scholarly journals Adult-onset Focal Nesidioblastosis with Nodular Formation Mimicking Insulinoma

2021 ◽  
Author(s):  
Shunsuke Doi ◽  
Takatsugu Yamada ◽  
Yoshinori Kito ◽  
Shinsaku Obara ◽  
Yusuke Fujii ◽  
...  
Keyword(s):  
Islet Cells ◽  
Histopathological Examination ◽  
Insulin Level ◽  
The Body ◽  
Hyperinsulinemic Hypoglycemia ◽  
Histopathological Diagnosis ◽  
Adult Onset ◽  
Ductal Epithelium ◽  
High Insulin ◽  
Enhanced Computed Tomography

Abstract Nesidioblastosis is defined as the neoformation of the islets of Langerhans from the pancreatic ductal epithelium and is recognized as the most common cause of hyperinsulinemic hypoglycemia in infants. We herein report an extremely rare case of adult-onset focal nesidioblastosis with the unusual feature of hyperplastic nodular formation. A 55-year-old woman was admitted to our hospital for a tumor detected in the body of the pancreas by magnetic resonance imaging screening. Laboratory examinations showed a high insulin level in the blood. Contrast-enhanced computed tomography and the selective arterial calcium injection test suggested the presence of multiple insulinomas in the body and tail of the pancreas, and, thus, the patient underwent distal pancreatectomy. A histopathological examination of the tumor in the body of the pancreas showed the nodular hyperplasia of islet-like cell clusters. In addition, many small intralobular ductules and islet cells appeared to be budding from the proliferating ductal epithelium, forming “ductuloinsular complexes”. No other abnormal lesion was detected in the remainder of the pancreas. The histopathological diagnosis was focal nesidioblastosis. The patient has remained free of the recurrence of hypoglycemic episodes for more than 31 months. The present case of rare adult-onset focal nesidioblastosis with hyperplastic nodular formation was preoperatively identified as an apparent pancreatic tumor mimicking insulinoma. Nesidioblastosis and insulinoma need to be considered in cases of hyperinsulinemic hypoglycemia, even in adult patients.

scholarly journals Minocycline Derived Silver Nanoparticles for Assessment of Their Antidiabetic Potential against Alloxan induced Diabetic Mice

2021 ◽  
Author(s):  
Syed Akif Raza Kazmi ◽  
Muhammad Zahid Qureshi ◽  
Sadia . ◽  
Saleh S Alhewairini ◽  
Shaukat Ali ◽  
...  
Keyword(s):  
Silver Nanoparticles ◽  
Antioxidant Activities ◽  
Islet Cells ◽  
Histopathological Examination ◽  
Radical Scavenging Activity ◽  
Fasting Blood Glucose ◽  
Radical Scavenging ◽  
The Body ◽  
Central Vein ◽  
Diabetic Mice

Diabetes is a life-threatening disease and chronic diabetes affects the parts of the body including the liver, kidney and pancreas. The root cause of diabetes is mainly associated with oxidative stress produced by reactive oxygen species. The minocycline is a polyphenolic drug with excellent antioxidant activities. The objective of the present study was to investigate the antidiabetic potential of minocycline modified silver nanoparticles (Mino/AgNPs) against alloxan-induced diabetic mice. The Mino/AgNPs were synthesized using minocycline as reducing and stabilizing agents. UV-vis, FTIR, X-ray diffraction (XRD) and transmission electron microscopy (TEM) were applied for the characterization of Mino/AgNPs. The 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging assay was conducted to determine the antioxidant potential of newly synthesized Mino/AgNPs. The results revealed that the Mino/AgNPs showed higher radical scavenging activity (IC50 = 19.7 µg/mL) as compared to the minocycline (IC50 = 26.0 µg/mL) and ascorbic acid (IC50 = 25.2 µg/mL). Further, the Mino/AgNPs were successfully employed to examine their antidiabetic potential against Alloxan-induced diabetic mice. Hematological results showed that the mice treated with Mino/AgNPs demonstrated a significant decrease in fasting blood glucose level and lipid profile as compared to the diabetic group. The histopathological examination confirmed that the diabetic mice treated with Mino/AgNPs showed significant recovery and revival of histo-morphology of kidney, central vein of liver and islet cells of the pancreas compared to the diabetic mice. Hence Mino/AgNPs have good antidiabetic potential and could be an appropriate nanomedicine to prevent the development of diabetes.

scholarly journals HISTOPATHOLOGICAL STUDY OF UTERINE LESIONS IN HYSTERECTOMY SPECIMENS IN A TERTIARY CARE HOSPITAL.

2020 ◽  
pp. 1-2
Author(s):  
Reddythota Sujeeva Swapna ◽  
V Siva Sankar Naik ◽  
C Bhavani ◽  
M Neeraja
Keyword(s):  
Histopathological Examination ◽  
Tertiary Care ◽  
Female Genital Tract ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
The Body ◽  
Histopathological Study ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
Wide Range

Background: The Female Genital Tract is a hormone-responsive system to a degree unmatched by any other system in the body. The gross configuration of the uterus changes dramatically throughout life. It is a kind of 'Puppet on a string", thus manipulated throughout life by altering levels of ovarian hormones. Objective of the study: The present study is aimed at detailed histopathological evaluation of uterine lesions of hysterectomy specimens. Methodology: A total of 448 cases of hysterectomy specimens were received in the department of pathology GGH Ananthapur, for two years, were reviewed. The specimens were processed, and the histopathological diagnosis was studied. Result: Peak age group of hysterectomy was 40-49 years with 186 (41.51%) cases. The youngest patient was 21 years old, and the oldest was 75 years old. The most frequent type of hysterectomy done was total abdominal hysterectomy in 293 (65.4%) cases. Conclusion: Hysterectomy is the most common surgery performed in gynecological practice. A wide range of lesions were noted when hysterectomy specimens are subjected to histopathological examination.

scholarly journals Clinicopathological study of bacterial lesions in a tertiary care hospital

2021 ◽  
Vol 9 (7) ◽  
pp. 2072
Author(s):  
Sonti Sulochana ◽  
Jalavadi Rahul Siddartha
Keyword(s):  
Bacterial Infections ◽  
Tertiary Care Hospital ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Granulomatous Inflammation ◽  
The Body ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
H Pylori ◽  
One Year

Background: The incidence of bacterial lesions has been on the rise over the decades. In our study, we assessed and studied the spectrum of bacterial lesions retrospectively for one year and their clinicopathological correlation which was diagnosed on histopathological examination in a tertiary health care center.Methods: The present study (retrospective) has been done to analyse the incidence of bacterial infections obtained in the histopathology laboratory and study its clinical correlation and significance. Clinical details of the cases were accessed from biopsy requisition forms and included tissues from various sites in the body. Special stains were done which included acid fast bacilli (AFB), Fite Farraco (FF) stain and gram stain for the identification of bacteria.Results: A total of 318 cases including 288 H. pylori infections, granulomatous inflammation 18, Hansen disease 9 and 3 actinomycosis infections.Conclusions: The histopathological diagnosis of bacterial lesions are of utmost importance as it is more reliable than culture in circumstances of reduced tissue availability. Early reporting is extremely necessary to reduce complications related to bacterial lesions.

scholarly journals Intercostal Muscle Cavernous Haemangioma: A Chest Wall Pandora’s Box: Intercostal muscle cavernous hemangioma

2021 ◽  
Author(s):  
Klein Dantis ◽  
Yashwant Kashyap ◽  
Aghosh Raju ◽  
Swastik Bhardwaj
Keyword(s):  
Differential Diagnosis ◽  
Chest Wall ◽  
Histopathological Examination ◽  
Excision Biopsy ◽  
Histopathological Diagnosis ◽  
Cavernous Haemangioma ◽  
Intercostal Muscle ◽  
Chest Wall Tumours ◽  
Enhanced Computed Tomography ◽  
Feeding Vessel

Background: Haemangiomas are uncommon chest wall tumours arising outside the rib cage. Their occurrence in intercostal muscle is extremely rare. Aim: We describe a case of intercostal muscle cavernous haemangioma as a differential diagnosis for chest wall swelling. Case description: We describe an 18-year-old male patient with an asymptomatic left-sided chest wall swelling. Contrast-enhanced computed tomography revealed a well-defined homogenously non-enhancing mass lesion arising from the seventh intercostal muscle with differential diagnoses of various chest wall tumours. Clinical presentation and imaging findings were inconclusive, but histopathological examination following excision biopsy revealed a cavernous haemangioma. The present case emphasizes the importance of histopathological diagnosis when clinical and radiological examination is inconclusive. Hence, it is necessary to consider intercostal muscle haemangiomas as a differential diagnosis for chest wall tumours in the absence of a feeding vessel. Conclusion: Despite its rare occurrence, intercostal muscle haemangioma must be considered as a differential diagnosis in chest wall tumours even in the absence of a feeding vessel. We believe that histopathology can provide a definitive diagnosis when most investigative procedures are inconclusive.

scholarly journals Adult Nesidioblastosis With Hypoglycemia Mimicking an Insulinoma: A Challenging Case

2017 ◽  
Vol 102 (7-8) ◽  
pp. 324-327
Author(s):  
Banu Sarer Yurekli ◽  
Nilufer Ozdemir Kutbay ◽  
Ilker Altun ◽  
Sevki Cetinkalp ◽  
Deniz Nart ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Endoscopic Ultrasonography ◽  
Pancreatic Beta Cells ◽  
Insulin Level ◽  
Mass Lesion ◽  
Hyperinsulinemic Hypoglycemia ◽  
Case Presentation ◽  
High Insulin ◽  
Calcium Injection ◽  
Venous Plasma

Introduction: Nesidioblastosis is the primary cause of persistent hyperinsulinemic hypoglycemia in infants but it is a rare entity for the adults. Nesidioblastosis is defined as an increase of pancreatic beta cells in number and in size. Case Presentation: We describe a rare case of nesidioblastosis with positive endoscopic ultrasonography result mimicking an insulinoma. A 35-year-old female patient had hypoglycemic episodes with high insulin level. Her investigation revealed low venous plasma glucose, high insulin and C-peptide level with positive 72-hour fasting test suggestive of hyperinsulinemic hypoglycemia. Abdominal computed tomography did not show any mass lesion. Endoscopic ultrasonography revealed a mass lesion sized as 1 cm in diameter in the pancreas. But, insulinoma like lesion couldn't be found intra-operatively. It was decided to perform distal pancreatectomy. After distal pancreatectomy, nesidioblastosis was diagnosed histopathologically. The patient was free from her symptoms after surgery. Conclusion: This case illustrates difficulties and limitations of imaging modalities and false positive result of EUS in a case of nesidioblastosis. When there is no insulinoma like lesion during operation, operation should be performed as gradient guided pancreatectomy by the way of selective arterial calcium injection test.

scholarly journals A Novel Case of Hyperinsulinemic Hypoglycemia in a Neonate With SARS-CoV-2 Infection

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A693-A694
Author(s):  
Remberto Paulo ◽  
Deborah A Bowlby ◽  
Kristal Anne Matlock
Keyword(s):  
Insulin Level ◽  
Underlying Mechanism ◽  
Hyperinsulinemic Hypoglycemia ◽  
Nasopharyngeal Swab ◽  
Close Observation ◽  
High Insulin ◽  
Infection Patient ◽  
High Index Of Suspicion ◽  
Supportive Management ◽  
Dose Dependent

Abstract The Case: An 8 days old male, born at 40 wks, 2.8 kg (SGA) presented to local ED with lethargy, decreased PO intake and urine output, respiratory distress. No fever, URI sx, vomiting/diarrhea. His dad had URI symptoms and fever a week prior. He was found to have T=95.5F, glucose <10 mg/dL, improved to 125 after D10 boluses x2; and required supplemental O2 due to desats/cyanosis. CXR showed bilateral hazy opacities. Sepsis rule out was initiated, patient admitted to the PICU, started on antibiotics and dextrose. Patient became more alert over the next 3 days, but could not be weaned off from IV dextrose/continuous feeds, GIR up to 15 mg/kg/min. He was transferred to our institution. Critical sample at BG of 45 mg/dl showed high insulin level (6.9 uU/ml) and C-peptide (1.25 ng/dl); low beta-OH butyrate <0.2 mmol/L; and free fatty acids (0.25 mmol/L); all suggestive of hyerperinsulinemic hypoglycemia (HH). Cortisol and GH robust at 10.5 mcg/dl and 7.13 ng/ml. Nasopharyngeal swab for SARS-CoV-2 RT-PCR positive. Dad’s swab also positive. Mom was asymptomatic and not tested. ID was consulted, recommended supportive management and close observation. Pt was started on Diazoxide 10mg/kg/day divided q8h, and hydrochlorothiazide (HCT) 5mg/day. Patient’s status gradually improved - BG stabilized, feeds were compressed, IV fluids and O2 supplementation weaned off, and was discharged after 8 days with average BG in the 70-80’s range. Diazoxide and HCT were successfully weaned off in the following 3 mos. To this day patient remains well, no recurrence of hypoglycemia. Discussion/Conclusion: There is a dearth of information on SARS-CoV-2 infection in newborns. The few studies available show favorable outcomes in this population, with typical mild-moderate respiratory symptoms and fever, while some newborns are asymptomatic. Our patient required oxygen tx and developed HH requiring Diazoxide therapy. To our knowledge, this is the first reported case of HH in the newborn with SARS-CoV-2 infection. Hyerperinsulinism is the most common cause of hypoglycemia in infants. These newborns are at risk of developing significant neurologic morbidity, which can be dose dependent. Prompt diagnosis and aggressive management are important to reduce such risk. Perinatal stress is likely the underlying mechanism leading to HH in newborns with SARS-CoV-2 infection. Patient is also SGA. Both perinatal stress and SGA can lead to inappropriately elevated insulin levels and resultant hypoglycemia. HH in both of these conditions is effectively managed by Diazoxide. Our case illustrates that although most newborns do well with SARS-CoV-2 infection, a high index of suspicion for HH should be maintained in such newborns, particularly in those with at least one other risk factor for HH such as SGA. More studies are needed to elucidate underlying pathology and tease out actual incidence of hypoglycemia in neonates with SARS-CoV-2 infection.

scholarly journals Minocycline-Derived Silver Nanoparticles for Assessment of Their Antidiabetic Potential against Alloxan-Induced Diabetic Mice

Pharmaceutics ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 1678
Author(s):  
Syed Akif Raza Kazmi ◽  
Muhammad Zahid Qureshi ◽  
Sadia ◽  
Saleh S. Alhewairini ◽  
Shaukat Ali ◽  
...  
Keyword(s):  
Silver Nanoparticles ◽  
Antioxidant Activities ◽  
Islet Cells ◽  
Histopathological Examination ◽  
Radical Scavenging Activity ◽  
Fasting Blood Glucose ◽  
Radical Scavenging ◽  
The Body ◽  
Central Vein ◽  
Diabetic Mice

Diabetes is a life-threatening disease, and chronic diabetes affects parts of the body including the liver, kidney, and pancreas. The root cause of diabetes is mainly associated with oxidative stress produced by reactive oxygen species. Minocycline is a drug with a multi-substituted phenol ring and has shown excellent antioxidant activities. The objective of the present study was to investigate the antidiabetic potential of minocycline-modified silver nanoparticles (mino/AgNPs) against alloxan-induced diabetic mice. The mino/AgNPs were synthesized using minocycline as reducing and stabilizing agents. UV-visible, FT-IR, X-ray diffraction (XRD), and transmission electron microscopy (TEM) were applied for the characterization of mino/AgNPs. A 2,2-diphenyl-1-picrylhydrazyl free radical scavenging assay was conducted to determine the antioxidant potential of newly synthesized mino/AgNPs. The results revealed that the mino/AgNPs showed higher radical scavenging activity (IC50 = 19.7 µg/mL) compared to the minocycline (IC50 = 26.0 µg/mL) and ascorbic acid (IC50 = 25.2 µg/mL). Further, mino/AgNPs were successfully employed to examine their antidiabetic potential against alloxan-induced diabetic mice. Hematological results showed that the mice treated with mino/AgNPs demonstrated a significant decrease in fasting blood glucose level and lipid profile compared to the untreated diabetic group. A histopathological examination confirmed that the diabetic mice treated with mino/AgNPs showed significant recovery and revival of the histo-morphology of the kidney, central vein of the liver, and islet cells of the pancreas compared to the untreated diabetic mice. Hence, mino/AgNPs have good antidiabetic potential and could be an appropriate nanomedicine to prevent the development of diabetes.

F.N.A.C. AS DIAGNOSTIC TOOL OF PAROTID TUMORS AND ASSOCIATED PITFALLS IN CORRELATION WITH HISTOPATHOLOGY

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Bhawana Pant ◽  
Sanjay Gaur ◽  
Prabhat Pant
Keyword(s):  
Preoperative Diagnosis ◽  
Histopathological Examination ◽  
Clinical Information ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Histopathological Diagnosis ◽  
Cytological Diagnosis ◽  
Tertiary Referral Centre ◽  
Clear Cut ◽  
Parotid Tumors

F.NA.C has been used for ages as a safe and economical tool for fast preoperative diagnosis of parotid tumors. It has certain pitfall which sometimes leads to misdiagnosis and consequently it may have affect on treatment of the tumors. Keeping in view of the diverse classification of parotid tumors’ information from cytology should be combined with radiology as well as clinical diagnosis. Aim: To discuss some cases where there was discrepancy between cytological diagnosis and histopathological result and also suggest measures to improve the efficacy of F.N.A.C. Material and methods: The study includes 50 cases of parotid tumours who presented to the  department of ENT at Government medical college Haldwani which is a tertiary referral centre during 2009 to 2016. Only adult patients were included and inflammatory swelling were excluded from the study. All patients evaluated  Contrast enhanced computerized tomography(CECT) and  Magnetic resonance imaging (MRI) followed by Fine needle aspiration cytology .Preoperative diagnosis was made upon the findings of the above investigations and different types of  parotid surgeries  were done. . Final diagnosis was made on  histopathological  examination. Result :The most common tumour  came out to be pleomorphic adenoma (23 cases-46%) followed by mucoepidermoid carcinoma(12cases-24%). In ten  cases there was no clear cut  association between cytological diagnosis and final histopathological diagnosis. Conclusion: FNAC is highly sensitive and specific technique for diagnosis of many salivary gland swellings. FNAC can be used preoperatively to avoid unnecessary surgery and biopsy. Details of clinical information and radiologic features may help the pathologist to arrive at the appropriate diagnosis and reduce false interpretation. Pitfalls may also occur with improper technique of FNAC which can be overcome by proper caution.

scholarly journals Percutaneous C-Arm Free O-Arm Navigated Biopsy for Spinal Pathologies: A Technical Note

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 636
Author(s):  
Masato Tanaka ◽  
Sumeet Sonawane ◽  
Koji Uotani ◽  
Yoshihiro Fujiwara ◽  
Kittipong Sessumpun ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Standard Technique ◽  
Percutaneous Biopsy ◽  
Technical Note ◽  
Spinal Tumors ◽  
Histopathological Diagnosis ◽  
Ct Guided ◽  
Ct Guided Biopsy ◽  
The Right

Background: Percutaneous biopsy under computed tomography (CT) guidance is a standard technique to obtain a definitive diagnosis when spinal tumors, metastases or infections are suspected. However, specimens obtained using a needle are sometimes inadequate for correct diagnosis. This report describes a unique biopsy technique which is C-arm free O-arm navigated using microforceps. This has not been previously described as a biopsy procedure. Case description: A 74-year-old man with T1 vertebra pathology was referred to our hospital with muscle weakness of the right hand, clumsiness and cervicothoracic pain. CT-guided biopsy was performed, but histopathological diagnosis could not be obtained due to insufficient tissue. The patient then underwent biopsy under O-arm navigation, so we could obtain sufficient tissue and small cell carcinoma was diagnosed on histopathological examination. A patient later received chemotherapy and radiation. Conclusions: C-arm free O-arm navigated biopsy is an effective technique for obtaining sufficient material from spine pathologies. Tissue from an exact pathological site can be obtained with 3-D images. This new O-arm navigation biopsy may provide an alternative to repeat CT-guided or open biopsy.

scholarly journals Histopathological Analysis of Endometrial Biopsy in Gandaki Medical College Teaching Hospital, Pokhara, Nepal

2019 ◽  
Vol 12 (1) ◽  
pp. 25-30
Author(s):  
B Parajuli ◽  
G Pun ◽  
S Ranabhat ◽  
S Poudel
Keyword(s):  
Histopathological Examination ◽  
Hydatidiform Mole ◽  
College Teaching ◽  
Histopathological Diagnosis ◽  
Age Group ◽  
Medical College ◽  
Dilatation And Curettage ◽  
Partial Mole ◽  
Proliferative Endometrium ◽  
The Common

Objective: To study the spectrum of histopathological diagnosis of endometrial lesions and their distribution according to age. Methods: All the endometrium samples obtained by the procedure of dilatation and curettage and hysterectomy sent for histopathological examination at Pathology Department of Gandaki Medical College Teaching Hospital, Pokhara, Nepal. The study duration was total 12 months ranging from July 2016 to June 2017. All the endometrial samples were processed, sectioned at 4 - 6 μm and stained with routine H & E stain. Patient’s data including age, sex, procedure of the biopsy taken and histopathological diagnosis were noted. A pathologist, using Olympus microscope, reported the slides. Cases were reviewed by a second pathologist whenever necessary. Results: A total of 128 cases were studied. The most common histopathological diagnosis was proliferative endometrium (28.9%) followed by disorder proliferative endometrium (15.65%). Most of the patients were in age group 36 - 45 years comprising 32.03%. Hydatidiform mole comprised of 7.03% and among Hydatidiform mole, partial mole was more common. Dilatation and curettage (82.8%) was the common procedure in compare to hysterectomy for the evaluation of endometrial lesions. Conclusions: In this study, we observed a variety of endometrial lesions. Most of them are benign; among benign, proliferative endometrium was the common histopathological diagnosis followed by disorder proliferative endometrium. Most common presenting age group was found to be at 36 - 45 years. In evaluation of hydatidiform mole, partial mole was more frequent in compare to complete mole. Conventional dilatation and curettage is the preferred method in developing countries with limited resource to screen endometrial lesion and therefore biopsy should be sent for histopathological examination. Thus histopathological examination of routinely stained hematoxylin and eosin is readily available and widely accepted standard technique for evaluation of the endometrial lesions.

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