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Endometrial stromal sarcomas are rare uterine tumours usually seen in perimenopausal females. We report here a case of low grade endometrial stromal sarcoma in a 45 year female with a clinical diagnosis of fibroid uterus and final histological diagnosis of low grade endometrial stromal sarcoma.
ABSTRACT
Background: Bone marrow examination is useful in the diagnosis of both hematological and non-hematological disorders. The two most important techniques used for the diagnosis of hematological disorders are bone marrow aspiration and trephine biopsy which are complementary to each other. The present study is to evaluate the findings of bone marrow aspiration & trephine biopsy and their cytological and histological patterns in various hematological disorders. The aim of the study is to evaluate the clinical profile, spectrum, cytological and histological pattern of various hematological disorders reported in bone marrow aspiration and trephine biopsy respectively. Methods: It was a cross-sectional study design with 105 patients who underwent bone marrow examination for evaluation of hematological disorders in the Department of pathology, Andhra Medical College during the period of 2012 to 2014. Results: Among 105 cases studied, age of patients ranged from 1 to 68 yrs with mean age of 32.4 yrs and male predominance (1.5:1). Most of the patients presented with fever, shortness of breath, Easy fatigability and generalized weakness. The commonest physical findings were pallor followed by splenomegaly & hepatomegaly and in hematological parameters predominantly pancytopenia. Bone marrow aspiration was diagnostic in 53(50%) cases and trephine biopsy was diagnostic in 52(50%) cases. Anemias (50%) and leukemias (16%) are most common hematological disorders. Among the anemias, megaloblastic anemia is the most common (40%) cause of hematological non-malignancies. Among leukemias, acute myeloid leukemias are common cause of hematological malignancies. Conclusion: The present study showed the usefulness of bone marrow aspiration and trephine biopsy in evaluation of the bone marrow in routine haematological disorders and also for understanding disease progression, for diagnosis and therapeutic evaluation. These are also helpful in planning further investigation and management.
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Background: Cervical cancer is the most common, preventable cancer and does not develop suddenly from normal epithelium but is presented by a spectrum of intraepithelial neoplasia. Pap smear is an ideal screening and low cost effective test to detect intraepithelial neoplasia especially in developing countries but has limitations and needs confirmation by histopathology. The study aimed to determine the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of pap smears as screening test in cervical lesions by comparing with histopathology. Methods: This is a prospective study conducted at a tertiary care centre in Department of pathology from October 2012 to September 2014. A complete clinical history and demographic status of the subjects was recorded. Conventional pap smears were reported adopting Bethesda system and biopsies were taken in cases of epithelial cell abnormality, routinely processed and stained with H&E. Results: Total number of pap smears analysed were 356. NILM (negative for intraepithelial lesions or malignancy) constituted major group 248/356 (69.64%) and epithelial cell abnormality were 98/356 (27.5%). In the present study overall sensitivity was 94.11% specificity 64.28% positive predictive value 82.75%,negative predictive value 85%,diagnostic accuracy 83.33%,concordance rate 78.2% and P value <0.001. Concordance rate for CIN I was 78.9%, for CINII and CINIII 60% and for squamous cell carcinoma 100%. Conclusion: Pap smear is simple, inexpensive and can be performed in the outpatient department. Hence, it should be recommended routinely as a method of improving reproductive health, early detection of premalignant and malignant cervical lesions.
ABSTRACT
A simple slide test and image analysis were used to reveal the presence of an acute-phase response and to determine its intensity in subjects of acute myocardial infarction and acute ischemic stroke. Erythrocytes tend to aggregate during an inflammatory process. Evaluation of erythrocyte adhesiveness/aggregation is currently available to the clinicians indirectly by erythrocyte sedimentation rate (ESR), but ESR correlates poorly with erythrocyte aggregation, hence a simple slide technique using citrated blood was used to evaluate erythrocyte aggregation microscopically and also by using image analysis. Aims: (1) To study erythrocyte aggregation/adhesiveness by a simple slide test in subjects with acute ST-elevated myocardial infarction (STEMI), acute ischemic stroke and healthy controls. (2) To study the prognostic significance of ESR and erythrocyte aggregation/adhesiveness test (EAAT) in predicting the outcome after 1 week in subjects of acute myocardial infarction and acute ischemic stroke. Patients and Methods: Three groups of subjects were included in the study; 30 patients of acute STEMI, 30 patients of acute ischemic stroke, and 30 subjects with age- and gender-matched healthy controls. Citrated blood was subjected to simple slide test and ESR estimation by Westergren's method. Stained smears were examined under 400Χ and graded into four grades. Images were taken from nine fields; three each from head, body, and tail of the smear. The degree of erythrocyte aggregation was quantified using a variable called erythrocyte percentage (EP), by using the software MATLAB Version 7.5. A simple program was used to count the number of black and white pixels in the image by selecting a threshold level. Results: The mean ESR of the subjects with acute myocardial infarction (29 + 17.34) was significantly higher (P = 0.001) than the mean ESR of the control group (15.5 + 12.37). The mean EP of the subjects with acute myocardial infarction (69.91 + 13.25) was significantly lower (P < 0.001) than the mean EP of the control group (85.16 + 8.41). The mean ESR of the subjects with acute stroke (40.46 + 33.75) was significantly higher (P = 0.0005) than that of the controls (15.5 + 12.37). The mean EP of the stroke patients (70.59 + 11.30) was significantly lower (P < 0.001) than the mean EP of the controls (85.16 + 8.41). In subjects with acute myocardial infarction there was a significant negative correlation (r = −0.623) between ESR and EP. In acute stroke patients there was a significant negative correlation (r = −0.69) between ESR and EP. On performing standard error of proportions, P value was < 0.05. Conclusion: EAAT is a simple bedside test for erythrocyte aggregation, which indirectly reveals the presence and proportion of inflammation. This test has the potential to assess the prognosis of acute myocardial infarction and acute stroke. It can also be used as a screening test for high-risk individuals, so that necessary interventions could be adopted. However, further studies need to be conducted to establish standard protocols.