ABSTRACT
Background and aim: Gallstones are known to produce diverse histopathological changes in the gall bladder. Our aim was to correlate various gallstone characteristics (number, size, weight, volume and morphological type) with the type of mucosal response in gall bladder (inflammation, hyperplasia, metaplasia and carcinoma). Methods: The study was conducted on 330 open cholecystectomy specimens with complete gallstones. The stones were assessed for various parameters i.e. number, size, weight, volume and morphological type. For microscopy, sections were obtained from the fundus, body and neck of the gallbladder. Additional sections were taken from abnormal looking areas. Results: Out of the 330 cases, 194 (59%) had mixed stones, 84 (25%) combined, 30 (9%) pigment and 22 (7%) had cholesterol stones. Number of stones varied from a single calculus in 131 (39.6%) cases, double in 29 (8.8%) and multiple in the remaining 170 (51.6%) cases. Cholecystitis, hyperplasia, metaplasia and carcinoma were more commonly seen with mixed and multiple stones. The average weight of calculi in cholecystitis was 2.551 gm, in hyperplasia 3.619 gm, metaplasia 4.549 gm and 17.96 gm in cases with carcinoma. Similarly, average volume of the stone(s) was 2.664 ml in cholecystitis, 3.742 ml in hyperplasia, 4.532 ml in metaplasia and 19.178 ml in carcinoma. The average calculus size (2.147 cm) was found to be maximum in cases with carcinoma, followed by hyperplasia (1.187 cm), metaplasia (1.145 cm) and cholecystitis (1.136 cm). Conclusion: As the weight, volume and size of the stone increases the changes in the gall bladder mucosa changes from cholecystitis, hyperplasia, metaplasia, dysplasia, to carcinoma.
ABSTRACT
Tuberculosis of the thyroid gland is an uncommon disease and primary involvement of thyroid is even more rare. It is a rare disease even in countries in which tuberculosis is endemic. The diagnosis is often difficult as the clinical presentation has no distinct characteristics. Clinical course of the disease may resemble toxic goiter or acute thyroiditis or may follow a subacute or chronic growth pattern without specific symptomatology. Histologically presence of necrotizing epithelioid cell granulomas along with langhans type giant cells are the hallmark of thyroid tuberculosis. Demonstration of acid fast bacilli by ZN staining confirms the diagnosis, but this stain is frequently negative in tissue sections.
ABSTRACT
Tuberculosis (TB) today remains one of the world's most lethal infectious diseases. Despite the availability of effective treatment for most cases, tuberculosis is still a cause of death in our environment. Some cases of active tuberculosis are not identified until after the patient had died and an autopsy has been performed. This study was done to determine the prevalence of tuberculosis in autopsy cases. We analysed all the autopsy cases sent for histopathology over a period of one month. 8.7% cases of active tuberculosis were found in autopsy specimens, of which 60% were males. Tuberculosis was suspected in only 40% of patients before death. Tuberculosis is not an uncommon finding at autopsy for most of autopsy surgeons, but as the cause of death it is not so common. The presence of unspecific symptomatology, insufficient cost-effectiveness of the diagnostic tests and precocious death, are identified as the most frequent causes of undiagnosed tuberculosis. Awareness of tuberculosis and its high prevalence in India is essential for minimising missed diagnoses. Absence of suspicion and delayed diagnosis mean increased risk in health care and at autopsy.