Spectrum of vulvar lesions: patient’s anxiety, clinician’s concern and pathologist’s diagnostic challenge

Background: A wide variety of inflammatory, premalignant and malignant lesions can occur on the vulva. Some of the lesions are limited to the vulva, while some also involve other parts of the body. Although vulvar diseases can cause a significant issue in the patients, they are less commonly discussed than those of cervix, uterus and ovary. Most of the asymptomatic lesions remain un-noticed, and are seen during routine gynecological checkups. Common complaints in symptomatic lesions are lumps, discomfort, itching and pain. Since the symptoms are nonspecific; determining the location of the lesion can assist with the diagnosis. Being a genital part with skin covering on outer aspect and mucosal lining inside, it is associated with various dermatological, nutritional, and hormonal as well as sexually transmitted diseases. The present study thus was conducted to categorize vulvar lesions based on their histological diagnosis and also to study the morphological spectrum of precursor lesions for malignancy.Methods: Present study includes all types of vulvar lesions sent for pathological study in the Department of pathology, at GMC Nagpur over the period of one year.Results: Total 34 lesions were studied including a wide diagnostic range from inflammatory, dermatological to benign, premalignant and malignant. Inflammatory lesions including various infections and LSA (Lichen sclerosus atrophicus) were the most commonly seen lesions along with collection of neoplastic lesions.Conclusions: Proper diagnostic categorization of the lesions is essential for initiating therapy and reducing patient’s anxiety. Morphology of these lesions along with their diagnostic significance is discussed

Fetus acardius amorphous: a rare case report

Fetus acardius amorphous is a rare fetal malformation, lacking a functional heart and bearing no resemblance to human embryos. The main differential diagnosis is with placental teratoma and is based on the degree of skeletal organization and umbilical cord formation. A 27-year old woman delivered a healthy newborn at 36 weeks gestation. An oval well defined mass, covered with normal looking skin, was connected to the placenta with a thin walled vessel. X-ray examination of the mass revealed the presence of vertebral column. Histopathologic examination demonstrated the presence admixture of tissues including neural tissue, osteoid, cartilage, muscle, fat etc. beneath the skin. The rarity of fetal monsters without a functioning heart is emphasized

Single Donor Plasmapheresis for COVID-19: An Experience from a Tertiary Care Hospital Based Blood Centre

Introduction: Corona Virus Disease-2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) became a global health problem since December 2019. No single treatment was found to be effective against COVID-19. Transfusion of COVID Convalescent Plasma (CCP) was found to be a useful and logistically feasible therapeutic strategy in COVID-19. Aim: To study the feasibility of single donor plasmapheresis for COVID-19, to analyse statistical significance of clinicodemographical data and biochemical parameters of convalescent plasmapheresis donors and to further study the adverse reactions and technical problems that occurred during the procedure of single donor plasmapheresis. Materials and Methods: A prospective observational study was carried out over a period of 10 months from June 2020 to March 2021. The study included 235 screened donors and 50 procedures for single donor plasmapheresis (SDPs). Donors were selected as per the standard criteria given by Indian Council of Medical Research (ICMR). All plasmapheresis procedures were performed on an automated blood cell separator. The results were tabulated and statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) software. Results: Out of 235 prospective CCP donors, 164 (69.78%) were found eligible. The causes of non eligibility donors were unwillingness to donate, absence of SARS-CoV-2 antibody, Transfusion Transmitted Disease (TTD) positivity, and improper haematological parameters. Actual plasma donations were carried out in 50 (21.27%) eligible donors. Therapeutically needed amount of CCP (400 mL) could be collected from most of the donors. Adverse reactions were seen in 4 (8%) donors. Conclusion: Adequate amount of CCP could be collected by single donor plasmapheresis with satisfactory technical support. The procedure was well accepted by the prescreened donors with minimum adverse reactions

Study of Extramedullary Lymphoblastic Lymphoma (LBL) Diagnosed by Flowcytometric Immunophenotyping (FCI) on Fine Needle Aspirate (FNA) Sample—A Case Series of 18 Cases

Background: Lymphoblastic lymphoma (LBL) accounts for about 2% of all lymphomas. Recognition of T/B-LBL albeit of their rareness is very important as they present as localized diseases with low tumor burden. They can present both at nodal and extranodal sites. Limitation of diagnosis and classification of lymphoma on fine needle aspirate (FNA) can be minimized by clubbing it with flowcytometric immunophenotyping (FCI) to ensure diagnostic accuracy rapidly. Aim: Study of a series of 18 cases of LBL to assess the utility of FCI on FNA and effusion samples in extramedullary LBL. Methods and Material: FCI was done on FNA and effusion samples from 130 morphologically diagnosed/suspicious cases of lymphoreticular malignancy, followed by peripheral blood and bone marrow (BM) examination. The patients diagnosed to have B/T LBL, based on WHO 2017 classification, were selected for further analyses. Results: FCI of 130 cases showed 91 mature and 18 precursor lymphoid neoplasms. These 18 cases were from lymph nodes (11), pleural fluid (03), and soft tissue masses (04). Peripheral blood and BM of 15/18 cases were normal of which FCI revealed T-LBL (11) and B-LBL (04). Two cases (both T LBL) showed BM involvement (<25%), while one case of B-LBL which was misdiagnosed as mature lymphoma by immunohistochemistry (IHC) evolved as B ALL. Conclusions: Diagnosis of extramedullary B/T-LBL needs comprehensive evaluation of clinical presentation, cytomorphology, and immunophenotyping. Rapid and accurate diagnosis by FCI on FNA and effusion samples allows early therapeutic decisions, thereby avoiding leukemic dissemination