2024-03-29T06:44:00Z
https://www.pacificejournals.com/journal/index.php/apalm/oai
oai:ojs.localhost:article/13
2014-03-24T06:14:27Z
apalm:ART
oai:ojs.localhost:article/18
2014-08-01T13:27:38Z
apalm:Ed
"140720 2014 eng "
2349-6983
2394-6466
dc
Basal-like breast cancer: The road less traveled.
Bhanvadia, Viral M
M.P.Shah Govt. Medical College
Goyal, Prashant
Basal like breast cancer is a heterogeneous subtype having poor disease free and overall survival and distinct type of recurrence and metastasis, identified by gene expression profile study. Current chemotherapy fails to curtail the innate aggressive behavior in the majority of patients. The poor prognosis coupled with a lack of targeted use of therapies is reflected in the high mortality. Future research work will be directed upon better understanding of this entity for tailored therapy.
Pacific Group of e-Journals (PaGe)
2014-07-20 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/18
Annals of Pathology and Laboratory Medicine; Vol 1 No 1 (2014)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/20
2014-10-07T16:33:35Z
apalm:CR
"140928 2014 eng "
2349-6983
2394-6466
dc
Unusual occurrence of Ewings sarcoma/PNET with pregnancy: 2 cases and literature review.
Kaptan, Kumarbhargav R
Toprani Advanced Lab system, Vadodara, Gujarat
Bhagat, Vasudha M
Additional professor in G.M.E.R.S. medical college, Valsad, Gujarat.
Dudhat, Reena B
Consultant Pathologist at Private hospital, Surat, Gujarat
Italiya, Sonal L
Consultant Pathologist at BAPS hospital, Surat, Gujarat
Shah, Miteshkumar B
Consultant Pathologist at Toprani Advanced Lab System, Vadodara, Gujarat
The occurrence of cancer in a pregnant woman is a relatively low-probability event. The influence of pregnancy on the initiation, promotion and development of sarcomas is yet unclear. Epidemiological data suggest that the incidence of cancer during pregnancy is 0.07% to 0.1% of all malignant tumours. To our knowledge, only few cases of Ewing's sarcoma/PNET developing during pregnancy have been described. The treatment approach is strongly influenced by the type and site of the primary tumour, its growth rate and associated symptoms, and by the need to treat the woman while minimizing foetal toxicity. Here we describe two cases of Ewing's sarcoma/PNET in a pregnant woman, in whom the diagnostic and therapeutic approaches were tailored in order to cure the patient and to avoid unnecessary toxicity to the foetus. One out of two patients underwent abortion and other successfully delivered baby before receiving treatment for underlying sarcoma.
Pacific Group of e-Journals (PaGe)
2014-09-28 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/20
Annals of Pathology and Laboratory Medicine; Vol 1 No 2 (2014): Oct-Dec
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/21
2014-08-01T13:27:38Z
apalm:CR
"140720 2014 eng "
2349-6983
2394-6466
dc
Fine Needle Aspiration diagnosis of Carotid Body Tumor (Paraganglioma) in a patient suspected of Tuberculosis.
Bhagat, Vasudha M
Additional Professor in G.M.E.R.S. Medical College, Valsad, Gujarat
Tailor, Hemali J
Assistant Professor in Government Medical College, Surat, Gujarat.
Kaptan, Kumarbhargav Rameshchandra
Carotid body tumor (CBT) or paraganglioma is a rare tumor which presents as a mass in the lateral part of the neck. It is typically a slow-growing and asymptomatic mass in the beginning, arising from the chief cells of carotid body which is situated at the bifurcation of the common carotid artery. We describe detection of one such tumor by fine needle aspiration cytology in a 30-year-old lady with left neck swellings clinically suspected of tubercular lymphadenitis. The aspirate was hemorrhagic with clusters of round to oval cells showing moderate anisokaryosis and uniform nuclear features. Delicate fibrous strands with spindle cells were also observed within these clusters. Based on these cytologic findings and location of the swelling, a diagnosis of CBT was made. It was evaluated later on by Doppler USG which supported our diagnosis. Subsequently the mass was excised and the diagnosis was confirmed on histopathological examination. Our case report adds to the existing literature on cytologic diagnosis of CBT, further attesting to its safety and accuracy. Also, stating the importance of morphology which is still the cornerstone in the field of pathology for reaching final diagnosis.
Pacific Group of e-Journals (PaGe)
2014-07-20 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/21
Annals of Pathology and Laboratory Medicine; Vol 1 No 1 (2014)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/22
2014-10-07T16:36:21Z
apalm:CR
"140928 2014 eng "
2349-6983
2394-6466
dc
Cytological diagnosis of Adrenocortical Carcinoma with metastatic lesion in liver
Bhagat, Vasudha M
Govt. Medical College, Surat.
Tailor, Hemali J
Government Medical College, Surat, Gujarat, India
Dudhat, Reena B
Govt. Medical College, Surat.
Unjiya, Ravi M
Govt. Medical College, Surat.
Adrenocortical Carcinoma (ACC) is rare tumor with a reported incidence of 2 cases per million individuals per year. These tumors are highly aggressive and at the time of diagnosis, these are at higher stage. Here, we report a case of adrenal mass and multiple hypodense lesions in liver detected on imaging study which on subsequent USG-guided fine needle aspiration cytology (FNAC) performed from adrenal glands and liver turned out to be a ACC with metastatic lesion by using immunocytochemistry as an ancillary technique which showed tumor cells immunoreactivity for inhibin and calretinin; and negativity for cytokeratin, vimentin and epithelial membrane antigen (EMA) thus confirming the suspected morphological diagnosis and highlighting the accuracy of FNAC as a diagnostic tool.
Pacific Group of e-Journals (PaGe)
2014-09-28 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/22
Annals of Pathology and Laboratory Medicine; Vol 1 No 2 (2014): Oct-Dec
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/32
2014-08-01T13:27:38Z
apalm:CR
"140720 2014 eng "
2349-6983
2394-6466
dc
Myeloid Sarcoma presenting as orbital mass: a diagnostic challenge
Chaudhury, Supriyo Roy
Medical College, Kolkata.
West Bengal
Jain, Bhawna Bhutoria
Medical College, Kolkata.
West Bengal
Jain, Chetan
Medical College, Kolkata.
West Bengal
Chattopadhyay, Sarbani
Medical College, Kolkata, West Bengal
Myeloid sarcomas (MS) are extramedullary myeloid neoplasm and can present as solitary tumor without bone marrow and blood involvement.The rarity of the condition, its atypical presentation & difficulty to diagnose it in routine histopathological sections pose a diagnostic challenge to both pathologists and clinicians which prompted us to present this case.
A case of myeloid sarcoma occurring as orbital mass in a 60 year old is presented here. The finding as seen on a cytological smear, histological features and immunohistochemistry is discussed.
Strong clinical suspicion is prerequisite. The pathologist should examine the slide carefully so that the diagnosis is not missed. Presence of eosinophilic myelocyte provides a diagnostic clue.
Pacific Group of e-Journals (PaGe)
2014-07-20 00:00:00
application/pdf
application/vnd.openxmlformats-officedocument.wordprocessingml.document
https://www.pacificejournals.com/journal/index.php/apalm/article/view/32
Annals of Pathology and Laboratory Medicine; Vol 1 No 1 (2014)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/37
2016-06-17T06:16:05Z
apalm:CR
"150510 2015 eng "
2349-6983
2394-6466
dc
Cytological diagnosis of undifferentiated carcinoma of the pancreas with osteoclast-like giant cells: report of three cases
Samanta, Swapan
EKO X-RAY & IMAGING INSTITUTE; 54, Jawaharlal Nehru Road,
Kolkata -700 071
Sharma, S. K.
EKO X-RAY & IMAGING INSTITUTE; 54, Jawaharlal Nehru Road,
Kolkata -700 071
Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells is a very rare, highly malignant tumor of the exocrine pancreas and only few cases, diagnosed by Fine needle aspiration cytology (FNAC) have been reported till date. This tumor consists of two distinct cell populations composed of numerous multinucleated giant cells resembling osteoclasts of the bone and mononuclear stromal cells. Other heterogeneous cell populations may be present. We report three such cases in young patients with abdominal mass /digestive problems and rapid weight loss. Diagnoses were primarily made by FNAC and eventually confirmed by histopathology in tertiary centers.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/37
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/42
2014-08-01T13:27:38Z
apalm:OA
"140717 2014 eng "
2349-6983
2394-6466
dc
Serum aminotransferase activity in patients of epilepsy and mania taking sodium valproate.
Khubchandani, Asha
Parmar, Vijay R
B.J.MEDICAL COLLEGE,
GUJARAT UNIVERSITY
Jadav, Janki
Sidhu, Gagandeep
Solanki, Viral
Gangwani, Sagar
Solanki, Meghna
Background: Our aim is to study the serum aminotransferase activity in patients of epilepsy and mania taking sodium valproate. Sodium valproate is a common drug to be prescribed to the patients of epilepsy and mania. Aminotransferase, both AST (Aspartate amino transferase) and ALT (Alanine amino transferase) is an accepted marker for any liver injury.
Methods: Serum sample of fifty patients of known cases of epilepsy and mania, who were on sodium valproate since at least 3 month and fifty normal subjects were taken. Serum aminotransferase level (both AST & ALT) were estimated by colorimetric method in fully automated Erba XL-640 Analyser.
Results: The level of aminotransferase enzymes were increased in patients of epilepsy and mania after administration of sodium valproate and elevation was highly significant as compared to the normal subjects (p value <0.05).
Conclusion: From our study it is concluded that there is a need for monitoring serum aminotransferase level in patients receiving sodium valproate.
Pacific Group of e-Journals (PaGe)
2014-07-20 00:00:00
application/pdf
application/vnd.openxmlformats-officedocument.wordprocessingml.document
https://www.pacificejournals.com/journal/index.php/apalm/article/view/42
Annals of Pathology and Laboratory Medicine; Vol 1 No 1 (2014)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/43
2014-10-07T16:32:39Z
apalm:CR
"140928 2014 eng "
2349-6983
2394-6466
dc
Primary Pulmonary Choriocarcinoma in a male: a rare case report
Samanta, Swapan
EKO X-RAY & IMAGING INSTITUTE
54, Jawaharlal Nehru Road,
Kolkata -700 071
Sultania, Nirmal
EKO X-RAY & IMAGING INSTITUTE
54, Jawaharlal Nehru Road,
Kolkata -700 071
Primary Choriocarcinoma (PCC) most commonly occurs in the female genital tract following gestational events such as hydatidiform mole, normal pregnancy, abortion and ectopic pregnancy. The tumor also occurs in males. In males, choriocarcinoma occurs most often in the testes. Less frequently, these tumors have also been reported in other organs such as the urinary bladder, kidney, liver, stomach and colon. Metastasis to the lung is common, but PCC originating in the lung is extremely rare.
The authors report a case of a 26-year-old male non-smoker who presented with respiratory distress and constitutional symptoms along with a large left lung mass and bilateral multiple pulmonary nodules. Clinical and imaging findings of testes and other organs were normal. Level of serum human chorionic gonadotrophin was markedly elevated and it raised the suspicion of primary pulmonary choriocarcinoma of the lung which was confirmed by trans-thoracic biopsy from the mass with immunohistochemistry. This is the third case from India occurring in a male.
Pacific Group of e-Journals (PaGe)
2014-09-28 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/43
Annals of Pathology and Laboratory Medicine; Vol 1 No 2 (2014): Oct-Dec
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/44
2014-10-07T16:30:10Z
apalm:OA
"140928 2014 eng "
2349-6983
2394-6466
dc
Dyslipidemia in patients taking anti-retroviral therapy
Parmar, Vijay R
B.J.MEDICAL COLLEGE
Khubchandani, Asha
Jadav, Janki
Solanki, Viral
Gangwani, Sagar
Background: People with human immunodeficiency virus (HIV) infection are living longer with the use of anti-retroviral therapy (ART). But as they do, non-HIV medical problems become more relevant. In particular dyslipidemia, an important reversible risk factor for cardiovascular disease, has been linked to HIV infection and its treatment. Its pathogenesis is complex and includes factor related to the virus, the host and ART. Our aim is to study the changes in the lipid profile in the patients of HIV taking ART.
Methods: Data were collected from 50 normotensive, non-diabetic and non-obese, HIV-infected patients who were on ART for at least 6 months at ART Center, Civil hospital, Ahmedabad, Gujarat and 50 healthy normal controls. Fasting lipid profiles were analyzed enzymatically by colorimetric method in fully automated Erba XL-640 Analyser.
Results: The level of serum total cholesterol (TC), serum triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) were increase while high-density lipoprotein cholesterol (HDL-C) were decrease in patients of HIV who were on ART for at least 6 month as compared to the normal subjects (p value <0.05).
Conclusion: The study has demonstrated dyslipidemia in HIV infected patients receiving ART. There is a need for monitoring lipid profile in patients on ART.
Pacific Group of e-Journals (PaGe)
2014-09-28 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/44
Annals of Pathology and Laboratory Medicine; Vol 1 No 2 (2014): Oct-Dec
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/46
2014-08-01T13:27:38Z
apalm:OA
"140720 2014 eng "
2349-6983
2394-6466
dc
Doxycycline sensitivity in multidrug resistant Acinetobacter baumanii isolates from blood
Khan, Fatima
Siddiqui, Naushaba
Shukla, Indu
Shujatullah, Fatima
Background: Acinetobacter species has become a leading cause of blood stream infection in health care setting. Acinetobacter species possess a wide array of β-lactamases that hydrolyze and confer resistance to penicillins, cephalosporins and carbepenems. Doxycycline, a semisynthetic tetracycline, has effective antibacterial effect on multidrug resistant Acinetobacter species.
Methods: Total numbers of 13,880 samples were received in 5 years for blood culture in brain heart infusion broth. Antimicrobial susceptibility testing was done on Mueller Hinton’s agar by Kirby Bauer Disc diffusion method as per the Clinical and Laboratory Standards Institute (CLSI) guidelines for the following antimicrobials: cefotaxime 30µg, ceftriaxone 30µg, cefoperazone 75µg, cefipime 30µg, cefoperazone+sulbactum 75/75 µg, gentamicin 10µg, amikacin 30µg, netilmicin 30µg, tobramycin 10µg ,ciprofloxacin 5µg, piperacillin+tazobactum 100/10 µg , Imipenem 10µg and doxycycline 30µg. Isolates resistant to atleast three drugs belonging to three different groups were considered to be multidrug resistant (MDR).
Results: One hundred and fifty one isolates were identified as Acinetobacter baumanii. Majority of the isolates 101(66.88%) were from the patients between 0-10 years of age. 45% of the isolates were found to be multidrug resistant. Barring imipenem, doxycycline was found to have the best spectrum of activity with just 48.34% (73 isolates) resistance
Conclusion: Rational and appropriate use of antimicrobial agents is of paramount importance to minimize the risk of resistant organism. Doxycycline can be used as an effective therapeutic agent in multidrug resistant Acinetobacter baumanii.
Pacific Group of e-Journals (PaGe)
2014-07-20 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/46
Annals of Pathology and Laboratory Medicine; Vol 1 No 1 (2014)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/47
2014-08-01T13:27:38Z
apalm:OA
"140720 2014 eng "
2349-6983
2394-6466
dc
Study of relationship between Platelet Volume Indices and Hyperlipidemia
Khemka, Rashi
B.J. Medical College, Pune, India
Kulkarni, Kalpana
B.J. Medical College, Pune, India
Background: Mean platelet volume (MPV) correlates well with platelet activity as larger platelets tend to be metabolically and enzymatically more active than smaller platelets and secrete more prothrombotic factors. Studies have shown that there is a constant association of increased MPV with atherosclerotic diseases like coronary ischemic disease, myocardial infarction and cerebral infarct as well as with diabetes and hypertension. Hyperlipidemia, being a closely associated condition, is also expected to show changes in platelet size. We try to study the relationship between platelet volume indices and hyperlipidemia.
Methods: 100 patients with deranged lipid profile on recent lab biochemical lab reports in OPD and indoor ward patients of Sassoon general hospital, Pune have been studied. Included cases have been segregated as separate groups for patients with deranged lipid profile along with atherosclerotic disease, diabetes or hypertension. The platelet parameters like platelet count and the platelet volume indices (PVI), including mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P‐LCR); were compared with 30 age matched controls.
Results: Mean MPV (9.79 ±1.01), PDW (13.18 ± 2.44) and P-LCR (24.85 ± 7.14) of cases were significantly higher than the controls (mean MPV = 9.22 ± 0.91, mean PDW= 11.64 ± 1.75, mean P-LCR= 20.70 ± 7.07; p-value < 0.05). Also, hyperlipidemic patients having an associated disease had significantly higher PVI than the patients having hyperlipidemia in isolation.
Conclusion: The estimation of these indices can be considered as an early, economical and rapid procedure for identification of complications in hyperlipidemic patients.
Pacific Group of e-Journals (PaGe)
2014-07-20 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/47
Annals of Pathology and Laboratory Medicine; Vol 1 No 1 (2014)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/48
2014-10-07T16:34:12Z
apalm:CR
"140928 2014 eng "
2349-6983
2394-6466
dc
Cutaneous metastasis of carcinoma lung: a rare cytological association
Akhtar, Kafil
Shadan, Maryam
Sherwani, Rana
Siddiqui, Shahid
Skin metastasis is an uncommon presentation of cancer. Cutaneous metastases as initial manifestation of internal neoplasms, represent only 0.8% of total cases and implies, in general, a very advanced grade of the disease and short survival. Metastasis to the skin from lung cancer is less common than metastasis to other organs. The incidence of skin metastasis was 2.8% among all 579 cases of lung cancer. Large cell carcinoma showed the greatest tendency to spread to the skin and epidermoid carcinoma showed the least tendency. Back of the trunk was the most common site for metastatic cutaneous lesions. Almost all lesions ranged from 1 to 5 cm in diameter. Clinical manifestation of skin metastasis was nodular type in all the cases and was accompanied by metastasis to other organs at the time of clinical presentation. A slight response to combination chemotherapy was noted in only 5 cases of lung cancers, with most lesions being progressive. Median survival after skin involvement was approximately 4 months. The lung cancer metastasizes to the skin in 2.8–24% of the cases, generally in advanced stages of the disease, although in 7–19%, skin metastases appear as the first manifestation of the malignant disease. We hereby present a rare case of a male diagnosed with a lung cancer, whose first manifestation was the appearance of skin metastases.
Pacific Group of e-Journals (PaGe)
2014-09-28 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/48
Annals of Pathology and Laboratory Medicine; Vol 1 No 2 (2014): Oct-Dec
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/49
2014-10-07T16:25:55Z
apalm:OA
"140928 2014 eng "
2349-6983
2394-6466
dc
Conjunctival surface changes in diabetics: an unusual cytological study
Khan, Adeeb A
Kesarwani, Divya
Vasenwala, Shaista M
Amitava, A K
Siddiqui, Zia
Akhtar, Kafil
Background: To study the conjunctival surface changes in diabetics with and without retinopathy, its relation to systemic factors and comparison to control.
Methods: In this study, 123 eyes of 74 subjects were divided into two study groups (Diabetes with and without retinopathy) and control. Diabetes mellitus (DM) without retinopathy comprised of 34 cases with 50 eyes, diabetic retinopathy (DR) of 19 cases with 33 eyes and control of 21 cases with 40 eyes. Conjunctival impression cytology (CIC) was compared in the three groups. We also noted relationship of CIC to the sign and symptoms of dry eye, duration of diabetes, the status of retinopathy and metabolic control in diabetes.
Results: CIC analysis showed that goblet cell density (GCD) was significantly lower in diabetics as compared to controls which was related to worsening retinopathy and dry eye symptoms(p<0.05) but not with duration of diabetes and poor metabolic control. Highly significant conjunctival squamous metaplasia (CSM) was seen in diabetics as compared to control group. (p<0.0001) The median CSM grade was poorer with long duration diabetes and worsening retinopathy (p<0.015), with no relation to dry eye symptoms and metabolic control.
Conclusion: Conjunctival surface changes in diabetics include goblet cell loss and CSM. Interestingly, diabetics with retinopathy had significantly worse changes on CIC analysis than those without it, and both groups showed worse changes than controls.
Pacific Group of e-Journals (PaGe)
2014-09-28 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/49
Annals of Pathology and Laboratory Medicine; Vol 1 No 2 (2014): Oct-Dec
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/51
2014-08-01T13:27:38Z
apalm:CR
"140720 2014 eng "
2349-6983
2394-6466
dc
Refractory Extra nodal Rosai-Dorfman disease of cheek and upper eyelid: A rare case
Biswas, Manjusha
Vivekananda Institute of Medical Sciences, Kolkata, India.
Sarkar, Tirthankar
Das, Anjan
Naskar, Snehanshu
Rosai-dorfman disease (RDD) is a rare benign disorder of histiocytes characterized histologically by intracellular engulfment of lymphocytes. Extra-nodal RDD has been reported in 43% of cases. However, soft tissue cheek mass is rare presentation of extra-nodal RDD. A 31-year-old female presented with a history of right cheek mass and right upper eyelid mass gradually increasing for 8 months, with no palpable cervical lymphadenopathy. The masses were excised and sent for histopathological examination. The histiocytes showed positive immunostaining for S100 and negativity for CD1a, consistent with extra-nodal RDD. Patient was on systemic steroids and was doing well. After 12 months of follow-up, patient had recurrence in right cheek, which was again excised. Again the mass recurred after 10 months, was excised and patient was put on radiotherapy to the cheek mass. Extra-nodal RDD with involvement of cheek is a rare presentation. Incorporation of S100 and CD1a is helpful in diagnoses of RDD and differentiating it from other benign histiocytosis. The causes of RDD are not fully understood, and treatment strategies can be different according to severity or vital organ involvement.
Pacific Group of e-Journals (PaGe)
2014-07-20 00:00:00
application/pdf
application/vnd.openxmlformats-officedocument.wordprocessingml.document
https://www.pacificejournals.com/journal/index.php/apalm/article/view/51
Annals of Pathology and Laboratory Medicine; Vol 1 No 1 (2014)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/52
2014-10-07T16:36:50Z
apalm:CR
"140928 2014 eng "
2349-6983
2394-6466
dc
Primary biphasic synovial sarcoma of left parapharyngeal region: an exceedingly rare site
Pujara, Krupal
P.D.U.Medical College, Rajkot
Goswami, Sfoorti
Bhalara, Rohit
Dalsania, Jagdish
Dhruva, Gauravi
Jha, Bharti
Primary synovial sarcoma is an unusual tumor of the head and neck region and again primary parapharyngeal synovial sarcoma is a rare tumor entity. In our case a male patient, aged 27 years, presented with feeling of swelling and discomfort in the left parapharyngeal region. CT findings suggestive of soft tissue mass in prestylar region on left side. A transcervical excision of the tumor was performed and histopathological examination of H & E stained sections show biphasic tumor composed of epithelial and spindle cells components. The epithelial areas show glandular structure lined by cuboidal cells while spindle cells areas show densely cellular fascicles surroundings the epithelial cells. Immunohistochemistry shows strong positivity of cytokeratin, vimentin and weak positivity of S-100, BCl2, CD99 and SMA. Synovial sarcoma may be mistaken for other tumors due to its rarity. Treatment is essentially surgical, requiring wide margins; radiotherapy is usually associated. The value of chemotherapy has yet to be assessed.
Pacific Group of e-Journals (PaGe)
2014-09-28 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/52
Annals of Pathology and Laboratory Medicine; Vol 1 No 2 (2014): Oct-Dec
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/53
2014-08-01T13:27:38Z
apalm:CR
"140720 2014 eng "
2349-6983
2394-6466
dc
Actinomycosis of the ankle joint
Ramachandra, Sunitha
Armed forces hospital, muscat oman
Kuruvila, Sarah
armed forces hospital,muscat oman
CK, John
armed forces hospital, muscat
We report a case of actinomycosis of the ankle joint with synovial involvement which resisted the usual treatment. Actinomycotic infection of the extremities involving the bone and joints is rare. After the initial diagnosis, our case was treated with ampicillin for six months with no benefit. Instead the condition worsened with the development of tiny pockets of fluid collections within the soft tissue and increased inflammation. Surgical debridement was done to drain the fluid collections and the patient was treated with combined regimen of Cotrimoxazole and Rifampicin with good response clinically and radiologically. Timely intervention and the correct diagnosis saved the limb.
Pacific Group of e-Journals (PaGe)
2014-07-20 00:00:00
application/pdf
application/vnd.openxmlformats-officedocument.wordprocessingml.document
https://www.pacificejournals.com/journal/index.php/apalm/article/view/53
Annals of Pathology and Laboratory Medicine; Vol 1 No 1 (2014)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/56
2017-02-17T18:20:33Z
apalm:CR
"150130 2015 eng "
2349-6983
2394-6466
dc
Radio-cytological diagnosis of nodulocaseous tubercular lymphadenitis: a clinical dilemma
Kaushik, Ankit
VMMC and Safdarjung Hospital, GGSIPU https://in-mg61.mail.yahoo.com/neo/launch?.rand=ejohb35rqg472#4622231937
Arora, Disha
Kolte, Sachin
Gupta, Kusum
Mandal, A K
Nodulocaseous tubercular lymphadenitis is a rare entity presenting with ill-defined breast lump, accompanied by non-specific systemic presentation. We present a case report of a young female patient presenting with breast lump and no definitive clinical diagnosis. The radiological investigation like ultrasound breast revealed multiple enlarged nodulocaseous lymph nodes in all four quadrants of breast. The presence of epitheloid cell granuloma with necrosis on fine needle aspiration cytology established primary diagnosis of intramammary tubercular lymphadenitis.
Nodulocaseous tubercular lymphadenitis breast often presents with atypical presentation and primary diagnosis is often difficult to establish. The case establishes the role of ultrasound breast and fine needle aspiration cytology being rapid and cost effective way of diagnosing this lesion.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/56
Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/57
2014-10-07T16:40:08Z
apalm:CR
"140928 2014 eng "
2349-6983
2394-6466
dc
Cytological diagnosis of lepromatous nerve abscess: a case report
Kaushik, Ankit
VMMC and Safdarjung Hospital, GGSIPU
Arora, Disha
Kolte, Sachin
Gupta, Kusum
Mandal, A K
Leprosy, also known as Hensen’s disease is a long standing chronic multisystem disorder mainly involving skin and peripheral nerves, prevalent in many parts of World including Asia, Latin America and Africa.
We present a case report of 30-year-old male presented with a long standing ulcerated nodular cord-like swelling on right forearm for past six months. The patient was diagnosed as leprosy on cytology and confirmed on histopathology. Multi drug treatment for leprosy was given. The patient responded well. This case report provides an insight in to the usefulness of fine needle aspiration cytology as primary investigation in diagnosing lepromatous nerve abscess.
Pacific Group of e-Journals (PaGe)
2014-09-28 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/57
Annals of Pathology and Laboratory Medicine; Vol 1 No 2 (2014): Oct-Dec
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/60
2017-02-17T18:20:33Z
apalm:OA
"150206 2015 eng "
2349-6983
2394-6466
dc
Cytomorphological spectrum and Ziehl-Nelson staining in suspected tuberculous lymphadenitis: A study of 100 cases.
Dhawan, Indrani
VMMC and Safdarjung Hospital, GGSIPU https://in-mg61.mail.yahoo.com/neo/launch?.rand=ejohb35rqg472#4622231937
Gupta, Oneal
Kaushik, Ankit
VMMC and SJH
Ranga, Sunil
Kasana, Dimple
VMMC and SJH
Gupta, Prem Kumar
Background: Tuberculosis (TB) is the leading cause of death from a curable infectious disease. The situation is further worsened by a resurgence of the disease in immunocompromised AIDS cases. Lymphadenitis is the most frequent form of extrapulmonary tuberculosis. The diagnosis of tuberculous lymphadenitis remains challenging in spite of the availability of various diagnostic tools.
Aims: The present study aims at studying different cytomorphological patterns in suspected cases of tuberculous lymphadenitis and the efficacy of cytology and Ziehl-Nelson (ZN) staining in diagnosing tuberculous lymphadenitis in these different patterns.
Methods: One hundred cases clinically suspected of tuberculous lymphadenitis were studied (over a period of one year) with the aid of fine needle aspiration cytology (FNAC) complemented with AFB staining. The cytomorphological spectrum along with AFB positivity in different groups was compared.
Results: Maximum AFB positivity was seen in cases showing cytomorphological features consistent with a granulomatous lesion with necrosis (i.e. in 10 out of 21 cases; 48%). The difference in AFB positivity between various cytomorphological groups was found to be statistically significant (p < 0.01) especially between cases showing caseating granuloma and those showing non-caseating granuloma or reactive lymphadenitis at 1% level of significance. The maximum sensitivity of ZN stain was found in cases showing caseating granuloma, and was nil in cases showing non-caseating granuloma and cases showing reactive lymphadenitis.
Conclusion: The maximum AFB positivity is seen in cases showing cytomorphological features consistent with a granulomatous lesion with necrosis. A combination of conventional techniques (FNA and ZN staining for AFB) and newer diagnostic techniques must be applied for the rapid and early diagnosis of tuberculosis in paucibacillary specimens to achieve maximum sensitivity.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/60
Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/63
2014-10-07T16:28:49Z
apalm:OA
"140928 2014 eng "
2349-6983
2394-6466
dc
Role of IL-8, IL-10 and TNF-α level in pathogenesis of leptospiral acute hepatitis syndrome
Rizvi, Meher
Assistant Professor
Department of Microbiology
JNMCH, AMU,
Aligarh
Azam, Mohd
Sultan, Asfia
Khan, Fatima
Shukla, Indu
Malik, Abida
Ajmal, Masihur R
Background: Leptospirosis is the most widespread zoonosis occurring worldwide. Severity of disease may range from inapparent infection to fulminant, fatal disease. Besides, direct injury by microbial factors, cytokines produced in response to infection have been proposed to be involved in the pathogenesis of leptospirosis.
Objective: This study was done to assess the impact of cytokines IL-8, IL-10 and TNF-α in pathogenesis of leptospirosis and to establish their role as diagnostic markers in disease severity.
Methods: Fourty six patients with signs and symptoms of acute hepatitis who were positive for leptospira by IgM ELISA along with 30 control individuals were included in the study. Concentrations of circulating IL-8, IL-10 & TNF-α were measured in pg/ml by ELISA.
Results: There were two to threefold rise in liver enzymes in patients with leptospirosis. Concentrations of IL-8, IL-10 were found to be elevated in 41 (89.1%), 26 (56.52%) patients while that of TNF-α were largely suppressed in patients with leptospirosis. Mean levels of IL-8, IL-10 & TNF-α was 175.96 pg/ml, 32.9 pg/ml and 46.49 pg/ml respectively. Higher levels of IL-8, IL-10 and lower levels of TNF-α were found to be associated with better prognosis. IL-10/TNF-α ratio was significantly high in our study.
Conclusion: Ratios of IL-10/TNF-α may play a role in predicting disease prognosis as high IL-10/TNF-α ratios are associated with good prognosis.
Pacific Group of e-Journals (PaGe)
2014-09-28 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/63
Annals of Pathology and Laboratory Medicine; Vol 1 No 2 (2014): Oct-Dec
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/65
2017-02-17T18:20:33Z
apalm:OA
"150206 2015 eng "
2349-6983
2394-6466
dc
An evaluation of histopathological findings of skin biopsies in various skin disorders
Narang, Sanjeev
Department of Pathology, Index Medical College, Indore
Jain, Ravi
Department of Pathology, MGM Medical College, Indore
Background - Skin conditions are among the most common health problems in India. Skin biopsy is most common diagnostic technique for diagnosing skin disease. The interpretation of a skin biopsy requires clinicopathological correlation.
Methods: The present study was undertaken in the Department of Pathology, M.G.M Medical College and M.Y. Hospital, Indore (M.P) to determine the incidence and age-sex distribution of various skin diseases, to study the various histopathological changes encountered in the course of the study and to establish clinic pathological correlation. A total number of 262 biopsies retrieved from the archives during the period of January 2007 to June 2008 along with skin biopsies sent for histopathological evaluation during June 2008 – June 2010 were included in the study. On the basis of histopathological classification the skin disorders are divided into eight groups.
Result: Maximum number of cases belonged to group V disorders i.e. disorders showing perivascular, diffuse and granulomatous infiltrates of the reticular dermis 65(24.8 %), followed by group VI disorders that is tumors and cysts of the dermis 28(10.7 %). Out of 262 skin biopsies which came for Histopathological evaluation, 137 (52.3 %) cases were given definite diagnosis by microscopic examination of slides. Amongst 216 cases, clinico-histopathological correlation was seen in 95(44 %) cases. Highest number of cases 68(25.95 %) were observed in the age group of 21-30 years, with majority of the cases were male 149(56.9 %) while 113(43.1 %) cases were female.
Conclusion: Leprosy is still most prevalent, thereby emphasizing stronger measures to control it.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/65
Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/66
2017-02-17T18:20:33Z
apalm:CR
"140128 2014 eng "
2349-6983
2394-6466
dc
Epidermoid renal cyst: an unusual finding
Rathod, Dharmendra Rameshbhai
Dr. Bhatt Pathology Laboratory
Bhatt, Jayprakash Gunvantrai
Dr. Bhatt Pathology Laboratory
Khakkhar, Riddhi Vivekbhai
Dr. Bhatt Pathology Laboratory
parmar, Pratyush virjibhai
Dr. Bhatt Pathology Laboratory
This report describes a case of epidermoid cyst affecting the left kidney of a 52-year-old female. The condition was accidentally discovered during the histopathology examination. Patient presented with complain of burning micturition, nausea, vomiting and fever for 15 days. Grossly, the kidney was distorted cyst like that was filled with a cheesy material. The histological picture of non-functioning kidney was apparent in the compressed renal parenchyma by the cyst that was identical to an epidermoid cyst. In conclusion, although rare, epidermoid cyst of the kidney could cause serious kidney damage leading to a non-functioning of kidney. Epidermoid cyst of the kidney could be multiple, producing a picture similar to hydronephrosis and broadening the differential diagnosis of multicystic disease of the kidney. Timely diagnosis is essential to prevent radical surgery.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/66
Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/78
2017-02-17T18:20:33Z
apalm:CR
"140128 2014 eng "
2349-6983
2394-6466
dc
Cytology of nodal Rosai-Dorfman disease: a case report
Duraisami, Puvitha Rajeswari
Coimbatore Medical College,Coimbatore,Tamil Nadu,India.
Rosai-Dorfman disease (RDD) or sinus histiocytosis with massive lymphadenopathy is a rare, benign, histiocytic proliferative disorder. It can be encountered in both nodal and extra nodal locations. Fine needle aspiration technique is a simple, accurate and most economic tool, being used widely. Fourteen year old male child presented with bilateral cervical lymphadenopathy. Fine needle aspiration of cervical node revealed RDD, which was later confirmed by histopathology and immunochemistry. Owing to the rarity, cytomorphological appearance of this disease and its mimics are considered here.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/78
Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/81
2017-02-17T18:20:33Z
apalm:CR
"140128 2014 eng "
2349-6983
2394-6466
dc
Extra-oral verruciform xanthoma: an uncommon entity
Jain, Akanksha
LADY HARDINGE MEDICAL COLLEGE
Agarwal, Shilpi
Lady Hardinge Medical College
Nain, Manupriya
Lady Hardinge Medical College
singh, Deeksha
Lady Hardinge Medical College
Verruciform xanthoma (VX) is an uncommon benign condition, which frequently affects the oral mucosa in adults. Only few cases of VX of anogenital region and skin have been reported. Clinically, it presents as a white or yellowish-white sessile or pedunculated, papillary or verrucous mucosal growth and is usually less than 2 cm in size. Although it is considered a benign entity, it has clinical importance as it needs to be differentiated with wart like growths i.e. verrucous carcinoma, condyloma acuminatum, seborrheic keratosis and due to its strong association with more serious diseases like epidermolysis bullosa, epithelial dysplasia, pemphigus vulgaris, solar keratosis and discoid lupus erythematosus. The etiology of this lesion is unknown, however is thought to be reactive rather than a neoplastic process secondary to epithelial damage induced by different associated conditions. We present two cases of VX and discuss their clinical and histopathological findings and possible correlation with a postulated etiopathogenesis.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/81
Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/84
2017-02-17T18:20:33Z
apalm:CR
"140128 2014 eng "
2349-6983
2394-6466
dc
Inflammatory myofibroblastic tumor of the gall bladder: a rare case report
Nangia, Anita
Lady Hardinge Medical College
Sehgal, Shivali
Lady Hardinge Medical College
Pujani, Mukta
Lady Hardinge Medical College
Patiri, Karsing
Lady Hardinge Medical College
Inflammatory myofibroblastic tumor (IMT) is a benign proliferation of myofibroblasts, which is prone to recurrence, persistent local growth as well as malignant transformation. The commonest site reported in the biliary tree is the extrahepatic bile duct. Gall bladder is a rare site for the development of an IMT. We report a case of an inflammatory myofibroblastic tumor of the gall bladder in an adult female with coextistent cholecystitis and cholelithiasis. It is important to acknowledge this entity since it can mimic malignancy.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/84
Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/86
2014-08-01T13:27:38Z
apalm:Ed
"140717 2014 eng "
2349-6983
2394-6466
dc
Annals of pathology and laboratory medicine: looking forward
Mondal, Asitava
see full text
Pacific Group of e-Journals (PaGe)
2014-07-20 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/86
Annals of Pathology and Laboratory Medicine; Vol 1 No 1 (2014)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/89
2017-02-17T18:20:33Z
apalm:CR
"140128 2014 eng "
2349-6983
2394-6466
dc
Fetus Papyraceus: a rare case report
Masamatti, Smita Surendra
Assistant professor , Sapthagiri Medical college and research centre, BANGALORE,INDIA
Ramteerthakar, Nayan Anant
Associate professor, Government medical college, Miraj, Maharashtra
Pandav, Amit Bapuso
Assistant professor, Government medical college, Miraj, Maharashtra
Gosavi, Alka Vikas
Associate professor, Government medical college, Miraj, Maharashtra
Fetus papyraceus (FP) also called fetus compressus is a mummified and compressed fetus as a result of fetal death during multiple pregnancy. Fetus papyraceus is a rare condition and is associated with obstetric complications. Sonography is a visual tool to confirm the diagnosis, but it is not always possible due to anatomical position and technical difficulties. FP is usually discovered among the placenta and membranes of its well developed twin. Searching for a fetus papyraceus should be a routine part of placental examination.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/89
Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/96
2017-02-17T18:20:33Z
apalm:CR
"150128 2015 eng "
2349-6983
2394-6466
dc
Xanthogranulomatous oophoritis-masquerading as ova-rian neoplasm: report of two cases
Gupta, Neeru
sri balaji action medical institute
Paschim Vihar
Delhi-110063
Gupta, Chhaya
Xanthogranulomatous oophritis is an unusual chronic inflammatory condition which clinically presents as a mass like lesion in the pelvic cavity. It invades the surrounding tissue and thus mimics like a tumor. Patients with xanthogranulomatous oophoritis presents with lower abdominal or suprapubic pain, fever, menorrhagia, vaginal bleeding, adnexal tenderness and rarely as a pelvic mass. Only a few cases of this entity have been reported in India.
We report two cases of xanthogranulomatous inflammation of the female genital tract presenting with unilateral ovarian masses having clinical and radiological suspicion of an ovarian tumor. Both patients underwent panhystrectomy. Gross examination revealed enlarged unilateral ovaries with multiloculated cystic cavities on cut surface. Histopathological examination revealed massive infiltration of the ovarian tissue by lipid laden histiocytes and mixed inflammatory infiltrate suggesting a diagnosis of xanthogranulomatous oophoritis. These cases mimicked as malignancy and are of interest in view of their rarity.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/96
Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/97
2017-02-17T18:20:33Z
apalm:OA
"150129 2015 eng "
2349-6983
2394-6466
dc
ABO blood group phenotype in and around Delhi: A study from tertiary care hospital
Arora, Disha
VMMC and Safdarjung Hospital, GGSIPU https://in-mg61.mail.yahoo.com/neo/launch?.rand=ejohb35rqg472#4622231937
Kaushik, Ankit
VMMC and SJH
Rawat, D S
Mandal, A K
Background: ABO blood group shows marked geographical and racial variation. The study of regional ABO phenotype is extremely important for understanding the regional demand of rare blood groups and to tide over the massive demands in case of natural calamities or mass disaster.
Methods: A retrospective study was carried out at Department of Blood Bank and Transfusion Medicine, VMMC and Safdarjung Hospital, Delhi from January 2013 to May 2014 constituting a total of 42,456 donors including both voluntary and replacement donation. The blood group antigens were determined using electromagnetic technology and the frequency is expressed in percentage.
Results: B phenotype is most common phenotype constituting 39.84%of total donors, followed by O phenotype with 28.56%, A with 21.24% and AB with 10.56%. A total of 91.16% donors are Rh positive, while the rest are Rh negative.
Conclusion: The ABO phenotype of Delhi and nearby regions is different from the western countries, South India and other parts of Asia. Thus this study aids in constructing a regional ABO phenotype data register for meeting regional transfusion demands.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/97
Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/100
2014-08-16T17:49:17Z
apalm:Ed
"140720 2014 eng "
2349-6983
2394-6466
dc
From Editor’s Desk
Sehgal, Shelly
see full text
Pacific Group of e-Journals (PaGe)
2014-07-20 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/100
Annals of Pathology and Laboratory Medicine; Vol 1 No 1 (2014)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/102
2014-08-01T13:27:38Z
apalm:msg
"140720 2014 eng "
2349-6983
2394-6466
dc
Message from Dr Harsh Mohan
Mohan, Harsh
PDF File
Pacific Group of e-Journals (PaGe)
2014-07-20 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/102
Annals of Pathology and Laboratory Medicine; Vol 1 No 1 (2014)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/112
2016-06-17T06:16:04Z
apalm:OA
"150510 2015 eng "
2349-6983
2394-6466
dc
Subtyping and grading of synovial sarcomas: a cyto-histopathologic correlation study
Kaushik, Ankit
VMMC and Safdarjung Hospital, GGSIPU
Khanna, Geetika
., Rajni
Yadav, Yogesh Kumar
Introduction: Synovial sarcoma is a mesenchymal spindle cell tumor which displays variable epithelial differentiation, including glandular formation and has a specific chromosomal translocation t(X; 18). Fine-needle aspiration cytology (FNAC) is increasingly accepted as a valid screening technique with high sensitivity and specificity in establishing the presence of malignancy and determining the mesenchymal nature of a lesion.
Aims and Objectives: In this present study, cytological features, subtyping and grading were studied retrospectively from the histologically confirmed 14 cases of synovial sarcomas and then subsequently correlated our findings from histology section.
Methods: This is a retrospective study conducted in Central Institute of Orthopedic (CIO) laboratory. A total 14 cases with a diagnosis of synovial sarcomas from CIO laboratory from past 4 years were retrieved and reviewed for cytohistological correlation, subtyping and grading of synovial sarcoma.
Results: Out of total 14 cases of histological proven synovial sarcomas, 12 cases were exactly subtype on cytology. The cytological grading was only similar in 7 of 13 cases that were graded.
Conclusion: FNAC is an important and useful tool in diagnosing and subtyping synovial sarcoma.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/112
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/113
2014-10-07T16:41:14Z
apalm:Let
"140928 2014 eng "
2349-6983
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dc
Cytological diagnosis of pigmented basal cell carcinoma
Agarwal, Shilpi
Lady Hardinge Medical College
Agarwal, Kiran
Lady Hardinge Medical College
Sehgal, Shivali
Lady Hardinge Medical College
Rai, Preeti
Lady Hardinge Medical College
Cytology is increasingly being used for the diagnosis of cutaneous neoplasms. We report a case of pigmented basal cell carcinoma in a 70 year old male which was diagnosed on fine needle aspiration cytology.
Pacific Group of e-Journals (PaGe)
2014-09-28 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/113
Annals of Pathology and Laboratory Medicine; Vol 1 No 2 (2014): Oct-Dec
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/117
2016-06-17T06:16:05Z
apalm:CR
"150510 2015 eng "
2349-6983
2394-6466
dc
A rare case of neoplastic transformation in a longstanding case of fistula-in-ano
Gupta, Neeru
sri balaji action medical institute
Paschim Vihar
Delhi-110063
Gupta, Chhaya
Sud, Aruna
Mucinous adenocarcinoma development in a long standing case of with fistula-in-ano is rare. A case of fistula–in-ano diagnosed as low grade mucinous adenocarcinoma on biopsy and confirmed on Immunohistochemistry is discussed. It was established that the carcinoma had developed within the fistula and was not a secondary manifestation of any other tumor.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/117
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/118
2017-02-17T18:20:33Z
apalm:CR
"140128 2014 eng "
2349-6983
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dc
Giant cells in phyllodes tumour of breast: a diagnostic dilemma
Agrawal, Kiran
Lady Hardinge Medical College, Delhi
Dewan, Khushboo
Shukla, Shailaja
Professor
Department of Pathology
Lady Hardinge Medical College, Delhi
Phyllodes tumour (PT) accounts for 0.3-1% of all primary tumours of the breast. Classification of PT into benign, borderline and malignant types is important in determining the prognosis of the disease. Occurrence of multi-nucleate giant cells (MNGC) in PT is a rare occurrence. Two types of MNGC have been described in mammary neoplasms, the multinucleate stromal giant cells (MNSGC) and the osteoclast-like giant cells (OLGC). Of thirteen cases of Phyllodes tumour (PT) with MNGC reported till date, eleven possessed pleomorphic, bizarre-appearing MNSGC and two had bland-looking OLGC. We present a case of borderline PT with multiple foci of both MNSGC and OLGC intermixed together in a hypervascular stromal background. To the best of our knowledge, such a case has not been reported earlier. The case also highlights the dilemma in grading of PT in the presence of many pleomorphic MNSGC. In these cases, Ki-67 proliferation index is important as it is not increased in the otherwise pleomorphic and bizarre-appearing MNSGC. It is also similar to the surrounding stromal cells, implying that MNSGC do not represent a more malignant population of cells. The case details along with a brief review of literature are presented.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
application/pdf
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Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/119
2016-06-17T06:16:05Z
apalm:CR
"150510 2015 eng "
2349-6983
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Primitive neuroectodermal tumour of kidney: an unusual entity
Wadhwani, Deepa
santokba durlabhji memorial hospital
Gangwal, Kumud
Bhargava, Shilpi
Shah, Ruchit
Tejwani, Shankar
Gauba, Rajat
Primitive neuroectodermal tumor (rPNET ) of kidney is an extremely rare tumour which occurs in children and young adults and has only a few published reports. The present case is of a 24-year-old female presenting with complaining of pain abdomen since 2-3 months duration. USG guided FNAC showed a cellular aspirate composed of small round to oval cells with scanty or small amount of cytoplasm was seen. Cells were arranged in clusters with occasional microacinar or papillary arrangement was also noted. Two possibilities were suggested- 1.Carcinoid tumour, 2. small cell anaplastic carcinoma. Histopathological and immunohistochemical (IHC) correlation was done. A highly malignant small cell neoplasm composed of small round cells having scanty cytoplasm and dense nuclei against hemorrhagic background was seen. IHC panel was performed and was found to be strongly positive for MIC-2 (CD99) and showed weak positivity for NSE and ki -67. A final diagnosis of Primitive Neuro-ectodermal Tumour of kidney was made.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/119
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/122
2017-02-17T18:20:33Z
apalm:CR
"150130 2015 eng "
2349-6983
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Metaplastic carcinoma of the breast: a case report
Santosh, T
KIMS & RF
Rao, Epari Sanjeeva
Professor
Rao, B R Mohan
HOD, Professor
Metaplastic Carcinomas of the breast are malignant neoplasms composed of both epithelial and mesenchymal elements. The rarity of this tumor is exemplified by the fact that it accounts for only about 0.2% of all breast carcinomas. It presents histologically with diverse differentiation and the exact histogenesis of this tumor is unknown. The present case is reported for its rarity.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/122
Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/125
2016-06-17T06:16:05Z
apalm:CR
"150510 2015 eng "
2349-6983
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Minimal deviation adenocarcinoma and its mimickers: a case report with review of literature
Jain, Manjula
Director Professor and Head, Department of Pathology, Lady Hardinge Medical College and Smt S.K. Hospital, Shaheed Bhagat Singh Marg, New Delhi 110001, India
Agarwal, Savita
Department of Pathology, Lady Hardinge Medical College and Smt S.K. Hospital, Shaheed Bhagat Singh Marg, New Delhi 110001, India
Malhotra, Sonal
Amongst all the glandular lesions of the cervix, minimal deviation adenocarcinoma (MDA) the, so called Adenoma-malignum and its mimickers have been the subject of great interest in the literature. Although a rare entity, MDA commonly requires consultancy to distinguish it from many benign cervical glandular lesions.
MDA is a unique neoplasm of the uterine cervix, characterized by mucinous glands with deceptively benign histological appearance posing difficulty in its diagnosis.
In the present case report MDA was an incidental finding in a 45 year old female, on the hysterectomy specimen submitted for multiple leiomyomas, and the diagnosis was based on histopathological and immunohistochemical (IHC) findings.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/125
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/127
2015-07-28T19:59:53Z
apalm:CR
"150712 2015 eng "
2349-6983
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Soft Tissue Chondromas: A case series of 6 cases with review
kaushik, Ankit
VMMC and Safdarjung Hospital, GGSIPU https://in-mg61.mail.yahoo.com/neo/launch?.rand=ejohb35rqg472#4622231937
Malik, Amita
Rajni, .
Batra, Sumit
Sharma, V K
Khanna, Geetika
Soft tissue chondroma is extraskeletal benign cartilagenous soft tissue tumor rare to their skeletal counterpart enchondromas. They manifest characteristic radiological and histological features with consistent cytological features. Although several histologic studies of soft tissue chondromas have been published, correlative studies of cytologic, radiologic and corresponding histologic features are limited. To better define the triad of cytological, radiological and histological features of various Soft tissue chondroma, we reviewed the radiological and corresponding cytohistologic material of six tumors. The radiological finding consists of a well defined soft tissue mass, partly calcified not attached to underlying bone. Classical cytological patterns were found to be small clusters of benign appearing chondrocytes along with chondromyxoid fragment, with a impression of soft tissue chondroma. Post operatively all six cases show characteristic histologic features consisting of adult type hyaline cartilage with mild atypia in chondocytes in one and inflammation in other tumor. The cyto-histologic features along with radiologic feature constitute definitive triad in diagnosing soft tissue chondromas.
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm127
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/128
2017-02-17T18:20:33Z
apalm:CR
"150203 2015 eng "
2349-6983
2394-6466
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Retroperitoneal extraskeletal osteosarcoma with cystic change arising from heterotopic ossification: a rare entity
Agarwal, Kiran
Professor, Department of Pathology, Lady Hardinge Medical College and Smt S.K. Hospital, Shaheed Bhagat Singh Marg, New Delhi 110001, India
Agarwal, Savita
Department of Pathology, Lady Hardinge Medical College and Smt S.K. Hospital, Shaheed Bhagat Singh Marg, New Delhi 110001, India
Kumar, Lokesh
Assistatnt Professor
Department of Radiodiagnosis
FH Medial College
NH-2, Near Etmadpur Railway ovrbridge, Tundla, Firozabad, Uttar Pradesh
Extraskeletal osteosarcoma arising from myositis ossificans or heterotopic benign ossification is an extremely rare entity. Heterotopic ossification under rare circumstances may undergo malignant transformation and give rise to extraskeletal osteosarcoma however diagnosis of such transformation requires the presence of a remnant of the benign precursor lesion. Most of the cases reported as secondary extraskeletal osteosarcoma did not contain residual tissue of the previous benign condition and its presence was suggested solely on the basis of clinical course without any histopathological or radiological evidences. We describe a case of secondary extraskeletal osteosarcoma of retroperitoneum showing morphologic evidence of heterotopic benign ossification with extensive cystic change in an eighty- five year old female.
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2015-01-30 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/139
2017-02-17T18:20:33Z
apalm:OA
"150130 2015 eng "
2349-6983
2394-6466
dc
The study of platelet indices in acute coronary syndromes
Manchanda, Jaya
SHRI B.M.PATIL MEDICAL COLLEGE,BIJAPUR
Potekar, R M
Badiger, Sharan
Tiwari, Abhishek
Background: Platelets have been implicated in the pathogenesis of cardiovascular disorders including atherosclerosis and its complications such as acute myocardial infarction (MI), unstable angina and sudden cardiac death. Platelet indices correlates with functional status of platelets and is an emerging risk marker for atherothrombosis
Methods: A prospective hospital based study was carried out on 175 cases diagnosed with Acute Coronary Syndromes and 175 controls from October 2011 to March 2013 considering the inclusion and exclusion criteria.
Results: The incidence of ACS in males (62.86%) was more as compared to females (37.14%).The average age with which the patient presented with ACS was 57.76 ± 13.19 years. The commonest manifestation of ACS was ST elevation MI. Analysis of PVI indicated MPV & PDW as significant risk factor for developing a myocardial infarction. This was in concordance with the elevated cardiac enzymes levels.
Conclusion: The study concludes that Platelet Indices especially MPV & PDW is raised in patients who have suffered STEMI & NSTEMI as compared with patients diagnosed with unstable angina.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/140
2017-02-17T18:20:33Z
apalm:OA
"150128 2015 eng "
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Bacterial meningitis in north India: trends in antimicrobial resistance
Khan, Fatima
Assistant Professor
Department of Microbiology
JNMCH, AMU,
Aligarh
Rizvi, Meher
Sultan, Asfia
Shukla, Indu
Malik, Abida
Background: The mortality rate in ABM remains significant and has been reported in the range of 8-40%. It is important to know the regional bacterial etiology in semitropical countries like India along with their sensitivity profile to allow optimum management of such patients. This study was undertaken to evaluate the trends in etiology of bacterial meningitis and the antimicrobial resistance pattern of the pathogens prevalent in North India over a period of 8 years.
Material and Methods: The study was performed from June 2001 to June 2009. CSF samples were collected from all patients suspected of meningitis and cultured on chocolate agar, blood agar and MacConkey agar. Antimicrobial susceptibility testing was done using Kirby Bauer disc diffusion method. Detection of MRSA, HLAR, ESBL, AmpC and MBL was also done.
Results: 401 samples were positive on culture. S. aureus was the most common pathogen isolated. Among the gram positive cocci as well as the gram negative bacilli a gradual decline in the antimicrobial susceptibility was seen. The aminoglycosides were found to be most effective group of antimicrobial. Towards the end of the study an alarming rise of methicillin resistance in S. aureus to 69.4%, HLAR among the Enterococci to 60% was noticed and among the Enterobacteriaceae ESBL and AmpC production was found to be 16.67% and 42% respectively.
Conclusion: The high prevalence of drug resistant pathogens should be dealt with by rational use of antimicrobials. Frequent revision in drug policy may be necessitated for optimum management of patients.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/140
Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/141
2017-02-17T18:20:33Z
apalm:CR
"150203 2015 eng "
2349-6983
2394-6466
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Giant lipoleiomyoma of uterus mimicking ovarian dermoid cyst: a rare case report
Jain, Akanksha
SHRIBALAJI ACTION MEDICAL INSTITUTE
Sinha, Navin Kumar
SHRIBALAJI ACTION MEDICAL INSTITUTE paschim vihar new delhi
Khandelia, Binet
Deen Dayal Upadhyaya hospital New Delhi
Lipomatous tumors of uterine origin are unusual benign neoplasms. The histological spectrum includes lipoleiomyoma, fibrolipomyoma,angiomyolipoma, pure lipomas and leiomyoliposarcoma depending open various compositions of mesodermal tissue. The tumor consists of long intersecting bundles of bland, smooth muscle cells admixed with nests of mature fat cells and fibrous tissue.They are typically found in postmenopausal women and are associated with ordinary leiomyomas. However, giant lipoleiomyomas more than 20 cm are rare and cause diagnostic dilemma on imaging studies as they need to be differentiated with ovarian dermoid cyst. We report this unusual case of uterine lipoleiomyoma because of its rarity and giant size.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/143
2017-02-17T18:20:33Z
apalm:OA
"150129 2015 eng "
2349-6983
2394-6466
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Prevalence of Non-albicans candida and its drug susceptibility pattern isolated from a tertiary care hospital, Karnataka
R, Shyamala
Assistant Professor
Department of Microbiology
Kannur Medical College
Parandekar, Prashanth K
Background: Candida infections have increased over the past few decades. Candida species are opportunistic yeast infections which are also common commensal of human gastro-intestinal tract. It causes spectrum of diseases extending from Mucocutaneous infections to systemic infection with dissemination. The increased incidence of life threatening infections in immunocompromised hosts and the emergence of non albicans candida (NAC) have made the treatment options difficult. Over to it, rampant use of azoles as prophylaxis has led to the emergence of azole resistant strains which are of great concern for clinical and therapeutic aspects. The present study was taken up with the aim to isolate and identify the candida species from clinical samples using a chromogenic media and to derive anti-fungal susceptibility pattern.
Methods: Total 484 samples was processed using Hichrome agar media and idenfied using standard identification methods up to species level. Antifungal susceptibility tests were performed according to CLSI guidelines for Fluconazole, Voriconazole, Ketoconazole and Itraconazole.
Results: Total 484 clinical specimens was collected from all the department. Out of which 176 candida species was isolated. Predominant isolate was C. tropicalis followed by C. guilliermondi and C. parapsilosis. Hichrome agar showed good sensitivity and specificity. Voriconazole (77.5%) showed good sensitivity over Fluconazole (41.4%) sensitivity.
Conclusion: present study highlights there is need to identify NAC and give sensitivity pattern.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/144
2016-06-17T06:16:04Z
apalm:OA
"150510 2015 eng "
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Determination of frequency of thalassaemia trait in a rural tertiary care hospital of India by using various red cell indices as screening tool.
Pethe, Neeraja
Munemane, Anil
Rural Medical College
Dongre, Suryakant
Background:Thalassemias are among the most common genetic disorders in humans. The blood picture of thalassaemia trait and iron deficiency anaemia is that of microcytic hypochromic anaemia and hence it is of utmost importance to differentiate between these two conditions. The patients with beta thalassemia trait who are treated under the mistaken diagnosis of iron deficiency may develop siderosis leading to cardiac arrhythmias, congestive heart failure and ultimately death. Thalassemia trait being common in this particular area, the present study was conducted in a rural tertiary care hospital of Western Maharashtra, India with an aim to determine the frequency of thalssemia trait and to differentiate thalassemia trait from iron deficiency anaemia. Methods: Blood sample of the patients was collected in K3 EDTA tubes and the various parameters were checked by an automated cell counter. By using these parameters, values of the 4 indices were calculated. These included the England and Fraser’s index, the Mentzer’s index, Red cell distribution width and RBC count. Results: During the study period out of 3362 patients who underwent haematological investigations, 14.87% had microcytic hypochromic anaemia. Depending on the positivity of the indices, probable numbers of cases of thalassaemia trait were calculated.6.2 % cases are most probably of thalassaemia trait by using all the four indices. Conclusion: Red cell distribution width, RBC count, England and Fraser’s index, and Mentzer index can be used as initial discrimination between the iron deficiency anaemia from thalassemia trait. For confirmation of thalassemia trait HbA2 estimation is essential.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/144
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/147
2014-10-07T16:42:02Z
apalm:Image
"140928 2014 eng "
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Incidentally detected renal mass: what is your diagnosis?
Ramaswamy, A S
P E S INSTITUTE OF MEDICAL SCIENCES AND RESEARCH, KUPPAM. N T R UNIVERSITY OF HEALTH SCIENCES
Mahalingashetti, Prashant B
Srinivas, Venugopal S
See Full Text
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Annals of Pathology and Laboratory Medicine; Vol 1 No 2 (2014): Oct-Dec
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/151
2016-06-17T06:16:04Z
apalm:OA
"150429 2015 eng "
2349-6983
2394-6466
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Virulence factors attributed to pathogenicity of non albicans Candida species isolated from Human Immunodeficiency virus infected patients with oropharyngeal candidiasis.
Deorukhkar, Sachin Chandrakant
Rural Medical college
Saini, Santosh
Rural Medical College
Background: Oropharyngeal candidiasis (OPC) is the most common opportunistic mycoses among HIV infected patients. Although Candida albicans is the most common aetiological agent of OPC, in recent years non albicans Candida (NAC) species have become increasingly prominent pathogens. As compared to C. albicans, NAC spp. often demonstrates low susceptibility to commonly used antifungal drugs.
Aim: The present study was conducted with an aim to determine the expression of virulence factors of NAC spp. isolated from HIV infected patients with OPC.
Methods: A total of 123 NAC spp. isolated from HIV infected patients with OPC were included in the study. The virulence factors studied were adherence to buccal epithelial cell, exoenzymatic activity and haemolytic activities.
Results: C. glabrata and C. tropicalis were predominant isolates from NAC spp. ABEC was more in C. dubliniensis isolates. As compared to other NAC spp. C. glabrata demonstrated low ABEC. High phospholipase activity was noted in C. tropicalis followed by C. kefyr. Proteinase activity was high in C. dubliniensis followed by C. tropicalis. Haemolysin production was high in C. tropicalis followed by C. kefyr isolates.
Conclusion: NAC spp. once overlooked as mere contaminants or non pathogenic commensals have emerged as potent pathogens. These isolates are capable of producing virulence factors once attributed only to C. albicans. Knowledge of these virulence factors is important for understanding the pathogenesis of candidiasis and will help to explore new antimycotic drug targets for improved therapeutic regimens.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/151
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/152
2016-06-17T06:16:04Z
apalm:CR
"150510 2015 eng "
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Metaplastic Tumour of the Breast: A case presentation
Dewan, Khushboo
Lady Hardinge Medical College, Delhi
Agarwal, Kiran
Lady Hardinge Medical College, Delhi
Pathania, Om Prakash
Lady Hardinge medical College
Sehgal, Shivali
Senior Resident
Department of Pathology
Lady Hardinge medical College
Metaplastic carcinoma (MPC) is a rare breast neoplasm with an incidence of 0-2.5%.Metaplastic spindle cell carcinoma should always be considered in the differential diagnosis of atypical spindle cell proliferations of the breast. We describe the diagnostic challenge posed by a MPC (Spindle cell type) in differentiating it from a Phyllodes tumour (PT) with epithelial hyperplasia on a trucut biopsy. Conventionally, CK and Vimentin co-expression by spindle cells is taken as an evidence for a diagnosis of MPC, but recently, heterogenous CK expression by spindle cells in MPC has been described. Therefore, in such a setting it is not advisable to make a definitive diagnosis of either MPC or PT on a trucut biopsy. However, a few histological and immunohistochemical considerations may help us in deciding the diagnosis. Histologically, blending of squamous cells with spindle cells, presence of extensive lymphocytic infiltrate, keloid-like stromal areas and presence of DCIS, favour the diagnosis of MPC over PT. Absence of CK, EGFR, p63 expression and positive CD34 and bcl-2 expression by spindle stromal cells favours PT over MPC.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/153
2016-06-17T06:16:05Z
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"150510 2015 eng "
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Gelatinous transformation of bone marrow: a rare cause of pancytopenia
Dikondwar, Aparna Raghunathrao
Government medical college,nagpur
Gupta, Anupama Pravin
government medical college, nagpur
Kawthalkar, S M
Kumbhalkar, D T
Raut, W K
Gelatinous marrow transformation (GMT) also known as serous atrophy is a very rare entity characterized by fat cell atrophy, accumulation of extracellular gelatinous material in the bone marrow and adjacent marrow hypoplasia. This morphologically defined condition is non specific and can be seen in many hematological and non hematological conditions. Hence, appropriate identification and management of underlying etiology is important. Mostly seen in adult patients and very few cases are reported in pediatric age group.
We describe two cases of pediatric age group who presented with pancytopenia. First was a case of protein energy malnutrition and underlying chronic liver disease. Second was a case of disseminated tuberculosis. On bone marrow aspiration both showed fat cell atrophy, marrow hypoplasia and accumulation of extracellular eosinophilic material which was PAS positive suggestive of gelatinous transformation of bone marrow. Our case report adds to the existing literature on gelatinous marrow transformation diagnosed on bone marrow aspiration study. It also suggests that this condition should be looked for as a cause of pancytopenia.
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2015-05-11 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/155
2014-10-07T16:35:33Z
apalm:CR
"140928 2014 eng "
2349-6983
2394-6466
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Cervical lipoleiomyoma in premenopausal woman: a rare case report
Agrawal, Dipti
Fotedar, Sunita
Daral, Rekha
Kumar, Kalpna
Lipoleiomyoma is a rare benign tumor and predominantly located in the uterus with an estimated incidence of 0.03% to 0.2%. Lipoleiomyoma usually occur in uterine corpus, predominantly intramurally, less commonly subserosal and submucosal. Clinical manifestations of lipoleiomyoma are identical to those of uterine leiomyoma. Histologically lipoleiomyomas consist of spindle-shaped smooth-muscle cells in a whorled pattern admixed with varying amounts of mature adipose tissue.
We report here a rare case of cervical lipoleiomyoma which was misdiagnosed as cervical polyp in a 38 year-old woman who had continuous per vaginal bleeding for three and half months.
Pacific Group of e-Journals (PaGe)
2014-09-28 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 1 No 2 (2014): Oct-Dec
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/157
2014-10-07T16:27:17Z
apalm:OA
"140928 2014 eng "
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Serum Cystatin C compared with conventional renal function tests: A study in patients with pre-eclampsia
Sharma, Shalvi
Hindu Rao Hospital
Ranjan, Rajiv Kumar
Hindu Rao Hospital
Gupta, Mamta
Hindu Rao Hospital
Singh, Anjana
Hindu Rao Hospital
Gupta, Ruchika
All India Institute of Medical Sciences
Pant, Leela
Hindu Rao Hospital
Singh, Sompal
Hindu Rao Hospital
Objective: The aim of this study was to evaluate the value of serum cystatin C in assessment of renal function and compare with conventional renal function tests.
Methods: For this study, 30 females with pre-eclampsia (cases) and 30 healthy pregnant females (controls) were included from antenatal clinics. Venous blood samples were collected for estimation of cystatin C, creatinine, urea, uric acid, lipid profile, protein, albumin, blood sugar and glycosylated hemoglobin. Spot urine samples were taken for measurement of microalbumin and creatinine. Appropriate statistical tests were applied for significance of difference.
Results: Serum levels of cystatin C and uric acid were significantly higher in cases (P value <0.001 and 0.002, respectively) compared to controls. Urinary microalbumin-creatinine ratio also showed highly significant difference between cases and controls. However, renal function markers like urea and creatinine did not show any difference between the healthy pregnant females and pre-eclamptic patients.
Conclusion: Serum cystatin C appears to be a superior marker of renal function compared to creatinine in patients with pre-eclampsia and showed be routinely included in the investigative work-up of these patients.
Pacific Group of e-Journals (PaGe)
2014-09-28 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 1 No 2 (2014): Oct-Dec
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/158
2017-02-17T18:20:33Z
apalm:CR
"150131 2015 eng "
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Splenogonadal fusion: a rare case report
Falah, Kani Muhammed
Slemani University
Hama, Mahdi A
Yasseen, Hadeel A
Abdullah, Ari M
Abdulla, Goran F
Splenogonadal fusion is a rare malformation consisting of an abnormal connection between the spleen and the gonad. Splenogonadal fusion has been classified into two types: continuous and discontinuous. The majority of the cases present as scrotal mass, scrotal tenderness or as clinical suspicion of testicular pathology, some cases are found incidentally during herniotomy or orchidopexy procedure, this report tries to highlight a case of discontinuous splenogonadal fusion found incidentally during orchidectomy in a 13- months-old male with tetra Amelia.
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2015-01-30 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/159
2014-10-07T16:24:10Z
apalm:RA
"140928 2014 eng "
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Screening and diagnostic modalities in carcinoma cervix: A Pathologist's perspective.
Mohan, Harsh
Professor and Head, Department of Pathology,
Government Medical College and Hospital, Chandigarh
Kundu, Reetu
Carcinoma cervix is the second most common cancer among women worldwide with majority of cases in the developing nations. It develops over a considerable period of time through precursor lesions that are amenable to detection when properly screened. A sea change has occurred in the detection and further the management of cervical cancer with the advances in the field of diagnostics. The orchestra ranges from the conventional Papanicolaou (Pap) test to high throughout expression profiling. The discovery of human papilloma virus (HPV) as the etiologic agent with recognition of various high risk types prompted the development of techniques for HPV detection. Several biomarkers have been recognized although many of them still require validation before they can be put to use at a large scale. Efforts directed at early detection of carcinoma cervix are desired for reducing incidence rates for carcinoma cervix. This review highlights the screening guidelines and the entire available armamentarium which can be applied to screen and diagnose cervical cancer at an early stage. However it can be foreseen that the etiology based testing is unlikely to replace cytology as a screening modality although it will remain a useful adjunct. This is especially true for the developing countries which are resource poor where cost-effective Pap test continues to be main method.
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2014-09-28 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 1 No 2 (2014): Oct-Dec
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/161
2017-02-17T18:20:33Z
apalm:OA
"150130 2015 eng "
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Impact of subclinical hypothyroidism on iron status and hematological parameters
Chandel, Rittu Surjit
Grant Government Medical College, Mumbai, MAharashtra, India
Chatterjee, Gangadhar
Abichandani, Leela
Background: Thyroid hormones play an important physiological role to maintain balance of metabolism of entire human body. Erythrocyte abnormalities are frequently associated with thyroid disorder. Subclinical hypothyroidism, often a hidden condition, is associated with iron-deficiency anemia along with other disorders. Thyroid hormones have a crucial role in metabolism and proliferation of blood cells. Thyroid dysfunction induces different effects on blood cells such as anemia, alters RBC indices including MCV and MCHC. In this study it was attempted to evaluate effect of subclinical hypothyroidism on hematological parameters and body iron store
Methods: This retrospective study included 158 subjects, among which 118 were newly diagnosed, untreated subclinical hypothyroid [n=118], and 40 healthy euthyroid [n=40] individuals. The hematological parameters and thyroid profile of the subjects were assessed by the mean, standard deviation [SD]. Student’s t-test was used to report our results, with p-value < 0.05 considered as statistically significant.
Results: In this study we have compared hemoglobin level, red cell indices, serum Ferritin among study group and euthyroid healthy group and found that mean hemoglobin, serum ferritin and RBC indices were significantly depleted in subclinical hypothyroid patient in comparison to euthyroid group. 21 of total 118 [17.8%] newly diagnosed subclinical hypothyroid patients was suffering from Iron deficiency anemia with hemoglobin level less than 10 g%.
Conclusion: Subclinical hypothyroidism is often associated with anemia, depleted body iron store and complication of getting converted into primary hypothyroidism. As there is no significant clinical manifestation of SCH at earlier stages with anemia it is advisable to routinely investigate it for early detection allowing its early management.
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2015-01-30 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/165
2014-10-07T16:22:49Z
apalm:Ed
"141003 2014 eng "
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From Editor’s Desk
Goyal, Prashant
See full text
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Annals of Pathology and Laboratory Medicine; Vol 1 No 2 (2014): Oct-Dec
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/175
2016-06-17T06:16:04Z
apalm:OA
"150510 2015 eng "
2349-6983
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Mast Cell Association In Hemangiomas and Arteriovenous Vascular Malformations.
Pawane, Pravin
Background: Vascular anomalies, classified as hemangiomas and arteriovenous malformations (AVMs), were analyzed for the presence of mast cells. Hemangiomas in the proliferative phase contained large numbers of mast cells (53.12 ± 27.83 cells/mm2) in comparison with hemangiomas in the involuting phase (11.43 ± 7.9 cells/mm2), and AVM (25.31 ± 27.3 cells/mm2). Considering the fact that hemangiomas are characterized by endothelial proliferation and increased numbers of mast cells, these data raise the possibility that mast cells may have an important role in the formation and/or maintenance of these lesions.
Aim: This study aimed at evaluation of presence of mast cells in hemangiomas proliferating, involuting ones and AVMs.
Methods: A total of 120 cases of benign vascular lesions were retrieved from 12 years period. A total of 94 cases, where complete clinical details and representative paraffin sections were available, were included in this study. Hematoxylin and eosin (H and E) stain and Mast cell density in all lesions was calculated from toluidine blue stained sections.
Results: Mean mast cell density was significantly higher in proliferating hemangiomas (53.12 ± 27.83 cells/mm2) compared to involuting hemangiomas (11.43 ± 7.9 cells/mm2) and AVM (25.31 ± 27.3 cells/mm2)
Conclusions: The significantly higher mast cell density seen in proliferating hemangiomas compared with involuting ones, seem to suggest that mast cells play an important role in the natural history of these lesions.
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2015-05-11 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/176
2016-06-17T06:16:04Z
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"150505 2015 eng "
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Extranodal marginal zone lymphoma of mucosa associated lymphoid tissue arising in the pleura
Malek, Anita
Boston Medical Center
Lee, John Cho
Boston Medical Center
A 77-year-old Haitian woman complained of two months history of cough and left upper quadrant abdominal pain. She had a remote history of tuberculosis that was treated back in Haiti many years ago. Imaging studies showed a left pleural effusion with posterior pleural thickening as well as lymphadenopathy in the left hilum and left supraclavicular area. The Pleural biopsy was consistent with extranodal marginal zone lymphoma of mucosa associated lymphoid tissue (EMZL/MALT). The supraclavicular lymph node also showed partial involvement by EMZL/MALT but was largely effaced by non-necrotizing granulomatous inflammation. Culture from this lymph node grew Mycobacterium tuberculosis complex. Primary pleural lymphoma is a rare entity and to the best of our knowledge only ten cases of pleural EMZL/MALT have been reported.We report a new case and a review of literature.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
application/pdf
https://www.pacificejournals.com/journal/index.php/apalm/article/view/176
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/177
2016-06-17T06:16:05Z
apalm:CR
"150510 2015 eng "
2349-6983
2394-6466
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Focal hematopoietic hyperplasia of rib, mimicking to fibrous dysplasia
Afrose, Ruquiya
senior resident, Department of Pathology
JN medical college
Aligarh Mslim University Aligarh
Akram, Mohammad
JN medical college
Aligarh Mslim University Aligarh
Alam, Mohammad Feroz
Aligarh Mslim University Aligarh
Khalid, Saifullah
Aligarh Mslim University Aligarh
Naim, Mohammed
Aligarh Mslim University Aligarh
Focal haematopoietic hyperplasia is a rare and localized proliferation of the bone marrow to such an extent that it produces a tumor-like expansion hence called as pseudotumor. Radiologically it presents as an osteolytic expansile mass and may mimics with certain bony tumors. We report a case of Focal haematopoeitic hyperplasia in the 3rd anterior rib of a 45 year old man clinically presenting as a bone tumor and radiologically mimicking to fibrous dysplasia.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/177
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/181
2015-07-28T19:59:53Z
apalm:CR
"150712 2015 eng "
2349-6983
2394-6466
dc
Splenic lymphoma with villous lymphocytes; a case report with review of literature
Afrose, Ruquiya
senior resident, Department of Pathology
JN medical college
Aligarh Muslim University Aligarh
Akram, Mohammad
Aligarh Muslim University Aligarh
Khan, Nirupama Panikar
Delhi University
Rusia, Usha
Delhi University
Splenic lymphoma with villous lymphocytes (SLVL) is a rare low-grade B cell non-hodgkin's lymphoma with distinct clinical and morphologic features.
We report a case in a 55 year old man with the diagnosis of Chronic lymphocytic leukemia. On examination patient had no peripheral lymphadenopathy, but had splenomegaly of 2cm below costal margin. Laboratory investigations revealed WBC count 27.9x109/l with an absolute lymphocyte count of 22.3x109/l. Peripheral smear examination showed 80% lymphoid cells, 36% of which showed villous morphology, R-O nucleus, opened up chromatin and no nucleolus. Bone marrow aspirate and biopsy also showed involvement by these villous lymphocytes. These cells were negative for all cytochemical stains including tartrate-resistant acid phosphatase. On flow cytometric immuno-phenotyping these lymphoid cells were highly positive for CD19, CD20, FMC-7, moderately positive for CD10 and negative for CD5, CD23, CD25, CD103 and surface immunoglobulins (SIg) . Based on these findings a diagnosis of SLVL was suggested
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/182
2016-06-17T06:16:04Z
apalm:OA
"150429 2015 eng "
2349-6983
2394-6466
dc
Toluidine blue stain and crystal violet stain versus H&E stain in the Diagnosis of Hirschsprung’s Disease: A Study in Sulaimani City in Kurdistan/Iraq
Yasseen, Hadeel Adnan
Sulaimani University
Background Hirschsprung’s Disease (HD) is a congenital disorder of the colon in which certain nerve cells, known as ganglion cells are absent.
Setting and Design: To demonstrate the efficacy of Cresyl Violet and Toluidine blue (Tb) special stains in the identification of ganglion cells in suspected Hirschsprung’s disease and to find other adjuvant histological criteria for the diagnosis.
Method: In Sulaimani Teaching Hospital and Pediatric teaching hospital in Sulaimani Governorate/ Kurdistan-Iraq a total of fifty non selected cases biopsied for suspected HD were stained with hematoxylin and eosin (H&E) stain and divided into two groups: HD and-non-HD. All cases then should be stained with Tb special stain to identify ganglion cells and to count mast cells in the submucosa. Cases were stained with Cresyl Violet special stain to identify ganglion cells. H&E- and Tb-stained sections were examined for the presence or absence of hypertrophic nerve fibers in the submucosa.
Results: Both Cresyl violet and Tb stains were superior to H&E in the identification of ganglion cells with no statistically significant difference between the two stains. Mast cell count in the submucosa has no important effect on diagnosis while nerve bundle hypertrophy was found to be associated with absence of ganglion cells in Hirschsprung disease.
Conclusions: Toluidine blue and/or Cresyl violet stains should to be used as the routine stain to highlight ganglion cells in suspected Hirschsprung’s disease cases. Submucosal nerve bundle hypertrophy has to be assessed as an adjuvant histolological criterion.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/182
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/183
2016-06-17T06:16:04Z
apalm:OA
"150429 2015 eng "
2349-6983
2394-6466
dc
Thrombocytopenia and Malaria: A coincidental co-existence or a significant association? An Analysis.
Jairajpuri, Zeeba
Department of Pathology
HIMSR
Jamia Hamdard
New Delhi
Rana, Safia
Department Of Pathology
HIMSR, Jamia Hamdard
Jaseem, Salamah
Department Of Pathology
Jetley, Sujata
Department of Pathology
HIMSR, Jamia Hamdard
Background: Malaria is a major health problem and a cause of significant morbidity and mortality worldwide especially in the tropics. Anemia, thrombocytopenia, atypical lymphocytosis and infrequently disseminated intravascular coagulation. Leucopenia, leucocytosis, eosinophilia and monocytosis have also been reported.
Methods: The aim of the present study was to detect if an haematological index like thrombocytopenia is a significant indicator of malaria and whether its presence increases the probability of malaria in patients suspicious of suffering from this disease. Clinically suspected cases of malaria with febrile illness presenting at Hakeem Abdul Hameed Centenary, Hospital were included in the study and evaluated.
Results: Among 1248 patients with clinical suspicion of malaria, 230(18%) patients were confirmed by the demonstration of malarial parasite on peripheral blood film mostly in the months of August and September, monsoon season. A male predominance, with a male to female ratio of 2.3:1 was seen. 212 patients out of 230 had accompanying thrombocytopenia. The sensitivity and specificity of this was 92.1% and 88.2% respectively with a disease prevalence of 19%. The positive and negative predictive values were 63.8% and 98.1%with a positive likelihood ratio (LR+) of 7.82 and negative likelihood ratio(LR-) of 0.09.
Conclusions: The malaria-endemic regions of the world are mostly developing countries with limited resources and trained health personnel. The hematological aspects may be used in addition to the clinical assessment, to heighten the suspicion of this disease. Thrombocytopenia is associated with both P. falciparum and P. vivaxinfections. Significant association between malaria and thrombocytopenia has been demonstrated in our study and we suggest malaria should be a consideration in all patients with fever and low platelet counts.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/183
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/184
2017-02-17T18:20:33Z
apalm:CR
"140128 2014 eng "
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Primary pure large cell neuroendocrine carcinoma of ovary: An extremely rare entity
Bhaker, Poonam
Postgraduate Institute of Medical Education and Research, Chandigarh, 160012
INDIA
Dey, Pranab
PGIMER, Chandigarh
Srinivasan, Radhika
PGIMER, Chandigarh
Saha, Subhash Chandra
PGIMER, Chandigarh
Primary large cell neuroendocrine carcinoma of ovary is an uncommon neoplasm with an aggressive biological behaviour. These carcinomas usually occur in association with epithelial-sex cord tumours; pure form being a rarity which can pose a diagnostic difficulty. A 42 year old female presented with a large abdominal mass and pain. Computed tomography revealed a heterogeneously enhancing solid left ovarian mass. Differential diagnoses on histopathology included large cell neuroendocrine carcinoma, carcinoid tumour, hepatoid carcinoma and malignant steroid cell tumour, not otherwise specified (NOS). Positive neuroendocrine markers including CD56, chromogranin, and NSE facilitated a correct diagnosis of large cell neuroendocrine carcinoma. Primary ovarian large cell neuroendocrine carcinomas are under-recognized aggressive tumours and must be considered as a differential in undifferentiated ovarian tumours. Histologic features and a panel of immunohistochemical stains should lead to the correct diagnosis.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/184
Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/185
2016-06-17T06:16:05Z
apalm:CR
"150510 2015 eng "
2349-6983
2394-6466
dc
HIV seropositivity and Neoplasms with plasma cell morphology: Plasmablastic lymphoma and Plasma cell myeloma : Is it a chance association or an increasing occurrence?
Gupta, Anupama Praveen
Government Medical College, Nagpur, India
Kumbhalkar, Dinkar T
Government Medical College, Nagpur
Parate, Sanjay Nanaji
Government Medical College, Nagpur
Kawthalkar, Shirish M
Government Medical College, Nagpur
Nayak, Suprita
Government Medical College, Nagpur
Kodate, Purnima M
Government Medical College, Nagpur
Shende, Nitin
Government Medical College, Nagpur
Hake, Ganesh
Government Medical College, Nagpur
Plasma cell tumors have shown an increased incidence in Human Immuno Deficiency Virus (HIV) positive patients. Plasma cell tumors in these patients occur in a younger age group than that in the general population, present at unusual sites and progress rapidly to involve multiple sites, including the soft tissues and viscera. Pathologically, many of these tumors show plasmablastic morphology. We present here six interesting cases of plasma cell tumor in HIV seropositive patients diagnosed on fine needle aspiration cytology (FNAC) and confirmed on histopathology and immunohistochemistry. These lesions presented at unusual locations like subcutaneous, oral and nasal. They presented at younger age, had aggressive behavior and unusual cytomorphology.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/185
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/189
2017-02-17T18:20:33Z
apalm:Let
"150203 2015 eng "
2349-6983
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Ganglion cyst of the leg: A rare site
Sehgal, Shivali
Lady Hardinge Medical College
Shukla, Shailaja
Lady Hardinge Medical College
Rai, Preeti
Lady Hardinge Medical College
SEE FULL TEXT
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/189
Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/191
2015-07-28T19:59:53Z
apalm:Let
"150712 2015 eng "
2349-6983
2394-6466
dc
Cytopathology of intramuscular myxoma.
Agarwal, Shilpi
Lady Hardinge Medical College
Sehgal, Shivali
Lady Hardinge Medical College
Rai, Preeti
Lady Hardinge Medical College
Thomas, Priya
Lady Hardinge Medical College
SEE FULL TEXT
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
application/pdf
application/vnd.openxmlformats-officedocument.wordprocessingml.document
https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm191
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/192
2016-06-17T06:16:05Z
apalm:CR
"150510 2015 eng "
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dc
Extra medullary myeloid cell tumor: A Case Report
Vemula, Sreenivas
professor'
department of pathology,
CAIMS
Kasturi, Sumalatha
assistant professor, department of pathology, Chalmeda Anand rao Institute of Medical Sciences.
Maddi, Rahul Narayana
Margam, Vijay Mohan
Rendla, Santhosh Babu
Extra medullary myeloid cell tumors or granulocytic sarcomas or chloromas represents a localised tumor of myeloblasts or monoblasts infiltrating extramedullary sites. The term is used for any solid collection of leukemic cells in the extra haematopoietic sites. There have been reports of these tumors occurring concomitantly with, after, or rarely prior to the onset of leukemia. We present a case of a child presented with swelling in the right parotid region, which was diagnosed as chloroma on fine needle aspiration cytology. Further confirmation was done on peripheral blood and bone marrow evaluation.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/192
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/194
2016-06-17T06:16:05Z
apalm:CR
"150510 2015 eng "
2349-6983
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dc
Krukenberg tumor arising from bilateral lobular carcinoma, in a pregnant lady: a rare case report
Santosh, T
KIMS & RF
Rao, Epari Sanjeeva
KIMS & RF
Rao, B R Mohan
KIMS & RF
Metastatic ovarian tumors are thought to account for approximately 10–30% of malignant ovarian tumors. Krukenberg tumor refers to a malignancy in the ovary that metastasized from a primary site, classically the gastrointestinal tract, although it can arise in other tissues such as the breast (approx. 04%). Krukenberg tumor during pregnancy arising from breast is even rarer (0.1 - 0.2%). The presence of adnexal masses during pregnancy ranges from 1:81 to 1:2,500 pregnancies, but only 3% of these masses are malignant. Management of such cases can present as diagnostic & treatment dilemma. We report a case of 25 year primiparous female with Krukenberg tumor of breast origin.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/194
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/196
2016-06-17T06:16:05Z
apalm:CR
"150510 2015 eng "
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Medullomyoblastoma: a case report and literature review of a rare tumor entity
Chaudhari, Chetan
Assistant Professor,Dept of Pathology LTMMC & LTMGH,Sion,Mumbai
Gadgil, Nitin
Khare, Manisha
Margam, Sangeeta
Medulloblastomas are the most common malignant Central nervous system neoplasms of childhood. However cerebellar midline primitive neuroectodermal tumors containing muscle elements are exceeding rare hence awareness and knowledge of this entity is necessary to make correct diagnosis.
We report a case of Medullomyoblastoma that presented as a cerebellar mass of brief duration. Four and half year old child presented with vomiting and headache with convulsions. She underwent total resection of the tumor. The resected specimen showed a tumor composed predominantly of elongated cells with eosinophilic cytoplasm, some showing discernible cross striations (indicating myoblastic differentiation) and focally of round cells with scant cytoplasm (indicating neuroectodermal differentiation). Based on these findings, the differential diagnosis thought of were Medullomyoblastoma, Atypical teratoid rhabdoid tumor, and Metastatic rhabdomyosarcoma. Immunohistochemistry staining revealed positive expression of desmin and myogenin in the elongated eosinophilic cells while the round cells were negative for the same. The round cells were weakly positive for synaptophysin and retained INI-1 protein expression.
The travail faced during the diagnosis cued us to report this case. A thorough history physical examination, imaging findings, histopathology and immunohistochemical markers are crucial to arrive at accurate diagnosis in such difficult cases.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/196
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/197
2015-07-28T19:59:53Z
apalm:CR
"150712 2015 eng "
2349-6983
2394-6466
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Eccrine Angiokeratomatous Hamartoma: Report of a Case with Brief Review
Raghavan, Vijayashree
Chettinad Hospitals and Research Institute
Subbarayan, Devi
Chettinad Hospitals and Research Institute
Rao, Ramesh K
Chettinad Hospitals and Research Institute
Eccrine angiokeratomatous hamartoma is a newly recognised vascular lesion of the skin, with the first case being reported only in 2006. It has a distinctive histology with features derived from two well established vascular lesions affecting the skin: solitary angiokeratoma and eccrine angiomatous hamartoma.
A 26 year old woman presented with a long standing painless warty lesion on her right ankle. Histological examination of the excised lesion showed a combination of two vascular lesions: superficial angiokeratoma and a deeper eccrine angiomatous hamartoma. Such a histological picture is consistent with the diagnosis of recently described eccrine angiokeratomatous hamartoma. Our case represents only second such case to be reported. Immunohistochemical analysis with CD34, smooth muscle actin and cytokeratin was done.
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/198
2017-02-17T18:20:33Z
apalm:OA
"150128 2015 eng "
2349-6983
2394-6466
dc
Cytospin preparation from residual material in needle hub: Does it add to fine needle aspiration diagnosis?
Gupta, Shilpa
Hindu Rao Hospital
Deka, Lopamudra
Hindu Rao Hospital
Gupta, Ruchika
Chacha Nehru Bal Chikitsalaya
Gupta, Kusum
Hindu Rao Hospital
Kaur, Charanjeet
Hindu Rao Hospital
Singh, Sompal
Hindu Rao Hospital
Background: Fine needle aspiration is currently the most favored technique for pre-operative diagnosis of most palpable and certain non-palpable masses. The present study aimed at exploring the utility of cytospin preparation from residual material in the needle hub for assisting in routine cytologic diagnosis.
Methods: For this prospective study, 100 cases of fine needle aspiration from lymph node, breast, soft tissue, thyroid and salivary glands were included. After preparation of routine smears, material in needle hub was rinsed in saline and cytospin preparation was made. Routine and cytospin preparations were assessed for cytologic diagnosis and results compared.
Results: Of the 100 cases included, the cytospin preparation showed good staining in all (100%). Cellularity was adequate in 90% of the cases with satisfactory cellular preservation in 72% cases. In 16 cases (16%), the diagnostic material was present in cytospin preparation while routine smears were inadequate for opinion.
Conclusion: Cyto-centrifugation of the residual material in needle hub after fine needle aspiration improves the diagnostic yield of routine smears. Hence, this technique can be utilized to reduce the number of re-aspirations, especially at centers where the requisite equipment is already available.
Pacific Group of e-Journals (PaGe)
2015-01-30 00:00:00
application/pdf
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Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/199
2016-06-17T06:16:05Z
apalm:CR
"150510 2015 eng "
2349-6983
2394-6466
dc
A rare solid variant of primary neuroendocrine carcinoma of breast
Panjvani, Sahil I
Smt. NHL Municipal Medical College, Ahmedabad. India.
Gandhi, Minesh B
Smt. NHL Municipal Medical College, Ahmedabad. India.
Chaudhari, Bhawana R
Smt. NHL Municipal Medical College, Ahmedabad. India.
Sarvaiya, Ankur N
Smt. NHL Municipal Medical College, Ahmedabad. India.
Solid Primary Neuroendocrine Carcinoma of Breast (NECB) is an extremely rare tumor of breast. Much less is known about it because of only few reported cases. Immunohistochemical examination showing expression of chromogranin and/or synoptophysin in more than 50% of cell population confirms evidence of neuroendocrine carcinoma. Here, we describe a case of 70-years old patient with brief review of clinopathological features, treatment and prognosis of solid NECB. Microscopy Solid islands of tumor cells are separated by fibrovascular stroma. Tumor cells are round to oval, polygonal with finely granular (stippled) nuclear chromatin with eosinophilic cytoplasm and immunohistochemistry reveal strong and cytoplasmic positivity for synaptophysin in >50% tumor cell population.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/199
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/200
2016-06-17T06:16:04Z
apalm:CR
"150505 2015 eng "
2349-6983
2394-6466
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Primary ovarian malignant mixed mullerian tumors / carcinosarcomas: a clinico-pathological and immunohistochemical analysis of four cases and review of literature
Badyal, Rama K
Dey, Pranab
Professor
Post Graduate Institute of Medical Education and Research, Chandigarh
Ovarian carcinosarcomas (OCS), also known as malignant mixed mullerian tumors (MMMTs) are among the rarest and most challenging malignancies arising from the female genital tract. This tumor is estimated to account for only 1-3% of all ovarian malignancies. The influence of proportion of the malignant epithelial or sarcomatous component on the disease progression is a matter of debate. Herein, we analysed clinico-pathological and immunohistochemical features of four cases of ovarian carcinosarcomas diagnosed over a period of seven years from 2008-2014. All the patients were post-menopausal with a mean age of 59.25 years. Carcinomatous component was high grade serous in three cases and high grade endometroid in one case. CK and EMA immunostains were used to highlight carcinomatous component while vimetin immunostain highlighted sarcomatous areas. Two patients had heterlogous sarcomatous components; rhabdomyosarcomatous and chondromatous areas which were highlighted by Myogenin, desmin and S-100 respectively. Immunohistochemistry is an essential ancillary technique in highlighting biphasic nature and areas of heterologous differentiation which may have a prognostic impact. The patients were treated with optimal debulking surgery followed by adjuvant platinum/taxane or platinum/ifosfamide combinations based chemotherapy.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/201
2016-06-17T06:16:04Z
apalm:OA
"150429 2015 eng "
2349-6983
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Prevalence and correlation of atherosclerosis in internal mammary artery and coronaries: an autopsy study
Jain, Suraj
Bangalore Medical College and Research Institute, Bangalore
Biligi, Dayananda S
Bangalore Medical College and Research Institute, Bangalore
P K, Devadass
Bangalore Medical College and Research Institute, Bangalore
Background: Coronary Artery Bypass Grafting (CABG) is one of the standard surgical procedures for treatment of multivessel Coronary Artery Disease (CAD). Among the various arterial grafts, Internal Mammary Artery (IMA) has been preferred as conduit of choice to bypass the coronary occlusion. But now with the incremental utilization of IMA grafts in CABG, there is a need for reassessment of its histological structure and presence of atherosclerosis. A prospective study was taken up to assess and correlate the prevalence of atherosclerosis in IMA and coronaries on autopsy.
Methods: Representative segments of bilateral IMA and all major coronaries were taken from 150 autopsy cases conducted at Victoria hospital, Bangalore. These were processed conventionally. H&E sections of all cases were studied microscopically for presence of atherosclerosis. Morphological assessment of atherosclerotic lesions was done according to American Heart Association (AHA) classification.
Results: Study included 114 males and 36 females. Atherosclerosis in IMA was seen in 11 (7.3 %) cases and coronary atherosclerosis in 122 (81.3%) cases. Prevalence of Coronary Atherosclerosis in male cases was 85.9%, while in female cases was 66.6%. LAD was the most commonly involved among coronaries. All 11 cases with IMA atherosclerosis showed coronary atherosclerosis. Higher AHA types of atherosclerosis (type 4/5) were not seen in IMA. There was no other vascular pathology apart from atherosclerosis in IMA.
Conclusion: The Prevalence of atherosclerosis in IMA is on a higher side suggesting a need to look for and evaluate other conduit vessels as alternate to IMA in CABG.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/201
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/202
2016-06-17T06:16:04Z
apalm:CR
"150505 2015 eng "
2349-6983
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Pancreatic Schwannoma: a rare entity.
Garg, Rashi
Postgraduate Institute of Medical Education and Research, Chandigarh, INDIA
Kakkar, Nandita
Vashisht, R K
Pancreatic schwannomas are rare neoplasms. These tumors vary in size and two thirds are partially cystic which grossly mimic pancreatic cystic lesions. Computed tomography and magnetic resonance imaging are the primary imaging modalities. Definitive diagnosis is made on histopathologic examination. Surgical resection is the mainstay of treatment.
Here we report a rare case of schwannoma in the uncinate process of pancreas with preoperative diagnosis of cystic tumor of pancreas.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/202
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/203
2016-06-17T06:16:05Z
apalm:CR
"150510 2015 eng "
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Gastrointestinal lipoma presenting as colonic intussuception: report of two cases.
Medhi, Pranita
Associate professor, Department Of Pathology, Assam Medical College and Hospital,Dibrugarh,Assam
Sharma, Mahak
Demonstrator, Department Of Pathology, Assam Medical College and Hospital, Dibrugarh,Assam
Biswas, Manjusha
Consultant Pathologist, Nightingle Hospital,Kolkatta
Lipomas are benign mesenchymal tumors of adipose tissue, though common at other sites, are rare in GIT. Most gastrointestinal lipomas are located in the colon, ileum and jejunum, are rarely responsible for clinical symptoms and are usually detected incidentally at colonoscopy. We present two such cases of large colonic lipomas. One is a 38-years old female presenting with complaint of loose stool and sessile mass in transverse colon on colonoscopy, suspected to be a malignant lesion. The other is a 40 years old female presenting with acute abdomen, colonoscopy revealed a submucosal mass in descending colon. Both underwent resection of mass, and histologically were revealed to be lipomas of colon. Colonic lipomas, although unusual, continue to present difficulties in the preoperative differentiation between malignant and benign colonic neoplasm. Two cases of colonic lipomas are reported.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/205
2016-06-17T06:16:04Z
apalm:CR
"150510 2015 eng "
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Bilateral Serous adenocarcinoma of Ovary coexisting with mature cystic teratoma- Case report and review of literature
Bhagat, Priyanka
Postgraduate Institute of Medical Education and Research, Chandigarh, INDIA
Dey, Pranab
Professor
Post Graduate Institute of Medical Education and Research, Chandigarh
Collision tumors represent occurrence of two histologically distinct tumors adjacently in the same organ without any admixture. The simultaneous occurrence of a serous adenocarcinoma with a mature teratoma is very rare. In this case report, we describe a rare case of a bilateral serous adenocarcinoma of the ovary with bilateral mature teratoma and serous tubal intraepithelial carcinoma of the fallopian tube.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/207
2015-07-28T19:59:53Z
apalm:OA
"150712 2015 eng "
2349-6983
2394-6466
dc
Cytological features in the early diagnosis of papillary carcinoma of thyroid in clinically inapparent cases
Jain, Anshu
Jawaharlal Nehru Medical College, Aligarh Muslim University
Alam, Kiran
Jawaharlal Nehru Medical College, Aligarh Muslim University
Maheshwari, Veena
Jawaharlal Nehru Medical College, Aligarh Muslim University
Rabindranath, Divya
Jawaharlal Nehru Medical College, Aligarh Muslim University
Khan, Azka Anees
Jawaharlal Nehru Medical College, Aligarh Muslim University
Khan, Roobina
Jawaharlal Nehru Medical College, Aligarh Muslim University
Background: Papillary thyroid carcinoma (PTC) is the most common among the thyroid malignancies. Fine needle aspiration cytology (FNAC) is the first line investigation in the diagnosis of thyroid lesions. Here we review the significance of certain features conventionally considered to be diagnostic of papillary thyroid carcinoma on FNAC – including type of background, type of colloid, presence or absence of papillary clusters, intranuclear inclusions and nuclear grooves which were also considered for their importance in early diagnosis of PTC.
Methods: We reviewed all the thyroid FNACs performed over 18 months period and correlated them clinically and histopathologically, wherever available.
Results: Out of a total of 354 cases of thyroid FNACs, histopathological correlation was possible in 90 cases, with a concordant diagnosis in 82 cases. Analysis of the 8 discordant FNAC smears revealed papillary clusters along with nuclear features, especially nuclear grooves to be the most important finding in indicating a diagnosis of PTC.
Conclusion: Although the presence of papillary clusters along with characteristic nuclear features on FNAC is well known to indicate diagnosis of PTC, these findings can be easily missed on cytology smears, especially when the lesions are small (less than 1 cm) and diagnosis is clinically inapparent. Hence, we propose that the presence of papillary clusters in any case should alert the pathologist towards a diagnosis of PTC. A diligent search for nuclear features should follow. Thus a high index of suspicion while examining the FNAC smears in these patients will help in early detection of PTC.
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/208
2015-07-28T19:59:53Z
apalm:CR
"150712 2015 eng "
2349-6983
2394-6466
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Primary chondrosarcoma of the breast: a rare case presentation
Jain, Anshu
Jawaharlal Nehru Medical College, Aligarh Muslim University
Maheshwari, Veena
Jawaharlal Nehru Medical College, Aligarh Muslim University
Qadri, Shagufta
Jawaharlal Nehru Medical College, Aligarh Muslim University
Rabindranath, Divya
Jawaharlal Nehru Medical College, Aligarh Muslim University
Afroz, Nishat
Jawaharlal Nehru Medical College, Aligarh Muslim University
Pure sarcomas are very uncommon tumors of the breast. Only ten case reports of primary chondrosarcoma of breast have been published in literature till date. We report this rare case highlighting the cytological features which helped in a preoperative diagnosis of this tumor. A 40 year old lady presented with lump and pain in right breast. She did not have any other significant findings. Fine needle aspiration cytology yielded abundant material, comprising of benign ductal epithelium along with malignant cartilaginous component. Subsequent histopathology and immunohistochemistry confirmed the cytological diagnosis of primary chondrosarcoma of breast. Primary chondrosarcoma of breast, even though a rare entity, should be kept in the differential diagnosis of breast tumours exhibiting chondrosarcomatous areas.
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm208
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/212
2015-07-28T19:59:53Z
apalm:CR
"150714 2015 eng "
2349-6983
2394-6466
dc
Pleural effusion obscuring pulmonary echinococcosis: diagnosis by cytology
Jain, Anshu
Jawaharlal Nehru Medical College, Aligarh Muslim University
Maheshwari, Veena
Jawaharlal Nehru Medical College, Aligarh Muslim University
Rabindranath, Divya
Jawaharlal Nehru Medical College, Aligarh Muslim University
Sharma, Kashmi
Jawaharlal Nehru Medical College, Aligarh Muslim University
Echinococcosis or hydatid disease, caused by larvae of the tapeworm Echinococcus, is frequently seen in an endemic country like India. A single organ is involved in 85-90% cases, pulmonary involvement occurs in 10 - 30% of cases, being second only to the hepatic involvement. Besides anaphylactic reactions a pulmonary hydatid cyst may be complicated by rupture into neighbouring structures like bronchi and pleural cavity with or without infection. We report an unusual case of ruptured hydatid disease in pleural cavity rarely seen in adults diagnosed by fine needle aspiration cytology. A 45 year old male came to our emergency department in shock with symptoms of shortness of breath and altered mental status from the previous day. Radiograph showed massive left sided pleural effusion and therapeutic aspiration was done. Pleural fluid cytology showed few hydatid scolices. Serum echinococcal antigen was also tested to be positive. CT scan revealed pleural effusion with multiple air pockets and pleural thickening on left side, and loculated cyst with septae on right side, thereby confirming the diagnosis as active pulmonary hydatid cyst with rupture into the pleural cavity, which is not a common finding in adult population.
Hydatid cyst rupture should be considered in the differential diagnosis of cases with pleural effusion. Rupture of a pulmonary hydatid cyst into the pleural cavity is rare, but represents the most serious complication of the hydatid disease. In regions where echinococcal disease is endemic, a high level of clinical suspicion is necessary for diagnosis and appropriate management of this condition.
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm212
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/215
2015-07-28T19:59:53Z
apalm:CR
"150714 2015 eng "
2349-6983
2394-6466
dc
Cytology: a diagnostic modality in cryptococcal lymphadenitis
Srivastava, Pooja
VMMC and Safdarjung hospital New delhi
Gupta, Kusum
Arora, Rashmi
Cryptococcosis is a common, life-threatening, opportunistic, fungal disease in human immunodeficiency virus (HIV) infected individuals. A prompt diagnosis is of utmost importance because disseminated cryptococcal infection is life-threatening. Different organs can be involved, but involvement of lymph node is a rare feature. We here present a case of cryptococcal lymphadenitis diagnosed on fine needle aspiration cytology.
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm215
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/219
2015-09-02T13:25:55Z
apalm:CR
"150714 2015 eng "
2349-6983
2394-6466
dc
Hydatid Cyst in Femur: A Rare Case Report
Chaturvedi, Shweta
Santokba Durlabhji Memorial Hospital
Gupta, Shubha
Santokba Durlabhji Memorial Hospital
Faujdar, Mansi
Santokba Durlabhji Memorial Hospital
Gupta, Gajendra
Santokba Durlabhji Memorial Hospital
Patel, Jaimini
Santokba Durlabhji Memorial Hospital
Khandelwal, Vishal
JLN Medical College
Hydatid cyst is caused by the larva of Echinococcus granulosus. Its usual occurrence is in liver and lungs. Osseous hydatidosis is a rare event and is often a diagnostic challenge to the clinician. We report a case of 18 year old boy who presented with complaints of pain over left hip for past one year and subsequently whose MRI was done which suggested it the lesion to be either due to giant cell tumour or chondroblastoma. On the contrary, histopathological examination of the lesion stated it to be osseous hydatid cyst.
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm219
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/221
2016-06-17T06:16:04Z
apalm:CR
"150510 2015 eng "
2349-6983
2394-6466
dc
Chronic Disseminated Histoplasmosis in a Young Immunocompetant Patient of Hypobetalipoproteinemia: A rare Presentation
Gupta, Rakesh Kumar
G. B. Pant Institute of Post Graduate Medical Education and Research
Batra, Vineeta Vijay
G. B. Pant Institute of Post Graduate Medical Education and Research, New Delhi
Sakhuja, Puja
Dept of Pathology, G. B. Pant Institute of Post Graduate Medical Education and Research, New Delhi
Dahale, Amol
Department of Gastroenterology, G. B. Pant Institute of Post Graduate Medical Education and Research, New Delhi
Puri, Amarender Singh
Department of Gastroenterology, G. B. Pant Institute of Post Graduate Medical Education and Research, New Delhi
Disseminated histoplasmosis is commonly found in immunocompromised patients in association with acquired immunodeficiency syndrome in endemic regions but is rare in other parts of the world. We herein describe a case of subacute disseminated histoplasmosis in a young 20-year-old lady presenting with the chief complaints of pyrexia of unknown origin, loose stools and generalized body swelling with a previous diagnosis of hypobetalipoproteinemia. Supraclavicular lymph node, bone marrow aspiration and colonic biopsy revealed numerous yeast forms of fungus histoplasma. This case illustrates that DH should be ruled out in immunocompetent non-endemic patients presenting with chronic fever even in the absence of respiratory symptoms.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/221
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/222
2015-07-28T19:59:53Z
apalm:Let
"150712 2015 eng "
2349-6983
2394-6466
dc
Spindle cell lipoma: an unusual lipoma variant
Sharma, Pranshuta
Deen Dayal Upadhyaya Hospital,
Hari Nagar,
New Delhi
India
Sood, Neelam
Deen Dayal Upadhyaya Hospital,
Hari Nagar,
New Delhi
India
SEE FULL TEXT
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2015-07-28 19:59:53
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Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/223
2015-07-28T19:59:53Z
apalm:OA
"150712 2015 eng "
2349-6983
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dc
Experience of the external quality assessment scheme (EQAS) in haematology at C.U. Shah Medical College, Surendranagar.
Desai, Killol Nathubhai
Assistant Professor in Pathology Department, GMERS Medical collage, Junagadh
Vithalani, Parth H
First year PG student in C.U. Shah Medical college, Surendranagar.
Agnihotri, Ashok S
Patel, Kimmyben
Background: The attainment of quality services in a laboratory requires a comprehensive quality assurance program which includes both internal and external quality control material. External quality assessment scheme programs are accepted around the world as an invaluable tool by laboratories to assess the performance of their testing systems. Results are objectively compared to other laboratories, using the same methodologies for every parameter.
Aims: The goal of this study was to review EQAS result from time to time in an effort to improve the performance of the laboratory.
Methods: Observational study done at C.U. Shah medical college and hospital, Surendranagar from January 2007 to August 2014. In the current study, our EQAS test results have been evaluated for the past 7 years and 8 months from 2007 to 2014.One EDTA whole blood sample for blood cell counts and 2 slides for peripheral smear examination and reticulocyte count are received quarterly in a year from AIIMS. The test results of all Indices of blood samples and peripheral smears for cell morphology and reticulocyte count were analyzed and documented.
Results: Satisfactory results were obtained in all the cycles except thrice. Discrepancy was observed in RBC, MCH and platelet counts. Root cause analysis was performed and necessary action was taken.
Conclusion: This participation in EQAS over the last 7 years and 8 months has helped us significantly to improve our laboratory services in terms of performance evaluation, Patient care and overall quality of laboratory practices.
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm223
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/225
2015-07-28T19:59:53Z
apalm:CR
"150714 2015 eng "
2349-6983
2394-6466
dc
Gigantic lipoleiomyoma of cervix with extensive hyaline degeneration: A case report with review of literature
Mandal, Rupali
Mondal, Krishnendu
Pramanik, Pulakesh
Uterine lipoleiomyomas are rare benign neoplasms of mature smooth muscle and adipose tissue. Although mostly located intramurally within uterine corpus; cervix is rather an unusual site of its origin. Premenopausal or postmenopausal obese ladies commonly suffer with this tumour. Lipoleiomyomas generally grow asymptomatically, but larger tumours often elicit symptoms due to pressure effects exerted on adjacent organs. We highlight a giant cervical subserosal lipoleiomyoma in a 48-years-aged menopausal female. She presented with ill-defined lower abdominal pain. Radiologically a circumscribed genital mass was detected, which was removed with total abdominal hysterectomy plus bilateral adnexectomy.
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm225
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/229
2016-06-17T06:16:04Z
apalm:RA
"150510 2015 eng "
2349-6983
2394-6466
dc
Prevalent clones of methicillin resistant Staphylococcus aureus strains in Pakistan by various typing techniques
Altaf, Naila
Quaid-I-Azam university,Islamabad,Pakistan
Staphylococcus aureus (S.aureus) is an important pathogen that causes infections in both hospital and community settings .The resistant to methicillin in S.aureus emerged in 1960s and since then the prevalence of Methicillin resistant S.aureus (MRSA) has been increasing globally. The increasing incidence of MRSA infections demands a quick and reliable characterization of isolates and investigation of clonal spread of clones in hospitals as well as in the community to generate information that helps health care professionals to implement appropriate measure to control these infections. To investigate the MRSA outbreaks, evaluation of transmission of MRSA strains and their evolution, bacterial typing techniques are important tools. The continuous surveillance and monitoring of presence of MRSA in community and hospital settings is important to make a clear understanding of dynamics of spread of MRSA to assist in controlling its dissemination.
In this review the various typing techniques that have been used to type MRSA isolates from Pakistan have been discussed. This review also focuses on the various clones of MRSA that are reported in Pakistani community as well as in hospitalized patients
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/229
Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/231
2015-07-28T19:59:53Z
apalm:CR
"150728 2015 eng "
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A rare renal neoplasm with dimorphic histology and mucinous stroma
Ramachandra, Sunitha
Armed forces hospital, muscat oman
Rao, Lakshmi
Armed forces hospital, Muscat
Al Kindi, Masoud
Armed forces hospital
Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare and recently described histologic variant of renal cell carcinoma (RCC). Usually considered as a tumor of low malignant potential it is important to appreciate the characteristic histologic features to arrive at the correct diagnosis. We report a case of MTSCC in a female aged 54years who presented with a long standing vague loin pain. Diagnostic work-up showed a renal mass suggestive of RCC. With the preoperative diagnosis of RCC followed by nephrectomy showed a completely different histology of a rare tumour with tubules, spindle cells and mucinous stroma consistent with MTSCC, a low grade tumour with good prognosis.
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2015-07-28 19:59:53
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm231
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/233
2015-08-04T16:30:48Z
apalm:CR
"150721 2015 eng "
2349-6983
2394-6466
dc
Congenital Hepatic Fibrosis associated with polycystic kidney disease
Patel, Jaimini Natvarlal
Santokba Durlabhji Memorial Hospital
Gupta, Shubha
Santokba Durlabhji Memorial Hospital
Faujdar, Mansi
Santokba Durlabhji Memorial Hospital
Gupta, Gajendra
Santokba Durlabhji Memorial Hospital
Chaturvedi, Shweta
Santokba Durlabhji Memorial Hospital
Congenital hepatic fibrosis (CHF) is an autosomal recessive disorder and occurs as a result of ductal plate malformation. Clinically it is characterized by hepatic fibrosis, portal hypertension, and renal cystic disease. The exact incidence and prevalence of CHF are not known, but it is a rare disease. This disorder is diagnosed in most patients during childhood or young adulthood. We present the case of 8 year old female with hepatosplenomegaly, hematemesis, melena, bilateral polycystic kidney disease and a histopathological diagnosis of congenital hepatic fibrosis. She had a history of celiac disease. Congenital hepatic fibrosis belongs to the so-called fibropolycystic diseases. Celiac disease is an immune-mediated enteropathy. We describe its association with congenital hepatic fibrosis.
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm233
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/240
2016-06-17T06:16:04Z
apalm:CR
"150505 2015 eng "
2349-6983
2394-6466
dc
Peripheral blood hypereosinophilia masquerading a case of acute lymphoblastic leukemia
Reddy, Suganya Kuppovi
JIPMER, Puducherry
Mishra, Pritinanda
JIPMER, Puducherry
G, Maya
JIPMER, Puducherry
K, Arun
JIPMER, Puducherry
Jacob, Sajini Elizabeth
JIPMER, Puducherry
W, Jyoti
JIPMER, Puducherry
Hamide, Abdoul
JIPMER, Puducherry
Basu, Debdatta
JIPMER, Puducherry
Dubashi, Biswajit
JIPMER, Puducherry
Acute lymphoblastic leukemia (ALL) usually presents with fever, pallor, lymphadenopathy, hepatosplenomegaly and presence of lymphoblasts in the peripheral blood and bone marrow. ALL presenting as peripheral blood hypereosinophilia is a rare entity with less than 50 cases reported since 1973. It is a distinct clinico-pathologic entity with specific cytogenetic abnormalities. It is important for clinicians and the pathologists to be aware of the specific manifestation of ALL with eosinophilia. We report a case of ALL with peripheral blood eosinophilia.
A 39 year male presented with fever, cough with expectoration and dyspnoea. There was no past history of allergies, skin rash or parasitic infection. On examination there was hepatosplenomegaly with no lymphadenopathy. Chest X ray showed diffuse reticular pattern throughout the lungs.
Peripheral smear examination revealed high leucocyte count (52,900/mm3) with eosinophils constituting 89% (AEC- 47740/mm3). No atypical cells or hemoparasites were seen. Stool examination for parasites and filarial serology were negative.
Bone marrow examination, however, showed blasts constituting 90%. Blasts were positive for TdT, CD20, CD10 by immunocytochemistry and a diagnosis of precursor B cell ALL was made. The patient was started on treatment. Cytogenetic analysis was also done.
Hypereosinophilia can mask many underlying pathologies, of which ALL is a rare condition. As this condition usually presents with absence of blasts in the peripheral blood, there may be delay in diagnosis.So, in patients with persistant hypereosinophilia where there are no contributory causes, a bone marrow examination is a must for an accurate diagnosis.
Pacific Group of e-Journals (PaGe)
2015-05-11 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 2 No 2 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/242
2015-07-28T19:59:53Z
apalm:CR
"150721 2015 eng "
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Solitary Eosinophilic Granuloma of the Radius: A Case Report
Devi, Junu
Gauhati Medical College.
Kalita, Sukanya
Eosinophilic granuloma (EG) is an uncommon tumor of bone and soft tissue usually presenting in children. The clinical and radiological features of EG are highly valuable but not sufficient for diagnosis. Histopathology and immunohistochemistry give confirmatory diagnosis. We present here a case of EG localized to the radial head which was diagnosed histopathologically. Immunohistochemistry was done for CD1a, which was positive in our case confirming the diagnosis.
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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application/vnd.openxmlformats-officedocument.wordprocessingml.document
https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm242
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/244
2017-02-17T18:20:33Z
apalm:Ed
"150128 2015 eng "
2349-6983
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From Editor’s Desk
Goyal, Prashant
Sehgal, Shelly
See full text
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2015-01-30 00:00:00
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Annals of Pathology and Laboratory Medicine; Vol 2 No 1 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/245
2015-07-28T19:59:53Z
apalm:Let
"150712 2015 eng "
2349-6983
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Tumor or Gossypiboma
Gupta, Pankaj
Resident Pathology
Dharamshila Hospital And Research Centre, New Delhi
Chaudhary, Shruti
Gupta, Noopur
Deb, Sanjay
Kotwal, Sumedha
Dawar, Ramesh
SEE FULL TEXT
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2015-07-28 19:59:53
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm245
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/249
2016-03-17T16:45:45Z
apalm:CR
"160225 2016 eng "
2349-6983
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Secretory carcinoma breast: A rare cytodiagnosis.
Kaushik, Ankit
VMMC and Safdarjung Hospital, GGSIPU https://in-mg61.mail.yahoo.com/neo/launch?.rand=ejohb35rqg472#4622231937
Singh, Mukul
VMMC and Safdarjung Hospital, Delhi
Kolte, Sachin
VMMC and Safdarjung Hospital, Delhi
Gupta, Kusum
Mandal, A K
Secretory carcinoma is a rare low grade malignant breast carcinoma of children and adults. Since patients are often young and presents with indolent breast lump in the breast, a high degree of suspicion is often needed for the clinical diagnosis. Fine needle aspiration cytology (FNAC) is often the primary investigation, and because of the indolent clinical presentation, rarity of tumour and unanticipated cytological findings a primary cytological diagnosis of secretory carcinoma is often difficult.
We present a case of 13-year-old female, presented with a well defined mobile right breast lump. The aspiration cytology revealed highly cellular smears consisted of singly scattered and loosely cohesive cluster of monomorphic cell population of round to ovoid cells with bland cytological appearance in background of thick mucinous material, leading to cytological diagnosis of secretory carcinoma.
A primary diagnosis of secretory carcinoma on FNAC can provide early and definite surgical management including simple mastectomy with axillary lymph node resection recommended for treatment of secretory carcinoma.
Pacific Group of e-Journals (PaGe)
2016-02-24 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm249
Annals of Pathology and Laboratory Medicine; Vol 3 No 1 (2016)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/255
2015-07-28T19:59:53Z
apalm:CR
"150721 2015 eng "
2349-6983
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Low-grade appendicial mucinous neoplasm presenting with obstructed inguinal hernia: a rare association
Chowdhury, Abhishek
Basu, Keya
Chatterjee, Uttara
Datta, Chhanda
Sarkar, P.K.
Choudhuri, Manoj Kumar
Low grade appendicial mucinous neoplasm is a rare entity. It is grouped under appendicial adenocarcinoma. Though it presents commonly with pain abdomen, asymptomatic patients are not uncommon. It is a low grade neoplasm, but capable of producing progressive and fatal disease in the form of pseudomyxoma peritonei. Management in case of localised appendicial disease includes simple appendectomy. We came across a patient presenting with obstructed inguinal hernia. While performing emergency exploration, a dilated appendix was uncovered. Appendectomy was done as a result and the histopathological examination of the appendix revealed that it was a low grade appendicial mucinous neoplasm.
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm255
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/260
2015-07-28T19:59:53Z
apalm:CR
"150721 2015 eng "
2349-6983
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Cystic partially differentiated nephroblastoma: Report of a rare case
Dowerah, Swagata
Assam Medical College
Borgohain, Mondita
Introduction: Cystic partially differentiated nephroblastoma(CPDN) is a rare tumour of infancy which is considered to be a low risk malignant neoplasm. It has a favourable outcome as compared to classical Wilms tumor.
Case history: A 10 month old male child presented with abdominal lump of two months duration. Ultrasound abdomen revealed a cystic mass involving most of the left kidney. After nephrectomy we received a specimen of kidney measuring 7x6x5 cms. Multiple cystic areas were seen along with areas of hemorrhage and a narrow rim of normal kidney.On microscopy, multiple cysts of varying sizes were seen lined by cuboidal, flattened, eosinophilic and hobnail cells. The septa were relatively thick containing bland spindle cells with few foci of blastemal cells .A diagnosis of cystic partially differentiated nephroblastoma was made.
Conclusion: CPDN is a rare variant of Wilms tumor with a favorable prognosis. Histopathologic examination helps to differentiate it from other cystic lesions of the kidney and is of therapeutic importance.
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm260
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/261
2015-07-28T19:59:53Z
apalm:CR
"150721 2015 eng "
2349-6983
2394-6466
dc
Solitary Fibrous Tumour of the Prostate with Ossification: A rare Case Report
Dhameja, Neeraj
Institue of Medical Sciences ,BHU,
Santosh, Deepa
Institue of Medical Sciences ,BHU,
., Vikash
Institue of Medical Sciences ,BHU,
Dwivedi, U S
Professor and Head, Department of urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India
Solitary fibrous tumour (SFT) is a tumour of fibroblastic origin with characteristic histopathological and immunohistochemical features. Initially described in the pleura, it has now been described in various extrapleural locations including soft tissues and different organs.It is very rare in the prostate with only approximately 30 cases have been described in the literature mostly as case reports. It presents as slowly growing painless mass in the prostate with associated urinary symptoms. Radiologically andclinically it mimics prostatic adenocarcinoma. We report a case of 62 year male patient presenting with obstructive urinary symptoms. Computed tomography imaging suggested a prostatic origin. A trucut biopsy and immunohistochemistry was done which showed features of solitary fibrous tumour which was confirmed on subsequent radical cystoprostatectomy. We review the literature and discuss the challenging issues of misdiagnosis and prognosis.
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm261
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/265
2015-07-28T19:59:53Z
apalm:CR
"150721 2015 eng "
2349-6983
2394-6466
dc
Intra-cystic papillary neoplasm of salivary gland with focal low grade malignant change: a rare entity.
Fatima, Sohaila
King khalid University,Abha
Haider, Nazima
King khalid University,Abha
Nemri, Sabah Nayef
Aseer Central Hospital, Abha
Adiga, Balkur Krishnamoortthi
King khalid University,Abha
Intraductal papilloma is a rare benign salivary gland tumor. It is found in the duct of the minor salivary glands, predominantly in lip and buccal mucosa, but the tumors in the sublingual region are quite rare. Malignant counterpart of intraductal papilloma which is a well defined entity in WHO classification is also extremely rare. This report shows a case of borderline intraductal papillary tumor with low malignant potential. It developed in minor salivary gland of sublingual region. This is a very rare entity, not included in WHO classification of salivary gland tumors and needs to be distinguished from other more common papillary and cystic tumors found in salivary glands.
Pacific Group of e-Journals (PaGe)
2015-07-28 19:59:53
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application/msword
https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm265
Annals of Pathology and Laboratory Medicine; Vol 2 No 3 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/266
2015-11-03T07:39:02Z
apalm:OA
"151026 2015 eng "
2349-6983
2394-6466
dc
Diagnostic Value of Cytokeratin 5 and Cytokeratin 6 in Benign and Malignant Lesions of Breast
Akhtar, Kafil
Bharduaj, Sanjay
Naim, Mohammed
Mansoor, Tariq
Sherwani, Rana
Background: Correlation of Cytokeratin 5 and Cytokeratin 6 expression in benign and malignant lesions of the female breast-ducts and to find out the utility of Cytokeratin 5/6 in the prognosis of carcinoma breast.
Methods: The present study was carried out on 78 benign and malignant lesions of breast. Tissues were fixed in formal saline, processed for paraffin sections and stained with Haematoxylin and Eosin (H&E) stain. Immunohistochemical staining was performed using mouse antihuman polyclonal D5/16B4 antibody for cytokeratin 5/6 and visualization obtained with DAB and the slides were examined for staining pattern (cytoplasmic or membrane), proportion and intensity of staining of tumour cells.
Results: Amongst the 78 cases of breast lesions, 38 (48.7%) cases were benign breast disease, 18 (23.1%) were ductal carcinoma in situ and 22 (28.2%) cases were of malignant breast carcinoma. Out of 22 cases of malignant breast disease, 16 (72.7%) cases showed negative cytokeratin reaction with staining score of <2 and 6 (27.3%) cases of triple negative breast carcinoma (TNBC) showed positive cytokeratin expression with staining score of 5-8.
Conclusions:Immunohistochemistry is efficiently used for differentiating the UDH (usual-ductal-hyperplasia) from the DCIS (ductal carcinoma in situ), ruling out micro-invasion, distinguishing invasive carcinoma from pseudo-invasive lesions, identifying breast cancer histological sub-type and molecular phenotype.
Pacific Group of e-Journals (PaGe)
2015-10-26 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm266
Annals of Pathology and Laboratory Medicine; Vol 2 No 4 (2015)
eng
##submission.copyrightStatement##
oai:ojs.localhost:article/267
2016-03-17T16:45:45Z
apalm:OA
"160207 2016 eng "
2349-6983
2394-6466
dc
Diagnostic and Prognostic Significance of E-Cadherin and Vimentin in Oral Cancer Metastasis
Akhtar, Kafil
Ara, Anjum
Siddiqui, Shahid
Sherwani, Rana
Background: To study the role of epithelial-to-mesenchymal transition by E- cadherin and vimentin expression in precancerous and cancerous lesions of oral cavity and oropharynx and to predict invasiveness by the specific pattern of E-cadherin and vimentin expression.
Methods: Biopsies/ specimens of oral cavity and oropharynx were evaluated for all premalignant lesions and invasive epithelial squamous lesions, by haematoxylin and eosin sections and by immunohistochemical expression of E-cadherin and vimentin, wherever. Patients follow up and therapy related changes were also studied during the period of study.
Results: E-cadherin staining showed 6/10 (60%) cases of well differentiated carcinoma with 4+ degree of expression while 0/10 case of poorly differentiated carcinoma showed 4+ and only a single case showed 3+ degree of expression with 8/10 (80%) cases of well differentiated carcinoma depicting strong staining intensity of E-cadherin. 6/10(60%) cases of well differentiated oral squamous cell carcinoma showed 1+ degree of expression of vimentin while 6/10(60%) cases of poorly differentiated carcinoma showed 4+ degree of expression. 1(1.6%) case of positive lymph node metastasis showed strong positive staining for E-cadherin and 4 (66.6%) cases showed absent staining pattern of E-cadherin. The differences in the immunoreactivities were statistically significant between CIS and mi-croinvasive or invasive carcinomas (p<0.001) in our study.
Conclusions:Invasiveness and recurrence can be analysed by the use of immunohistochemical stains of E-cadherin and vimentin, which can help in predicting the tumor behaviour, prognosis, survival and management of the patient. Also, these biomolecules can be used as biomarkers for further research on the micro-invasion of the tumor for early diagnosis and survival of the patients.
Pacific Group of e-Journals (PaGe)
2016-02-24 00:00:00
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https://www.pacificejournals.com/journal/index.php/apalm/article/view/apalm267
Annals of Pathology and Laboratory Medicine; Vol 3 No 1 (2016)
eng
##submission.copyrightStatement##
a40b26141272a7c08c18869495a8db7c