[Show abstract][Hide abstract] ABSTRACT: Choroid plexus carcinoma is a very rare tumor in adults. Here we report a rare case of choroid plexus carcinoma in an adult patient. A 24-year-old male presented with a right temporal intraventricular tumor with a cystic component also extending up to the cortex. Histological examination revealed complex papillary structures and glandular spaces showing stratification and multilayering of cells with nuclear crowding and numerous mitotic figures and large areas of necrosis. The patient went through a complete search for a possible primary keeping in mind the differential diagnosis of metastatic carcinoma that is more common in adults but there was no evidence of any other tumor. Finally a diagnosis of choroid plexus carcinoma was rendered. Immunohistochemical analysis for p53 protein showed positivity. Choroid plexus carcinoma is exceptionally rare in adults but cases do occur.
Journal of neurosciences in rural practice. 01/2012; 3(1):71-3.
[Show abstract][Hide abstract] ABSTRACT: Rhabdoid morphology in tumors refers to resemblance of the cells to rhabdomyoblasts without true skeletal muscle differentiation. The cytological features include abundant eosinophilic cytoplasm, eccentric nuclei, and intracytoplasmic hyaline inclusions. Besides the rhabdoid morphology, cytoarchitectural features of atypical meningioma (four or more mitoses per 10 high-power fields, high cellularity, sheeting architecture, nuclear atypia, and necrosis) are seen in most cases. A case is presented here to highlight the appearance of rhabdoid cells on intraoperative squash smears, for most accurate treatment and close follow-up, as rhabdoid morphology is related to aggressive behavior and poor outcomes.
[Show abstract][Hide abstract] ABSTRACT: Finding fruiting bodies and hyphae of Aspergillus species in a routine cervicovaginal Pap smear is a rare occurrence. When encountered, it is important to distinguish between a true infection and contamination. The fruiting body also plays a very important role in distinguishing the various Aspergillus species.
A 52-year-old woman underwent routine gynecologic and Pap smear examination. Her per-vaginal and per-speculum examinations were unremarkable. Pap smear showed atrophic changes with few acute inflammatory cells. However, a large number of hyphae and many fruiting bodies of Aspergillus species were observed in the smears. Close examination of the smear and clinical investigation indicated that the presence of Aspergillus species was due to contamination. Clinical follow-up with repeat Pap smear after I month was unremarkable.
Fruiting bodies and hyphae of Aspergillus are rare in routine Pap smears. If seen, a differentiation between a true infection and contamination becomes mandatory. The fruiting bodies and hyphae provide an important clue to diagnosis of particular Aspergillus species and differentiating from other similar fungi. A contaminated smear overrules the toxic antifungal therapy and undue follow-up, whereas true infection requires careful study of immune status and prompt investigation.
[Show abstract][Hide abstract] ABSTRACT: Oesophageal cancer is the third most common gastrointestinal cancer, especially in the Asian population. Only 1.3 percent of oesophageal cancers cases present as carcinosarcomas. A 43-year-old male who is a chronic smoker presented with progressive dysphagia and weight loss. On barium swallow, a large polypoidal mass was found filling the oesophageal lumen. Gross and microscopical findings along with immunohistochemistry helped in establishing its diagnosis as oesophageal carcinosarcoma. This unusual and controversial malignant tumour is biphasic in nature, composed of both carcinomatous and sarcomatous elements. This case showed a rarer feature that the epithelial element was of the adenocarcinomatous type instead of the expected squamous cell carcinomatous component.
Singapore medical journal 11/2008; 49(10):e283-5. · 0.63 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Hematological malignancies are quite common and affect all ages and genders. The diagnosis involves a multiparameter approach. The geographical distribution of various types of hematological malignancies has been provided by various authors but no such data have been published regarding the State of Uttarakhand in India.
To study the hematological malignancies at Uttarakhand in India based on age, sex and the type of malignancy with further sub typing wherever possible.
A total of 220 cases of hematological malignancies were worked up from the Reference Laboratory of Himalayan Institute of Medical Sciences over an eight year period (1998-2005).
Diagnosis was mainly based on morphological examination of peripheral blood and bone marrow smears stained by Leishman's stain and MPO, Sudan Black and PAS stain as and where required. Distribution of cases was studied based on age, sex and the type of malignancy with further sub typing wherever possible.
The most common hematological malignancy was found to be Leukemia 129/220 (58%) followed b Lymphoma 33/220 (14.8%), Multiple Myeloma 55/220 (24.7%) and Metastatic Lesions 3/220 (1.3%). These malignancies were seen to be distributed throughout all ages with a peak at 11-20 years age group 39/220 (17.5%) and another peak at 51-60 years age group 41/220 (18.4%). We found an overall male preponderance with a M:F ratio of 2.3:1.
The commonest haematological malignancy in our series was Leukemia. Other diagnoses were Multiple Myeloma, Lymphoma and Secondaries. Multiple Myeloma which turned out to be the second most common diagnosis was an unusual finding.
Indian Journal of Hematology and Blood Transfusion 03/2008; 24(1):7-11. · 0.25 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Metaplasia is a reversible reprogramming of stem cells of the epithelium. Usually, squamous metaplasia is observed in the endocervix. However, less frequently, tubal metaplasia may develop, replacing nonciliated columnar cells by ciliated columnar cells, similar to fallopian tube epithelium. Here we present a case of tubal metaplasia of the endocervical canal. A 40 year-old female presented with postcoital bleeding; her uterus was retroverted, normal-sized and the fornices were free. Erosion was seen around the external os with ulceration. The clinical diagnosis was chronic cervicitis. Cytobrush sampling showed abundant endocervical columnar cells. A distinct morphological variation showing apical ciliary plates with distinct cilia were noticed in many columnar cells. Mucoid, neutrophil-rich secretions were seen in the background but no malignant cells were seen, resulting in a diagnosis of tubal metaplasia of the endocervical epithelium. There was no Trichomonas vaginalis infection. Tubal metaplasia should be identified as a unique benign identity and should not be confused with early endocervical glandular neoplasia of the cervix. Cytobrush technique for endocervical smears helps detect such uncommon metaplastic changes.
[Show abstract][Hide abstract] ABSTRACT: Objective : To evaluate the usefulness and cost effectiveness of bronchial washing in addition to endobronchial biopsies and/or bronchial brushing for the diagnosis of endoscopically visible lung cancer. Material and method : We retrospectively analyzed the medical records of all fi-beropticbronchoscopies at Himalayan institute of medical sciences from January 2002 to August 2005. All patients with endoscopically visible tumours in whom a definite cytological or histological diagnosis of pulmonary malignancy was made were included in the study. We analyzed usefulness and cost effectiveness of three potential specimen collection stragetgies. These stratgies were (1) Bronchoscopy with biopsy, brushing, and washing (2) Bronchoscopy with biopsy and washing; and (3) Bronchoscopy with biopsy and brushing. Results : 107 cases of endoscopically visible abnormality underwent forceps biopsy, brushing and washing. Ninety-nine of these 107 patients had atleast one of the three endoscopic procedures (bronchial washing, endobronchial biopsies and bronchial brushing) positive for lung cancer (92.52%). The sensitivity of endobronchial biop-sy, brushing and bronchial washing for diagnosing lung cancer was 83.17%, 69.15% and 47.66% respectively. Bronchial washing was the only diagnostic procedure in two patients (1.86%). Cost effectiveness analysis revealed that bronchial washing as an additional diagnostic tool to endobronchial biopsies/or bronchial washing for diagnosis of endoscopically visible lung cancer may not be cost effective. Conclusion : The best yields for diagnosis of lung cancer is obtained with endobronchial biopsy and brushing. The addition of bronchial washing to either endobronchial biopsy or bronchial brushing is beneficial, but it may not be cost effective.
[Show abstract][Hide abstract] ABSTRACT: Bronchial brushing (BB) and the more recent trans-bronchial needle aspiration (TBNA) are well established techniques performed using flexible fiberoptic bronchoscope, for sampling trachobronchial lesions suspected of malignancy. Our aim was to assess the efficacy of these two techniques in diagnosing carcinoma lung, when used individually as well as in combination, taking bronchial biopsy as the "Gold Standard" diagnostic test. Of all the cases of suspected lung cancer received between 1 st January 2003 to 30 th September 2004, 181 cases were selected where flexible bronchoscopic samples of BB, TBNA as well as bronchial biopsy were taken. Samples were processed as per standard procedures of cytology and histology. Squamous cell carcinoma was the most common lung cancer followed by small cell type. Sensitivity of BB was 81.5%; while that of TBNA was 62.5%. Specificity of BB and TBNA was 77.8% and 66.7%, respectively. Efficacy of BB was better than TBNA in diagnosing lung cancers. Combined use of BB and TBNA showed better sensitivity and accuracy than either techniques used individually. Bronchial brushing is a superior technique in the diagnosis of lung cancers than TBNA. Their combined use can further improve the chances of early detection of lung cancers.
[Show abstract][Hide abstract] ABSTRACT: Helicobacter pylori (H. pylori), infection has been linked to acute and chronic gastritis, non-ulcer-dyspepsia, peptic ulcer, gastric adenocarcinoma and gastric non-Hodgkin's lymphoma of mucosa-associated lymphoid tissue (MALT). The epithelial changes in H. pylori colonized gastric mucosa are easy to recognize in routine Haematoxylin & Eosin stained sections and are so distinctive that they can serve as a helpful histological indicator for the presence of H. pylori in gastric biopsies. The histopathology of seventy-five gastric biopsies showing colonization by H. pylori was studied. Histologically, the H. pylori colonized gastric epithelium showed characteristic changes that were topographically related to the bacteria. These changes included irregular surface, epithelial pits, individual cell dropout and microerosion, which were specific for H. pylori colonization. These were absent in areas not colonized by H. pylori and in 20 consecutive H. pylori negative gastric biopsies seen during the same study period. As specific treatment for H. pylori infection is available, identification of H. pylori colonization in gastric biopsies should be attempted in all cases of gastritis, peptic ulcers and non-ulcer-dyspepsia.
Indian Journal of Pathology and Microbiology 08/2006; 49(3):352-6. · 0.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This hospital-based study seeks to find out the most common cancers amongst the patients attending Himalayan Institute of Medical Sciences (HIMS), Dehradun, situated in Uttaranchal, which has inadequate health care facilities and low socio-economical status. In our study, of the 20,247 cases reported in the pathology department from July 1996 to Dec. 2003, 18.57% cases were malignant. Male to female ratio was 1.7:1.Top five cancers in males were those of lung, larynx, non-Hodgkins lymphoma, oesophagus & stomach. Top five cancers in females were those of breast, cervix, gall bladder, ovary & oesophagus. Tobacco and alcohol related cancers predominated in males. Skin and soft tissue cancers and were also common amongst both genders. Patients mostly reported with cancers in advanced stages, which could be attributed to poor medical facilities and health awareness in this region.
Indian Journal of Pathology and Microbiology 05/2006; 49(2):193-8. · 0.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Of all the cases investigated for suspected lung cancer between June 1999 and June 2003, 196 cases were selected where flexible bronchoscopic samples of broncho-alveolar lavage (BAL) and bronchial brush (BB) cytology as well as bronchial biopsy were taken and processed as per standard procedures of cytology and histology. The aim of this study was to compare the diagnostic efficacy of BAL and BB cytology in diagnosing lung cancer, taking bronchial biopsy as the 'Gold Standard' diagnostic test. Sensitivity of BB was 87.3%; while that of BAL was 39.4%. Specificity of BB and BAL was 97.6% and 89.6%, respectively. BB was better than BAL in morphological typing of lung cancers. We conclude that bronchial brushing is a much superior technique in the diagnosis and morphological typing of lung cancers.