ABSTRACT
Background: Diffuse large B-cell lymphoma (DLBCL) represents a heterogeneous group of lymphoid malignancies with distinct oncogenic events and clinical behavior that cannot be unraveled by morphology and immunophenotype alone. Simple biological segregation such as the Hans classifier helps to explain the heterogeneous responses to standard treatment and provides a rationale for the investigation of novel targeted therapies. Aims and Objectives: In this study, we tried to estimate immunohistochemical (IHC) features of nodal and extranodal DLBCL using cell-of-origin classification (Hans Algorithm) with the markers CD10, Bcl-6, MUM1. Materials and Methods: Blocks of the patients with a histological diagnosis of DLBCL over the past 3 years were retrieved and submitted for IHC analysis to classify into germinal center B cell type (GCB) and non-GCB type. Results: Mean age for nodal DLBL was 48.19 � 14.68 years, extranodal were 55.7 � 13.22 years. Mean age for GCB were 56.6 � 15.66 years whereas for non-GCB were 51.45 � 12.85 years. Among nodal lymphomas cervical was the most common site and among extranodal lymphomas, intestinal lymphomas were commonest (including colorectal). Relative proportion of GCB among extranodal was 28.78%, whereas in nodal DLBCL it was 16.67%, relative risk of getting GCB type DLBCL was 1.72 times higher in extranodal compared to nodal DLBCL (P = 0.081). Total positivity of MUM1 was 17%, whereas for Bcl6 and CD10 it was 29% and 15% respectively. Ki67 was considerably higher in GCB type and for extranodal DLBCL in our study. Conclusion: Proportion of extranodal GCB type DLBCL compared to nodal DLBCL is considerably higher in our study population, though it varies greatly among Asian and world data. Uniform meta-analysis and systematic review is necessary to stratify.
ABSTRACT
Background: Primary extra-nodal lymphomas (ENLs) are rare neoplasm but can affect many organ systems of body. Proper and timely diagnosis and justified treatment of primary ENL are often affected due to variety of lymphoma types and the relative rarity of many of these tumor types. They are mainly of Non-Hodgkin lymphoma which further consists of many subtypes having variation of epidemiology and clinical presentation along with geographic distribution. Aim and Objectives: Aim and objectives of the study were to find out topographical distribution and histological patterns of ENL along with their immunohistochemical character in a tertiary care hospital of Eastern India. Materials and Methods: All the cases from April 2015 to March 2018 diagnosed as ENL by histopathological examination were included in this descriptive cross-sectional study for further immunohistochemical analysis for CD45 Life-cycle assessment (LCA), CD3 and CD 20 to identify the cell of origin (B cell vs. T cell). Results: Out of total 31 cases, 67.74% were male and the most common age group was 51–60 years. Gastrointestinal tract was the most common organ system (61.29% of cases) affected and stomach (29.03%) followed by Ileum (9.67%) were the most common sites affected by ENL. Histomorphologically diffuse large cell lymphoma was the most common pattern while immunohistochemistry study revealed all the cases were B cell type with LCA and CD 20 positive and CD3 negative. Conclusion: This study revealed the topographical pattern along with predominant histomorphological and immunohistochemical character of ENL in study population. However, further studies with meta- analysis can enlighten these characters more comprehensively.
ABSTRACT
Background: Although most of the COVID-19 patients presented with mild symptoms and recovered, a considerable number of cases became serious with poor prognosis in an unpredictable manner. They mostly presented with respiratory symptoms and coagulation abnormalities with thrombosis and multi-organ failure. Hence, timely prediction of these cases with the early intervention might decrease mortality. Aims and Objectives: The objectives of this were to determine whether values of fibrinogen, fibrin degradation products (FDP), and D-dimer level correlates with disease severity in COVID-19 patients. Materials and Methods: This observational cross-sectional study was done on total 400 hospitalized COVID-19 adult patients where patients were categorized into moderate and severe cases as per guideline of Government of India. Patients with pre-existing coagulation disorder or receiving anticoagulant drugs were excluded from the study. FDP, fibrinogen, and D-dimer values of these two groups were evaluated and compared statistically to determine their significance. Results: Overall mean and standard deviation of fibrinogen, FDP, and D-dimer were 607.48 ± 177.73, 34.93 ± 29.2, and 6.23 ± 6.48 for severe category, while for moderate category disease, they were 389.77 ± 110.16, 10.79 ± 10.47, and 1.96 ± 3.3, respectively. Unpaired t-test showed that the study parameters are significantly higher in severe COVID-19 patients compared to moderate ones. Conclusion: It was concluded that elevated level of D-dimer, fibrinogen, and FDP is indicator of disease progression in COVID-19. Thus, regular estimation of these simple coagulation parameters may predict disease severity and help in adequate management.
ABSTRACT
Background: Most of the patients of Coronavirus Disease-19 (COVID-19) presented with mild symptoms and recovered, but a considerable number of cases deteriorated and succumbed to death. They often present with hemostatic abnormalities mimicking disseminated intravascular coagulation with increased risk of thrombosis rather than bleeding. Hence, early prediction of disease severity by some easily available hematological parameters might be helpful to reduce mortality in COVID-19 cases. Aim and Objectives: The aim of the study was to determine whether values of Prothrombin Time (PT), International Normalized Ratio (INR), Activated Partial Thromboplastin Time (APTT) and D-Dimer (DD) correlate with disease severity in COVID-19 and also to find out cutoff value of these parameters to predict disease severity. Materials and Methods: This observational cross-sectional study was done on total 400 hospitalized COVID-19 adult patients where patients were categorized into moderate and severe cases as per guideline of Government of India. Patients with pre-existing coagulation disorder or receiving anticoagulant drugs were excluded from the study. PT, INR, APTT, and DD values of these two groups were evaluated and compared statistically to determine their significance and the cut-off value to predict severity. Results: Among the measured blood parameters means of PT (P < 0.001), INR (P < 0.001) and DD (P < 0.001) found to be significantly higher in the severe group of patients compared to moderate ones and DD value ?1.365 mg/L indicates severe disease. APTT showed no statistically significant association with severity. Conclusion: PT and INR can be used as severity marker in COVID-19 patients; however, DD is the most reliable marker correlating with disease severity.
ABSTRACT
This study was undertaken to find out the frequency of bone tumours and to evaluate the effectiveness of drill biopsy for tumourous bony lesions. A total of 182 cases of bone tumours and tumour-like lesions were studied histopathologically. Of these, 100 (54.95%) cases were found to be malignant, 45 (24.73%) benign and 28 (15.38%) tumour-like lesions. A total of 38 drill biopsies were performed where 29 cases had corresponding open biopsies. Of these, 22 cases (75.86%) had concordances in diagnosis. The overall success of drill biopsy was 73.68%.