Placental pathology in intra: uterine foetal deaths

Background: Intra-uterine foetal death (IUFD) is an agonizing and often unpredictable event. Most of the times, placental lesions are direct cause of perinatal morbidity and has an impact on management of further pregnancies. The objective of this study was to diagnose lesions of placenta in intra-uterine foetal deaths and to evaluate placental causes of intra-uterine foetal deaths.Methods: A retrospective study of 65 cases of IUFD within a period of 5 years from January 2007 to December 2011 was carried out in our institute.Results: Amongst 65 cases of IUFD, in 50 cases (77%) the cause of death was directly related to placenta while in 2 cases (3%) the cause was related to foetal abnormality. In 9 cases (13.8%) lesions of placenta were not directly leading to IUFD while unexplained causes were noted in 4 cases (6%).Conclusions: Placental examination plays a vital role in evaluating cause of IUFD

Histopathological study of precursor and neoplastic lesions of endometrium in endometrial samplings

Background: Endometrial lesion presenting as abnormal uterine bleeding, abdominal pain and menstrual irregularities form most common presenting complaint in women of reproductive age group and in premenopausal women. Endometrial sampling is a safe and effective diagnostic step in evaluation of abnormal uterine bleeding (AUB). The present study was carried out to establish histopathological diagnosis of precursor and neoplastic lesions of endometrial samplings in correlation with clinical details and other investigations.Methods: A two-year prospective study was carried out in the department of pathology in a tertiary care hospital from June 2013-May 2015 which included endometrial samplings of precursor and neoplastic lesions. All cases were analyzed histopathologically.Results: The study included 46 cases comprising 30% of total 153 endometrial samplings. Out of these, precursor lesions were 36 cases (23.6%) and malignant were 10 case (5.8%). The highest incidence of precursor lesions (endometrial hyperplasia) was in the age group of 41- 50 years. Among the precursor lesions, endometrial hyperplasia without atypia (86%) was the commonest observation followed by atypical hyperplasia (14%).Conclusions: For the correct evaluation of cases presenting with AUB, histopathological evaluation of endometrial samplings is the gold standard method

A parasitic myoma: clinicopathological study of a rare case

Leiomyoma is a benign tumour composed of smooth muscle cells with fibrous stroma and it is the commonest tumour amongst the tumours of uterus. As per FIGO classification system parasitic leiomyoma has no myometrial involvement or uterine attachment. These myomas get detached from the uterus and receive the blood supply from another source. The etiology and pathologic basis of these parasitic fibroids is not yet clearly understood. We report a rare case of parasitic myoma in a 29 years old female patient presented with abdominal discomfort and difficulty in micturition. Clinical examination and subsequent imaging studies revealed a pelvic mass. Histopathological examination of which proved it to be a parasitic myoma. Parasitic myoma is a rare entity which may be iatrogenically created after surgery particularly with morcellation technique. With increasing rates of laparoscopic procedures, surgeons should be aware of the possibility of formation of parasitic myoma and should take intraoperative precautions to minimise its formation

Papillary squamotransitional carcinoma of cervix: a series of four cases

Background: Carcinoma of cervix is the most common cancer in Indian women and squamous cell carcinoma is the principal histologic type. Papillary Squamotransitional carcinoma is a rare and distinctive variant of squamous cell carcinoma of the uterine cervix, which differs by histology and clinical behavior from conventional squamous cell carcinoma. It shows papillary architecture with fibrovascular cores lined by multilayered atypical epithelium and is known for local recurrence and late metastasis.Methods: 4 cases of papillary squamotransitional carcinoma of cervix were diagnosed on cervical punch biopsies. All 4 cases were analyzed histopathologically.Results: Patients ranged from 40 years to 70 years with pain in abdomen being commonest presenting symptom. All the cases showed papillary architecture with fibrovascular cores lined by multi-layered atypical epithelium. Three cell types were observed: Clear, intermediate and basaloid.Conclusions: Papillary Squamous Cell Carcinoma is a rare subtype of squamous cell carcinoma of cervix and is characterized by its aggressive behavior

An unusual case of huge hamartoma of breast in a 23 year old female: a case report

Breast hamartoma is an underdiagnosed and poorly recognized rare benign lesion, accounting for approximately 4.8% of all benign breast lumps. There is lack of awareness of the characteristic clinical and histologic features of this entity in clinicians and pathologists. The pathogenesis of the development of breast hamartoma is still not fully understood. A 23-year-old female presented with a huge painless lump in right breast. The lump was present since last nine years. It was previously of the size of a bean, which rapidly increased to the present size during her pregnancy. FNAC revealed features of lipoma. However, on histopathological examination diagnosis of Hamartoma was rendered. A definitive diagnosis of hamartoma is hard to achieve on clinical examination, imaging studies and fine needle aspiration cytology. A correlation of histology, imaging findings with clinical impression is necessary

TBCRC 019: A phase II trial of nanoparticle albumin-bound paclitaxel with or without the anti-death receptor 5 monoclonal antibody tigatuzumab in patients with triple negative breast cancer

Purpose: Tigatuzumab (TIG), an agonistic anti-DR5 antibody, triggers apoptosis in DR5+ human tumor cells without crosslinking. TIG has strong in vitro/in vivo activity against basal-like breast cancer cells enhanced by chemotherapy agents. This study evaluates activity of TIG and chemotherapy in patients with metastatic triple-negative breast cancer (TNBC). Experimental Design: Randomized 2:1 phase II trial of albumin-bound paclitaxel (nab-PAC) ± TIG in patients with TNBC stratified by prior chemotherapy. Patients received nab-PAC weekly × 3 ± TIG every other week, every 28 days. Primary objective was within-arm objective response rate (ORR). Secondary objectives were safety, progression-free survival (PFS), clinical benefit, and TIG immunogenicity. Metastatic research biopsies were required. Results: Among 64 patients (60 treated; TIG/nab-PAC n = 39 and nab-PAC n = 21), there were 3 complete remissions (CR), 8 partial remissions (PR; 1 almost CR), 11 stable diseases (SD), and 17 progressive diseases (PD) in the TIG/nab-PAC arm (ORR, 28%), and no CRs, 8 PRs, 4 SDs, and 9 PDs in the nab-PAC arm (ORR, 38%). There was a numerical increase in CRs and several patients had prolonged PFS (1,025+, 781, 672, 460, 334) in the TIG/nab-PAC arm. Grade 3 toxicities were 28% and 29%, respectively, with no grade 4–5. Exploratory analysis suggests an association of ROCK1 gene pathway activation with efficacy in the TIG/nab-PAC arm. Conclusions: ORR and PFS were similar in both. Preclinical activity of TIG in basal-like breast cancer and prolonged PFS in few patients in the combination arm support further investigation of anti-DR5 agents. ROCK pathway activation merits further evaluation

Trichomonas vaginalis: Clinical relevance, pathogenicity and diagnosis

Trichomonas vaginalis is the etiological agent of trichomoniasis, the most prevalent non-viral sexually transmitted disease worldwide. Trichomoniasis is a widespread, global health concern and occurring at an increasing rate. Infections of the female genital tract can cause a range of symptoms, including vaginitis and cervicitis, while infections in males are generally asymptomatic. The relatively mild symptoms, and lack of evidence for any serious sequelae, have historically led to this disease being under diagnosed, and under researched. However, growing evidence that T. vaginalis infection is associated with other disease states with high morbidity in both men and women has increased the efforts to diagnose and treat patients harboring this parasite. The pathology of trichomoniasis results from damage to the host epithelia, caused by a variety of processes during infection and recent work has highlighted the complex interactions between the parasite and host, commensal microbiome and accompanying symbionts. The commercial release of a number of nucleic acid amplification tests (NAATs) has added to the available diagnostic options. Immunoassay based Point of Care testing is currently available, and a recent initial evaluation of a NAAT Point of Care system has given promising results, which would enable testing and treatment in a single visit

The dominant Anopheles vectors of human malaria in the Asia-Pacific region: occurrence data, distribution maps and bionomic précis

<p>Abstract</p> <p>Background</p> <p>The final article in a series of three publications examining the global distribution of 41 dominant vector species (DVS) of malaria is presented here. The first publication examined the DVS from the Americas, with the second covering those species present in Africa, Europe and the Middle East. Here we discuss the 19 DVS of the Asian-Pacific region. This region experiences a high diversity of vector species, many occurring sympatrically, which, combined with the occurrence of a high number of species complexes and suspected species complexes, and behavioural plasticity of many of these major vectors, adds a level of entomological complexity not comparable elsewhere globally. To try and untangle the intricacy of the vectors of this region and to increase the effectiveness of vector control interventions, an understanding of the contemporary distribution of each species, combined with a synthesis of the current knowledge of their behaviour and ecology is needed.</p> <p>Results</p> <p>Expert opinion (EO) range maps, created with the most up-to-date expert knowledge of each DVS distribution, were combined with a contemporary database of occurrence data and a suite of open access, environmental and climatic variables. Using the Boosted Regression Tree (BRT) modelling method, distribution maps of each DVS were produced. The occurrence data were abstracted from the formal, published literature, plus other relevant sources, resulting in the collation of DVS occurrence at 10116 locations across 31 countries, of which 8853 were successfully geo-referenced and 7430 were resolved to spatial areas that could be included in the BRT model. A detailed summary of the information on the bionomics of each species and species complex is also presented.</p> <p>Conclusions</p> <p>This article concludes a project aimed to establish the contemporary global distribution of the DVS of malaria. The three articles produced are intended as a detailed reference for scientists continuing research into the aspects of taxonomy, biology and ecology relevant to species-specific vector control. This research is particularly relevant to help unravel the complicated taxonomic status, ecology and epidemiology of the vectors of the Asia-Pacific region. All the occurrence data, predictive maps and EO-shape files generated during the production of these publications will be made available in the public domain. We hope that this will encourage data sharing to improve future iterations of the distribution maps.</p