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1.
Indian J Cancer ; 2014 Oct-Dec; 51(4): 469
Article in English | IMSEAR | ID: sea-172612
2.
Indian J Cancer ; 2014 Jul-Sep; 51(3): 267-271
Article in English | IMSEAR | ID: sea-154377

ABSTRACT

Background: The histological detection of axillary lymph node tumor metastases in cases of breast carcinoma is of major prognostic significance, but may be difficult when metastases are of microscopic size. The micrometastases can be detected either by immunohistochemistry (IHC) or serial sectioning. Aims: We investigated whether immunohistochemical techniques and serial sectioning can increase the accuracy of metastatic detection and compared the efficacy of both. Materials and Methods: Thirty cases of breast carcinoma were studied in all of whom the axillary lymph nodes had been reported as free of metastases. Blocks from these cases were serially sectioned and stained with hematoxylin and eosin and a single section was stained with monoclonal antibody to cytokeratin AE1/AE3 and epithelial membrane antigen. The positivity for micrometastases was correlated with size, number, grade and histological type of primary tumor, lymph node size and number. Results and Conclusion: In 5/30 previously unsuspected cases, micrometastases were revealed by IHC and in 1/30 by serial sectioning. These findings suggested that serial sectioning is a labor intensive, time consuming and impractical procedure. Micrometastases were more frequently detected with age of patient >50 years, Grade 2/3 tumor, tumor size >5 cm and more than one primary tumor. Immunohistochemical analysis can be recommended as a routine procedure or an adjunct to routine histological procedures for the correct staging of breast carcinoma and use of adjuvant chemotherapy, especially in the high risk group.


Subject(s)
Breast Neoplasms/diagnosis , Breast Neoplasms/surgery , Female , Humans , Immunohistochemistry/methods , Lymph Nodes/chemistry , Lymph Nodes/immunology , Lymph Nodes/surgery , Microtomy/methods , Neoplasm Metastasis/diagnosis
3.
Indian J Cancer ; 2013 Jan-Mar; 50(1): 58-64
Article in English | IMSEAR | ID: sea-147321

ABSTRACT

Aims: To compare the clinical and pathologic assessment of response to neoadjuvant chemotherapy and describe the various histopathologic changes observed. Materials and Methods: We studied a group of 40 patients with locally advanced breast cancer who had their initial workup in the form of clinico-imaging assessment of the size and pretreatment biopsy from the lesion. All the patients received two to six cycles of neoadjuvant chemotherapy, either cyclophosphamide 50 to 60 mg/m 2 IV, doxorubicin 40 to 50 mg/m 2 IV and 5-fluorouracil 500 to 800 mg/m 2 IV (CAF) or cyclophosphamide, epirubicin, and 5-fluorouracil (CEF). Clinical and pathologic assessment of response to chemotherapy was done based on the UICC guidelines. Result: Complete clinical response (cCR) was seen in 10% cases (4/40), thirty percent patients had (12/40) partial response and 60% (24/40) had stable disease after neoadjuvant chemotherapy. Pathologic complete response (pCR) with no evidence of viable tumor was observed in 20% patients (8/40). Fifteen patients (37.5%) showed partial response and 42.5% patients (17/40) had a stable disease. No patient progressed during the course of chemotherapy. Changes in the tumor type were observed following chemotherapy, most common being the mucinous change. Histologic changes like dyscohesion, shrinkage of tumor cells, elastosis, collagenization, necrosis, lymphocytic reaction, giant cell response are some of the common observations seen following treatment with neoadjuvant chemotherapy. Conclusion: Pathologic assessment of response to neoadjuvant chemotherapy is a better predictor than the clinical response. The chemotherapy drugs can be modified based on the response observed after 1-2 cycles of neoadjuvant, the response being based on both tumor and patient's responsiveness.


Subject(s)
Biomarkers, Pharmacological/metabolism , Breast Neoplasms/drug therapy , Breast Neoplasms/pathology , Carcinoma, Ductal/drug therapy , Carcinoma, Ductal/pathology , Cyclophosphamide/administration & dosage , Cyclophosphamide/adverse effects , Disease-Free Survival , Doxorubicin/administration & dosage , Doxorubicin/adverse effects , Epirubicin/administration & dosage , Epirubicin/adverse effects , Female , Fluorouracil/administration & dosage , Fluorouracil/adverse effects , Humans , Middle Aged , Neoadjuvant Therapy , Predictive Value of Tests , Prognosis , Treatment Outcome
4.
Article in English | IMSEAR | ID: sea-135685

ABSTRACT

Background & objectives Fibrous dysplasia (FD) is a rare metabolic bone disease and information available from India is limited to only anecdotal case reports. We describe the clinical profile and therapeutic outcome of 25 patients with FD observed over a period of 14 yr in a tertiary care centre from north India. Methods In this retrospective study patients (n = 25) with diagnosis of fibrous dysplasia based on either classical radiological features and/or histological evidence on bone biopsy, were analyzed. Associated endocrinopathies if any, were evaluated. The diagnosis of McCune Albright syndrome (MAS) was considered when fibrous dysplasia was accompanied by either café-au-lait macules and/or endocrinopathies. The clinical presentation, biochemical parameters and imaging were analysed. Seven patients received bisphosphonate therapy. The final outcome and side effects were noted. Results Age of the patients ranged from 7 to 48 yr (mean ± SD, 24.2 ± 11.4 yr) with a lag time between onset of symptoms and presentation ranging from 1 to 20 yr (mean ± SD, 6.6 ± 6.2 yr). The mean duration of follow up was 3.5 ± 2.1 yr. Eighteen (72%) patients had polyostotic disease while the remaining had monostotic FD. Eight patients had endocrinopathies: five had acromegaly, one each had gonadotropin independent precocious puberty (GIPP), hyperthyroidism and hypophosphatemic rickets. One child with GIPP later developed hyperthyroidism. McCune Albright syndrome was observed in 10 (40%) patients. A majority of the patients underwent various minor or major surgical procedures and seven patients received bisphosphonates for recurrent pathological fractures. Bone pain was reduced in all bisphosphonate treated patients with a decrease in subsequent fractures. Interpretation & conclusions This series of FD patients from north India shows the varying presentations of this rare disease. Medical treatment with bisphosphonates appears to be potentially rewarding.


Subject(s)
Adult , Adolescent , Child , Diphosphonates/therapeutic use , Female , Fibrous Dysplasia, Polyostotic/drug therapy , Fibrous Dysplasia, Polyostotic/epidemiology , Fibrous Dysplasia, Polyostotic/pathology , Fibrous Dysplasia, Polyostotic/surgery , Humans , India/epidemiology , Male , Middle Aged , Retrospective Studies , Treatment Outcome
5.
Indian J Cancer ; 2010 Jul-Sept; 47(3): 280-286
Article in English | IMSEAR | ID: sea-144351

ABSTRACT

Aims: Various features have been described in the literature to differentiate benign from malignant lesions. The aim of the present study was to study the accuracy of each of these features and that of magnetic resonance imaging (MRI) in diagnosing malignant lesions. Materials and Methods: Fifty-five consecutive patients presenting with neoplastic (both benign and malignant) lesions diagnosed clinically and on ultrasound were studied and their MRI features were compared with the findings on surgical exploration and histopathologic examination. Results: There were 32 (58%) benign and 23 (42%) malignant masses. Malignant masses were more common in patients older than 20 years (83%), and these had symptoms of less than 6 months duration (75%), as against benign lesions. The swelling was painful in 8 malignant masses and these were more common in the upper limbs (61%). Various features of malignant lesions were size more than 5 cm in 83%, change in signal intensity from homogenous on T1-weighted images to heterogenous on T2-weighted images in 74%, irregular margins in 74%, and heterogenous contrast enhancement in 91%. The accuracy of these features was 76%, 58%, 78%, and 60%, respectively. Most benign and malignant lesions were intramuscular in location. A significant number (38%) of benign lesions were located in the intermuscular facial plane. Definitive diagnosis was made in 42% of the lesions. Conclusions: MRI is an excellent modality for evaluating soft tissue neoplasms; however, prediction of a specific diagnosis and differentiation of malignant and benign lesions is not always possible.


Subject(s)
Diagnosis, Differential , Feasibility Studies , Female , Histiocytoma, Malignant Fibrous/diagnosis , Histiocytoma, Malignant Fibrous/pathology , Histiocytoma, Malignant Fibrous/physiopathology , Histiocytoma, Malignant Fibrous/diagnostic imaging , Humans , Magnetic Resonance Imaging/methods , Male , Muscle Neoplasms/diagnosis , Muscle Neoplasms/pathology , Muscle Neoplasms/physiopathology , Muscle Neoplasms/diagnostic imaging , Predictive Value of Tests , Prognosis , Sensitivity and Specificity , Soft Tissue Neoplasms/diagnosis , Soft Tissue Neoplasms/pathology , Soft Tissue Neoplasms/physiopathology , Soft Tissue Neoplasms/diagnostic imaging
6.
Article in English | IMSEAR | ID: sea-94744

ABSTRACT

BACKGROUND: In the past decade, there have been many clinical trials investigating the potential benefits of adjunctive therapy with colony stimulating factors (CSFs) both to ameliorate or prevent profound neutropenia and its potentially life threatening consequences. Neutropenia is the most common dose limiting side effects of cytotoxic chemotherapy. We decided to study the effect of same in our patients coming to haematology clinic. AIMS AND OBJECTIVES: To see the effect of G-CSF on severity of neutropenia following chemotherapy in patients of haematological malignancies and to see the effect of G-CSF on duration of hospitalization, documented infections and duration of fever as compared to control group in patients with neutropenia following chemotherapy in haematological malignancies. MATERIAL AND METHODS: Thirty patients of acute leukemia were prospectively studied. Patients were given G-CSF 24.hours following chemotherapy induced neutropenia and following parameters were observed. (a) median time to ANC recovery (b) incidence and duration of fever (c) duration of hospitalization following chemotherapy (d) incidence of documented infections. The patients were given G-CSF until the neutrophil count was >1000/ml for 3 days or maximum of 7 days. RESULTS: Mean age was 29.33 +/- 14 years in G-CSF group and 27.53 +/- 13.75 in control group. Mean duration of neutropenia was 11.4 days (p < 0.05) in G-CSF group and 15.8 days in control group. Mean duration of fever was 8.2 days in G-CSF group and 13.53 days in control group (p < 0.05). Mean duration of hospital stay was 21.33 days in G-CSF group and 25 days in control group (p > 0.05). CONCLUSIONS: The study demonstrates that G-CSF administration is efficacious in chemotherapy induced neutropenia by decreasing the duration of neutropenia and duration of fever.


Subject(s)
Adolescent , Adult , Antineoplastic Agents/adverse effects , Case-Control Studies , Female , Fever/drug therapy , Granulocyte Colony-Stimulating Factor/administration & dosage , Hematologic Neoplasms/complications , Humans , Incidence , Infections/complications , Length of Stay , Leukemia/complications , Male , Middle Aged , Neutropenia/chemically induced , Neutrophils , Prospective Studies , Time Factors , Treatment Outcome
7.
Article in English | IMSEAR | ID: sea-89510

ABSTRACT

OBJECTIVE: To study the clinical spectrum associated with gelatinous bone marrow transformation (GMT). METHODS: All subjects whose bone marrow aspiration showed pink purple material on Leishman stain underwent a detail history, clinical examination and investigation (biochemical/microbiological/radiological). Additionally, in each subject the smear was stained with special stains of Periodic Acid Schiff and Alcian blue. RESULTS: Out of total 1498 marrows, 65 showed evidence of GMT. All of these had anaemia. The associated clinical spectra of diseases noticed were: Infection (31 cases), Nutritional deficiency (5 cases), Haematological disorders (Aplastic/toxic depression) (17 cases), Malignancies (3 cases), and Miscellaneous (9 cases). CONCLUSION: Based on the heterogenecity of associated clinical disorders, GMT indicates severe illness and not a particular disease. GMT may be a result of bioregulatory process (which presently needs further prospective studies) that are activated in different pathologic conditions but resulting in similar lesion in the bone marrow and so till then it may be concluded that GMT is a symptom of bone marrow.


Subject(s)
Adolescent , Adult , Aged , Biopsy, Needle , Bone Marrow/pathology , Bone Marrow Diseases/complications , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged
8.
Article in English | IMSEAR | ID: sea-92090

ABSTRACT

AIM: To determine the effect of enalapril, angiotensin-converting-enzyme inhibitor (ACE-I) on progression of renal insufficiency in primary membranoproliferative glomerulonephritis with mild to moderate renal insufficiency. METHOD: Thirty patients with histopathologically proved MPGN having hypertension (grade I and II of JNC-VI criteria of hypertension) and mild to moderate impairment of renal function (creatinine clearance varying from 30-80 ml/min, significant albuminuria and serum creatinine 1.2-3.0 mg/dl) were initially treated with diuretics and 3-blockers to bring down BP < 140/90 mm Hg. These patients were then randomly divided into three groups of 10 each, group I--Control; group II--Nifedipine and group III--Enalapril. In group II and III Nifidepine 30 mg/day and in group III Enalapril 10 mg/day respectively were added in addition and treatment was continued for nine months. These patients were followed up monthly for drug efficacy, side effects and any adverse drug reaction. RESULTS: Out of 30, 28 patients completed the study. At the end of nine months of treatment the patients of control group revealed significant increase in serum creatinine (1.65 +/- 0.38 to 2.17 +/- 0.31 mg/dl), blood urea (34.0 +/- 3.9 to 40.0 +/- 3.1 mg/dl), and 24 hours albuminuria (3.6 +/- 0.6 to 4.2 +/- 0.6 gm) and decrease in creatinine clearance (60.3 +/- 13.3 to 37.5 +/- 11.8 m/min); however, in enalapril group there was decrease in serum creatinine (1.72 +/- 0.45 to 1.24 +/- 0.58 mg/dl), blood urea (34.6 +/- 4.7 to 28.1 +/- 6.7 mg/dl) and 24 hours albuminuria (3.3 +/- 1.0 to 1.6 +/- 1.1 gm) and increase in creatinine clearance (56A +/- 15.8 to 77.1 +/- 23.5 ml/min). The patients on nifedipine showed statistically nonsignificant changes in creatinine clearance, blood urea and serum creatinine; while albuminuria increased from 3.0 +/- 1.3 to 3.9 +/- 0.4 gm/24 hours (p < 0.01). The blood pressure was well controlled in all patients. None of the patient had side effects leading to withdrawal of drugs. No adverse drug reaction was noted. CONCLUSION: ACE-I (enalapril) provided protection against the progression of renal insufficiency in patients of MPGN having hypertension with mild to moderate renal impairment. The renoprotective effects of ACE inhibitor (enalapril) is associated with substantial decrease in albuminuria.


Subject(s)
Adult , Analysis of Variance , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Dose-Response Relationship, Drug , Drug Administration Schedule , Enalapril/administration & dosage , Female , Follow-Up Studies , Glomerulonephritis, Membranoproliferative/complications , Humans , Hypertension/complications , Renal Insufficiency/complications , Kidney Function Tests , Male , Middle Aged , Nifedipine/administration & dosage , Probability , Severity of Illness Index , Treatment Outcome
9.
Article in English | IMSEAR | ID: sea-149285

ABSTRACT

This study was undertaken to look for evidence of acid fast bacilli (AFB) in bone marrow (BM) in patients of extrapulmonary tuberculosis. Fifty cases suspected of extrapulmonary tuberculosis underwent bone marrow aspiration from sternum/illiac crest and were put on a therapeutic trial of antituberculosis therapy. All cases taken in the study responded to the therapy. The pattern of involvement were – abdominal (20), CNS (19), pericardial involvement (5), cervical lymphadenopathy (2), PUO (2), spinal (1) and miliary (1). 52% cases showed evidence of AFB in BM (on Ziehl Neelsen’s (ZN) staining) whereas only 4% of cases showed evidence of AFB in any other body fluid (CSF/pericardium/peritonium). Besides this, cytomorphological changes of BM showed evidence of lymphocytosis (22%), increased plasma cells (80%) and prominence of macrophages (88%), thus signifying infective pathology with macrophage overactivity. So we conclude that bone marrow aspiration has a definite diagnostic value and may prove useful when other investigations are unrewarding.


Subject(s)
Tuberculosis
11.
Indian J Pathol Microbiol ; 1996 Oct; 39(4): 313-5
Article in English | IMSEAR | ID: sea-72769

ABSTRACT

An unusual case of peripheral odontogenic fibroma, presenting as a swelling on gingiva involving hard palate in a 3-year-old female child, is described. Even with cellular stroma and unencapsulation these tumors behave in a benign fashion. To the best of our knowledge, cartilagenous differentiation of stroma as observed in this case has not been reported in English literature so far.


Subject(s)
Cartilage/pathology , Cell Differentiation , Child, Preschool , Female , Fibroma/pathology , Humans , Odontogenic Tumors/pathology , Palatal Neoplasms/pathology
12.
J Indian Med Assoc ; 1996 Oct; 94(10): 379-80, 390
Article in English | IMSEAR | ID: sea-100371

ABSTRACT

Buffy coat smears prepared from peripheral blood and bone marrow aspirate obtained from proved 60 untreated cases of pulmonary tuberculosis were stained with Ziehl-Neelsen method and thoroughly screened for presence of tubercle bacilli. Acid-fast bacilli were detected in 55% cases in buffy coat, 48.3% cases in bone marrow, 38.3% cases both in buffy coat and bone marrow and 65% cases either in buffy coat or in bone marrow or in both. Considering the fact that demonstration of acid-fast bacilli may not be possible in more than 25-50% of the suspected cases of tuberculosis, these techniques are recommended for evaluation of their utility in establishing diagnosis of tuberculosis, particularly in reference to sputum negative cases of pulmonary tuberculosis and tuberculosis of inaccessible extrapulmonary sites.


Subject(s)
Bacteriological Techniques , Bone Marrow/microbiology , Bone Marrow Examination , Cross-Sectional Studies , Developing Countries , Humans , Incidence , India , Leukocytes/microbiology , Mass Screening , Mycobacterium tuberculosis/isolation & purification , Predictive Value of Tests , Sputum/microbiology , Tuberculosis, Pulmonary/diagnosis
13.
Indian J Pathol Microbiol ; 1995 Oct; 38(4): 407-11
Article in English | IMSEAR | ID: sea-75421

ABSTRACT

Numerous representative samples taken from forty placentas immediately after delivery from mothers associated with prematurity (i.e. less than 38 weeks), were semiquantitatively studied by phase contrast microscopy. Twenty placentas delivered from mothers without any antenatal complication served as control. Hypoplasia of the syncytium, stromal edema, ischaemia were prominent findings on phase contrast microscopy in the study group. Increased basement membrane thickening and high villous edema scores observed on light microscopy were statistically significant in prematurity as compared to controls. Observations by phase contrast and light microscopy were found complementary to each other. Phase contrast microscopy provided quicker results without disadvantage of fixation artefact and was found distinctly superior over the conventional histological methods.


Subject(s)
Case-Control Studies , Edema/pathology , Female , Humans , Infant, Newborn , Ischemia/pathology , Microscopy, Phase-Contrast , Obstetric Labor, Premature/pathology , Organ Size , Placenta/blood supply , Pregnancy
15.
Article in English | IMSEAR | ID: sea-111923

ABSTRACT

The clinicohaematological findings of acute state (Group A, 30 patients) and chronic state (Group B, 34 patients) of falciparum malaria in paediatric patients are compared. The children with chronic falciparum malaria were apyrexic and presented with features of moderate to severe anaemia with hepato-splenomegaly. Greater severity of anaemia and haemolysis, higher incidence and severity of neutropenia, atypical lymphocytosis, monocytosis and thrombocytopenia were observed in patients with chronic falciparum malaria as compared to patients with acute falciparum malaria despite lesser degree of parasitaemia in the former as compared to the latter. While mechanical destruction of parasitised RBC's, ineffective and dysplastic erythropoiesis either due to unmasking of border line dierty folic acid deficiency or otherwise, transient hypoplasia of bone marrow, impaired utilization of iron and immune destruction of RBCs with hypersplenism may be the mechanisms for anaemia, transient hypoplasia of bone marrow and hypersplenism may be the factors responsible for thrombocytopenia and neutropenia.


Subject(s)
Acute Disease , Adolescent , Anemia/epidemiology , Bone Marrow/parasitology , Child , Child, Preschool , Chronic Disease , Humans , Incidence , India/epidemiology , Infant , Malaria, Falciparum/blood
16.
Indian Pediatr ; 1991 Jun; 28(6): 647-52
Article in English | IMSEAR | ID: sea-10802

ABSTRACT

The present study was carried out in 100 children of acute pneumonia to establish the diagnosis of etiologic agents. Clinico-radiological assessment and routine investigations including sputum, throat swab and blood culture did not help in identifying the offending micro-organisms. The bacteriological examination of lung puncture aspirate was the most satisfactory tool for the etiological diagnosis. Direct smear examination/culture were positive in 50% aspirates. On cytology, definite epithelioid granulomas indicated tuberculous infection. However, in direct smear/culture negative patients, predominant mononuclear cell infiltration in the aspirated material may indicate non-pyogenic infection. Staphylococcus aureus (22%) was the commonest organism causing pneumonia in the present study.


Subject(s)
Acute Disease , Adolescent , Biopsy, Needle , Child , Child, Preschool , Humans , Infant , Pneumonia/etiology , Sputum/microbiology
18.
Article in English | IMSEAR | ID: sea-112490

ABSTRACT

Of 138 patients with malaria, 90 were found to be having Plasmodium falciparum in their peripheral blood smears. Megaloblastosis alone or in combination with the other patterns of erythropoiesis was observed in 82.1 percent cases of chronic P. falciparum malaria as compared to 36.3 and 26.5 per cent cases of acute P. falciparum and P. vivax malaria respectively. Iron deficiency was observed in 15.5 percent cases of chronic P. falciparum, 18.2 per cent cases of acute P. falciparum and 13.3 per cent patients of P. vivax infection. Of patients with chronic falciparum malaria, 33.3 percent revealed features of both megaloblastosis and defective iron utilization and transient hypoplasia of marrow was observed in 8.9 per cent of these cases.


Subject(s)
Adolescent , Adult , Aged , Anemia, Hypochromic/blood , Anemia, Megaloblastic/blood , Animals , Bone Marrow Examination , Child , Child, Preschool , Erythrocyte Indices , Erythropoiesis/physiology , Hemoglobins/analysis , Humans , India/epidemiology , Infant , Infant, Newborn , Malaria/complications , Middle Aged , Plasmodium falciparum , Plasmodium vivax , Platelet Count , Reticulocytes/chemistry
19.
Indian J Lepr ; 1990 Jul-Sep; 62(3): 321-7
Article in English | IMSEAR | ID: sea-55201

ABSTRACT

Seventy-two cases of multibacillary leprosy were investigated for cytomorphological changes and presence of lepra bacilli in bone marrow. These patients were divided in two groups. Group A (28) comprised of new cases and group B (44) of those receiving treatment. Myeloid hyperplasia was mostly seen in patients of group B who had erythema nodosum leprosum. Megaloblastic change in erythroblasts was seen frequently in both the groups. While average number of plasma cells and macrophages was on the higher side of normal range, detection of large number of plasma cells underlined enhanced humoral response and created diagnostic problem with multiple myeloma. Morphological changes in the macrophages, their collections and epithelioid cell granulomas were observed in bone marrow. Their nature and significance is discussed.


Subject(s)
Adult , Aged , Aged, 80 and over , Bone Marrow/microbiology , Erythema Nodosum/pathology , Humans , Hyperplasia , Leprosy, Lepromatous/pathology , Macrophages/pathology , Middle Aged , Plasma Cells/pathology
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