ABSTRACT
Background: Placenta-related disorders of pregnancy are almost unique to human species. These disorders, which affect around a third of pregnancies, primarily include miscarriage and preeclampsia. Aim and objectives: The aim of the present study was to examine the morphological changes in placentas of normal and high risk pregnancies, and to evaluate the fetal outcome in these cases, which in turn will improve the quality of placental diagnosis. The objectives were to know the extent of the gross and microscopic placental changes that occur in normal pregnancies and to study the placentas of high risk pregnancies. Materials and methods: A study of 132 placentas in normal and high risk pregnancies was conducted in the Department of Pathology, Kakatiya Medical College, MGM Hospital, Warangal, from 1st September 2014 to 31st August 2016. The materials included in this study were placentas from thirty females with normal pregnancies (controls) and one hundred thirteen with high risk pregnancies (cases) comprising anemia (27), pregnancy-induced hypertension (38), intrauterine growth retardation (15), diabetes mellitus (13), and twins (9). Results: In high risk cases, women in the age group 21-25 years were 66.6% in anemia, 60.5% in PIH, and 60% in IUGR 69.2% in diabetes mellitus, and 33.3% in twin pregnancies. Only a few cases Samala Raghuram Mohan, Jyosna, Sandhya Anil, S. Chandra Sekhar. Morphological changes in placentas of normal and high risk pregnancies - 2 years study in MGM hospital. IAIM, 2017; 4(5): 61-78. Page 62 were seen in the age group of 26-30 in both controls and cases. Seventy percent of the controls belonged to primigravida and 30% were multiparous women. In high risk cases, 66.6% were primigravida and 33.3% multipara. Majority of the multiparous mothers were seen in anemia constituting 48.1%. High risk cases exhibited exaggerated changes, except for calcification, which was seen equally in both the groups. Infarction was seen in 50% cases of PIH. Single case of retroplacental hematoma was also observed in PIH. Subchorionic fibrinoid was seen in 53.4% of IUGR placentas. Maternal floor infarction was seen in 4 cases of PIH and 3 cases of IUGR placentas. Subchorionic hematoma was seen in 1 case of IUGR placenta. IUGR placentas were small in size and weight for the gestational age and twin placentas were of diamniotic dichorionic type. The most prominent microscopic features were syncytiotrophoblastic knot formation and calcification. The high risk groups were showing prominent infarcts, fibrinoid necrosis, and stromal fibrosis more than those of control group. Conclusion: The present study has highlighted the importance of examination of placenta in normal as well as high risk pregnancies. The placental changes are essential to correlate the fetal outcome, as it provides the information for the cause of death. Hence, it has an effective role in planning prenatal monitoring of a future pregnancy.
ABSTRACT
Aim and objectives: To show the incidence of triple negative breast carcinomas in the younger age group (20-40 years) in the study sample and to establish a correlation between expression patterns of estrogen receptor (ER), progesterone receptor (PR) and HER2 /neu with tumour histopathology of breast carcinoma. Material and methods: A 5 years study, 2 years restopective and 3 years prospective was conducted in Mahatama Gandhi Memorial hospital, Warangal, from 2009 to 2014 on triple negative breast carcinomas. All the mastectomy specimens, received in the pathology Department during this period were considered. Results: Total of 28 cases of carcinoma breast in females diagnosed histopathologically, were included in the study. In the present study, the patients were in the age group of 20-40 years Since most carcinomaS in this age group are triple negative. most of the tumours werte of size > 5 cm, 12 cases (43%), followed by 10 cases (36%) of size 2-5 cm. Total 20 (71.4%) were IDC (NOS), followed by 4 (14.2%) were Medullary carcinomas and 2 (7.1%) cases of ILC and each 1 (3.6%) case of tubular and Mucinous carcinomas. Histopathological grading was done according to Modified Bloom Richardson grading and found that 11 (39.3%) were of grade II followed by 5 (17.9%) cases were grede lll,4 cases were of grade I and 8 cases were inassessible. ER and PR were positive in 61% and 47% of tumors respectively. HER-2 over expression was seen in 36% of tumors and was negative in 64% of tumours. Triple negative carcinomas were 4 out of 28 cases, of which 3 were IDC (NOS) and 1 was medullary carcinoma. Triple negative carcinomas are associated with poor prognosis. Conclusion: ER, PR and HER-2 status correlates well with histopathological grading and other clinico-pathological parameters. Higher grade is associated with HER-2 positivity and ER/PR negativity,larger tumor size, lympho-vascular invasion, lymph node metastasis, and higher clinical stage.
ABSTRACT
Aim and objectives: To compare the conventional and the Bethesda system for reporting thyroid cytopathology (TBSRTC), to correlate the cases with histology wherever available and to determine the sensitivity, specificity and false positive rates of both the methods. Material and methods: A Total of 240 patients who presented with thyroid gland swelling were subjected to thyroid fine needle aspiration cytology (FNAC) and the smears were made followed by H&E staining and reporting was done The convential system used at our centre includes description of microscopic findings of the case along with an impression at the end. The categorization according to the Bethesda system of reporting thyroid cytology were done using criteria published in the atlas and related literature. The cytological diagnosis was correlated with the histological diagnosis wherever it was available. The sensitivity, specificity, false positive rates were calculated considering cytology as screening test for differentiating between neoplastic and non-neoplastic lesions. Results: When the results of the conventional system were compared with the Bethesda adapted method was found to be more superior. Sensitivity of Bethesda system was significantly high (100%) as compared to conventional system (77%). Specificity of Bethesda system was also significantly high (82.5%) as compared to conventional system (69%). Conclusion: Our findings were consistent with others who used the Bethesda cytopathology reporting system.