RESUMO
Introduction: The term vasculitis refers to a heterogeneous group of diseases, all characterized by inflammation and destruction of blood vessel walls leading to ischemic, thrombotic, and hemorrhagic damage to tissues of central and peripheral nervous system. The main indication for triple biopsy (skin, muscle and nerve) is to rule out peripheral vasculitis neuropathy. However, the drawback is that any systemic inflammatory process may show changes in a skin biopsy and hence these changes need to be interpreted with caution. The aim of this study is to establish the diagnostic yield and the usefulness of the triple biopsies in clinically suspected cases of vasculitis. Material and Methods: The present study was conducted in the Department of General Pathology, SBKS MI & RC, Vadodara over a period of one year (1/1/2022 to 31/12/2022). All the clinically suspected cases of vasculitis received at OPD were included in the study. Any case with either muscle, nerve or skin biopsy reported as inadequate were excluded from the study. Results: On evaluation the usefulness of triple biopsies for vasculitis, we found a very low diagnostic yield with only 3.3% of peripheral nerve biopsy and 0.8% of muscle and nerve biopsy showed definite vasculitis. In case of suspected peripheral/systemic vasculitic neuropathy, nerve biopsy was sufficient in the majority of case and has the diagnostic armamentarium for the evaluation of vasculitis. Conclusion: In conclusion, nerve biopsies provide the best yield for the diagnosis of vasculitis, as opposed to muscle and skin biopsies. The role of triple biopsies as a routine protocol for the evaluation of vasculitis is questionable.
RESUMO
Introduction: Menorrhagia is one of the commonest clinical conditions for which patients seek advice in the gynecological outpatient department. Aim and objectives of study: To determine the prevalence of various histopathological changes, patterns and lesions of endometrium associated with menorrhagia in the women of different age groups; to describe the morphological features of various lesions of endometrium; to assess demographic pattern of various types of endometrium lesions in this part of our country and to do clinicopathological correlation and give diagnosis based on it. Materials and methods: This was a prospective, non-interventional and observational hospital based crosssectional one year study carried out between January 2020 to June 2021 in Histopathology Department of Dhiraj Hospital on 52 cases of D & C and hysterectomy specimens. All the specimens were fixed in 10% formalin were received in the department of Pathology and processed and embedded in paraffin wax. Multiple serial sections of 4-5 microns thickness were obtained from the paraffin block and then stained with H & E. Detailed study of the sections was done by light microscopy. Results: 52 cases of menorrhagia were studied clinically and histopathologically. In present study, large proportion of patients with menorrhagia showed proliferative endometrial pattern (38.46%) followed by secretory phase (34.62%). Hyperplastic pattern was seen in 13.46% of patients. Non hyperplastic endometrial pattern was more common than hyperplastic pattern. Simple hyperplasia was more commonly seen than complex and atypical hyperplasia. Overall incidence of atypical hyperplasia was low (28.57%) and atrophic endometrium seen in 5.7% of cases. Endometrial polyp was seen in 3.84% cases and endometrial carcinoma was seen in 3.84% cases. Conclusion: Histopathological study of endometrium is very useful to reveal different endometrial patterns in menorrhagia and to distinguish between anovulatory and ovulatory causes. It is also useful for the diagnosis of endometrial hyperplasia and endometrial carcinoma.