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B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) is one of the common lymphoproliferative disorders with an increased risk of developing subsequent neoplasms of epithelial and mesenchymal origin. The decreased immunity and B-cell dysfunction in CLL probably accounts for this emergence of secondary malignancy. Breast, brain, skin and prostate tumors have been reported as usual coincident malignancies of CLL, while in occasional cases CLL may occur with malignancies of other solid organs, such as skin, lung, heart, and prostate. Synchronous CLL with urothelial carcinoma (UC) is an infrequent occurrence. We report this case because of its rarity in Indian literature and interesting hematological, immunophenotypic, histopathological, and cytopathological features of metastatic high-grade UC in a 61-year-old male with CLL
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Background and Objectives: Proteinuria of more than 2.0 g in 24 hours is indicative of renal disease and a value of more than 3.5 g is a component of Nephrotic syndrome. The pathology resulting in proteinuria can be glomerular, tubular and others. Renal biopsy is gold standard in evaluation and management of patients with proteinuria especially Nephrotic syndrome. Methods: A retrospective analysis of all renal biopsies from adult patients with significant proteinuria over a period of 4 years was performed to study the pattern of renal pathology. The morphological findings were correlated with Clinical findings, laboratory findings &Immunofluorescence profile as per availability. Results: It was observed that clinical diagnosis matched the final pathological diagnosis in 79 (58.09%) cases. Further, Light Microscopy findings corresponded with Immunofluorescence in 142 out of 158 cases, while the diagnosis was changed in 16 (10.13%) cases after IF. Conclusions: The results thus indicate that renal biopsy along with IF plays an important role in diagnosis of cases with significant proteinuria a fact highlighted by low concordance % between the clinical and the pathological diagnosis. An accurate diagnosis is not only essential to initiate appropriate therapy but also in prognostication of renal lesions.
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Objective: Recently few reports have reported high incidence of urinary bladder cancer in the Punjab region in India while others have shown high inorganic arsenic levels in the ground waters of the same region. Furthermore, the malignancy of the urinary bladder contributes significantly to the morbidity, mortality and thus adding to the burden on the healthcare and society. Materials and Methods: A retrospective analysis over a period of 4 years was undertaken to review all urinary bladder tumour biopsies, transurethral resection of bladder tumours (TURBT) and cystectomy specimens to study the histomorphological spectrum of the urinary bladder cancers according to the “WHO Classification of Tumours of the Urinary Tract”. The records of Pathology department were probed for urinary bladder specimens. Further demographic characteristics, clinical diagnosis, cystoscopic findings were retrieved from the patient’s files from the record section. The tissue section slides were then reviewed and results recorded. Results: In our cohort, 144 patients were from State of Punjab with about 50% belonging to the city where our hospital is located. Cystoscopic revealed papillary appearance in 112 out of 135 patients. Moreover, 111 cases (82.22 %) were unifocal. Urothelial neoplasms were the most common bladder tumours and Invasive Urothelial Carcinomas constituted the bulk of these. Conclusions: Our cohort comprised of relatively younger population with dominance of high grade urothelial carcinoma showing features of invasion on microscopy. Further, we observed that WHO/ISUP classification to be comprehensive and universally acceptable. The role of arsenic as a causative agent in urothelial neoplasms needs to be studied further.