Gliosarcoma: An audit from a single institution in India of 24 post-irradiated cases over 15 years

Background: Gliosarcomas (GS) are biphasic brain tumors composed of glioblastoma multiforme (GBM) and sarcomatous component. Therapeutic approaches include maximum surgical decompression with postoperative radiotherapy. Outcomes in gliosarcoma are poor despite multimodality management. Aims: To analyze the outcome in patients of GS treated in our institute over a period of 15 years and compare it with GBM treated during the same period. Settings and Design: Clinical records of the post-irradiated GS patients and GBM patients seen between 1990 and 2004 were retrieved. Materials and Methods: Demographic and treatment variables were evaluated for their influence on overall survival (OS). The survival outcomes of GBM and GS treated during the same period were also compared. Statistical Analysis: Univariate analysis was carried out using the Kaplan-Meier method and tested using log-rank test for significance. Results: During these 15 years, 24 evaluable GS patients were treated as compared to 251 evaluable patients of GBM. There was a slight male preponderance in GS (14 males vs.10 females) with a median age of 50 years. All patients underwent surgery followed by post-operative radiotherapy (median dose of 60 Gy). None of the patient or treatment related factors were found to be significantly influencing their OS. Median OS in GS was 7.3 months compared to 7.5 months in GBM patients (P = 0.790). Conclusions: The OS appears to be similar for GS and GBM. None of the demographic variables appeared to prognosticate the survivals of GS

Fine needle aspiration cytology in xanthogranulomatous cholecystitis, gallbladder adenocarcinoma and coexistent lesions

To evaluate the diagnostic efficacy of fine needle aspiration cytology (FNAC) in gallbladder mass lesions and to explore the possibility of overlooking malignancy in coexistent adenocarcinoma with xanthogranulomatous cholecystitis (XGC) on fine needle aspiration smears. STUDY DESIGN: In a retrospective, seven-year study, ultrasound-guided needle aspirates from 25 histologically proven cases of gallbladder adenocarcinoma, 11 cases of gallbladder adenocarcinoma associated with XGC and 20 cases of XGC were evaluated for the presence of mesotheliumlike, foam, inflammatory and multinucleate giant cells; pink, granular background; bile; and degenerated cells, along with atypical or frankly malignant cells. Detailed clinical findings were retrieved from the records. RESULTS: The overall sensitivity of detecting carcinoma was 90.63% and specificity 94.74%. The sensitivity of detecting malignancy was 80% when adenocarcinoma was associated with XGC. CONCLUSION: FNAC plays an important role in making the preoperative diagnosis of adenocarcinoma, XGC and coexistent lesions. The probability of detecting malignancy is greater than with XGC in coexistent lesions. Thus, a preoperative FNAC diagnosis would help in determining the urgency of treatment and in planning for the surgical procedure in gallbladder lesions

Evaluation of abdominal fat pad aspiration cytology and grading for detection in systemic amyloidosis

To evaluate the diagnostic efficacy of abdominal fat pad aspiration cytology as a screening procedure for systemic amyloidosis and to assess the clinical usefulness of semiquantitative grading criteria of fat pad amyloid deposits. Study Design: Aspiration cytology samples from 297 cases of abdominal fat pad were retrospectively analyzed for amyloid deposits. The smears were graded semiquantitatively. The deposits in the smears were compared with histologic evidence of amyloidosis in deeper tissues in 44 cases. Results: Retrospective analysis of 297 cases of aspiration cytology revealed amyloid in 90 cases. Follow-up biopsies from deeper tissues in 44 cases showed presence of systemic amyloidosis in 13 cases. The sensitivity and specificity of abdominal fat pad fine needle aspiration cytology was 78% and 93%, respectively. The positive predictive value was 84% and negative predictive value 90%. Conclusion: Fat pad aspiration cytology is a useful screening procedure for diagnosis of systemic amyloidosis. Patients with grade 1 deposits should not undergo a toxic therapeutic regimen on the basis of fat pad cytology alone; histologic confirmation of visceral amyloid deposition in deeper tissue is advised. Patients with grades 2 and 3 deposits may undergo suitable therapy for amyloidosi

Spectrum of adrenal lesions on fine needle aspiration cytology

Background: Fine needle aspiration (FNA) cytology of adrenal gland is not a commonly performed technique and is limited primarily to tertiary care centers. However, it is a sensitive and specific procedure in the workup of patients with adrenal gland′s mass lesions. Though cytomorphological features for various lesions have been described, there are a limited number of studies in cytologic literature. Aims: We report our 7 years of experience in FNAC of adrenal lesions. We have not only described the cytomorphological details of different lesions, but also tried to discuss the various diagnostic difficulties encountered during reporting of adrenal fine needle aspirations. Materials and Methods: All ultrasound-guided percutaneous aspirations of adrenal gland received in the department between the years 2002 and 2009 were reviewed. There were a total of 52 FNA samples of adrenal masses from 35 patients in 7 years. The lesions were categorized as non-neoplastic and neoplastic categories. Neoplastic lesions were further divided into benign and malignant lesions. Results: In our study, FNA proved to be 100% specific for diagnosing malignant lesions. The overall inadequacy rate was 11.4% with no major complications of the procedure. A wide variety of non-neoplastic as well as neoplastic lesions were identified

Meningeal chondroma in a young female

Meningeal chondroma is a rare intracranial neoplasm. It is usually diagnosed clinically as meningioma. Histologically it may have a differential diagnosis of chordoid meningioma, a malignant lesion, and needs radiotherapy. A chondroma is a benign lesion where surgical removal is the treatment. A 20-year-old female presented with symptoms of space occupying lesion which was clinically and radiologically considered meningioma. On histopathology, the lesion turned out to be a chondroma. Meningeal chondroma is a benign lesion for which surgical removal is the curative treatment. No further treatment in the form of radiation is required

Spectrum of Biopsy Proven Primary Tubulointerstitial Diseases of the Kidney: A Single Centre Study

Background: The tubulointerstitial diseases can be due to a wide variety of etologies and mechanisms which vary with age, race and geographical area. In this study we aim to study the clinicopathological spectrum of biopsy proven primary tubulointerstitial diseases among patients in North India. Methods: This is a 5 year retrospective, single centre cohort, observational study.The data base was searched to identify all patients with primary tubulointerstitial diseases in their native kidney biopsies. Results: A total of 3091 renal biopsies were studied of which 283 were primary tubulointerstitial diseases. The mean age of patients was 43.2 (±14.6) years. Most of the patients were males with acute kidney injury as the most common presentation. Tubulointerstitial nephritis was the most common disease occurring in 126 patients. Acute interstitial nephritis was seen in 81 patients and chronic interstitial nephritis was seen in 45 patients. Granulomatous interstitial nephritis was seen in 27 patients. There were four patients of pigment nephropathy, 83 cases of acute tubular necrosis and 19 cases of cast nephropathy. Conclusion: Primary tubulointerstitial diseases comprise about 9.1% of the total cases. Tubulointerstitial nephritis is the most common diagnosis in these patients. Tuberculosis is still a leading cause of granulomatous interstitial nephritis in our country followed by fungal etiology. Acute cortical necrosis affects mostly females post obstretric complications in our setup. Given the enemic nature of malaria in India, G-6PD deficiency is an important differential in patients presenting with pigment nephropathy. Keywords: Biopsy, Tubulointerstitial Diseases of the Kidney, Tuberculosis, Acute cortical necrosi

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Not AvailableThe present study delineate the various biochemical and histopathological tool to evaluate as strong biomarker in the field condition for detection of the least and maximize level of pollution and contamination. We have collected Labeo rohita from 13 different sites from East Kolkata wetland to determine biochemical and histopathological status to analyse metal contamination in the significant biological hot spot EKW. The biochemical marker as antioxidative status, i.e., catalase, superoxide dismutase (SOD), and glutathione-S-transferase (GST) in liver and gill, were remarkably higher (p < 0.01) at some of the sampling sites, but catalase in brain, SOD in kidney, GST in brain and kidney, and neurotransmitter as acetylcholine esterase (AChE) in brain were not significant (p > 0.05) among the sampling sites. The glycolytic enzymes, such as lactate dehydrogenase (LDH) and malate dehydrogenase (MDH) in liver, gill, and muscle, and protein metabolic enzymes, such as alanine amino transferase (ALT) and aspartate amino transferase (AST) in liver, gill, muscle, and kidney, were noticeably higher (p < 0.01) at some of the sampling sites. The histopathology of the liver and gill were altered at different sampling sites, such as blood congestion, leucocyte infiltration with parenchymal vacuolisation, nucleus with blood vessels, hepatocytes granular degeneration, haemorrhage, karyorrhexis, shrink nucleus, and pyknotic nuclei in liver. In the gill, structural changes, such as complete destruction and shortening of secondary gill lamellae, blood vessel in gill arch, curling of secondary gill lamellae, aneurism in gill lamellae, and neoplasia, were observed. Most of the metals were found within the safe limit all along the 13 sampling sites, indicating that fishes are safe for the consumption. Based on our finding, we could recommend that a rational application of biochemical profiles, such as oxidative and metabolic stress parameters, including histopathology to be used as biomarkers for biomonitoring the metal contamination in the aquatic environment.Not Availabl