Autograft ossicle selection in cholesteatomatous ear disease: histopathological considerations.

In order to determine whether selection of autograft ossicles in cholesteatomatous ear disease should be based upon their appearance under the surgical operating microscope, we studied the histopathological features of 113 such ossicles. We attempted to correlate the extent of erosion of the ossicle, as noted under the surgical operating microscope, with their histopathological appearance. There were 60 mallei and 53 includes. Seventy-nine ossicles were eroded and 34 were intact. The commonest abnormality noted was erosion of the long process of the incus (75 per cent). Both intact and eroded ossicles had similar histological features. There was no evidence of intra-ossicular cholesteatoma. The results suggest that the extent of erosion of these ossicles as seen under the surgical operating microscope should in no way prejudice their use as autografts when required.

Infections in haematological malignancies: an autopsy study of 72 cases.

Autopsy material from 72 patients with haematological malignancies treated in India was reviewed. Thirty-seven patients (51%) had documented infections; 20 (27%) had bacterial infections, 14 of which were Gram-negative organisms (Pseudomonas species in 10); tuberculosis was present in 2 patients (2.7%). Twenty-one patients (29%) had systemic fungal infections; invasive pulmonary aspergillosis and gastrointestinal candidiasis were present in 10 patients each. Only 3 patients (4%) had viral infection, all of which were due to cytomegalovirus. Eleven patients (15%) had polymicrobial infections. No patient had any parasitic infection. Systemic fungal infections due to Aspergillus and Candida predominated, while Gram-negative bacterial infections were also common.

Infections in bone marrow transplant recipients in south India--a post-mortem study.

A study of post-mortem material obtained from ten patients who had undergone bone marrow transplantation is presented. The cause of death in all patients was infection. Six patients had fungal infection, two had bacterial infection and three had cytomegalovirus infection. Pneumocystis carinii and tuberculous infections were not detected.

Osteomalacia--fifty five patients seen in a teaching institution over a 4 year period.

A retrospective analysis of 55 cases of osteomalacia shows that poor calcium intake and poor sunlight exposure are the most common causes for osteomalacia. However, in patients with normal nutritional history, other disorders such as renal tubular acidosis and tumour induced osteomalacia should be looked for. A careful drug history, particularly anticonvulsant use is essential. In 4 patients there was an association between anti-tuberculous drug use and osteomalacia. Further prospective studies are needed to determine the relationship between Rifamicin use and osteomalacia.

Management of patients with mildly dysplastic cervical smears.

The management of patients with mild dysplasia on cervical smears remains controversial. Recent studies have shown that many harbor high grade squamous intraepithelial lesions (HSIL) and human papillomavirus (HPV) and warrant further evaluation rather than follow-up. This prospective study dealt with the evaluation of patients with mild dysplastic smears using colposcopy and directed biopsies with view to identifying HSIL/HPV and treating them. Among 100 cases studied, 61% revealed HSIL/HPV; of them, 10% had high grades. Hence, patients with mildly dysplastic lesions should be evaluated further and managed with histopathologic examination of the biopsy specimen. This protocol may be cost effective for evaluating women with mildly dysplastic smears in a referral center, though it may not be so when compared to a policy of treating the infection, repeating the smears and performing colposcopy and biopsy on all those with persistent abnormality.

Large solitary luteinized follicle cyst of pregnancy and puerperium.

A case of large solitary luteinized follicle cyst of pregnancy and the puerperium, arising in a 22 year old primipara, three months post partum, is presented with clinical and pathological details. This is a rare type of follicle cyst and has to be differentiated from a cystic neoplasm.

Medical therapy of rhinosporidiosis with dapsone.

Clinical, histopathological and ultrastructural studies in three cases of rhinosporidiosis show complete remission of infection within one year of therapy with dapsone. Light and electron microscope studies confirmed arrest of the maturation of the spores and accentuated granulomatous response with fibrosis following dapsone therapy.

Testicular malacoplakia.

Testicular malacoplakia presenting as painless enlargement of the testis in a 23-year-old man is described. The literature is reviewed.

Colposcopy in the diagnosis of cervical neoplasia.

Two hundred and ninety one women were evaluated for cervical cancer by cytology and colposcopy. Of these, 152 patients underwent colposcopically directed biopsy for histological evaluation. Colposcopy and cytology were in agreement in 88 per cent of cases whereas colposcopy and histopathology were in agreement in 79 per cent of cases. Cytology underestimated the severity of the lesion in nine per cent while colposcopy underestimated the lesion in 7.2 per cent (False negative rate). In 13.8 per cent of cases colposcopy overestimated the lesion (False positive rate). The cone biopsy rate in this series was 30 per cent. We conclude that since colposcopy shows excellent correlation with histopathology, it will be a useful tool to reduce cone biopsy rates, particularly in younger women in the child-bearing age group.

Leiomyoma of the small intestine with giant cyst formation. Case report.

A case of small-intestinal leiomyoma presenting as a large intra-abdominal cyst is reported. Cystic degeneration is a common feature of leiomyoma, but presentation of this tumour as a giant cyst is uncommon.

Non-Hodgkin's lymphoma in a south Indian Hospital--our experience with the International Working Formulation.

There were 836 biopsy cases of Malignant Lymphomas over a seven year period, among which Non-Hodgkin's Lymphomas (70 percent) predominated over Hodgkin's Disease (30 percent). Non-Hodgkin's lymphomas could be easily classified using the IWF. The Diffuse variety was much commoner than the Follicular variety. The Diffuse Large cell type was the commonest histologic type. The Gastrointestinal tract was the commonest site for extranodal lymphomas. Though sophisticated immunological methods are available for lymphoma analysis, histologic classification will continue to remain the principal method of lymphoma typing in our country.

Cellularity of bone marrow--a comparison of trephine biopsies and aspirate smears.

The estimation of cellularity of bone marrow was done on 212 trephine biopsies and their corresponding aspirate smears by a single observer using the visual scanning method. On applying the statistical test of agreement, it was found that the trephine biopsies and the aspirate smears were equally reliable in assessing marrow cellularity.

Experience with fungal infections affecting the heart in necropsies at an Indian hospital.

Twenty-one cases of fungal infection of the heart were encountered among 4000 necropsies performed in a South Indian hospital over a period of 20 years. All 5 cases of endocarditis due to infection with Aspergillus followed cardiac surgery, while the 4 cases of endocarditis due to Candida affected normal heart valves. Cardiac micro-abscesses secondary to fungal infections elsewhere were caused by Aspergillus in 5 cases and Candida in 4. A fibrosing granulomatous Aspergillus infection extended from the lungs to involve the base of the heart in 3 patients.

Granulomatous peritonitis caused by Ascaris eggs: a report of three cases.

Three cases of granulomatous peritonitis, due to the eggs of Ascaris lumbricoides, are reported. All patients presented with a palpable mass in the abdomen and two patients, in addition, had fever and abdominal pain. Laparotomy was performed and the operative diagnosis in each case was tuberculosis. The diagnosis of Ascaris ova peritonitis was made by histopathological examination of tissue removed at operation. The pathogenesis and differential diagnosis of this condition are briefly discussed.