Online ISSN: 2515-8260

Keywords : Histopathology


Correlation of Cyclin D1 and Ki 67 Immunoexpression in Head and Neck Squamous Cell Carcinomas

Rama Devi Pyla; Swathi Cheruku; C Shalini; Swarnalatha Sripathi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 1853-1872

Background: Head and neck cancer is the sixth most prevalent cancer, constituting 3% of all localizations. In 48% of instances, oral cancers are squamous cell carcinomas. Epidermal growth factor receptor (EGFR) is an ErbB family tyrosine kinase receptor expressed in solid tumours, including head and neck squamous cell carcinoma (HNSCC). HNSCCs have various clinicopathological characteristics and a dismal prognosis.
Martial and Methods: 160 HNSCCs were studied in the Department of Pathology, Mallareddy Medical College for women 18 months [Nov 2020-April 2022] for the immunoexpression of Cyclin D1 and Ki 67 with relation to histopathological grade and various clinical parameters such as age, gender, history of smoking, alcohol consumption, tobacco chewing, anatomical site involvement, lymph node status, and cancer stage wherever available.
Results: 113 of 160 cases were male; 47 were female. 106 head and neck squamous cell carcinomas (66.25%) were male and drank. 26 of 160 cases were radical neck dissected. 73% of patients had metastatic lymph nodes. 14 cases (66.6%) had >50% immunoreactive cells. 13 of 21 patients (62 %) were Ki-67 immunopositive. Lymph node-positive HNSCC had higher Cyclin D1 and Ki 67 immunoexpression. In 160 of 29 patients, cyclin D1 positive was unrelated to clinical stage. Stage IV tumours (66.6 %) had the highest Ki 67 values, followed by stage III. Higher pathogenic stages enhanced Ki 67 expression (p=0.037). Cyclin D1 and KI 67 immunoexpression correlated with lymph node metastases (p = 0.005 and 0.008, respectively).
Conclusion: The present investigation found a link between Cyclin D1 and Ki 67 immunoexpression correlated with histopathological grade and lymph node status, and Ki 67 with advanced tumor stage.

Figo’s Palm Coein Classification of Abnormal Uterine Bleeding – It’s Clinico-Histopathological Correlation in Indian Setting"

Keshamalla Swetha, Mortha Sanjana

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3728-3740

Background: To study and analyze the structural and functional component of PALM COEIN of AUB in Perimenopausal women and its correlation with the Histopathology where ever applicable especially PALM component.
Materials and Methods: This is a prospective observational study carried out on 100 non gravid women of perimenopausal and postmenopausal age groups who came to Gynaecology OPD with complaints of AUB. The data was analysed considering the inclusion and exclusion criteria. The PALM- COEIN classification was used to classify causes of AUB.
Results: In our study most of the patients were in the age group of 41-50 years (45%). So that AUB is most common in late reproductive years and perimenopausal age groups. Most women with AUB were multiparous. More than half of the women were overweight and obese. So that high BMI is a risk factor for AUB. Most common presenting complaint was heavy menstrual bleeding (44%). Most cases of AUB were due to structural (PALM) abnormalities (61%) &67% based on HPE. Most common cause of AUB was leiomyoma (30%) and more cases were seen in the age group of 31- 50 years .most of the cases of leiomyoma were. Sub mucosal type. 2nd most common cause of AUB was ovulatory dysfunction (17%). In endometrial polyps the D & C reports showed more cases of proliferative endometrium showing that estrogen regulates the growth of the polyps. More cases of AUB-A, AUB-M, AUB-A,L were detected on histopathological examination. Malignancy and hyperplasia is mostly seen after 51 years and mostly these are post-menopausal.
Conclusions: In our study more cases of AUB-A,AUB-M,AUB-A,L were detected more than that of clinical case after histopathological examination, which is more accurate in detecting the pathology. Hence, a proper and adequate clinico histopathological workup of perimenopausal patients helps in accurate diagnosis which aids in better management of AUB.

Histopathological study of Urinary tract neoplasms: A five year study in a Tertiary care hospital

Anusha mullagura MD Inuganti Venkata Renuka, P. Ramya, P. Sri Harsha, K.Nikitha

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3242-3250

Introduction:  Neoplasms of the urinary tract are commonly encountered in clinical practice and important from clinical and pathological perspectives as they have various histological patterns with prognostic implications.
Aim: The aim of this study was to observe the spectrum of lesions among various organs of the urinary tract and categorize them into benign and malignant based on histopathological findings.
Materials and methods:  This is a hospital based five-year retrospective study of urinary tract specimens received in the department of Pathology.
 Results: A total of 90 cases were studied, 87 cases were malignant, and 3 cases were benign. Among the malignant cases, most common were Clear Cell type of Renal Cell Carcinoma (RCC) in kidney, low grade urothelial carcinoma of the ureter/Renal pelvis and non-invasive low grade urothelial carcinoma in bladder.
Conclusion: Most of the lesions in the urinary tract had a male predominance with most patients being in the 6th and 7th decades. In kidney Clear Cell Renal Cell Carcinoma predominated, in bladder Non-invasive Papillary Urothelial Carcinoma was the commonest 9lesion and in renal pelvis /ureter Low grade urothelial carcinoma was the commonest.  Histopathological examination provides a confirmatory diagnosis which helps in the management and in assessing the prognosis of these lesions based on invasion into muscle, capsule, and adjacent tissues.

A MORHOLOGICAL ANALYSIS OF SKIN BIOPSIES IN HANSENS DISEASE

Dr.C.Aparna, Dr. G.Harinath, Dr. K.Sharada Devi, Dr. A.Shanmugapriya, Dr. K.Harika Reddy, Dr. R.Sugatamil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3172-3179

 Background; Leprosy still continues to be an important public health problem. The present study was undertaken to study the histopathological features of  leprosy in skin biopsies and to categorize them into various types based on microscopy, bacterial index to correlate with clinical presentations whenever possible.  Aim;To know the prevalence of Leprosy in our Institute with Clinico-Histopathological correlation.  Objectives;To know the distribution of various types of Leprosy in our Institute.To know the sensitivity and overall correlation of Histopathology and Bacterial index in diagnosing various types of Leprosy Material and methods :We have done the study on a Sample size of 55cases.  Results:  Borderline Tuberculoid leprosy constituted  the  maximum percentage of cases. Conclusion : Correlation between clinical, bacteriological and histopathology was 100% in diagnosing BB,IL, and ENL followed by BT.

Correlation between histopathological results and BIRADS classification in breast masses

Dr Parag Goyal , Dr Parul Maheshwari, Dr Pawan Bhambani, Dr Sanjeev Narang, Dr Bhawana Bansal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2819-2826

Background: Breast cancer incidence in India is increasing and has now become the most common cancer among women. Preoperative pathology diagnosis and mammography (using breast imaging reporting and data system (BI-RADS) scoring system) constitute an essential part of the workup of breast lesions. The present study was aimed to compare the diagnostic accuracy    of BI-RADS score with histopathological finding in diagnosis of benign and malignant lesions of breast.
Methods: This is a cross-sectional study with study duration of 1.5 year (January 2021- June 2022) The present study was conducted on 100 randomly selected newly diagnosed cases of breast  masses.
Results: Considering histopathological examination as gold standard, the sensitivity and specificity of BI-RADS score is 93.9% and 82.8% respectively. The positive predictive value, negative predictive value and diagnostic accuracy of BI-RADS score is 91.04% and 87.8 % respectively.
Conclusions: The inference derived from the present study is that BIRADS is a very useful tool specially owing to the fact that it is noninvasive, which leads to lesser trauma and faster report however the tissue diagnosis using H&E and other stains remains the gold standard and should always be restored to before undertaking surgery.

Role of P63 Immunostain in the Histomorphological Analysis of Salivary Gland Tumors- In Tertiary Care Hospital

C. Shalini, Jostna Devi Akarapu, M. Mamatha, Swathi Cheruku

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2480-2495

Background: Salivary gland tumors are rare head-and-neck neoplasms. They demonstrate dual cell differentiation and morphologic overlap. Dual cell differentiation requires histomorphological study and immunohistochemistry to diagnose. p63 is a selective  immunohistochemical marker expressed in nuclei of myoepithelial cells and basal duct cells in normal salivary glands and aid in the diagnosis of of salivary gland tumors by highlightining the biphasic nature of the tumors. Extent of p63 positivity can be a useful predictor of clinical outcome and could help in the aggressive mode of treatment in certain types of salivary glands tumors.To study the role of p63 in the diagnosis of salivary gland tumors.
Material and Methods: The present study was conducted at Malla Reddy Institute of Medical Sciences in the Department of Pathology on the surgically resected salivary gland specimens received for routine histopathological evaluation. A total of 60 cases of salivary gland tumors were included in the study. It is a retrospective study carried out from January 2018 to December 2021, on surgically resected salivary gland tumor specimens and Immunohistochemical analysis with p63.
Results: A Total of 60 Salivary gland tumors were studied with different cytomorphology and mixed architectural patterns. In the present study, most frequent age groups were between 40 and 60 years.. All tumors except Warthin's were female-predominant. The parotid gland was the most common site, with adenoid cystic carcinoma mostly seen in smaller salivary glands. Pleomorphic adenoma and Mucoepidermoid carcinoma were frequent tumors seen. Standard techniques of IHC with p63 antibody were carried out on all the 60 Salivary gland tumors. All the benign tumors were positive for p63. Malignant tumors with basal cell involvement, such as Adenoid cystic carcinoma 6/7 cases showed p63 positivity with varying intensities. Clear, intermediate and squamous cells of all Mucoepidermoid carcinoma were p63 positive. p63 was negative in  Acinic cell carcinoma. Differential localization of p63 in various neoplasms was observed which has given information on myoepithelial cells.
Conclusion: P63 is an important Immunohistochemical marker which aids in diagnosis of salivary gland tumors and also helps in localization of myoepithelial cells by differential expression in various salivary gland tumors.

Clinico-pathological study of Acute Appendicitis with Special Reference to Modified Alvarado Scoring System and Post Operative Histo-pathological Examination from Northwestern Bihar: A Prospective Study

Dr Rituraj, Dr. Akhalesh Kumar, Dr. Pradeep Kumar Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2205-2209

Background: Appendicitis is anticipated to affect about 6% of the population at some point in their lives. The reduced prevalence of acute appendicitis in Asian and African nations is likely due to the dietary patterns of these populations. Objectives: To compare the diagnosis of acute appendicitis by Alvarado score to that by histopathological examination as well as to determine whether there is any correlation between dietary intake pattern and the occurrence of acute appendicitis. Methodology: It was a prospective cohort study involving 148 participants attending surgery OPD between 08 months from June 2021 to January 2022. Detailed history and clinical examination was done followed by admission and laboratory investigations. Confirmation of diagnosis was done based on modified Alvarado scoring system and ultrasonography. Results: After analysis of 148 study participants, it was found that 88% of them belong to age group of >18 upto 40 years and 63% of them were males. No significant association was found between diet and appendicitis.Conclusion: Both Modified Alvarado Scoring System (MASS) and histopathological examination was found to be diagnostic for appendicitis.

A Prospective Study to Evaluate the Accuracy of Fine Needle Aspiration Cytology (FNAC) and Touch Imprint Cytological Study in Correlation with Histopathological Study of Thyroid Lesions at Tertiary Care Center

Mukesh Kumar Khinchi, Ashish Bagaria, Subhash Chandra Sharma, Kamlesh Yadav

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 531-538

Background: Fine Needle Aspiration Cytology has been established as the investigation of choice in thyroid lesions. Different imaging techniques are now used for preoperative diagnosis of thyroid nodules like radionuclide scanning, high-resolution ultrasonography (USG). The present study aims at diagnosing various thyroid diseases based upon cytomorphological features in FNAC and wherever possible with its histopathological correlation, which is the gold standard.
Material & Methods: A prospective study done on 100 specimens from thyroid were received in the Department of pathology, SMS Medical College, Jaipur for histopathological examination from SMS hospital, Jaipurduring one year period. Out of these 100 cases imprint cytology was done for 48 cases. A correlative study between Fine Needle Aspiration Cytology and histopathology was done for these 100 cases. Data analysis was done with the help of computer using Epidemiological Information Package (EPI 2002).
Results: Our study showed that mean age of patients was 40.2 years and maximum patients were seen in 21 to 30 years of age group. There is a female preponderance with a Female to Male ratio of 13.28:1. Out of these 100 lesions 61 cases were non neoplastic lesions and 39 were neoplastic lesions. Among the 61 non neoplastic lesions 45cases were reported as nodular goiter, 15 cases as hashimato thyroiditis and 1 case as Granulomatous thyroidits. Out of the 39 neoplastic lesions 21 cases were reported as benign neoplastic lesions and 18 as malignant neoplastic lesions. A correlation done between Fine Needle Aspiration cytology with imprint cytology and histopathology showed the following results. 31 Fine Needle Aspiration cytology reports (64.58%) were correlated with histopathological diagnosis.
Conclusion: High rate of diagnostic accuracy can be achieved by use of ultrasound guidance with strict adherence to adequacy criteria and meticulous examination of all the smears. Touch Imprint Cytology alone may provide a correct diagnosis in vast majority of cases with minimal expense and without the need of sophisticated cryostat machine thus making it quite suitable when cryostat machines are not available.

A CLINICOPATHOLOGICAL STUDY OFBREAST LUMPS

Dr. P. Swarnalatha, Dr. R.Swarupa Rani , Dr. S.Rajasekhar Reddy , Dr. Shaik. Raja Husne Kalam

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 12-39

Breast cancer affects women more than men. From puberty to death, breasts go through
constant physical and physiological changes related to menstruation, pregnancy, and
menopause. The goal was to classify different types of breast lesions and conduct a
clinicopathological study on them.Methodology: In the present study carried out at the
department of Pathology of ACSR Govt Medical College, Nellore AP during the period
from January 2019 to June 2021 (18 months) a total number of 150 FNAs were performed
on patients with breast lumps. Results: The youngest patient in this study was 12 years
and the oldest 79 years. Majority of the patients were in the age group of 21-40 years. In
majority of the patients i.e. From 150 aspirates, 65 were from the right breast and 70 from
the left. 15 cases involved both breasts.Upper outer quadrant of right and left breast had 39
and 35 cases of breast lumps, respectively. Lower outer quadrant of the right breast had 11
cases and upper medial had 11 cases. Two breast cases showed diffuse all-quadrant
involvement. 2 of the 45 cases were clinically suspected of malignancy and 1 of
fibroadenosis, but FNAC showed fibroadenoma. Three clinicocytologically discordant cases
lacked excision biopsy. 15 cases of breast cancer were in the right breast and 9 in the left.
Upper outer quadrant is most common for breast lumps. Side and quadrant distribution are
shown below. All 20 cases were confirmed by excision biopsy. FNAC diagnosed 18 IDC
NOS cases and 2 IDC Mucinous cases.CONCLUSION: FNAC is the procedure that is most
commonly used since it is an initial outpatient procedure that is straightforward, risk-free,
quick, and dependable. Additionally, it contributes to an early preoperative diagnosis of any
lump in the breast.

EVALUATION OF PATTERN OF CERVICAL PAP SMEAR CYTOLOGY AND TO CORRELATE IT WITH HISTOPATHOLOGICAL FINDINGS

Dr. Prashant Gupta, Dr. Rohini Bansal, Dr. Shraddha Agarwal, Dr. Pankaj Bansal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 2178-2183

Background: Cervical cancer is the third most common cancer among women worldwide, with 85% of its global burden occurring in less-developed countries. The present study was conducted to evaluate the pattern of cervical Pap smear cytology and to correlate it with histopathological findings.
Materials & Methods: 360 females of age ranged 18-60 years were enrolled. Cervical smears were taken with the help of Ayer’s spatula and cyto brush to collect specimen from thesquamocolumnar junction. Thesmears were stained with Papanicolaou stain(PAP stain) and slides wereexamined under light microscope following 2001 Bethesda system.
Results: Age group 18- 30 years had 68 patients, 31-40 years had 112, 41-50 years had 120 and 51-60 years had 60 patients. The difference was significant (P< 0.05). Maximum number of cases 160 were categorized as negative for intraepithelial lesion or malignancy (NILM). Atypical squamous cells of undetermined significance (ASCUS) seen in 54 followed by followed by low gradesquamous intraepithelial lesion (LSIL) in 50 and high gradesquamous intraepithelial lesion (HSIL) in 30, squamous cell carcinoma 4 and cases of adenocarcinoma 2. 88%diagnosed on Pap smears correlated on histopathology findings.
Conclusion: Pap smears found to be effective in screening for earlydetection of premalignant and malignant lesionsof cervix.

COMPARISON OF PIPELLE ENDOMETRIAL SAMPLING VERSUS DILATATION AND CURETTAGE IN CASES OF ABNORMAL UTERINE BLEEDING

Kesavachandra Gunakala, P.M. Rekharao, Seshadri Sahaja, Vennela Mude

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 2338-2359

Background: Pipelle endometrial sampling versus Dilatation and curettage in collecting a sufficient endometrial sample for histopathological diagnosis was the subject of this observational clinical correlation diagnostic study. Aim: The present study is done in our hospital to know if Pipelleaspiration endometrial sampling can replace D&C for histological examination in cases of AUB.
Materials and Methods: This was an observational clinical correlation diagnostic study designed to compare the efficacy of Pipelle endometrial sampling with Dilatation and curettage in obtaining an adequate endometrial sample for histopathological diagnosis. After obtaining informed consent to participate and determining fitness for the procedure, 100 patients who reported with AUB to the Department of Obstetrics &Gynaecology at Government Medical College, Kadapa, were enrolled in the study. The study was carried out from October 2019 to September 2021. The patient underwent a thorough clinical evaluation in the outpatient department, which included a history, physical examination, and baseline investigations. Prior to the procedure, TAS/TVS were done. Endometrial sampling was performed using the Pipelle device, followed by a diagnostic reference standard and D&C endometrial sampling under anaesthesia.
Results: The most common age group presented with AUB is between 41 and 45 years. Most of the patients (45%) had < 6months duration of AUB. Pre and perimenopausalwomen made up 94% of the study population, whereas postmenopausal women made up 6%. Among the study group, 4% were nulliparous, and the remaining 96% were parous women. Of the study group, the ET thickness varies as - 13 had < 6mm, 18 had ET between 6.1- 9mm, 50 had ET between 9.1-12mm, 13 had ET between 12.1-15mm, 4 constitute between 15.1-18mm, 2 had >18mm ET. In Pipelle and D & C, sampling inadequacy was significantly more in menopausal women compared to pre-menopausal women. (P<0.05). In 16 cases, Pipelle sampling was deemed challenging. Sampling was difficult in nulliparous women when compared to parous women. Histopathology reports were obtained in 93 of the 100 Pipelle samples and 94 of the 100 D&C samples in current study.  The most frequent endometrial pattern observed was Hyperplasia without atypia (21%) , followed by proliferative phase of the endometrium (20%), no evidence of malignancy (14%), Secretory phase (11%),  disordered proliferative phase (11%), atrophic endometrium (4%), nonsecretory phase in (4%), endometrial polyp (2%), Hyperplasia with atypia (2%), early secretory phase (1%), endometrial carcinoma (1%), late secretory phase (1%), Endometrial glandular hypertrophy (1%). When comparing Pipelle to D&C, the chi-square test shows that Pipelle has a sensitivity of 98.9% for retrieving sufficient tissue and a specificity of 100%. The positive predictive value is 100 percent, while the negative predictive value is 85.7%. The p-value estimated is< 0 .001, which is statistically significant. Out of 100 cases that had Pipelle sampling, 91 had no complications. 5 had pain, and 4 had bleeding. Out of 100 cases that had D & C, 59 had no complications, 29 had pain, 5 had bleeding, and 7 had both pain and bleeding.
Conclusion: Pipelle sampling can be used as an effective screening procedure in the outpatient department.

STUDY OF BONE MARROW BIOPSY IN HAEMATOLOGICAL DISORDERS

Dr. V. Srinivas Kumar, Dr. Bairi Laxminarayana

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 2756-2764

Bone marrow examination is very useful not only in the diagnosis of hematological disorders. Both bone marrow biopsy and aspiration findings were studied and findings are compared morphologically. The biopsy specimen is best for the architectural evaluation and its relation with pathologic marrow elements. Core biopsy is best for ancillary study like immuno-histochemistry . The diagnoses of hematological disorders were mainly done by taking complete clinical history, careful physical examination, complete haemogram and bone marrow examination.

Skin adnexal tumors: A clinicopathological study

Dr. G Sudhakar, Dr. B Krishna Murthy, Dr. B Penchala Prasanna, Dr. K Suneetha

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3715-3719

Skin adnexal tumors are very difficult to diagnose and most of the benign tumors present as asymptomatic lesions. Malignant skin adnexal tumors are rare and they exhibit more aggressive clinical course and have potential of metastasis. So it is important to diagnose benign and malignant nature of lesion. Histopathological examination along with clinical findings like anatomic location, number and distribution of lesions helps in diagnosis of skin adnexal lesions. Microscopic architectural features are most important in differentiating benign and malignant tumors. Immunohistochemistry may helps in confirmation of the diagnosis.

A Prospective Study Evaluating Correlation Between Preoperative Histopathology And Morphologywith Recurrence Of PterygiumAfter CLAU Surgery

Dr. Neetu Kori Shankhwar, Dr. Shweta Walia, Dr. DivyaKhandelwal, Dr. V. Bhaisare, Dr. Preeti Rawat, Dr. Manushree Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 317-323

Aim- To observe recurrence rate after conjunctival limbal autograft (CLAU) and tocorrelate
this with preoperative histopathological and morphologicalcharacteristics of pterygium.
Design: Interventional, Prospective, Hospital-Based Study.
Methods: 107 patients with primary pterygium were examined, managed by CLAU and
histopathology sample sent. The outcomes were assessed in terms of clinically significant or
insignificant recurrence till 6 months follow-up.
Results: 57% patients were female. 17.8% participants had Stockers Line and all patients
having stocker’s line had stationary type of pterygium. Fuchs spots were seen in 4.7% of
patients. Histopathology findings includeEpithelial Hyperplasia (80.4%), Vascularity
Overwhelms Fibrosis (39.1%), Vascularity Similar to Fibrosis (28.3%), Fibrosis Overwhelms
Vascularity (34.8%), Perivascular Stromal Inflammation (54.3%), Diffuse Stromal
Inflammation (37.0%). The following variables were significantly associated (p<0.05) with
the Recurrence: Age, Fuchs Spots, higher vascularity and Diffuse Stromal Inflammation on
histopathology.
Conclusion: Factors such as younger age group,higher redness and thickness of pterygium,
Fuchs Spots, higher vascularity and diffuseinflammation on histopathological examination
can be considered as a risk factor for recurrence. However, occupation, laterality, location
and type of pterygiumwere found not to be related to recurrence.

Histomorphological Spectrum of Leprosy: Study in a Tertiary Care Centre in South India

Himaja Sayana, Grace Madhuri Kambala, M.Vijayasree, Sai Kiranmai, Shalini

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 9994-10002

Background:The clinical manifestations of leprosy are so different and of wide range,
that they can mimic variety of unrelated diseases, so for correct and adequate
treatment, the diagnosis must be made early and it should be accurate. Various methods
of diagnosis, further improve the accuracy of diagnosis and also give idea about
immunological status. The aim is to diagnose and categorize Leprosy into various types,
based on histopathological examination and to correlate the findings withFite-Faraco
staining of the sections.
Materials and Methods: The data base of skin biopsies, suspicious of leprosy were
studied in Department of Pathology, Siddhartha Medical College, Vijayawada
retrospectively for a period of one year and total 62 cases diagnosed as leprosy on
histopathological examination ofpatients with clinically suspicious signs, ofall age
groups, were included in the study.
Results: A total of 62 cases diagnosed as leprosy on histopathological examination were
evaluated. 32 cases (51.61%) were between age group of 21-40 years.In this study
66.12% were males and 33.8% were females. Highest No of cases,30 werediagnosed
onhistopathological examinationas Borderline Tuberculoid type, amounting to 48.38%
of all cases. Strength of agreement, during correlation study was higher in Tuberculoid
(TT), Lepromatous (LL), and Histoid (HL) subtypes of leprosy, but was found lower in
Borderline Lepromatous (BL) group.
Conclusion: Histopathological examination and demonstration of acid-fast lepra bacilli
in sections is recommended in all cases suspicious of leprosy for a good diagnostic
accuracy, which would ultimately help in thecorrect diagnosis and treatment of the
patient, and give idea about the Immunological status of the patient.

Evaluation of Ohmann Score in the Diagnosis of Acute Appendicitis in Patients Admitted in a Tertiary Care Hospital

Nandula Sai Bharath, M. Anurag, Lavudya Srinivas, Ganesh Banothu

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 4729-4737

Background:To Diagnose Acute Appendicitis based on Ohmann score and correlating it
with postoperative histopathological report.
Materials and Methods: This study was undertaken in 80 patients with a provisional
diagnosis of acute appendicitis getting operated over a period of 18. months.Ohmann
score was applied in the preliminary diagnosis, which was confirmed by intra operative
and histopathological findings.
Results: Fifty-eight patients were males and 22 were females. There was no statistical
significance in the male to female ratio. The highest incidence was found in the age
group of 21-30 and the lowest was seen in the age group of >40. Ohmann score of 13.5
was found in 11 patients and score of 14 was also seen in 11 patients .1.5 was least
ohmann score seen who had a normal appendix on histopathology. As ohmann score
was categorised into 3 categories,3 patients had Ohmann score of less than 6 out of
which 2 had a normal appendix on histopathology and the other patient had
appendicitis on histopathology. Depending on the cut-off value taken, sensitivity ranges
from 100% to 4.54%, specificity ranges from 14.28% to 100%, positive predictive value
ranges from 84.61% to 100% and negative predictive value ranges from 100% to
18.18%.
Conclusion: Ohmann scoring system significantly reduces the number of negative
laparotomies without increasing overall rate of appendicular perforation. It can work
effectively in routine practice as an adjunct to surgical decision making in questionable
acute appendicitis. It is simple to use and easy to apply since it relies only on history,
clinical examination and basic lab investigations.

Histopathological Study of Ovarian Lesions at a Tertiary Level Hospital

Samir Ranjan Bhowmik, Ranbir Singh Chawla, Prabhat Kumar Lal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2724-2729

Background:Ovary is a common site of both neoplastic and non-neoplastic lesions. Ovarian cancer presents with non-specific symptoms and majority of these are in advanced stage. The histopathological patterns of these lesions is helpful in treatment. Hence, the present study was done to determine the prevalence and distribution of various types of lesions of ovary.
Materials and Methods: The present study was cross-sectional descriptive in nature conducted on a total of 100 samples of ovary brought to the department of pathology for histopathology. The specimens were prepared using normal histopathological procedures and findings were noted.
Results: Corpus luteal cyst was the most common non-neoplastic lesion seen (49.1%). Serous cystadenoma (41.9%) was frequent benign lesion seen while Serous adenocarcinoma (4.7%) was the most common malignant lesion. 82.5% of the lesions were benign, 12.3% were malignant and 5.3% were borderline in nature.
Conclusion: Luteal cyst was common in non-neoplastic lesions. Serous cystadenoma was commonest benign tumour, whereas serous cystadenocarcinoma was frequent in malignant ones.

A Study to Correlate Preoperative Ultrasonographic Tirads Scoring System and Postoperative Histopathology of Thyroid Swellings

J.Parthasarathi, D.Ravisundar, M.Praveena, M. Anurag

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2451-2460

Background:Aim & Objectives: To correlate preoperative TIRADS scoring system with postoperative histopathology of thyroid swellings.
Materials and Methods: A total of 66 patients of thyroid swellings who were treated at the Department of General Surgery, Govt Medical College, Nalgonda, with an age range of 20 – 68 years, were evaluated in this study with respect to age, sex, symptoms type and symptom duration and were investigated with routine hemogram, thyroid profile, FNAC and USG with TIRADS score. The results of USG TIRADS score were compared with the histopathology after excision of the thyroid swelling.
Results: Thyroid swellings are more common in females than in males (M:F ratio = 1:4). Majority of the patients are in the age group of 30-50 years. Swelling in front of the neck is the most common complaint. Majority of the patients had an average duration of symptoms of 6months to 3 years. On clinical evaluation all patients had swelling of thyroid. On USG with TIRADS scoring, TIRADS – 3 is the most common category of the thyroid swelling with 30 patients (45%). On USG TIRADS score, majority were benign lesions 55 (83%), while the rest were malignant 11 (17%). On histopathology, 55 lesions (83%) were benign, while 11 lesions (17%) were malignant. Incidence of malignancy with respect to TIRADS score is TIRADS 2- 4%, TIRADS 3 – 16.7%, TIRADS 4 – 50%, TIRADS 5 – 0%. The present study has a USG TIRADS score sensitivity of 45.5%, specificity of 89.1%, positive predictive value of 45.5%, negative predictive value of 89.1% and accuracy of 81.8%.  The prevalence of malignancy among the patients with thyroid swellings in the present study is 16.7%. USG proved to be a more sensitive modality to evaluate the nodularity of thyroid swellings than clinical evaluation.
Conclusion: The present study was undertaken to evaluate the usefulness of clinical evaluation and USG TIRADS score in management of thyroid nodules High resolution ultrasound is an accurate technique, that has helped to analyse the suspicious sonographic features of thyroid swellings and to assess the risk of malignancy and quantify it using TIRADS score.

A Prospective Study to Evaluate the PAPSmear and Acetic Acid Test (VIA) as Cervical Cancer Screening Tools with Histopathological Correlation at Tertiary Care Center

Neha Gupta, Ruchi Agrawal, Shweta Agarwal, Suneeta Meena

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1383-1387

Background: Cervical cancer is the second most common cancer among women
globally. There are different methods for control and prevention of cervical cancer
which include conventional cytology (Pap smear), liquid-based cytology, human
papillomavirus (HPV) screening, and vaccination against HPV. The aim of this study to
evaluate the pap smear and acetic acid test as cervical cancer screening tools with
histopathological correlation.
Material & Methods: The present study was carried out in department of pathology at
SMS Medical College, Jaipur, Rajasthan, India for one year period. A total of 150
patients attending the gynecology OPD were enrolled in the study. All the patients in the
study were subjected to colposcopy. The cervix was inspected with the naked eye than
with a colposcope. After taking the Pap smear with Ayre’s spatula and cytobrush and
was evaluated by the Bethesda system and then cervix was washed with normal saline
and visualized, followed by application of 3% acetic acid and visualization by
colposcope. Collected data was statistically analyzed to determine specificity and
sensitivity, PPV, NPV of Pap smear, VIA.
Results: Our study shows that majority of cases were seen in 40-50 years of age
group.Sensitivity of VIA was found to be 90% (versus Pap smear, which had 40%) and
specificity of VIA was 87.85% (versus Pap smear, which had specificity of 96.42%).
Conclusion: PAP smear screening needs good infrastructure, trained manpower to
make & interpret the slides which is not feasible considering the facilities available in
the periphery. However, VIA can be done even by sisters in the remotest place with
minimum facilities & patient is diagnosed.

A RETROSPECTIVE RESEARCH TO EVALUATE THE ROLE OF FINE NEEDLE ASPIRATION CYTOLOGY IN THE DIAGNOSIS OF THYROID LESIONS

Yadav P; Kolta N; Kaundal V

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1115-1120

Aim: To evaluate the role of Fine Needle Aspiration Cytology in Diagnosis of Thyroid lesion. Materials and Methods: A retrospective research was conducted at the Department of Pathology, Assiut University and Hospital, Egypt. An overall total of 200 patients with a single thyroid nodule who met the inclusion criteria were included in the research. In the case of fine needle aspiration cytology, the sensitivity, specificity, positive predictive value, and negative predictive value were determined based on histopathologic examination, which was the gold standard. Results: There were 120 females and 80 men in attendance, resulting in a female to male ratio of 1.5:1. The patients' ages varied from 14 to 71 years, with a mean age of 43.69 years plus standard deviation (12.49 years). The majority of the patients are between the ages of 30 and 40. Neck oedema was the most common symptom among these patients (100 percent), followed by vocal cord palsy (15 percent), breathing difficulties 11 percent, and dysphagia 9 (4.5 percent), respectively. The thyroid nodule varied in size from 2 to 6.9 cm, with a mean of 4.51 +/- S.D. 1.89 cm and a standard deviation of 1.89 cm. Based on the results of this study, nodular goitre accounted for 52 percent of solitary thyroid nodules, with benign cyst accounting for 32 percent of benign lesions, 33 percent of follicular carcinoma, 17 percent of papillary carcinoma, and three cases being suspicious of neoplasm among the benign lesions. Conclusion: FNAC has key rule in diagnosis of solitary thyroid nodule because it is safe, minimally invasive and cost effective diagnostic tool. 

SIGNIFICANCE OF HISTOPATHOLOGICAL EVALUATION IN THE DIAGNOSIS OF ENDOMETRIAL LESIONS IN PREMENOPAUSAL AND POSTMENOPAUSAL WOMEN

Madhavi Bodepudi; Lakshmi P; Bharani K

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1111-1114

AIMS and Objectives: To study the incidence, clinical and histopathological correlation of various types of endometrial lesions in premenopausal and postmenopausal women. To study the clinicopathological spectrum and histopathological evaluation of endometrium in abnormal uterine bleeding in peri-menopausal and post-menopausal age groups. 

DERMOSCOPIC PATTERNS OF ORAL MUCOSAL LESIONS: NEW DIMENSIONS TO MUCOSCOPY

Dr. Varinder Kaur, Dr. Tejinder Kaur, Dr. SK Malhotra

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1482-1487

Background: Dermoscopy can act as an alternative diagnostic method to mucosal biopsy for diagnosis of various oral mucosal lesions.
Aim: To study the dermoscopic and histopathological characteristics of oral mucosal lesions.
Methods: The present prospective study was conducted among 53 patients of oral mucosal lesions presenting to the indoor and outdoor facilities in Department of Dermatology, Venereology and Leprosy. After performing routine investigations, dermoscopic evaluation was done in all the cases and recorded in the prestructured proforma. Oral mucosal lesions were evaluated by using non-contact videodermatoscope (AM7515MZT Dino-Lite), polarised mode. It was followed by mucosal biopsy from the same site.
Results: Nonvascular findings were the predominant features on dermoscopy. Structureless grey areas was the most common finding, seen in 72.41% patients of lichen planus. In lichen planus, it is suggested that structureless grey areas on dermoscopy corresponded histologically to hyperkeratosis. Vascular findings in form of light to intense red areas was seen in all patients of pemphigus vulgaris as well as both cases of aphthous ulcer and in each case of actinic cheilitis, bullous pemphigoid, disseminated discoid lupus erythematosus.
Conclusion: Theresultsof this rare pioneer study revealed that dermoscopy of mucosa may prove to be a valuable tool for diagnosis and may obviate need for mucosal biopsy.
 

PROFILE OF ANALYSIS OF COLONIC BIOPSIES IN CHRONIC COLITIS IN TERTIARY CARE HOSPITAL OF CENTRAL INDIA

Dr.Pradip Butale, Dr. Syed Waseem, Dr. BalawantKove

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1149-1158

Background: Chronic colitis, regardless of type, is defined histologically by chronic
inflammation, mainly plasmacytosis, in the lamina propria. Specific diagnosis of chronic
colitides in biopsies can be challenging for practicing pathologists. The present research was
undertaken to study complete clinico-pathology of chronic colitis, pathological pattern and
spectrum of colitis, also study correlation of colonoscopy and histopathology of these
lesions.Method:This study was a retrospective and prospective analysis of 187 cases
ofhistopathologicallyproven colitis on colonic biopsies over a period of 5 years from June 2015
to May 2020. Results:Majority of specimen were rectal biopsies (57.22%) followed by mapping
biopsies (34.22%). Of 85 cases where both colonoscopy and histopathology diagnosis was
available, 61 (71.76%) colonoscopy diagnosis were consistent with histopathology. Among 187
cases, 107 were inflammatory bowel disease (57.22%), they were further sub classified as
ulcerative colitis (UC) (96.26%), Crohn’s (0.93%) and indeterminate colitis (2.8%). Cases of
UC had features of basal plasmacytosis (97.19%), crypt distortion (93.45%), crypt loss
(70.09%) and goblet cell depletion.48cases diagnosed as non-specific colitis. Infectious colitis
comprised 8.56% of total colitis cases. It included tuberculosis 4 (2.14%), CMV colitis
2(1.07%) and 5.35% cases of acute self-limiting colitis. 5(2.67%) cases were diagnosed as
lymphocytic colitis and 2 cases showed focal active colitis. Also, found single case of
eosinophilic colitis and radiation proctitis each.Conclusion:Good clinico-pathological
correlation helps to reduce number of cases diagnosed as non-specific colitis. To improve the
detection rate of microscopic colitis, it is important to take multiple biopsies from normal
looking colon on colonoscopy.

HEPATOPROTECTIVE EFFECT OF d-LIMONENE AGAINST ADRIAMYCIN INDUCED HEPATOTOXICITY IN EXPERIMENTAL RATS

Dr. IndumathiSelvanathan; Dr.Sivasakthi Arumugham; S.M.Fazeela Mahaboob Begum

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 7712-7721

Objective: Monoterpenes plays an essential role to fight against various diseases. Among the various monoterpenes an efficientd-Limonene plays a fundamental role to fight against hepatotoxicity caused by cancer chemotheraphy treatment. Hence the presence study is to evaluate hepatoprotective function of d-limonene against adraimycin induced hepatotoxicity.
Methods: Male albino Wistar rats were administrated with ADR (15mg/Kg body weight) in six equal injection, and the protection efficacy of d-limonene (100mg/Kg body weight) was examined with reference to tissue AST level and the pathological studies was examined by microscopic study.
Results: Rats treated with ADR results in elevated level of liver AST marker enzymes, whereasthe level of AST was controlled when administrated with d-Limonene. However Histopathological proof added more protective role of rats treated with d-limonene against hepatotoxicity.
Conclusion:ADR administration of 15mg/Kg body weight of rats increase the level of hepatotoxicity by increasing the marker enzyme activity and show severe morphological changes. The final outcome from our result suggests that d-limonene (100mg/Kg body weight) a vibrant monoterpene act as latent hepatoprotective negotiator by attenuating ADR induced hepatotoxicity

“Assessment of lymph node status in cases of metastatic malignancy by frozen section and imprint cytology”

Dr Miheer Milind Jagtap; Dr Samarth Shukla; Dr Sunita , Vagha; Dr Ankita Tamhane; Dr Sourya Acharya; Dr. Miheer Milind , Jagtap

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 2557-2551

Abstract: Introduction: Dissemination of cancers most commonly occurs by the lymphatic
route and is generally favoured by carcinomas. The best achievable goal of any surgical
procedure is removal of all the affected tissue and leave behind healthy tissue which is
entirely free of any malignant cells. Though histopathological examination is gold
standard, it is time consuming and cannot be implemented as an intraoperative diagnostic
tool. The present study utilises frozen section analysis and touch imprint cytology as
intraoperative tools and analyses their diagnostic accuracy to detect lymph node metastasis
in comparison with routine histopathology in epithelial malignancies.
Aim: To evaluate the efficacy of intraoperative diagnosis by touch imprint cytology and
frozen section analysis for the assessment of metastatic lymph node deposits.
Materials and methods: Total 76 cases of primary malignancy with suspicious metastatic
lymph nodes were investigated. Metastatic nodes were subjected to frozen section and 
touch imprint cytology and these findings were compared with routine histopathology and
the sensitivity, specificity, positive predictive value, negative predictive value and accuracy
were calculated.
Results: The sensitivity, specificity, positive predictive value, negative predictive value and
diagnostic accuracy of frozen section was found to be 97.30%, 100%, 100%, 97.5% and
98.68%. The values of the same parameters for imprint cytology was found to be 75.68%,
100%, 100%, 81.25% and 67% respectively.
Conclusions: Frozen section analysis proved superior to imprint cytology in detecting
lymph node metastasis intraoperatively. Apart from detecting the presence of metastasis,
frozen section is able to provide details regarding micro-metastasis, macro-metastasis and
perinodal fat invasion. This study predominantly evaluated epithelial malignancies and
thus proves the utility of these two intraoperative modalities in them. It also opens new
avenues for research pertaining to the utility of these modalities in various malignant
mesenchymal tumours.

Multi-Stage Classification Technique for Breast Cancer Detection in Histopathology Images using Deep Learning

Nagamani Gonthina; C. Jagadeeswari; Prabhavathi V; Sneha B

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 4, Pages 1104-1110

This research paper proposes the past decenary, substantial improvement in computational ability and betterment in algorithms for analysis of Images has gained vast fame in resolving challenges in the area of medical diagnosis. Subsequently, computerized tissue histopathology at present is becoming tractable towards the implementation of digitized analysis of images and deep learning methods. Cancer is a cluster of disorders involving irregular cell maturation with the capability to conquer or proliferate to other organs of the body. Detection of cancer in the earlier stages is a exacting task due to which many people are prone to death. Treatment of cancer benefits from the pace, perfection of Deep Learning-obliged practice of diagnosis. Deep Learning techniques are utilized to diagnose the features of progressed carcinoma with enhanced perfection compared to individual pathologist. This paper suggests a deep convolution neural network for categorizing a tissue as malicious, there after segregate the tissue then ultimately perform multi-class detection and classification of Breast Cancer disease and its stages in histopathology images