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Introduction Lymphadenopathy, characterized by the enlargement of lymph nodes, is a common concern encountered by physicians in outpatient settings. It is deemed significant and warrants evaluation due to the diverse range of potential causes, ranging from treatable infections to incurable metastatic malignancies. Fine needle aspiration cytology (FNAC) emerges as a crucial tool in addressing these concerns, acknowledged for its rapid diagnostic capabilities, simplicity, accuracy, and minimal invasiveness. Objectives This retrospective study aims to characterize the spectrum of lymphadenopathy cases observed in a tertiary care center over a specified period, shedding light on the prevalence, etiology, and clinical outcomes associated with this condition. Methods Electronic medical records of patients presenting with lymphadenopathy to the tertiary care center between May 2021 and June 2023 were reviewed. Data on patient demographics, clinical presentation, imaging findings, and cytopathological and histopathological diagnoses were analyzed. Results A total of 300 cases of lymphadenopathy were identified during the study period. The study population exhibited a diverse range of age groups, with a slight predilection for the age range of 11-20 years. The most common sites of lymphadenopathy were in the cervical group, and the predominant clinical presentations included tender lymph nodes and fever. Etiologically, infectious causes, such as accounted for the majority of cases, followed by inflammatory and neoplastic etiologies. Notably, 2.6 % of cases presented with non-specific lymphadenopathy, warranting further investigation. Diagnostic modalities, including imaging studies and histopathological examinations, played a crucial role in establishing accurate diagnoses. The study also highlights the challenges in differentiating benign from malignant lymphadenopathy, emphasizing the need for a comprehensive diagnostic approach. Conclusion This study provides a comprehensive overview of the lymphadenopathy spectrum in a tertiary care center, emphasizing the importance of a multidisciplinary approach for accurate diagnosis and management. The findings contribute to our understanding of the epidemiology and etiological patterns of lymphadenopathy, guiding clinicians in optimizing patient care and outcomes in a tertiary healthcare setting.
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The uncommon, non-hereditary congenital abnormalities known as nasal glial heterotopias (NGH) are composed of heterotopic neuroglial tissue. Typically, NGH manifests in infancy, but occasionally it can also be seen in older children and adults. To rule out intracranial extension, magnetic resonance imaging (MRI) and computed tomography (CT) scans should be performed. Numerous cases have been documented where NGH was mistakenly identified as encephaloceles, teratomas, dermoid cysts, capillary haemangiomas, and even desmoids. A proper clinical, sonological, and even CT and MRI evaluation can lead to a near-final diagnosis; nonetheless, surgical excision and histological confirmation are the gold standards. We report a rare case of a firm, subcutaneous, non-tender, non-reducible midline 2 x 2 x 1 cm swelling with bluish-red skin near the root of the nose that was not affected by posture or pressure. Encephalocele, NGH, and dermoid were the differential diagnoses made based on the oedema found on CT and MRI scans. Histopathology provided a conclusive NGH diagnosis. The instance illustrates the significance of histology as the gold standard for NGH diagnosis.
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The incidence of tuberculosis (TB) worldwide is still significantly high, with India contributing a high global TB burden. This case study features a 49-year-old male who had complaints of pain and abdominal distention for one and a half months. An erect abdominal radiograph showed features suggesting small bowel obstruction. Contrast-enhanced computed tomography (CT) of the abdomen was done. It showed multiple strictures involving the distal jejunum and ileum, causing small bowel obstruction. There was mesenteric and retroperitoneal lymphadenopathy with central necrosis and ascites. The patient was operated on for a small bowel obstruction. The resected intestine showed four strictures, tiny nodules on the serosal surface, and many enlarged lymph nodes. Representative tissue from these areas showed the typical picture of multiple caseating granulomas and fibrosis. Ziehl-Neelsen (ZN) staining highlighted the acid-fast bacilli (AFB). The suspicion index for intestinal tuberculosis (ITB) should be kept high while evaluating patients with intestinal obstruction presenting in endemic areas and high-risk populations, such as HIV-infected, undernourished, immunocompromised, and those with diabetes, smoking, and alcohol addiction.
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Blood donations play a crucial role in medical care; however, the global shortage of donors remains and has a serious impact on medical interventions. The challenges involved include the lack of public awareness of the importance of blood donation, the lack of understanding of the process and eligibility criteria for blood donation, and the lack of comprehensive strategies aimed at raising awareness and participation among potential donors, with particular emphasis on the involvement of young people. It is essential to recognize that blood donation delivers significant benefits to donors and recipients, improves overall health, and ultimately saves lives. Various initiatives, such as blood donation camps, dynamic social media campaigns, and strategic networking of medical professionals, have proved effective in promoting blood donation. In particular, in the event of an emergency, the availability of sufficient blood supplies is increasingly essential, underlining the urgent need to establish and maintain a sustainable blood donor network. An in-depth understanding of the motivation and conservation of donors is crucial in this context, as it is known that demographic factors significantly impact the frequency of blood donation. In addition, ethical and legal considerations require careful attention, highlighting the essential role of obtaining informed consent and ensuring the confidentiality of donors throughout the process. As we look ahead to the evolving landscape, it presents a series of formidable challenges. These challenges encompass the critical necessity to broaden and diversify our donor base, thereby extending and varying our sources of financial support for specific initiatives, organizations, or projects. Moreover, we must proactively harness the opportunities presented by emerging technologies and commit ourselves to closing the information gaps within the existing public knowledge sphere. In summary, the review emphasizes the paramount importance of ongoing efforts to strengthen and enrich donors' engagement through customized strategies and educational outreach.
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Background The skin is the largest organ of the body with many different functions. All age groups are affected by skin diseases, which are widespread in underdeveloped nations. From a straightforward vesicular non-neoplastic lesion to a catastrophic neoplastic lesion, skin disorders exhibit a wide variety of geographic patterns. To make an accurate diagnosis, identify etiological agents, and assist a dermatologist or clinician in selecting the best course of treatment, a skin biopsy must undergo histopathological analysis. The present study was conducted to investigate the histological diagnosis of skin lesions, establish the distribution by age and sex, identify the most prevalent skin lesions, and further subclassify the most prevalent condition. Methodology A retrospective, cross-sectional study was conducted in the Department of Pathology at Datta Meghe Medical College, Wanadongari, Nagpur over the course of a year. Hematoxylin and eosin were used to stain a total of 50 skin biopsy samples, with special stain when necessary, and then examined. Results The study involved a total of 50 patients, with 39 (78%) males and 11 (22%) females. With 16 (32%) cases in the 21-30-year age group, the early age group preponderance was recorded. Overall, 16 (32%) cases had microbial diseases, followed by eight (16%) cases with non-infectious vesicobullous diseases and vesicopustular disease, and five (10%) cases with non-infectious erythematous papular and squamous disease. In 12 (24%) cases, leprosy was the most prevalent microbiological disease. In five (10%) cases, pemphigus vulgaris was the most prevalent vesicobullous condition. Psoriasis, which was present in two (4%) cases, was the most common non-infectious erythematous papular and squamous disease. Squamous cell carcinoma, which was seen in seven (14%) cases, was the most prevalent neoplastic lesion. Conclusions In skin lesions, males outnumbered females. Patients in the younger age groups were most commonly involved. Leprosy and squamous cell carcinoma were, respectively, the most prevalent non-neoplastic and neoplastic skin lesions in our study.
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A 49-year-old female patient was referred to a tertiary care hospital with a history of postmenopausal bleeding and abdominal pain that had persisted for the last two months. An abdominal examination revealed a huge mass that had been present for 12 weeks. A fibroid uterus was suggested by USG. A biopsy was done and sent to histopathology which revealed myxoid leiomyoma. Subsequently, the patient underwent total abdominal hysterectomy without bilateral salpingo-oophorectomy. Histopathological examination confirmed the diagnosis of myxoid leiomyosarcoma (MLMS) of the uterus.
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The rise of antimicrobial resistance (AMR) is a major global public health threat due to excessive and inappropriate use of antibiotics and is responsible for prolonged illness, longer hospital stays, and economic burden to society. This article aims to review the factors, role of antimicrobial stewardship, preventive strategies, and role of various organizations in combating AMR. Three major factors of AMR are inappropriate and excessive utilization of antibiotics, nonadherence to infection control measures, and the emergence of pathogens that are resistant to multiple drugs. Antimicrobial stewardship initiatives play a vital role in promoting judicious and targeted utilization of antimicrobials, thereby safeguarding their efficacy and mitigating the emergence of resistance. Implementing such programs optimizes patient outcomes by ensuring that individuals receive the most suitable therapeutic interventions. International organizations have a vital role to play in addressing AMR by promoting the responsible use of antimicrobials, developing new drugs, and improving surveillance systems. As AMR's impact grows, it is critical to take a collaborative and interdisciplinary approach to mitigate its consequences effectively.
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Xanthogranulomatous oophoritis is a rare, chronic and non-neoplastic condition in which a heavy foamy histiocyte inflammatory infiltrate admixed with neutrophils, plasma cells, multinucleated giant cells, fibroblasts and foci of necrosis causing extensive tissue damage and organ destruction. The gallbladder and kidney are just two examples of the different organs that exhibit histological changes resembling xanthogranulomatous alteration. The present case involved a 40-year-old female who presented with a tuboovarian mass and was ultimately diagnosed with xanthogranulomatous oophritis, despite initial clinicoradiological suspicions for malignancy. Xanthogranulomatous oophritis is a significant entity because, clinically and radiographically, it resembles tumours of the ovary and hinges on a careful histopathological analysis to establish a diagnosis.
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Introduction The uterus is a crucial reproductive organ that is susceptible to the development of several non-neoplastic and neoplastic diseases in women, greatly increasing morbidity and mortality. Although there are various therapeutic options, hysterectomy is still a popular treatment option throughout the world. Abnormal uterine bleeding, pelvic pain, pelvic inflammatory disease (PID), prolapse of the uterus, adenomyosis, endometriosis, fibroids, gynecological malignancies, and obstetric problems that require hysterectomy, all samples must be examined histopathologically. Histopathological examination of the specimens obtained after hysterectomy is important for both diagnosis and treatment. The current work aimed to identify the various clinical indications, analyze the clinicopathological correlation in hysterectomy specimens, and analyze the patterns of lesions in hysterectomy specimens. Materials and methods This study was conducted in the Department of Pathology at the Datta Meghe Medical College, Wanadongari, Nagpur, from February 2022 to January 2023. All types of hysterectomy specimens received during this year were examined, and the tissues were processed and stained with H&E. Histopathological examination was performed, and various lesions in the hysterectomy specimens were examined. The study included all forms of hysterectomy, including abdominal, vaginal, laparoscopic, and total abdominal hysterectomy. Results An analysis of 110 cases of hysterectomy revealed that abdominal hysterectomy was the type of hysterectomy in 79 (71.82%) cases, with a maximum age range of 35 to 45 years (42.72%). The proliferative phase endometrium was the most common endometrial pathology, accounting for 43 (39.09%) cases, followed by the atrophic endometrium in 35 (31.82%) cases. Leiomyoma was the most prevalent myometrial lesion, accounting for 52 (47.28%) cases, followed by adenomyosis, accounting for 23 (20.91%) cases. Chronic cervicitis was the most common incidental finding in the hysterectomy samples, accounting for 85 (77.28%) cases. Follicular cysts, representing 22 (20%) cases, were the most common ovarian lesions, followed by serous cystadenoma in seven (6.37%) cases. Two cases of malignant tumors were noted: one case of endometrial carcinoma and one case of mucinous cystadenocarcinoma of the ovary. In most cases, ranging from 70% to 100%, the final histopathological diagnosis supports the preoperative clinical diagnosis. Conclusion Hysterectomy is the most common major gynecological surgery performed under elective conditions. Although histological studies and clinical diagnoses are closely correlated, several lesions, including chronic cervicitis and adenomyosis, were discovered incidentally. Therefore, every hysterectomy specimen must undergo a thorough histological investigation, even if it appears superficially normal, to confirm the diagnosis and improve postoperative care.
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Signet ring cell carcinoma (SRCC) is a rare lesion in the gastrointestinal tract. Further, the condition is very uncommon at the ampulla of Vater. A majority of the reported cases are typical, gland-forming adenocarcinomas. In our case, a patient aged 59 years, was diagnosed as a case of peri-ampullary carcinoma based on physical exam findings and imaging. Ultrasonography (USG) abdomen and magnetic resonance cholangiopancreatography (MRCP) revealed an enlarged common bile duct (CBD) and there was a presence of stricture at the terminal CBD. Endoscopic retrograde cholangiopancreatography (ERCP) showed growth at the ampulla of Vater. An endoscopic ultrasound guided needle core biopsy was obtained. Histopathological examination revealed the case as SRCC at the ampulla of Vater. We present this as an uncommon case of SRCC at the ampulla of Vater.
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Turnaround time (TAT), which doctors frequently use as the benchmark for laboratory performance, is a typical way to communicate timeliness. It also acts as a quality indicator to evaluate the effectiveness and efficiency of the testing process and the satisfaction of clinicians and patients. TAT is the time from receipt of the sample in the laboratory to final delivery or dispatch of the report of said test. The TAT procedure can be broadly divided into three stages pre-analytical, analytical and post-analytical. There is variability in TAT according to different conditions like the volume of sample size, staff expertise, availability of adequate resources, distances of the hospital from the lab, and various sub-departments. To remove obstacles to optimizing TAT, we must take a practical approach. A workload reduction plan, proper stock management, specialized work assignments, and skilled staff retention are crucial strategies to reduce the setting's delayed TAT.
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INTRODUCTION: A brain tumor occurs when neurons are mutated and thus abnormal cells are formed. Glioma and meningioma are the two most common types, comprising approximately 75% of all brain tumors. The incidence rate of all primary brain tumors was 15.80/100,000 person-years in females and 14.33/100,000 person-years in males. An association of higher risk of brain tumors in adults with cured meat and fruit/vegetable consumption, the primary source of dietary N-nitroso compounds, is seen. Cigarette smoking is a major source of chemical carcinogens. The present study aimed at determining the effects of lifestyle and dietary habits in the development of brain tumor. METHODS: The study aimed at the assessment of various dietary factors, lifestyle, and occupational and personal habits in patients diagnosed with brain tumor in a rural tertiary health-care hospital, using a structured questionnaire and statistical analysis. RESULTS: It was observed that - (1) people with stressful, sedentary lifestyle and wrong diet and those addicted to alcohol consumption and the habit of cigarette smoking have higher risk of brain tumors; (2) males are more prone to brain tumors; and (3) among subtypes, majority had glioblastoma and the least had meningioma and opdivoglioblastoma and according to location, majority had cerebellopontine angle tumor and the least had left thalamic glioma and multicentric glioma. Primary care to preoperative brain tumor patients should be given in terms of preventing exposure to radiations, avoiding cigarette smoking, providing healthy diet, and avoiding chronic stress and environmental pollution and postoperative patients should be taken care including avoiding infections by maintaining proper hygiene and providing healthy diet for their speedy recovery. CONCLUSION: People with stressful life condition, wrong diet, and sedentary lifestyle and those addicted to alcohol, with the habit of cigarette smoking, have higher risk of brain tumors. Males are more prone to brain tumors.
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BACKGROUND: Nottingham's modification of Bloom-Richardson histopathological grading system (NGS) for carcinoma breast is a time-tested prognostic indicator; however, of lately, breast cancer has been evaluated through molecular techniques, particularly assessing the gene expression profiling and establishing molecular or immunophenotypes. The present-day utility of NGS needs to be reassessed with the modern predictive markers, this may help refine breast cancer classification specifically to help improve the treatment protocol. OBJECTIVE: The objective was to compare breast cancer immunophenotypes with prognostic factors such as age (based on menstrual status), tumor size, lymph node (LN) status, also to compare the NGS grade with the molecular immunphenotypes of breast cancer. MATERIALS AND METHODS: The present work was carried out in the Histopathology and Immunohistochemistry section of Department of Pathology, of a central Indian medical college and rural hospital from January 2013 to July 2016. It was a prospective analytical study. A tota1 of 114 female patients presenting in the outpatient department of surgery with lump in breast were included in the present study. All patients underwent modified radical mastectomy for tumor resection. Tumor masses and LNs were subjected to routine hematoxylin and eosin staining as well as immunohistochemistry then examined by a senior pathologist. Comparisons were made between molecular immunophenotypes with patient age, tumor size, and LN status, further NGS grade of breast cancer was compared with immunophenotypes. RESULTS: The study found that the molecular immunophenotypes when compared with clinical prognostic parameters, i.e; age (based on menstrual status of female), LN involvement in patients of breast carcinoma showed inconsequential correlation, the tumor size showed significant correlation. However, when histopathological grades were compared with molecular immunophenotypes, a significant correlation was seen. CONCLUSION: NGS grade being an excellent predictive prognostic tool should be continued for assessing the grades in breast cancer patients. The molecular markers correlate with the histopathological grading and indirectly aid the oncologist in assessing the aggressiveness, these immunophenotypes are not helpful as suitable prognostic tools. As the molecular phenotypes definitely indicate the hormonal receptor status in breast cancer patients, they become mandatory in guiding oncologists for planning the treatment strategy and protocol.
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Cavitary lung lesions have a specific array of differential diagnosis. Among rare causes is mucormycosis that should not be overlooked. A high index of suspicion is necessary for a correct diagnosis and aggressive management. It usually occurs in immunosupressed patients. It is a life-threatening, rapidly progressive, and angioinvasive fungal infection. We present a case of pulmonary mucormycosis presenting as a cavity in an immunocompetent middle aged male.