1
|
Singh A, Phulware RH, Kumar A, Kishore S. Embryonal Rhabdomyosarcoma of the Prostate: Clinico-Pathological Highlights with Review of Literature. J West Afr Coll Surg 2024; 14:225-228. [PMID: 38562397 PMCID: PMC10980313 DOI: 10.4103/jwas.jwas_36_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 10/16/2023] [Indexed: 04/04/2024]
Abstract
Rhabdomyosarcoma (RMS) is the third most common extra-cranial sarcoma occurring in childhood, adolescents, and young adults (AYAs); and is rare in adults. Literature about RMS mainly considers RMS in AYAs, either with that in the children or adults, even though histological, molecular, and clinical characteristics of RMS in AYAs are significantly different from either of the two. Herein, we report a case of prostatic embryonal RMS, in a 17-year-old boy, along with the review of literature of prostatic RMS, with emphasis on AYAs. Our patient presented with clinical complaints of acute urinary retention, Grade IV prostatomegaly and, low serum prostate-specific-antigen (0.11ng/dl). The diagnosis was clinched by prostatic biopsy, which revealed diffuse 'small round blue cell' tumour admixed with larger rhabdomyoblasts, displaying positivity for desmin and myogenin, on immunohistochemistry. Clinicians should be mindful that RMS is found in all age groups ranging from childhood to adults; however, the clinical, histological, and molecular features are different. RMS in AYAs is often treated according to the guidelines provided for the paediatric age group. Treatment mostly comprises a multimodality approach, including surgery with/without chemo- and radiotherapy. Prognosis in AYAs is worse than in children but is better than in adults. Thus, early diagnosis gains utmost importance to provide comparatively more probability of rendering treatment and, hopefully, a better quality of life.
Collapse
Affiliation(s)
- Anshima Singh
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Gorakhpur, Uttar Pradesh, India
| | - Ravi Hari Phulware
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Arvind Kumar
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| |
Collapse
|
2
|
Kiran K, Chowdhury N, Singh A, Malhotra M, Kishore S. The Relationship of Grade, Stage and Tobacco Usage in Head and Neck Squamous Cell Carcinoma With p53, PIK3CA and MicroRNA Profiles. Cureus 2024; 16:e54737. [PMID: 38524071 PMCID: PMC10960946 DOI: 10.7759/cureus.54737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Head and neck squamous cell carcinoma (HNSCC) has multiple epigenetic modifications including post-transcriptional regulation by microRNAs (miRNAs) as well as alterations in molecular pathways due to mutations. Examining these miRNAs and location-specific molecular alterations is essential to understanding the intricacies of HNSCC and directing focused diagnoses and treatments. AIM To investigate tobacco-related changes in the expression of miRNAs and proteins with clinicopathological parameters of HNSCC and disease-modifying personal habits like tobacco and alcohol use. METHODOLOGY The study concentrated on oropharyngeal cancers using immunohistochemistry and reverse transcription-polymerase chain reaction. Expression of microRNAs mir15a, mir20b, mir21, mir31, mir33b, mir146a, mir155, mir218, mir363 and mir497 and immunohistochemical expression of P53 and PIK3CA were correlated with grade, stage and personal habits like tobacco and alcohol intake. RESULTS mir21 and mir15a are under-expressed in higher grades with a trend towards statistical significance (P-value of 0.094 and 0.056 by one-way analysis of variance (ANOVA) on ΔCT values). mir155 and mir146a are overexpressed in stage IV tumours while mir 31 is under-expressed in stage IV tumours but statistical significance was not reached. mir497 showed overexpression in tobacco users, but these results were limited by many tumours not showing any amplification for the miRNA and statistical significance was not reached. There was no statistically significant association found between immunohistochemical expression of p53 and PIK3CA with grade, stage or personal habits. CONCLUSION Through the deciphering of complex miRNA patterns and their relationships with clinicopathology, this study attempted to increase our understanding of HNSCC. Some candidate miRNAs showing probable association with grade, stage and personal habits were identified, but larger studies are needed to confirm or refute the importance of these miRNAs.
Collapse
Affiliation(s)
- Kamini Kiran
- Oral Pathology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Nilotpal Chowdhury
- Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Ashok Singh
- Pathology/Histopathology/Renal Pathology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Manu Malhotra
- Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Sanjeev Kishore
- Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| |
Collapse
|
3
|
Singh A, Phulware RH, Kumar A, Kumar A, Kishore S. Actinomycotic osteomyelitis of maxillary sinus and hard palate in a post-COVID-19 patient. INDIAN J PATHOL MICR 2023; 0:00004270-900000000-99958. [PMID: 38394400 DOI: 10.4103/ijpm.ijpm_68_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Affiliation(s)
- Anshima Singh
- Department of Pathology, All India Institute of Medical Sciences (AIIMS), Gorakhpur, Uttar Pradesh, India Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | | | | | | | | |
Collapse
|
4
|
Thapa S, Phulware RH, Kumar A, Kishore S. Cytomorphological Features of Complex Fibroadenoma Breast. J Cytol 2023; 40:220-222. [PMID: 38058663 PMCID: PMC10697316 DOI: 10.4103/joc.joc_58_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/05/2023] [Accepted: 09/13/2023] [Indexed: 12/08/2023] Open
Affiliation(s)
- Samikshya Thapa
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi H. Phulware
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Arvind Kumar
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
5
|
Mani R, Gupta A, Gupta S, Goyal B, Mishra R, Tandon A, Sharma O, Rohilla KK, Kishore S, Dhar P. Expression of ER, PR, and HER-2 Neu and correlation with tumor markers in gall bladder carcinoma. J Cancer Res Ther 2023; 19:1279-1287. [PMID: 37787296 DOI: 10.4103/jcrt.jcrt_1754_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Background Females having a large proportion of gallbladder carcinoma (GBC) and a higher incidence of gallstones pointed toward the role of sex hormones in GBC development. In this study, we evaluated the expression of Estrogen receptor (ER), Progesterone receptor (PR), and Her2/neu and their correlation with tumor markers and clinicopathological parameters in the GBC. Methods A total of 50 patients of GBC and 42 patients in control group undergoing surgery for other conditions were taken. The patient's biopsy sample's paraffin block was tested for ER, PR, and Her2/neu expression by immunohistochemistry. Results ER and PR had no significant expression in GBC and control group, but Her2/neu had 16% expression in GBC, significantly associated with the degree of differentiation with 62.5% (n-5) being well-differentiated; 75% of Her2/neu positive were in stages III and IV. Her2/neu did not correlate with tumor markers despite expression. Conclusions Her2/neu amplification is a small step in validating that option so it could be included in the treatment and prognostication of GBC.
Collapse
Affiliation(s)
- Rishit Mani
- Department of Surgery, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Amit Gupta
- Department of Surgery, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Sweety Gupta
- Department of Radiation Oncology, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Bela Goyal
- Department of Biochemistry, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Rahul Mishra
- Department of Surgery, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Amoli Tandon
- Department of Surgery, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Oshin Sharma
- Department of Surgery, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Kusum K Rohilla
- Department of Nursing, College of Nursing, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Puneet Dhar
- Department of Surgical Gastroenterology, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| |
Collapse
|
6
|
Bahadur A, Bhattacharya N, Mundhra R, Khoiwal K, Chawla L, Singh R, Naithani M, Kishore S. Comparison of Human Epididymis Protein 4, Cancer Antigen 125, and Ultrasound Prediction Model in Differentiating Benign from Malignant Adnexal Masses. J Midlife Health 2023; 14:176-183. [PMID: 38312761 PMCID: PMC10836431 DOI: 10.4103/jmh.jmh_77_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/01/2023] [Accepted: 07/22/2023] [Indexed: 02/06/2024] Open
Abstract
Background This study aimed to compare the diagnostic performance of carcinogenic antigen (CA) 125, (HE)-4 (Human epididymis protein 4), and ultrasound (International Ovarian Tumor Analysis [IOTA]) Simple Rules individually and to derive a composite score in the differentiating ovarian cancer from benign ovarian mass. Subjects and Methods Consecutive patients (n = 100) with pelvic mass admitted during February 2018-August 2019 were included prospectively. Patients with either known case of epithelial ovarian cancer (EOC) or metastatic EOC were excluded. The primary outcome was to assess the sensitivity and specificity of CA-125, HE-4, and IOTA Simple Rules in predicting benign from malignant mass independently, while secondary outcome was derivation of a new model incorporating these variables using multivariate logistic regression analysis to predict benign from malignant lesions. Receiver operator curve (ROC) was drawn to redefine the best-performing cutoff values and difference between area under the ROC (AUROC) were compared by DeLong's method. Results Out of 100 cases of adnexal mass selected, the sensitivity and specificity of CA-125 were 73.8% and 77.6%, HE-4 were 90.5% and 87.9%, and IOTA Simple Rules were 92.9% and 81.0%. CA-125, HE-4, and IOTA Simple Rules were independently associated with the likelihood of malignancy/borderline (P < 0.001). The area under the curve for the "composite score" (AUC = 0.93) was the highest and was significantly better than that of CA-125 (AUC = 0.786) (P = 0.004 using DeLong's test) and comparable with HE-4 (AUROC = 0.90; P = 0.128 using DeLong's Test). Conclusion The sensitivity and specificity of HE-4 and IOTA Simple Rules for predicting malignant ovarian tumor was better than those of CA-125. The diagnostic performance of "composite score" was comparable to those of either HE-4 or IOTA Simple Rules and significantly better than CA-125.
Collapse
Affiliation(s)
- Anupama Bahadur
- Department of Obstetrics and Gynaecology, AIIMS, Rishikesh, Uttarakhand, India
| | | | - Rajlaxmi Mundhra
- Department of Obstetrics and Gynaecology, AIIMS, Rishikesh, Uttarakhand, India
| | - Kavita Khoiwal
- Department of Obstetrics and Gynaecology, AIIMS, Rishikesh, Uttarakhand, India
| | - Latika Chawla
- Department of Obstetrics and Gynaecology, AIIMS, Rishikesh, Uttarakhand, India
| | - Rajni Singh
- Department of Obstetrics and Gynaecology, AIIMS, Rishikesh, Uttarakhand, India
| | - Manisha Naithani
- Department of Biochemistry, AIIMS, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, AIIMS, Rishikesh, Uttarakhand, India
| |
Collapse
|
7
|
Jahan M, Mittal A, Rao S, Kishore S, Singh A, Jadli M, Paul P, Iqbal A, Chowdhury N. Cytomorphologic visualization of circulating tumor cells in urinary bladder cancer patients using ScreenCell™ technology: Potential as a simple cytology test. Diagn Cytopathol 2023. [PMID: 37067512 DOI: 10.1002/dc.25141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/02/2023] [Accepted: 04/07/2023] [Indexed: 04/18/2023]
Abstract
Circulating tumor cells (CTC) are a recent technique which is a potentially important prognostic factor in many solid tumors. There are many techniques of detecting CTCs, but they usually implement costly techniques like EpCAM targeted detection, fluorescence-based diagnosis, or magnetic bead based positive or negative selection. The diagnostic utility of simple cytomorphological diagnosis after routine staining of CTCs have been rarely studied. We aimed to detect CTCs in 24 patients clinically suspected to have Urinary Bladder Cancer using a simple but efficient patented filtration technology (ScreenCell™), followed by optical microscopic visualization after routine May-Grunwald-Giemsa (MGG) staining. The detected CTCs were then tested for association with the histologic type, lamina propria invasion, deep muscle invasion and the T-stage. Out of the 24 patients tested, one was found to have papilloma, nine had low grade urothelial carcinoma, 13 had high grade urothelial carcinoma and one had poorly differentiated adenocarcinoma. Of these, two LGUC, eight HGUC and one adenocarcinoma had detectable CTC. Presence of CTCs had a statistically significant association with Lamina propria invasion (P = .006) and T-stage (P = .02), and a trend toward significance for differentiating LGUC from HGUC (P = .10). These results suggest that cytomorphological detection of CTC is likely to be clinically useful in diagnosis and prognostication of urinary blader cancers. These findings need to be confirmed on studies with larger sample sizes.
Collapse
Affiliation(s)
- Meriyam Jahan
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Ankur Mittal
- Department of Urology, All India Institute of Medical Sciences, Rishikesh, India
| | - Shalinee Rao
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Sanjeev Kishore
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Ashok Singh
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Mohit Jadli
- Multidisciplinary Research Unit, All India Institute of Medical Sciences, Rishikesh, India
| | - Pranoy Paul
- Multidisciplinary Research Unit, All India Institute of Medical Sciences, Rishikesh, India
| | | | - Nilotpal Chowdhury
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
- Multidisciplinary Research Unit, All India Institute of Medical Sciences, Rishikesh, India
| |
Collapse
|
8
|
Singh B, Phulware RH, Baishya P, Singh A, Durgapal P, Kumar A, Hazarika N, Kishore S. Epidermoid Cyst: An Esthetic Challenge, If Neglected-A Comprehensive Analysis of 217 Cases. J Cutan Aesthet Surg 2023; 16:140-144. [PMID: 37554672 PMCID: PMC10405554 DOI: 10.4103/jcas.jcas_81_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
Background An epidermoid cyst is a benign keratin-filled cyst, commonly located in the face, scalp, neck, and trunk. Although it is a common benign cystic neoplasm, large series of analyses in English literature are still scarce. To comprehend the clinical and pathological variation of epidermoid cysts in the sub-Himalayan region of India, as well as their clinical implications for late diagnosis, a retrospective study on epidermoid cysts was conducted. Materials and Methods This was a retrospective observational study conducted on 217 cases of epidermoid cyst subjected for fine-needle aspiration cytology over a period of 3.6 years (from 2018 to 2021). The clinical details and other epidemiological data were archived from the pathology requisition forms. Results It showed slight male preponderance with head and neck site as the most common area. Most patients were adults. Few uncommon sites were also seen namely breast, parotid, epididymis, and tonsils. Few large lesions were identified measuring up to 10 cm. The skin changes were seen in 5.5% cases, 0.9% cases show extreme ulceration, and 4.1% cases show foreign body giant cell reactions. Due to the province's steep terrain and limited access to medical services, the majority of patients arrived at out patient department (OPD) late. Conclusion The findings suggest that fine-needle aspiration can be used as a quick diagnostic test even in remote areas by the general practitioner who can send the slides for evaluation to a pathologist. Many times, clinically looking epidermoid cyst can reveal certain challenging entities such as a biphasic fibroepithelial tumor with cystic squamous metaplasia and proliferating pilar tumor in our series. The study of this lesion is also needed for early diagnosis as long-standing lesion may rupture and cause requirement of extensive treatment followed cosmetic impairment.
Collapse
Affiliation(s)
- Bhagyshree Singh
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Ravi H Phulware
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Pakesh Baishya
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Ashok Singh
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Prashant Durgapal
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Arvind Kumar
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Neirita Hazarika
- Department of Dermatology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| |
Collapse
|
9
|
Singh D, Kumar A, Gowda V, Sahai R, Kumar S, Kishore S. An adding up of an exceptionally rare case report: Primary Squamous cell carcinoma of Jejunum from North India. J Cancer Res Ther 2023; 19:S451-S453. [PMID: 37148011 DOI: 10.4103/jcrt.jcrt_1333_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Squamous cell carcinoma (SCC) of lower gastrointestinal tract is a rare tumor and duodenum is the most common site of involvement. In addition, involvement of jejunum by SCC is further exceptionally rare, and only nominal cases are present world literature. Being a very infrequent finding, a clinician and a pathologist must be aware of this rare entity. Diagnosis requires histopathology along with clinico-radiological correlation since merely histopathology is unable to differentiate between primary and metastatic tumor. Treatment modality is totally different in primary and secondary tumor of lower gastrointestinal tract. Being an extremely rare case of primary SCC of jejunum in an elderly female makes it eligible to be acknowledged at the global platform of medical literature.
Collapse
Affiliation(s)
- Divya Singh
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, Uttarakhand, India
| | - Arvind Kumar
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, Uttarakhand, India
| | - Vinay Gowda
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, Uttarakhand, India
| | - Rishabh Sahai
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, Uttarakhand, India
| | - Sudhir Kumar
- Department of General Surgery, AIIMS, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, Uttarakhand, India
| |
Collapse
|
10
|
Martin L, Chang M, Miller S, Gupta A, Kishore S, Kothary N. Abstract No. 78 Association of Bilirubin and Overall Survival in Veterans who Receive Radioembolization for Hepatocellular Carcinoma Treatment. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
|
11
|
Dangi A, Debnath A, Kishore S, Jat S, Mudasir F, Nirmal T, Mukha R, Chandrasingh J, Kumar S, N’Dow J. Circumferential stricture segment metaplastic squamous mucosa & associated spongiofibrosis excision and urethroplasty by ventral approach with double face oral mucosal graft replacement. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01366-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
12
|
Muacevic A, Adler JR, Chandra A, Khanal A, Jha N, Kumar A, Phulware RH, Singh A, Durgapal P, Joshi P, Sundriyal D, Kishore S. Primary Malignant Melanoma of the Oral Cavity: A Retrospective Study From a Tertiary Care Centre of North India. Cureus 2022; 14:e32621. [PMID: 36654614 PMCID: PMC9841555 DOI: 10.7759/cureus.32621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mucosal melanoma is a rare but aggressive tumor associated with a poor prognosis arising from pigmented cells called melanocytes. They are usually asymptomatic and present in an advanced stage. It has an aggressive clinical outcome and is proven to be of poor prognosis. MATERIALS AND METHODS This is a retrospective review of the computer database and clinical records at the All India Institute of Medical Sciences, Rishikesh, India. The data between 2018-2022 were reviewed for all small biopsy or excision specimen-proven cases of oral mucosal melanoma. RESULTS The most common site of involvement in the head and neck region is the nasal cavity and paranasal sinuses. In this retrospective study from our institute, all three cases presented involved oral cavities. The median age of presentation was 51 years. Some literature specifies male preponderance. Our patients presented clinically with a black nodule in the oral cavity, which was increasing in size and associated with bleeding. A biopsy performed confirmed the diagnosis of melanoma based on the morphology and immunohistochemical profile of the tumor cells. CONCLUSION Surgical resection is the mainstay treatment, followed by radiation postoperatively to reduce local and regional recurrence. Mucosal melanoma has a poor prognosis, and the majority of patients develop incurable metastatic disease.
Collapse
|
13
|
Talwar HS, Panwar VK, Mittal A, Kishore S, Mandal AK. A Clinicopathological Correlation of Bladder Cancer in Young and Old Patients: Our Experience and Review of Literature. Indian J Surg Oncol 2022; 13:915-923. [PMID: 36687251 PMCID: PMC9845444 DOI: 10.1007/s13193-022-01575-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 06/28/2022] [Indexed: 01/25/2023] Open
Abstract
To compare the clinical, cystoscopic, and pathological characteristics of bladder cancer in patients younger than 40 years of age and those of patients older than 40 years of age. We conducted a prospective observational study at our department from September 2019 to February 2021 to compare the clinico-pathological characteristics of young and old patients with biopsy proven bladder cancer after a transurethral resection of bladder tumour. The patients were managed according to standard guidelines. Two hundred sixty-eight patients of bladder cancer were included in the analysis. Out of these, 58 patients were < 40 years of age and 210 were > 40 years. The mean age of two groups were 31.43 ± 6.30 vs 59.08 ± 9.87 years. With respect to tumour grade, 36.2% (versus 17.6%) of young patients had low grade tumour, and 58.6% had high-grade tumour (versus 82.4%). In the young population, 63.8% patients had NMIBC (versus 61.9%) and 36.2% had MIBC (versus 38.1%). Even in the NMIBC group, a large majority of young patients had high-risk disease (51.4%). The incidence of bladder cancer is on the rise in the northern belt of India, especially in the younger age group. High exposure to smoke and heavy metals in drinking water/occupation are the major risk factors. Majority of young patients aged < 40 years had a high-grade disease on presentation and a large subset had muscle invasive bladder cancer, contrary to previously reported studies.
Collapse
Affiliation(s)
- Harkirat Singh Talwar
- Department of Urology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand India 249203
| | - Vikas Kumar Panwar
- Department of Urology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand India 249203
| | - Ankur Mittal
- Department of Urology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand India 249203
| | - Sanjeev Kishore
- Department of Urology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand India 249203
| | - Arup Kumar Mandal
- Department of Urology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand India 249203
| |
Collapse
|
14
|
Thapliyal S, Singh J, Mamgain M, Kumar A, Bisht M, Singh A, Meena K, Kishore S, Handu S. Efficacy of Ferulic Acid in an Animal Model of Drug-Resistant Epilepsy: Beneficial or Not? Cureus 2022; 14:e30892. [DOI: 10.7759/cureus.30892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/05/2022] Open
|
15
|
Supehia S, Bahurupi Y, Singh M, Goel S, Kishore S, Aggarwal P, Sharma N. Compliance of vendors with legislation restricting the sale of tobacco near educational institutions in India. Int J Tuberc Lung Dis 2022; 26:883-885. [PMID: 35996286 DOI: 10.5588/ijtld.22.0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- S Supehia
- Department of Community and Family Medicine, Dr Rajendra Prasad Government Medical College, Kangra, India
| | - Y Bahurupi
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - M Singh
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - S Goel
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | | | - P Aggarwal
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - N Sharma
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| |
Collapse
|
16
|
Bhirud DP, Mittal A, Kumar S, Narain TA, Kishore S, Navriya SC, Ranjan SK, Panwar VK. When to Avoid a Restaging Procedure for Non-muscle Invasive Bladder Cancer? Inferences from a Tertiary Care Center. Indian J Surg Oncol 2022; 13:604-611. [PMID: 36187522 PMCID: PMC9515286 DOI: 10.1007/s13193-022-01516-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 01/31/2022] [Indexed: 11/30/2022] Open
Abstract
The increasing incidence of urinary bladder carcinoma is alarming. Approximately seventy percent of these patients are non-muscle invasive bladder cancer (NMIBC). Restage transurethral resection of bladder tumor (TURBT) is the current recommendation for any T1 and or high-grade non muscle invasive bladder cancers (NMIBC) to accurately stage the malignancy. The question whether a second surgery is always required as a restage procedure is still unanswered. The patient's concern about completeness, morbidity, and financial considerations of a major surgery cannot be overlooked. Moreover, it also puts a strain on the already overburdened healthcare system. To answer this question, whether it is oncologically sound to omit a second resection, the current study evaluated the outcomes of patients undergoing restage TURBT, and analyzed the preoperative factors predicting a change in the staging of this malignancy. The study design was a prospective observational including NMIBC patients from September 2018 to February 2020. A total of 72 patients underwent restage TURBT. Their demographic data, imaging and cystoscopic findings, and histopathological data were recorded. The objective was to study the clinico-pathological correlations and factors predicting recurrence and upstaging of tumor in NMIBC patients undergoing restage TURBT. A total of 101 patients were found eligible for restage TURBT. Eventually, 72 underwent restage TURBT. Twelve (16.7%) patient had recurrence at restage while 3(4.16%) were upstaged to T2. Presence of lower urinary tract symptoms (LUTS) was independently associated with the risk of recurrence of same stage compared to no recurrence (p-0.025, OR-8.793, 95% CI-1.316-98.773). Chemical exposure (p-0.042) was also significantly associated with the same. Presence of lymphadenopathy on CT was independently associated with the risk of upstaging compared to no recurrence (p-0.032, OR-18.25, 95% CI-1.292-257.85). The study concluded that in the presence of a well-performed and adequate initial TURBT, restage TURBT could be skipped for further management. However, in small subgroup of patients with lymphadenopathy on preoperative imaging having a higher risk of tumor recurrence and upstaging, and patients with a history of chemical exposure and previous lower urinary tract symptoms having a high risk of recurrence alone, restage TURBT should still be performed to accurately stage the disease. Further studies with large patient cohort are needed to confirm and reinforce the facts proposed. Supplementary Information The online version contains supplementary material available at 10.1007/s13193-022-01516-8.
Collapse
Affiliation(s)
| | - Ankur Mittal
- Department of Urology, AiimsRishikesh, Uttarakhand India 249203
| | - Sunil Kumar
- Department of Urology, AiimsRishikesh, Uttarakhand India 249203
| | | | | | | | | | | |
Collapse
|
17
|
Singh M, Kumari S, Kaushik B, Kumar A, Singh A, Phulware RH, Baishya P, Durgapal P, Chowdhury N, Rao S, Kishore S, Goyal B. Clinical and Biochemical Correlation With Cytomorphological Findings of Lymphocytic Thyroiditis: An Experience at a Tertiary Centre in the Himalayan Foothills. Cureus 2022; 14:e24127. [PMID: 35573548 PMCID: PMC9106563 DOI: 10.7759/cureus.24127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Lymphocytic thyroiditis is an autoimmune disorder and one of the major causes of hypothyroidism. On cytomorphology, it is characterized by follicular destruction by lymphocytes with elevated biochemical markers, including a panel of autoantibodies against thyroid antigens. This study aimed to determine the prevalence of various cytological features of lymphocytic thyroiditis and their correlation with clinical presentation and biochemical parameters. Materials and methods We conducted a hospital-based cross-sectional study of 105 patients diagnosed with lymphocytic thyroiditis on cytology at our tertiary care center in the Himalayan foothills from December 2018 to December 2019. We recorded and analyzed baseline demographic characteristics, clinical features, and biochemical parameters to assess correlations between cytological findings and grades. Results The study included 105 patients with lymphocytic thyroiditis (90 females, 15 males). The study population age ranged from 11 years to 80 years, with the disease most common in patients aged 21 to 40 years. Grade II was the most common cytological presentation (n=65, 62%). Thyroid-stimulating hormone levels were elevated in 33.3% of cases, and anti-thyroid peroxidase levels were elevated in all 25 cases for whom data were available (p>0.05). Conclusion Cytological diagnosis of lymphocytic thyroiditis was compatible in all cases in the study. However, cytological grading did not correlate with the clinical presentation and biochemical parameters. The diagnosis of lymphocytic thyroiditis could be missed if clinicians use clinical findings and biochemical parameters alone.
Collapse
|
18
|
Verma R, Singh A, Chowdhury N, Joshi PP, Durgapal P, Rao S, Kishore S. Evaluation of Histomorphological Parameters to Predict Occult Nodal Metastasis in Early-Stage Oral Squamous Cell Carcinoma. Turk Patoloji Derg 2022; 38:227-234. [PMID: 34978064 PMCID: PMC10508408 DOI: 10.5146/tjpath.2021.01566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 12/03/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The oral squamous cell carcinoma (OSCC) treatment protocol depends upon lymph node metastasis. Elective neck dissection for early-stage OSCC (pT1/T2) elective neck dissection reduces the morbidity rate. It also reduces the overall survival and thus it becomes important to detect lymph node metastasis in early-stage OSCC. MATERIAL AND METHOD Various histomorphological parameters have been studied to predict nodal metastasis in early-stage OSCC. We aim to evaluate these parameters in the context of nodal metastasis. 78 cases of early-stage OSCC were included in the study with histopathologic parameters like tumor size, grade, tumor depth of invasion (DOI), lymphovascular invasion (LVI), perineural invasion (PNI), worst pattern of invasion (WPOI), and lymph node level. RESULTS Out of the 78 patients, 32 patients had lymph node metastasis. T stage, DOI, LVI, and WPOI showed statistically significant deviance from the null model (P-values of 0.007, 0.01, 0.04 and 0.02 respectively). The Odds Ratio (OR) of T stage, DOI, LVI and WPOI were 4.45 (95% C.I =1.47-14.1), 4.4 (95% C.I =1.32-15.88), 8.12 (95% C.I =1.002-198.20), and 3.39 (95% C.I =1.24-9.74) respectively. On multivariate analysis (Firth logistic regression) using DOI, LVI, and WPOI as independent variables, only T-stage and WPOI retained statistical significance. CONCLUSION The prognostic information supplied by evaluating DOI, LVI, and WPOI warrants the inclusion of these parameters in the standard reporting format for all cases of OSCC.
Collapse
Affiliation(s)
- Rahul Verma
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India
| | - Ashok Singh
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India
| | - Nilotpal Chowdhury
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India
| | | | - Prashant Durgapal
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India
| | - Shalinee Rao
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India
| | - Sanjeev Kishore
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India
| |
Collapse
|
19
|
Sherwani P, Bolia R, Kaushik A, Kumar S, Kishore S, Chauhan U. An Unusual Cause of Cholestasis in an Infant: Biliary Atresia Type IIB. Indian J Radiol Imaging 2021; 31:689-692. [PMID: 34790315 PMCID: PMC8590570 DOI: 10.1055/s-0041-1736165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Biliary atresia (BA) is a progressive destructive cholangiopathy of unknown etiology that presents in early infancy. It has a worldwide frequency of 1:8,000–1:15,000 and is common in Asia than in the west. Based on the level at which the lumen of the extrahepatic duct is obliterated, BA is classified into three types. Type III is the commonest (∼85%) type and has the most proximal level of obstruction in the porta hepatis, while type II in which the atresia is at the level of the common hepatic duct, is the least common (∼2.5%) and has been rarely reported. Here, we report the imaging features of an infant with type IIB biliary atresia.
Collapse
Affiliation(s)
- Poonam Sherwani
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rishi Bolia
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ashish Kaushik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sumit Kumar
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Udit Chauhan
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
20
|
Kumar U, Anthony ML, Sahai R, Mittal A, Durgapal P, Kishore S. Immunoexpression of PD-L1 and PD-1 and Its Clinicopathological Correlation in Urothelial Carcinomas. J Lab Physicians 2021; 14:197-201. [PMID: 35982880 PMCID: PMC9381309 DOI: 10.1055/s-0041-1736480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction
Urothelial carcinomas are the most common types of bladder tumors that have recently shown a changing trend in treatment protocols with the introduction and approval of immune checkpoint inhibitors. The most important immune checkpoint lies with the PD-1–PD-L1 axis. Although multiple drugs have been approved, there is uncertainty about patient selection criteria and diagnostic assays. Recent studies related to the laboratory-developed tests have opened up the horizon of PD-1 and PD-L1 immunohistochemistry even at resource-constrained laboratories. We propose to study these immunohistochemistry markers in our laboratory using newer clones.
Materials and Methods
We selected 116 consecutive cases of transurethral bladder tumor resection from our laboratory archive and applied PD-1 and PD-L1 immunohistochemistry. The study was approved by the institution's ethics committee.
Results
We found high expression of PD-1 and PD-L1 in urothelial carcinoma even with different cut-offs of PD-L1. Muscle invasion, lamina invasion, and grade of carcinoma had a statistically significant effect on the expression; however, age and sex did not affect the expression.
Conclusion
Based on our current study, we can conclude that the clones used in our study show high expression in urothelial carcinoma and can aid in patient selection and treatment protocol, irrespective of age and sex.
Collapse
Affiliation(s)
- Utpal Kumar
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, Uttarakhand, India
| | | | - Rishabh Sahai
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, Uttarakhand, India
| | - Ankur Mittal
- Department of Urology, AIIMS, Rishikesh, Uttarakhand, India
| | - Prashant Durgapal
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, Uttarakhand, India
| |
Collapse
|
21
|
Gupta A, Gupta S, Rajput D, Durgapal P, Chennatt JJ, Kishore S, Rao S, Dhar P, Gupta M, Kant R. Expression and clinicopathological correlation of Ki-67 in gallbladder carcinoma. J Carcinog 2021; 20:11. [PMID: 34729043 PMCID: PMC8511828 DOI: 10.4103/jcar.jcar_9_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/01/2021] [Accepted: 05/12/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION: Gallbladder cancer is an aggressive cancer with short median survival from the time of diagnosis. Improved understanding of the pathological molecular mechanisms of gallbladder carcinogenesis is important to refine the diagnosis, prognosis, and also to develop novel targeted therapies for patients with advanced Gallbladder cancer (GBC) malignancy. Ki-67 is a marker of cell proliferation and its detection by immunohistochemistry is considered to be an effective method for the detection of prognosis in several tumors. In the present study, we have analyzed expression of immunohistochemical marker Ki-67 in gallbladder carcinoma and its correlation with clinicopathological and radiological parameters. MATERIALS AND METHODS: This prospective observational study was conducted from December 2017 to July 2020. The patients of newly diagnosed gallbladder cancer were enrolled as per the inclusion and exclusion criteria defined in the study protocol. Contrast-enhanced computer tomography of the chest and abdomen and serum tumor markers such as carbohydrate antigen (CA)-19.9, carcinoembryonic antigen, and CA 125 were done. Immunohistochemical expression of Ki-67 was evaluated on biopsy tissue from the gallbladder mass. RESULTS: Fifty newly diagnosed patients of carcinoma gallbladder were included in the present study. The correlation was studied between clinicodemographic parameters and Ki-67, but no association was found with age, gender, and symptoms. There was a weak positive correlation between Ki-67 and direct bilirubin, serum glutamic pyruvic transaminase, serum glutamic oxaloacetic transaminase, and alkaline phosphatase (P = 0.094; 0.126; 0.542; and 0.328, respectively). There was a weak positive correlation between body mass index (Kg/m2) and Ki-67, but this correlation was not statistically significant (P = 0.304). CONCLUSIONS: Ki-67 is a marker of proliferation and it correlated with histological differentiation, jaundice and liver function tests, presence of stones, and location of metastases but did not correlate with stage and extent of disease.
Collapse
Affiliation(s)
- Amit Gupta
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sweety Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Deepak Rajput
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Prashant Durgapal
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Jaine John Chennatt
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Shalinee Rao
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Puneet Dhar
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Manoj Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Kant
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
22
|
Ranjan SK, Mittal A, Kumar S, Kishore S, Narain TA, Mammen KJ. Papillary Renal Cell Carcinoma with Sarcomatoid Differentiation in a Native Kidney of Transplant Recipient: A Case Report and Review of Literature. Indian J Nephrol 2021; 31:386-389. [PMID: 34584356 PMCID: PMC8443092 DOI: 10.4103/ijn.ijn_239_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/23/2020] [Accepted: 08/18/2020] [Indexed: 11/13/2022] Open
Abstract
Renal cell carcinoma (RCC) developing in a transplant recipient is about 5–20 times higher than the general population. It is more common in native kidneys than graft kidney, and incidence varies between 0.3% and 4.8%. Clear cell and papillary types are more frequently reported. Most RCC of allograft recipient is usually low-grade with favorable prognosis. We present a case of papillary RCC with sarcomatoid differentiation (SD) in a native kidney of renal transplant (RT) recipient. The coexistence of sarcomatoid variant with papillary RCC, as in our case, makes it a high grade (WHO/ISUP grade 4) and portends a poor prognosis. Relative aggressiveness and rarity of this variant histology in transplant recipients prompted us to report this case and carry out an extensive search of the available literature.
Collapse
Affiliation(s)
| | - Ankur Mittal
- Department of Urology, AIIMS, Rishikesh, Uttarakhand, India
| | - Sunil Kumar
- Department of Urology, AIIMS, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, AIIMS, Rishikesh, Uttarakhand, India
| | - Tushar A Narain
- Department of Pathology, AIIMS, Rishikesh, Uttarakhand, India
| | - Kim J Mammen
- Department of Pathology, AIIMS, Rishikesh, Uttarakhand, India
| |
Collapse
|
23
|
Bhatia R, Hazarika N, Chandrasekaran D, Gupta V, Durgapal P, Kishore S. Treatment of Posttraumatic Reactive Angioendotheliomatosis With Topical Timolol Maleate. JAMA Dermatol 2021; 157:1002-1004. [PMID: 34106199 DOI: 10.1001/jamadermatol.2021.1770] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Riti Bhatia
- Department of Dermatology, Venereology and Leprosy, All India Institute of Medical Sciences, Rishikesh, India
| | - Neirita Hazarika
- Department of Dermatology, Venereology and Leprosy, All India Institute of Medical Sciences, Rishikesh, India
| | - Divya Chandrasekaran
- Department of Dermatology, Venereology and Leprosy, All India Institute of Medical Sciences, Rishikesh, India
| | - Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Prashant Durgapal
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India
| | - Sanjeev Kishore
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India
| |
Collapse
|
24
|
Gupta A, Gupta S, Siddeek RAT, Chennatt JJ, Singla T, Rajput D, Kumar N, Sehrawat A, Kishore S, Gupta M. Demographic and clinicopathological Profile of Gall Bladder Cancer Patients: Study from a tertiary care center of the Sub-Himalayan region in Indo-Gangetic Belt. J Carcinog 2021; 20:6. [PMID: 34321956 PMCID: PMC8312375 DOI: 10.4103/jcar.jcar_3_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 01/26/2021] [Accepted: 03/05/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Gall bladder cancer (GBC) accounts for 80%-95% of biliary tract malignancies in the world. There is however striking variability in the global incidence of gallbladder cancer, reaching epidemic levels for some regions and ethnicities. The aim of this study was to evaluate the demographic and clinicopathological profile of the gallbladder cancer patients. MATERIALS AND METHODS All patients of carcinoma gall bladder presenting to department of surgery in hepatopancreaticobiliary unit from July 2017 to November 2020 were included in this study. A proforma containing all the relevant details including history, examination, blood, radiology, and pathological investigations was filled. RESULTS A total of 326 patients of GBC were analyzed. The majority (75%) were found to be females with a mean age of 55 years. Pain abdomen was the most common presenting symptom in 81% of patients. The most common stage of presentation was stage IV and only 6 were in stage I. Two hundred and thirty three (71.4%) patients had metastatic disease at presentation. Liver infiltration at the time of diagnosis was present in 89% of patients. The most common site of metastasis was found in the liver (23.3%). GBC was more common in patients with A blood group. Baseline serum albumin levels were found to be significantly associated with the staging of GBC. CONCLUSIONS Due to the non specific symptoms patients of GBC present at very advanced stages, high index of suspicion and health education seems to play an important role in early detection and improvement of survival.
Collapse
Affiliation(s)
- Amit Gupta
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sweety Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rohik Anjum T. Siddeek
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Jaine John Chennatt
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Tanuj Singla
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Deepak Rajput
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Navin Kumar
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Amit Sehrawat
- Department of Medical Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Manoj Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
25
|
Gupta A, Gupta S, Mani R, Durgapal P, Goyal B, Rajput D, Rao S, Dhar P, Gupta M, Kishore S, Kant R. Expression of Human epidermal growth factor receptor 2, Survivin, Enhancer of zeste homolog -2, Cyclooxygenase-2, p53 and p16 molecular markers in Gall bladder carcinoma. J Carcinog 2021; 20:7. [PMID: 34321957 PMCID: PMC8312376 DOI: 10.4103/jcar.jcar_4_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 02/26/2021] [Accepted: 03/05/2021] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION: Gallbladder cancer exhibits striking variability in the global rates, reaching epidemic levels for some regions and ethnicities. The basis of its variability resides in differences in environmental exposure and intrinsic genetic predisposition to carcinogenesis. There is little information present regarding genetic and molecular alterations in gall bladder cancer (GBC). We, therefore, have evaluated the molecular marker expression in GBC and studied their correlation with clinicopathological staging. MATERIALS AND METHODS: This prospective observational study was conducted on newly diagnosed GBC patients from July 2017 to July 2020. After complete staging workup, the GBC biopsy samples paraffin block was tested for molecular markers estrogen receptor (ER), progesterone receptor (PR), p53, p16, Human epidermal growth factor receptor 2 (HER 2-neu), Survivin, Enhancer of zeste homolog-2 (EZH2), and Cyclooxygenase-2 (COX-2) expression by immunohistochemistry. RESULTS: Fifty newly diagnosed patients of carcinoma gall bladder were included in the present study. Age was ranged from 29 – 69 years (mean 53.42). p53 was the most common positive marker in 74% of patients, survivin in 58%, COX-2 in 44%, and p16 in 42% whereas Her 2 neu and EZH-2 were positive in 16% of patients each. None of the patients of GBC were ER or PR positive. There was a significant difference between the various groups in terms of the distribution of histological grade and Her 2 neu (χ2 = 9.886, P = 0.014) but not with other markers. Furthermore, there was a significant difference in terms of distribution of p16 and p53 with stage (χ2 = 7.017, P = 0.037 and χ2 = 5.861, P = 0.033) respectively. CONCLUSIONS: The present study shows the expression of molecular markers Her2 neu, p53, p16, survivin, COX-2, and EZH-2 in GBC. Now the time has come, and it is also the need of the day to establish early biomarkers of this highly lethal malignancy. It can be used in future for the detection of disease in the early phase and targeted therapy.
Collapse
Affiliation(s)
- Amit Gupta
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sweety Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rishit Mani
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Prashant Durgapal
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Bela Goyal
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Deepak Rajput
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Shalinee Rao
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Puneet Dhar
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Manoj Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Kant
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
26
|
Mahesh M, Mittal SK, Kishore S, Singh A, Gupta N, Rana R. Expression of p53 and Ki-67 proteins in patients with increasing severity and duration of pterygium. Indian J Ophthalmol 2021; 69:847-850. [PMID: 33727444 PMCID: PMC8012974 DOI: 10.4103/ijo.ijo_1034_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose: Pterygium is a triangular fibrovascular subepithelial ingrowth of degenerative bulbar conjunctival tissue over the cornea. It is now considered to be a result of uncontrolled cellular proliferation as overexpression of p53 protein and Ki-67 nuclear protein was found in the epithelium. This study was done to find the expression of p53 and Ki-67 with the severity and duration of the pterygium to explain the etiopathogenesis. Methods: Data were analyzed from 43 Indian participants of all age groups. All patients were divided according to the severity of pterygium (mild, moderate, and severe groups) and according to the duration of pterygium (<4 years and >4 years). The samples were studied by immunohistochemistry by using antibodies against p53 and Ki-67 proteins considering >5% expression as significant. Results: Of 43 cases, p53 and Ki-67 expression were positive in 33 cases. In mild, moderate, and severe cases p53 positivity was 33.3%, 78.4%, 100%, respectively. P53 expression increased with duration, 79.3% positive in <4 years, and 92.9% positive in >4 years. With increasing severity of pterygium, mild, moderate, and severe cases, Ki-67 positivity was 66.7%, 78.37%, 66.7%, respectively. Ki-67 expression with duration, 79.3% positive in <4 years, and 85.7% positive in >4 years of the duration of pterygium with no statistical significance. Conclusion: Our study revealed that with increasing duration and severity of pterygium, p53 expression was observed to be increasing. Ki-67 expression increased with the duration of pterygium but not with the severity.
Collapse
Affiliation(s)
- Mood Mahesh
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev K Mittal
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Anupam Singh
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Neeti Gupta
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rimpi Rana
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
27
|
Jose A, Dhar M, Panda PK, Kishore S. Expanded dengue syndrome with small-medium-vessel vasculitis: A case report. Int J Crit Illn Inj Sci 2021; 11:39-42. [PMID: 34159136 PMCID: PMC8183367 DOI: 10.4103/ijciis.ijciis_109_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/28/2020] [Accepted: 02/19/2020] [Indexed: 01/01/2023] Open
Abstract
Expanded dengue syndrome (EDS) is a well-described entity in the literature (after 2009), with various new atypical presentations being identified each year. We report a case of 38-year-old man who presented to the emergency department with high-grade, intermittent fever for 7 days along with myalgia and headache. He had multiple painless palpable purpura over both lower limbs and breathlessness from the 4th day of fever. On admission, purpura progressed in the severity and dry impending gangrene of the toes of both feet developed. Blood cultures turned out to be sterile, and other infectious markers (malaria, scrub typhus, and chikungunya) were negative except for dengue serology (enzyme-linked immunosorbent assay-immunoglobulin M [ELISA-IgM]). Skin biopsy confirmed to be cutaneous small-vessel vasculitis. The respiratory distress was due to myocarditis (supported by raised NT-pro-BNP levels) and pulmonary edema. He also had possibly hemolytic anemia due to microangiopathy. Although there are many EDS cases of dengue myocarditis reported till date, dengue resulting in widespread endothelial activation and extensive vasculitis (small vessel due to purpura and medium vessel due to gangrene) is a rare phenomenon.
Collapse
Affiliation(s)
- Augustine Jose
- Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Minakshi Dhar
- Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Prasan Kumar Panda
- Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
28
|
Kalonia T, Kumari N, Malik A, Kumar A, Bahadur A, Kishore S. A rare combination of Dermoid cyst and Cystadenoma: Are collision tumors in the ovary a real entity? Autops Case Rep 2021; 11:e2021249. [PMID: 34307216 PMCID: PMC8214883 DOI: 10.4322/acr.2021.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/02/2020] [Indexed: 12/04/2022] Open
Abstract
Collision tumors have been reported in various organs like the gastrointestinal tract, lung, skin, adrenals, central nervous system, lymph nodes, uterus, but are rarely seen in the ovary. Collision tumors are two histologically distinct neoplasms in the same organ without any intermixture between them. Here we present a case of a collision tumor of the ovary represented by a mucinous cystadenoma and teratoma. It is imperative for a surgical pathologist to correctly diagnose the collision tumor components and differentiate them from mixed tumors as it will dictate the appropriate treatment based on the individual biological aggressiveness of each component.
Collapse
Affiliation(s)
- Tushar Kalonia
- All India Institute of Medical Sciences, Rishikesh,Tushar Kalonia, Deapartment of Pathology and Laboratory Medicine. Rishikesh, Deharadun, Uttarakhand, India
| | - Neha Kumari
- All India Institute of Medical Sciences, Rishikesh,Tushar Kalonia, Deapartment of Pathology and Laboratory Medicine. Rishikesh, Deharadun, Uttarakhand, India
| | - Akanksha Malik
- All India Institute of Medical Sciences, Rishikesh,Tushar Kalonia, Deapartment of Pathology and Laboratory Medicine. Rishikesh, Deharadun, Uttarakhand, India
| | - Arvind Kumar
- All India Institute of Medical Sciences, Rishikesh,Tushar Kalonia, Deapartment of Pathology and Laboratory Medicine. Rishikesh, Deharadun, Uttarakhand, India
| | - Anupama Bahadur
- All India Institute of Medical Sciences, Rishikesh, Tushar Kalonia, Department of Gynecology and Obstetrics. Rishikesh, Deharadun, Uttarakhand, India
| | - Sanjeev Kishore
- All India Institute of Medical Sciences, Rishikesh,Tushar Kalonia, Deapartment of Pathology and Laboratory Medicine. Rishikesh, Deharadun, Uttarakhand, India
| |
Collapse
|
29
|
Kumar U, Rajkumar B, Kumar A, Kishore S, Jat B. Squamous cell carcinoma larynx with concurrent Warthin's tumor of the submandibular gland: A rarely reported co-existence. INDIAN J PATHOL MICR 2021; 63:331-333. [PMID: 32317550 DOI: 10.4103/ijpm.ijpm_436_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Utpal Kumar
- Department of Pathology, AIIMS, Rishikesh, Uttarakhand, India
| | - Bindu Rajkumar
- Department of Pathology, AIIMS, Rishikesh, Uttarakhand, India
| | - Arvind Kumar
- Department of Pathology, AIIMS, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, AIIMS, Rishikesh, Uttarakhand, India
| | - Bhinyaram Jat
- Department of Surgical Oncology, AIIMS, Rishikesh, Uttarakhand, India
| |
Collapse
|
30
|
Ravi K, Pushpa NB, Kishore S, Kaur S, Mehta V, Reddy KS. Taxation of micronuclei frequency as a prognostic marker in oral and oropharyngeal carcinoma: A cytogenetic study. Natl J Clin Anat 2021. [DOI: 10.4103/njca.njca_8_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
31
|
Ravi K, Pushpa NB, Kishore S, Kaur S, Mehta V, Krishnan A. Karyoanomalic frequency assay during radiation therapy – A promising marker in the prognosis of oral and oropharyngeal carcinoma. J Family Med Prim Care 2021; 10:4548-4552. [PMID: 35280601 PMCID: PMC8884334 DOI: 10.4103/jfmpc.jfmpc_948_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 11/06/2022] Open
Abstract
Introduction: Radiotherapy is commonly used in the treatment of oral and oropharyngeal carcinomas, either alone or in combination with other modalities of treatment like surgery/chemotherapy. It is always essential to know the nature of tumor response to the irradiation for successful outcomes and prognosis. With this view, the study has been conducted to document the usefulness of nuclear changes, karyolysis (KL), and karyorrhexis (KR) in particular as prognostic markers during the treatment. Materials and Method: Sixty patients, aged between 28 and 73 years (56 males and 4 females) years, histopathologically confirmed cases of oral and oropharyngeal carcinoma of different degrees of differentiation, were included in the study. The mode of treatment for the patients was radiotherapy with a radiation dose plan of 4 Gy, 14 Gy, 24 Gy, and 60 Gy on the 2nd, 7th, 12th, 30th days, respectively. The mucosal scrapings obtained from the site of the lesion at each interval were stained with Giemsa and May-Grunwald's stain. The stained slides were studied to assess the frequency of KL and KR. Results: It was observed that there was no significant difference between the site of lesion and tumor differentiation with the frequency of KL or KR. However, there was a statistically significant difference in the KL and KR indices with each interval of treatment. The percentage of relative increment among both the studied parameters was also significant, indicating their efficiency as a promising prognostic marker in radiotherapy. Conclusion: Hence, assessment of KL and KR at different intervals of time during radiotherapy could be used as an efficient tool to determine the radiosensitivity and prognosis in oral and oropharyngeal carcinoma patients.
Collapse
|
32
|
Gupta S, Gupta A, T. Siddeek R, Chennatt J, Singla T, Rajput D, Kumar N, Sehrawat A, Kishore S, Gupta M. Demographic and clinicopathological profile of gall bladder cancer patients: Study from a tertiary care center of the sub-himalayan region in indo-gangetic belt. J Carcinog 2021. [DOI: https://doi.org/10.4103/jcar.jcar_3_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|
33
|
Singh A, Bhardwaj A, Kaushik S, Kishore S, Acharya S. Role of Immunohistochemical Markers p53 and Ki-67 in Grading of Glial Tumours: A Prospective Study. J Clin Diagn Res 2021. [DOI: 10.7860/jcdr/2021/46974.14768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: Gliomas are the tumours of neuroepithelial tissues and are named according to their cell of origin. Squash cytology and sterotactic biopsies with Haematoxylin and Eosin (H&E) staining form the backbone of diagnosis, nevertheless recent advances in Immunohistochemistry (IHC) have revolutionised the way gliomas are diagnosed and graded. Aim: To evaluate expression and correlation of p53 and Ki-67/MIB 1 amongst a series of gliomas diagnosed morphologically according to World Health Organisation (WHO) classification of Central Nervous System (CNS) tumours 2007. Materials and Methods: The present study was a prospective study conducted over a period of 18 months from December 2016 to May 2018 at a tertiary care centre in Uttarakhand, India. The study group comprised all consecutive cases of glial tumours that were clinically diagnosed and histopathologically confirmed as Gliomas during this period. Histopathological sections were made from formalin fixed tissue and stained with H&E and grading was done according to the WHO grading system 2007 for CNS neoplasms. Subsequently, IHC sections were taken on poly L-lysine coated slides and IHC staining of p53 and MIB1 (Ki-67) was performed. The IHC scores were calculated and correlated with histopathological grade. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) software version 17.0. Results: A total of 40 cases of glial tumours diagnosed on histopatholgy were included in the study. They showed M:F ratio of 1.22:1 with peak age incidence of 21-30 years. Astrocytoma, grade IV was the most frequent diagnosis followed by grade II on H&E. On IHC, grade II diffuse astrocytomas, grade III Anaplastic Astrocytomas (AA), and Glioblastoma Multiforme (GBM) demonstrated a mean p53 positivity of 29.5, 50.83 and 47.66, respectively and a Ki-67 positivity of 32.5, 48.33 and 58.08, respectively. For ependymomas grade I, II and III the mean p53 positivity was 9, 5.26 and 12, respectively and the mean Ki-67 positivity was 2, 7.93 and 40, respectively. Amongst oligodendrogliomas grade II and III showed a p53 positivity of 6 and 8.25 and Ki-67 positivity of 12 and 30.5, respectively. A stronger correlation was found between an increase in histologic grade and proliferation markers. Conclusion: Histologic grade was the most important prognostic factor with respect to patient survival in glial neoplasms. The immunopositivity for p53 and Ki-67 correlated well with histological malignancy grade in all glioma subtypes, but a considerable overlap of proliferative index was observed between different subtypes.
Collapse
|
34
|
Verma R, Gowda VN, Singh A, Priya M, Kishore S, Joshi PP. Epistaxis: the cause found beyond the nose. Autops Case Rep 2020; 11:e2020207. [PMID: 34277483 PMCID: PMC8101650 DOI: 10.4322/acr.2020.207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/08/2020] [Indexed: 12/31/2022] Open
Abstract
Renal cell carcinoma (RCC) is a malignant disease that is often diagnosed at a metastatic stage. The head and neck represent up to 3% of the metastatic RCC, and the paranasal sinus area is one of the least involved sites. Here, we introduce the case of a 74-year-old female patient who presented with a history of traumatic nasal bleed. A cranial computed tomography scan and magnetic resonance imaging showed a fronto-ethmoidal mass with pachymeningeal involvement. A nasal biopsy from the paranasal sinuses was taken. On histopathological examination, metastatic clear cell carcinoma was the main hypothesis, which later was confirmed to be RCC on immunohistochemistry. On further radiological examination, an exophytic mass was depicted in the kidney's upper and middle pole. The patient had no renal complaints and was asymptomatic. Fronto-ethmoidal sinus is a rare site for metastatic RCC, especially in cases where the patient is asymptomatic. Early detection by keeping RCC metastasis as the differential diagnosis in such cases can lead to early treatment and improve the overall survival of the patient.
Collapse
Affiliation(s)
- Rahul Verma
- All Institute of Medical Science Rishikesh, Department of Pathology. Rishikesh, Uttarakhand, India
| | - Vinay Nagaraja Gowda
- All Institute of Medical Science Rishikesh, Department of Pathology. Rishikesh, Uttarakhand, India
| | - Ashok Singh
- All Institute of Medical Science Rishikesh, Department of Pathology. Rishikesh, Uttarakhand, India
| | - Madhu Priya
- All Institute of Medical Science Rishikesh, Department of Ear, Nose and Throat. Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- All Institute of Medical Science Rishikesh, Department of Pathology. Rishikesh, Uttarakhand, India
| | - Prashant Pranesh Joshi
- All Institute of Medical Science Rishikesh, Department of Pathology. Rishikesh, Uttarakhand, India
| |
Collapse
|
35
|
Anthony ML, Durgapal P, Joshi P, Mittal A, Sahai R, Kishore S, Singh A. Diagnostic pitfall of a rare variant of angiomyolipoma, epithelioid angiomyolipoma - a case report. Pan Afr Med J 2020; 37:210. [PMID: 33505578 PMCID: PMC7813654 DOI: 10.11604/pamj.2020.37.210.26269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 10/13/2020] [Indexed: 11/19/2022] Open
Abstract
Angiomyolipoma of the kidney is a common benign mesenchymal neoplasm of kidney. A rare variant, epithelioid angiomyolipoma, however, may show malignant behavior. We report a case of epithelioid angiomyolipoma in a patient not having tuberous sclerosis which was initially misdiagnosed as renal cell carcinoma. A 39-year-old woman presented with a history of flank pain. Ultrasonography revealed a left renal mass. Contrast-enhanced computed tomography (CECT) abdomen revealed mass involving hilum of the kidney. On core biopsy a possibility of renal cell carcinoma was suggested. The patient underwent radical nephrectomy. After immunohistochemical analysis, a final diagnosis of epithelioid angiomyolipoma was made. Renal epithelioid angiomyolipoma without adipocytic component is extremely rare. It is pivotal to keep a possibility of epithelioid angiomyolipoma whenever an epithelioid renal tumor is encountered showing marked pleomorphism and mitosis. The use of melanocytic markers and specific markers of renal cell carcinoma will aid the diagnosis.
Collapse
Affiliation(s)
- Michael Leonard Anthony
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Prashant Durgapal
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Prashant Joshi
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Ankur Mittal
- Department of Urology, All India Institute of Medical Sciences, Rishikesh, India
| | - Rishabh Sahai
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Sanjeev Kishore
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Ashok Singh
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| |
Collapse
|
36
|
Saini P, Chakraborty A, Singh A, Kumar S, Kansal NK, Kishore S. Pemphigus Vulgaris Localized to a Surgical Scar. Skinmed 2020; 18:252-253. [PMID: 33050992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Poonam Saini
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Rishikesh-249 203, India
| | - Atreyo Chakraborty
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Rishikesh-249 203, India
| | - Ashok Singh
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh-249 203, India
| | - Sheetanshu Kumar
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Rishikesh-249 203, India
| | - Naveen Kumar Kansal
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Rishikesh-249 203, India;
| | - Sanjeev Kishore
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh-249 203, India
| |
Collapse
|
37
|
Siddeek RAT, Gupta A, Gupta S, Goyal B, Gupta AK, Agrawal S, Roshan R, Kumar U, Kumar N, Gupta M, Kishore S, Kant R. Evaluation of platelet distribution width as novel biomarker in gall bladder cancer. J Carcinog 2020; 19:5. [PMID: 33033461 PMCID: PMC7511895 DOI: 10.4103/jcar.jcar_12_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/17/2020] [Accepted: 05/24/2020] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION: Gall bladder cancer (GBC) tends to present in advanced stages, therefore, early diagnosis of GBC is necessary. There is no ideal single tumor marker available presently for the diagnosis and prognosis of GBC. Platelet distribution width (PDW) is an early marker for activated platelets and has been used in a variety of tumors to assess prognosis. This study was designed to evaluate the utility of PDW in identifying GBC patients and its association with tumor markers, staging and resectability of GBC. MATERIALS AND METHODS: This cross sectional study was done on 100 patients of GBC and 100 age- and sex- matched healthy controls. PDW was evaluated and compared between GBC and healthy controls. Receiver-operating characteristics was plotted to determine optimal cut-off for identifying GBC patients and to determine sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PDW. Correlation between serum tumor markers (carbohydrate antigen 19-9, carcinoembryonic antigen, and carbohydrate antigen 125) and PDW were evaluated. Association of PDW with hyperbilirubinemia, staging and resectability of GBC was also studied. RESULTS: A significantly higher PDW with a median of 18.1 was observed in GBC as compared to healthy controls with median value of 13. PDW was found to have a very high sensitivity (90%), specificity (95%), PPV (94%) and NPV (90%) in identifying GBC at cut-off of 16 with area under the curve (AUC) of 0.97. An increase of PDW was observed with increasing stage and unresectable GBC. However, it was not statistically significant. Significant positive correlation was observed between PDW and all three serum tumor markers and good positive correlation with r = 0.61 was observed with CA 19-9. CONCLUSION: PDW was associated with GBC and may be considered as a cost- effective marker in adjunct to other investigations for the diagnosis of GBC.
Collapse
Affiliation(s)
- Rohik Anjum T Siddeek
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Amit Gupta
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sweety Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Bela Goyal
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Arvind Kumar Gupta
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Saumya Agrawal
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Roshan
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Utkarsh Kumar
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Navin Kumar
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Manoj Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Kant
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
38
|
Agrawal S, Gupta A, Gupta S, Goyal B, Siddeek RAT, Rajput D, Chauhan U, Kishore S, Gupta M, Kant R. Role of carbohydrate antigen 19-9, carcinoembryonic antigen, and carbohydrate antigen 125 as the predictors of resectability and survival in the patients of Carcinoma Gall Bladder. J Carcinog 2020; 19:4. [PMID: 33033460 PMCID: PMC7511893 DOI: 10.4103/jcar.jcar_10_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/17/2020] [Accepted: 04/26/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) have been reported in previous studies to assess the prognosis of gall bladder cancer (GBC) individually and in combination. However, the evidence of utility of preoperative CA 19-9, CEA and carbohydrate antigen 125 (CA 125) in determining the resectability and prognosis of GBC is still lacking. In the present study we correlated the serum levels of tumor markers CA 19-9, CEA and CA 125 individually and combined to determine the resectability and prognosis of the GBC. MATERIALS AND METHODS Seventy one diagnosed patients of GBC between January 2018 and September 2019 were included in the present study. Serum CA 19-9, CEA and CA 125 were determined by chemiluminescence. Receiver operating characteristic (ROC) curve was used to evaluate the role of tumor markers in determining the resectability of GBC. The Kaplan Meier survival curves were made and log rank analysis was performed to assess the prognostic role of tumor markers in terms of overall median survival. RESULTS All the three tumor markers CA19-9, CEA and CA 125 showed high discriminatory power in determining the resectability with respective area under curve of 0.76, 0.68 and 0.78 as determined by ROC. Median survival in patients with high serum CA 19-9, CA 125 was significantly lower than patients with normal serum CA 19-9, CA 125 whereas no significant difference was observed in case of CEA. CONCLUSION The present study suggested that CA 19-9, CEA and CA 125 can predict resectability in GBC and raised levels of CA 19-9 and CA 125 can predict poor prognosis in patients with elevated levels.
Collapse
Affiliation(s)
- Saumya Agrawal
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Amit Gupta
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sweety Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Bela Goyal
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rohik Anjum T Siddeek
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Deepak Rajput
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Udit Chauhan
- Department of Radiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Manoj Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Kant
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
39
|
Sahai R, Rajkumar B, Joshi P, Singh A, Kumar A, Durgapal P, Gupta A, Kishore S, Chowdhury N. Interobserver reproducibility of The Paris System of Reporting Urine Cytology on cytocentrifuged samples. Diagn Cytopathol 2020; 48:979-985. [PMID: 32543091 DOI: 10.1002/dc.24476] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 05/05/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND The Paris System of Reporting Urine Cytology aims to screen samples for HGUC and to provide a universally acceptable reporting format for urine cytology specimens. However, studies detailing the reproducibility of this system, especially on cyto-centrifuge preparations, are lacking. METHODS 149 voided urine samples received in Department of Pathology were reviewed independently by five cytopathologists. To estimate the overall agreement, Gwet's AC and AC1statistics between each pair of raters were used. To measure the random error component, polychoric correlations were used. To assess the systematic error, Friedman test was used. RESULTS There was moderately good inter-rater agreement between the raters. Gwets AC2 ranged between 0.67 and 0.89 for the classification of the cases once the sample was found adequate for assessment, while the Gwet's AC1 ranged between 0.61 and 0.94 in assessing for adequacy. There were significant systematic differences between raters in their thresholds for the different categories as well as in differentiating between an adequate and inadequate sample (P value by Friedman test <.001). The association between pathologists was moderately high (polychoric correlations ranging from 0.67 to 0.93). In the majority (108 of 149, 72.5%) of the cases, the range of differences between raters were of one category or less, suggesting satisfactory agreement, but having large disagreements in minority. CONCLUSION The interobserver reproducibility for the Paris System is moderately good, and is suitable for adoption. It is limited by the lack of agreement as to what constitutes an adequate specimen and differing threshold for categorizing the lesions in differing groups.
Collapse
Affiliation(s)
- Rishabh Sahai
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Bindu Rajkumar
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Prashant Joshi
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ashok Singh
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Arvind Kumar
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Prashant Durgapal
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Arvind Gupta
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Nilotpal Chowdhury
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
40
|
Singh M, Kishore S, Jain B, Kishore S, Aggarwal P, K Verma S. Prevalence of Diabetes Mellitus and its associated risk factors. Indian J Community Health 2020. [DOI: 10.47203/ijch.2020.v32i01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background: Type 2 diabetes mellitus (T2DM) is a chronic, debilitating non communicable diseases (NCDs) which has emerged as a leading global health problem. Aim & Objective: To find out the prevalence of known cases of diabetes mellitus and associated risk factors in the study area. Material & Methods: Community-based cross-sectional study was conducted among people living in Barrage colony of Rishikesh, Uttarakhand for a period of 3 months from December 2018 to February 2019. House to house survey was done in all the four blocks (A, B, C, D) of Barrage colony. Total of 815 study participants (both male and female) ≥ 20 years of age were surveyed. Data collected was entered into Microsoft Excel and analyzed using epi info software version 7. Results: The prevalence of DM was found to be high i.e 5.6% among the study participants. Prevalence was significantly more among females as compared to males and significantly increased by aging in both genders. Conclusions: It seems that the prevalence of diabetes is increasing in our region as well as our country and the world. To control DM public health education regarding consumption of balanced diet, increasing physical activity and leading a stress-free life is needed.
Collapse
|
41
|
Kishore S, Singh M, Jain B, Verma N, Gawande K, Kishore S, Aggarwal P, Verma SK. A study to assess prevalence of anaemia among beneficiaries of Anaemia Mukt Bharat Campaign in Uttarakhand. J Family Med Prim Care 2020; 9:1691-1694. [PMID: 32509673 PMCID: PMC7266259 DOI: 10.4103/jfmpc.jfmpc_941_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/14/2020] [Accepted: 02/24/2020] [Indexed: 12/01/2022] Open
Abstract
Context: Anaemia is defined as a decreased concentration of blood haemoglobin. It is one of the most common nutritional deficiency diseases observed globally affecting both developing and developed countries. Aims: To find out the prevalence of anaemia among the beneficiaries of Anaemia Mukt Bharat and its association with age and gender. Settings and Design: A cross-sectional study was conducted in Uttarakhand by AIIMS Rishikesh in a month-long campaign including 5,776 beneficiaries. Camps were organized at the hospital campus, schools, district hospitals, Community Health Centre (CHC), Primary Health Centre (PHC), subcentres (SC), Anganwadi Centres (AWCs), slum areas, adolescent health day celebration sites and Village Health and Nutrition Day (VHND) sites. Methods and Material: Data on age and gender along with haemoglobin level using HemoCue Haemoglobinometer was collected. Statistical Analysis Used: These data were entered into Microsoft Excel and analysed to calculate the prevalence of anaemia and its association with age and gender using Epi Info software version 7. Pearson's Chi-square test was applied. P value <0.05 was considered as significant. Results: Out of 5,776 participants 53.2% were anaemic. Females (54.6%) were more anaemic than males (45.1%). 33.5% of pregnant females were found to be anaemic. Conclusions: Prevalence of anaemia was very high among the study participants. It shows that anaemia is a major public health problem so efforts should be taken to reduce the prevalence of anaemia and promote the health of an individual, community as well as the country.
Collapse
Affiliation(s)
- Surekha Kishore
- Department of Community and Family Medicine, AIIMS, Rishikesh, Uttarakhand, India
| | - Mahendra Singh
- Department of Community and Family Medicine, AIIMS, Rishikesh, Uttarakhand, India
| | - Bhavna Jain
- Department of Community and Family Medicine, AIIMS, Rishikesh, Uttarakhand, India
| | - Neha Verma
- Department of Community and Family Medicine, AIIMS, Rishikesh, Uttarakhand, India
| | - Kanchan Gawande
- Department of Community and Family Medicine, AIIMS, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, AIIMS, Rishikesh, Uttarakhand, India
| | - Pradeep Aggarwal
- Department of Community and Family Medicine, AIIMS, Rishikesh, Uttarakhand, India
| | | |
Collapse
|
42
|
Pang KP, Baptista PM, Olszewska E, Braverman I, Carrasco-Llatas M, Kishore S, Chandra S, Yang HC, Chan YH, Pang KA, Pang EB, Rotenberg B. SLEEP-GOAL: A multicenter success criteria outcome study on 302 obstructive sleep apnoea (OSA) patients. Med J Malaysia 2020; 75:117-123. [PMID: 32281591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To demonstrate SLEEP-GOAL as a more holistic and comprehensive success criterion for Obstructive Sleep Apnoea (OSA) treatment. METHODS A prospective 7-country clinical trial of 302 OSA patients, who met the selection criteria, and underwent nose, palate and/or tongue surgery. Pre- and post-operative data were recorded and analysed based on both the Sher criteria (apnoea hypopnea index, AHI reduction 50% and <20) and the SLEEP-GOAL. RESULTS There were 229 males and 73 females, mean age of 42.4±17.3 years, mean BMI 27.9±4.2. The mean VAS score improved from 7.7±1.4 to 2.5±1.7 (p<0.05), mean Epworth score (ESS) improved from 12.2±4.6 to 4.9±2.8 (p<0.05), mean body mass index (BMI) decreased from 27.9±4.2 to 26.1±3.7 (p>0.05), gross weight decreased from 81.9±14.3kg to 76.6±13.3kg. The mean AHI decreased 33.4±18.9 to 14.6±11.0 (p<0.05), mean lowest oxygen saturation (LSAT) improved 79.4±9.2% to 86.9±5.9% (p<0.05), and mean duration of oxygen <90% decreased from 32.6±8.9 minutes to 7.3±2.1 minutes (p<0.05). The overall success rate (302 patients) based on the Sher criteria was 66.2%. Crosstabulation of respective major/minor criteria fulfilment, based on fulfilment of two major and two minor or better, the success rate (based on SLEEP-GOAL) was 69.8%. Based solely on the Sher criteria, 63 patients who had significant blood pressure reduction, 29 patients who had BMI reduction and 66 patients who had clinically significant decrease in duration of oxygen <90% would have been misclassified as "failures". CONCLUSION AHI as a single parameter is unreliable. Assessing true success outcomes of OSA treatment, requires comprehensive and holistic parameters, reflecting true end-organ injury/function; the SLEEP-GOAL meets these requirements.
Collapse
Affiliation(s)
- K P Pang
- Asia Sleep Centre, Department of Otolaryngology, Paragon, Singapore,.
| | - P M Baptista
- Clinica Universidad de Navarra, Department of Otolaryngology, Pamplona, Navarra, Spain
| | - E Olszewska
- Medical University of Bialystok, ENT Department, Poland
| | - I Braverman
- Hillel Yaffe Medical Center, Technion Faculty Medicine, Department of Otolaryngology Head and Neck Surgery, Haifa, Israel
| | | | - S Kishore
- Nova Specialty Hospital, Otolaryngology Department, Hyderabad, India
| | - S Chandra
- Belle Vue Clinic & Hospital, ENT Department, Kolkata, India
| | - H C Yang
- Chonnam National University Hospital, Otolaryngology Department, Korea
| | - Y H Chan
- National University Singapore, School of Medicine, Biostatistics Unit, Singapore
| | - K A Pang
- Asia Sleep Centre, Department of Otolaryngology, Paragon, Singapore
| | - E B Pang
- University of Glasgow, Medicine Faculty, Scotland
| | - B Rotenberg
- Western University, Otolaryngology Department, London, Ontario, Canada
| |
Collapse
|
43
|
Chandra H, Gupta AK, Nath UK, Singh N, Kumar U, Kishore S. Clinico-hematological study of pancytopenia: A single-center experience from north Himalayan region of India. J Family Med Prim Care 2019; 8:3944-3948. [PMID: 31879641 PMCID: PMC6924218 DOI: 10.4103/jfmpc.jfmpc_539_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 08/22/2019] [Accepted: 09/10/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Pancytopenia, an important hematological presentation is associated with different causes, which may vary in different regions. Uttarakhand, a north Himalayan state of India lacks studies of pancytopenia and the prevalent causes present in this region. Therefore, the present study was conducted to study the clinico-hematological profile of pancytopenia in a tertiary care center in the Uttarakhand, a north Himalayan state of India. It was also intended to study if these causes showed any variation from other studies done in different regions of India. Materials and Methods: The present observational study was conducted in a tertiary care institute situated in Uttarakhand state of India over a period of 1 year and 8 month from June 2017 to Feb 2019 including all the cases of pancytopenia. Results: The most common cause of pancytopenia was megaloblastic anemia (25%), followed by aleukemic leukemia and hypoplastic/aplastic anemia (19.1% each). Visceral leishmaniasis also constituted an important cause of pancytopenia in this study (11.7%). Conclusion: The study concludes that megaloblastic anemia and aleukemic leukemia are the most common cause of pancytopenia. Although leishmaniasis is considered to be non-endemic in this region, it constitutes an important cause of pancytopenia here. The clinicians, especially the physicians practicing the primary care and pathologists, should be aware of the different causes of pancytopenia present in this Himalayan region of India; therefore, delay in diagnosis can be prevented along with unnecessary investigations.
Collapse
Affiliation(s)
- Harish Chandra
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Arvind K Gupta
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Uttam K Nath
- Department of Medical Oncology and Hematology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Neha Singh
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Utpal Kumar
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
44
|
Abstract
Cancer remains the scourge of mankind, lets us not delude ourselves. Despite recent advances in molecular biology and very advanced techniques leading to early detection of malignant tumours and despite newer drugs and use of nanotechnology an adjunct measures for targeted therapy, cancer remains the most deadly enemy and killer of mankind. Thus cancer remains the single most factor for increase mortality and morbidity of human being as well as for entire nation, impacting its manpower and economy. It is this vicious cycle that needs to be controlled, broken and irradiated which at present appears to be a herculean tasks although not an impossible one.
Collapse
|
45
|
Durgapal P, Joshi PP, Gupta A, Gupta A, Kishore S, Singh A. Granulomatous inflammation still fooling surgeons. Trop Doct 2019; 49:252-253. [PMID: 30885055 DOI: 10.1177/0049475519836364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Prashant Durgapal
- 1 Assistant Professor, All India Institute of Medical Sciences, Rishikesh, India
| | - Prashant P Joshi
- 1 Assistant Professor, All India Institute of Medical Sciences, Rishikesh, India
| | - Ashish Gupta
- 1 Assistant Professor, All India Institute of Medical Sciences, Rishikesh, India
| | - Amit Gupta
- 2 Additional Professor, All India Institute of Medical Sciences Rishikesh, Rishikesh, India
| | - Sanjeev Kishore
- 3 Professor, Department of Pathology, All India Institute of Medical Sciences Rishikesh, Rishikesh, India
| | - Ashok Singh
- 4 Assistant Professor, Department of Pathology, All India Institute of Medical Sciences Rishikesh, Rishikesh, India
| |
Collapse
|
46
|
Sutton C, Zhang Y, Yarmohammadi H, Ziv E, Boas F, Kishore S, Camacho J, Erinjeri J. 03:45 PM Abstract No. 283 Analysis of the chemotherapy free interval following image-guided ablation in sarcoma patients. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
47
|
Abstract
BACKGROUND Urothelial carcinoma is common urinary malignancy responsible for a significant proportion of cancer morbidity and mortality. We carried out the present study to demonstrate the clinicohistopathological features and to correlate the p53 and Ki-67 immunoexpression with grade and stage of bladder carcinomas. MATERIALS AND METHODS We investigated 110 cases of bladder tumor. Grading and staging were done according to the WHO-2004 and American Joint Committee on Cancer-TNM staging recommendations. Immunohistochemical staining for p53 and Ki-67 was performed in all the cases, categorized as high and low expression taking 20% positivity as cutoff value. Statistical analysis was done using McNemar's Chi-square test and Fisher's exact test. RESULTS There were 61 cases of high grade and 49 cases of low grade exhibiting urothelial carcinoma as the most common variant (97.3%). Muscle invasive carcinomas (pT2) noted in 29 cases whereas 23 and 58 cases revealed stage pTa and pT1, respectively. Evaluation of p53 and Ki-67 immunoexpression showed a significant association with histological grade and stage individually and also in combination (P < 0.05). CONCLUSION Our results corroborate with the opinion that combined use of p53 and Ki-67 immunomarkers may provide additional prognostic information along with histological grading and staging in bladder carcinomas.
Collapse
Affiliation(s)
- Brijesh Thakur
- Department of Pathology, SGRRIM and HS, Dehradun, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, SGRRIM and HS, Dehradun, Uttarakhand, India
| | - Kanika Dutta
- Department of Pathology, SGRRIM and HS, Dehradun, Uttarakhand, India
| | - Sanjay Kaushik
- Department of Pathology, SGRRIM and HS, Dehradun, Uttarakhand, India
| | - Aparna Bhardwaj
- Department of Pathology, SGRRIM and HS, Dehradun, Uttarakhand, India
| |
Collapse
|
48
|
Arora D, Kaushik S, Azad S, Kaur A, Kishore S. Haematological Alterations in Initially Diagnosed and Relapse/Recurrent Cases of Malaria: A Comparative Study. J Clin Diagn Res 2018. [DOI: 10.7860/jcdr/2018/35968.11989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
49
|
Chauhan P, Chauhan RK, Upadhyaya A, Kishore S. Dermoscopy of a rare case of linear syringocystadenoma papilliferum with review of the literature. Dermatol Pract Concept 2018; 8:33-38. [PMID: 29445572 PMCID: PMC5808369 DOI: 10.5826/dpc.0801a07] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 11/07/2017] [Indexed: 11/20/2022] Open
Abstract
Syringocystadenoma papilliferum (SCAP) is a benign hamartomatous tumor arising from pluripotent cells with either apocrine or eccrine differentiation. We report a rare case of de novo linear SCAP in a 12-year-old female child with lesions over the chest along with the dermoscopic findings.
Collapse
Affiliation(s)
- Payal Chauhan
- Department of Dermatology, Venereology & Leprology, All India Institute of Medical Sciences, Rishikesh, India
| | - Rishabh Kumar Chauhan
- Department of Dermatology, Venereology & Leprology, All India Institute of Medical Sciences, Rishikesh, India
| | - Amrita Upadhyaya
- Department of Dermatology, Venereology & Leprology, All India Institute of Medical Sciences, Rishikesh, India
| | - Sanjeev Kishore
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India
| |
Collapse
|
50
|
Nautiyal N, Bhardwaj A, Acharya S, Kishore S, Kudesia S. Diagnostic Utility of Epithelial Membrane Antigen (EMA) and Calretinin (CAL) in Effusion Cytology. J Clin Diagn Res 2017; 11:EC36-EC39. [PMID: 28658770 DOI: 10.7860/jcdr/2017/24339.9888] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 01/26/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Fluid cytology and subsequent utilization of immunocytology on cell block is being used commonly for increasing the diagnostic accuracy in effusion cytology. AIM To do cytological analysis of fluids and evaluate the role of Epithelial Membrane Antigen (EMA) and Calretinin (CAL) to differentiate between reactive and malignant cell in pleural and peritoneal fluids. MATERIALS AND METHODS This was a prospective study carried out in Department of Pathology, Shri Guru Ram Rai Institue of Medical and Health Science, for a period of 18 months from January 2014 to June 2015. A total of 253 samples of pleural and peritoneal fluid were studied by May-Gruenwald-Giemsa (MGG) stain and Papanicolaou (Pap) staining. In 73 cases which were suspicious for malignancy, cell blocks were prepared and IHC was done using two immunomarkers- EMA and CAL. RESULTS A total of 253 cases of effusion cytology were studied out of which 73 were found positive for malignant cells. Maximum cases of malignant cells or atypical cells were seen in peritoneal fluid. A total of 34 cases were histologically positive for malignancy. All these cases showed strong membranous and cytoplasmic positivity for EMA. Most of cases also showed 2%-5% positivity for CAL. There were 38 cases categorized as atypical or reactive mesothelial cell hyperplasia. These cases showed nuclear and cytoplasmic staining for calretinin and none of these were positive for EMA, although 5 cases showed score 2-3, which was considered as negative. CONCLUSION The distinction between reactive and malignant mesothelial cells in cytological specimens can be problematic. A combination of CAL and EMA may help in accurate diagnosis.
Collapse
Affiliation(s)
- Neha Nautiyal
- Resident, Department of Pathology, Sri Guru Ram Rai Institute of Medical and Health Science, Dehradun, Uttarakhand, India
| | - Aparna Bhardwaj
- Professor, Department of Pathology, Sri Guru Ram Rai Institute of Medical and Health Science, Dehradun, Uttarakhand, India
| | - Seema Acharya
- Professor, Department of Pathology, Sri Guru Ram Rai Institute of Medical and Health Science, Dehradun, Uttarakhand, India
| | - Sanjeev Kishore
- Professor and Head, Department of Pathology, Sri Guru Ram Rai Institute of Medical and Health Science, Dehradun, Uttarakhand, India
| | - Sandip Kudesia
- Professor, Department of Pathology, Sri Guru Ram Rai Institute of Medical and Health Science, Dehradun, Uttarakhand, India
| |
Collapse
|