Tropical Journal of Pathology and Microbiology

Histopathological spectrum of Cervical Lesion”– two and half Year prospective Study in Tertiary Care Center of Chhattisgarh, India

2021-03-26T14:53:20+0530

Introduction: Cervical lesions are the leading cause of morbidity in Indian women and cervical cancer is the second most common cancer in women worldwide next to breast cancer.

Objectives: To study the age distribution, the relative frequency of various cervical lesions and histopathological features of cervical lesions.

Materials and Methods: This is a two & half years retrospective study of all cervical biopsies and hysterectomy specimens received from September 2017 to March 2020 in the department of pathology.

Result: In a total of 485 cases studied 359 (74.1%) cases were non-neoplastic, 107(22%) were preinvasive and 19 (3.9%) cases were malignant. Cervicitis was the most common non-neoplastic lesion and squamous cell carcinoma was the most common cancer.

Conclusion: Our study highlights a vast spectrum of cervical lesions and therefore early detection and management of certain lesions can help in reducing morbidity.

Surrogate molecular subtyping of breast carcinomas– A study on recent modifications and their clinicopathological significance

2021-04-17T14:30:14+0530

Context: Breast carcinoma is a heterogenous disease with varied clinicopathological features and response to therapy. Molecular classification through gene studies helps in planning therapy but has economic constraints. Hence immunohistochemical subtyping of breast carcinomas has been used as a surrogate method. Criteria for this subtyping has undergone many modifications since it was originally proposed.

Objectives: To immunohistochemically subtype breast carcinomas based on St.Gallen 2017 guidelines and analyse the differences in clinicopathological parameters like age, tumour size, histopathological grade and lymph node staging between the various subtypes.

Materials and methods: The study was done retrospectively at a tertiary care health centre in South India on breast carcinoma patients from January 2017 to June 2020. Immunohistochemistry was done with antibodies to the Estrogen receptor, Progesterone receptor, Human epidermal growth factor receptor-2 (HER-2) and Ki-67. Immunohistochemical Subtypes were correlated with Clinicopathological features.

Results: The study had 107 cases. Hormone receptor (HR) positive HER-2 negative was the most common subtype (55 cases, 51.4%). This subtype frequently presented without nodal metastasis (58.2%) and in >50 years of age (56.4%). Triple-negative subtype frequently presented with grade III (69.2%), highest nodal metastasis stage (38.5%) and in < 50 years of age (69.2%). Difference in grade, tumour size and nodal metastasis stage between the different subtypes was significant with p <0.001.

Conclusion: St.Gallen 2017 guidelines for immunohistochemical subtyping classified breast carcinomas into groups that differed significantly in their clinicopathological features. Further studies on differences in treatment response and survival rate differences between these different subtypes are needed.

Red Cell Distribution Width (RDW) – A useful parameter to assess prognosis in COVID patients

2021-05-05T13:36:16+0530

Background and Objectives: The world is currently grappling with the COVID-19 pandemic. Therefore, it is important to identify reliable and cost-effective biomarkers that can help in triage and early detection of severe patients, thus preventing morbidity and mortality thereby reducing the need for invasive and critical care management. With this study, we aimed to observe --

1) Variations in red cell distribution width (RDW) in survivors and non – survivors of COVID – 19.

2) If there is an association between elevated RDW and unfavourable outcome in patients.

3) If there was an association between RDW and currently used biomarkers.

Method: A retrospective study was conducted from June – August 2020 on 100 RTPCR confirmed patients, with 50 admitted in ICU (non-survivors) and 50 in isolation wards (survivors). Eight laboratory parameters with their changes were monitored daily on all patients.

Results: We found that all eight parameters (RDW, CRP, LDH, Albumin, WBC count, Ferritin, Creatinine, NLR) were markedly deranged among non-survivors as compared to survivors. A male preponderance was found in the study. RDW values progressively increased in non-survivors till the end of the observation period and indicated unfavourable outcome sooner. In survivors, RDW showed minimal variation throughout the observation period. The RDW values were not affected by complications arising due to COVID-19 infection or by therapy as compared to other biomarkers.

Conclusions: RDW showed a direct relationship with other commonly used biomarkers and can be successfully used in triage and treatment of mild, moderate and severe Covid-19 patients.

Fine needle aspiration cytology of thyroid lesions: A single-centre experience

2021-05-05T14:47:32+0530

Background FNAC (Fine needle aspiration cytology) is an easy and cost-effective method for the diagnosis of thyroid lesions. The use of the Bethesda system is largely helpful in eliciting the risk of malignancy and helps in further management of patients with thyroid lesions. In this study we studied thyroid lesions and reported them according to the BETHESDA System of Classification based on cytological features on FNAC.

Materials and Methods: In this prospective single-centre study conducted over 2 years we included 642 patients with thyroid lesions who underwent FNAC. These lesions were then classified according to the Bethesda system based on cytomorphological features.

Results: Out of 642 patients included in our study, 100 were males and 542 were females with a male: female ratio of 1:5.42. The age of the patient population in our study ranged from 4-94 years. Among 642 cases in our study most (61.38%) cases were benign whereas 9.96% cases were found to be malignant and 2.60% cases were suspicious of malignancy.

Conclusion: Bethesda System of reporting FNAC of thyroid lesions is a standardized system and helps in deciding diagnostic approach and appropriate management of patients.