was positive in 115 patients (23%). Fever (99.8%) and severe body a...
4H syndrome is a congenital hypomyelinating leukodystrophy characterized by hypodontia, hypomyeli... more 4H syndrome is a congenital hypomyelinating leukodystrophy characterized by hypodontia, hypomyelination and hypogonadotropic hypogonadism belonging to the Pol III-related leukodystrophies which arise due to mutations in the POLR3A or POLR3B gene. The clinical presentation is of neurodevelopmental delay or regression with ataxia, dystonia, nystagmus, delayed deciduous dentition and abnormal order of eruption of teeth. MRI brain shows a characteristic hypomyelination pattern. Several mutations have been described in the implicated genes but there are no reports on mutations seen in patients from India. We report a 1½ year old girl, only child of a non-consanguinous couple who presented with delayed developmental milestones and delayed dentition. On physical examination she had downward slanting palpebral fissures, low set ears, smooth philtrum, hypodontia, prominent body hair and clitoromegaly. There was prominent horizontal nystagmus, hypertonia of both upper and lower limbs, exagger...
The ileum is one of the most common sites of intestine to undergo endoscopic biopsy. However, eve... more The ileum is one of the most common sites of intestine to undergo endoscopic biopsy. However, even with the experienced histopathologists, a definite diagnosis can be achieved only in 18% cases. Lack of knowledge about proper tissue handling, tissue orientation, overlapping histological findings, and lack of a standard algorithm based approach results in this low diagnostic yield. In this review article, we have tried to discuss these aspects and give a clear picture how to approach the ileal lesions. It would help the surgical pathologists in effectively interpreting the lesions and to identify the common pitfalls.
The American Journal of Gastroenterology is published by Nature Publishing Group (NPG) on behalf ... more The American Journal of Gastroenterology is published by Nature Publishing Group (NPG) on behalf of the American College of Gastroenterology (ACG). Ranked the #1 clinical journal covering gastroenterology and hepatology*, The American Journal of Gastroenterology (AJG) ...
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Papers by Ritu Mehta