Anandraj Vaithy. K

Introduction: The clinical condition of anaemia is defined as reduction below normal limits of the total circulating red cell mass. It is measured by the reduction in packed red cell volume or reduction in haemoglobin concentration of blood. Patients with hemoglobin below 6 gm/dl usually require transfusion therapy. In stabilized patients with hemoglobin values between 6 and 10 gm/dl, the decision whether to transfuse is based on an evaluation of clinical status. Materials and Methods: The present study comprised of 140 Anaemic patients who received packed red cell transfusion. The study was analyzed for a period of one year. Haematological parameters – complete blood counts were collected by running anticoagulated blood in automated haematology analyser before and after transfusing the blood units. Peripheral smear by using Leishman’s stain. Reticulocyte count by using new methylene blue. Results: Of total 140 patients, 45(34.6%) of patients were clinically diagnosed as iron deficiency anaemia followed by 43(33.1%) anaemia of chronic disease patients, 18(13.8%) of anaemia of chronic kidney disease, 20(15%) of anaemia of liver disease, 10(7.7%) of dimorphic anaemia (anaemia of combined deficiency) and 4(3.1%) of anaemia in hypersplenism. Iron deficiency anaemia is the most common disease group in the present study followed by anaemia of chronic disease. Anaemia is more prevalent in the female population with M:F ratio of 4:5. Particularly iron deficiency anaemia is more prevalent among females with M:F ratio of 1:3. After one unit of packed red cell transfusion the mean increase in Hb in IDA was 1.106gm/dl, in anaemia of ACD was 0.922gm/dl, in anaemia of CKD was 1.015gm/dl, in anaemia of liver disease was 0.614gm/dl in anaemia of combined deficiency was 0.925gm/dl and in hypersplenism was 0.367 gm/dl. Conclusion: From this background the present study concludes that before planning transfusion in anaemic patients, accurate clinical assessment and work up for type of anaemia is essential. After transfusion of one unit of packed red cells in chronic anaemia patients,. In all the types of anaemia studied, the mean increase in Hb and PCV values were statistically more significant (Pvalue   Keywords: Packed red cells, Anaemia, Indications for Transfusion

Serous effusion cytology being a minimally invasive, readily accessible and inexpensive diagnostic procedure. Nevertheless, the accuracy of SEC could vary widely due to the multitude factors including the level of experience of the cytologists Conventional smear has its own limitations with varied efficacy and hence warranting ancillary studies. Cell block has emerged as a paramount and robust platform for sample processing techniques in cytology. Research studies have proved that the efficiency of cytological diagnosis increases by significant margin of 15-20 percent when it is done in conjunction with cell block techniques especially in cases of exudative fluids in picking up crucial cases and based on this, we intended with a novel aim to analyse the accuracy of Serous effusion cytology by combining conventional smear and cell block technique with an attempt to assess the effectiveness of the cell block by our indigenous Modified Bouin’s method. Cell block method prepared by our indigenous Modified Bouin’s preparation with formalin fixative proved to show high quality significance and hence it could be followed in routine practice across laboratories. Cell block technique is quantitatively superior both standalone as well as in conjunction with conventional smear by improving the effective diagnosis of SEC. Diligent use of cell block technique eliminates the suspicious of malignant category on CS and thereby giving more definite diagnosis and thus it is mandated that combined approach of CB in conjunction with CS should be practiced as binary protocol which proved to have obvious influence on patient management.   Keywords: Conventional smear, cell block, serous effusion cytology, Histopathology

Background: Gestational trophoblastic diseases (GTD) are a spectrum of lesions occurs as sequelae of pregnancy and it included non-neoplastic and neoplastic lesions in varied proportions. Multi system approach is warranted to diagnose GTD and studies proposes that clinico-pathological correlation aids in effective diagnosis of GTD in conjunction with ultrasonographic studies. Aim: To analyze the incidence of GTD, clinical characteristics, histopathological evaluation with an attempt to study clinico-radio-pathological correlations in different forms of gestational trophoblastic diseases Methodology: The study was conducted in Department of Pathology, Mahatma Gandhi Medical College & Research Institute, Puducherry from duration between 2014 to 2019 for a period of 6 years as a Quantitative observational and analytical study including all abnormal cases of gestational related histopathological specimens (Products of conception, evacuation, hysterectomy) referred to the laboratory from clinical side The clinical details including patients obstetric history, biochemical parameters like hCG levels, ultrasound findings, etc. were documented to attempt correlation Results: The study analysed 160 cases and showed hydatidiform mole (130 cases) was the common GTD followed by choriocarcinoma (13 cases)and Placental site trophoblastic tumour (17 cases). Beta HCG was the sensitive marker in predicting GTD. Clinico-pathological correlation proved to be significant in directing the clinicians for planning treatment Conclusion: Any pregnant women presenting with abnormal uterine bleeding should be evaluated for underling presence of any GTD. Histopathological evaluation stays as gold standard procedure whereas ultrasonography is significant in detecting GTD lesions preoperatively thereby aids clinicians in proper planning of treatments. Keywords: Gestational Trophoblastic diseases, Mole, Histopathology, Ultrasonography choriocarcinoma.

Background: Fine needle aspiration cytology (FNAC) is a cost-effective diagnostic technique for evaluation of salivary gland lesions. But, then, cytological evaluation of salivary gland lesions also has lot of challenges. To overcome the difficulties, “The Milan system for reporting salivary gland cytopathology” (MSRSGC) was introduced for diagnosis and management and establishing the risk of malignancy (ROM) in different categories. The present study was conducted to grade the salivary gland lesions according to Milan system of reporting and to correlate with their histopathological findings. Material and Methods: The current study was conducted in the department of Pathology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry for a period of 5 years. Around 153 salivary gland lesions were aspirated. Salivary gland swellings were examined clinically, correlated with the details on the request forms and ultrasound findings, palpated and aspirated. The cytological features were evaluated and categorized according to Milan System for Reporting Salivary Gland Cytopathology”: Category 1: Nondiagnostic (ND); Category 2: Non-neoplastic (NN); Category 3:Atypia of undetermined significance (AUS); Category 4a: Neoplasm: benign (NB), Category 4b: Neoplasm:salivary gland neoplasm of uncertain malignant potential (SUMP); Category 5: suspicious of malignancy(SM); and Category 6: Malignant (M). They were further correlated with histopathological findings. All data were entered in MS excel sheet. Results: Total 153 cases were evaluated cytologically, and histological followup was available in 134 cases. The distribution of cases into different categories were as follows Non-Diagnsotic (2.6%), Non-Neoplastic (20.9%), Atypia of Undetermined Significance (1.9%), Neoplastic-Benign (41.1%),Salivary gland neoplasm of Uncertain Malignant Potential (0%), Suspicious of Maligancy (0%) and Malignancy (33.3 %). Risk of malignancy were observed in categories 2 and 6 and were 3.84 % and 78.2 %. Sensitivity of FNAC in diagnosing salivary gland lesions was 84.2 %, specificity was 98.21%,positive predictive value was 94.64%, and negative predictive value was 91.70% with an accuracy of 93.60%. Conclusion: MSRSGC is a novel reporting system in cytological diagnosis of salivary gland lesions. Implementation of this reporting system in cytological diagnosis has enabled establishment of adequate diagnosis, assessment of risk stratification and facilitating clinicians to take further step in management plan. Keywords: Milan system, Salivary gland carcinoma, Diagnostic histopathology, Cytology.

Background: Polycystic Ovarian syndrome (PCOS) is aheterogeneous disorder characterized by systemic dysfunctions and hormonal imbalance causing many morbidities. The incidence is on higher margin especially among Tropical Countries the major reason being inadequate awareness and knowledge about the disease condition. Studies available on PCOS focusses only on clinical diagnostics rather than reassuring awareness to combat the condition Aims & Objectives: To assess and analyse the knowledge, attitude and awareness towards Polycystic Ovarian Syndrome among women of South East coastal population of India Materials and Methods: The study included 150 participants and analysed multiple parameters including sociodemographic profile, knowledge and awareness in a validated questionnaire format. Results: Among the participants, the awareness on PCOS is still below the expected margin with similar results on knowledge and attitude on practices. Conclusion: The present study observed that the current level of awareness on PCOS among the South- Eastern population is still in low key though relatively better than past decades and emphasizes the need to health education and awareness programmes to be incorporated in educational system improve to combat the low knowledge among rural population especially utilizing different sources, targeted approach to provide clear, appropriate and tangible information and preventive measures. Keywords: Polycystic ovarian syndrome, Awareness, Knowledge, Questionnaire.

Introduction: Effusion cytology have gained acceptance worldwide in analysing body fluids, and a positive diagnosis renderedon cytomorphologyis often considered as a definitive diagnosis for further work up. However due to the known limitations, diagno stic problems arise in routine practice to differentiate reactive versus atypical mesothelial cells and malignant cells by the routine conventional smear (CS) method, thereby warranting adjunct studies like cell block techniques to enhance its efficacy Aims: To compare and analyse the cytomorphological features of the conventional cytosmears with those of the cell block sections and also to assess the utility and sensitivity of the cell block method in picking up the definitive diagnosis of pleural effusions. Materials and Methods: The study was conducted in the cytology section of the Department of Pathology, MGMCRI, SBV, Puducherry. Overall 50 pleural fluid samples were subjected to diagnostic evaluation for over a period of 18 months. Along with the conventional smears, cell blocks were prepared from the remnant fluid using Thromboplastin- pooled plasma method. Histopathology samples were obtained in feasible cases Results: Cellularity yield was low in cytosmears and was enhanced when combined with cell block method especially in non diagnostic /hemorrhagic samples, suspicious cases for malignancy, the efficacy was increased by a margin of 20 % more by the cell block method. Also pattern analysis was possible in Cell block and to categorize primary versus metastatic. Conclusions: The cell block method provides high cellular yield, architectural patterns analysis, morphological features and aids in categorizing primary and metastatic effusions thereby, increases the efficacy of effusion cytology serving as a bridge between cytology and histopathology. Keywords: Cell block conventional smear pleural effusions sensitivity.

Introduction: Breast diseases are the major pathological lesion occurring among Tropical females with high co-morbidities. Cystic disease of breast is a broad entity often having many differentials clinically reaching out to the Pathologists. Epidermoid cysts of breast are condition occurring in cutaneous adnexae of extremities and its occurrence in breast is a rare entity. While trauma/therapeutic surgery including trucut biopsy is the major underlying cause, it is characterized by cystic lesion in dermis especially in peri-areolar region. Though radio-imaging serves to pick up cystic lesions, it downplays in categorizing the nature of the cyst. Cytology plays a major role in diagnosing the disease, appropriate clinico-pathological correlation with radio-imaging may improvise early pick up of this condition, thereby aiding in prompt treatment. Materials and Methods: The present study was conducted for a period of 4 years with specific inclusion and exclusion criteria. All the clinical details including history of surgery, trauma, site, socio-demography, size, radio diagnosis etc, were documented in a proforma. Patients are subjected to routine cytology procedure at clinician’s request. Biopsy was done in specific indicated cases as therapeutic procedure and also for histological correlation the data are entered in tables and analysis was done aiming to frame clinico-pathological correlation with radio-imaging interpretation. Results and Observations: A total number of 10 cases were analysed in the study period. Left breast was predominantly affected and age incidence ranged between 3rd to 5th decade. While retro-areolar region was commonly involved, clinical diagnosis had many differentials. Cytology aspirates showed pultaceous to blood mixed material and corresponding Cytology showed keratinous cells with inflammation which were confirmed on histology on 7 available cases. Conclusion: Epidermoid cyst of breast is a rare condition and should be kept as one of the differential diagnosis by clinician and Pathologist while dealing with cystic breast diseases. Cytology procedure holds good in effective diagnosis of the condition and Clinico-Pathological correlation aids in improvising early diagnosis thereby alleviating patient’s stress. Keywords: Epidermoid cyst of Breast, FNAC, Histopathology, Radio-imaging.  

Introduction: Breast being well-developed mammary organ in females is a common site for many non-neoplastic and malignant lesions due to varied underlying etio-pathogenesis. Lymphoma being a malignant clonal proliferation of lymphoid cells, primary breast lymphoma is an unusual entity with non-epithelial origin characterized by florid proliferation of neoplastic lymphoid cells. With uncertain etiology, the clinical presentation is vague with varied radiological and histopathological patterns. In the present study, we analyzed the incidence of primary breast lymphoma with a study on clinico-histopathological pathological spectrum. Methodology: The study was conducted retrospectively and included patients with breast lesions and the histopathological evaluation from their subsequent tissue biopsies. All the clinical data was documented and cytological correlation were done in available cases. Hematological and radiological interpretations are analyzed subsequently as pre-op work up of the patients. Clinico-pathological analysis of the results were done based on knowledge from research works. Results and Observation: The seven years retrospective study included nine cases which fell into the criteria of PBL with average age incidence between 4th & 5th decade occurring retroareolar region with right breast preponderance. Radiological studies picked up malignancy only in few cases but categorization of lymphoma were not reported by imaging. Hematological parameters showed anaemia, leucopenia and pancytopenia depending on extent and involvement of the bone marrow. Histomorphology and subsequent IHC expression stayed gold standard role in diagnosis compared to radiological interpretations. Conclusion: Primary breast lymphoma is rare type of breast cancer with varied presentation. Any patient presenting with solitary, lobulated breast lump in 5th decade, PBL should be kept as one of the differentials especially with anaemia and axillary node enlargement. Clinico-hematological correlation with subsequent histomorphology helps the Pathologist is diagnosing the condition thereby aiding the in Prompt management.   Keywords: Breast Lymphoma, Hematological parameters, Histopathology, IHC, Radio-imaging.