Annals of Pathology and Laboratory Medicine

Lesions of the Eyelid: A 5 - year Retrospective Study in a Tertiary Care Centre

Anupa Toppo — 2019-08-01

Background: Eyelid oncology is of utmost importance. Eyelid lesions are rarely lethal and completely treatable if detected early. Overview of eyelid lesions guides ophthalmogists to design for optimal therapy.

Materials and methods: A retrospective analysis of eyelid lesion was done from 2013 to 2018 in the department of pathology, VSSIMSAR, Burla, Odisha, confirmed through histopathology. Data regarding age, sex and topography of lesion were also included.

Results: A total of 104 biopsies were evaluated. Male to female ratio were 1:1.16 for benign tumours and 1:1.36 for malignant tumours. The age of the patient at the time of biopsies ranged from ½ year to 78 years old. The most common benign eyelid lesion encountered in our practice was epidermoid cyst followed by vascular haemangioma.

Conclusion: The majority of eyelid lesions were benign eyelid tumours while malignant eyelid tumours contributed 25% of total eyelid lesions. Sebaceous gland carcinoma was the most common eyelid tumour found in the present study that was consistent with other studies for Asian countries.

Lesions of The Eyeball and Ocular Adnexa - Our Experience Over A Period of 18 Months

Shailesh Vartak — 2019-08-01

BACKGROUND: The eyeball is a unique sensory organ, with a varied spectrum of lesions, which are rare with subtle presentation, thus posing diagnostic challenges. Our aim is to evaluate histomorphology of lesions of eye and ocular adnexa, classify and compare with other studies.

METHODS: All biopsies and specimens of eyelid, eyeball and orbital lesions received in histopathology section of our Pathology department between January 2017 and June 2018 were analysed and a total 43 cases were evaluated.

RESULTS: The age distribution of cases analysed ranged from 6 years to 85 years with mean age of 39 years and equal gender distribution. Neoplastic lesions (53.49%) were more common than non-neoplastic lesions. Among neoplastic lesions, benign (56.52%) were more common than malignant. The most common non-neoplastic lesion was zygomycosis of orbit (75%), epidermal cyst in eyelid (30%) and granulation tissue in eyeball (50%).The only benign tumour in orbit was meningioma. The most common benign tumour in eyelid was hemangioma (50%) and in eyeball, we encountered 1 pigmented nevus of conjunctiva and 1 apocrine hidrocystoma. Common malignant eyelid tumours were basal cell carcinoma and sebaceous carcinoma(33.33% each) , whereas in orbit we received 1 basal cell carcinoma and 1 adenoid cystic carcinoma. In eyeball, we encountered 1 basal cell carcinoma and 1 squamous cell carcinoma of conjunctiva.

CONCLUSION: Most of the studies done in this arena focus on either adnexa or orbit alone, and through our study we have tried to understand the frequency of occurrence and histomorphology of all lesions pertaining to eyeball, orbit and adnexa .

Morphological Spectrum of Lesions in Upper Gastrointestinal Endoscopic Biopsies

Janani Mathialagan — 2019-08-02

Background:

Gastrointestinal disorders are one of the most common clinically encountered problem. The Spectrum varies significantly due to geographical, dietary and environmental factors. Endoscopic examination along with histopathological biopsy examination is the gold standard for the detection of lesions. Correlation with other clinical data aids in accurate and early diagnosis of lesions.

Methods:

This descriptive study comprises of 454 endoscopic biopsies of gastrointestinal tract received in the Department of Pathology, Mahatma Gandhi Medical College and Research Institute, Pondicherry over a period of 18 months from December 2016 to May 2018. Brief clinical data, provisional clinical diagnosis, endoscopic findings and histopathological diagnosis were noted.

Result:

Of the 454 cases examined, 53.9% of patients were males. Highest incidence was recorded in the 41-50 age group comprising of 22.4%. Endoscopic examination showed maximum cases with inflamed mucosa (38.5%). The commonest biopsied site is Gastric antrum. Non-neoplastic lesions were more prevalent (83.4%) than neoplastic lesions.

Conclusion:

Histopathological evaluation along with details of endoscopic findings aids in providing an accurate diagnosis.

Seroprevalence of Syphilis Infection among Apparently Clinically Healthy Blood Donors in Northern Mid - Karnataka

Bhakti V Kulkarni — 2019-08-02

Background: Blood transfusion is one of the important modalities of treatment in hospitals these days. Transfusion transmissible infections (TTI) are one of the important complications of blood transfusion.

Objective: To study the seroprevalence of syphilis infection among healthy blood donors in our region

Materials and methods: This is a retrospective study done over a period of 3 years from August 2015 to July 2018 in two blood banks of Gadag i.e. Gadag Institute of Medical Sciences (GIMS) blood bank and Indian Medical Association (IMA) blood bank. A total of 20,144 blood donors were included in the study. It included both voluntary donors and replacement donors. Donors were screened using donor questionnaire form followed by general physical examination for medical and surgical illness. Eligible blood donors donated blood and their blood samples were subjected to a test that detected the presence of non treponemal antibodies by using rapid plasma reagin (RPR) test kit.

Result: In the present study, the total number of donors is 20,144. Out of this, 19,676 (97.67%) were males and 468 (2.33%) were females. Total number of seropositive cases of syphilis was 5. The overall seroprevalence was 0.023%. All the seropositive cases were males. The prevalence of seropositive cases among voluntary donors was 0% and among replacement donors was 0.14%

Conclusion: Seroprevalence of syphilis in the region of Gadag is 0.023%.

Neutrophil to lymphocyte ratio and Platelet to lymphocyte ratio: Novel markers of inflammation in Psoriasis

Shakti Kumar Yadav — 2019-08-08

Background:

Psoriasis is a systemic, autoimmune chronic inflammatory disease. Novel inflammatory biomarkers like neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) may help in evaluation of systemic inflammation. Aim of the present study was to evaluate NLR and PLR in patients of psoriasis and to correlate them with psoriasis area severity index (PASI) score.

Methods:

The study was done in a tertiary care hospital. A study was performed with 40 psoriasis patients (study group) and 20 healthy control subjects. Complete hemogram was determined using the 5-part hematology analyser. NLR and PLR values were calculated from the appropriate absolute cell counts. Mann-Whitney U test was applied to compare the data between patients and controls. Pearson correlation was used to find correlation between NLR, PLR and PASI.

Result:

Mean PLR was 121.79 (42.36) for study group and 101.42 (SD 52.28) for the control group. We found that PLR was significantly higher in study group than the control group (p value = 0.041). There was a positive correlation between PASI and PLR (r=0.476, p value 0.002). We found no difference in NLR values between patients and controls as well as no correlation between PASI and NLR in the study group.

Conclusion:

PLR can be used as a biomarker to measure and monitor the disease activity in psoriasis patients at the time of diagnosis and follow up. This can also aid in preventing comorbidities in psoriasis patients.

The Relationship Between Serum Levels Of CA- 125 and Interleukin -6 with the Degree of Differentiation in Ovarian Neoplasms

Minakshi Rajput — 2019-08-08

Background: To study the serological correlation between serum levels of CA -125 and IL-6 with various histo morphological features of ovarian neoplasm.

Methods: Prospective study of two year duration from 2016 to 2018.Total of 40 women presented clinically with pelvic mass lesion were included. These patients undergoing concomitant serological analysis of CA -125 and IL-6. In each case, age, parity, marital life, radiological finding, histological type, degree of differentiation, extra ovarian tissues involvement was determined.

Result: Most of the ovarian neoplasm belongs to benign category 19/40 (47.5%) then malignant tumors 15/40 (37.5%). Surface epithelial tumours (80%) were common histopathological findings with raised CA-125 and Interleukin-6 levels. Most of the patient present with abdominal pain in their late reproductive age group (41-60 years). There is significant correlation ( p-value=.000) in rise of levels of CA-125 and Interleukin-6 levels in patients with benign and malignant ovarian lesion. Levels of both the biomarkers are near normal levels in benign cases and levels were raised in malignant cases.

Conclusion: Amongst the ovarian neoplasm benign tumor were more common than malignant with predominance histological type is surface epithelial tumors. Serum levels of CA –125 and IL-6 were associated with histological grade in primary ovarian neoplasms, especially in high-grade malignant tumors, suggesting that high serological levels of these biomarkers are associated with lesions of more aggressive biological behavior.

Seroprevalence of HIV Infection in Donated Blood and Its Implications in Safe Blood Practices

Bhakti V Kulkarni — 2019-08-08

Background: Blood transfusion is an integral and indispensible part of treatment in hospitals these days. Transfusion transmissible infections (TTI) are one of the important complications of blood transfusion. This study is aimed at assessing the seroprevalence of HIV among healthy blood donors in our region and its implications on safe blood practices.

Materials and methods: This is a retrospective study done over a period of 3 years from August 2015 to July 2018 in two blood banks of Gadag i.e. Gadag Institute of Medical Sciences (GIMS) blood bank and Indian Medical Association (IMA) blood bank. A total of 20,144 blood donors were included in the study. It included both voluntary donors and replacement donors. Donors were screened using donor questionnaire form followed by general physical examination for medical and surgical illness. Eligible blood donors donated blood and their blood samples were subjected to a test that detected the presence of antibodies to HIV by using rapid test kit by Qualpro and then confirmed by 4^th generation Qualisa ELISA test kit.

Result: In the present study, out of 20,144 blood donors 19,676 (97.67%) were males and 468 (2.33%) were females. Total number of seropositive cases of HIV was 34. The overall seroprevalence was 0.17%. All the seropositive cases were males and the seroprevalence was 0.17%. The prevalence of seropositive cases among voluntary donors was 0.048% and among replacement donors was 0.72%.

Conclusion: Seroprevalence of HIV in the region of Gadag is 0.17%.

Pseudomyogenic Hemangioendothelioma (Epithelioid Sarcoma-like Haemangioendothelioma) - Case Report of a Rare Entity

Kumarguru B. N. — 2019-08-02

Pseudomyogenic Hemangioendothelioma (Epithelioid Sarcoma-like Haemangioendothelioma) is a rare soft tissue tumor of endothelial origin. It is a distinctive neoplasm having indolent behaviour. A 27-year-old male presented with history of multiple small ulcers over right shoulder region since 2 months. On examination, diffuse indurated plaques were seen over right shoulder with multiple ulcers. A Provisional diagnosis of non-healing ulcer over right shoulder was offered. Pus culture was positive for coagulase negative Staphyloccus species. The lesion was excised and sent for histopathology.Microscopy showed ulcerated epidermis. Subepithelium showed tumor tissue composed of cells arranged in fascicles, sheets and irregular nodules. Individual tumor cells were oval to spindle shaped cells having brightly eosinophilic cytoplasm and vesicular nucleus with noticeable nucleoli. At places endothelial cell proliferation and neovascularization was seen. Possibility of epithelioid sarcoma, epithelioid hemangioendothelioma and malignant melanoma was considered. Immunohistochemistry was performed. Neoplastic cells were positive for vimentin, CD31, CK19 and negative for CD34, HMB45 and EMA. A final diagnosis of Epithelioid sarcoma-like Hemangioendothelioma (Pseudomyogenic Hemangioendothelioma) was offered. It is an unusual pathological entity with a unique clinical presentation. Histopathology is challenging. Immunohistochemistry is not only confirmatory, but also mandatory to solve the diagnostic dilemma.

The The Weigert – Meyer Law of Ureteral Duplication

Sudhamani S — 2019-08-02

Ureteral duplication is a developmental anomaly leading to many complications in children. The Weigert-Meyer law states that ‘In a complete ureteral duplication, the ureter whose orifice is more medial and caudal reaches the upper moiety and the other ureter whose orifice is more lateral and cephalad reaches the lower renal moiety’. This law has been observed universally in cases of ureteral duplication. The possible complications of double ureter and duplex system include obstruction, lithiasis, ureterocele and vesico-ureteral reflux. Hence it is important to recognize this entity for early intervention and to prevent complications. We are publishing one such rare case in a 10 month old child with review of literature.