Indian journal of pathology & microbiology最新文献

Purpose: An Innovative and economical method of "Microscopic Photo-quilting" to create a virtual slide for teaching and learning.

Materials and methods: Capturing Individual focal images with a Digital Research Microscope using "High Frequency Wave Pattern" and digitally quilting them to create a seamless virtual image.

Results: Microscopic Photo-quilting can be used to create a virtual seamless image/virtual slide economically and manually using easy to follow steps and without the need for huge investments for procuring whole slide imaging scanners.

Conclusion: Virtual slides can be implemented as a virtual and practical teaching tool for both the undergraduates and post-graduate students. These slides can serve as an excellent reference tool for students as individual and multiple areas of interest can be highlighted upon the virtual slide itself. The virtual slide serves as a Whole slide interface as the user can focus on any area of interest without distortion and the need to change objectives.

Abstract: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare clonal disorder of hematopoietic stem cells characterized by complement-mediated intravascular hemolysis. Renal involvement, though often subclinical, can occasionally present as acute kidney injury (AKI). We report a case of a 24-year-old female who presented with AKI without any clinical or laboratory evidence of hemolysis. Kidney biopsy revealed acute tubular necrosis with hemosiderin deposition, suggestive of chronic hemolysis. The patient recovered with supportive care, and a diagnosis of PNH was not confirmed until 6 years later, following evaluation for anemia. Flow cytometry at that time revealed CD55 and CD59 deficiency, confirming PNH. This case highlights the diagnostic challenge of PNH when it presents atypically and emphasizes the importance of recognizing renal hemosiderosis as a potential early clue. In patients with unexplained AKI and biopsy evidence of hemosiderin deposition, PNH should be considered even in the absence of overt hemolysis or classical symptoms.

Abstract: Juxtaglomerular cell tumor, otherwise known as reninoma, is an unusual renal neoplasm arising from vascular smooth muscles of the juxtaglomerular apparatus of the kidney. It usually presents with uncontrolled hypertension. Approximately 100 cases have been reported till date. We present here a rare case of juxtaglomerular cell tumor, which presented with uncontrolled hypertension and was proceeded with nephrectomy.

Background: Newly introduced topic AETCOM (attitude, communication, and ethics) includes modules 2.4 (working in a health care team [HCT]) and 2.8 (What does it mean to be a family member of a sick patient?) (Empathy) in Competency based medical education (CBME) pathology curriculum through a combination of activities. The actual implementation has been tedious with a few modifications felt to be necessary to accomplish it.

Aims: 1) To increase students' interest, participation and understanding of importance of pathology AETCOM topics. 2) Assessing the effectiveness and students' feedback of the teaching methodology used.

Settings and design: In II MBBS pathology students (CBME Batch) while implementing pathology AETCOM module.

Materials and methods: Planning, sensitization for the new topic, and various activities for carrying out AETCOM session along with reflective writing (RW) and skits by students and students' feedback of the whole session was conducted. Consent was obtained from students for analyzing the scores of RW and feedback for this study purpose. Formal assessment of RW and skits was conducted with the help of checklists having key features for empathy and working in an HCT. Feedback was assessed to find perception of students towards AETCOM sessions and effectiveness of various activities used in learning them.

Statistical analysis: Percentages.

Results: Relevant RWs were 94.6% with mean scores of 7.71/10 for empathy and 7.75/10 for working in HCT. Feedback reflected an overall positive experience of AETCOM Pathology teaching. The most useful activity found was skit and combined effect of all the activities was the most helpful in the maximum retention of topics of AETCOM Pathology in final pathology theory paper.

Conclusions: Various activities with RW with discussion and skits increased students' performance and interest in learning AETCOM pathology.

Abstract: Trichilemmal tumors are rare dermal neoplasms derived from the outer root sheath of hair follicles, showing a follicular differentiation on histology and are categorized into benign and malignant entities. Usually presenting as solitary lesions, they have a predilection for women in the fourth to eighth decades of life, with the scalp being the most common site of occurrence. In this article, we report two extremely rare cases, one diagnosed as malignant proliferating trichilemmal tumor with sarcomatous differentiation (MPTT-S) and the other as proliferating trichilemmal cyst with foci of carcinoma in situ (PTC-CIS). These tumors, thus, reveal a spectrum of unusual trichilemmal tumors with similar clinical presentations but contrasting histopathological characteristics. Squamous cell carcinoma is a close differential diagnosis of these lesions; hence, a higher degree of awareness is a requisite for an accurate understanding and diagnosis, as both of them have distinct prognoses and treatment options.

Abstract: Granulomatous hypophysitis is a rare form of pituitary inflammation that closely mimics pituitary macroadenoma in clinical presentation as well as radiological appearance. Histopathology remains the gold standard diagnostic modality. Here, we present the case of a young female who presented with symptoms of anterior and posterior pituitary dysfunction, including secondary amenorrhea, cold intolerance, polyuria, and polydipsia. Magnetic resonance imaging revealed a sellar mass with suprasellar extension, suggesting a pituitary macroadenoma. Histopathological examination of the transsphenoidal biopsy revealed granulomatous hypophysitis. Extensive systemic workup of the patient did not identify any secondary infectious or autoimmune etiological conditions. She was treated with corticosteroids, thyroxine, and desmopressin. This case emphasizes the importance of considering hypophysitis as a differential diagnosis of common sellar lesions like pituitary macroadenoma and highlights the role of histopathological examination in definitive diagnosis and to determine the appropriate course of management.

Abstract: Orthokeratinized odontogenic cysts (OOC) are uncommon developmental odontogenic cysts of jaw. It was previously considered as an orthokeratinized variant of Odontogenic keratocyst (OKC). OOC differs from OKC of its clinical and histological behavior. A 34-year-old male came for replacement of missing teeth in the right side of lower jaw. History revealed extraction of 46, 47, 48, and enucleation of cyst 15 years before for a radiolucent lesion of right posterior region, which was histologically diagnosed as orthokeratinized variant of OKC. On a radiographic evaluation, unilocular radiolucency was evident in the left posterior mandible and right maxillary anterior region that were clinically diagnosed as OKC in posterior mandible and dentigerous cyst in anterior maxilla in relation to impacted 13. Histologically, both the lesions showed a thin and uniform thickness of orthokeratinized stratified squamous epithelium with abundant keratin in the lumen. The case was diagnosed as Multiple OOC.

Objectives: Peripheral blood smear (PBS) is an essential diagnostic test in current medical practice. AI100 with Shonit TM (AI100) is an automatic cell-locating device intended for white blood cell (WBC) differential count, red blood cell (RBC), and platelet morphology precharacterization. We report a multicenter study evaluating the clinical performance of the AI100 with Shonit™ (combined performance after qualified reviewer verification) in PBS analysis, establishing its equivalence to manual microscopy for diagnostic purposes.

Materials and methods: A retrospective multisite study was conducted at four sites (three in India and one in USA) from August 2021 to January 2023. A total of 882 samples were analyzed by two qualified reviewers in each site independently using manual microscopy and AI100 with Shonit TM . The post-review results were compared between AI100 and manual microscopy.

Results: The overall agreement, sensitivity, and specificity for WBC abnormality are 95.03%, 92.68% and 95.41%, respectively. The overall agreement for RBC anisocytosis and poikilocytosis is 94.7% and 92.1%, respectively. For platelet morphology, the overall agreement, sensitivity, and specificity were 96.8%, 97.9%, and 94.6%, respectively. The repeatability and reproducibility of AI100 with Shonit ™ were also evaluated.

Conclusion: The performance comparison study results demonstrate that the AI100 with Shonit TM is substantially equivalent to manual microscopy.

Abstract: ALK-positive histiocytosis is a systemic or localized form of histiocytosis that is associated with ALK gene rearrangements. Morphological diagnosis of this entity can be challenging due to overlapping morphology and limited case reports. We describe the clinicopathological features of localized ALK-positive histiocytosis in three pediatric cases. The main features were the presence of typical histiocytes and spindle-shaped cells with varying numbers of giant cells, which can exhibit emperipolesis . Neoplastic cells lacked significant atypia, mitotic activity, or pleomorphism. Immunohistochemistry showed positivity for histiocytic markers and ALK (clone 137E9E8). Break-apart FISH confirmed ALK rearrangement. Morphological overlap with juvenile xanthogranuloma and Rosai-Dorfman disease was observed. ALK immunohistochemistry and molecular testing facilitated definitive diagnosis.

Abstract: Collagenous gastritis (CG) is a rare entity characterized by subepithelial collagen deposition with increased thickness of >10 μm. Here we report a young-adult female patient presented with upper gastrointestinal symptoms. Upper gastrointestinal endoscopy revealed atrophic mucosa in the body of stomach, and a biopsy was taken. Histopathological examination showed increased collagen deposition only in the subepithelial region, which is highlighted by Masson's trichrome stain. Final diagnosis of CG was made.