Pub Date : 2024-07-15DOI: 10.18231/j.ijpo.2024.035
J. Thanka, Divya Dinesh, Vinutha Gali, Ajitha Rajalingam
Seromucinous neoplasms are new category of ovarian epithelial tumor in the 2014 revised World Health Organization classification. Surface epithelial neoplasms are the most common ovarian tumors. Based on the degree of stratification and the presence or absence of invasion, these epithelial proliferations are further divided into benign, borderline, and malignant categories. Benign tumors are divided into three subtypes: cystadenoma (cystic areas), cystadenofibroma (cystic and fibrous areas), and adenofibroma (predominantly fibrous sections). Serous adenofibromas are rare variant of serous surface epithelial tumors. They affect females between the ages of 15 and 65 and make up 1.7% of all benign ovarian tumors. Serous tumor with a solid, fibrous component is designated as serous cystadenofibroma in which both serous and mucinous components are closely intermixed. Seromucinous adenofibroma is a benign cystic neoplasm composed of glands and cysts lined by an admixture of bland mullerian type epithelium which includes ciliated, endocervical type mucinous, and endometroid. They have a characteristic prominent fibromatous hypocellular stroma which helps differentiate it from the commoner cystadenoma. Seromucinous borderline tumors is 10% -20% of all epithelial ovarian tumors. Develops in younger age, usually bilateral in upto 40%, associated with endometriosis. We discuss about four different cases of seromucinous tumor reported in our institute.
{"title":"Seromucinous tumors of ovary: A case series","authors":"J. Thanka, Divya Dinesh, Vinutha Gali, Ajitha Rajalingam","doi":"10.18231/j.ijpo.2024.035","DOIUrl":"https://doi.org/10.18231/j.ijpo.2024.035","url":null,"abstract":"Seromucinous neoplasms are new category of ovarian epithelial tumor in the 2014 revised World Health Organization classification. Surface epithelial neoplasms are the most common ovarian tumors. Based on the degree of stratification and the presence or absence of invasion, these epithelial proliferations are further divided into benign, borderline, and malignant categories. Benign tumors are divided into three subtypes: cystadenoma (cystic areas), cystadenofibroma (cystic and fibrous areas), and adenofibroma (predominantly fibrous sections). Serous adenofibromas are rare variant of serous surface epithelial tumors. They affect females between the ages of 15 and 65 and make up 1.7% of all benign ovarian tumors. Serous tumor with a solid, fibrous component is designated as serous cystadenofibroma in which both serous and mucinous components are closely intermixed. Seromucinous adenofibroma is a benign cystic neoplasm composed of glands and cysts lined by an admixture of bland mullerian type epithelium which includes ciliated, endocervical type mucinous, and endometroid. They have a characteristic prominent fibromatous hypocellular stroma which helps differentiate it from the commoner cystadenoma. Seromucinous borderline tumors is 10% -20% of all epithelial ovarian tumors. Develops in younger age, usually bilateral in upto 40%, associated with endometriosis. We discuss about four different cases of seromucinous tumor reported in our institute.","PeriodicalId":486471,"journal":{"name":"Indian Journal of Pathology and Oncology","volume":"17 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141646383","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 : 2024-07-15DOI: 10.18231/j.ijpo.2024.045
Vidhi Dineshkumar Modh, Preeti Jhaveri, Hinal K Gajjar
Solitary fibrous tumor is fibroblastic tumor, located mostly in deep soft tissue as well as extrapulmonary sites. In the present case, a 27-year female presented with complain of bilateral nasal blockage (right >left) with history of nasal bleed. The CT scan report revealed p/o hypervascular nasal polyp and sinusitis. Patient underwent excision of granulomatous mass arising from lateral nasal wall in right nasal cavity. The pathological report stated nasal tumor with hemangiopericytoma like pattern with differential diagnosis of 1) Solitary fibrous tumor – right nasal cavity 2) Glomangiopericytoma; further Immunohistochemistry was positive for CD34 (membranous) and STAT6 (nuclear) which leads to final diagnosis of Solitary fibrous tumor – right nasal cavity. Histopathological characteristics serve as the primary criteria for differentiating this condition from other entities.
{"title":"Solitary fibrous tumor of nasal cavity: A case report","authors":"Vidhi Dineshkumar Modh, Preeti Jhaveri, Hinal K Gajjar","doi":"10.18231/j.ijpo.2024.045","DOIUrl":"https://doi.org/10.18231/j.ijpo.2024.045","url":null,"abstract":"Solitary fibrous tumor is fibroblastic tumor, located mostly in deep soft tissue as well as extrapulmonary sites. In the present case, a 27-year female presented with complain of bilateral nasal blockage (right >left) with history of nasal bleed. The CT scan report revealed p/o hypervascular nasal polyp and sinusitis. Patient underwent excision of granulomatous mass arising from lateral nasal wall in right nasal cavity. The pathological report stated nasal tumor with hemangiopericytoma like pattern with differential diagnosis of 1) Solitary fibrous tumor – right nasal cavity 2) Glomangiopericytoma; further Immunohistochemistry was positive for CD34 (membranous) and STAT6 (nuclear) which leads to final diagnosis of Solitary fibrous tumor – right nasal cavity. Histopathological characteristics serve as the primary criteria for differentiating this condition from other entities.","PeriodicalId":486471,"journal":{"name":"Indian Journal of Pathology and Oncology","volume":"11 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141649358","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 : 2024-04-15DOI: 10.18231/j.ijpo.2024.011
Akanksha Hegde, Atira Mirza, Amrutha B Shankar
Follicular adenoma (FA) of the thyroid gland is a benign, solitary, encapsulated tumor. It shows microfollicular and macrofollicular growth patterns. Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy and follicular variant is the most common subtype of PTCs. They have tumor cells arranged in follicular pattern which exhibit nuclear features of papillary carcinoma. Here we present a remarkable case of a patient who was clinically diagnosed as multinodular goiter, TIRADS 2 (not suspicious) by ultrasonography and Fine needle aspiration cytology report was given as a benign adenomatoid nodule. However, histopathological examination revealed the unexpected coexistence of both follicular adenoma and PTC.
{"title":"Dual lesions in thyroidectomy, unravelling the enigma of thyroid collision tumors: A rare case report","authors":"Akanksha Hegde, Atira Mirza, Amrutha B Shankar","doi":"10.18231/j.ijpo.2024.011","DOIUrl":"https://doi.org/10.18231/j.ijpo.2024.011","url":null,"abstract":"Follicular adenoma (FA) of the thyroid gland is a benign, solitary, encapsulated tumor. It shows microfollicular and macrofollicular growth patterns. Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy and follicular variant is the most common subtype of PTCs. They have tumor cells arranged in follicular pattern which exhibit nuclear features of papillary carcinoma. Here we present a remarkable case of a patient who was clinically diagnosed as multinodular goiter, TIRADS 2 (not suspicious) by ultrasonography and Fine needle aspiration cytology report was given as a benign adenomatoid nodule. However, histopathological examination revealed the unexpected coexistence of both follicular adenoma and PTC.","PeriodicalId":486471,"journal":{"name":"Indian Journal of Pathology and Oncology","volume":"42 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140701599","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 : 2024-04-15DOI: 10.18231/j.ijpo.2024.010
S. Jagtap, Shubham S Jagtap, Nidhi Goswami, Neha Desai, Manasi Tamberi
Male synchronous bilateral breast cancer of Adenoid cystic carcinomaACC) is extremely rare.: A 84-year-old male presented with a simultaneously, bilateral, rapidly growing lump in breast of three months duration. Physical examination right breast, revealed a single subareolar mass measuring 3.4 x 3 x2.8 cm. It was firm to hard, well-defined mass with retraction of nipple. The left breast mass was firm tender, measuring 3.1x2.5x2.1cm with irregular margins. Bilateral lymphadenopathy was noted. Sonommamography was suspicious of neoplastic lesion with secondary changes. The FNAC reported as positive for carcinoma cell of bilateral breasts. The bilateral modified radical mastectomy was done. On histopathology, we reported as bilateral breast cancer of Adenoid cystic carcinomasolid, cribriform, tubular pattern, grade III in right breast and ACC with areas of invasive breast carcinoma and neuroendocrine features in left breast. All 24 right and left axillary lymph nodes were negative for metastesis. On immunohistochemistry staining tumor cells were negative for Estrogen Receptor, progesterone receptor, HER2/neu oncogene. ACC of breast is a rare subtype of breast cancer. We present extremely rare case of male synchronous bilateral breast cancer of ACC for its clinical manifestations, radio imaging, and histopathological features.
{"title":"Adenoid cystic carcinoma of the male breast: Case report and review of literature","authors":"S. Jagtap, Shubham S Jagtap, Nidhi Goswami, Neha Desai, Manasi Tamberi","doi":"10.18231/j.ijpo.2024.010","DOIUrl":"https://doi.org/10.18231/j.ijpo.2024.010","url":null,"abstract":"Male synchronous bilateral breast cancer of Adenoid cystic carcinomaACC) is extremely rare.: A 84-year-old male presented with a simultaneously, bilateral, rapidly growing lump in breast of three months duration. Physical examination right breast, revealed a single subareolar mass measuring 3.4 x 3 x2.8 cm. It was firm to hard, well-defined mass with retraction of nipple. The left breast mass was firm tender, measuring 3.1x2.5x2.1cm with irregular margins. Bilateral lymphadenopathy was noted. Sonommamography was suspicious of neoplastic lesion with secondary changes. The FNAC reported as positive for carcinoma cell of bilateral breasts. The bilateral modified radical mastectomy was done. On histopathology, we reported as bilateral breast cancer of Adenoid cystic carcinomasolid, cribriform, tubular pattern, grade III in right breast and ACC with areas of invasive breast carcinoma and neuroendocrine features in left breast. All 24 right and left axillary lymph nodes were negative for metastesis. On immunohistochemistry staining tumor cells were negative for Estrogen Receptor, progesterone receptor, HER2/neu oncogene. ACC of breast is a rare subtype of breast cancer. We present extremely rare case of male synchronous bilateral breast cancer of ACC for its clinical manifestations, radio imaging, and histopathological features.","PeriodicalId":486471,"journal":{"name":"Indian Journal of Pathology and Oncology","volume":"290 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703786","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 : 2024-04-15DOI: 10.18231/j.ijpo.2024.009
Shilpi Patel, Noorin Zaidi, Sumaiya Irfan, N. Lal
Seborrheic keratosis in axilla is a very rare finding. Here, we describe the case of a 46-year-old woman who visited a dermatology Opd and complained of a lesion over her left axilla that had been there for six years. On examination single pedunculated cerebriform nodules black-tan in color surrounded by hyperpigmented halo at its base, firm to palpate, painless present over left axilla, it was non-bleeding. The histopathological examination revealed seborrheic keratosis which is a very rare in axilla.
{"title":"Swelling in axilla - A rare diagnosis","authors":"Shilpi Patel, Noorin Zaidi, Sumaiya Irfan, N. Lal","doi":"10.18231/j.ijpo.2024.009","DOIUrl":"https://doi.org/10.18231/j.ijpo.2024.009","url":null,"abstract":"Seborrheic keratosis in axilla is a very rare finding. Here, we describe the case of a 46-year-old woman who visited a dermatology Opd and complained of a lesion over her left axilla that had been there for six years. On examination single pedunculated cerebriform nodules black-tan in color surrounded by hyperpigmented halo at its base, firm to palpate, painless present over left axilla, it was non-bleeding. The histopathological examination revealed seborrheic keratosis which is a very rare in axilla.","PeriodicalId":486471,"journal":{"name":"Indian Journal of Pathology and Oncology","volume":"319 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703514","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 : 2024-04-15DOI: 10.18231/j.ijpo.2024.008
Sarasa Bharathi Yeganathan, Thenmozhi M
Squash cytology is a rapid, inexpensive and accurate method of diagnosing intracranial lesions. Glial tumors are the most commonly encountered lesions whereas the Non-Glial lesions remain to be less explored. The distribution and detailed study of cyto-morphological features of Non-Glial lesions will lead to better diagnostic conclusions and effective managements. To analyze the distribution of Non-glial lesions using Squash cytology and to emphasize the potential of CNS smears in accurate diagnosis of Non-glial lesions. This was a retrospective study conducted over a period of one year from November 2019 to November 2021 in 30 cases. Samples of Non-glial lesions obtained from the Department of Neurosurgery were studied using Squash cytology method and confirmed with histopathology.: Out of the 30 cases studied, 2 cases were of non-neoplastic inflammatory lesions, 2 of them were cystic lesion, 19 cases were benign, 3 were malignant lesions and 4 cases were of metastatic origin. Meningioma was the most common benign tumor. Pediatric patients had more number of small blue round cell tumors. Meningioma is the most common Non-glial tumor, followed by schwannoma. Metastasis is seen in elderly patients and pediatric cases presented with small round blue cell tumors. Squash cytology has a highly significant positive correlation with final histopathological diagnosis.
{"title":"A study of squash smear cytology in the diagnosis of non-glial lesions in GMKMCH, Salem","authors":"Sarasa Bharathi Yeganathan, Thenmozhi M","doi":"10.18231/j.ijpo.2024.008","DOIUrl":"https://doi.org/10.18231/j.ijpo.2024.008","url":null,"abstract":"Squash cytology is a rapid, inexpensive and accurate method of diagnosing intracranial lesions. Glial tumors are the most commonly encountered lesions whereas the Non-Glial lesions remain to be less explored. The distribution and detailed study of cyto-morphological features of Non-Glial lesions will lead to better diagnostic conclusions and effective managements. To analyze the distribution of Non-glial lesions using Squash cytology and to emphasize the potential of CNS smears in accurate diagnosis of Non-glial lesions. This was a retrospective study conducted over a period of one year from November 2019 to November 2021 in 30 cases. Samples of Non-glial lesions obtained from the Department of Neurosurgery were studied using Squash cytology method and confirmed with histopathology.: Out of the 30 cases studied, 2 cases were of non-neoplastic inflammatory lesions, 2 of them were cystic lesion, 19 cases were benign, 3 were malignant lesions and 4 cases were of metastatic origin. Meningioma was the most common benign tumor. Pediatric patients had more number of small blue round cell tumors. Meningioma is the most common Non-glial tumor, followed by schwannoma. Metastasis is seen in elderly patients and pediatric cases presented with small round blue cell tumors. Squash cytology has a highly significant positive correlation with final histopathological diagnosis.","PeriodicalId":486471,"journal":{"name":"Indian Journal of Pathology and Oncology","volume":"58 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140701080","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}
Lymphangitis carcinomatosis is the malignant infiltration of lymphatic vessels because of the spread of cancer from a primary site. We present a case of a 40-year-old female with right upper abdominal pain for 2 months. Computed tomography revealed diffuse wall thickening of the colon, caecum, and terminal ileum with multiple enlarged lymph nodes. Biopsy of the ascending colon showed high grade dysplasia of colonic mucosa. Hence, proceeded with a right hemicolectomy. Histopathology showed moderately differentiated adenoma like adenocarcinoma with large areas of lymphangitis carcinomatosis like pattern.
{"title":"Lymphangitis carcinomatosis: A rare presentation in right sided colonic adenocarcinoma","authors":"Thanka Johnson, Sangeeta Banik, Rajendran Shanmugasundaram, Shobana Ashok","doi":"10.18231/j.ijpo.2024.018","DOIUrl":"https://doi.org/10.18231/j.ijpo.2024.018","url":null,"abstract":"Lymphangitis carcinomatosis is the malignant infiltration of lymphatic vessels because of the spread of cancer from a primary site. We present a case of a 40-year-old female with right upper abdominal pain for 2 months. Computed tomography revealed diffuse wall thickening of the colon, caecum, and terminal ileum with multiple enlarged lymph nodes. Biopsy of the ascending colon showed high grade dysplasia of colonic mucosa. Hence, proceeded with a right hemicolectomy. Histopathology showed moderately differentiated adenoma like adenocarcinoma with large areas of lymphangitis carcinomatosis like pattern.","PeriodicalId":486471,"journal":{"name":"Indian Journal of Pathology and Oncology","volume":"44 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140701786","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}
Hidradenocarcinoma is rare sweat gland tumor of skin which may have both apocrine and eccrine variants. We report a case of 27 year old postpartum female patient presented with complain of swelling over right breast since 8 months with pain on and off. The ultrasonography report revealed possibility of fibroadenoma (BIRADS CATEGORY -II). The patient underwent FNAC which was reported as fibroproliferative breast disease with atypia. Then wide local excision of mass was performed, the pathological report stated the tumor as a malignant epithelial neoplasm of adnexal origin – hidradenocarcinoma type and Immunohistochemical analysis revealed negative staining for ER, PR, HER2. This case represent difficulty in diagnosis of tumor. Histopathological features are main key to distinguish it from other entities.
{"title":"Malignant epithelial neoplasm of adnexal origin: Hidradenocarcinoma of breast: A rare case report","authors":"M. Gandhi, Viral Bharatkumar Suthar, Pragati Atulbhai Shah, Isha Sharad Pathak","doi":"10.18231/j.ijpo.2024.014","DOIUrl":"https://doi.org/10.18231/j.ijpo.2024.014","url":null,"abstract":"Hidradenocarcinoma is rare sweat gland tumor of skin which may have both apocrine and eccrine variants. We report a case of 27 year old postpartum female patient presented with complain of swelling over right breast since 8 months with pain on and off. The ultrasonography report revealed possibility of fibroadenoma (BIRADS CATEGORY -II). The patient underwent FNAC which was reported as fibroproliferative breast disease with atypia. Then wide local excision of mass was performed, the pathological report stated the tumor as a malignant epithelial neoplasm of adnexal origin – hidradenocarcinoma type and Immunohistochemical analysis revealed negative staining for ER, PR, HER2. This case represent difficulty in diagnosis of tumor. Histopathological features are main key to distinguish it from other entities.","PeriodicalId":486471,"journal":{"name":"Indian Journal of Pathology and Oncology","volume":"48 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140699284","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 : 2024-04-15DOI: 10.18231/j.ijpo.2024.001
Banushree C S
{"title":"A rare borderline neoplastic lesion of breast, a mimicker and precursor of carcinoma","authors":"Banushree C S","doi":"10.18231/j.ijpo.2024.001","DOIUrl":"https://doi.org/10.18231/j.ijpo.2024.001","url":null,"abstract":"","PeriodicalId":486471,"journal":{"name":"Indian Journal of Pathology and Oncology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703296","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 : 2024-04-15DOI: 10.18231/j.ijpo.2024.003
Preeti Tripathi, Shobhit Goel, Rajiv Kumar, Arijit Sen
Iron deficiency has been found to affect hemoglobin A2 (HbA2) values in HPLC. This can be an issue for thalassemia screening laboratories where there is heavy reliance on increased Hb A2 levels for diagnosis of heterozygous thalassemia state. In resource constrained countries like India this could be real challenging where iron deficiency is widespread and facilities for molecular confirmation in borderline HbA2 values is generally unavailable. It was a prospective study done in a tertiary care center over 18 months. All consecutive patients (n = 164) presenting with microcytic hypochromic anemia on peripheral smear were included for further investigations out of which 92 were found to have pure iron deficiency (Hb < 12 Gm/dL with ferritin less than12 ng/ml) on iron parameters. These patients were divided into two groups, Group A with Hb < 9 g/dl and Group B with Hb > 9 g/dl. Common hematological parameters, iron indices and HbA2 levels were analysed in these two group of patients at baseline and after 3 months of documented oral iron therapy. Chi-square and Pearson tests were used for statistical analysis and a P- value of < 0.05 was considered statistically significant. As expected iron deficiency was found more prevalent in females (72%) than in males(28%). Mean pre -treatment and post - treatment hemoglobin of patients in group A was 8±0.5 gm/dl and 11.3±1.1gm/dl respectively and in group B was 10.2±0.6 g/dl and 11.5±1 g/dl showing positive correlation. Mean pre treatment and post treatment HbA2 levels of patients in group A were 1.8±0.5% and 2.4±0.5% respectively showing statistically significant change after iron therapy (P< 0.0001) but mean pre treatment and post treatment HbA2 levels of patients in group B were 2.1±0.4% and 2.2±0.5% respectively . this change post therapy was statistically insignificant(P=0.1517). The change in HbA2 levels was statistically insignificant for patients with mild / moderate iron deficiency anemia (Hb > 9 Gm/DL). Thus diagnosis of β thalassemia trait will not be difficult in patients with concomitant mild iron deficiency anemia but patients with severe iron deficiency anemia should first be treated with iron supplements for correct diagnosis of β Thalassemia trait especially patients with borderline Hb A2 levels.
{"title":"HBA2 levels in iron deficiency - Can iron deficiency mask thalassemia screening?","authors":"Preeti Tripathi, Shobhit Goel, Rajiv Kumar, Arijit Sen","doi":"10.18231/j.ijpo.2024.003","DOIUrl":"https://doi.org/10.18231/j.ijpo.2024.003","url":null,"abstract":"Iron deficiency has been found to affect hemoglobin A2 (HbA2) values in HPLC. This can be an issue for thalassemia screening laboratories where there is heavy reliance on increased Hb A2 levels for diagnosis of heterozygous thalassemia state. In resource constrained countries like India this could be real challenging where iron deficiency is widespread and facilities for molecular confirmation in borderline HbA2 values is generally unavailable. It was a prospective study done in a tertiary care center over 18 months. All consecutive patients (n = 164) presenting with microcytic hypochromic anemia on peripheral smear were included for further investigations out of which 92 were found to have pure iron deficiency (Hb < 12 Gm/dL with ferritin less than12 ng/ml) on iron parameters. These patients were divided into two groups, Group A with Hb < 9 g/dl and Group B with Hb > 9 g/dl. Common hematological parameters, iron indices and HbA2 levels were analysed in these two group of patients at baseline and after 3 months of documented oral iron therapy. Chi-square and Pearson tests were used for statistical analysis and a P- value of < 0.05 was considered statistically significant. As expected iron deficiency was found more prevalent in females (72%) than in males(28%). Mean pre -treatment and post - treatment hemoglobin of patients in group A was 8±0.5 gm/dl and 11.3±1.1gm/dl respectively and in group B was 10.2±0.6 g/dl and 11.5±1 g/dl showing positive correlation. Mean pre treatment and post treatment HbA2 levels of patients in group A were 1.8±0.5% and 2.4±0.5% respectively showing statistically significant change after iron therapy (P< 0.0001) but mean pre treatment and post treatment HbA2 levels of patients in group B were 2.1±0.4% and 2.2±0.5% respectively . this change post therapy was statistically insignificant(P=0.1517). The change in HbA2 levels was statistically insignificant for patients with mild / moderate iron deficiency anemia (Hb > 9 Gm/DL). Thus diagnosis of β thalassemia trait will not be difficult in patients with concomitant mild iron deficiency anemia but patients with severe iron deficiency anemia should first be treated with iron supplements for correct diagnosis of β Thalassemia trait especially patients with borderline Hb A2 levels.","PeriodicalId":486471,"journal":{"name":"Indian Journal of Pathology and Oncology","volume":"20 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140700309","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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