Parasites found in surgical pathology: the institutional experience

Background: Parasitic infestation has a worldwide prevalence and it affects almost all age groups and both the sexes. The incidence of these infections is slowly rising in today’s era. Parasites are mainly found in stool samples but due to increase in a immunocompromised state now a days, tissue parasitaemia has increased globally necessitating more such type of studies. Parasite found in surgical pathology either incidentally or in clinically suspicious cases not only improves morbidity but also saves clinician’s time and patient’s money.Methods: A retrospective-cross sectional study is done based on histomorphological and cytomorphological evaluation of 25 cases diagnosed at The Department of pathology, New Civil Hospital Surat from January 2015 to January 2017.Results: Most common parasite seen was Echinococcus presenting as hydatid cyst in liver followed by filariasis. Most common age group affected was 0-20 years of age. Most common intestinal parasite found in our study was Entamoeba histolytica. Patients presented with variety of symptoms.Conclusions: Distribution of parasite in tissue section in relation to frequency, age, sex, various system involvements and its correlation with clinical symptoms are analyzed in our study

Fine needle aspiration cytology as a first line investigation in cervical swellings of 470 cases

Background: Fine needle aspiration cytology (FNAC) is a first line investigation in cervical swellings. The etiology varies from an inflammatory process to a malignant condition.Methods: The study was carried out in department of Pathology, Government Medical College, affiliated with government hospital in Gujarat. There were 470 patients with cervical swelling in a period from January 2017 to December 2017. Patients with thyroid swelling (swelling moves with deglutition) were excluded from the study. FNAC procedure was performed, smears prepared, stained with haematoxylin and eosin (H and E), May Grunwald Giemsa (MGG) and Pap stain. Zeihl Neelsen stain was carried out when required. Patient history, local examination findings and microscopic findings were recorded.Results: Total 470 patients, age ranged from 2 months to 90 years were studied. There were 286 males and 184 females. There were 449 cases in which conclusive opinion given. 111 cases were neoplastic and 338 cases were non-neoplastic. Various cytological diagnosis were; 207 cases of granulomatous lymphadenitis (tuberculosis), 1 case of filarial lymphadenitis, 72 cases of chronic reactive hyperplasia, 25 cases of acute suppurative inflammation, 1 case of sialadenitis, 10 cases of keratinous cyst, 6 cases of benign cystic lesion, 12 cases of lipoma, 4 cases of lymphoproliferative lesion, 1 cases of benign appendage tumor, 2 cases of mucoepidermoid carcinoma, 103 cases of metastasis and 5 cases of non Hodgkin lymphoma.Conclusions: FNAC is a simple, quick, inexpensive and minimally invasive technique to diagnose cervical swellings. It can differentiate the infective process from neoplastic one and avoids unnecessary surgeries

Reporting of thyroid fine needle aspiration cytology with the use of the Bethesda System (TBS) of 150 cases

Background: Fine needle aspiration cytology (FNAC) is very simple, rapid, cost effective diagnostic test to evaluate thyroid swelling. The Bethesda system for reporting thyroid cytopathology gives guidelines which remains the same while reporting the thyroid FNAC. There are six diagnostic categories of lesions: (I) Non-diagnostic/Unsatisfactory, (II) Benign, (III) Atypical follicular lesion of undetermined significance (AFLUS), (IV) Suspicious for follicular neoplasm (SFN), (V) Suspicious for malignancy (SM), (VI) Malignant.Methods: The study was carried out in Department of Pathology, Government Medical College affiliated with a Government hospital, Gujarat. It includes 150 patients, coming to the outpatient departments with a complaint of thyroid swelling from January 2017 to December 2017. The patients age ranges from 7 years to 75 years (Male-20, Female-130). The procedure was done with the patient in a supine position without a pillow. Patients were instructed not to speak or swallow during the procedure to avoid movement of the gland. The reporting was done with the current Bethesda nomenclature.Results: There were 150 cases of thyroid FNAC, 3 cases (2 %) were non-diagnostic (TBS-I), 133 cases (88.7 %) were benign (TBS-II), 6 cases (4 %) were atypical follicular lesion of undetermined significance (AFLUS) (TBS-III), 5 cases (3.4 %) were suspicious for follicular neoplasm (TBS-IV), 2 cases (1.3 %) were suspicious for malignancy (TBS-V), and 1 case (0.6 %) was malignancy (TBS-VI).Conclusions: The Bethesda system is very useful standardized system for reporting thyroid cytopathology, improving communication between cyto-pathologists and clinicians, inter-laboratory agreement, leading to more consistent management approaches.

Acinic cell carcinoma, papillary-cystic variant: a rare case diagnosed in fine needle aspiration cytology

Acinic Cell Carcinoma is a rarest malignant epithelial neoplasm arising from pleuripotent stem cells. ACC constitute 6% of all salivary gland tumor. Most common site is parotid. It is slowly growing tumor with female preponderance most commonly occur during fifth and sixth decades of life. Diagnosis by imaging study are complex, but USG is helpful in evaluating tumor. We are presenting a 9year female, complaint of a painless, freely movable, atraumatic swelling on left cheek measuring 2x1cm2, slowly enlarging since, 8 months. FNAC was performed from the swelling and routine stain (H and E, MGG, Pap) and special stain (PAS) was performed. On cytological smears, overall findings are suggestive of papillary-cystic variant of ACC which is difficult to diagnosed in cytology. PAS stain showed positivity for both intra-cytoplasmic granules and extra-cellular secretions. ACC is a slowly growing multi-potent malignant salivary gland tumor. Management is with surgery

A rare case of multilocular cystic renal neoplasm of low malignant potential diagnosed on intra-operative fine needle aspiration cytology

Multi-locular Cystic Renal Cell Carcinoma (MCRCC) is now considered as Multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) in World health organisation classification (WHO) 2016. It is usually seen in elderly people where it can mimic most of the time as benign cystic lesion. Authors are reporting a case of MCRNLMP in a 70 year male diagnosed intraoperative with the help of Fine Needle Aspiration Cytology (FNAC). Radiological and other clinical findings are in favour of cystic renal lesion. And it is very important to differentiate it from conventional renal cell carcinoma which requires radical nephrectomy. So, radiological finding and FNAC is instrumental in diagnosing this rare case which require different mode of surgical management

Autopsy findings in sudden death in adults: a study of 150 cases

Background: World Health Organization (WHO) defines sudden death as “deaths within 24 hours from the onset of the symptoms”. It is also defined as death, which is sudden, unexpected, clinically unexplained. Aims of the study was to classify underlying causes of sudden death, to find out risk factors, associated diseases and triggers of sudden deaths in the autopsy specimens received in the Department of Pathology, Government Medical College, South Gujarat.Methods: A review of autopsies of sudden deaths performed between January 2018 to August 2018 in age group 15-45 years at Department of Pathology, Government Medical College, South Gujarat were done.Results: A total of 150 cases were studied for sudden deaths during the study. The age ranged from 15 to 45 years. Maximum deaths occurred in the age group between 35-45 years. Males (n=120) were affected more than females (n=30). The cause of deaths in 84 cases (56%) were attributed to cardiac causes and the remaining cases (44%) were due to noncardiac causes like pulmonary diseases (17.3%) followed by hepatobiliary diseases (5.4%), cerebrovascular (2%) and others like suicide by ingestion of poisoning, hanging and asphyxia (9.3%). Major cardiac cause for sudden deaths was Coronary Artery Disease (CAD) (95.2%).Conclusions: Sudden deaths were common in young adults and most are attributed to a cardiac cause. This study highlights the serious health concern in our society and a necessity to create awareness among the population at risk so that sudden deaths can be averted and life expectancy can be improved

Characteristic and trends of malaria in Surat district of Gujarat: a hospital based study

Background: Malaria is a major health problem and infects many individuals despite of various efforts to control it. The present study was aimed to observe characteristics of malaria, seasonal variation and prevalence of malaria in our region.Methods: This retrospective study was conducted in our institute from period of January 2012 to December 2012.  All the fever cases undergone investigations for malarial parasites were included in present study for defined time period.  All the laboratory data of the patients having fever were retrieved from the Pathology Laboratory of our institute.Results: out of total 32674 reports studied 4907(15.01%) were positive for malaria with overall Slide positivity rate and slide falciparum rate were 15.01% and 38.29% respectively. Incidence of malaria occurs throughout year with increased incidence of P. falciparum in monsoon.Conclusion: In the present study incidence of malaria was higher in monsoon in comparison to other seasons. But throughout the year no declining trends in incidence of malaria was observed. P. vivax malaria was more commonly observed in our study but incidence of P. falciparum increased in monsoon

Study of metastasis in lymph node by fine needle aspiration cytology: our institutional experience

Background:Fine needle aspiration cytology (FNAC) is a reliable as well as an inexpensive diagnostic method. It is suitable for the developing countries for the diagnosis of lymphadenopathy at any approachable site. Fine needle aspiration cytology not only confirms the presence of metastatic disease but also, in most cases, gives the clue regarding the origin of the primary tumor, prognosis as well in the management of patient for staging purposes. The aim of the study was to detect and diagnose metastasis in lymph nodes. Methods:A study was done of all metastatic lymph node lesions reported in Department of Pathology, Govt. Medical College, Surat from May 2011 to April 2012.Results:A total of 2355 cases of fine needle aspiration cytology were carried out of which 580 cases were of lymph node. Cytology results were positive for metastasis in 157 specimens (27.06%). The most common site was cervical lymph nodes. Maximum numbers of cases of metastatic tumors were in 41-50 yrs age group. There were 115 males and 42 females with a male predominance (Male:Female= 2.8:1). The most common malignancy was squamous cells carcinoma, seen in 118 cases (75.15%), followed by metastatic mammary carcinoma (13 cases, 8.29%). In 26 cases out of 580 cases, histopathological confirmation was done and diagnostic accuracy of FNAC was 100%. Conclusions:Fine needle aspiration cytology of lymphadenopathy is a useful tool in diagnosing metastatic lesions with good certainty

Calibration of the CMS hadron calorimeters using proton-proton collision data at root s=13 TeV

Methods are presented for calibrating the hadron calorimeter system of theCMSetector at the LHC. The hadron calorimeters of the CMS experiment are sampling calorimeters of brass and scintillator, and are in the form of one central detector and two endcaps. These calorimeters cover pseudorapidities vertical bar eta vertical bar ee data. The energy scale of the outer calorimeters has been determined with test beam data and is confirmed through data with high transverse momentum jets. In this paper, we present the details of the calibration methods and accuracy.Peer reviewe