Hydatid cyst of the kidney: a case report and review of the literature

Primary involvement of the kidney is rare in case of hydatid disease. We present a case of primary left renal hydatid cyst in a 40 year old female patient admitted with left lumbar pain radiating to the back. Computed tomography of the patient was done and was suggestive of hydatid cyst involving the lower pole of the left kidney. The cyst was managed by left Nephrectomy with open surgical excision and preoperative course of Albendazole. This case emphasizes on better detection and evaluation of such rare cases to identify better treatment strategies

Study of haematological, biochemical profile and clinical presentation in dengue positive patients: 82 cases

Background: Dengue Fever (DF) is a self-limiting disease caused by arbovirus and transmitted by Aedes mosquitoes (Aedes aegypti and Aedes albopictus). It is one of the 17 neglected tropical diseases by WHO. Diagnosis of dengue depends mainly on the detection of IgM and IgG antibody, and NS1 antigen.Methods: The study was carried out in Department of Pathology, affiliated with a government hospital. It includes 82 dengue patients, admitted from August 2015 to August 2016. Haematological, biochemical profile, clinical signs and symptoms were recorded. The Tourniquet test was performed in all the patients on admission. Grading of dengue: DF/DHFI/DHFII/DHFIII/DHFIV. Grade III and IV were collectively called as Dengue Shock Syndrome.Results: Total 82 Dengue positive cases were studied, 52 (63%) were males and 30 (37%) were females. 24 (29%) patients were recorded in September 22 (27%) in October 19 (23%) in August. 12 (14.60%) had positive tourniquet test. Thrombocytopenia was present in 86.5 % patients. Majority cases were of classical dengue fever 51 (62.20%), 14 (17.07%) were of DHF I, 12 (14.63%) were of DHF II, 3 (3.66%) were of DHF III and 2 (2.44%) were of DHF IV.Conclusions: It is very important to correlate clinical examination with haematological and biochemical profile in dengue patients. Hematocrit value, leucopenia, thrombocytopenia, raised liver enzymes is very important to monitor dengue cases in their initial stages and thus facilitate early treatment. This would minimize morbidity and mortality arising out of serious complications of dengue fever

Histopathological analysis of lymph nodes in patient with clinical lymphadenopathy - 266 cases

Background: Lymphadenopathy is one of the most common clinical presentations among patients of all ages. This study has undertaken to study the histological patterns in various non-neoplastic condition, lymphoma and metastatic carcinoma in patient with lymphadenopathy and to do the clinico-pathological correlation with respect to age, sex and site of lymph node involved.Methods: Total 266 cases of lymph node biopsy were studied, for a period of 28 months at Pathology department, Government Medical College, Surat, Gujarat, India. Tissues were adequately fixed in formalin and blocks prepared, sections cut and slides were prepared, stained by routine H&E stain. A complete and thorough histopathological examination of all the slides was undertaken.Results: A total of 266 cases were studied, age range was 1-75 years, 136 were males and 130 were females. Out of 266 cases, 96 cases (36%) were non-specific lymph node hyperplasia, 81 cases (31%) were of metastatic deposits in lymph node, 70 cases (26%) were of specific non neoplastic conditions and 19 cases (7%) were of lymphoma.Conclusions: Lymph node biopsy plays an important role in establishing the cause of lymphadenopathy. Among the biopsied nodes, non-specific lymph node hyperplasia was the most common followed by metastatic deposits, specific non neoplastic conditions especially tuberculous lymphadenitis and lymphoma. Non neoplastic conditions were more common in early age while neoplastic conditions were more common in late age. TB lymphadenitis was more common in HIV positive patients as compared to general population.

Role of immunohistochemistry in the differential diagnosis of malignant small round cell tumor: a study of 38 cases

Background: : Immunohistochemistry play a very important role in modern surgical pathology especially for identification of tumors lacking the evidence of lineage differentiation on the basis of routine Hematoxylin and Eosin (H&E) stain alone. More than 90% of the tumor with diagnostic difficulties by routine H & E stain could be very well classified by using IHC. The aim of present study is to classify and identify MSRCT.Methods: The study was carried out in Department of Pathology, Government Medical College in a period from August 2008 to November 2011. Total 38 cases of MSRCT are selected for Immunohistochemical staining (IHC) and they are classified and categorized accordingly after IHC.Results: Out of 38 cases of  MSRCT, there are 18 cases (47.36%) of non-Hodgkin lymphoma, 3 (7.89%) cases of Neuroblastoma,  3 (7.89%) cases of Synovial Sarcoma, 2 (5.26%) cases of Ewing Sarcoma, 2 (5.26%) cases of Undifferentiated neuroendocrine carcinoma,  2 (5.26%) case of Desmoplastic Small Round Cell Tumor, 1 (2.63%) case of  Primitive Neuroectodermal Tumor, 1 (2.63%) case of Amelanotic Melanoma (Small cell variant), 1 (2.63%)  case of  Anaplastic Dysgerminoma, 1 (2.63%)  case of Osteosarcoma, 1 (2.63 %) case of Wilm's tumor, 1 (2.63%)  case of  Dendritic cell Tumor Testis, 1 (2.63%) case of Undifferentiated Nasopharyngeal Carcinoma, 1 (2.63%) case of  Embryonal rhabdomyosarcoma.Conclusions: IHC is very valuable tool for adequate and accurate categorization of MSRCT.

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

Clinical, biochemical and haematological changes in leptospirosis

Background: Leptospirosis is a globally important zoonotic disease caused by pathogenic leptospira. Leptospira species are spirochetes belonging to the order spirochetes and the family leptospiraceae. Present study is done to find out the incidence of thrombocytopenia in leptospirosis and to correlate it with other parameters like renal dysfunction, hepatic dysfunction and bleeding manifestation.Methods: Study includes 51 clinically suspected and diagnosed cases of leptospirosis, in Government hospital, South Gujarat, during a period from January 2017 to December 2017. Clinical signs and symptoms and complications, biochemical profile like bilirubin and creatinine, haematological profile like Hb, WBC count and platelet count were recorded. Thrombocytopenia was defined as a platelet count below 1,50,000/cmm.Results: The present study includes 51 cases of Leptospirosis. Age ranged from 16 years to 61 years (male-39 and Females-12) There were 38 (74.5%) cases with thrombocytopenia and 13 (25.4%) cases with normal platelet count. Out of 38 thrombocytopenic cases, 32 (84.2%) cases had renal dysfunction, 26 (68.4%) cases had hepatic dysfunction and 16 (42.1%) cases had pulmonary haemorrhage. Among 13 cases with normal platelet count, 8 (61.5%) cases had hepatic dysfunction and 7 (53.8%) cases had renal dysfunction and 3 (23%) cases had pulmonary haemorrhage.Conclusions: Thrombocytopenia is a frequent complication (present in more than half of the patient) in leptospirosis and associated with more frequent and more severe complications. Therefore, early recognition of thrombocytopenia is recommended to prevent complications and mortality in leptospirosis

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

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

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

Shifting trends of lung tumours and its diagnosis by lung biopsy: a study of 78 cases

Background: The objective of the study was to study the spectrum of pathological lesions in patients with lung mass and to study correlation between clinical findings, histopathological pattern and immunohistochemical stains in various biopsy specimen for differentiation and typing of tumors.Methods: This retrospective study was done for the period of three years at Department of Pathology, New Civil Hospital, Surat, India, which is a tertiary health care Centre. Here we studied 78 cases of lung biopsy received in formalin, which were subjected to histopathological examination. Immunohistochemistry was performed as and when required.Results: Total 78 lung biopsy specimens were examined. Out of which, 59 cases (75.6%) were neoplastic, 12 cases(15.4%) were non-neoplastic and 7 cases (9%) were inconclusive. The commonest histological type of malignancy was adenocarcinoma which is associated with peripheral mass lesion, female gender and in non-smokers. Commonest non-neoplastic lesion was tuberculosis.  Malignancy was seen quite common in patients presented with lung masses in our institute.Conclusions: Lung tumours are quite common in patients presented with mass lesion. Similar to global trend, adenocarcinoma is the commonest histological type now and associated with change in incidence among women, in non-smokers, molecular alteration and prognosis which need further investigation. Immunohistochemistry is helpful in cases which are not accurately subtyped by histomorphology alone.