COMPARATIVE EVALUATION OF CYTOLOGICAL AND HISTOPATHOLOGICAL GRADING IN INVASIVE DUCTAL CARCINOMA BREAST: A CROSS-SECTIONAL STUDY

Objectives: Carcinoma breast is most commonly diagnosed cancer in women. Fine-needle aspiration cytology (FNAC) and histopathology play very important role in diagnosing breast cancer. Main objective of this study is to compare the cytological and histopathological grading in invasive ductal carcinoma of breast. Methods: The study was conducted in the Department of Pathology, Government Medical College, Patiala. Fifty patients with palpable breast lump were selected. The age of whom varied from 30 to 86 years. FNAC was done, smears were prepared and stained with Romanowsky and Papanicolaou stains. Cytological grading was done according to Robinson’s method. After surgery, the results were compared with histological grading according to Nottingham’s Modification of Bloom–Richardson method. Results: On cytological grading of 50 cases, 25 (50%) cases were graded as Grade II, 21 (42%) as Grade I, and 4 (8%) as Grade III. Whereas on histological grading, Grades I, II and III tumors were 17 (34%), 22 (44%), and 11 (22%), respectively. Overall concordance of cytological grading with histological grading was 76% with a kappa value of 0.605 and p<0.001. Conclusion: The study showed that the cytological grade correlates well with the histological grade. Cytological grade can be of great value in evaluating the aggressiveness of tumor, neoadjuvant chemotherapy and can be used as a prognostic factor for better management of patients

CYTOLOGICAL, HPV GENOME, AND HISTOPATHOLOGICAL CORRELATION OF CERVICAL SMEARS IN FEMALES 30 YEARS AND ABOVE

Objectives: The objectives of the study were to evaluate the patterns of cervical smear cytology in relation to human papillomavirus (HPV) and to correlate with histopathological diagnosis in females of 30 years and above. Methods: The 2-year prospective study was done in the Department of Pathology in 100 patients who attended the Gynaecology OPD of Govt. Medical College, Patiala. The cervical brushings obtained were subjected to cytological examination by liquid-based cytology through SurePath method and for HPV evaluation by BD Onclarity HPV assay. The cytological findings were further correlated with histopathological examination. Results: Majority of the females were in the age group of 30−45 years (62%). There was high incidence of dysplasia and malignancy in those who were of parity 3, 4, and above. The most common presenting symptom was discharge per vaginum (DPV) seen in 28% of cases. Maximum cases on cytology were diagnosed as NILM (including inflammatory pathology, 49%) followed by LSIL as 14% and malignant as 13%. Overall HPV genome was detected in 54% of the samples, the cases diagnosed as dysplasia and malignancy showed 68.42% and 100% presence of HPV, respectively. This was found to be statistically significant (p<0.05). Conclusion: Pap smear along with HPV evaluation is an effective screening method for the detection of pre-invasive lesions and cancers of cervix that are potentially curable

EOSINOPHILIC GASTRITIS- A RARE CAUSE OF GASTRIC WALL THICKNESS: A RARE CASE REPORT

Idiopathic eosinophilic gastroenteritis is a rare inflammatory disease of unknown origin, characterized by diffuse eosinophilic infiltration of the gastrointestinal tract, accompanied by varying abdominal symptoms related to the location, severity and depth of invasion. A 63-year old male was admitted to our hospital with complaints of abdominal pain and constipation. Physical examination revealed a distended abdomen with diffuse tenderness. Ultrasound showed free fluid in peritoneal cavity. An emergency laparotomy was performed for a diagnosis of peritonitis due to intestinal obstruction. Pylorus of stomach showed thickening of wall. A Gastric perforation with indurated and rolled margins was identified, gastrojejunostomy was performed and provisional diagnosis of malignant growth with complication of perforation was made but histologically, thickened wall of the stomach revealed dense infiltration of eosinophils and eosiniphilic gastroenteritis was diagnosed. KEYWORDS: Eosinophils, Gastroenteritis; Eosinophilic gastroenteritis; Coticosteroid

EOSINOPHILIC GASTRITIS- A RARE CAUSE OF GASTRIC WALL THICKNESS: A RARE CASE REPORT

Idiopathic eosinophilic gastroenteritis is a rare inflammatory disease of unknown origin, characterized by diffuse eosinophilic infiltration of the gastrointestinal tract, accompanied by varying abdominal symptoms related to the location, severity and depth of invasion. A 63-year old male was admitted to our hospital with complaints of abdominal pain and constipation. Physical examination revealed a distended abdomen with diffuse tenderness. Ultrasound showed free fluid in peritoneal cavity. An emergency laparotomy was performed for a diagnosis of peritonitis due to intestinal obstruction. Pylorus of stomach showed thickening of wall. A Gastric perforation with indurated and rolled margins was identified, gastrojejunostomy was performed and provisional diagnosis of malignant growth with complication of perforation was made but histologically, thickened wall of the stomach revealed dense infiltration of eosinophils and eosiniphilic gastroenteritis was diagnosed. KEYWORDS: Eosinophils, Gastroenteritis; Eosinophilic gastroenteritis; Coticosteroid

THE INCIDENCE OF BETA-THALASSEMIA MINOR IN PREGNANT FEMALES BY MEASURING HBA2 THROUGH HIGH PERFORMANCE LIQUID CHROMATOGRAPHY

Objectives: The aim of the study was to study the incidence of thalassemia minor by determining HbA2 levels in pregnant females attending Obstetrics and Gynaecology OPD and HbA2 levels of husbands of positive females for beta-thalassemia trait. Methods: The prospective study spanning over 1½ years was conducted in the Department of Pathology in 1020 pregnant females who attended the Gynaecology and Obstetrics OPD of Government Medical College, Patiala for antenatal check-up. The pregnant females of any trimester without any specific sign and symptoms whose Hb level was <10 g/dL were screened in the study. Levels of HbA2 and HbF were determined by high performance liquid chromatography (HPLC) and the cases with raised HbA2 value above the cutoff limit (>3.5%) were labeled as BTT. Husbands of BTT positive females were also screened for the trait. Incidence of all these cases was calculated and analyzed statistically. Results: The majority of the females were in the age group of 21–30 years. In present study, we found that total 134 (13.1%) patients were having beta thalassemia trait. Husbands of all these positive patients were also screened for BTT and only 2 (1.49%) of them were found to be positive. Conclusion: HPLC has the advantage for screening and detection of various hemoglobinopathies by providing rapid and accurate results. HPLC can detect and measure HbF and HbA2 in a single system. Early diagnosis and management of thalassemia can help in reduction of burden on society as well as government