38 research outputs found
Mixed invasive fungal infections among COVID-19 patients
Background and Purpose: The healthcare system in India collapsed during the secondwave of the COVID-19 pandemic. A fungal epidemic was announced amid the pandemic with several cases of COVID-associated mucormycosis and pulmonary aspergillosis being reported. However, there is limited data regarding mixed fungal infections in COVID-19 patients. Therefore, we present a series of ten consecutive COVID-19 patients with mixed invasive fungal infections (MIFIs).Materials and Methods: Among COVID-19 patients hospitalized in May 2021 at atertiary care center in North India, 10 cases of microbiologically confirmed COVID-19-associated mucormycosis-aspergillosis (CAMA) were evaluated.Results: All patients had diabetes and the majority of them were infected with severeCOVID-19 pneumonia (6/10, 60%) either on admission or in the past month while twowere each of moderate (20%) and mild (20%) categories of COVID-19; and were treatedwith steroid and cocktail therapy. The patients were managed with amphotericin-B along with surgical intervention. In total, 70% of all CAMA patients (Rhizopus arrhizus with Aspergillus flavus in seven and Aspergillus fumigatus complex in three patients)survived.Conclusion: The study findings reflected the critical importance of a high index ofclinical suspicion and accurate microbiological diagnosis in managing invasive dualmolds and better understanding of the risk and progression of MIFIs among COVID-19patients. Careful scrutiny and identification of MIFIs play a key role in theimplementation of effective management strategies
Sellar lesion: Not always a pituitary adenoma
Inflammatory lesions of the hypophysis account for 0.5% of all symptomatic diseases of the pituitary, which include lymphocytic hypophysitis, granulomatous hypophysitis with or without specific etiology and pituitary abscess. Sellar tuberculoma is a rare type of granulomatous hypophysitis. We document a case of a postmenopausal lady who presented with galactorrhea, headache and blurring of vision. Based on preliminary investigations, a clinical diagnosis of pituitary adenoma was made and the pituitary gland was surgically excised. Histopathological examination showed caseating granulomas, along with normal areas of preserved pituitary gland and a final diagnosis of tuberculous hypophysitis was made. This case is being documented due to the extremely rare involvement of the pituitary gland by granulomatous lesions such as tuberculosis and to emphasize the role of intraoperative consultation to obviate the need for radical surgery in such lesions
Role of scrape cytology in ovarian neoplasms
<b>Aim:</b> The present study was done to evaluate the role of scrape cytology in the diagnosis of ovarian neoplasm and its utilization for teaching pathology residents. <b> Materials and Methods:</b> This was a prospective study on 50 solid/solid-cystic ovarian neoplasms sent in 10% buffered formalin. Scrapings obtained from the fresh cut surface of tumors were smeared uniformly on to glass slides, immediately fixed in 95% ethyl alcohol and stained with hematoxylin and eosin stain. <b> Results:</b> The overall diagnostic accuracy of scrape cytology has been satisfactory with 92% of cases correlating with the final diagnosis. Characteristic cytological pattern was noted in various types of surface epithelial, sex cord stromal and germ cell tumors. The technique had limited value in mucinous tumors to distinguish borderline cases from invasive carcinoma. Two mucinous carcinomas were diagnosed as borderline mucinous tumor and two endometrioid carcinomas were misinterpreted as cystadenocarcinoma on scrape cytology. Formalin did not interfere or produce any remarkable changes in cytomorphology. <b> Conclusions:</b> Scrape cytology is a simple, rapid, accurate, inexpensive adjunctive cytodiagnostic technique and its routine utilization in ovarian lesions could aid in expanding the cytological knowledge of ovarian neoplasms
Circumscribed Congenital Alopecias Harbouring Dual Lesions
Treatment of alopecia is often challenging for the clinician as it includes a spectrum of lesions ranging from congenital to acquired causes. We present three cases of congenital circumscribed alopecia, present since birth, clinically diagnosed as nevus sebaceous. Histopathological examination of the excised tissue showed syringocystadenoma papilliferum with dermatophytosis in one and nevus sebaceous with dermatophytosis in the other two cases. Although complete excision is the treatment of choice for these lesions, an antifungal agent is needed to eradicate the concurrent superficial mycosis. A careful histopathological examination of the lesional skin helps in identifying such unexpected dual lesions that would need further treatment
Characterization of morphologically benign biologically aggressive meningiomas
Background : Meningiomas are presently categorized into three grades by
World Health Organization (WHO). Grade I, in general, is expected to
behave in a benign fashion. However, a borderline group of grade I
meningioma also exists, which may behave aggressively. Aims and
Objective : To evaluate the proliferation index and p53 antigen
expression of meningiomas and correlate with histological grade and
clinical course. Materials and Methods : All 123 cases of meningiomas,
diagnosed between January 2000 and August 2007, were regraded according
to WHO 2000 criteria. Immunostaining for Ki-67 antigen and p53 protein
were performed on 68 cases selected for the study. Results : Six of
the 68 cases presented with recurrence. Mean Ki-67 labeling index
(Ki-67 LI) was 3.8%, 13.7%, 19.4% for grade I, II, and III cases,
respectively. Multivariate analysis of mean Ki-67 LI showed
statistically significant difference between subgroups. Mean p53
expression was found to be 15.5%, 57%, 60.8%, and 62.5% for grade I,
II, III, and recurrent cases, respectively. Multivariate analysis of
mean p53 expression showed no statistically significant difference
between higher grades. All recurrent cases were histologically WHO
grade I, and showed a high Ki-67 LI and p53 expression with mean Ki-67
LI and p53 expression of 8.6% and 62.5% respectively. Conclusion :
Utilization of markers for proliferation and cell cycle regulators in
combination with histopathological features helps in the identification
of a subset of biologically aggressive morphologically benign
meningiomas