Oral Submucous Fibrosis – A Clinicopathological Correlation

Objective: Oral Submucous Fibrosis (OSMF) is a potentially malignant disorder of the oral mucosa and collagen metabolic disorder caused by betel nut use. Diagnosis of this condition can be made clinically, but ascertaining its malignant transformation histopathology is mandatory. So, the correlation between the clinical and histopathology was conducted. Materials and Methods: The correlation study was conducted on 20 OSMF patients. Clinical diagnosis with histopathological confirmation was based on the standard approach. Study structure included gender, duration, frequency, and quid placement correlated with clinical and histopathological staging. Results: The current study has included most of the subjects being males and was below 25 years. Habit duration, frequency, and quid placement were correlated with clinical and histopathological staging and were directly related. Six subjects of (30%) Group 1 cases associated with 3 (42.9%) in the histologically early stage of the disease. Further, 14 (70%) cases in Group 2 clinical staging correlated with 8 (88.9%) cases in moderately advanced histological staging. Conclusion: The clinical and histopathological correlation was not obtained in the present study. The negative p-value could be because of certain factors like biopsy site selection and decreased study subjects. However, factors like frequency and quid keeping had a positive histopathological correlation.

Application of IAC Yokohama system for breast cytology – The experience at a tertiary care hospital

Breast malignancies are one of the commonest malignancies in Indian women. Increasing urbanization is attributed to raise of breast cancers and have surpassed cervix cancer in recent times and are now ranked top in some metros. FNA is used as an important diagnostic tool as a part of triple assessment. The application of the IAC Yokohama system in breast cytology improves the reporting and also allows the calculation of risk of malignancy (ROM). The main aim of the study is to; 1. Apply the IAC Yokohama system for the diagnostic; 2. assessment and subsequent categorization of FNA samples and correlate them with histopathology examination (HPE); 3. calculate ROM; 4. Calculate p-value.A total of 305 samples received were diagnosed and classified according to the IAC Yokohama system. The study was conducted over a period of 2 yrs retrospectively from June 2019 to May 2021. For the 305 FNA samples received, HPE correlation was made and statistical parameters, ROM , p-value were calculated.305 FNA samples were obtained and categorized according to the IAC Yokohama system. They were categorized and the percentage of incidence noted as 1. Insufficient - 6.89%, 2.Benign - 72.46%, 3.Atypical probably benign - 3.28%, 4. Suspicious - 3.28%, 5. Malignant - 14.09%. ROM was also calculated. The distribution of cases in percentage as per categories are: category 1 – 0%, category 2 - 2%, category 3 – 0%, category 4- , 42.86% category 5- 100%. For 305 FNA samples reported 95 cases received for HPE and subsequently cyto – histopathological correlation was made and statistical parameters were calculated. Compiled statistics showed sensitivity of 100%, specificity of 93.54%, NPV of 100%, PPV of 89.19% and diagnostic accuracy at 95.78%. The p-value for the present study is 0.0001 which is very significant.Application of the IAC Yokohama system of reporting breast cytopathology helps in better categorization of FNA samples and it improves the efficacy of cytopathologist. It gives better clarity to the clinicians in the management of the patient and can reduce unnecessary surgeries.

A Case Series of Atrial Myxomas – A Tertiary Care Centre Experience

Aim: The current study aims at highlighting the clinical presentation, echocardiographic profile and histopathological details of the four cases of cardiac myxoma which we had encountered in our institution within a period of one year and to identify a relationship between the clinical behaviour and the histopathological picture. Results: Among the four cases 2 were males and 2 were females and their ages ranged from 36 to 49 years. Two of the four patients presented with chest pain and palpitations , one with dyspnoea and the other case presented with recurrent stroke. Three of the cases were located in the left atrium while one case was in the right atrium. The histopathological examination of all the cases showed stellate , round and polygonal cells surrounded by abundant myxoid stroma. There was no histopathological correlation between the different clinical presentations or locations of the myxomas. Conclusion: Although histopathological examination is necessary along with echocardiography to make a diagnosis of cardiac myxoma , there is no correlation between the different clinical presentation , site and the histopathological examination.

JESSNER LYMPHOCYTIC INFILTRATE POST COVID VACCINATION

Jessner-Kanof lymphocytic inltrate is a rare benign chronic T cell inltrative disease characterized by multiple tumid erythematous papules,plaques and nodules predominantly on sun exposed sites like face, neck and upper back. Etiology of Jessner lymphocytic inltrate is unknown but autoimmunity, Borrelia burgdorferi infection may have a possible role. There is a case report of Jessner lymphocytic inltrate after third dose of bee venom immunotherapy in hymenoptera venom anaphylaxis. Here,we report a case of 27 year married female who presented with multiple erythematous plaques and few nodules on face ,neck and upper back after 2 days of second dose of covishield vaccine. Clinical and histopathological correlation conrmed the diagnosis of Jessner-Kanof lymphocytic inltrate. Skin biopsy revealed dense perivascular and periadnexal lymphocytic inltrates in the dermis. Dermatological manifestations with covid vaccines are few in clinical volunteers but have been increasing since mass vaccination has started. A few side effects like urticaria , erythema and edema at injection site, pityriasis rosea, covid toes, systemic lupus erythematosus,rheumatoid arthritis have been reported after covid vaccination.

Histopathological Correlation in Different Types of Leprosy in a Tertiary Health Care Centre

Hansen’s disease or Leprosy, is a chronic infectious disease that is contagious and has a slow evolution. It affects mainly skin and schwann cells in the peripheral nerves and causes peripheral neuropathy which contributes to the permanent functional impairments [1]. It is caused by a rod shaped,acid fast staining bacteria known as Mycobacterium Leprae which has parallel sides, round ends and a characteristic bundle of cigar appearance due to the presence of a glial substance which is a surface lipid that makes the bacilli to be arranged side by side in parallel arrays [2]. It has a distinctive empathy towards the peripheral nerves where it establishes originally therefore it is the site where the pathological processes start mainly with the principal target being Schwann cell [3,4]. Amidst the communicable diseases, Leprosy is the most common cause of physical disabilities which is permanent. When the bacterium enters a person with good cell-mediated immunity against it, it gets destroyed. If there is a slight impairment in the cell-mediated immunity against it, some bacilli will multiply and a lesion develops. Depending upon the immune status of a host, it expresses itself in different clinico-histopathological forms [5]. Ridley and Jopling suggested a five-group classification of leprosy known as immunological classification based upon the immunological status of the patient as (a) tuberculoid (TT), (b) borderline tuberculoid (BT), (c) mid-borderline (BB), (d) borderline lepromatous (BL) and (e) lepromatous (LL) [6]. Bacteriological, immunological, clinical and histopathological features exhibit continuous but slow changes from one pole to another pole. The main disadvantage of this classification is that there is no specific position for pure neuritic as well as indeterminate leprosy in the spectrum [7].