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Publications (7)1.21 Total impact

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    ABSTRACT: A one-year-old male child presented with progressive enlargement of abdomen and loss of appetite which he had suffered from, since 4 months. Physical examination showed a palpable mass in right hypochondrium. Ultrasonography and MRI showed a solid mass arising from right lobe of liver. The resected mass was well encapsulated, yellowish white in colour and it measured 20 x 18 x 17cm. Cut surface showed a Nutmeg like appearance. Histology showed a well-defined, fibrous capsule with numerous ducts which were lined by flat to low cuboidal epithelium and which were surrounded by concentric layers of fibrous tissue which showed myxoid changes at places. Intervening area showed normal appearing hepatocytes with clear cell changes, dilated congested sinusoids, along with extramedullary haematopoiesis. Based on distinctive morphological features, a histological diagnosis of Benign Hepatic Mesenchymal Hamartoma of liver was made. IHC was not done, as no specific marker has been described for making a differential diagnosis. Benign Hepatic Mesenchymal Hamrtoma (HMH) of liver is an extremely rare tumour of childhood and therefore, the case was considered worth documentation.
    03/2014; 8(3):119-120. DOI:10.7860/JCDR/2014/6522.4129
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    Js Nigam · V Misra · V Dhingra · S Jain · K Varma · A Singh ·
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    ABSTRACT: The nasal cavity and paranasal sinuses - including the maxillary, ethmoid, sphenoid, and frontal sinuses are collectively referred to as the sinonasal tract. Fine needle aspiration (FNA) of paranasal sinus lesions for early diagnosis of neoplastic lesions is difficult due to closed architecture, and only one study has been documented in the literature. To find the efficacy of intra-operative cytology and frozen section for frequently encountered tumor and tumor-like lesions of the nose and paranasal sinuses. Thirty cases were included in this study. The material for cytologic examination and frozen sections were taken per-operatively. Cytological smears were prepared by imprint/squash methods from the representative tissue pieces and stained with Leishman-Giemsa and Papanicolaou. Frozen section and paraffin-embedded section were stained with hematoxylin and eosin stain. A rapid opinion regarding the benign or malignant nature of the lesion and the type of tumor was given. The sensitivity, specificity, and positive predictive value of imprint cytology, squash cytology, and frozen section were 100%, 100%, and 100%; 100%, 96.15%, and 80.0%; and 100%, 96.15%, and 80.0%, respectively. Overall diagnostic accuracy of imprint smears, squash smears, and frozen section was100%, 96.7%, and 96.7%, respectively. Imprint smears had better specificity as cells morphology could be more accurately appreciated. Intra-operative cytology and frozen section examinations of lesions of nose and paranasal sinuses are useful, quick, and reliable diagnostic technique for rapid diagnosis in the operation theatre and can be used as an adjunct to histopathology for better management of patients.
    Journal of Cytology 03/2013; 30(1):13-7. DOI:10.4103/0970-9371.107506 · 0.37 Impact Factor
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    Brijesh Thakur · Vatsala Misra · Vishal Dhingra · Smita Chauhan ·
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    ABSTRACT: Pure myoepithelioma of breast is an extremely rare tumor. Only a few cases have been reported in the literature so far. A 30-year old female presented with a large fungating mass arising from the areolar region of her right breast of six months duration. A clinical diagnosis of breast carcinoma was made and a mastectomy was performed. The specimen measured 23×22×9 cm with attached skin, and showed a large white ulcerated growth with areas of necrosis and hemorrhage. No normal breast tissue, nipple or areolar region was seen. Histopathological examination showed oval to spindle cells arranged in fascicles and bundles with whorling pattern in places showing mild pleomorphism with oval to spindle-shaped vesicular nuclei, prominent eosinophilic nucleoli, eosinophilic cytoplasm and clear cell changes in places, along with perivascular hyalinization and collagenization. Differential diagnosis of pleomorphic hyalinizing angiectatic tumor, solitary fibrous tumor, perivascular epithelioid cell tumor, mammary type myofibroblastic tumor and myoepithelioma were all considered. Immunohistochemistry for vimentin, smooth muscle actin, calponin, caldesmon, p63, epithelial membrane antigen, S-100, CD-31, CD-34, muscle specific antigen, myogenin, desmin, and pancytokeratin was carried out. On the basis of positive staining for vimentin, actin, p63 (nuclear), calponin and caldesmon (focal), a final diagnosis of myoepithelioma was considered; however, cytokeratin negativity was an unusual finding. This case was considered worthy of documentation because of its rarity, and because it highlights the importance of proper clinical examination and radiological examination to prevent misdiagnosis.
    Rare tumors 10/2012; 4(4):e50. DOI:10.4081/rt.2012.e50
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    Vatsala Misra · Vishal Dhingra · S P Misra · Manisha Dwivedi ·
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    ABSTRACT: The aim of this paper was, first, to show in a case control study that in alcoholic cirrhotic patients colonic vascular ectasias (VE) are a complication of portal hypertension and, second, to establish in a histomorphometric study that colonic vascular ectasias and rectal varices (RV) are only endoscopic features of a new entity: portal hypertensive colopathy, the pathologic basis of which is colonic mucosal capillary ectasia. In the case control study, for each case, three age- and sex-matched controls selected from consecutive patients were used. Sixteen alcoholic cirrhotic patients, 12 men, 4 women (mean age ±sd: 62±10 years) had colonic vascular ectasias. The prevalence of esophageal varices (88% vs 44%,PPPPP2 vs 1676±345 µm2,P
    Colonoscopy, 08/2011; , ISBN: 978-953-307-568-6
  • Vishal Dhingra · Vatsala Misra · Anthony P Singh · Stuti Agarwal ·
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    ABSTRACT: Cytodiagnosis of cutaneous metastasis of renal cell carcinoma (RCC) in the absence of history of primary tumor is difficult as it can be confused with other clear cell tumors. We report here a case of cytodiagnosis of cutaneous metastasis of RCC in a patient who had nephrectomy done 9 years back at some other centre, but did not have any records with him. Clinicians should be aware of the possibility of primary internal organ malignancy in patients presenting with cutaneous lesions and therefore conduct a careful examination and get necessary investigations. Prompt diagnosis and treatment will have its bearing on the eventual outcome.
    Journal of Cytology 04/2011; 28(1):30-2. DOI:10.4103/0970-9371.76947 · 0.37 Impact Factor
  • V. Dhingra · V. Misra · R. Mishra · R. Bhatia · M. Singhal ·
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    ABSTRACT: Introduction: Lymphadenopathy is one of the commonest clinical presentations among paediatric patients, having several aetiologies and can pose as a diagnostic dilemma to a paediatrician. Therefore, it is necessary to arrive at a definitive diagnosis in order to administer proper treatment. The objective of this study was to evaluate the diagnostic role of fine needle aspiration cytology in lymphadenopathy in the paediatric age group. Material and Methods: This study was carried out in patients up to 14 years of age, who had palpable lymph node masses. The duration of this study was 3 years. A total number of 270 cases were included in the study for cytological examination. Histopathological examination was performed in 90 patients. Both dry and wet fixed smears were prepared in all cases and were stained by MGG and Papanicolaou stains. Results: Overall, inflammatory lymphadenopathy comprised 88.5% of the total lesions of the lymph nodes; it included 56% cases of reactive hyperplasia, 28.1% cases of granulomatous lymphadenitis and 4.4% cases of acute nonspecific lymphadenitis. Malignant lesions were seen in 11.5% patients. Overall, the diagnostic accuracy of the cytological examination was 98.89% and the overall sensitivity and specificity were 91.3% and 99.1%, respectively. Conclusions: Fine needle aspiration cytology is a reliable, easy and economical technique in the diagnosis of paediatric lymphadenopathy.
    Journal of Clinical and Diagnostic Research 01/2010; 4(3):2452-2457. · 0.23 Impact Factor
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    ABSTRACT: Stones are frequently seen in the gall bladder, kidney and the urinary tract. Rarely can a large stone be found in the thyroid. Only few cases of calcification in thyroid have been reported, especially in association with papillary carcinoma (thyroid). A case of a large stone (2.9 cm x 1.9 cm x 1 cm) in the thyroid, in association with colloid goiter in a 35 yrs old female is documented here.
    Journal of Clinical and Diagnostic Research 01/2010; 4(2). · 0.23 Impact Factor