Argyrophilic nucleolar organiser regions (AgNORs) in breast lesions.

Nucleolar organiser regions (NORs) demonstrated by argyrophilia of NOR-proteins are indicator of cellular proliferative activity. The NORs can be identified in the nuclei as brown or black dots with silver colloidal staining technique in formalin fixed paraffin sections and in cytology smears. Seventy-five cases including 45 tissue sections and 30 fine needle aspiration cytology (FNAC) smears of benign and malignant lesions of breast have been studied to evaluate the significance and practical application of AgNOR count per nucleus. Out of 45 tissue sections 15 belonged to fibrocystic disease, 10 fibro-adenomas and 20 carcinomas and of the 30 FNAC smears, 10 were fibrocystic disease, 8 fibro-adenomas and 12 carcinomas. In fibrocystic disease the mean AgNOR count was 1.60 (FNAC group-0.75, tissue section-1.61). In fibro-adenomas it was 1.61 (FNAC-1.63, tissue section-1.59). The mean count in carcinoma was 12.10 (FNAC-12.08, tissue section-12.10). The difference in AgNOR count in fibrocystic disease and fibro-adenoma was not significant, but that between benign breast lesion and carcinoma was significant. No difference was observed between FNAC and tissue section groups in benign or malignant lesions. The simple staining technique can be used as an additional criterion to differentiate the benign and malignant lesions of breast.

Clinicopathological study of clinically undiagnosed cases of kala-azar with special reference to grading of parasites.

Clinicopathological study of 34 clinically undiagnosed cases of kala-azar has been undertaken with a view to establish the diagnosis and correlate the quantitative grading of Leishmania donovani in bone marrow/splenic aspirates with clinical features and duration of disease. The ages of the patients were between 5 and 45 years. The duration of illnesses ranged from 2-24 months with 47% having 2 months' duration. Splenomegaly was less than 7 cm in 70.5% cases. Anaemia, leucopenia and mild thrombocytopenia were present in all the cases. Aldehyde test was positive in 47% cases. Bone marrow aspiration revealed the parasites in 82.3% cases. L donovani was also observed in 66.6% cases of splenic aspiration including 6 cases where bone marrow failed to reveal the parasite. Grading of the parasites in bone marrow and splenic aspirates revealed majority of the cases (73.5%) were in 3+ and 4+ grades. No correlation between splenic size and duration of illness or parasite grading was detected. Neither any positive correlation between parasite grading and duration of illness was observed.

Fine needle aspiration cytology of cervical lymphadenopathy with special reference to tuberculosis.

One hundred eighty cases of cervical lymphadenopathy have been studied by fine needle aspiration cytological examination followed by histopathologic examination of the excised lymph nodes. The diagnostic accuracy was 84.4% for tuberculous lymphadenitis by fine needle aspiration cytological examination. Observation of caseous necrosis (84.2%) and epithelioid cells (73.6%) were the most characteristic diagnostic features in the aspirated smears. Acid-fast bacilli were observed in 45.6% cases. Metastatic carcinoma also yielded a high diagnostic accuracy ie, 89%. Fine needle aspiration cytology has been found to be safe, quick, inexpensive with high diagnostic accuracy in cervical lymphadenopathy.

Malignant lymphoma--a 15-year study report.

Analysis of incidence of different types of malignancies during 15 years showed occurrence of malignant lymphoma in 192 cases (4.1%). There were 82 cases (42.7%) of non-Hodgkin's lymphoma and 110 cases (57.3%) of Hodgkin's disease. Lymphocytic lymphoma, the major type observed among the non-Hodgkin's lymphoma with 58 cases (30.21%), showed a preponderance of well differentiated type (40 cases). Other cases in this group comprised mixed cellularity (2.08%), histiocytic (3.64%) and unclassified one (6.77%). Analysis of the Hodgkin's disease cases showed majority in it belonged to the mixed cellularity type (44.5%) followed by the lymphocytic predominant type (27.3%), lymphocytic depletion type (18.2%) and nodular sclerosing type (10%). The incidence of 14 cases of extranodal lymphomas was 7.3% among the lymphomas with maximum occurrence in the gastrointestinal tract (42.8%).

Sclerema neonatorum--histopathologic study.

Histopathological study of 10 cases sclerema neonatorum showed subcutaneous fibrosis with lobulation in all the cases. 8 (80 percent) cases showed non-specific chronic inflammation of dermis and thinning of epidermis with atrophy of rete pegs and hypercollgenisation of dermis was evident in 70 percent cases. Fat necrosis with crystallisation of fat content was not a conspicuous feature.

Rare variant of acute promyelocytic leukaemia.

Acute promyelocytic leukaemia (APL) is a peculiar sub-type of acute myeloblastic leukaemia characterised by presence of atypical promyelocytes in bone marrow and peripheral blood and common occurrence of haemorrhagic episodes associated with disseminated intravascular coagulation. Two morphological forms of APL are recognised--typical hypergranular and microgranular or M3 variant. This microgranular form of APL is rare but has got some peculiar features and often can be diagnosed by peripheral blood smear examination alone without bone marrow examination. Three cases of microgranular form of APL observed during a period of 6 months are reported here.