A 5 Year Retrospective Study of Ovarian Tumours and Tumour-like Lesions in a Tertiary Referral Centre, Gandhi Medical College, Bhopal

Ovaries can be afflicted by various lesions, which can be non-neoplastic or neoplastic. Varied spectrum of clinical features and histopathological patterns are seen in these lesions. The present study was done to study the histopathological patterns of ovarian neoplastic and non-neoplastic lesions and their distribution in women of different age groups.METHODSThis was retrospective study of all cases of neoplastic ovarian tumours, and non-neoplastic ovarian tumours including functional ovarian cysts received during 5-year period from January 2014 to December 2018 in the Department of Pathology of Gandhi Medical College and Hamidia Hospital, Bhopal (M.P.). Data regarding age and tumour histopathology were recorded from pathology records. Routine H/E staining was performed.RESULTSA total of 541 different non-neoplastic and neoplastic lesions of ovaries were seen. Neoplastic tumours were more common (350; 64.6%) than tumour-like lesions of the ovary (191; 35.3%). Non neoplastic ovarian tumours were found to be more common than neoplastic ones in all age groups. Maximum number of ovarian tumours were seen in the age group of 21 - 50 years (272, 77.7%). Among tumour-like ovarian lesions, the most common were corpus luteal cysts (75, 13.8%). These were found to be more common in the age group of 31 – 50 years (123, 65%). Surface epithelial tumours were the most common (253, 72.2%) followed by germ cell tumours (70, 12.9%).CONCLUSIONSNeoplastic tumours of ovaries are more common than tumour-like lesions of ovary. For all age groups, benign tumours are more common than malignant ones.

Study of Morphological Pattern of Anaemia at a Tertiary Care Centre.

Anaemia is a disease of low erythrocyte count and haemoglobin (Hb) concentration less than the normal range. The main causes of anaemia are a decrease in RBCs, their destruction and decrease of Hb synthesis. A useful method for diagnosis and classification of anaemias is based on the morphological appearance of RBCs on an ideal stained blood smear. The main terms used in such classification are normocytic normochromic, microcytic hypochromic and macrocytic anaemia. In general, microcytic hypochromic anaemias are caused by reduced haemoglobin synthesis (most commonly because of iron deficiency), while macrocytic anaemias caused by reduced DNA synthesis that impair the maturation of erythroid precursors in the bone marrow. Normocytic normochromic anaemias have diverse aetiologies; in some of these anaemias, specific abnormalities of red cell size and shape which is best appreciated through visual inspection of peripheral smears provide an important clue as to cause.METHODSRetrospectively and prospectively we evaluated the results of complete blood count (CBC) and peripheral blood picture (PBP) of all anaemic patients attending during the year 2018 (from 1st January to 31st December), in the Department of Pathology, Gandhi Medical College, Bhopal (M.P.).RESULTSOut of a total of 500 patients, 220 were males and 280 were females. Results of CBC and PBP showed that 145 (29%), 275 (55%) and 80 (18%) of the patients had normocytic normochromic, microcytic hypochromic and macrocytic pattern of anaemia respectively.CONCLUSIONSThe microcytic hypochromic pattern of anaemia is highly frequent among this sample of patients while the macrocytic pattern of anaemia is the lowest. According to gender groups, microcytic hypochromic pattern of anaemia is more common among females; malnutrition, increase of blood loss due to pregnancy or menstruation, and lack of iron absorption are the main causes, while the normocytic normochromic anaemia is highly prevalent among males, which is mainly due to blood loss or chronic diseases.

Clinico-Haematological Profile of Haemophilia in Patients Attending Gandhi Medical College and Associated Hamidia Hospital, Bhopal..

BACKGROUND Haemophilia A and haemophilia B are the commonest form of haemophilia encountered and they result from a defect in Factor VIII and Factor IX gene respectively. This hinders the process of haemostasis and predisposing haemophiliacs to spontaneous or post traumatic bleeding. We wanted to study the clinico-haematological profile of patients with haemophilia.METHODSThis observational study was conducted in Gandhi Medical College and Associated Hamidia Hospital, Bhopal, during the period of March 2017 to June 2018. After clinical evaluation, patients were subjected to a battery of coagulation tests (Bleeding Time, Prothrombin Time, Activated Partial Thromboplastin Time, Correction Studies and whenever possible, Specific Coagulation Factor Assay). The results were analysed.RESULTSDuring the study period, 100 patients of haemophilia were studied. Majority of patients were of haemophilia A (89%). Most common age group was 6 - 15 years (49%) and mean age was 19.02±12.58 years. Most common age of onset was <1 year (62%). Positive family history was present in 57% of cases. 52% patients had severe haemophilia. Most common presentation was haemarthrosis & knee joint was the most common joint involved. APTT was prolonged in all cases.CONCLUSIONSHaemophiliacs are distributed worldwide and have heterogeneous presentation depending upon disease severity. Knowledge of the spectrum of presentation of haemophilia in the population helps in early diagnosis and management planning. Promotion of regular availability of factor concentrate, establishing comprehensive care center and positive public awareness along with good haematology laboratory will help in achieving outcome comparable to that of developed countries.

Adult choroid plexus papilloma: cause of sudden death.

Choroid plexus papilloma (CPP) is a rare, benign neoplasm, relatively more common in childhood. It is associated with signs and symptoms of increased intracranial pressure, frequently in association with obstructive hydrocephalus. CT and MRI are the investigations of choice and are diagnostic. Sudden deaths have been reported, but are very unusual. A 41 year old male was brought for medico-legal autopsy examination on ground of sudden death. He was reported to have headaches over a long period of time. On autopsy examination, massive sub-arachnoid hemorrhage was seen on both the cerebral hemispheres and cerebellum. A cyst measuring about 1 cm diameter was found in choroid plexus of right lateral ventricle. On histopathological examination, it was found to be a choroid plexus papilloma. Calcification was also evident in the papilloma. From medico-legal aspect, the present case reveals an unusual cause for sudden death in an adult male. The pathology could have been diagnosed easily by CT scan or MRI. When diagnosed, it has good survival rate, the morbidity depending on the extent of pathological effects. The present case was likely to have survived having minimal effects with appropriate treatment had he been diagnosed. The pathology is rare and a suspicion for this pathology in the adult male was not expected, but a CT scan to investigate chronic headache was warranted. Absence of such a suggestion leading to death, which could have been preventable, is sufficient ground for charge of professional negligence.

Skeletal angiomatosis - rare cause of bone destruction: a case report with review of literature.

Classification of skeletal angiomatosis into aggressive and nonaggressive types is on the basis of their clinical behavior and pattern of skeletal involvement (regional and disseminated). Gorham's disease (massive osteolysis) is an aggressive form of skeletal angiomatosis that shows regional involvement, frequently involving the shoulder and hip areas. Cystic angiomatosis is a nonaggressive form of skeletal angiomatosis with multifocal involvement, predominantly affecting the trunk bones. The imaging modalities gave the diagnosis of cystic angiomatosis of humerus showing multicystic lytic areas. The histopathological differential diagnosis was cystic angiomatosis and Gorham's disease, as microscopically both are indistinguishable from each other. Both represent a complex network of dilated thin-walled capillaries growing in the marrow space associated with the destruction of bone and infiltration into the adjacent soft tissues. The case is presented because of its extreme rarity and due to the diagnostic dilemma, whether to label it as Gorham's disease or as cystic angiomatosis. Considering the site involved and its aggressiveness, the diagnosis is in favor of Gorham's vanishing bone disease as cystic angiomatosis is multicentric and nonaggressive, involving mostly vertebrae and skull with multicystic lytic lesions.

Congenital epulis of the newborn: a case report with review of literature.

Congenital epulis, also known as congenital gingival granular cell tumor, is a rare benign intraoral tumor found only in the new born. It can be solitary or multiple and may occur in the mandible, maxilla or tongue and may or may not be associated with other congenital anomalies. The size of the mass varies and if very large may interfere with respiration and feeding at birth, thus necessitating the immediate surgical resection at birth to maintain patency of the airways. Antepartum detection by careful imaging and coordination of multidisciplinary team of maternal-fetal medicine, neonatal-perinatal medicine, anesthesiology and otolaryngology and finally the histopathologists who confirm the diagnosis is essential as the histology differentiates it from other congenital intraoral masses like haemangioma, fibroma, rhabdomyoma, rhabdomyosarcoma, lymphangioma, osteogenic and chondrogenic sarcomas.

Transformation of solitary osteochondroma calcaneum to chondrosarcoma--a case report.

Solitary osteochondroma of calcaneum is an uncommon benign tumor. Its malignant transformation to chondrosarcoma is rarely encountered. Pain and recent enlargement are clinical manifestations of this complication. Magnetic resonance imaging is a valuable tool to detect this change.

Breast lesions in young females--a 20-year study for significance of early recognition.

The aim of this case series is to evaluate the pattern of breast lumps in males and females with special reference to spectrum of lesions in females below 40 years of age. A 20 years retrospective study was undertaken from the records of the department of Pathology, Bhopal. The lesions were classified into benign and malignant. In young females histological pattern was analyzed in various age groups. A total of 1824 cases were studied. 1724 (94.5%) cases were seen in females and 100 (5.5%) in males. There were 1276 (74%) females below 40 years of age and 448 (26%) were above 40 years of age. In young females 1136 (89%) lesions were benign and 140 (11%) were malignant lumps. Fibrocystic disease in 60 (49%) cases constituted the largest group of benign lumps followed by 30 (24.5%) cases of inflammatory lesion in older females. The mean age of malignant tumors was 34.1 in young females and 51.4 in females above 40. Infiltrating duct carcinoma constituted 83.5% of malignant tumors in young females and 86.1% in older females.