Non RhD isoimmunization causing severe hemolytic disease of fetus and newborn in Rh positive pregnancies: report of 2 cases with review of literature

Anti D immunoprophylaxis widespread use in antenatal patients has led to dramatic reduction in the rates of alloimmunization due to anti D, which is the most common Rh antibody causing severe Hemolytic Disease of Fetus and New born (HDFN). However, there has been increase in the rates of non Rh D antibodies causing alloimmunization in pregnant women and leading to moderate to severe HDFN. We hereby report two cases of neonates presenting with moderate to severe HDFN with strongly positive DAT due to Rh anti-c antibody in Rh-positive mothers. Thus, antenatal antibody screening should be done in all Rh-positive pregnant women to prevent the diagnostic delay of HDFN occurring due to Non anti-D isoimmunization in the fetus.

Angiomatoid Fibrous Histiocytoma In An Elderly Male: An Unusual Presentation With Review Of Literature

Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumor occurring mostly in children, adolescents, and young adults. Clinically and radiographically, it is difficult to differentiate AFH from hematoma, soft tissue hemangioma, and malignant fibrous histiocytoma. Here, we present the clinical, radiologic, and pathologic findings of a case of AFH due to its rarity in a 67-year-old man. The patient underwent wide surgical excision with a provisional diagnosis of sarcoma. On pathological examination, the lesion demonstrated solid-cystic nodules of histiocytes with blood-filled cysts, a dense hyaline fibrous pseudo capsule, and a very focal peripheral lymphoplasmacytic infiltrates. The tumor cells showed strong positivity for CD68, variable positivity for CD34, Desmin, EMA, negativity for CK and a low Ki67 index.

Critical evaluation of peripheral smear in cases of anemia with high mean corpuscular hemoglobin concentration in children: A series of four cases.

Mean corpuscular hemoglobin concentration (MCHC), a parameter that is reported as a part of a standard complete blood count by automated analyzer, is a measure of the concentration of hemoglobin in a given volume of packed red blood cell. Values of MCHC significantly above reference range are not physiologically possible due to limitations on solubility of hemoglobin. The high MCHC can give us a clue to certain type of hemolytic anemia and necessitate critical evaluation of peripheral smear to reach a definitive diagnosis. Here we are presenting a series of four cases with raised MCHC, emphasizing the importance of systematic and meticulous examination of the peripheral smear to render a definitive diagnosis.

Botryoid rhabdomyosarcoma of common bile duct.

Common bile duct is an unusual site for occurrence of botryoid rhabdomyosarcoma. Clinically it is often misdiagnosed as infectious hepatitis. Early diagnosis and treatment has greatly improved the prognosis of this aggressive neoplasm. Here the authors present a case report of Bortroyid Rhabdomyosarcoma of CBD in a two and half year old child masquerading as obstructive jaundice.

Ki-67 immunostaining in Pap smears of cervix: assessment of proliferation in preinvasive and invasive squamous epithelial lesions.

Ki-67 is a novel proliferation marker. Its use has been extensively studied in biopsy sections of preinvasive and invasive squamous epithelial lesions of cervix. However, only limited work has been done on its application on Pap smears of cervix. We applied Ki-67 immunostaining on cytology smears of various grades of squamous epithelial lesions of cervix. Sixty cases were chosen for immunostaining by Peroxidase antiperoxidase method using DAB as a chromogen. High level of Ki-67 labelled proliferation was measured in squamous cell carcinomas of cervix. Statistically significant difference was observed between preinvasive and invasive squamous epithelial lesions of cervix. Ki-67 could prove as a useful adjunctive test to routine Pap smear in triage of patients harboring lesions of cervix.

Proliferation in squamous cell carcinoma of cervix: a comparative assessment by two markers.

The study was aimed at assessing the cell proliferation in various grades of squamous cell carcinoma of cervix using two proliferation markers: AgNORs and Ki-67. 18 biopsy sections of various grades of SCC of cervix were chosen. AgNORs staining was done by single step staining technique using gelatin. Ki-67 immunostaining was done by Avidin--Biotin technique using DAB as a chromogen. Highest mean number of AgNORs was found in poorly differentiated squamous cell carcinoma and statistically significant difference was observed between well and poorly differentiated SCC and between moderately and poorly differentiated SCC. Highest mean Ki-67 LI was seen in poorly differentiated SCC. We observed correlation between histological grade and Ki-67 and AgNORs separately but no statistically significant correlation was found between Ki-67 and AgNOR counts. AgNORs and Ki-67 are both simple and easily performed techniques. They may prove to be a useful adjunct in estimating tumor proliferation and hence in determining the management strategy of the patients.

Proliferative activity in squamous intraepithelial and invasive lesions of cervix: analysis by AgNOR staining.

Proliferation potential of squamous intraepithelial lesions of cervix is the main factor affecting the biological aggressiveness of the lesion. The present study was aimed at assessing the proliferation in preinvasive and invasive squamous epithelial lesions of cervix using a simple and inexpensive proliferation marker: AgNOR (Argyrophilic nucleolar organizer regions). Fifty biopsy sections of various grades of preinvasive and invasive squamous epithelial lesions of cervix were taken for AgNOR staining. Single step staining technique using gelatin in formic acid solution was employed. Counting was done with the help of 'CAMERA LUCIDA' drawings. AgNOR counts/nucleus in parabasal and basal layer showed progressive rise in their mean value with increasing grade of lesion. Amongst invasive malignancies, highest mean of AgNORs/nucleus was observed in poorly differentiated squamous cell carcinoma of cervix. In conclusion, AgNORs can prove to be a simple inexpensive and reliable proliferation marker in lesions of cervix.

Ki-67 labelling as a proliferation marker in pre-invasive squamous epithelial lesions of cervix.

Study was conducted to evaluate proliferation in squamous intraepithelial lesions of cervix. 36 cases of cervical biopsies were chosen including unremarkable cervix, basal cell hyperplasia, cervical intraepithelial neoplasia (CIN I, CIN II, CIN III). Ki-67 immunostaining was performed by peroxidase-antiperoxidase method. Ki-67 labelling index in basal and parabasal layers of cervix showed progressive rise with increasing grade of lesion but may not be helpful in classification of individual lesion. Also extent of staining from the basement membrane increases with increasing grade. High basal Ki-67 reactivity might be of greater biological significance than surface differentiation.

Botryoid rhabdomyosarcoma of mesentery--a case report.

Botryoid rhabdodmyosarcomas are described predominantly in hollow visceral organs. We present case of an embryonal (botryoid) rhabdomyosarcoma arising in mesentery of a two year old male child.

Solitary intramuscular nasal Juvenile Xanthogranuloma: a case report with review of literature.

Juvenile Xanthogranuloma is a non-langerhans cell histiocytosis characterized by yellowish cutaneous nodules that usually appear in early infancy and childhood. Intramuscular variant is a rare form, with only eight reported cases, and none reported in ala of nose. Sheets of histiocytes, few touton giant cells and infiltrative borders makes it susceptible to misdiagnosis as childhood sarcomas or lymphoproliferative disorders. Awareness of the lesion aided by immunohistochemistry helps in reaching the proper diagnosis.