Pathology and Oncology

Introduction: Fluid cytology, a relatively non invasive technique, throws light on both malignant and non malignant causes of effusions. It especially contributes in cancer research and staging of various tumors.
Materials and Methods: This was a retrospective study done over a period of two years from January 2014 to December 2015 in the department of Pathology, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad. The body fluids included in the study were pleural, peritoneal, pericardial and synovial fluids. All other fluids were excluded. The relevant clinical data was noted. Gross, cell count and cytomorphological examinations of fluid were done.
Results: Out of 302 cases, pleural fluids, 148 (49.0%) cases, were most common, followed by peritoneal fluid, 125 (41.39%) cases and least common was pericardial fluid, 8 (2.64%) cases. The maximum numbers of cases was in 5th decade. The age range was 3 years to 84 years. Female preponderance was observed with M: F ratio of 1: 1.17. Lymphocyte rich exudates were most common in pleural effusion. In peritoneal and pericardial effusions, transudates were more and suppurative inflammation was predominant in synovial fluid analysis. Over all, malignant effusions constituted 18.54% of effusions. Metastatic adenocarcinoma was the commonest malignancy detected in all body cavity effusions.
Conclusions: Fluid cytology is relatively painless, simple, cost effective, rapid technique that yields quick and reliable results. Some cases may present major interpretative challenges to the pathologist. Ancillary studies such as cell count, biochemical, microbiologic evaluation, cell block and immunohistochemistry (IHC) study help in accurate identification of diagnosis.
Keywords: Body fluids, Malignant effusions, Transudates.

This is a case-control study designed to assess the glycated haemoglobin, total protein and albumin levels
in patients with type 2 diabetes mellitus visiting NAUTH, Nnewi. A total of 114 subjects comprising of
57 diabetic subjects and 57 controls aged between 40 and 73 years were recruited for the study. The
patients and controls were aged and sex matched. Subsequently, structured questionnaire were used
to obtain patients’ biodata and thereafter, 5mls of blood sample was collected from each patients and
1ml was dispensed into EDTA for the estimation of glycated haemoglobin, and 4ml was dispensed into
plain containers for the determination of serum albumin and total protein levels using standard laboratory
methods. HbA1c, serum albumin and total protein levels were assayed by using immunoturbidimetric
method, Bromo Cresol green Method and Biuret Method respectively. The result revealed that the mean
level of HbA1c was significantly higher in the diabetic subjects when compared with the non diabetic
subjects (9.621.27 Vs 5.580.62; p=<0.01). However, the mean serum of levels of Albumin and total
protein did not differ significantly when compared between the diabetic patients and control subjects
(p>0.05). This finding implies that there was a poor glycemic control in the diabetic subjects studied.
Therefore, there is need for better management of diabetic patients through medication and use of diet and
exercise.

Introduction: Diseases of prostate, particularly Benign prostate hyperplasia and prostate adenocarcinoma
accounts to considerable mortality and morbidity in elderly male. Serum Prostate specific antigen along
with Digital rectal examination and transurethral resection/trucut biopsies of prostate plays a crucial role
as initial line of investigation in diagnosis of prostate pathology.
Objectives: This study is undertaken with the aim to analyze various clinico – histopathological parameters
of prostate lesions and its correlation with serum Prostate specific antigen.
Materials and Methods: This is a prospective study conducted in Histopathology section of Department
of Pathology, Dr. B R Ambedkar medical College and Hospital, Bangalore during June 2017 to June 2019.
Results: A total of 134 cases of prostate specimens were analyzed. Most common lesion to be encountered
was Benign Prostate hyperplasia followed by Prostate adenocarcinoma. Most of the benign lesions were
found in sixth decade and malignant lesions in seventh decade. Increased frequency of micturition is
the most common presenting symptom. Among Prostate adenocarcinoma, the Gleason pattern 4 and the
Gleason score 7 is the most commonly encountered. Serum Prostate specific antigen showed correlation
with both benign and malignant lesions.

Introduction: Meningioma comprises if 33.5% of total CNS tumors detected. There is lack of
clinicopathological study of meningioma from rural setup in central India. The objective of this study
is to give idea about the descriptive epidemiology, clinical presentation and histopathology for the central
India rural population.
Materials and Methods: This study is retrospective observational study from the period of January 2014
to Feb 2019 in MGIMS, Sewagram. Inclusion criteria consists of all the histopathological proven cases of
meningioma in department of Neurosurgery, MGIMS Sewagram during the same period. Rest of the CNS
tumors were excluded from the study.
Results: Out of 168 cases of CNS tumors operated, menigioma consists of 44 cases accounting for 26.19%
of total CNS tumors. The average age of presentation was 44.1 years. M:F ratio of 1:1.32. Most common
affected age group was 30-50 years comprising 24 cases (54.54%) The most common clinical symptoms
for intracranial meningioma were headache followed by vomiting and seizures. Among intracranial
meningioma, the most common location was convexity meningioma (40.54%) followed by parasagittal
(13.51%) and parafalcine meningioma (10.81%). Most common histopathological variety encountered
was meningothelial in 42.72% cases. WHO grade I consists of majority of the tumors (95.45%) while
grade II consists of 4.55%.
Conclusion: The descriptive epidemiology of meningioma in our rural setup roughly correlates with the
epidemiology elsewhere in India apart from the male to female ratio; which could be due to lack of seeking
medical care among females in our society.

Introduction: Quality lab reports require high degree of precision and accuracy. This study was undertaken
to study pre-analytical errors as a quality measure in Central Clinical Laboratories of rural Tertiary Care
Hospital.
Materials and Methods: This study was a non-participatory observational study for a period of two
months from 6/7/2019 to 6/9/2019 conducted at HIMS, UP, India. After obtaining clearance from
Institutional Human Ethical committee, study was undertaken in Central Clinical Laboratory(CCL). The
blood samples of OPD and IPD were included. Checklist for pre-analytical errors was followed.
Results: Total 13604 blood samples were received in CCL in study periodand pre-analytical error was
found to be 398 (2.93%). The commonest error was inadequate (underfilled/Overfilled) samples(1.15%),
second commonest was Clotted sample (0.99%), Hemolyzed samples were 0.26%, Lipemic samples were
0.15%, and remaining were diluted sample, incorrect vaccutainer and sample spillage each accounted for
0.08%, followed by test ID form missing (0.06%) and specimen ID and order form mismatch (0.02%).
There was a statistical difference between pre-analytical errors in IPD(3.68%) and OPD(0.87%) samples
with p value less than <0.05.
Conclusion: Pre-analytical errors are avoidable and could be manage by preventive and corrective
measures and proper education and skill enhancing training to paramedical staff and efficient monitoring
by Lab managers.

Introduction: To provide safe blood to the recipients, proper donor selection and deferral is as important as screening of blood bags for various transfusion transmissible infections (TTI). Aims and Objectives: To study and analyse various causes & rate of pre-donation deferral of blood donors and to take proper follow up actions to decrease the temporary deferral rate without compromising blood quality and recipient's safety, thus retaining prospective blood donors and preventing loss of precious blood. Materials and Method: A retrospective study of various causes of pre-donation deferral of whole blood donors in the blood bank of our institute was done. Records of all deferrals of Financial Year 2012 to 2016 (4 years) were reviewed and analysed. Results: A total of 6633 potential blood donors were registered during the study period which includes 6474 males (97.6%) and 159 females (2.4%) with 5840 Voluntary and 793 Replacement donations. Out of which, a total of 273 donors (4.11%) were deferred due to various reasons. Among these, 235 were Temporary (86.08%) and 38 were Permanent deferrals (13.92%). The main reason for temporary deferral is Low Haemoglobin; while for permanent deferral is Hepatitis B Positivity. Conclusion: The donor deferral rate obtained in our study is 4.11% which is quite good as compared to higher deferral rates of some other studies. Majority of the donors were males, so encouragement and motivation of female donors is equally important to increase the overall donor pool. Temporary deferrals were more as compared to permanent deferrals. So by counselling and educating the temporary deferred donors regarding some common causes of temporary deferrals and deferral period, they can be brought back for future donations. The Leading causes of permanent deferrals were Transfusion Transmissible Infections (HBV, HIV, HCV). So proper counselling is also necessary to prevent them from donating blood for the safety of the recipient. In this ways, a pool of healthy blood donors can be increased without compromising quality of blood and safety of the recipients as well as donors.

Introduction: India is the diabetic capital of the world. Vitamin B12 deficiency has been recognized since many years ago as an important side effect in diabetic patients who take metformin for more than 5-10 years.This research aimed to determine the prevalence of anemia in type 2 diabetes mellitus (T2DM) and its association with vitamin B12 deficiency due to use of Metformin.
Materials and Methods: Total 200 type 2 diabetes mellitus (T2DM) males and females were included in the study.Blood collection for Fasting blood glucose and Hba1c levels were measured from all participants in tubes without anticoagulant. Hemoglobin, mean corpuscular volume (MCV) were measured by automated cell counters. Measurement of vitamin B12 level was done only in those patients who presented with Macrocytic anemia.
Results: Among 200 patients, 113 patients were on vegetarian. The prevalence of anemia in this study population was 65(32.5%). 11(16.9%) were diagnosed as Normocytic Normochromic anemia, 22 (33.8%) with Microcytic Hypochromic Anemia, 26(40%) with Macrocytic Anemia and 6(9.2%) with Dimorphic anemia. Among these 32 patients, who presented with macrocytic and dimorphic anemia, vitamin B12 levels were measured. For 23 vitamin B 12 level was<200>200 pg/ml. 149 patients were on Metformin.
Conclusion: Our findings suggest that correction of anemia may have a significant role in prevention of other diabetic complications, thus we recommend that treatment criteria for diabetes should include routine hematological tests and annual screening of Vitamin B12 deficiency along with supplementation should be adopted while treating T2DM.
Keywords: Macrocytic Anemia, Type-2 Diabetes Mellitus.

ntroduction: Malaria is the most common infectious disease that affecting many people worldwide. Microscopic method is remain gold standard method for diagnosis but Hemazoin pigments produced by malaria are also scatter the laser light and producing abnormal scattergrams during CBC analysis & thus we have conducted this study to prove usefulness of 5-part automated hematology analyzer (LH-750) in presumptive diagnosis of malaria
Materials and Methods: This prospective study was done at pathology department of C.U. Shah Medical college & hospital, Surendranagar from November 2013 to April 2014. 2 ml of EDTA blood samples were collected and blood analysis was done on hematology analyzer (5-part LH – 750). Thick and thin blood films were prepared and stained with giemsa stain in all cases.
Results: Among 100 positive cases out of 2710 samples, 63 cases were positive for plasmodium vivax and 37 cases were positive for plasmodium falciparum. Among 100 malaria positive cases, abnormal scattergram pattern was observed in 65 cases. In P.vivax group (n=63 cases), 50 cases showed abnormal scattergram out of 63 cases, having sensitivity of 79.36%. In P. falciparum group (n=37 cases), 15 cases showed abnormal scattergram out of 37 cases with having sensitivity of 40.54%. Various abnormalities found on WBC-DIFF scattergrams in patients of malaria were merging & graying of neutrophils & eosinophils clusters, prominent blue coded events below neutrophils clusters.(in RBC ghost region)
Conclusion: Automated hematology analyzer is very important diagnostic tool for malaria with scattergram abnormalities are helpful in presumptive diagnosis of malaria. All such cases should be confirmed by gold standard method.

Introduction: A wide variety of benign diseases, occur in the uterus. 1 Tissue eosinophilia has been
demonstrated under physiological conditions in different organs and loose connective tissues of mammals.
Such an eosinophilia although slight, has been demonstrated in human uterus. 2 If a patient has tissue
eosinophilia, the number of eosinophils in blood likely be normal.
Aim: The incidental finding of eosinophilic infiltration only in myometrium, needs to be highlighted.
Case Report & Conclusion: Histopathological diagnosis of Isolated Eosinophilic Myometritis, a rare
incidental finding in a 50 year female without involvement of endometrium, leiomyoma and cervix, is
being presented. The literature is being reviewed for this rare entity.
Objective: To highlight rare incidental histological finding of eosinophilic infiltration only in the
myometrium when there is no involvement of endometrium, leiomyoma, cervix, fallopian tubes and
ovaries.

Introduction: Pancytopenia is a common hematological problem characterized by anemia, leucopenia and thrombocytopenia. It is a striking feature of many serious and life threatening illnesses. The disease pattern varies in different population groups, in age pattern, nutritional status and prevalence of infective disorder. Present study was conducted to assess the etiology, clinical profile and bone marrow morphology of pancytopenia.
Objectives: 1. To study the clinical presentations and hematological parameters in patients with pancytopenia. 2. To study the morphological pattern in bone marrow in patients with pancytopenia.
Materials and Methods: A two year study was conducted in department of Pathology, Sri Devaraj Urs medical college, Kolar, Karnataka. Total 70 pancytopenia patients were studied to determine their presenting symptoms and signs, peripheral blood smear study and bone marrow morphology.
Results: Bone marrow study showed 48.5% hypercellular marrow, 32.8% normocellular and 18.7% hypocellular marrow. Females (55.7%) were affected more than males (44.2%) and the commonest cause for pancytopenia was megaloblastic anemia (51.4%), followed by iron deficiency anemia (37.1%), viral infections (4.2%), leukemia (1.4%), MDS (2.8%), pure red cell aplasia (1.4%), hereditary elliptocytosis (1.4%).
Conclusion: Large number of patients with pancytopenia had reversible etiology. Hence complete work up including clinical details with hematological examination along with bone marrow study will lead to early and proper diagnosis of case followed by proper treatment.

Introduction: Fine needle aspiration cytology (FNAC) forms one of the first diagnostic tools in evaluation of soft tissue lesions. Aim of this study was to evaluate the role of FNAC in the primary diagnosis of soft tissue tumors and tumor like lesions and to assess the effectiveness of FNAC in the histological subtyping and grading of soft tissue tumors.
Materials and Methods: We reviewed FNAC smears of 170 soft tissue tumors and tumor like lesions over a 3 years period and correlated with the histopathological features which were available in 117 cases. Conventional Papanicolaou (PAP) and Giemsa staining was done in all cases.
Results: 152 out of 170 cases [89.41%] were neoplastic, of which 130 tumors were labelled as benign. Lipoma constituted 83.07% of benign tumors. Based on the predominant cytomorphological features and background, the tumors were classified into myxoid (4), spindle cell (20), pleomorphic (2), small round cell(4), epithelioid /polygonal cell (7), lipomatous (108) and miscellaneous (7). The non-neoplastic lesions included tuberculosis, filariasis, actinomycosis, scar endometriosis and calcinosis cutis.
Conclusion: FNAC proved to be helpful in distinguishing between neoplastic and non-neoplastic soft tissue lesions, differentiating metastatic carcinoma and melanoma in soft tissue from primary soft tissue tumors and differentiating benign and malignant soft tissue tumors. Accurate subtyping was possible in many tumors of myxoid category and round cell tumors. Spindle cell tumors of intermediate grade were difficult to grade on FNAC. Pleomorphic sarcomas were of high grade and their subtyping could not be done on FNAC.
Keywords: FNAC, Soft tissue lesions, Soft tissue tumors.

Introduction: Central nervous system tumors show varied histomorphological spectrum although they are less frequent when compared to other sites. Central nervous system (CNS) tumors refer to neoplasms that originate in the brain and spinal cord of which over 90% are located in the brain. CNS malignancies account for approximately 1.7% of new cancers annually.
Aims and Objectives: 1: To study the demography and determine the relative frequency of the various histopathological types of CNS tumors; 2: To relate the occurrence of the various types of CNS tumors with age, sex, signs, symptoms, location and to study the various spectrum of histopathological features of CNS tumors and grade according to WHO classification (2007).
Results and Conclusion: The most frequent type of CNS tumor was meningioma followed by astrocytoma of which WHO grade IV tumor was frequent and schwannoma. The peak incidence was in 41-50 years age group. Overall Males are affected more than females, with male to female ratio of 1.2:1 except in meningioma where there is a female preponderance with male to female ratio of 1:2.1. The most frequent clinical feature was headache and seizures in supratentorial tumors of intracranial region, backache, weakness and sensory disturbances in spinal cord tumors. The most commonest site of occurrence was frontal lobe followed by multilobe involvement.

Introduction: Pancytopenia is an important clinico-hematological entity encountered in our day-to-day clinical practice from a number of disease processes primarily and secondarily involving bone marrow. This study was carried out to evaluate bone marrow findings in patients with pancytopenia.
Materials and Methods: This is a prospective cross sectional study carried out on 140 pancytopenia patients over the period of one and half years. Relevant clinical details were recorded, followed by screening of patients for routine blood investigations included a complete blood count, peripheral blood smear examination, reticulocyte count. Bone marrow aspiration was done in all cases and bone marrow biopsy performed whenever necessary and Perl’s Prussian blue stain for grading of bone marrow iron stores were done in all cases. Data analysed was compared with various studies published in literature.
Results: The maximum cases of pancytopenia were in the age group of 31 to 40 years with male preponderance. Dimorphic anemia (49.3%) was found to be the most common etiology of pancytopenia followed by megaloblastic anemia (35%), iron deficiency anemia (5.7%). We encountered two cases of non-Hodgkin’s lymphoma and one case each of multiple myeloma, acute lymphoblastic leukemia, aplastic anemia and anemia of chronic disease. Most common clinical presentation was pallor followed by fatigue and fever.
Conclusion: Present study concludes that basic primary hematological investigations along with bone marrow aspiration/trephine bone biopsy in the pancytopenia patients are helpful in understanding the disease process. This plays a key role in planning the further management.
Keywords: Adults, Bone marrow, Dimorphic anemia, Megaloblastic anemia, Pancytopenia.

Aims and objectives: The main objective of the current study is to delineate prevalence, type of anemia in patients enduring with hypothyroidism and to correlate its severity with deficient levels in thyroid profile.
Material and Methods: The prospective study spanning for a year (December 2017 to November2018) consisting of 1500 patients was done in collaboration with Department of Biochemistry at tertiary care Centre. A detailed history was taken and investigations were done in all patients conferred with Anemia and hypothyroidism. Peripheral smear examination, RBC indices, Complete Blood Count were the essential investigations for anemia.
Results: The prevalence of anemia was found to be 41.8%. In anemic patients, the predominance of normocytic normochromic anemia was 98.56% (most common), microcytic hypochromic anemia was 0.95% and macrocytic anemia was 0.49%. 59.34% had mild anemia, 39.71% had moderate anemia and 0.95% had severe anemia.
Conclusion: The study showed the association of anemia and hypothyroidism and it further highlighted the relation between the two with respect to severity. Normocytic normochromic anemia and mild anemia were observed to be the most widely recognized types of anemia in hypothyroid patients. This will help in implementing appropriate therapeutic decisions for both the conditions and contribute to the wellbeing of the patients.
Keywords: Anemia, Hypothyroidism.

Enterobius vermicularis is one of the most prevalent human nematode worldwide. Besides intestine extra intestinal sites especially the female gential tract may be involved. We present herein a case of infestation of the ovary by Enterobius in a lady aged 40 years.

The assessment of platelet count is essential in clinical practice. The traditional method of estimating platelet counts from peripheral blood smears is a fairly accurate method and provides adequate quality assurance. Widespread use of automated analyzers based on impedance technology has resulted in an unprecedented improvement in accuracy and allows measurement of additional indices such as Plateletcrit (PCT), Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW). However, both the methods have certain limitations.
Platelet counts were estimated on a 5-part Differential Automated Hematology Analyzer and manually on Leishman stained peripheral blood smears in 200 indoor patients admitted in Government Medical College Jammu to detect the correlation between the two. Estimation of MPV and PDW was done followed by a comparison with automated platelet counts.
The Mean Platelet Count, of the cases under study, given by the automated analyzer was significantly lower than the Mean Platelet Count estimated by manual method (P < 0.001).
However, the platelet count assessed by automated analyzer showed a strong correlation with manual platelet count (correlation coefficient, r = 0.857).
In thrombocytopenic patients, the platelet count assessed by automated analyzer, showed an inverse relation with Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW).
It was concluded that automated hematology analyzer is crucial for quick and accurate complete blood count evaluation but all blood samples that show abnormal results or low platelet counts on analyzers should be confirmed by manual count on peripheral smear. The platelet indices like Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) can point to the underlying pathology especially in cases of thrombocytopenia.

Introduction: Colorectal malignancies stand out to be one of the chief causes of morbidity and mortality
in the world. Although the total incidence of colorectal malignancy in India n population has marginally
increased, it is now a common cause of cancer mortality among Indians.
The oncogene HER2/neu belongs to the tyrosine kinase receptor family. The favorable outcome of
HER2/neu in management of breast carcinoma patients has direct ed to evaluation of gene amplification
protein overexpression, and anti-tumor activity of Herceptin in various tumor types one amongst which
is colorectal carcinomas. The objective of the study was to evaluate the frequency of overexpression of
HER2/neu in colorectal adenocarcinomas (CRC) and its association with various histomorphological and
clinicopathological parameters.
Materials and Methods: A total of 52 cases of colorectal adenocarcinomas including colonoscopic
biopsies & resected specimens were studied. Paraffin embedded sections were stained with Hematoxylin &
Eosin and histological and clinicopathological parameters were assessed. In IHC, antigens were retrieved
by Heat Induced Epitope Retrieval method and HER2/ neu status was determined using a semiquantitative
scoring system. The scores were then correlated with histological grade, type and clinicopathological
parameters.
Results: The HER2/neu overexpression was noted in 53.8% of our cases and was seen to be commonly
expressed by moderately differentiated tumours and conventional/ NOS histological type.
There was a statistically significant correlation observed between HER2/neu status and tumour grade (p=
0.001), tumour type (p = 0.008). There was no significant correlation between age, gender or localisation
or stage of tumour.
Conclusion: Histological grade and histological type of CRC showed a significant correlation with
HER2/neu overexpression, hence can be used as a predictive tool for determining the prognosis of the
patients.
Patients who overexpress HER2/neu could become potential candidates for this monoclonal antibody based
targeted immunotherapy thus reduce overall mortality and morbidity of CRC worldwide.

Introduction and Objective: Ovary is one of the complex organs in terms of its embryology, histology, steroidogenesis and tumor incidence. The present study highlights the correlation between the clinical and pathological features of neoplastic lesions of ovary in order to arrive at a better understanding of the disease process.
The objective of study is to assess the overall incidence of various histological types of ovarian neoplasm, the pattern of occurrence of ovarian tumors in relation to age, parity and modes of presentations and to study the histopathological findings of various ovarian tumors.
Materials and Methods: Biopsies received at the Department of Pathology, Sree Balaji Medical College and Hospital-Chrompet were subjected for histopathological study. Specimens were then fixed in 10% formalin for 24-48 hour, processed and embedded in paraffin blocks. Sections of 4-6 microns thickness were taken and stained with routine haematoxylin and eosin and studied. IHC was done whenever necessary.
Result: Out of 92 cases of ovarian tumors 68 cases were benign, 3 were borderline and 21 were malignant. Serous cystadenoma formed the majority (38%) among benign lesions and among malignant lesions serous cystadeno carcinoma (5.4%) were common. Majority were surface epithelial tumors and constituted 64.13% (59 cases) with germ cell tumors 26% (24 cases) and sex cord stromal tumors 8.6% (8 cases).
Interpretation and Conclusion: The correct histopathological diagnosis of ovarian tumor is of prime importance in view of their behavioural predictability, clinical correlation and the proper management of patient.
Keywords: Ovary, Tumor, Histopathology.

Aim: To determine the prevalence of vitamin B12 deficiency in subjects with anaemia and elevated mean corpuscular volume.
Materials and Methods: Blood samples from 119 subjects were selected for the study based on the inclusion and exclusion criteria laid down. Blood samples were analysed on sysmex KX 21 haematology analyser. Morphological evaluation of blood cells was done on peripheral blood smear. Serum vitamin B 12 assays were done. Qualitative and quantitative variables were analysed by statistical methods.
Results: Out of 119 subjects taken for study 70 (58.8 %) were male and 49 (41.2 %) were female with mean age ± SD 40.5± 18. Vitamin B 12 deficiency was noted in 82 (69 %) of which 12 (10.1%) were in Borderline levels of deficiency, 31 (26.1%) were in deficient levels and 39 (32.8%) were in severely deficient group. Red blood cell indices were categorized as per different groups of vitamin B 12 levels. Pancytopenia was noted in 67.1% (54) of B 12 deficient individuals. Significant negative correlation was found between vitamin B 12 levels and mean corpuscular volume (r = - 0.215 .p = 0.019). A positive correlation was found between vitamin B12 and platelet count. (p= < 0.001) and also with leukocyte counts (p value < 0.001) These correlations were found to be statistically significant. Peripheral blood film examination shows macrocytosis in 76 (64%) smears and hypersegmented neutrophils in 66 (56%) smears.
Keywords: Vitamin B 12 deficiency, prevalence, Megaloblastic anaemia, Pancytopenia, Mean corpuscular volume.

Introduction: Skin is the largest organ among all the organs of the body. The clinical manifestations of diseases of skin are vary in nature both in clinical presentations and behavior. It is necessary to cross talk between pathologist and dermatologist for better management of patients. Histopathological examination plays a significant role and the gold standard in providing accurate diagnosis for a variety of skin lesions.
Objective: 1. To evaluate histopathology as an ideal diagnostic method for vesiculobullous (non–neoplastic) and neoplastic (tumourous) skin lesions. 2. To establish the correlation between the microscopic pathological findings of various skin lesions with the presenting clinical features.
Materials and Methods: 100 patients of skin diseases were included for the study. Punch, excisional or incisional biopsy techniques were used to get the tissues. The tissue was obtained for detailed histopathological examination. The histological sections were stained with hematoxylin and eosin stains and histochemical stains were used as supplementary diagnostic tool.
Results: Out of 100 patients, 54% had vesiculobullous lesions, 22% granulomatous morphology and 24% were neoplastic. Epidermoid cysts included in benign neoplasm category and accounted for 37.5% of neoplasms. Squamous cell carcinoma was the most common malignant tumor (52.8%).
Conclusion: Histopathological study of skin biopsies helps to make an early and accurate clinically useful diagnosis in almost all of the normal looking or vesiculobullous or non neoplastic and neoplastic skin lesions, as the study of microscopic morphological features of different types of skin lesions had differentiating findings under the microscope.

Phyllodes tumors are uncommon fibroepithelial tumors of breast that have potential for recurrence and
metastasis. Triple assessment by clinical, radiological and histological examination forms the fundamental
basis for the evaluation of phyllodes tumor. Treatment could be either by wide excision or mastectomy
provided that clear histological margins are achieved. Wide local excision with at least 1 cm clear margin is
currently the standard of treatment of phyllodes tumor in most institutions. Most of these behave in benign
fashion however, malignant tumors have higher tendency for local recurrence and systemic dissemination
to lungs, brain. Lymph node involvement is rare.

Introduction: Gall bladder carcinoma accounts for 0.3-0.7% of all cancers and has a peak incidence among women aged 70 and 79 years. Recently many molecular markers like Ki-67, cyclin D1, MUC1 and p53 with prognostic impact on GBC have been described. Ki-67 is a proliferative marker which is expressed in all active phases of the cell cycle and it can be detected in the nucleus of tumour cells indicating its proliferative activity.
The aim of this study is to evaluate the expression of Ki-67 in carcinoma of gall bladder by immunohistochemistry and to correlate the mean Ki-67 labelling index with the various histological grades of gallbladder carcinoma.
Materials and Methods: All the histopathologically proven cases of gall bladder malignancy from July 2014 to June 2017 (n=44) were examined for Ki-67 expression immunohistochemically.Ki-67 labelling index was calculated. ANOVA test and independent ‘t’ test were applied to see correlation of Ki-67 expression with various grades of gall bladder carcinoma.
Results: The Ki-67 labelling index was minimum in well-differentiated adenocarcinoma of gall bladder and maximum in poorly differentiated adenocarcinoma of gall bladder. The p value amongst these groups was found to be statistically significantly different.
Conclusion: 88.64% of Gall bladder carcinoma was positive for Ki-67 and the Ki-67 labelling index increased significantly as the histological grade increased.
Keywords:  Ki-67, Ki-67 labelling index, MIB labelling index, Gall bladder carcinoma.

Introduction: Fungal lesions are common in immunocompromised patients like Diabetic Mellitus, patients on anticancer drug and radiotherapy, HIV and transplant recipients. Although tissue culture being the gold standard for diagnosing fungal infections, histopathological examination gives better idea about tissue invasion.
Materials and Methods: This study was done over 47 cases for a period of four years. This study was done to analyze the clinicopathological spectrum of fungal infections, morphology and their distribution according to age, sex and site of involvement in histopathological specimens in our hospital setup.
Results: In this study, the most common fungal organism was found to be Phaeohypomycosis and most of these cases of phaeohypomycosis presented as ganglion and dermoid cyst .Most common site was foot.
Conclusion: In this study we attempted to determine the etiological diagnosis of fungal infections in histopathological specimens received in our department.
Keywords: Fungal lesions, Dermoid cyst, Ganglion, Gomori methenamine silver stain, Immunocompromised patients, Phaeohyphomycosis.

Introduction: Haemoglobinopathy is a major genetic public health problems in India, responsible for significant morbidity and mortality. Individuals with trait (carriers) are healthy and unaware of their carrier status unless specifically screened. If a couple carry a clinically significant haemoglobinopathy trait there is a 1 in 4 chance with each pregnancy that their child will inherit a major haemoglobinopathy. The most effective approach to reduce the burden of the society is to reduce the incidence by implementation of a carrier screening programme.
Material and Methods: The present study was carried out in a tertiary care hospital for a period of 2 years. 500 Antenatal patients attending Obstetric-out patient department for routine check-up were included in the study. Screening of patient was done by Solubility test, Sickling test and Alkali denaturation test. Finally a very standardized method to detect HbA2 and HbF was done by using an automated High Performance Liquid Chromatography.
Results: Out of a total of 500 pregnant women 4% were having haemoglobinopathies, whereas 96% had normal haemoglobin. Out of 20 cases, maximum number of cases i.e. 2.2% was of ? –Thalassemia trait, followed by Sickle cell trait cases i.e. 1.2%. Other haemoglobinopathies are also found i.e. sickle cell disease 0.2% ?? Thalassemia case 1.2% and double heterozygous 0.2%.Out of a total of 20 positive pregnant women only partners of 8 women were screened and out of them 37.5% were found positive.
Conclusion: Detection of carrier status using HPLC during pregnancy along with couple screening provides prospective parents with the option of testing the fetus for hemoglobinopathy.
Keywords: Antenatal, Double heterozygous, Haemoglobinopathies, High Performance Liquid Chromatography, ? –Thalassemia trait.

Introduction: Prognostication of acute leukemia by detecting immunophenotypic marker expression on leukemic cells by flow cytometry is crucial in providing individualized treatment and improving outcome in Pediatric ALL (Acute lymphoblastic leukemia). The Aim of the study was to determine whether expression of CD34 and CD10 could be used as additional prognostic markers in predicting treatment response in Pediatric ALL cases. Materials and Method: This study was conducted among 44 pediatric ALL cases diagnosed in 2 year period in a tertiary care centre in North Kerala. Peripheral smear (PS), & bone marrow (BM) were examined, clinical and laboratory parameters were studied and flow cytometry was done in all cases and expression of CD10 & CD34 were noted. Treatment response was assessed by examining peripheral smear on day 7 after treatment, BM after induction, Cerebrospinal fluid (CSF) examination during induction phase .All the cases were followed up. Result: In our study it was observed that presence of blasts on day 7 peripheral smear and CSF were more in CD34 negative cases compared to CD34 positive cases. BM remission after induction, treatment response and good outcome on follow up were more among CD34 positive cases. The results were statistically significant for CD34 expression. CD10 expression alone was not found to be statistically associated with treatment response. Conclusion: CD34 expression predicts treatment response and is a significant favourable prognostic factor in pediatric ALL cases. It can be included in risk stratification for planning treatment along with established parameters.

Introduction: Tumours of Bones & joints are rare. The histogenesis of some of these is still uncertain. Unpredictable behaviour of undifferentiated tumours and some of the differentiated tumours, are a challenge.
Aims and Objectives: Cases of tumours of bones & joints were studied for their varied Histopathology. Tumour like conditions were not included.
Materials and Methods: Biopsies of 74 Patients with tumours of Bones & joints, admitted to J.S.S. Medical College Hospital and Dental College Hospital, from April 2015 to April 2018 were studied. Cases were clinically & radiologically examined & studied by routine Haematoxilin & Eosin stains after decalcification by 10% formic acid. Special stains & I.H.C were done when required.
Results: In this study, benign tumours of bone were 56.25% & Malignant were 43.75 %. Joints infiltrated by synovial sarcoma was 8.10%. Benign odontogenic tumours were 5.4% & malignant tumours were 6.75%. Male to female ratio in benign tumours was 2.65:1 & in malignancy, 1.35:1. Sex incidence of the commonest malignant tumour osteosarcoma was to 1: 1. Next commoner malignancy was synovial sarcoma infiltrating the joints with a sex ratio of 1:5. Giant cell tumours showed a sex ratio of 3:2.
Conclusion: Tumours of bones & joints are a real challenge to the pathologist, Radiologist & orthopedic surgeons because of their varied presentation, uncertain histogenesis in some & their behavior to treatment. A sincere effort is done to classify, study their varied histopathological features & rarities which definitely deepens our knowledge on this.

Introduction: In pregnancy induced hypertension (PIH), pathological changes in the placenta occurs which may result in reduced blood flow across placenta. The present study has been undertaken to assess the morphology & histology of placenta from mothers with PIH and to correlate their findings with those of normal pregnancies.
Materials and Methods: The present study was a case-control study conducted during July 2015 to September 2017. Placenta of cases of singleton normal pregnancies & those complicated by pre-eclampsia/ eclampsia and of known gestational period were included. The placentae were divided into two groups; Group 1: Pregnancy with hypertension (cases) and Group 2: Normal pregnancy (control). Detailed macroscopic and microscopic examinations were conducted on the placentae.
Results: The mean weight of placenta (474 ± 58 grams) was higher among control group in comparison to PIH group (420 ± 61 grams). This difference was statistically significant. (p 0.001) The mean fetoplacental weight ratio (6.14 ± 0.503) was higher among PIH group in comparison to control group (6.03 ± 0.409). This difference was statistically insignificant. (p ?0.05). There was significant association between presence of gross infarction, calcification, Hyalinised area /10 lpf, medial coat proliferation/ 10 lpf, intervillous hemorrhage, decreased villous vascularity and PIH.
Conclusion: It is concluded that there was statistically significant difference between mean birth weight of the babies and mean placental weight in control group and PIH group. It also revealed striking villous lesions like increased syncytial knots, cytotrophoblastic cell proliferation, villous stromal fibrosis and fibrinoid necrosis in placenta from preeclampsia cases.
Keywords: Placenta, Histopathological Changes, Pre-eclampsia, Eclampsia.

Introduction: FFP contains the labile as well as stable components of the coagulation, fibrinolytic and complement systems. The use of plasma and its products has increased manifold over the four decades. In blood transfusion service, the primary goal of quality is 'transfusion of safe unit of blood.'
Aim of the Study: To ensure that the prepared fresh frozen plasma (FFP) consistently met the requirements for quality and to find out the potency and possible extension of shelf life of fresh frozen plasma once thawed and refrozen within stipulated period.

Materials and Methods: 66 units of FFP prepared by Platelet Rich Plasma (PRP) method were divided into two groups. Group 1 comprised of 33 samples, which were tested on 0 day, last week of 12th month and last week of 18th month. Group 2 comprised of remaining 33 units which were tested on 0 day, thawed and tested on 1st week of 12th month and were again refrozen within 12 hours of thawing. Later, the refrozen units were again retested on the last week of 12th month. All the FFP units were evaluated as per the DGHS Guidelines.
Results: Group 1: The quality of fresh frozen plasma stored at -30OC for 12 months adhered to quality parameters but on extended storage period (-30OC for 18 months) showed non-compliance to the standardized quality control. Group 2: Refrozen thawed plasma complied with all quality parameters.
Discussion: Fibrinogen and Factor VIII levels, which were representative of stable and labile factors respectively, were within normal limits in both the study groups when stored at standardized temperature and time, but showed non-compliance to the standardized quality control at extended time. Refrozen thawed plasma retained all coagulation factors. These findings were in concordance with the DGHS Standards and various other studies.
Conclusion: Fresh Frozen Plasma should be used judiciously and if thawed plasma is not used for some reasons, it should not be discarded. The thawed FFP can be refrozen and added up to the inventory and hence, useful to the society.
Keywords: Good manufacturing practice, Fresh frozen plasma, Platelet rich plasma, Thawed and refrozen fresh frozen plasma.

The characteristic cytological features of parotid gland lesions have been well described in literatures, but there also exist cytological diagnostic pitfalls that make it difficult to form an accurate diagnosis in some cases.
Aim: To evaluate the sensitivity, specificity, along with positive predictive value, negative predictive value by Cyto- histological correlation in various lesions with an emphasis on discordant cases.
Materials and Methods: A retro-prospective study of 250 non- guided/palpable FNAC of suspected parotid gland enlargements were performed from 2006 to 2018 at tertiary care hospital. The cytological smears were stained with May grunwald giemsa, papanicolaou, hematoxylin eosin stains. Surgically resected specimens were received for histopathology in 103 relevant cases only. The cytologic and Histologic slides were studied, compared and correlated where ever possible and statistical analysis done. Result: Out of 250 patients male to female ratio was 1.4: 1. The different categories of salivary gland lesions included: non neoplastic, benign and malignant constituted 109,108 and 33 cases respectively. Pleomorphic adenoma and mucoepidermoid carcinoma was the commonest benign and malignant neoplasm reported in this study respectively. False negative and false positive results were mainly due to cystic and papillary lesions. The sensitivity, specificity, along with positive predictive value, negative predictive value and diagnostic accuracy of present study was 68.42%, 98.80%, 92.85%, 93.25% and 93.20% respectively.
Conclusion: Though palpable FNAC of the parotid gland tumors is simple, rapid and cost-effective in a developing country but rate of characterization of specific type of parotid gland tumor is lower due to overlapping cytomorphology.
Keywords: Parotid swelling, Histopathology, Cytology, Morphological discordance.

Introduction: Head and neck lesions are very common in day to day practice. These diseases range from common cold to the uncommon, malignant neoplasms. These lesions are responsible for very high morbidity and mortality. Factors known to contribute to the risk of developing head and neck cancer are smokeless tobacco (Pan masala, soda), alcohol, HPV viral infections, etc. Smokeless tobacco is commonly used in Northern part of India, especially in Uttar Pradesh.
Aim: To evaluate the diagnosis, frequency and histopathological subtypes of head and neck lesions and their distribution in different age groups and sex in Western Uttar Pradesh.
Settings and Design: A retrospective study of 3 years from March 2014 to February 2017 was conducted and the data were collected from the archives of the department. The data were analyzed using SPSS version 15.0.
Materials and Methods: All the biopsies from the head and neck region, which were submitted for histopathology in the Post Graduate department of Pathology, Rohilkhand Medical College and Hospital, Bareilly, were reviewed and analyzed for their demographic profile, age, gender, site and diagnosis. The lesions were then categorized accordingly as inflammatory, benign and malignant.
Results: All the lesions of head and neck region, diagnosed on histopathology were included in the present study. A total of three hundred twenty one biopsies were studied, including 212 (66%) males and 109 (34%) females (M: F=1.9:1). 197 (61%) of the cases were benign, followed by 69 (22%) malignant and 55 (17%) inflammatory lesions.
The maximum numbers of malignant cases were in the age group of 41 to 50 years with Squamous cell carcinoma as the most common histopathological type. The most common site of malignant lesions was the oral cavity. The maximum benign lesions were in the 11-20 years age group.
Conclusions: The present study helped us in assessing the frequency as well as the different histopathological types of head and neck lesions in different age groups and gender in this part of the country.
Keywords: Benign, Head and Neck, Inflammatory, Malignant, North India

Introduction: Pulmonary lesions include a wide variety of benign and malignant conditions of lung, pleura, mediastinum and vertebrae. Lung cancer is a frequently diagnosed cancer worldwide.1 Although clinical data, location and radiological findings can narrow down the diagnostic possibilities, a cytological diagnosis is warranted before initiating the specific treatment for the malignant disease.
Aims and Objectives: The present study was undertaken with the aim to compare the sensitivity and specificity of bronchioalveolar lavage (BAL), transbronchial needle aspiration cytology (TBNA) and image-guided fine needle aspiration cytology (FNAC) in the evaluation of patients with pulmonary lesions.
Materials and Methods: The present study was conducted on 100 patients with pulmonary lesions coming to the department of pulmonary medicine at MMIMSR, Mullana. For diagnostic purposes various procedures like BAL, TBNA and image guided FNAC were performed. Cytological examination was carried out in the department of Pathology.
Results: Among 100 cases, TBNA was done in 63 cases, BAL in 52 cases and image guided FNAC was performed in 37 cases. Using these cytological techniques, a diagnosis was obtained in 81% cases. The sensitivity and specificity of each technique was assesed. On cytological evaluation, 12% cases had a non-neoplastic diagnosis, whereas 69% cases, malignancy was diagnosed. However, in 19% cases no diagnosis was offered. The most common diagnosis amongst malignant lesions was non-small cell carcinomas. (Squamous cell carcinoma- 28%, Adenocarcinoma-23%) followed by small cell carcinoma (8%).
Conclusion: Image-guided FNAC of pulmonary lesions is a simple, safe, economically viable technique with low morbidity and offers quick and early diagnosis. Our study revealed that TBNA and FNAC were comparatively better in the diagnosis when compared to BAL.
Keywords: Image-guided Fine Needle Aspiration Cytology, Pulmonary Lesions, Squamous Cell Carcinoma.

Introduction: Mucin deregulation occurs in gastrointestinal lesions progressing to cancer. Evidences
advocate utility of mucin profile to predict malignant transformation in preneoplastic colonic lesions,
however data are controversial.
Objectives: This clinicopathological descriptive study identifies the histochemical profiles of acidic and
neutral mucins in human colonic tissues including inflammatory, non-neoplastic and neoplastic lesions.
Mucin alteration in different histological grades of adenocarcinoma is also evaluated.
Materials and Methods: After collection of relevant data, tissue samples from a cohort of 88 patients
recruited from King Abdul Aziz Specialized Hospital, Taif, Saudi Arabia were examined. Dual Alcian
Blue (AB; pH 2.5)/ Diastase (D) Periodic Acid Schiff (PAS) technique was used to differentiate acidic and
neutral mucins respectively. Statistical analysis including descriptive statistics, Pearson’s chi-square test
and linear regression was performed using SPSS.
Results: Acidic and neutral mucins were positive in 67.1 and 46.6% of lesions, respectively. All ulcerative
colitis tissues were positive for acidic mucin and 75% for neutral mucin. All non-neoplastic polyps were
positive for both mucins. Adenomatous polyps demonstrated reduced mucin but more neutral (59.3%) than
acidic one (44.4%). About 86% of adenocarcinomas revealed acidic mucin and 22.2% showed neutral
mucin with trends for acidic mucin to decrease with grade and for neutral mucin to increase with grade.
Conclusion: Altered both acidic and neutral mucin profiles occur in colonic lesions of different
pathologies. As colonic adenocarcinoma progresses from grade 1 to grade 3, acid mucin declines with
a corresponding increase in neutral mucin. Mucin profile may be of value in evaluating the preneoplastic
colorectal lesions.

Introduction: The spectrum of diseases affecting the prostate gland in men can be inflammatory, benign, premalignant lesions and malignancy. Major diagnostic challenge of surgical prostate biopsy interpretation is either due to a small focus of cancer or presence of various benign mimickers of malignancy which is labeled as suspicious foci. Aim of the study was to evaluate complete histopathological spectrum of lesions encountered on transrectal ultra sonography (TRUS) guided prostate needle biopsy and transurethral resection of prostate (TURP) chips and to use immunohistochemistry (IHC) markers like Alpha-methylacyl-Co enzyme A racemase (AMACR) and p63 as an adjunct in resolving the suspicious cases.
Materials and Methods: We assessed total 60 cases of prostatic specimens received during December 2015 to November 2017. The received specimens were routinely processed and histopathological examination was carried out. IHC for AMACR and p63 was performed and results were analyzed using SPSS software.
Results: Majority of cases were benign prostatic hyperplasia (BPH) (73.3%). Incidence of prostate cancer was low (16.6%). After IHC, out of the six (10%) histomorphologically suspicious cases, three cases were positive for only AMACR; two cases were positive for only p63 and one case showed positivity for both. Immunohistochemistry with AMACR and p63 proved to be highly sensitive markers for detecting malignancy but AMACR marker showed less specificity.
Conclusion: Histomorphologically, benign lesions of prostate are more common than malignant ones. Combination of AMACR and p63 IHC enhances the diagnostic accuracy in suspicious cases by identifying premalignant lesions or malignancy and reduces misdiagnosis.

Introduction: Transfusion transmissible infections (TTI) are a major threat for the recipients of blood and blood products. Voluntary blood donations (VBD) are considered safe to Replacement blood donations (RBD). Our main of the study is to find out the seroprevalence of TTIs in our area and also to find out whether there is a significant difference in seroprevalence of TTIs between VBD and RBD.
Materials and Methods: It is a retrospective, cross sectional study carried out in the regional blood bank of a tertiary care centre. Records of total 33341 blood donations carried out in a period of 6 years (January 2012 to December 2017) were studied for calculating the seroprevalence of HIV, HBsAg, HCV and Syphilis. Comparison of seroprevalence between VBD and RBD was done.
Results: Predominant donor population was male (91.86%). 91.63% donations were VBD and 8.37% donations were RBD. Most common type of TTI was HBsAg (85.9%) followed by HIV (6.72%), HCV (4.98%) and Syphilis (2.38%) respectively. The difference in seroprevalence of TTIs between VBD and RBD was statistically significant (p value <0.05).
Conclusion: There is seen statistically significant difference in seroprevalence of TTIs between VBD and RBD suggesting RBD are at more risk for transmitting TTIs than VBD. Hence we recommend regular, non-remunerated, voluntary blood donations for assuring better safety and quality of blood and blood products.

Introduction: Pancytopenia is a caused by single or different co-existing pathology. As the management
and prognosis depends on underlying pathology, identification of correct aetiology is crucial.
Aims: The current study intends to study the etiological profile of Pancytopenia and to identify the CBC,
peripheral smear findings which are helpful in planning the additional investigations to arrive at a specific
diagnosis.
Materials and Methods: It is a retrospective descriptive study conducted in a tertiary care centre in
Kerala.132 Cases of Bone marrow aspirates with the indication of pancytopenia, received from January
2011 to June 2012 were analyzed. The etiological profile was studied. The clinical features, Hemoglobin,
Total Leukocyte count, Platelet count and Peripheral smear findings were evaluated in detail.
Results: The most common cause of Pancytopenia in the present study is Sub leukemic leukemia
(23.5%) followed by Hypersplenism (17.4%) and Megaloblastic Anemia (14.3%). Age range was from
12 to 88 years and Males and Females were almost equal in distribution. Hepatomegaly, Splenomegaly
were seen in 19% and 28% cases respectively. Lowest median Hemoglobin value was observed in
Megaloblastic Anemia whereas Leucopenia and Thrombocytopenia were most severe in Hypoplastic
Anemia. Anisopoikilocytosis, Polychromasia, circulating normoblasts and Hypersegmented neutrophils
were predominant in Megaloblastic Anemia. Relative Lymphocytosis was predominant in Hypoplastic
anemia whereas Immature WBCs were seen commonly in acute leukemia.
Conclusion: This study highlights the importance of the primary haematological investigations, which are
helpful in narrowing down the differential diagnosis and to plan the further investigations to arrive at a
definite diagnosis.

Plasma Cell Dyscrasias (PCD) by definition are represented by excessive proliferation of a single clone
of cells producing entire immunoglobulins, immunoglobulin fragments, heavy chains or light chains.
These encompass a wide range of disorders. In this study we try to discuss the clinical and pathological
characteristics of this rare but important group of hematological malignancies.
Materials and Methods: This study was carried out in a tertiary care centre retrospectively for a period
of four years. All the cases diagnosed with Plasma Cell Dyscrasias were selected. They were re-evaluated
taking into consideration clinical aspects, radiological findings and blood and bone marrow examinations.
These were further categorized using Salmon Durie Staging system.
Results: During this study a total of 41 cases fulfilled the diagnostic criteria of Plasma Cell Dyscrasias.
Among them 33 were newly diagnosed cases of Multiple Myeloma, 4 cases were of relapse and 4 were
of Waldenstrom’s Macroglobulinemia’s. Males outnumbered females in our study. The most common
complaint was anemia (seen in 90% of cases) followed by lytic bone lesions and presence of M Band
on electrophoresis. Deranged Renal Function Test were seen in 45.94 % of cases and hypercalcemia 54
% cases. Maximum cases were of stage III Multiple Myeloma (14) and 9 among them showed renal
involvement as well.
Conclusion: Plasma Cell Dyscrasias are rare group of disorders, the diagnosis of which requires a
systematic approach. The clinicopathological characteristic of different types of Plasma Cell Dyscrasias
has varied presentations but Salmon Durie classification if applied carefully can help us to identify each
type, evaluate and manage patients in a better way.

Introduction: The liver is a common location for primary as well as secondary malignant tumours, and
the clinical and imaging findings are usually nonspecific. Though histopathology is the gold standard,
ultrasound-guided fine needle aspiration cytology offers promising results.
Materials and Methods: A total number of 38 patients with single and multiple space-occupying lesions
of the liver, were subjected to ultrasound-guided FNAC and the cytology features were analyzed.
Results: The present study included hepatocellular carcinoma (11), hepatoblastoma (1), and metastatic
deposits (19). Four cases were inflammatory, and the rest were cell poor and inconclusive.
Conclusion: Ultrasound guided FNAC is an affordable and accurate means of confirming the diagnosis of
the primary and secondary malignant tumors of the liver.