Oral pemphigus vulgaris: clinicopathological study of 35 cases at a tertiary care centre in North India

Background: The purpose of the study was to evaluate the clinical and histopathological features of oral pemphigus vulgaris.Methods: A prospective study of 35 cases of oral pemphigus vulgaris, over a period of 2.5 years from June 2014 to December 2016 in the Department of Dermatology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar was designed. Complete history and detailed mucocutaneous examination was done. Punch biopsy was performed from the oral mucosa and skin lesions (if present). Specimen was sent for histopathological examination and results analysed.Results: Out of 35 patients, 17 (48.57%) were males and 18 (51.42%) were females. Male to female ratio was 1:1.1. The majority of the patients (12, 34.29%) were in the 40-49 year age group. Multiple sites were involved in all patients with bilateral buccal mucosa being involved in all the cases, followed by tongue (30, 85.71%). Histopathological examination showed presence of suprabasal split and acantholytic cells in all cases. Conclusions: Oral ulcers are a presenting feature of pemphigus vulgaris which commonly precede the skin lesions. Histopathological examination enables early diagnosis of the disease which leads to prompt treatment and decreased morbidity.

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Histomorphological analysis and clinical correlation of neoplastic and non neoplastic skin lesions: a study in a tertiary care centre of Western Uttar Pradesh, India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20203093 ◽

2020 ◽

Vol 8 (8) ◽

pp. 2820

Author(s):

Mithila Bisht ◽

Anjana Arya ◽

B. C. Choudhry

Keyword(s):

Histopathological Examination ◽

Tertiary Care ◽

Uttar Pradesh ◽

Skin Lesions ◽

Punch Biopsy ◽

Histopathological Analysis ◽

Histopathological Diagnosis ◽

Tertiary Care Centre ◽

Male Predominance ◽

Dermatological Disorders

Background: Clinical examination may suffice in making diagnosis of most dermatologic disorders but histopathological examination is often required to confirm the diagnosis and further categorize the lesions. Authors carried out this study to analyse the demographic and histomorphological characteristics of skin lesions, to determine the frequency of various dermatological disorders in the region and to evaluate the agreement between clinical and histopathological diagnosis.Methods: Punch biopsies of skin lesions received in histopathology section, were included in the study. Cases over a period of six months were analysed. Clinical details were recorded and histopathological analysis done. Special stains were applied wherever required.Results: Of the 120 cases studied, maximum cases fell in the category of 31-40 years, with male predominance. Authors observed wide variety of non-neoplastic and neoplastic lesions. Infectious diseases were the most common of all pathologies. Leprosy was the most common histopathological diagnosis. Complete clinicopathologic correlation was seen in 51.67% of cases while partial correlation was noted in 23.33% making a total of 75%. 25% histopathological diagnosis were inconsistent with the clinical diagnosis.Conclusions: Histopathology is a gold standard investigation and plays a very important role in confirmation of clinical diagnosis of various skin lesions. Punch biopsy is a relatively easy outpatient procedure to perform.

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Histopathological Study of Lesions of the Nasal Cavity, Paranasal Sinuses and Nasopharynx in a Tertiary Care Centre, Visakhapatnam over a Period of 2 Years

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/557 ◽

2021 ◽

Vol 8 (33) ◽

pp. 3054-3059

Author(s):

Rajendra Prasad Jagannadham ◽

Lakshmi Latchupatula ◽

Sravani Ponnada ◽

Neelima Lalam ◽

Raghunadhababu Gudipudi ◽

...

Keyword(s):

Nasal Cavity ◽

Paranasal Sinuses ◽

Histopathological Examination ◽

Tertiary Care ◽

Histopathological Study ◽

Histopathological Diagnosis ◽

Malignant Tumours ◽

Tertiary Care Centre ◽

Female Ratio ◽

Male Predominance

BACKGROUND A variety of non - neoplastic and neoplastic conditions involve the nasal cavity, paranasal sinuses and nasopharynx and these are very common lesions encountered in clinical practice. Histopathological examination of these lesions is the gold standard for diagnosis because management and prognosis vary among different lesions. The aim of the present study was to evaluate the histopathological study of the lesions of the nasal cavity, paranasal sinuses and nasopharynx in relation to their incidence, age, gender and site wise distribution and to compare the results with the available data. METHODS A study of 88 cases was conducted for a period of 2 years from August 2017 to July 2019. After fixation, Processing and Haematoxylin and Eosin staining and special stains histopathological diagnosis was made. RESULTS Among 88 total cases, 58 were males and 30 were females. A male predominance was observed with a male to female ratio of 1.93 : 1. They were more common in third, fourth and fifth decade of life. Malignant nasal lesions were seen after fourth decade of life. Nasal lesions were more common in nasal cavity (67.05 %), followed by paranasal sinuses (18.18 %) and nasopharynx (14.75). Out of 88 total cases, 39 (44.32 %) were non - neoplastic, 30 (34.09 %) were benign and 19 (21.59 %) were malignant nasal lesions. CONCLUSIONS Sinonasal lesions and nasopharyngeal lesions can have various differential diagnoses. A complete clinical, radiological and histopathological correlation helps to categorize these sinonasal lesions into various non - neoplastic and neoplastic types. But histopathological examination remains the mainstay of definitive diagnosis. KEYWORDS Nasal Cavity, Paranasal Sinuses, Nasopharynx, Benign Tumours, Malignant Tumours, Histopathological Examination

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Diagnostic challenges in late-presenting congenital diaphragmatic hernia: a 16-year experience from tertiary care centre in North India

Tropical Doctor ◽

10.1177/0049475519827109 ◽

2019 ◽

Vol 49 (2) ◽

pp. 138-141 ◽

Cited By ~ 1

Author(s):

Kamal Nain Rattan ◽

Jasbir Singh ◽

Poonam Dalal

Keyword(s):

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Tertiary Care ◽

Therapeutic Interventions ◽

North India ◽

Ultrasound Screening ◽

Care Centre ◽

Tertiary Care Centre ◽

Female Ratio ◽

Plain Chest Radiograph

With increasing use of ultrasound screening, the prenatal diagnosis of congenital diaphragmatic hernia (CDH) in better resourced areas has become the norm. However, early diagnosis is still not universal in resource-poor settings and late presentations of CDH continue. We retrospectively analysed the medical records of children operated for late-presenting CDH from 2001 to 2016 at our tertiary care centre in North India. A total of 32 patients were operated during the period with a male-to-female ratio of 3:1. Of these, 78% presented with respiratory symptoms, 37% with recurrent vomiting and 18% with an acute abdomen. Nine (28%) had been treated erroneously for gastroenteritis and another six (18%) had received anti-tubercular therapy for variable periods. A plain chest radiograph with a Ryle’s tube in situ was confirmatory in 75% (24/32). In conclusion, initial misdiagnosis and subsequent unnecessary therapeutic interventions were the leading cause of morbidity .

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Clinico-pathological features in fatal Covid-19 Infection: A Preliminary Experience of a Tertiary Care Centre in North India using Post-Mortem Minimally Invasive Tissue Biopsies

10.1101/2020.11.12.20229658 ◽

2020 ◽

Author(s):

Animesh Ray ◽

Deepali Jain ◽

Shubham Agarwal ◽

Shekhar Swaroop ◽

Ayush Goel ◽

...

Keyword(s):

Minimally Invasive ◽

Histopathological Examination ◽

Diffuse Alveolar Damage ◽

Tertiary Care ◽

North India ◽

Common Finding ◽

Post Mortem ◽

Tertiary Care Centre ◽

Cell Hyperplasia ◽

Suitable Alternative

AbstractBackgroundThe Covid-19 pandemic began in China in December 2019. India is the second most affected country, as of November 2020 with more than 8.5million cases. Covid-19 infection primarily involves the lung with severity of illness varying from influenza-like illness to acute respiratory distress syndrome. Other organs have also found to be variably affected. Studies evaluating the histopathological changes of Covid-19 are critical in providing a better understanding of the disease pathophysiology and guiding treatment. Minimally invasive biopsy techniques (MITS/B) provide an easy and suitable alternative to complete autopsies. In this prospective single center study we present the histopathological examination of 37 patients who died with complications of Covid-19.MethodsThis was an observational study conducted in the Intensive Care Unit of JPN Trauma Centre AIIMS. A total of 37 patients who died of Covid-19 were enrolled in the study. Post-mortem percutaneous biopsies were taken by the help of surface landmarking/ultrasonography guidance from lung, heart, liver, and kidneys; after obtaining ethical consent. The biopsy samples were then stained with haematoxylin and eosin stain. Immunohistochemistry (IHC) was performed using CD61 and CD163 in all lung cores. SARS-CoV-2 virus was detected using IHC with primary antibodies in selected samples. Details regarding demographics, clinical parameters, hospital course, treatment details, and laboratory investigations were also collected for clinical correlation.ResultsA total of 37 patients underwent post-mortem minimally invasive tissue sampling. Mean age of the patients was 48.7years and 59.5% of them were males. Respiratory failure was the most common complication seen in 97.3%. Lung histopathology showed acute lung injury and diffuse alveolar damage in 78% patients. Associated bronchopneumonia was seen in 37.5% patients and scattered microthrombi were visualised in 21% patients. Immunostaining with CD61 and CD163 highlighted megakaryocytes, and increased macrophages in all samples. Immunopositivity for SARS-CoV-2 was observed in Type II pneumocytes. Acute tubular injury with epithelial vacuolization was seen in 46% of the renal biopsies but none of them showed evidence of microvascular thrombosis. 71% of the liver tissue cores showed evidence of Kupfer cell hyperplasia. 27.5% had evidence of submassive hepatic necrosis and 14% had features of acute on chronic liver failure. All the heart biopsies showed non-specific features such as hypertrophy with nucleomegaly with no evidence of myocardial necrosis in any of the samples.ConclusionsThe most common finding in this cohort is the diffuse alveolar damage with demonstration of SARS-CoV-2 protein in the acute phase of DAD. Microvascular thrombi were rarely identified in the lung, liver and kidney. Substantial hepatocyte necrosis, hepatocyte degeneration, Kupffer cell hypertrophy, micro, and macrovesicular steatosis unrelated to microvascular thrombi suggests that liver might be a primary target of Covid-19. This study highlights the importance of MITS/B in better understanding the pathological changes associated with Covid-19.

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A HISTOPATHOLOGICAL STUDY OF LEPROSY ALONG WITH CLINICAL CORRELATION.

10.36106/ijar/9106785 ◽

2020 ◽

pp. 1-4

Author(s):

Gudeli Vahini ◽

C. Swathi ◽

P. UmaRani ◽

G.Mary Niharika ◽

T. Asha

Keyword(s):

Histopathological Examination ◽

Tertiary Care ◽

Giant Cells ◽

Lepromatous Leprosy ◽

Clinical Feature ◽

Histopathological Study ◽

Tertiary Care Centre ◽

Female Ratio ◽

Erythema Nodosum Leprosum ◽

Tuberculoid Leprosy

Background: Leprosy or Hansen’s disease is a chronic infectious disease that mainly affects skin and peripheral nerves. Histopathology and demonstration of lepra bacilli is an essential tool to supplement clinical examination and diagnosis for correct classification and therefore treatment of patients. Aim: To study histopathology of leprosy cases and identify histological types in patients in a tertiary care centre, Asram hospital in Eluru. Materials and Methods: 18 skin biopsies diagnosed as leprosy over a period of two years from January 2018 to December 2019 were studied. Haematoxylin-eosin and Fite-Faraco staining for demonstrating lepra bacilli were done. Results: Male to female ratio of patients was 4.5:1. Maximum number of cases was seen in the 3rd and fourth decades of life. The commonest histological type was borderline tuberculoid (5 cases, 28%) and indeterminate type, lepromatous type (3 cases, 16%); followed by tuberculoid leprosy and erythema nodosum leprosum (2 cases, 11%), the least common cases were of lepromatous leprosy to borderline tuberculoid leprosy (1cases, 6%). The most common site was upper limb (26%). All 3/18(24%) patients with affected nerves showed ulnar and auricular nerve involvement. Hypopigmented, anaesthetic plaque was the commonest clinical feature followed by erythematous lesions. All cases of borderline tuberculoid, borderline lepromatous, lepromatous, midboderline and indeterminate showed acid-fast bacilli on Fite stain. Tuberculoid cases showed well-formed granulomas, borderline tuberculoid type showed additional feature of giant cells and lepromatous types showed grenz zone and no granulomas. Conclusion: Histopathological examination is the gold standard for accurate diagnosis and typing of leprosy. It should be done in all leprosy cases presenting to the clinician.

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Postinfective Glomerulonephritis (PIGN) in Children Attending a Tertiary Care Centre in Nepal

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v34i3.10707 ◽

2015 ◽

Vol 34 (3) ◽

pp. 221-224

Author(s):

DR Poudel ◽

S Basnet ◽

FC Gami

Keyword(s):

Clinical Features ◽

Past History ◽

Tertiary Care ◽

Skin Lesions ◽

University Teaching ◽

Tertiary Care Centre ◽

Female Ratio ◽

Pedal Oedema ◽

The Common ◽

Pedal Edema

Introduction: Post infectious glomerulonephritis (PIGN) is one of the common paediatric kidney disease in developing countries. This study was undertaken to describe the common clinical features, biochemical findings and complications in children with PIGN. Materials and Methods: This was a retrospective descriptive study in which 30 patients admitted with a diagnosis of PIGN at Tribhuvan University Teaching Hospital (TUTH) in a six month period (July 2014 to Dec 2014) were included. Hospital medical records were reviewed for the data collection. Results: Out of 30 patients, 24 (80%) were between 5 to 15 years of age (mean age of 11.5±3.3) with male to female ratio of 2.3:1. Pedal oedema and hypertension were the clinical features seen in 29 (97%) and 28 (93%) patients respectively. Hypocomplementemia was found in 29 (97%) patients. Recent past history of sore throat seen in 10 (33%) patients and skin lesions in 12 (40%). The complications noted were congestive cardiac failure in 5 (17%) patients, rapidly proliferative glomerulonephritis in 3 (10%) and encephalopathy in 1(3%). Conclusion: The most important clinical and biochemical profile observed in nepalese children with PIGN are the hypertension, pedal edema and hypocomplementemia. J Nepal Paediatr Soc 2014;34(3):221-224 DOI: http://dx.doi.org/10.3126/jnps.v34i3.10707

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Pigmented Lesions of Skin: A Histopathologic Experience at a Tertiary Care Center in Central Nepal

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v17i1.28276 ◽

2021 ◽

Vol 17 (1) ◽

pp. 1-9

Author(s):

Binita Goyal ◽

Suman Rai ◽

Mamata Sedhain ◽

Pratigya Subedi

Keyword(s):

Cell Carcinoma ◽

Malignant Tumors ◽

Histopathological Examination ◽

Care Center ◽

Tertiary Care ◽

Skin Lesions ◽

Histopathological Diagnosis ◽

Female Ratio ◽

Pigmented Lesions ◽

Pigmented Skin Lesions

Introduction Pigmented skin lesions refer to lesions that are brown, black or blue in color. These are not always melanocytic in origin. Keratinocytic, vascular or reactive pigmentation in other lesions can also appear pigmented. The main aim of the study was to see the histopathological spectrum and objective was to compare clinical and histopathological diagnoses in pigmented skin lesions. Methods This descriptive study was carried out on 43 pigmented skin lesions that were biopsied over a 1 and half year period from Jan 2018 to June 2019 in College of Medical Sciences and Teaching Hospital. Results Age of the patient ranged from 10 to 88 years and mean±SD was 42.02±19.73 years. There were 21 (48.8%) males and 22 (51.2%) females with a male female ratio 0.9:1. Melanocytic nevus was the most common histopathological diagnosis (11 cases, 25.6%). Reactive pigmentation was seen in 20 (46.5%) cases. Malignant cases comprised 6 (14.0%) cases which included 2 (4.7%) cases of melanoma, 2 (4.7%) cases of pigmented basal cell carcinoma and 1 (2.3%) case each of basaloid squamous cell carcinoma and trichoblastic carcinoma each. Clinicopathological agreement could be seen in 32 (74.4%) cases. However, malignancy was clinically suspected in only half of histologically diagnosed cases. Conclusions Melanocytic nevi were the most common pigmented lesions diagnosed. Not all pigmented lesions are melanocytic in origin. Malignant tumors can sometimes appear deceptively benign and also tumors other than melanoma can be pigmented. Hence, histopathological examination remains the gold standard in diagnosing these conditions and guiding appropriate management. Keywords: melanocytic; melanoma; nevus; pigmented.

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Peripheral lymphadenopathy and FNA: a two-year evaluation at a tertiary care centre

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20190057 ◽

2019 ◽

Vol 7 (2) ◽

pp. 582

Author(s):

Jiby Soosen Ninan ◽

De Souza Johanna Alba ◽

Thoppil Reba Philipose

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Histopathological Examination ◽

Tertiary Care ◽

Age Groups ◽

Surgical Excision ◽

Needle Aspiration ◽

Tertiary Care Centre ◽

Diagnostic Laboratory ◽

Female Ratio

Background: Lymphadenopathy is an age old affliction of mankind and a very common presentation in clinical practice. The main purpose of an FNA biopsy of abnormal peripheral lymph nodes is to determine whether further surgical excision of the lymph node is indicated for histopathological examination. The aim of the present study was to evaluate the role of fine needle aspiration cytology in patients with superficial lymphadenopathy and to correlate with histopathology wherever possible.Methods: A two-year study was undertaken at the Central Diagnostic Laboratory at A.J. Institute of Medical Sciences, Mangalore. Patients of all age groups referred to the Central Diagnostic Laboratory for FNA of superficial lymph nodes were included in the study. All the slides of the cases were reviewed and impression recorded.Results: Out of 200 cases, 73% were non neoplastic, 27% were neoplastic. Cases occurred most commonly in age group of 21-30 years. The male to female ratio was 1.7:1 and most common site of lymph node aspiration was cervical lymph node in (n =107) 53.5% cases. Reactive hyperplasia was the most common non- neoplastic cause of lymphadenopathy seen in 34.5% cases and metastasis to lymph node was the most common cause of neoplastic lymphadenopathy seen in 22% of the cases. The sensitivity was 90%, specificity was 100% and accuracy was 96.2%.Conclusions: FNA is a very efficient, simple, safe, inexpensive and economical test for detecting the various causes of lymphadenopathy.

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Correlation of clinical and histopathological diagnoses of oral mucosal lesions at tertiary care centre: a retrospective study

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20202657 ◽

2020 ◽

Vol 6 (4) ◽

pp. 515

Author(s):

Ankita M. Maheshwari ◽

Vidya D. Kharkar

Keyword(s):

Retrospective Study ◽

Histopathological Examination ◽

Tertiary Care ◽

Pemphigus Vulgaris ◽

Definitive Treatment ◽

Tertiary Care Centre ◽

Oral Mucosal Lesion ◽

Histopathological Correlation ◽

Oral Mucosal Lesions ◽

Mucosal Lesions

Background: The objective of the study was to study the correlation between clinical and histopathological diagnoses of oral lesions.Methods: Data of all patients attending the department of Dermatology KEM Hospital, Mumbai with oral mucosal lesions who underwent biopsy for histopathological examination in a duration of one year was included in this retrospective study. Their clinical and histopathological diagnoses were correlated and data was analysed.Results: A data of total of 164 patients was included in study. Out of the clinically diagnosed, histopathological correlation was found to be 66.66% for oral leucoplakia, 81.25% for lichen planus, 72% for squamous cell carcinoma, 88% for pemphigus vulgaris and 75% for submucosal fibrosis. Overall correlation found was 75.60%.Conclusions: Histopathological examination of oral mucosal lesion is very important to arrive at the accurate diagnosis and to plan definitive treatment. Histopathological examination of oral mucosal lesions must be done routinely because wide variety of conditions present with similar morphologic features and can be the initial signs of many skin disorders.

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Profile of head and neck neoplasms at a tertiary care centre in North India: two years pilot study (2018-2019)

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202221 ◽

2020 ◽

Vol 6 (6) ◽

pp. 1175

Author(s):

Manish Munjal ◽

Porshia Rishi ◽

Nitika Tuli ◽

Harjinder Singh ◽

Shivam Talwar ◽

...

Keyword(s):

Oral Cancer ◽

Oral Cavity ◽

Head And Neck ◽

Salivary Glands ◽

Head And Neck Neoplasms ◽

Tertiary Care ◽

Neck Surgery ◽

North India ◽

Tertiary Care Centre ◽

Female Ratio

Background: In India 53,251 New Head and neck cancer cases are diagnosed every year. Oral cancer is the predominant subsite among both benign and malignant lesions.Methods: A retrospective study of cases with head and neck neoplastic lesions was conducted in department of otolaryngology, head and neck surgery, Dayanand Medical College and Hospital Ludhiana during for a period of 2 years (January 2018 to December 2019). Demographic, gender profile of the patients was studied. Results: Incidence of oral cancer was 21.5% followed by salivary glands 18.9%. among head and neck neoplasms over a period of 2 years (January 2018 to December 2019). The overall male to female ratio was 1:1.25, among benign was 1:1 and among malignant was 1:1.3.Conclusions: Commonest subsite of benign lesions was - oral cavity followed by salivary glands and larynx. Most common malignant subsite was oral cavity followed by larynx and thyroid. Male patients outnumbered the female. Mean age of presentation varied according to subsite.

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