Annals of Pathology and Laboratory Medicine https://www.pacificejournals.com/journal/index.php/apalm <p><strong>Annals of Pathology and Laboratory Medicine (APALM)</strong> is an international, Double-blind peer-reviewed, indexed, open access, online and print journal&nbsp;for pathologists, microbiologist, biochemist and clinical laboratory scientists, and is published by <strong><a href="https://www.pacificejournals.com" target="_blank" rel="noopener"><strong>Pacific group of e-Journals</strong>' (<strong>PaGe</strong>)</a>, </strong>an&nbsp;<em>ISO 9001:2008</em> Certified&nbsp;academic publishing house.</p> <p>Set up in 2014, APALM is a specialized journal, which publishes original, peer-reviewed articles&nbsp;in the field of Pathology and Laboratory Medicine which, <em>inter alia</em>, includes Histopathology, Cytopathology, Hematology, Clinical Pathology, Forensic Pathology, Blood Banking, Clinical Bio-Chemistry, Medical Microbiology (Bacteriology, Virology, Mycology, Parasitology), etc.</p> <p><strong>DOI: 10.21276/APALM (<a title="Verify APALM DOI " href="https://dx.doi.org/10.21276/apalm" target="_blank" rel="noopener">https://dx.doi.org/10.21276/apalm</a>)<br></strong></p> <p>Index Copernicus (IC) Value (ICV 2016): 74.20</p> en-US <p>Authors who publish with this journal agree to the following terms:</p> <ol> <li class="show">Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a&nbsp;<a href="https://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</a>&nbsp;that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li> <li class="show">Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li> <li class="show">Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See&nbsp;The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).</li> </ol> <p>&nbsp;</p> editor.apalm@gmail.com (Dr. Prashant Goyal) contactus@pacificejournals.com (Amit Saggar) Mon, 26 Aug 2019 17:12:08 +0000 OJS 3.1.1.2 http://blogs.law.harvard.edu/tech/rss 60 Immunohistochemical Evaluation of Chronic Endometritis by CD138, CD3 and CD20 https://www.pacificejournals.com/journal/index.php/apalm/article/view/2625 <p><strong>Background: </strong>Chronic inflammation of endometrium is often clinically silent but may present as abnormal uterine bleeding, dyspareunia, infertility, leucorrhoea and sometimes urinary symptoms. The diagnosis is often rendered on histopathological examination of endometrial biopsy showing chronic inflammatory infiltrate in general and plasma cells in particular. In order to identify scant plasma cells and lymphocytes in the chronic endometritis, immunohistochemistry is increasing being used to confirm the diagnosis.</p> <p><strong>Aims and objectives: </strong>To study the utility of panel of CD3, CD20 and CD 138 in the evaluation of chronic endometritis in cases of abnormal uterine bleeding and infertility and correlate the result of immunohistochemistry with routine H &amp; E&nbsp; staining.</p> <p><strong>Method and Material: </strong>100 consecutive cases of abnormal uterine bleeding and infertility were taken and histopathological diagnosis was made. IHC with all the three markers were applied in all the cases irrespective of histopathological diagnosis.</p> <p><strong>Results: </strong>A total of 100 cases of endometrial currettings and biopsies were studied who presented with AUB. 17 cases were diagnosed as chronic endometritis purely on histopathology while 8 additional cases were identified with help of immunohistochemistry. Two cases diagnosed on histopathology were negative on immunohistochemistry. Out of all the three markers CD 138 was the most specific while CD 3 was least specific in diagnosing chronic endometritis.</p> <p><strong>Conclusion</strong>: Immunohistochemistry particularly CD 138 is very useful in suspected cases of chronic endometritis particularly in cases where histopathology does not show any evidence of chronic inflammation.</p> Tarunpreet Kaur Sarpal, Ranjeev Bhagat, Rajpal Singh Punia, Pavithra H N, Bharti Goyal, Uma Handa ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://www.pacificejournals.com/journal/index.php/apalm/article/view/2625 Mon, 26 Aug 2019 17:27:28 +0000 The Study of Platelet Parameters- Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) in Type 2 Diabetes Mellitus https://www.pacificejournals.com/journal/index.php/apalm/article/view/2467 <p><strong>Background:</strong> Diabetes Mellitus is a global public health problem with morbidity due to complications caused by macrovascular and microvascular disease. Platelet parameters like Mean Platelet Volume (MPV) and Platelet Distribution Width&nbsp;&nbsp; (PDW) are related to platelet size, enzymatic activity and prothrombotic potential. &nbsp;These parameters can be obtained from routine hemogram reports of automated hematology analyzers at a relatively low cost. Fasting blood glucose, postprandial blood glucose, and hemoglobin A1C (HbA1c) are widely used to monitor glycaemic control in patients with DM.&nbsp; &nbsp;&nbsp;The aim of this study is to study Platelet parameters- Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) in type 2 diabetes and its predictive role in diabetic angiopathies.</p> <p><strong>Methods:</strong> The present study was a Case control study carried for a period of 2 months. Statistical analysis was done with appropriate tests.</p> <p><strong>Result: </strong>&nbsp;MPV values were lower in cases than controls. In controls, MPV shows a negative correlation with fasting blood sugar while in cases it shows a positive correlation with fasting blood sugar. MPV showed no association with HbA1c. PDW was high in cases than controls. In controls, negative correlation between PDW and FBS was observed, while in cases, a positive correlation was observed. A strong association between PDW and HbA1c was noted. At a cut off of 9.5 fL, MPV had a sensitivity of 78.33%, specificity of 70% and a positive predictive value of 72.30%. At a cut off of 15fL, PDW showed a sensitivity of 81.66%, specificity of 91.66% and a positive predictive value of 90.74%.</p> <p><strong>Conclusion: </strong>The present study shows strong association between PDW and HbA1c and so it can be used as an indicator of impending vascular events. Of all the platelet parameters obtained by haematology cell counters, Platelet count is only widely used as investigative tool.&nbsp; Platelet indices can be used as simple and cost effective bio markers for predicting diabetic vascular complications.</p> Advait Anirudha Joshi, Janice Jaison ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://www.pacificejournals.com/journal/index.php/apalm/article/view/2467 Mon, 26 Aug 2019 17:32:09 +0000 Distribution of Galactomannan antigen in BAL and serum samples among Aspergillus isolates and its correlation with culture among Immunocompetent and Immunocomporomised patients in Aligarh region, a north India town https://www.pacificejournals.com/journal/index.php/apalm/article/view/2473 <p><strong>Background:</strong> Aspergillosis is one of the most common fungal infection among both general patients and immunocompromised individuals.</p> <p><strong>Methods:</strong> The study was carried out on 2 groups of patients: immunocompetent and immunocompromised comprising of a total of 90 patients. Microscopy, culture, identification of isolates was done and some specialised tests on serum and BAL for antigen detection were performed.</p> <p><strong>Result:</strong> Most of the patients i.e., 47 (31.3%) were between 31-40 years with a mean age of 32.5 years. The male to female ratio was 1.8:1. Galactomannan antigen was positive in 13 (28.9%) BAL samples and in 15 (33.3%) serum samples wherein the 45 BAL samples represented immunocompetent cases and 45 serum samples represented immunocompromised cases. Sensitivity and specificity of GM assay in BAL samples were found to be 100% and 97% respectively. On the other hand, sensitivity and specificity in serum samples were found to be 94.1% and 100% respectively. All patients were categorized into 4 categories as proven IPA, probable IPA, possible IPA and non-IPA. 22 (24.4%) patients were of proven invasive pulmonary aspergillosis (IPA), 7 (7.8%) of probable IPA, 2 (2.2%) belonged to possible IPA while 59 (65.5%) were of non IPA. All of the cases of proven IPA were positive on culture.</p> <p><strong>Conclusion: </strong>GM assay in BAL is a very sensitive and specific marker for Aspergillosis while in case of serum samples it is somewhat lesser sensitive.</p> Asma Husein Roohani, Nazish Fatima, Mohammad Shamim, Haris Manzoor Khan, Anees Akhtar ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://www.pacificejournals.com/journal/index.php/apalm/article/view/2473 Wed, 28 Aug 2019 17:20:27 +0000 Histopathological Study and Expression of CD 117 in Renal Cell Carcinoma https://www.pacificejournals.com/journal/index.php/apalm/article/view/2484 <p><strong>Background:</strong></p> <p>Hypernephroma or Renal Cell Carcinoma (RCC) accounts for over 90% of all malignancies of the kidney occurring in adults. Of all renal cell carcinomas, Clear cell carcinoma accounts for around two-thirds to three-quarters&nbsp; and&nbsp; Chromophobe&nbsp; RCC accounts for &nbsp;around 5%. The present study highlights the diagnostic usefulness of CD117 as a phenotypic marker in Renal Cell Carcinoma.</p> <p><strong>Methods:</strong></p> <p>Current study include 48 cases of histopathology proven renal cell carcinoma. Each&nbsp; case was reviewed and classified according to the WHO classification criteria. The expression of CD117 was assessed using immunohistochemistry.</p> <p><strong>Result:</strong></p> <p>Of the 48 cases studied, 6cases, that is 2 case of Papillary RCC and 3 case of&nbsp; Chromophobe RCC showed moderate intensity and diffuse positivity for CD 117 and 1case of clear cell RCC with sarcomatoid areas showed mild and focal positivity. Papillary RCC showed both cytoplasmic and membrane positivity, while Chromophobe RCC showed mainly membranous positivity. Sarcomatoid areas showed weak cytoplasmic positivity.</p> <p><strong>Conclusion: </strong></p> <p>Histopathology supported by immunohistochemistry &nbsp;is a helpful tool in subtyping the various RCC. Treatment options in advanced disease is minimal. CD 117 positivity may favour the use of targeted therapy in renal cell carcinomas.</p> Rasmi Unnikrishnan, Praseeda I, Santha Sadashivan ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://www.pacificejournals.com/journal/index.php/apalm/article/view/2484 Wed, 28 Aug 2019 17:24:53 +0000 A Study of p53 immunostaining in prostate carcinomas: Correlation with Gleason’s score https://www.pacificejournals.com/journal/index.php/apalm/article/view/2507 <p><strong>Background:</strong> Prostate cancer is the second most common cause of cancer and the sixth leading cause of cancer death among men worldwide. In view of the above, early diagnosis and effective treatment of the disease are immensely important. The increasing number of options for the treatment of prostate cancer has made the prognostic evaluation of the disease even more important. P53 is a tumor suppressor gene characterised by a highly proliferative pattern and an aggressive behaviour. The Objectives was to study the immunostaining patterns of p53 in prostate cancers and to compare the results with Gleason's score.</p> <p><strong>Methods:</strong> Fifty cases of histopathologically proven prostate carcinomas diagnosed on needle biopsies and transurethral resection specimens was studied in JSS medical college and hospital, mysore for a period of 3 years and histopathological grade was assessed using Gleason grading system. Immunohistochemistry (IHC) for p53 was done on paraffin embedded wax sections.</p> <p><strong>Result:</strong> p53 staining was positive in 47(94%) cases out of 50 cases, three (6%) cases were negative. Although there was an increase in positive p53 staining with increased Gleason’s score, it was not statistically significant (‘p’ value = 0.068).</p> <p><strong>Conclusion: </strong>p53 is a tumor suppressor gene, that express high proliferative pattern. It can be used as a prognostic factor. The immunoreactivity of p53 marker with increased tumor grade can benefit patients with appropriate targeted treatment and increase their survival period.</p> Roopa Urs A.N, Manjunath G V, Suchitha S, Hugara Siddalingappa ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://www.pacificejournals.com/journal/index.php/apalm/article/view/2507 Wed, 28 Aug 2019 17:32:06 +0000 Clinical profile and Histopathological spectrum of Interface Dermatitis https://www.pacificejournals.com/journal/index.php/apalm/article/view/2509 <p><strong>Background- </strong>Interface Dermatitis is an etiologically diverse and poorly understood group of skin diseases characterized by pathology at the dermo-epidermal junction. The prototype disease is Lichen Planus but there are many other disease entities that exhibit Lichenoid tissue reaction / Interface changes.</p> <p><strong>Aims-</strong> To study the clinical profile and Histopathological spectrum of Interface Dermatitis.</p> <p><strong>Materials &amp; Methods-</strong> This was a prospective study conducted at a tertiary care hospital over a period of eighteen months. A total of Ninety-eight cases clinically suggestive of diseases believed to show interface changes on histology were studied. Clinical details were recorded. Skin biopsies were taken from representative lesions. H&amp;E stained sections were studied in detail for diagnosis and subtyping. Analysis was done in percentages and proportions.</p> <p><strong>Results-</strong> Fifty-three cases (54%) showed IFD on histopathological examination. The most common age range was between 11-40 years and both the sexes were equally affected. Majority of the cases clinically presented as papules and plaques. The most common type of IFD were LP and its variants (52.1%). The most consistent microscopic findings were vacuolar degeneration of basal layer, pigment incontinence and inflammatory infiltrate around DEJ and blood vessels.</p> <p><strong>Conclusions</strong>- IFD includes various diseases which have overlapping clinical as well as histopathological features. A detailed histopathological examination and correlation of the interface changes with clinical diagnosis is helpful in arriving at a definitive diagnosis which is essential for predicting the course of the disease and its optimal management.</p> Kaira Kriti, Azad Sheenam, Bisht Jeetendra S, Kumar Rajnish ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://www.pacificejournals.com/journal/index.php/apalm/article/view/2509 Sun, 08 Sep 2019 13:55:01 +0000 Correlation of Biochemical Parameters with Cytomorphological grading in Hashimoto’s Thyroiditis https://www.pacificejournals.com/journal/index.php/apalm/article/view/2580 <p><strong>Background:</strong> Hashimoto’s thyroiditis (HT) is one of the most common cause of hypothyroidism in iodine sufficient areas. Diagnosis of HT is based on clinical, cytomorphological and biochemical parameters. Fine Needle Aspiration Cytology (FNAC) of thyroid provides a safe and accurate method for diagnosis of HT. Cytological grading of HT helps in assessing the severity of the disease and can predict the thyroid functional status.</p> <p><strong>Methods: </strong>Retrospectively, 50 diagnosed cases of HT on FNAC were studied over a period of 6 months in a tertiary care hospital. Clinical, biochemical parameters such as T3, T4 and TSH values were collected. Cytological grading of FNAC smears was done based on Bhatia et al cytological grading system into three grades. These grades were compared with the clinical and biochemical parameters of HT.</p> <p><strong>Result: </strong>Of 50 patients, 47 were females. Maximum number of cases were seen between 36 -45 years. Most of the patients presented with goiter. 31 out of 50 (62%) cases were grade II thyroiditis, of them most cases were hypothyroid. 17 out of 50 cases (34%) were grade I thyroiditis, of which most cases were euthyroid biochemically.</p> <p><strong>Conclusion: </strong>Higher the grades of HT in cytology the more abnormal are the biochemical parameters. A combined approach of cytological grading along with clinical and biochemical parameters can detect subclinical hypothyroid state which provides a guide to therapy.</p> Amrita Dhakal Sharma, Navya B N, Sathyavathi R Alva ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://www.pacificejournals.com/journal/index.php/apalm/article/view/2580 Sun, 08 Sep 2019 14:02:30 +0000 Primary Thyroid Schwannoma with Papillary Carcinoma and Hurtle Cell Adenoma in a Background of Hashimoto’s Thyroiditis https://www.pacificejournals.com/journal/index.php/apalm/article/view/2401 <p>Schwannomas are common benign neurogenic tumours that arise from Schwann cells of nerve roots; up to 45% arise in head and neck. However primary thyroid schwannomas are extremely rare. Among thyroid tumours papillary carcinoma of thyroid (PCT) are the most common. Hurthle cell neoplasms are also rare. In addition occurrence of all the three neoplasms in the same patient is extremely rare. In this report we discuss a case of left lobe intrathryroidal schwannoma with papillary carcinoma of thryroid (PCT), Hurthle cell adenoma and background Hashimoto thyroiditis in a 25 year old female. On FNAC it was diagnosed as colloid nodule with cystic change, total thyroidectomy was done and histopathological examination showed that the largest well circumscribed nodule was a benign neurogenic tumour, schwannoma (left lobe of thryroid gland). There were other smaller thyroid nodules; one showing papillary carcinoma with lymph node metastasis and other showing hurthle cell adenoma with background Hashimoto’s thyroiditis.</p> Shilpa Mishra, Tejaswini Waghmare, Annapurna Taware ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://www.pacificejournals.com/journal/index.php/apalm/article/view/2401 Mon, 26 Aug 2019 17:39:08 +0000 Steroid cell tumor : A rare ovarian tumor https://www.pacificejournals.com/journal/index.php/apalm/article/view/2500 <p>Steroid cell tumors of ovary are a rare subgroup of sex cord tumors, account less than 0.1% of all ovarian tumors and also will present at any age. Some of this tumor may be functional and secrete hormones. Nearly 56-77% of the cases present with hypergonadism. However, there may be atypical presentations of these tumors also when they do not show any symptoms of virilization. In these cases diagnosis is usually made postoperatively on finding a tumor in ovary. A careful correlation between Clinical and surgical evaluation and microscopic analysis is necessary, as is a regular follow up. We reported a case of 45 years old female with complained of abdominal pain on &amp; off since two years. She had no other complains. Histopathology confirmed the diagnosis of steroid cell tumor not otherwise specified type (NOS type) with no cytological atypia.</p> Falguni T. Patel, Bhoomi A. Shah, Nisarg R. Parikh, Ratigar N. Gonsai ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://www.pacificejournals.com/journal/index.php/apalm/article/view/2500 Mon, 26 Aug 2019 17:49:52 +0000 Persistent Mullerian Duct Syndrome https://www.pacificejournals.com/journal/index.php/apalm/article/view/2559 <p>Persistent Mullerian duct syndrome (PMDS) is usually an accidental finding either during orchidopexy or during routine inguinal hernia repair in male patients presenting with undescended testes. It is a rare form of internal male pseudohermaphroditism caused by defect in synthesis or action of Mullerian inhibiting factor due to which Mullerian derivatives such as uterus, fallopian tube and upper vagina are normally present in 46XY males. Here we present a case report of a 7 year old male presenting with bilateral undescended testes.</p> Shabnam Izhar, Purnima Singh, Kusum Gupta ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://www.pacificejournals.com/journal/index.php/apalm/article/view/2559 Mon, 26 Aug 2019 18:00:41 +0000