Anupama Praveen Gupta

Abstract

Introduction: Urinary bladder lesions pose significant morbidity and mortality throughout the world. Cystoscopy, a widely accepted technique for diagnosing lower urinary tract lesions has its own limitations. Histopathology is gold standard for diagnosing, staging and to assess the microscopic invasion in malignant lesions. Thus present study was undertaken to study bladder biopsies and to correlate cystoscopic impression with histopathology and to know depth of invasion in malignant lesions. Materials and Methods: It is an observational, prospective study of sixty cystoscopic guided urinary bladder biopsy done at tertiary care hospital over two year period. Results: Out of total sixty biopsies 19 were non neoplastic (8 inflammatory, 9 metaplastic and 2 immune mediated) and 41 were neoplastic (2 benign, 39 malignant) on histopathology. Non neoplastic lesions (19/60) comprised of 4 follicular cystitis, 2 tuberculous cystitis, 2 eosinophilic cystitis. 4 cystitis cystica, 4 squamous metaplasia, one nephrogenic metaplasia and 2 amyloidosis. Neoplastic group (41/60) comprised of one papilloma, one papillary neoplasm of low malignant potential (PUNLMP), 28 transitional cell carcinoma (TCC), 3 adenocarcinoma, 6 squamous cell carcinoma, one small cell carcinoma and one embryonal RMS. Muscle invasion was detected in 8 and vascular invasion in 2 cases respectively. Cystoscopic impression was non neoplastic and neoplastic in 14 /60 and 46/60 respectively accounting for five discordant cases where final diagnosis was offered on histopathology. Conclusion: Cystoscopy and histopathological examinations are complementary to each other in evaluating bladder pathologies but histology remains gold standard. Keywords: Cystoscopy, Urinary bladder, Biopsy, Histopathology, Transitional cell carcinoma.

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Introduction: A focal mass or a nodule in the liver has become easily accessible to the needle of a pathologist, courtesy the rising numbers of guided FNAC. Precise localisation of lesions helps in studying the cytological features in greater detail, of the area in question. A targeted needle aspiration achieves high rates of sensitivity and specificity with regard to the varied spectrum of the pathologies encountered in liver especially when correlated with serological tests. Thus present study was carried out with aim to assess the role of guided FNAC in the diagnosis of nodular lesions of liver and to study their cytomorphology. Materials and Methods: It is an observational, prospective study of 130 adequate aspirates from liver nodules done at tertiary care hospital over two year period. All patients presenting with nodular liver mass detected on imaging techniques were selected for FNAC under USG or CT guidance. Another pass was taken from the surrounding liver to ascertain the presence of parenchymal changes like fatty change, cirrhosis and dysplasia. Results: Adequate aspirates from 130 cases were studied. Lesions were categorised into non neoplastic (11) and neoplastic which were further classified benign (1), primary malignancies (31HCC, 4 cholangiocarcinoma) metastasis (72) and undifferentiated malignancies (11) respectively on cytology. Conclusion: Guided FNAC of the liver is a rapid simple and precise method of identifying the pathology in liver nodules. It can be a useful modality to triage the patients and decide further line of management. Keyword: FNAC, Guided, Nodular lesions, Liver, Cirrhosis.

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Introduction: Corneal buttons removed during penetrating keratoplasties (PK) from recipients’ which were routinely discarded were studied with aim to analyze the common indications of PK and changing pattern of corneal diseases in developing countries like India. Materials and Methods: This is an observational case series carried out in tertiary care hospital of central India from October 2012 to October 2014. Histopathology of 156 corneal tissues was done of which 75 were recipients’ corneal tissues removed during PK and 81 were residual adjacent donors’ corneal tissues left out after corneal button was removed for transplant. Results: The most common indication of PK in our study was corneal ulcer (n=37, 49.33%), followed by infectious keratitis (n=22, 29.33%) which included ulcers in various stages of healing and complications associated with ulcer like adherent leucoma. Amongst infectious keratitis, 17 were (77.27%) of bacterial keratitis and 5 (22.73%) of fungal keratitis. Followed by bullous keratopathy 8(10.66%), 3(4%) of graft rejection and one each (1.33%) of Fuchs’ dystrophy and chronic actinic keratopathy. Of 81 donor’s corneal tissues, 75 were the residual corneal tissues from corneo-conjunctival junction which were transplanted within stipulated time. Only one case showed changes of chronic actinic keratopathy, rest showed normal histology. 6 corneas which were not transplanted within stipulated time showed epithelial denudation and stromal degeneration with loss of keratocytes. Conclusion: Histopathology gives additional insight to clinical diagnosis. Specific diagnosis can be commented in corneal opacities and infectious keratitis. Keywords: Penetrating Keratoplasty, PK, Histopathology, Corneal buttons, Recipient.

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