India is the most tuberculosis prevalent country in the world. Many cases of active tuberculosis are diagnosed at autopsy. This study was aimed to determine the autopsy prevalence of tuberculosis over a period of 3 years at a tertiary... more
India is the most tuberculosis prevalent country in the world. Many cases of active tuberculosis are diagnosed at autopsy. This study was aimed to determine the autopsy prevalence of tuberculosis over a period of 3 years at a tertiary care centre. Out of 801 cases of autopies done in 3 years, 27 cases (3.37%) had tuberculosis and 92.59% of cases were active tuberculosis. Most of the cases were seen in men of 40-50 years age group. There is an increasing trend in number of cases over the years. Autopsy cases of tuberculosis can be a source of transmission to health care providers in autopsy rooms and in pathology department. Complex clinical histories prevent the clinical diagnosis of tuberculosis, so clinicians should be sensitised and stringent screening for tuberculosis should be done in all patients with respiratory symptoms. Keywords: Tuberculosis, Autopsy, Active tuberculosis.
Introduction: Pap smear is the conventional screening procedure for cervical cancer. MLBC (Manual Liquid Based Cytology) has been developed as a cost effective alternative as it has a short screening time, better morphology and background... more
Introduction: Pap smear is the conventional screening procedure for cervical cancer. MLBC (Manual Liquid Based Cytology) has been developed as a cost effective alternative as it has a short screening time, better morphology and background while also providing residual material to test for HPV DNA. Aim: To evaluate the diagnostic efficacy of MLBC and compare the morphological parameters with conventional PAP smear. Materials and Methods: This is a prospective study comparing 50 cervical smears using Pap smear and MLBC by the split sample method. The smears were stained by Rapid Pap stain and reported using Bethesda System. Results: In MLBC 18 (36%) cases were reported as inadequate smear but none of the smears were inadequate in CS. By MLBC method 10(20%) cases showed inflammatory cells while CS showed inflammatory background in 31(62%) cases. MLBC preparations showed 2 (4%) cases of LSIL while CS showed 2(4%) HSIL and 4(8%) LSIL. The interpretation of results revealed that there was...
Indian population is affected with atherosclerosis at younger age when compared to other ethnic groups. In this study histopathological grading of atherosclerotic lesions of the ascending aorta in archival specimens were performed with... more
Indian population is affected with atherosclerosis at younger age when compared to other ethnic groups. In this study histopathological grading of atherosclerotic lesions of the ascending aorta in archival specimens were performed with immunohistochemical marker for CD4+ cells in each grade of atherosclerosis. Mean ages of males and females in our study were 52.11±15.79 and 40.18±17.73 years respectively. The prevalence of various grades of atherosclerosis revealed, Grade 1 atherosclerosis in 4.90%, Grade 2 in 17.65%, Grade 3 in 32.35%, grade 4 in 28.43%, grade 5 in 13.73% cases. Grade 6 was the least common grade of atherosclerosis (1.96%). Immunohistochemistry for CD4+ was performed in 18 subjects with three cases each of grade 1 to 6. CD4+ was quantified higher in grade 1 and grade 2 lesions while progressive reduction in CD4+ positivity was seen in the advanced lesions. Keywords: Aorta, Archival specimens, Atherosclerosis, CD4, Histopathology.
Many lung cancers present in an advanced stage and only cytology specimens or small biopsies are available for diagnosis. In modern era therapy for lung cancer is based on subtype of cancer. Immunohistochemistry done on cell blocks of... more
Many lung cancers present in an advanced stage and only cytology specimens or small biopsies are available for diagnosis. In modern era therapy for lung cancer is based on subtype of cancer. Immunohistochemistry done on cell blocks of pleural samples help in subtyping of lung cancers. In this study,immunohistochemical analysis on plasma thromboplastin cell blocks of cytology samples of pulmonary lesions received as pleural effusion, bronchial wash and guided FNA of lung lesions were included. A total of 100 cases were studied by plasma thromboplastin method. By cell block technique, cytology specimen were made into mini paraffin embedded biopsy materials which are available for immunohistochemistry . All the 14 cases diagnosed to be malignant on cell block by Hematoxylin and Eosin stain were confirmed and subtyped by immunohistochemistry. A panel of immunohistochemistry markers CK7, CK20, PanCK, Synaptophysin, p63,TTF-1,Calretinin and Estrogen receptor were used. This study showed c...
Breast carcinoma is graded by Modified BloomRichardson score and predictive immunohistochemical markers are estrogen receptors, progesterone receptors and HER2/neu status. Conventionally these analyses are done by immunohistochemistry(... more
Breast carcinoma is graded by Modified BloomRichardson score and predictive immunohistochemical markers are estrogen receptors, progesterone receptors and HER2/neu status. Conventionally these analyses are done by immunohistochemistry( IHC) on whole sections. In our study we use tissue microarray technique(TMA) where small representative tissue samples from many cases were assembled on a single histology slide and subjected to Immunohistochemical analysis. We assessed the cost-effectiveness of IHC done on TMA slides. 50 cases of invasive breast carcinoma were included in the study. First the design for TMA construction was laid out. Paraffin embedded tissue blocks were collected and the areas of invasive carcinoma were cored from donor blocks and transferred to the recipient blocks using bone marrow needle. Thus tissue microarray was constructed manually. Immunohistochemical analysis using ER, PR and Her2/neu were done for all these cases. Of the 50 patients analysed, majority were ...
Chorioangiomas are the most common non‐trophoblastic benign vascular tumor of the placenta, highly associated with perinatal death rate. Herewith, we are reporting the prenatal diagnosis, management and postnatal outcome of a fetus... more
Chorioangiomas are the most common non‐trophoblastic benign vascular tumor of the placenta, highly associated with perinatal death rate. Herewith, we are reporting the prenatal diagnosis, management and postnatal outcome of a fetus referred at 33 weeks gestation with massive cardiomegaly secondary to placenta chorioangioma.
Cutaneous Leiomyosarcoma is a rare tumor with an incidence of 2-3% of all the superficial smooth muscle tumors. Cutaneous leiomyosarcoma is divided based on the prognosis into leiomyosarcoma arising from the dermis and subcutaneous plane.... more
Cutaneous Leiomyosarcoma is a rare tumor with an incidence of 2-3% of all the superficial smooth muscle tumors. Cutaneous leiomyosarcoma is divided based on the prognosis into leiomyosarcoma arising from the dermis and subcutaneous plane. Metastasis, recurrence and death are more common in subcutaneous leiomyosarcoma when compared with dermal LMS. Dermal leiomyosarcoma is a tumor of an adult with a male preponderance with a peak age incidence of 60 years. Commonest site is the extremities. These tumors are usually smaller in size. Histopathologically, two growth patterns are recognized, diffuse and nodular. Atypia and mitosis more than one per 10 high power fields are the diagnostic criteria that help in distinguishing cutaneous leiomyosarcoma from leiomyoma. Markers like smooth muscle actin and caldesmon are helpful in arriving at the diagnosis. Treatment is wide local excision with 2-5cm margin. The depth, size, location and grade alter the prognosis.
Background: Gynecological surgeries are done for both benign and malignant conditions involving the uterus, cervix, tubes, ovaries, vagina and vulva. Very few rare entities are seen in the gynaecopathological practice. Aim: To analyze the... more
Background: Gynecological surgeries are done for both benign and malignant conditions involving the uterus, cervix, tubes, ovaries, vagina and vulva. Very few rare entities are seen in the gynaecopathological practice. Aim: To analyze the uncommon benign and malignant entities diagnosed in the gynecological specimens. Materials and Methods: During our one year study period, all the gynecological specimens were retrieved from the records. Rarely encountered specimens were included in our study after reanalysis. The histomorphology and the differential diagnosis are discussed. Results: Out of 3100 gynecological specimens we received, few rare benign and malignant conditions were diagnosed. Most of them were incidental findings. The commonest presenting symptom was abdominal pain and the provisional diagnosis was leiomyoma in most of the cases. Ten interesting cases were diagnosed during our study period. Brief review of literature and differential diagnosis of these rare entities are discussed. Conclusion: Rare entities like pure lipomatous lesion of the uterus and adenocarcinoma of mammary gland like arising from hidradenoma papilliferum were encountered during our study period. Diagnostic criteria's of these rare tumors and the review of literature gave us a true learning experience.
Extraskeletal osteosarcoma is a rare soft tissue sarcoma. Survival is related with the wide resection of the tumor. The role of adjuvant chemotherapy and radiation therapy remains controversial. In our study, we present a patient with... more
Extraskeletal osteosarcoma is a rare soft tissue sarcoma. Survival is related with the wide resection of the tumor. The role of adjuvant chemotherapy and radiation therapy remains controversial. In our study, we present a patient with extraskeletal osteosarcoma of the thigh which was initially misdiagnosed as lipoma.
Background and objective: an incidence of one in 5000 live births with a male predominance. In our setup for the diagnosis of Hirshcsprung's dis practiced. As a novel diagnostic procedure, rapid on table acetylcholine esterase stain was... more
Background and objective: an incidence of one in 5000 live births with a male predominance. In our setup for the diagnosis of Hirshcsprung's dis practiced. As a novel diagnostic procedure, rapid on table acetylcholine esterase stain was tried. It is a diagnostic accuracy test don rapid hematoxylin and eosin staining in the frozen section of rectal biopsy as a part of intra operative consultation. 2 To correlate routine formalin fixed, hematoxylin and eosin staining results with ra methods. 3. Fe Method: obstruction were screened by pediatric surgeons. frozen acetylcholine esterase staining and rapid haematoxylin and eosin staining was done. In the formalin fixed specimen routine haematoxylin and eosin was done. Results: and eosin in a formalin fixed specimens gave equal results. the routine formalin fixed specimen very much reduced. By rapid staining, intra pull-through. Repeat surgery was avoided as both the diagnosis and the level of colon having ganglion cells were assessed si Conclusion: diagnostic efficacy of rapid methods correlated with that of the routinely processed tissue sections stained with haematoxylin and eosin. The facilitated on and, there
Inter-digitating dendritic cell (IDC) sarcoma is a rare tumor presenting as an asymptomatic slow growing lesion. The median age of occurrence is around 56 years and has a male preponderance. Peripheral lymphadenopathy is the commonest... more
Inter-digitating dendritic cell (IDC) sarcoma is a rare tumor presenting as an asymptomatic slow growing lesion. The median age of occurrence is around 56 years and has a male preponderance. Peripheral lymphadenopathy is the commonest presenting symptom. The clinical course of patients with IDC sarcoma varies from indolent to more aggressive with widespread metastases and death within a year. There is no standardized therapeutic approach for patients with IDC sarcoma. We are presenting a case of IDC sarcoma in a 40 year old male with cervical node and liver involvement. Histologically, there was complete effacement of nodal architecture with tumor cells arranged in sheets composed of spindle cells and epithelioid cells having convoluted nuclei. Immuno-reactivity for S100 and vimentin were observed. Other stains such as CD 1a, CD21, CD3 and CD45 were negative. Histology, Immuno histochemistry and differential diagnosis are discussed in our presentation which would help in arriving at the diagnosis of this rare tumor.
Background: Chondromas are benign tumors that may be found in any part of the body. Tumors of cartilaginous origin presenting as an intracranial neoplasm, are very rare,[0.2-0.3%]. There are many hypotheses regarding its origin in the... more
Background: Chondromas are benign tumors that may be found in any part of the body. Tumors of cartilaginous origin presenting as an intracranial neoplasm, are very rare,[0.2-0.3%]. There are many hypotheses regarding its origin in the intracranial location. Diagnosing this tumor is mandatory as treatment and follow up depends upon the exact diagnosis. A retrospective cross sectional study Aim: To diagnose intracranial chondroma and to calculate the incidence, mean age, sex predilection and site predilection of this rare tumor in our hospital set up. Method: All central nervous tumor cases that were diagnosed during May 2011- May 2014 in our hospital was evaluated. From that, cases diagnosed as Intracranial chondromas was reevaluated. The incidence of this tumor among the central nervous system tumors was calculated. From this, the rarity of this tumor in our setup is established. Along with that the differential diagnosis and treatment options were also studied. Results: Of all the two hundred eighty Central nervous system tumors reported during our study period, only two cases of intracranial chondroma was reported in our hospital. The incidence of Central nervous tumor in our hospital was 2.4% per year. The calculated incidence of Intra cranial Chondroma was 0.2% during our study period. This correlated with the study of Chorobski et al. The mean age was calculated as 41 years. There was an equal gender distribution and site from which the tumor arose was also analyzed. Conclusion: In this cross sectional study, the diagnostic approach and the methods to rule out each differentials are analyzed. The incidence of intracranial chondromas among the central nervous system tumor was calculated and the rarity established.Equal gender distribution, mean age of occurrence of this tumor and the site predilection correlated with other studies.
Background: Ischemia and placental pathology are the two main basic etiopathogenesis behind intra uterine growth retardation (IUGR). Various histomorphological changes are observed in IUGR placenta. distribution, gravidity, socio economic... more
Background: Ischemia and placental pathology are the two main basic etiopathogenesis behind intra uterine growth retardation (IUGR). Various histomorphological changes are observed in IUGR placenta. distribution, gravidity, socio economic statu placenta. To correlate the data with the neonatal outcome in terms of fetal weight and apgar score. To suggest treatment modalities based on this. Settings and born with birth weight less than 10th percentile of normal weight for age and sex were taken up for the study. Appropriate sections were taken and morphology ananlysed. Age of the mother, gravidity, econo factors were retrieved from the records. Baby's weight and the Apgar score were retrieved from the records. 80% of the mother was in the age group 21 class and 45% of them had no specific etiology. 66% of the placenta had macroscopic abnormality and 60% of the had microscopic abnormality. 51 babies were <5 positive correlation between reduced placental weight and placental diameter with the fetal weight. When the number of lesions in the placenta is increased, apgar score decreased and infant mortality increased[p<0. 001]. Compulsory examination ofall the IUGR placenta
ARTICLE INFO ABSTRACT Ovarian tumors are the second most common tumor affecting the female genital tract. Post chemotherapy, the ovarian tumors shows myriad of histomorphology and poses diagnostic challenges to the pathologists. The aim... more
ARTICLE INFO ABSTRACT Ovarian tumors are the second most common tumor affecting the female genital tract. Post chemotherapy, the ovarian tumors shows myriad of histomorphology and poses diagnostic challenges to the pathologists. The aim of this study is to analyse the histomorphological changes that are observed in various ovarian tumors following chemotherapy and to assess the prognosis based on the variables. During the one year study period, eleven cases were received. In majority of the cases the residual tumor size was more than five centimetre. Mild fibrosis, mild inflammatory reaction and grade I and II residual tumor was seen in majority of the patients. 45.5% of the tumor showed necrosis. Pre-treatment biopsies help in arriving at the correct diagnosis and prevent unnecessary additional investigations. Grading of fibrosis, size of the residual tumor and presence of necrosis should be mentioned in the final pathology report of the post chemotherapy specimens as they have prognostic significance.
Background: Pancreaticoduodenectomy or Whipples's procedure is done for pancreatic carcinoma, bile duct carcinoma, duodenal carcinoma and periampullary carcinoma. About 5% of the gastrointestinal malignancy is constituted by the ampullary... more
Background: Pancreaticoduodenectomy or Whipples's procedure is done for pancreatic carcinoma, bile duct carcinoma, duodenal carcinoma and periampullary carcinoma. About 5% of the gastrointestinal malignancy is constituted by the ampullary and periampullary carcinoma. Histopathological studies related to the diagnosis, grade, stage, nodal status, marginal status, prognosis and incidence of these tumors are analyzed from the received Whipple's specimen in our study. Aim of this study is to analyze the incidence of various tumors we encounter in the Whipple's specimen, to calculate the sex ratio, to grade and to stage the tumors based on the WHO grading system. And to compare the incidence with other studies.
BACKGROUND: A rare disease of the newborn, Hirschsprung's disease has evolved since Harold Hirschsprung's days. In all the studies that were documented, the incidence was given as one in 5000 live births. There in not much study about it... more
BACKGROUND: A rare disease of the newborn, Hirschsprung's disease has evolved since Harold Hirschsprung's days. In all the studies that were documented, the incidence was given as one in 5000 live births. There in not much study about it in western Tamilnadu. So, we thought we would study the incidence, age at which it is diagnosed and the sex prevalence of this rare disease in our setup. STUDY DESIGN: Descriptive cross sectional study AIM: To analyze incidence, age and sex ratio of the children with Hirschsprung's disease in our setup. METHOD: This study was carried over a period of two years [November 2011-November 2013]. Biopsies that were sent as suspected Hirschprung's disease during the study period was analysed. The diagnosis was done using haematoxylin eosin staining and acetylcholine esterase staining of the frozen sections. RESULTS: Incidence of Hirshprung's disease was calculated based on positive acetylcholine esterase stain and haematoxylin stain. The incidence calculated was 1.54/5000 live births. Mean age at which the disease was diagnosed was1.03 in our setup and there was a male predominance. CONCLUSION: Incidence, age and sex prevalence of our study group correlated with other studies.
Background: Skin Adnexal Tumours (SATs) are large and divergent group of tumours which are classified based on their appendageal differentiation into eccrine,follicular,sebaceous and apocrine.They pose daunting diagnostic challenges to... more
Background: Skin Adnexal Tumours (SATs) are large and divergent group of tumours which are classified based on their appendageal differentiation into eccrine,follicular,sebaceous and apocrine.They pose daunting diagnostic challenges to both clinicians and pathologists alike.This study aims to evaluate the histopathological charecterestics of skin adnexal neoplasms and correlate with their clinical profile.
Background: Carcinosarcoma or Malignant Mixed Mullerian tumors of the female genital tract are very rare neoplastic lesions of the postmenopausal women. Uterus is the commonest site involved. Ovarian carcinosarcoma is one third less... more
Background: Carcinosarcoma or Malignant Mixed Mullerian tumors of the female genital tract are very rare neoplastic lesions of the postmenopausal women. Uterus is the commonest site involved. Ovarian carcinosarcoma is one third less common than uterine carcinosarcoma. As studies comparing ovarian and uterine carcinosarcoma were less prevalent in the literatures, an attempt was made to do the same in our study. Methods: From the reported gynaeco-pathological cases during May 2014-April 2016, carcinosarcomas of the female genital tract were retrieved. Apart from gross and microscopy of the carcinosarcoma of the uterus and ovary, literatures were analyzed to compare both based on its demography, histopathology, behaviour and survival.Results: Two cases, one each of ovarian and uterine carcinosarcoma were reported during our study period. Both gross and microscopy was similar in uterine and ovarian carcinosarcoma. Survival and prognostic factors were analyzed based on the literature.Conclusion: Though the histogenesis and morphology of the carcinosarcoma of both the sites were similar, the uterine carcinosarcoma was found to be more aggressive with poorer prognosis when compared with its ovarian counterpart.
