Cytopathological study of salivary gland lesions by fine needle aspiration cytology

Background: Fine needle aspiration cytology is an inexpensive, minimally invasive, outpatient diagnostic procedure. FNA of salivary gland is easier to perform as the site is superficial and repeat FNAC can be perform. As compared to biopsy methods, FNA is a very smooth, cheaper, outpatient procedure helping clinician to save his time for earlier diagnosis and treatment. Though anatomical structure of the gland is very simple, it is subjected to a diverse and heterogenous range of tumors.Methods: The present study on “Cytomorphological features of salivary gland lesion by FNAC” was carried out on department of pathology from June 2015 to June 2017. 65 patients with salivary gland lesions who were sent to pathology department for FNAC were aspirated and correlated histopathologically.Results: Benign salivary gland lesions contribute to majority of cases (54%). Pleomorphic Adenoma was the most common benign salivary gland lesions and Mucoepidermoid Carcinoma was most common malignant lesion. Parotid gland was the most commonly involved in benign tumors and submandibular gland was commonly involved by malignant tumors. Commonly affected age group by benign salivary gland lesion was 31-40 years and those with malignant salivary gland lesion was 41-50 years.Conclusions: FNA cytology provides useful information for the management of salivary gland lesions and prevents unnecessary surgery in cases of nonneoplastic lesions and identification of malignancy helps the surgeon in deciding type and extent of surgery.

Carcinoma of breast with medullary features: a case report in 27 year old female

Medullary carcinoma of breast is a rare variant of invasive ductal carcinoma of breast and its incidence is less than 5% of invasive breast carcinomas. These tumours tend to occur in younger women, with the average age reported to range from 42 to 52 years. Authors are presenting this case in a 27 years old female having single, large, well circumscribed mass in right breast for 6 months. Fine needle aspiration cytology report was proliferative lesion with atypia Histopathology report was given as carcinoma with medullary features. Immunohistochemistry showed Estrogen Receptor (ER), Progesterone Receptor (PR) and Her-2 neu negative. Authors are presenting this case of Medullary carcinoma of breast for being a specific histopathological subtype.

Diagnosis of malignant effusion using cell block and immunohistochemistry

The distinction between reactive mesothelial and adenocarcinoma cells specially signet ring type in serous effusions may be very difficult based only on morphological features particularly in early stage. Reactive mesothelial cells show varying degree of cytological atypia hence posing difficulty in differentiating it from adenocarcinoma cells. We report a case of 45 year old female patient presented with abdominal distension. Patient was an operated case of adenocarcinoma of stomach. Smears prepared from ascitic fluid and cell block shows large number of reactive mesothelial cells and few atypical cells. Atypical cells were immunoreactive for cytokeratin, epithelial membrane antigen and carcinoembryonic antigen. These confirmed the presence of malignant epithelial cells so we reported it as a malignant effusion.

The role of platelet indices in ischemic heart disease: a hospital based case control type of study

Background: In developing countries, Ischemic heart diseases (IHD) is one of the leading causes of morbidity and mortality. The underlying pathology of CAD is atherosclerosis. When this atherosclerotic plaque ruptures, platelets play a crucial role in the prothrombotic events and forms a thrombus on this plaque and as a result coronary artery gets occluded causing ischemia and infarction. Platelet contains many chemokines, cytokines and growth factors. Release of these factors along with interaction with endothelial cells and leukocytes promotes inflammation and progression of atherosclerosis. We aimed to investigate the association between platelet volume indices in patients with diagnosis of Ischemic heart disease in comparison with control group.Methods: By using automated cell counter platelet count and platelet volume indices - were compared with Normal healthy or non-cardiac chest pain patients with the use of unpaired t test.Results: In the present study, we demonstrated that platelet count is significantly low and MPV and PDW are significantly high in Ischemic heart disease as compared to patients with noncardiac chest pain or healthy subjects. The correlation of MPV with PC revealed an inverse correlation between the patients of IHD and healthy or non-cardiac chest pain patients which is statistically significant.Conclusions: The platelet volume indices are an important, simple, effortless and a cost-effective tool useful in predicting the development of an acute coronary event sometimes in the near future and therapeutic modification for improved patient’s cardiovascular care.

A rare case of multilocular cystic renal neoplasm of low malignant potential diagnosed on intra-operative fine needle aspiration cytology

Multi-locular Cystic Renal Cell Carcinoma (MCRCC) is now considered as Multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) in World health organisation classification (WHO) 2016. It is usually seen in elderly people where it can mimic most of the time as benign cystic lesion. Authors are reporting a case of MCRNLMP in a 70 year male diagnosed intraoperative with the help of Fine Needle Aspiration Cytology (FNAC). Radiological and other clinical findings are in favour of cystic renal lesion. And it is very important to differentiate it from conventional renal cell carcinoma which requires radical nephrectomy. So, radiological finding and FNAC is instrumental in diagnosing this rare case which require different mode of surgical management.

Thrombocytopenia in malaria: Correlation with various prevalent species.

Background: Most of the patients suffering from malaria shows reduced Red cell count, leukopenia and varying degree of thrombocytopenia but it is rarely associated with haemorrhagic manifestations. Aims & Objective: This study was undertaken to correlate the incidence and severity of thrombocytopenia with the prevalent species of malaria. Material and Methods: Total 1480 Patients were included in this study after positive identification on PSMP. Platelet count was done by haematology analyser (Sysmax Kx 21). Results: Incidence of thrombocytopenia was seen in 83.80% and 74% cases of P. falciparum and P. vivax malaria respectively. Severe thrombocytopenia in P. falciparum was found in 7.70% cases while in P. vivax 3.67% cases. No difference was observed in incidence of thrombocytopenia in both age groups in relation to both prevalent species. In paediatric age group, significant leukopenia was found in 22.22% Cases of P. falciparum in comparison to P. vivax (14.96%). Hb less than 10 mg/dl was found in 66.11% cases in P. Falciparum while in P. vivax it was found in 40.13% cases. In adults leukopenia was found in 27.46% Cases of P. falciparum in comparison to P. vivax 22.61% cases. Hb less than 10 mg/dl was found in 41.28% cases in P. falciparum while in P. vivax it was found in 28.57% cases. Conclusion: Severe thrombocytopenia is commonly associated with P. falciparum malaria however severe thrombocytopenia also observed in P. Vivax malaria. In both species of malaria significant number paediatric patients present with low Hb level compared to adults. In P. vivax malaria significant number of adult patients presented with leukopenia as compared to paediatric patients.

Characteristic and trends of malaria in Surat district of Gujarat: a hospital based study.

Background: Malaria is a major health problem and infects many individuals despite of various efforts to control it. The present study was aimed to observe characteristics of malaria, seasonal variation and prevalence of malaria in our region. Methods: This retrospective study was conducted in our institute from period of January 2012 to December 2012. All the fever cases undergone investigations for malarial parasites were included in present study for defined time period. All the laboratory data of the patients having fever were retrieved from the Pathology Laboratory of our institute. Results: out of total 32674 reports studied 4907(15.01%) were positive for malaria with overall Slide positivity rate and slide falciparum rate were 15.01% and 38.29% respectively. Incidence of malaria occurs throughout year with increased incidence of P. falciparum in monsoon. Conclusion: In the present study incidence of malaria was higher in monsoon in comparison to other seasons. But throughout the year no declining trends in incidence of malaria was observed. P. vivax malaria was more commonly observed in our study but incidence of P. falciparum increased in monsoon.