Pub Date : 2019-05-14DOI: 10.24321/2454.8642.201902
Neema Tiwari
Savitri Singh, Jyotsna Madan, Devajit Nath, Nita Radha Krishnan, Neema Tiwari 1Associate Professor, 2Professor, 3Assistant Professor, 5Senior Resident, Dept.of Pathology, Super Specialty Pediatric Hospital and Post Graduate Teaching Institute, Noida, Uttar Pradesh, India. 4Assistant Professor, Dept. of Pediatric Hemato-Oncology, Super Specialty Pediatric Hospital and Post Graduate Teaching Institute, Noida, Uttar Pradesh, India. DOI: https://doi.org/10.24321/2454.8642.201902 The bone marrow is generally considered the fourth largest organ in the human body. In pediatric age group (up to 17 years) disease diversity and presentation is unique and that necessitates bone marrow examination (aspiration/ biopsy/ imprints. Imprint cytology gives excellent morphology and quick diagnosis and these procedures are well tolerated by patients. A pathologist faces many situations where either the aspirate is hemodiluted or it’s a dry tap. Dry taps can be due to marrow fibrosis or when marrow is packed with blasts. Here imprint cytology can be of an early help. We present a case in brief where the imprint helped in early diagnosis. A one-year old female presented with complaints of fever for 1 month. In this case the aspirate was hemodiluted and inconclusive while the biopsy reporting would have taken time and due to patient being critical a quick report was needed to start clinical management at its earliest. Here imprint cytology saved the time and helped the pathologist to give the clinician a diagnosis of acute leukemia. Hence we discuss the importance of imprint cytology in early and quick diagnosis specially where aspiration is non contributory.
{"title":"Imprint Cytology - A Primary Diagnostic Tool to Bone Marrow Pathology","authors":"Neema Tiwari","doi":"10.24321/2454.8642.201902","DOIUrl":"https://doi.org/10.24321/2454.8642.201902","url":null,"abstract":"Savitri Singh, Jyotsna Madan, Devajit Nath, Nita Radha Krishnan, Neema Tiwari 1Associate Professor, 2Professor, 3Assistant Professor, 5Senior Resident, Dept.of Pathology, Super Specialty Pediatric Hospital and Post Graduate Teaching Institute, Noida, Uttar Pradesh, India. 4Assistant Professor, Dept. of Pediatric Hemato-Oncology, Super Specialty Pediatric Hospital and Post Graduate Teaching Institute, Noida, Uttar Pradesh, India. DOI: https://doi.org/10.24321/2454.8642.201902 The bone marrow is generally considered the fourth largest organ in the human body. In pediatric age group (up to 17 years) disease diversity and presentation is unique and that necessitates bone marrow examination (aspiration/ biopsy/ imprints. Imprint cytology gives excellent morphology and quick diagnosis and these procedures are well tolerated by patients. A pathologist faces many situations where either the aspirate is hemodiluted or it’s a dry tap. Dry taps can be due to marrow fibrosis or when marrow is packed with blasts. Here imprint cytology can be of an early help. We present a case in brief where the imprint helped in early diagnosis. A one-year old female presented with complaints of fever for 1 month. In this case the aspirate was hemodiluted and inconclusive while the biopsy reporting would have taken time and due to patient being critical a quick report was needed to start clinical management at its earliest. Here imprint cytology saved the time and helped the pathologist to give the clinician a diagnosis of acute leukemia. Hence we discuss the importance of imprint cytology in early and quick diagnosis specially where aspiration is non contributory.","PeriodicalId":20962,"journal":{"name":"Recent Advances in Pathology & Laboratory Medicine","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75076684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-14DOI: 10.24321/2454.8642.201903
D. Nath
Case Report of a Rare Site of Occurrence Neema Tiwari, Devajit Nath, Savitri Singh, Jyotsna Madan, Sangeeta Tripathi 1Senior Resident, 2Assistant Professor, 3Associate Professor, 4Professor, Dept. of Pathology, Super Specialty Pediatric Hospital and Post Graduate Teaching Institute, Noida, Uttar Pradesh, India. 5Professor, Department of Radiology, Super Specialty Pediatric Hospital Post Graduate Teaching Institute, Noida, Uttar Pradesh, India. DOI: https://doi.org/10.24321/2454.8642.201903 Pediatric population is the most susceptible age for parasitic infestation and is common in the developing nations where cleanliness and hygiene are an issue and overpopulation and overcrowding are rampantly present. The incidence of cysticercosis is high in India though the exact figures are not known. Human cysticercosis is caused by infestation with larvae of pork tapeworm Taenia solium and is endemic in India. Ingestion of raw or under cooked meat/ pork containing the cysticercosis which spreads through feco-oral route. We present a case of a 6-yearold boy who presented with an upper abdominal wall mass without any other systemic complaints. Fine Needle Aspiration Cytology (FNAC) of the patient was performed and was reported as suspicious for parasitic infestation most likely cysticercosis and was advised excision biopsy. Surgery was performed followed by histopathological examination. A diagnosis of cysticercosis in the histopathology was given. This case highlights the presence of isolated cysticercosis occurring in the abdominal wall which is a rare presentation of the disease.
{"title":"Isolated Cysticercosis of the Abdominal Wall-A Case Report of a Rare Site of Occurrence","authors":"D. Nath","doi":"10.24321/2454.8642.201903","DOIUrl":"https://doi.org/10.24321/2454.8642.201903","url":null,"abstract":"Case Report of a Rare Site of Occurrence Neema Tiwari, Devajit Nath, Savitri Singh, Jyotsna Madan, Sangeeta Tripathi 1Senior Resident, 2Assistant Professor, 3Associate Professor, 4Professor, Dept. of Pathology, Super Specialty Pediatric Hospital and Post Graduate Teaching Institute, Noida, Uttar Pradesh, India. 5Professor, Department of Radiology, Super Specialty Pediatric Hospital Post Graduate Teaching Institute, Noida, Uttar Pradesh, India. DOI: https://doi.org/10.24321/2454.8642.201903 Pediatric population is the most susceptible age for parasitic infestation and is common in the developing nations where cleanliness and hygiene are an issue and overpopulation and overcrowding are rampantly present. The incidence of cysticercosis is high in India though the exact figures are not known. Human cysticercosis is caused by infestation with larvae of pork tapeworm Taenia solium and is endemic in India. Ingestion of raw or under cooked meat/ pork containing the cysticercosis which spreads through feco-oral route. We present a case of a 6-yearold boy who presented with an upper abdominal wall mass without any other systemic complaints. Fine Needle Aspiration Cytology (FNAC) of the patient was performed and was reported as suspicious for parasitic infestation most likely cysticercosis and was advised excision biopsy. Surgery was performed followed by histopathological examination. A diagnosis of cysticercosis in the histopathology was given. This case highlights the presence of isolated cysticercosis occurring in the abdominal wall which is a rare presentation of the disease.","PeriodicalId":20962,"journal":{"name":"Recent Advances in Pathology & Laboratory Medicine","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84563262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-28DOI: 10.24321/2454.8642.201814
Reetika Menia
Background: Hypothyroidism and diabetes usually coexist and are the most common endocrine disorders seen in India (1). Glycosylated Hb (HbA1c) is used for assessment of glycemia and American Diabetic Association (ADA) has recommended its use in diabetes and prediabetes (2). A value between 5.7% and 6.5% represents prediabetes while a value ≥6.5% is considered as diabetes mellitus (3). Glycosylated hemoglobin is a fraction of hemoglobin that undergoes non-enzymatic glycation over the circulatory life span of erythrocytes (4). Several studies have shown glycosylated Hb varies in different conditions like hemoglobinopathies, pregnancy and chronic kidney disease (5). Thyroid hormone plays an important role in glucose homeostasis (6). TSH regulates hematopoiesis in bone marrow (7). Hypothyroidism depresses the marrow which causes decreased erythrocyte production which alters the life span of erythrocytes. Altered life span causes spurious elevation of HbA1C (8, 9, 10). Hence, glycosylated Hb not only depends on glycemia but also on life span of RBC (11). Conditions which effect erythrocyte turnover or survival lead to falsely high or low Hb A1C levels (12). RBC turnover is increased in thyrotoxic states whereas hypothyroidism has the opposite effect (3). In the present study, we hypothesise that glycosylated hemoglobin shows variation in individuals with altered thyroid status. It also aim to establish if a correlation exits between fasting plasma glucose level and hemoglobin with glycosylated hemoglobin in patients with altered thyroid status. Aims and Objectives: To find a correlation between thyroid profile and glycosylated Hb in non-diabetic patients who have been diagnosed on cytology as benign thyroid lesions and Compare the fasting blood glucose and hemoglobin with glycosylated Hb in these patients. Material and Methods: A cross sectional study on 50 cases cytologically diagnosed as benign thyroid lesions in the Department of Pathology in ESIC Medical College and Hospital Faridabad were included in the study with consent of ethical committee. Data Analysis: Pearson’s coefficient was applied to test the association between variables. The significance level was set at 5%. Results: Out of 50 patients (n=25) 50% were hypothyroid, (n=13) 26% were hyperthyroid and (n=12) 24% were euthyroid and (n=22) 88% hypothyroid patients presented with HbA1C >6.5% and were labeled as Diabetic, (n=3) 12% hypothyroid patients were labelled as prediabetic and none was nondiabetic. Most of the euthyroid (n=11) 92% and all of the hyperthyroid patients (n=13) 100% had HbA1C in the nondiabetic range of 6.5%). The correlation of HbA1C with TSH, Hb and MCH of these patients showed statistical significance (p 6.5%) or prediabetic (HbAIc between 5.7 to 6.5%).
{"title":"Glycosylated Hemoglobin among Non-diabetic Patients Diagnosed as Benign Thyroid Lesions on Cytology: A Cross Sectional Study from a Tertiary Care Centre in India","authors":"Reetika Menia","doi":"10.24321/2454.8642.201814","DOIUrl":"https://doi.org/10.24321/2454.8642.201814","url":null,"abstract":"Background: Hypothyroidism and diabetes usually coexist and are the most common endocrine disorders seen in India (1). Glycosylated Hb (HbA1c) is used for assessment of glycemia and American Diabetic Association (ADA) has recommended its use in diabetes and prediabetes (2). A value between 5.7% and 6.5% represents prediabetes while a value ≥6.5% is considered as diabetes mellitus (3). Glycosylated hemoglobin is a fraction of hemoglobin that undergoes non-enzymatic glycation over the circulatory life span of erythrocytes (4). Several studies have shown glycosylated Hb varies in different conditions like hemoglobinopathies, pregnancy and chronic kidney disease (5). Thyroid hormone plays an important role in glucose homeostasis (6). TSH regulates hematopoiesis in bone marrow (7). Hypothyroidism depresses the marrow which causes decreased erythrocyte production which alters the life span of erythrocytes. Altered life span causes spurious elevation of HbA1C (8, 9, 10). Hence, glycosylated Hb not only depends on glycemia but also on life span of RBC (11). Conditions which effect erythrocyte turnover or survival lead to falsely high or low Hb A1C levels (12). RBC turnover is increased in thyrotoxic states whereas hypothyroidism has the opposite effect (3). In the present study, we hypothesise that glycosylated hemoglobin shows variation in individuals with altered thyroid status. It also aim to establish if a correlation exits between fasting plasma glucose level and hemoglobin with glycosylated hemoglobin in patients with altered thyroid status. Aims and Objectives: To find a correlation between thyroid profile and glycosylated Hb in non-diabetic patients who have been diagnosed on cytology as benign thyroid lesions and Compare the fasting blood glucose and hemoglobin with glycosylated Hb in these patients. Material and Methods: A cross sectional study on 50 cases cytologically diagnosed as benign thyroid lesions in the Department of Pathology in ESIC Medical College and Hospital Faridabad were included in the study with consent of ethical committee. Data Analysis: Pearson’s coefficient was applied to test the association between variables. The significance level was set at 5%. Results: Out of 50 patients (n=25) 50% were hypothyroid, (n=13) 26% were hyperthyroid and (n=12) 24% were euthyroid and (n=22) 88% hypothyroid patients presented with HbA1C >6.5% and were labeled as Diabetic, (n=3) 12% hypothyroid patients were labelled as prediabetic and none was nondiabetic. Most of the euthyroid (n=11) 92% and all of the hyperthyroid patients (n=13) 100% had HbA1C in the nondiabetic range of 6.5%). The correlation of HbA1C with TSH, Hb and MCH of these patients showed statistical significance (p 6.5%) or prediabetic (HbAIc between 5.7 to 6.5%).","PeriodicalId":20962,"journal":{"name":"Recent Advances in Pathology & Laboratory Medicine","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86029500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-28DOI: 10.24321/2454.8642.201816
Namrata Patro
Background: Consumption of alcohol is a major modifiable, rather avoidable lifestyle choice and has shown to affect male fertility. Alcohol has shown to cause various deleterious effects on the male reproductive system. Aims: To compare the effects of alcohol on the sperm count, motility, viability and morphology in alcoholic and non-alcoholic groups. This was a cross sectional study with sample size of 51. There were 25 semen samples of alcoholics (cases) and 26 semen samples of non-alcoholics (controls). Materials and Methods: Adequate history regarding the alcohol consumption was taken and the cases (n=25) were categorized into mild (n=17), moderate (n=8) and severe (n=0) alcoholics as per standard criteria of the CAGE Questionnaire. Semen was examined microscopically and the results were statistically analyzed using ANOVA. Results: Mean sperm count in the non-alcoholics was 58.81 million/ml. It was reduced to 45.44 million/ml and 35.62million/ml in mild and moderate alcoholic groups respectively. (P=0.03). Actively motile sperms in non-alcoholics, mild and moderate alcoholics were found to be 58.08%, 44.41% and 30.62% respectively. (P=0.016). The percentage of sluggishly motile sperms in non-alcoholics, mild and moderate alcoholics were found to be 19.09%, 32.35% and 32.5% respectively. The effect on the percentage of immotile sperms was ambiguous. 15 out of the 26 cases of non-alcoholics showed abnormalities in the morphology. The incidence of abnormal morphology of sperm was higher in the alcoholics. All 25 cases showed abnormal sperm morphology. Alcohol causes a decrease in the sperm vitality. As the grade of alcohol increased, the lowest vitality was in the range of 20-29% and the highest being in the range of 70-79%. Conclusion: The findings reveal that alcohol consumption had significant detrimental effects on the count, morphology and vitality of spermatozoa. It is important to create awareness among people of the adverse effects of alcohol on human health and fertility.
{"title":"Study of Effect of Alcohol on the Microscopic Analysis of Semen","authors":"Namrata Patro","doi":"10.24321/2454.8642.201816","DOIUrl":"https://doi.org/10.24321/2454.8642.201816","url":null,"abstract":"Background: Consumption of alcohol is a major modifiable, rather avoidable lifestyle choice and has shown to affect male fertility. Alcohol has shown to cause various deleterious effects on the male reproductive system. Aims: To compare the effects of alcohol on the sperm count, motility, viability and morphology in alcoholic and non-alcoholic groups. This was a cross sectional study with sample size of 51. There were 25 semen samples of alcoholics (cases) and 26 semen samples of non-alcoholics (controls). Materials and Methods: Adequate history regarding the alcohol consumption was taken and the cases (n=25) were categorized into mild (n=17), moderate (n=8) and severe (n=0) alcoholics as per standard criteria of the CAGE Questionnaire. Semen was examined microscopically and the results were statistically analyzed using ANOVA. Results: Mean sperm count in the non-alcoholics was 58.81 million/ml. It was reduced to 45.44 million/ml and 35.62million/ml in mild and moderate alcoholic groups respectively. (P=0.03). Actively motile sperms in non-alcoholics, mild and moderate alcoholics were found to be 58.08%, 44.41% and 30.62% respectively. (P=0.016). The percentage of sluggishly motile sperms in non-alcoholics, mild and moderate alcoholics were found to be 19.09%, 32.35% and 32.5% respectively. The effect on the percentage of immotile sperms was ambiguous. 15 out of the 26 cases of non-alcoholics showed abnormalities in the morphology. The incidence of abnormal morphology of sperm was higher in the alcoholics. All 25 cases showed abnormal sperm morphology. Alcohol causes a decrease in the sperm vitality. As the grade of alcohol increased, the lowest vitality was in the range of 20-29% and the highest being in the range of 70-79%. Conclusion: The findings reveal that alcohol consumption had significant detrimental effects on the count, morphology and vitality of spermatozoa. It is important to create awareness among people of the adverse effects of alcohol on human health and fertility.","PeriodicalId":20962,"journal":{"name":"Recent Advances in Pathology & Laboratory Medicine","volume":"155 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76411088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-28DOI: 10.24321/2454.8642.201815
N. Anand
Background: This study was carried out to know the incidence of co-existence of typhoid and malaria in western part of Uttar Pradesh. Both these infections are common febrile illnesses prevalent in tropical countries including India. Materials and Methods: A total of 300 blood samples were collected from the patients presenting with fever for more than one week. Diagnosis of typhoid was carried out using Widal test and blood culture and for diagnosis of malaria blood film examination was done. Results: Out of total 300 patients, 31 (10.3%) were positive for malarial parasite and 82 (27.3%) were positive for typhoid by Widal test while 12 (4%) were positive for typhoid by blood culture. Rate of co-infection was found out to be 21 (6.7%) with Widal test and 3 (1%) with blood culture. Conclusion: As there is paucity of data on co-infection of malaria and typhoid from this part of country, this study was carried out to know their prevalence. As both these illnesses present with same clinical features, the clinicians must look for co-existence of these infections. Hence, to facilitate the diagnosis and treatment more such studies must be carried out from different parts of the country.
{"title":"Incidence of Co-infection of Malaria and Typhoid and their Diagnostic Dilemmas","authors":"N. Anand","doi":"10.24321/2454.8642.201815","DOIUrl":"https://doi.org/10.24321/2454.8642.201815","url":null,"abstract":"Background: This study was carried out to know the incidence of co-existence of typhoid and malaria in western part of Uttar Pradesh. Both these infections are common febrile illnesses prevalent in tropical countries including India. Materials and Methods: A total of 300 blood samples were collected from the patients presenting with fever for more than one week. Diagnosis of typhoid was carried out using Widal test and blood culture and for diagnosis of malaria blood film examination was done. Results: Out of total 300 patients, 31 (10.3%) were positive for malarial parasite and 82 (27.3%) were positive for typhoid by Widal test while 12 (4%) were positive for typhoid by blood culture. Rate of co-infection was found out to be 21 (6.7%) with Widal test and 3 (1%) with blood culture. Conclusion: As there is paucity of data on co-infection of malaria and typhoid from this part of country, this study was carried out to know their prevalence. As both these illnesses present with same clinical features, the clinicians must look for co-existence of these infections. Hence, to facilitate the diagnosis and treatment more such studies must be carried out from different parts of the country.","PeriodicalId":20962,"journal":{"name":"Recent Advances in Pathology & Laboratory Medicine","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81256380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-28DOI: 10.24321/2454.8642.201813
V. Jha
Background: Turnaround time (TAT) is one of the key indicators of performance of a laboratory. Laboratories define it as the time from the receipt of sample/ specimen to the reporting. A fast TAT helps clinicians in making early diagnosis. Aim: To determine the turnaround time (TAT) of the biochemistry laboratory with evaluation of the contribution of pre-analytical and analytical phase to the total TAT. Results: A total of 399 samples were analysed from three outpatient departments. Average pre-analytical turnaround time contribution was found to be higher as compared to the analytical time. Excess workload and delay in pneumatic shoot were the main causes of delay in pre-analytical phase. Conclusion: Improved turnaround time is the key to clinicians’ and patients’ better satisfaction with the laboratory. It can be attained by minimising the bottlenecks within the process.
{"title":"Analysing Turnaround Time in Laboratory - A Key Performance Indicator","authors":"V. Jha","doi":"10.24321/2454.8642.201813","DOIUrl":"https://doi.org/10.24321/2454.8642.201813","url":null,"abstract":"Background: Turnaround time (TAT) is one of the key indicators of performance of a laboratory. Laboratories define it as the time from the receipt of sample/ specimen to the reporting. A fast TAT helps clinicians in making early diagnosis. Aim: To determine the turnaround time (TAT) of the biochemistry laboratory with evaluation of the contribution of pre-analytical and analytical phase to the total TAT. Results: A total of 399 samples were analysed from three outpatient departments. Average pre-analytical turnaround time contribution was found to be higher as compared to the analytical time. Excess workload and delay in pneumatic shoot were the main causes of delay in pre-analytical phase. Conclusion: Improved turnaround time is the key to clinicians’ and patients’ better satisfaction with the laboratory. It can be attained by minimising the bottlenecks within the process.","PeriodicalId":20962,"journal":{"name":"Recent Advances in Pathology & Laboratory Medicine","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91249451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-28DOI: 10.24321/2454.8642.201818
R. Mohan
Background: The role of the pathologist reporting a case of post-chemotherapy carcinoma breast involves not just looking for residual carcinoma, but also classifying the patient into a response category, based on histological findings, and thus, analyzing the efficacy of treatment. Therapy related changes are well described in carcinoma breast. This study aims at classifying post-chemotherapy specimens based on response to chemotherapy according to the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-18 system and also identifying important associations between morphology, lymph node metastases and hormone receptor status with response. Methods: The study classified thirty-one cases of carcinoma breast who had undergone neoadjuvant chemotherapy in our institution into three categories based on the NSABP B18 system, and analyzed the association of changes in morphology, hormone receptor status and metastases to lymph nodes with presence or absence of response. Results: The commonest response category was partial response (pPR) (17 cases), followed by pathological non-response (pNR) (11 cases) and pathological complete response (pCR) (3 cases). Statistically significant associations were found between presence of residual mass on gross assessment and presence of lymph node metastases with a poor response to treatment. Histopathological features and change in hormone receptor status did not show a significant association with response. Conclusion: The majority of patients showed a partial response to therapy. Presence of a residual mass and presence of metastases to lymph nodes signified poor response.
{"title":"Pathological Assessment of Response to Neoadjuvant Chemotherapy among Carcinoma Breast Patients in a Tertiary Level Hospital","authors":"R. Mohan","doi":"10.24321/2454.8642.201818","DOIUrl":"https://doi.org/10.24321/2454.8642.201818","url":null,"abstract":"Background: The role of the pathologist reporting a case of post-chemotherapy carcinoma breast involves not just looking for residual carcinoma, but also classifying the patient into a response category, based on histological findings, and thus, analyzing the efficacy of treatment. Therapy related changes are well described in carcinoma breast. This study aims at classifying post-chemotherapy specimens based on response to chemotherapy according to the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-18 system and also identifying important associations between morphology, lymph node metastases and hormone receptor status with response. Methods: The study classified thirty-one cases of carcinoma breast who had undergone neoadjuvant chemotherapy in our institution into three categories based on the NSABP B18 system, and analyzed the association of changes in morphology, hormone receptor status and metastases to lymph nodes with presence or absence of response. Results: The commonest response category was partial response (pPR) (17 cases), followed by pathological non-response (pNR) (11 cases) and pathological complete response (pCR) (3 cases). Statistically significant associations were found between presence of residual mass on gross assessment and presence of lymph node metastases with a poor response to treatment. Histopathological features and change in hormone receptor status did not show a significant association with response. Conclusion: The majority of patients showed a partial response to therapy. Presence of a residual mass and presence of metastases to lymph nodes signified poor response.","PeriodicalId":20962,"journal":{"name":"Recent Advances in Pathology & Laboratory Medicine","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85707324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-28DOI: 10.24321/2454.8642.201817
S. Zacharie
Introduction: Prostate cancer (PCa) is the second most commonly diagnosed cancer and the sixth most common cause of cancer-related mortality among men worldwide. Obesity increases the prevalence and mortality of multiple cancers. Consequently, the relationship between obesity and cancer is receiving more and more attention. Objective: To evaluate the impact of body mass index (BMI) on prostate cancer detection and aggressiveness in Cameroonian population. Methodology: This was a comparative cross-sectional study carried out at the hospitals in Cameroon. The study included Cameroonians who underwent prostate biopsies during a 9-year period, from 2008 to 2016. We analysed the BMI, age, prostate volume, and PSA of patients with prostate cancer in comparison with patients with benign prostate tissue who underwent prostate biopsies. Data entry was performed using CSpro 6.3.2, analysis was done using SPSS version 23.0. Results: A total of 316 patients were included in our study, 158 PCa and 158 BPH. The patients had a mean age ± standard deviation of 67.8 ± 10.32 with a modal class of 61 and 70 years. In our study, the mean age ± SD of the PCa group (71.48 ± 8.96) was significantly greater than that of the BPH group (64.17 ± 10.31) (p 0.05). The median total PSA and the median PSA f/t ratio was significantly different in both groups (p<0.001 and p = 0.006). A Gleason score of 7 was the most frequent. Amongst those with a high BMI 77.5% (55) had a high Gleason score, which was significantly higher than the fraction in the low BMI group (60.9%) (53) (P = 0.026). Conclusion: We therefore conclude that BMI is not an independent risk factor for the development of prostate cancer; rather, it is associated with High Gleason PCa.
{"title":"Body Mass Index as a Risk Factor for Prostate Cancer and Benign Prostate Hypertrophy: a Comparative Study at Three Reference Hospitals in Cameroon","authors":"S. Zacharie","doi":"10.24321/2454.8642.201817","DOIUrl":"https://doi.org/10.24321/2454.8642.201817","url":null,"abstract":"Introduction: Prostate cancer (PCa) is the second most commonly diagnosed cancer and the sixth most common cause of cancer-related mortality among men worldwide. Obesity increases the prevalence and mortality of multiple cancers. Consequently, the relationship between obesity and cancer is receiving more and more attention. Objective: To evaluate the impact of body mass index (BMI) on prostate cancer detection and aggressiveness in Cameroonian population. Methodology: This was a comparative cross-sectional study carried out at the hospitals in Cameroon. The study included Cameroonians who underwent prostate biopsies during a 9-year period, from 2008 to 2016. We analysed the BMI, age, prostate volume, and PSA of patients with prostate cancer in comparison with patients with benign prostate tissue who underwent prostate biopsies. Data entry was performed using CSpro 6.3.2, analysis was done using SPSS version 23.0. Results: A total of 316 patients were included in our study, 158 PCa and 158 BPH. The patients had a mean age ± standard deviation of 67.8 ± 10.32 with a modal class of 61 and 70 years. In our study, the mean age ± SD of the PCa group (71.48 ± 8.96) was significantly greater than that of the BPH group (64.17 ± 10.31) (p 0.05). The median total PSA and the median PSA f/t ratio was significantly different in both groups (p<0.001 and p = 0.006). A Gleason score of 7 was the most frequent. Amongst those with a high BMI 77.5% (55) had a high Gleason score, which was significantly higher than the fraction in the low BMI group (60.9%) (53) (P = 0.026). Conclusion: We therefore conclude that BMI is not an independent risk factor for the development of prostate cancer; rather, it is associated with High Gleason PCa.","PeriodicalId":20962,"journal":{"name":"Recent Advances in Pathology & Laboratory Medicine","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84608618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-05DOI: 10.24321/2454.8642.201809
Y. Khonglah
Introduction: Hemoglobinopathies are the most commonly encountered monogenic disorders of blood in Southeast Asia and Indian subcontinent. Screening of individuals at increased risk of being carriers for thalassemia and hemoglobinopathies, can identify couples with a 25% risk of having a pregnancy with a significant genetic disorder, for which prenatal diagnosis is possible. This study is done to know the prevalence of hemoglobinopathies and variant of haemoglobin using cation exchange high performance liquid chromatography (CEHPLC). Materials and Methods: 2 ml of venous blood was collected in EDTA vials from the pregnant mothers after informed consent. The blood was subjected to complete hemogram, peripheral blood smear and HPLC using Variant Hemoglobin Testing System (BioRad Laboratories). Beta Thalassemia short programme was used. Descriptive analysis was done and data is presented in numbers and percentages. Results: 467 blood samples from various ethnic groups were evaluated. 70 (14.99%) samples showed features of hemoglobinopathies by HPLC. There were 46 (9.85%) cases of HbE heterozygous,12 (2.57%) cases of HbE homozygous, 9(1.93%) cases of Beta Thalassemia Trait, 2 (0.43%) cases of double heterozygous and 1 (0.21%) case of Hb-D Iran. Conclusion: This study showed a high prevalence of hemoglobinopathies in antenatal mothers necessitating an appropriate screening strategy for antenatal mothers. We also concluded that HPLC is a sensitive technique for studying hemoglobinopathies during pregnancy and may be utilized for screening.
{"title":"Antenatal Screening for Hemoglobinopathies with HPLC","authors":"Y. Khonglah","doi":"10.24321/2454.8642.201809","DOIUrl":"https://doi.org/10.24321/2454.8642.201809","url":null,"abstract":"Introduction: Hemoglobinopathies are the most commonly encountered monogenic disorders of blood in Southeast Asia and Indian subcontinent. Screening of individuals at increased risk of being carriers for thalassemia and hemoglobinopathies, can identify couples with a 25% risk of having a pregnancy with a significant genetic disorder, for which prenatal diagnosis is possible. This study is done to know the prevalence of hemoglobinopathies and variant of haemoglobin using cation exchange high performance liquid chromatography (CEHPLC). Materials and Methods: 2 ml of venous blood was collected in EDTA vials from the pregnant mothers after informed consent. The blood was subjected to complete hemogram, peripheral blood smear and HPLC using Variant Hemoglobin Testing System (BioRad Laboratories). Beta Thalassemia short programme was used. Descriptive analysis was done and data is presented in numbers and percentages. Results: 467 blood samples from various ethnic groups were evaluated. 70 (14.99%) samples showed features of hemoglobinopathies by HPLC. There were 46 (9.85%) cases of HbE heterozygous,12 (2.57%) cases of HbE homozygous, 9(1.93%) cases of Beta Thalassemia Trait, 2 (0.43%) cases of double heterozygous and 1 (0.21%) case of Hb-D Iran. Conclusion: This study showed a high prevalence of hemoglobinopathies in antenatal mothers necessitating an appropriate screening strategy for antenatal mothers. We also concluded that HPLC is a sensitive technique for studying hemoglobinopathies during pregnancy and may be utilized for screening.","PeriodicalId":20962,"journal":{"name":"Recent Advances in Pathology & Laboratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79538273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-05DOI: 10.24321/2454.8642.201812
A. Sahay
Entamoeba histolytica infections of the gastrointestinal tract are common in the developing world. Only two isolated cases of colonic amoebiasis with colon carcinoma have been described in literature. Here, we describe unique series of four cases showing coexistence of Entamoeba trophozoites with colon cancer. The organisms were demonstrated by Periodic acid Schiff (PAS) stain, which highlighted the trophozoites. Three of the patients were treated with metronidazole and two underwent subsequent resection and adjuvant chemoradiotherapy. Importance of diagnosing coinfection lies in view of immunocompromised state of the cancer patients, most of whom also receive adjuvant chemotherapy and radiotherapy. In such a scenario, if Entamoeba coinfection is not treated, it may lead to complications such as spread of organisms to the brain, liver, lungs and pericardium. The series emphasizes that a high index of suspicion for co-existing parasites is needed in colon cancers, especially in endemic countries.
{"title":"Entamoeba Histolytica Infesting Colonic Malignancy: First Series of Four Cases","authors":"A. Sahay","doi":"10.24321/2454.8642.201812","DOIUrl":"https://doi.org/10.24321/2454.8642.201812","url":null,"abstract":"Entamoeba histolytica infections of the gastrointestinal tract are common in the developing world. Only two isolated cases of colonic amoebiasis with colon carcinoma have been described in literature. Here, we describe unique series of four cases showing coexistence of Entamoeba trophozoites with colon cancer. The organisms were demonstrated by Periodic acid Schiff (PAS) stain, which highlighted the trophozoites. Three of the patients were treated with metronidazole and two underwent subsequent resection and adjuvant chemoradiotherapy. Importance of diagnosing coinfection lies in view of immunocompromised state of the cancer patients, most of whom also receive adjuvant chemotherapy and radiotherapy. In such a scenario, if Entamoeba coinfection is not treated, it may lead to complications such as spread of organisms to the brain, liver, lungs and pericardium. The series emphasizes that a high index of suspicion for co-existing parasites is needed in colon cancers, especially in endemic countries.","PeriodicalId":20962,"journal":{"name":"Recent Advances in Pathology & Laboratory Medicine","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78234319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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