Histopathological audit of appendectomy specimen in a Tertiary Care Center.

Objectives: To evaluate the histopathological findings in appendectomy specimens and observe the negative appendectomy rate (NAR). Study Design: Observational study. Setting: Department of Surgery Unit III, Peoples University of Medical & Health Sciences, Nawabshah. Period: January to December 2018. Material and Methods: 117 consecutive cases of appendectomy. All the demographic data and the clinicopathological details were recorded on a proforma designed for the study. The histopathological assessment was carried out in all cases. The ultrasound examination and CT scan was carried out in selected cases. The data collected was statistically analyzed and the results were tabulated. Results: During study period 117 appendectomies were performed. The mean age of patient was 27+9.4 years, majority of patients (53.8%) were females with female to male ratio of 1.2:1. The histopathological diagnosis was made in all cases and the results indicates that 105 cases having positive appendectomy and in 12 (10.3%) cases the appendix was found histologically normal. Among 105 positive cases, 97 (83%) were diagnosed as acute appendicitis, 2 (1.7%) cases show fibrous obliteration and 6 (5.1%) cases were having unusual pathologies. The cases having histological diagnosis of acute appendicitis includs acute mucosal appendicitis, acute suppurative appendicitis with or without periappendicitis and peritonitis, acute necrotizing appendicitis and perforated gangrenous appendicitis. The 6 cases of unusual pathologies includes 3 cases of granulomatous lesions and one case each of carcinoid tumor, mucinous cystadenoma and worm infestation. The ultrasound was performed in 48 (41%) patients out of them 30 cases had positive findings on ultrasound examination were confirmed on histological examination and all 5 positive cases that were reported on CT scan were confirmed on histopathological examination. Conclusion: High rates of negative appendectomy in the female sex were observed, that can be reduced by the use of diagnostic imaging modalities specially ultrasound. The findings of abnormal pathologies on histopathological examination of the appendix suggest that histopathological analysis is necessary in all of the resected specimens.

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CLINICOPATHOLOGICAL STUDY OF SURFACE EPITHELIAL OVARIAN TUMORS- A TERTIARY CARE CENTER STUDY.

10.36106/paripex/6710834 ◽

2020 ◽

pp. 1-4

Author(s):

Priyanka Nimbalkar Jadhav ◽

Raviraj Jadhav

Keyword(s):

Histopathological Examination ◽

Wide Spectrum ◽

Care Center ◽

Tertiary Care ◽

Female Genital Tract ◽

Mucinous Cystadenoma ◽

Serous Cystadenoma ◽

Ovarian Tumors ◽

Histopathological Diagnosis ◽

Care Hospital

Background: Ovarian tumors are one of the most common tumors, which occur in female genital tract. Despite the newer techniques in imaging and molecular biology, the diagnosis of ovarian tumors primarily depends on histopathological examination. Ovarian tumors manifests a wide spectrum of clinical, morphological and histological features. The aim of the study was to find the incidence of surface epithelial ovarian tumors in a tertiary referral centre. Materials and methods: A retrospective data of 3 years were collected for surface epithelial ovarian tumors submitted to the pathology department of the tertiary care hospital and analysed. The correlation of these surface epithelial ovarian tumors was done with age, clinical presentation and histomorphological patterns. Non-neoplastic lesions like simple ovarian cysts, tubo-ovarian mass and polycystic ovaries were excluded. Results: A total number of 56 cases were studied. Out of which 44 cases were benign and 12 cases were malignant. Maximum cases were observed between 21 to 30 years. Mass per abdomen was the most common presentation(36%) followed by mass and pain in abdomen(27%).Serous cystadenoma formed maximum 28 cases(50%) followed by Mucinous cystadenoma(16 cases) 28 % , Serous cysadenocarcinoma formed 5cases (9%), followed by Mucinous cystadenocarcinoma 3 cases(5%) & 2 cases each(4%) of clear cell carcinoma and endometrioid carcinoma were noted. The most common histopathological type of benign and malignant tumor was serous cystadenoma (50.2%) and serous cystadenocarcinoma(9%) respectively. Conclusion: In the study majority (78.6%) of the surface epithelial ovarian tumors were benign. Malignancy was seen in (21.4)% of the cases. Surface epithelial tumours present a great challenge to the gynecologic oncologist because non-neoplastic ovarian lesions can form a pelvic mass and potentially mimic a neoplasm. Correct histopathological diagnosis of surface epithelial ovarian tumors is of prime importance in view of their behavioral predictability and clinical correlation for proper management of the patient.

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COMPARATIVE STUDY OF CT-SCAN FINDINGS WITH BIOPSY IN LIVER MASSES DONE AT A TERTIARY CARE CENTER

10.36106/ijsr/2430348 ◽

2020 ◽

pp. 1-2

Author(s):

Bhanupriya Singh ◽

Khushal N Pawar ◽

Suhas S Ghule ◽

Dilip L Lakhkar

Keyword(s):

Ct Scan ◽

Predictive Value ◽

Care Center ◽

Tertiary Care ◽

Malignant Lesion ◽

Normal Liver ◽

Liver Lesion ◽

Cross Sectional Study ◽

Histopathological Diagnosis ◽

Cross Sectional

Background: More than 80% of all primary hepatic malignancies are hepatocellular carcinoma. Identification of a liver lesion depends on the attenuation difference between normal liver and the lesion. CT helps in detecting tumors and their size in liver quiet successfully. Accurate detection of liver mass is crucial for the deciding the treatment regimens. Objective: The study was undertaken to compare the results of CT-scan to histopathology findings. Methodology: This cross-sectional study was carried out in the Department of Radiodiagnosis and Imaging, Dr. Vitthalrao Vikhe Patil Foundation’s Medical College, Ahmednagar in association with Department of pathology of the concerned institute for histopathological diagnosis from 01-03-2014 to 28-02-2015 for a period of one year. Patients having hepatic mass of any sex or age presenting in the hospital were included in the study. The exclusion criteria were as patients refusing consent, or CT-scan and/or biopsy, known adverse reaction to contrast agent. CT scan and histopathology were done in all the subjects. Result: 50 subjects were studied in this study. Mean age of all subjects was 52.88 ± 16.03 years with a range of 18 year to 85 years. 40 cases were male in the study group. Maximum number of cases were in the age group 40-59 years. Out of 28 confirmed malignant cases by histopathology, 27 cases were diagnosed as malignant by CT scan too. Sensitivity of CT to diagnose malignant lesion was 96.4%, specificity 86.4%, accuracy 92%, positive predictive value 90% and negative predictive value 95%. Conclusion: CT scan can be used as a tool for the detecting of malignant liver masses.

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A study on the clinical and sonological correlation in the diagnosis and management of acute appendicitis in a tertiary care centre

International Surgery Journal ◽

10.18203/2349-2902.isj20192365 ◽

2019 ◽

Vol 6 (6) ◽

pp. 2053

Author(s):

Keerthi Mudavath ◽

Thinagaran K.

Keyword(s):

Acute Appendicitis ◽

Scoring System ◽

Histopathological Examination ◽

Iliac Fossa ◽

Tertiary Care ◽

Negative Appendectomy ◽

Common Symptom ◽

Emergency Setting ◽

Alvarado Score ◽

Histopathological Findings

Background: Acute appendicitis is the most common acute surgical condition of the abdomen requiring early intervention. The diagnosis is often challenging and the decision to operate in an emergency setting is always debatable. Alvarado score for diagnosis of acute appendicitis is easy and additional tools like sonography results in accurate diagnosis. The aim was to evaluate accuracy of the clinical Alvarado scoring system, radiological findings and histopathological examination for the diagnosis of acute appendicitis.Methods: 100 cases of acute abdomen admitted in PES institute of medical sciences and research, Kuppam from December 2016 to June 2018 were included. Clinical examination was done and all patients were subjected to ultrasound abdomen examination and other relevant blood and imaging investigations.Results: Out of 100 patients 62 were males and 38 were Females. Most common symptom was pain in the right iliac fossa and patients with Alvarado Score 7 or > 7 subjected to USG followed by emergency appendectomy showed positive operative findings and histopathological findings. The overall specificity of abdominal USG in the diagnosis of acute appendicitis was 88.09% and sensitivity was 95.37%.Conclusions:The Alvarado scoring system combined with ultrasound can therefore be used as a cheap and less expensive useful, reliable and non invasive way of confirming acute appendicitis thus helps in reducing negative appendectomy rate. The overall accuracy of diagnosis of acute appendicitis goes up to 90% with positive histopathological findings.

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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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Clinical and histopathological analysis of the patients undergoing appendectomy

Journal of Pathology of Nepal ◽

10.3126/jpn.v8i2.20862 ◽

2018 ◽

Vol 8 (2) ◽

pp. 1337-1340

Author(s):

Kamal Koirala ◽

Shiva Raj KC ◽

Ganesh Simkhada ◽

Rupesh Mukhiya ◽

Nisheem Pokharel ◽

...

Keyword(s):

Acute Appendicitis ◽

Histopathological Examination ◽

Diagnostic Tools ◽

Histopathological Analysis ◽

Negative Appendectomy ◽

Alvarado Score ◽

Female Ratio ◽

Medical College ◽

Clinical Scoring ◽

Modified Alvarado Score

Background: Acute appendicitis is one of the most common surgical emergencies, but the diagnosis is difficult even with the sophisticated diagnostic tools. The aim of this study is to analyze the clinical and histopathological features of acute appendicitis and to see how reliable the clinical scoring system modified Alvarado score in our setup.Materials and Methods: This was a retrospective observational study of patients who underwent appendectomy at KIST Medical College and Teaching Hospital during two years. The clinical characteristics of the patients in terms of modified Alvarado scoring were outlined. The diagnosis of acute appendicitis was confirmed by histopathological examination. The data were tabulated in MS-Excel and statistically analyzed using SPSS statistics software, version 21.Results: Among 118 patients, who underwent appendectomy, 69 were male and 49 were female with male to female ratio of 1.41:1 and mean age of 27.46±12.724 years.The clinical diagnosis of acute appendicitis was more likely (MAS 7-9) in 56 patients, less likely (4–6) in 44 patients and unlikely (MAS 1-3) in 18 patients. The highest incidence of acute appendicitis was observed in 19-40 years and the lowest incidence in 61 years or above. After histopathological examination, 52 patients out of 56 in the more likely group had acute appendicitis and 4 patients had non-inflamed appendices. 7 patients out of 62 in the less likely and unlikely groups had acute appendicitis and 55 patients had non-inflamed appendices. The overall negative appendectomy rate was 9.32 percent.Conclusion: Our clinical practice of using modified Alvarado score in the diagnosis of acute appendicitis is effective, easy and non-invasive.

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Successful conservative surgical management of ovarian mucinous cystadenoma with silent torsion in pregnancy: a case report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200915 ◽

2020 ◽

Vol 9 (3) ◽

pp. 1278

Author(s):

Arpita De ◽

Reva Tripathi

Keyword(s):

Pregnant Woman ◽

Tumor Markers ◽

Surgical Management ◽

Histopathological Examination ◽

Care Center ◽

Tertiary Care ◽

Mucinous Cystadenoma ◽

Cystic Mass ◽

Gravid Uterus ◽

In Pregnancy

To report the successful conservative surgical management of Ovarian mucinous cystadenoma with silent torsion in a 24 years old pregnant woman in a tertiary care center in Delhi. An antenatal woman came for a routine visit to the OPD of the hospital at 13 weeks gestation. She had a vague, mild pain in lower abdomen since the last four weeks. A cystic mass was discovered during an abdominal examination. Further on sonography, a multisepatated cystic mass was seen, likely to be mucinous cystadenoma. Routine tumor markers came out to be negative. A laparotomy was planned at 15 weeks. On laparotomy a 20 × 15 cm multiloculated cyst with one and half turns of torsion was found. Detorsion, cystectomy of the intact cyst followed by ovarian reconstruction was done after due consent. On histopathological examination the cyst was found to be Benign mucinous cystadenoma. The pregnancy continued without any adverse effects. The woman delivered vaginally at 38 weeks without any feto-maternal complications. She was able to conceive again spontaneously at 18 months post-delivery. After 16 weeks of gestation in the second pregnancy she went to her home town and no further follow-up was possible. This case emphasizes the importance of a thorough examination in all pregnant woman to rule out any adnexal mass separate from the gravid uterus. Big ovarian masses in pregnancy, if not diagnosed can cause growth retardation, preterm deliveries, acute abdomen due to infection, rupture or torsion. Sonography, MRI and tumor markers can facilitate diagnosis before surgery. Torsion and rupture of mucinous cystadenoma need prompt surgery. Wherever possible conservative surgery (detorsion and cystectomy) should be done especially in young women.

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Necessity of routine histopathological examination of gall bladder specimens after elective cholecystectomy: An experience at Tertiary Care Hospital of Southern Punjab Pakistan

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.06.3846 ◽

2020 ◽

Vol 27 (06) ◽

pp. 1171-1175

Author(s):

Sadaf Shafique ◽

Raheel Khan ◽

Raees Abbas ◽

Bakhtawer Mehmood

Keyword(s):

Gall Bladder ◽

Histopathological Examination ◽

Tertiary Care ◽

Pathological Examination ◽

Histopathological Analysis ◽

Histopathological Diagnosis ◽

Care Hospital ◽

Benign Diseases ◽

Selective Approach ◽

Elective Cholecystectomy

Objectives: Few centers adopt a selective approach in sending these specimens to pathology department for histopathology whereas it is a routine procedure in our setup. In our study, few unexpected cases of adenocarcinoma of gall bladder were seen during investigation of results of pathological examination of gall bladder specimens. Study Design: A retrospective histopathological analysis of gall bladder specimens removed during elective cholecystectomy for benign diseases was done. Setting: Department of Pathology, Quaid-e-Azam Medical College/Bahawal Victoria Hospital Bahawalpur. Period: 1st January 2018 to 31st December 2018. Material & Methods: The demographic properties of the patients were evaluated from the past records and their association was seen with the histopathological diagnosis and frequency of unexpected cases of gall bladder carcinoma. Results: Total of 840 cases were reviewed with mean age of the patient 42.48±14.8 years. The most frequent diagnosis was chronic cholecystitis with cholelithiasis (n=806) which was associated with upper abdominal pain (p<0.01). It was more prevalent among females sex (n=742). Six patients (0.7%) showed evidence of adenocarcinoma of gall bladder which had no gross abnormality on macroscopic examination. Conclusion: It is very significant to do routine histopathological examination of all the gall bladder specimens removed for benign diseases during elective cholecytectomies which incidentally may also be associated with carcinoma gall bladder and may require further surgical intervention.

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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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CORRELATIVE STUDY OF HISTOPATHOLOGICAL DIAGNOSIS WITH CLINICAL & ENDOSCOPIC DIAGNOSIS IN UPPER GASTROINTESTINAL ENDOSCOPIC BIOPSY AT TERTIARY CARE CENTER

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i2.1737 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

Shana Nikhat Khan ◽

Sanjeev Narang

Keyword(s):

Gastrointestinal Tract ◽

Clinical Diagnosis ◽

Histopathological Examination ◽

Care Center ◽

Tertiary Care ◽

Upper Gastrointestinal Tract ◽

Histopathological Diagnosis ◽

Surgical Department ◽

Gastrointestinal Lesions ◽

Upper Gastrointestinal

Lesions of Upper gastrointestinal tract (GIT) is commonly seen in surgical department patients. These patients are subjected to endoscopic examination and biopsy is taken for further histopathological diagnosis. A clinical, endoscopic and histopathological diagnosis is made. This study was done to compare and correlate the results of histopathological diagnosis with endoscopic and clinical findings. Study Designed: A total 50 Upper Gastrointestinal tract biopsy cases received in histopathology lab were analyzed. Material and Method: All endoscopic biopsies from upper GIT were received and processed. Paraffin blocks were made and sections were cut at 4 microns thickness and stained with routine hematoxylin and eosin stain. Their clinical and endoscopic reports were collected and compared with histopathological diagnosis. Result: After analyzing statistically the data, we found that endoscopy results were better than clinical diagnosis and more closer to histopathological diagnosis. Conclusion: Relation of histopathological diagnosis with endoscopic findings & clinical diagnosis was done in our study. We conclude that endoscopy is incomplete without histopathological examination of biopsy & so, the combinations of both plays an important role in diagnosis & management of upper gastrointestinal tract disorders. Histopathological examination remains the gold standard. Keywords: Histopathology, endoscopy, gastrointestinal lesions.

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