ABSTRACT
Introduction: For a range of kidney abnormalities, including both neoplastic and nonneoplastic disorders, nephrectomy is a popular surgical treatment. We conducted this study to examine the range of lesions found in the nephrectomy specimens obtained and to ascertain the distribution of these lesions by age and sex. MaterialsandMethods: This study was conducted in the department of pathology, from 2017 to 2022. All nephrectomy specimens received during 5 years were included. Results: The spectrum of renal lesions observed in the study included both neoplastic (43.75%) and nonneoplastic (56.25%) conditions. Nineteen patients were males (59.37%) and 13 were females (40.62%) (M: F = 1.4:1). The most common entity in the nonneoplastic category was chronicpyelonephritis (n = 9, 28.12%). In our study, we documented two unusual cases of renal replacement lipomatosis (RRL), a type of pseudotumor related to nonfunctioning kidneys. Fourteen patients underwent nephrectomy for neoplastic conditions such as Wilm’stumor and renal cell carcinoma (RCC). Conclusion: Nephrectomy for the nonneoplastic condition was performed more frequentlyin our series. Histopathological evaluation of nonneoplastic nephrectomy specimens must be thoroughly considered, particularly in unusual circumstances such as RRL, where a preoperative erroneous initial impression of a malignant lesion such as angiomyolipoma or liposarcoma is possible.
ABSTRACT
Introduction: Clinically, all trophoblastic lesions are frequently combined under a broad spectrum of gestational trophoblastic diseases (GTDs)without the use of specific pathological terms. However, studies now demonstrate that various forms of GTDs demonstrate differences in etiology, histogenesis, morphology, and clinical behavior. Thus, the need for diagnostic histopathology of these lesions to distinguish gestational trophoblastic neoplasms from nonneoplastic lesions and molar pregnancies and also for early anticipation for early anticipation, risk category stratification, prognostication, management, and prediction of persistent GTD. Our study aimed to study the histomorphological patterns of various types of GTD with light microscopy and the pattern of occurrence of GTDs in relation to age, parity, and gestation. MaterialsandMethods: The present study was conducted in the department of pathology, from January 2020 to April 2022. All GTDs confirmed by histopathological examination by hematoxylin‑ and eosin‑stained slides were included. Results: The spectrum of GTDs found in this study was seventy cases of hydatidiform mole (92.10%), three cases of exaggerated placental site (EPS) reaction (3.94%), and two cases of choriocarcinoma (2.63%) and one case (1.31%) of placental site trophoblastic tumor (PSTT). The most common presenting symptom was vaginal bleeding (93.42%). Conclusion: Hydatidiform mole forms the most common type of GTD with an incidence of complete moles more than partial moles. Histomorphological examination and analysis are helpful for confirmatory diagnosis. The most common clinical presentation of GTD was vaginal bleeding followed by amenorrhea. Emphasis on detailed descriptive morphological assessment can help in the histological distinction of benign lesions such as EPS reaction and placental site nodule and avert such cases from being erroneously diagnosed as neoplastic. The Ki‑67 proliferation index helped in distinguishing the EPS reaction from neoplastic lesions such as PSTT which requires surgical intervention and chemotherapy.
ABSTRACT
Introduction: Bleeding from esophageal varices causes significant mortality and morbidity in patients with chronic liver disease. With upper GI endoscopy not available in many centers and in rural India, certain noninvasive methods can help to aid in the prediction of the presence of large esophageal varices. Early identification of large varices helps in prophylaxis to prevent bleeding until definitive management is done. Here in this study, we are using platelet count/spleen diameter ratio in predicting the large esophageal varices and comparing its sensitivity and specificity with non-invasive parameters. Study: This is a cross-sectional study (Prospective study) in a tertiary hospital. Methods: Patients admitted to SSIMS & RC, DAVANAGERE between January 2021 and June 2021 with a diagnosis of chronic liver disease were included in the study. Patients were assessed for ascites, splenomegaly, ultrasonographic measurements like splenic size and portal vein diameter, and laboratory parameters like hemoglobin, platelet count, total bilirubin, prothrombin time and serum albumin. The ratio of platelet count with spleen diameter was calculated. Univariate and multivariate analyses were done. Results: Incidence of large varices were seen in 44%. By ultrasonography, 22 were found to have splenomegaly while 28 were found to have normal spleen dimensions. Patients with large esophageal varices had significantly lower platelet counts as compared to those without. Spleen diameter was greater while platelet count/spleen diameter ratio was lower in patients with large esophageal varices. On multivariate analysis, independent predictors for the presence of large varices were palpable spleen, low platelet count, spleen size >13.8 mm, portal vein >13 mm and splenic vein >11.5 mm. The platelet count/ spleen diameter ratio had a sensitivity and specificity of 87 % and 85% respectively which was more than other parameters. Hence platelet count/ spleen diameter ratio can be a reliable indicator for predicting the presence of large esophageal varices than other non-invasive parameters. Conclusion: Platelet count/ spleen diameter ratio is more accurate and a strong predictor of large esophageal varices than any other non-invasive parameters in patients with chronic liver disease which warrant the need for prophylaxis and early intervention to prevent life-threatening hemorrhage.