The missing umbilical artery – A case report

Single umbilical artery (SUA) is a condition where one umbilical artery exists. Normally, the umbilical artery contains two umbilical artery and one umbilical vein. The incidence of SUA varies from 0.2% to 0.8%. We present a case of SUA in a term baby with birth weight of 1.7kg delivered by a 28-year-old mother. SUA is a condition which must be kept in mind during histopathological examination since it helps in improving the neonatal and maternal care.

Histopathological study of benign breast lesions

Benign breast lesions are common in young females and are painless. Fibroadenoma is the commonest lesion among all the breast lesions and occurs in any age.1:To study the age and sex wise distribution of benign breast lesions; 2: To study the clinicopathological changes of benign breast diseases; 3: To study different types of benign breast lesions; 4. To study the histomorphological changes of benign breast lesions with clinical correlation.A prospective study of two years was done to evaluate the different types, patterns of benign breast lesions in females in relation to age, clinical and radiological features.A total of 140 benign breast diseases were studied. Fibroadenoma (76; 54.2%) was the most common lesion noted in younger females (18-24yrs) followed by fibrocystic disease (25; 17.8%) & benign phyllodes (14; 10%).FNAC followed by histopathological examination were the diagnostic criteria used for confirmation of the lesions.Benign breast lesions were common in young females, presented with painless, mobile breast lumps. Mastalgia and nipple discharge were other symptoms.

Spectrum of soft tissue lesions in upper and lower extremities on fine needle aspiration cytology: A three years’ experience from Western Indian population

Soft tissue lesions have a wide spectrum which includes non- neoplastic, benign & malignant lesions. FNAC act as preliminary diagnostic tool providing a predictive diagnosis of a benign or malignant soft tissue neoplasm and thus helps for further intervention. This study discusses the spectrum of FNAC of soft tissue lesions in upper and lower limbs.All cytology smears of soft tissue lesions from both upper and lower limbs were included over a period of three years at tertiary care hospital. The most common age group was 31 to 40 years with male to female ratio being 1.3:1. The spectrum included broadly neoplastic (65.7%) & non-neoplastic (34.3%) cases. The neoplasms were further divided as benign (42.8 %), malignant (18.6%) and suspicious for neoplasm (4.3%) whereas (34.3 %) were non-neoplastic lesions. The most common lesion was giant cell tumor (GCT) of tendon sheath. The most common site was hand (24%) followed by feet (22.5%). FNAC of soft tissue lesions is useful for differentiating various lesions and neoplasms in extremities so as to help patients in further management.

Undifferentiated carcinoma with osteoclastic giant cells of pancreas: Case report and brief literature review

Undifferentiated carcinoma with osteoclastic giant cells is a distinctive rare neoplasm involving pancreas and rarely bile ducts. This neoplasm shows characteristic histologic features with variable admixture of mononuclear histiocytic cells, non- neoplastic osteoclastic giant cells and neoplastic mononuclear cell component. Though, this tumor has been shown to share genetic alterations with pancreatic ductal adenocarcinoma, clinically, it behaves unpredictably with a substantial proportion of patient showing prolonged survival period. We present a case of this rare pancreatic tumour with brief literature review discussing the key pathologic features, immunophenotype, genetic profile and clinical behavior. Undifferentiated carcinoma with osteoclastic giant cells is a rare neoplasm in pancreas which is believed to be of epithelial origin and shares genetic aberrations with ductal adenocarcinoma. Despite this, these tumours have better prognosis with prolonged survival period.

Clinicopathological study of lesions of nasal cavity and paranasal sinuses- A two year study

Sinonasal masses are common in the ENT Outpatient Department. The incidence being 1-4% of population. The symptoms and signs frequently overlap, hence, a diagnostic dilemma exists. The aim of this study was to study the occurrence of various lesions, the age, site and sex wise distribution in a tertiary care hospital of Maharashtra over the period of two years. The study aims to examine the occurrence of various lesions in nasal cavity and paranasal sinuses, to determine the age, sex and site wise incidence of different benign and malignant lesions of nasal cavity and paranasal sinuses and to correlate the clinical and histopathological findings. Descriptive Study A descriptive study was carried out in the Department of Pathology at Tertiary Health Care among patients with clinically diagnosed nasal and paranasal sinus lesions attending the OPD of ENT during a period of 2 years. The specimens were grossly examined; fixed and routine microscopic staining was done. Interpretation was done using colour of the nuclei and the specimens were classified as neoplastic and non-neoplastic lesions. The data was statistical analysed. Mean, Median, Mode The most common clinical presentation was nasal obstruction 97 (93.26%), rhinorrhoea 73 (70.19%) and facial pain 24 (23%). 1: Mean age for the lesions to occur was years with the range 21-30 years (20.92%); 2: Non-neoplastic lesions 82 (79.6%) were more common than neoplastic lesions; 3: Simple nasal polyp 74 (90.23%), hemangiomas (50%) and squamous cell carcinoma (50%) were most common. The study concludes that complete clinical, radiological and histopathological correlation helps us to categorize these sino-nasal lesions into various non-neoplastic and neoplastic types. But final histopathological examination provides a confirmatory diagnosis, as a significant number of cases may be missed on clinical evaluation alone.The clinical features of non-neoplastic and neoplastic nasal and paranasal sinuses lesions may be indistinguishable from each other leading to delay in proper diagnosis and treatment. Histopathological examination is a reliable, cost effective diagnostic tool for accurate diagnosis and management of such lesions, as a significant number of cases may be missed on clinical evaluation alone.

Follicular cholecystitis with cholelithiasis – A diagnostic pitfall

Follicular Cholecystitis (FC) is an extremely rare subtype of Chronic Cholecystitis (CC). It is characterized by hyperplastic lymphoid follicles along with prominent germinal centers. It constitutes about 2% of routine cholecystectomies. In this article, we report a case of FC in a 69 years lady. She had abdominal pain, clinically diagnosed as Calculus cholecystitis and managed by laparoscopic cholecystectomy. Grossly, thickening of the gall bladder wall was noted. Histopathological examination revealed gall bladder wall infiltrated by dense lymphoid infiltrate forming lymphoid follicles with prominent germinal centres. Hence, we rendered a diagnosis of FC. The purpose of presenting this case is to make pathologists aware about this entity. One should not mistake this lesion for lymphoma. A careful histopathological examination is diagnostic and Immunohistochemistry may be helpful in difficult cases.Follicular Cholecystitis is extremely rare variant of Chronic cholecystitis. It is characterized by at least 3 Lymphoid Follicles per cm of Gall Bladder tissue with inflammatory infiltrate composed almost exclusively of scattered well-formed Lymphoid Follicles. Pathologist must be familiar with this entity to avoid misdiagnosis of lymphoma.

A histopathological study of unusual findings in appendectomy specimens in a tertiary care hospital of Andhra Pradesh

Acute appendicitis is sudden inflammation of the appendix, usually initiated by obstruction of the lumen. This results in invasion of the appendix wall by gut flora, and it becomes inflamed and infected.: To investigate retrospectivelythe prevalence and implications of unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis.This is retrospective assessment of hospital records of 150 patients who were diagnosed as acute appendicitis and underwent appendicectomy during March 2018 to February 2020 at Government Medical College, Bhagya Nagar, Ongole, Andhra Pradesh .Data of the patients were assessed based on age, sex, histopathological diagnosis, coexisting pathologies and uncommon findings on histology. According to histopathology report, negative for acute appendicitis were noted in 82 cases (55%), whereas positive for acute appendicitis in 68 cases (45.3%) . Rare findings were foundin 38 (55.8%) cases out of 68 cases. Parasites were found in 7 (18.4%) (Enterobius Vermicularis, Balantidum Coli, Schistosoma Haematobium), Mucocele in 12 (32%), carcinoid tumour in 8(21%), B cell malignant lymphoma in 2 (5%), leiomyoma in 2 (5%), Primary appendiceal adenocarcinoma in 3 (8%), Acute appendicitis with dysplastic changes in 2 (5%) and inflammatory bowel polyp was reported in remaining two cases(5%).: Even though unusualpathologies can be seen rarely during appendectomy, this should be kept in mind for further evaluation of each cases.

Role of solid phase immunoassay as a screening test for antinuclear antibody – A comparative analysis on Indian population

Detection of Antinuclear antibody (ANA) is the hallmark of laboratory investigations in Connective Tissue Disorders (CTD). However, various methodologies used in both screening tests and specific antibody detection has led to a loss of consensus and poor reproducibility of results. The objective of this study is to compare Solid Phase Immunoassay (SPI) with Indirect Immunofluorescence (IFA) as a screening test in correlation with the clinical profile as well as subsequent detection of specific antibodies. The study was conducted as a pilot study with a sample size of 60 cases, recruited by Rheumatologists, between April 2019 to July 2019. Each sample was screened by IFA and SPI and tested for specific antibodies by three different specific antibody tests. Although the Sensitivity of SPI (71%) was lower when compared to IFA (79%), the Specificity (78%), Positive Predictive Value (PPV) (74%) and Negative Predictive Value (NPV) (76%) were all comparatively higher. In two clinically proven cases of Sjogren’s syndrome where IFA was negative and SPI was positive, specific antibody tests showed positivity for SSA/Ro. Also it was seen in two clinically confirmed cases of Systemic Lupus Erythematosus IFA was positive and SPI was negative. In this pilot study SPI appeared comparable to IFA as a screening test with better specificity, PPV and NPV. The utility of SPI was especially seen in cases with antibodies against SSA/Ro where IFA may be negative. However, in a few cases of high antibody titer SPI appeared to give a false negative result.

Myeloproliferative neoplasm related nephropathy

Primary Myelofibrosis associated Nephropathy is a recently described entity. Primary Myelofibrosis (PMF) is a Myeloproliferative Neoplasm (MPN) where the marrow space shows fibrosis with megakaryocyte dysplasia. We present a case of a 32 year old patient who was detected to have proteinuria, renal dysfunction and anemia ,on a routine health check up. Primary Myelofibrosis was confirmed by positive Jak 2 expression. Kidney biopsy showed focal segmental glomerulosclerosis along with thickened glomerular basement membrane. The histomorphological features of renal and bonemarrow biopsies are analysed and a detailed review of the literature is done.

Lip Lumps Need not be mucocele

Lip lesions are the most common oral mucosal lesions. Mucocele is the second most common benign soft tissue masses of the lips only next to infectious etiology. Tumors of the minor salivary glands of the lip were a rare diagnosis made clinically. Excision and histopathological examination must be done for all the lip lumps as this remains the gold standard for the diagnosis. In this article, we discuss three lip lumps which were clinically suspected as mucocoele turned out to be an unexpected diagnosis which only became clear following excision and histological examination.