Shilpa Garg’s research while affiliated with Shaheed Hassan Khan Mewati Government Medical College and other places

Ganglioneuromas (GNs) are rare benign tumors originating from the neural crest tissue. They are characteristically located in the posterior mediastinum and retroperitoneum; and are rarely found in the adrenal gland. GNs are usually hormonally inactive, and most of the cases are detected incidentally. We report a case of 25-year-old female who presented with pain abdomen in the right upper quadrant. Imaging studies showed a large well defined hypodense lesion with calcification measuring 14.5×11.5×11cm in the region of right adrenal gland and a possibility of adrenocortical carcinoma was suggested. The patient underwent right adrenalectomy and histopathological examination revealed ganglioneuroma. This report emphasizes that GN can be misdiagnosed preoperatively as the presenting symptoms are nonspecific and imaging characteristics are variable. Histopathological examination is the mainstay of diagnosis.

Background: Morbidity and mortality from chronic lung diseases are increasing worldwide. A combination of various cytological and histopathological techniques are required for the high diagnostic accuracy. This study aims to evaluate and compare diagnostic accuracy of fiberoptic bronchoscope aided cytohistological techniques such as BAL (bronchoalveolar lavage), TBNA (Transbronchoscopic needle aspiration) and FB (forceps biopsy) in diseases of lung. Method: A prospective study conducted on 100 patients with symptoms and signs of various respiratory diseases who underwent fibreoptic bronchoscopy. Diagnostic accuracy of various samples alone and in combination were analysed. Results: Sensitivity of BAL-24%, TBNA 64% and FB 66%. Addition of BAL to FB increased the sensitivity to 69%. Addition of BAL to TBNA increased the sensitivity to 70%. Sensitivity of cytological methods (FB and TBNA) 90%. Addition of both BAL and TBNA to FB increased overall senstivity to 93%. FB the most specific amongst the three techniques with specificity of 94% followed by TBNA (59.4%) and BAL (50%). Conclusions: There are variable results regarding diagnostic yields and utilities of various fibre-optic bronchoscope aided cytohistological techniques but there combination adds the yields. Thus a combination of various cytohistological samples should be taken in a patient undergoing fiberoptic bronchoscopic examination to increase the diagnostic yield, to cut short the diagnostic time and early start of treatment.

Background Nuclear size, shape, chromatin pattern, and nucleolar size and number have all been reported to change in breast cancer. Aim The aim of the study was to quantify nuclear changes on malignant breast aspirates using morphometry and to correlate the morphometric parameters with clinicopathologic features such as cytologic grade, tumor size, lymph node status, mitotic index, and histopathologic grade. Materials and Methods Forty-five cases of carcinoma breast diagnosed on cytology were included in this study. Cytologic grading was performed as per the Robinson’s cytologic grading system. Nuclear morphometry was done on Papanicolaou stained smears. One hundred nonoverlapping cells per case were evaluated. Both geometrical and textural parameters were evaluated. Results Comparison of cytologic grades with most morphometric features (nuclear area, perimeter, shape, long axis, short axis, intensity, total run length, and TI homogeneity) was highly significant on statistical analysis. Correlation with tumor size yielded significant results for nuclear area, perimeter, long and short axes, and intensity with p < 0.05. The study of lymph node status and morphometry showed a highly significant statistical association with all the parameters. Mitotic count was significantly associated with all the geometric parameters and one textural parameter (total run length). On correlation of ductal carcinoma in situ and histopathological Grades 1 to 3 with morphometry, it was found that all the parameters except long–run emphasis were highly significant with p < 0.001. Conclusion Morphometry as a technique holds immense promise in prognostication in breast carcinoma.

Objectives The primary objective of this study was to correlate nuclear morphometric parameters with clinicopathologic features such as cytologic grade, tumor size, lymph node status, mitotic index, and histopathologic grade. Secondary objective was to quantify nuclear changes on malignant breast aspirates using morphometry. Material and Methods Forty-five cases of carcinoma breast diagnosed on cytology were included in this study. These were graded into cytologic grades 1, 2, and 3 as per Robinson’s cytologic grading system. Nuclear morphometry was done in all cases on smears stained with Papanicolaou stain. Clinicopathologic parameters including cytological grade, tumor size, lymph node status, mitotic count, and histological grade were correlated with nuclear morphometric parameters, namely, area, perimeter, shape, long axis, short axis, intensity, long-run emphasis, total run length, and T1 homogeneity. Results There were 9 cases in cytologic grade 1, 26 in grade 2, and 10 cases in cytologic grade 3. Histopathology showed 42 cases of infiltrating duct carcinoma, not otherwise specified (IDC, NOS) and 3 cases (6.7%) of ductal carcinoma in situ (DCIS). IDC (NOS) included 6, 27, and 9 cases in grades 1, 2, and 3, respectively. Majority of our cases had a tumor size less than 5 cm (n = 38, 84.4%) and had positive nodes (n = 30, 66.7%). Correlation of cytologic and histopathologic grades (including DCIS) with all morphometric features except long-run emphasis was statistically significant. Correlation of morphometry with tumor size yielded significant results for nuclear area, perimeter, long and short axes, and intensity with p < 0.05. Study of lymph node status (positive/negative) versus morphometry showed a highly significant statistical association with all the geometric as well as textural parameters. Mitotic count was significantly associated with all the geometric parameters and one textural parameter (total run length). Statistics Continuous variables were presented as mean ± standard deviation and compared using the two-tailed, independent sample t-test and one-way analysis of variance test. Tests were performed at significance level of 0.05. Conclusion Morphometry is an objective technique which holds immense promise in prognostication in breast carcinoma.

Pleomorphic adenoma, also called mixed tumor, is the most common benign tumor of the salivary glands that mostly occurs in the parotid or submandibular glands, but may also occur in the minor salivary glands that are distributed throughout the oral cavity. The common sites of pleomorphic adenoma of the minor salivary glands are the palates followed by lips and cheeks. Here we report a case of this tumor presenting in minor salivary glands of upper lip in a 16 year old girl. The patient presented with a painless, mobile, circumscribed nodule, about 1.5 cm in diameter, slowly growing in size. The nodule was subjected to Fine Needle Aspiration Cytology (FNAC) and was found to be pleomorphic adenoma of minor salivary gland origin in upper lip. Complete excision was performed and the diagnosis was confirmed by histopathological examination. The aim of this article is to highlight the occurrence of pleomorphic adenoma as a differential diagnosis for the swellings in the upper lip.

Background: Objective was to study the histopathological spectrum of heart diseases in autopsy specimens, that play a major role as cause of death.Methods: During the period from October 2015 to October 2017. Total 170 medicolegal autopsies were received during this period. Out of 170, specimens of heart were 150. Nine specimens were autolyzed. So, 141 specimen of heart were included in the study. Gross and microscopic findings on H and E stained sections were studied.Results: out of 141 cases, 78 cases showed atherosclerosis, 20 cases showed features of myocardial infarction, myocardial hypertrophy was found in 10 cases, 5 cases revealed myocarditis, pericarditis in 4 cases and one case each of infective endocarditis and aortic stenosis. In 22 cases, there was no identifiable cause of death even after complete gross and microscopic autopsy was performed.Conclusions: Myocardial infarction due to atherosclerosis is probably the commonest finding in death cases subjected to medicolegal autopsies.

Case Report JARMS. 2014; 6(1): 79-81 PRIMITIVE NEUROECTODERMAL TUMOR OF THE KIDNEY – A RARE NEOPLASM: 3 CASE REPORTS *S.K. Mathur,*Nisha Marwah,*Sanjay Kumar,*Sant P. Kataria,**Ruchi Agarwal,*Shilpa Garg,***Qury S Mahapatra. Abstract Primitive Neuroectodermal Tumor (PNET) of the kidney is extremely rare entity with only few published case reports. PNET occurs predominantly in children and young adults with slight male predominance. It preferentially involves soft-tissues of the paravertebral region, chest wall and less frequently in extremities. We are presenting three cases of primary PNET because of their unusual location in the kidney. All the three cases revealed similar histologic features of small, round cells forming rosettes and pseudo rosettes. Immunohistochemistry revealed a diffuse positivity of the neoplastic cells for CD99, Neuron-Specific Enolase (NSE) and vimentin. We also reviewed the difficulties in the differential diagnosis as the differentiation of small round cell tumors may be challenging. Key words: CD99, Kidney, Neuron-Specific Enolase, Primitive Neuroectodermal Tumor

Ovarian sex cord-stromal tumors are relatively infrequent neoplasms that account for approximately 8% of all primary ovarian neoplasm. Sex cord-stromal tumors of the ovary include granulosa cell tumors, fibrothecomas, Sertoli-Leydigcell tumors, steroid cell tumors, and sclerosing stromal tumors (SST). Sclerosing stromal tumors account for 2% to 6% of ovarian stromal tumors. Despite the rarity of this particular neoplasm, it is not always possible to predict the presence of this tumor preoperatively on the basis of clinical and sonographic findings. Histopathological and immunohistochemical (IHC) examinations confirm the diagnosis. Herein, the clinical findings and histopathological features of SST are described in a 24-year-old female.