Histomorphological Spectrum of Ovarian Lesions in a Tertiary Care Institute in Gujarat with Special Emphasis on Ovarian Tumors

Introduction: Ovarian cancer is the third most common cancer among women of India. Microscopic examination is the goldstandard for diagnosing ovarian tumors and plays an important role in determining prognosis.Purpose: The aim of the study is to assess the frequency of non-neoplastic and neoplastic lesions in ovarian specimens andbiopsies and to study the histomorphological spectrum, gross features, and age distribution of the ovarian tumors.Materials and Methods: The present study was an observational retrospective study conducted over a period of 1 year(February 2019–January 2020) in the Department of Pathology in a Tertiary Care Hospital in South Gujarat. A total of cases (8ovarian biopsies and 82 ovarian specimens) were analyzed. Tumors were classified according to the WHO classification 2014.Results: Of 90 cases, eight were of non-neoplastic lesions, 13 were tumor-like lesions, and nine neoplastic lesions. Amongneoplastic lesions, 43 cases (62.3%) were benign, 3 (4.4%) were borderline, while 23 (33.3%) cases were malignant.Histopathologically, surface epithelial tumors (76.7%) were the most common subtype followed by germ cell tumors (13.3%)and then sex cord tumors (10%). Malignant surface epithelial tumors constitute 78.2% of the total malignant ovarian tumors. Themost common neoplastic lesion was serous cystadenoma. 30–39 years age group was the most common age group overall inovarian tumors. Benign tumors were most common in the 30–39 years age group, while malignant tumors were most commonin the 60–69 years age group. Bilaterality was seen in 10 (16.4%) of 61 gross specimens of ovarian tumors.Conclusion: The frequency of malignant ovarian tumors was higher in our institute. Accurate histopathological diagnosis isessential for management and determining prognosis

Study of histomorphological spectrum of lesions in nephrectomy specimen in a tertiary care hospital in South Gujarat

Background: Nephrectomy is a standard surgical procedure in urology indicated in patients with organ confined renal malignancies and irreversible kidney damage resulting from chronic infection, trauma, obstruction and congenital malformation. This study aims to study the histomorphological features of lesions in nephrectomy specimens in a tertiary care hospital, to analyse the neoplastic and non-neoplastic lesions of kidney according to age, gender and site and observe any variation from the conventional pattern.Methods: The present study was conducted in department of pathology, Tertiary care hospital over a period of 5 years and 7 months (1 Jan 2013 to July 31, 2018). This included 4 years retrospective and 1 year 7 months prospective.  A total of 73 cases of were studied.Results: Males constituted 65.73% and females constituted 35.27%  of all nephrectomy cases. Right kidney was more commonly affected. Highest percentage of patients belonged to 41-50 years age group. 45 cases were of non-neoplastic lesions and 28 cases were of neoplastic lesions. Among neoplastic lesions, one case was benign while remaining 27 cases were malignant. Chronic Pyelonephritis was the most common indication overall and also amongst non-neoplastic lesions with stone identified in 55% cases. Most common neoplastic lesion in nephrectomy specimen was Renal Cell carcinoma (71.4.1%) followed by Wilms tumour (14%).Conclusions: This study gives a fair insight of the current state of incidence of neoplastic and non-neoplastic lesions of kidney requiring surgical intervention.

Death due to sickle cell anaemia, an autopsy diagnosis: a study at a tertiary care hospital.

Background: Sickle cell disease (SCD) is the generic term for the group of inherited haemoglobinopathies caused by the occurrence of Haemoglobin S (HbS) in the homozygous or heterozygous form in combination of Hbs with another abnormal haemoglobin such as HbSC or beta-thalassaemias (HbS-thal). Sickle cell syndromes are remarkable for their clinical heterogeneity, including their presentations as sudden and unexpected deaths due to a sickle cell crisis. Less numbers of deaths are reported due to this cause because of ignorance of autopsy surgeon in considering this disease as a cause of death despite of its high prevalence. While doing autopsy in cases of deaths with no apparent cause and physical over activity medical officer must keep in mind the possibility of death due to vaso-occlusive crisis in sickle cell disease. Methods: The study covers a period of one year (January 2013 - December 2013) and it is a study of cases of autopsy carried out in a tertiary care hospital of South Gujarat. Results: A total of 607 cases examined, out of which sickled red blood cells were detected in 17 cases. The respective records were reviewed. Out of 17 cases, 13 cases were male and 4 cases were females. The youngest person was 15 years female and oldest was 70 years male. Conclusion: Sickle cell crisis is one of the causes of sudden unexplained deaths. The present study highlights the role of autopsy in such cases. Community awareness and marriage counseling programs are also helpful in preventing sickle cell disease.

Fine needle aspiration cytology: accurate and reliable tool for primary diagnosis of salivary gland lesions.

Background: Management of salivary gland lesions is greatly influenced by preoperative or intraoperative diagnosis of malignancy. Fine needle aspiration cytology (FNAC) is used as a primary diagnostic tool since long. Objective: The objective of study was to evaluate usefulness and diagnostic accuracy of FNAC in primary diagnosis of salivary gland lesions. Methods: Study includes 75 cases suspected of salivary gland lesions evaluated by FNAC from January 2010 to August 2012. Whenever possible follow up histopathology also studied. Results: Out of total of 75 cases of salivary gland lesions 30 cases (40%) were nonneoplastic, 30 cases (40%) were benign and 15 cases (20 %) were malignant. FNAC showed satisfactory sensitivity and specificity with about 91% diagnostic accuracy for benign lesions and for malignant lesions. Conclusions: Study concludes that FNAC has proven to be simple, easy, minimally invasive method with satisfactory accuracy for initial diagnosis of Salivary gland lesions especially benign and malignant neoplasms. It almost accurately type benign tumors like pleomorphic adenoma and showed fair accuracy and reliability. FNAC is vital for management primarily to exclude need of surgery as nonneoplastic lesions are managed conservatively and planning preoperative chemoradiation like in cases of Mucoepidermoid carcinoma arising in odd locations like palate.

Analysis of bone lesions in tertiary care center - A review of 79 cases.

Background: Bone tumours are comparatively uncommon among wide array of lesions and pose a diagnostic problem as they constitute a small portion of diagnostic experience among pathologist. Aims & Objective: To study the histopathological features of bone lesions and their correlation with age of presentation, site and type of lesion. Material and Methods: The present study was carried out at a tertiary care center from October 2003 to January 2006. A total of 79 bone lesions were analyzed. A detail clinical and radiological history was taken. Bone biopsy was performed by either percutaneous method with needle/drill or Open surgical biopsy. If attached soft tissue was also received, bony tissues were put for decalcification (10% nitric acid) and soft tissue was immediately fixed into 10 % formalin and processed by paraffin embedding. Sections were stained by haematoxylin and eosin stain. Results: Incidence of non-neoplatic and benign neoplastic lesions was 68.40% while that of malignant lesion was only 20.22%.Younger patients (58.24%) and males (59.49%) were more commonly affected. Amongst non-neoplastic lesions, tuberculous lesions (17.72%) were commonest while exostosis (15.19%) and osteosarcoma and chondrosarcoma were common benign and malignant neoplastic lesions respectively. Overall most common bone involved was femur. In tuberculous lesions, vertebrae were commonly involved. Osteolytic lesions were more common. Metaphysis was the commonest site. Conclusion: Though bone tumours are less common lesions and pose a diagnostic problem, if viewed in perspective of clinico-radiology and histopathology, a correct diagnosis can be reached.

Changes in WBC and platelet count in patients with malaria: a hospital based comparative study.

Introduction: Malaria is one of the most common infectious diseases of tropics. It presents with varied clinicopathological manifestations. Most of the complication in malaria occurs due to various hematological abnormalities. Present study was aimed to find out abnormalities in WBC and platelet counts in patients with malaria. Methods: A total 135 patients either hospitalized or treated on an outpatient basis were included in the study after positive identification for malarial parasites on Giemsa stained PSMP smears. WBC and platelet count was carried out on 3 part hematology analyzer (Sysmax KX 21). WBC count less than 4000/cumm was considered as leucopenia and platelet count less than 150000/cumm was considered as thrombocytopenia. Results: The present study includes 135 patients with malaria from which 72.59% of subjects were male and 27.41% of subjects were female. P. falciparum was present in 68.89% of cases, P. vivax in 28.15% of cases. Majority of patients had normal leucocyte count (97.03%). Neutrophilia with lymphopenia was observed in both species of malaria in our study. Thrombocytopenia was observed in89.62% of cases in malaria. Thrombocytopenia in P. falciparum was found in 92.48% of cases and in P. vivax it was 81.57% of cases. Conclusion: Present study did not show any significant change in WBC count. Present study showed neutrophilia with relative lymphopenia in both group of malaria. Incidence of thrombocytopenia was observed in both species of malaria without any statistical significance.