Abstract Introduction: Endometrial carcinoma (EC) is the most common gynaecological malignancy in developed countries and has been classified into two groups, type 1 and type 2. Type 1 or endometrioid endometrial carcinomas (EECA) accounts for 80% of EC and are thought to develop following a continuum of premalignant lesions ranging from endometrial hyperplasia without atypia (EH) and atypical hyperplasia (AH). PTEN (phosphatase and tensin homolog), a tumor suppressor gene is commonly inactivated in 83 % of endometrioid carcinoma and 55% of precancerous lesions. Cyclin D1, a cell cycle regulator is overexpressed in about 40% of endometrial carcinomas. Aim: To study the expression of PTEN (Phosphatase and tensin homolog) and Cyclin D1 in non-neoplastic and neoplastic endometrial lesions by immunohistochemistry (IHC). Methods: A 2 year cross-sectional study (September 2017 to August 2019) on 115 endometrial samples was done in the Department of Pathology, RIMS. Histomorphological features and IHC expression of PTEN and Cyclin D1 in the various endometrial lesions were studied and evaluated, data collected in IBM SPSS Statistics 21 was statistically analyzed using Chi - square and Fisher’s Exact test. Results: Out of the 115 cases, 47(40.9%) were diagnosed as benign proliferative endometrium, 20(17.4%) benign secretory endometrium, 21(18.3%) hyperplasia without atypia, 15(13.0%) atypical hyperplasia and 12(10.4%) endometrial carcinoma with an age group spanning from 26-68 years (mean age = 46.4). Following IHC staining, 91.7%(11/12) and 83.3%(10/12) cases of EC and 80%(12/15) and 73.3%(11/15) cases of AH showed complete loss of PTEN expression and Cyclin D1 overexpression, respectively when compared to other benign lesions and was statistically significant (p < .001). Conclusion: Loss of PTEN and Cyclin D1 overexpression was seen in a significant number of EECA and AH, suggesting both as an early event in endometrial carcinogenesis. Therefore, we propose the use of PTEN and Cyclin D1 immunostaining as an adjunct to histopathological diagnosis as it may be informative in the identification and further management of premalignant endometrial lesions that are likely to progress to carcinoma Keywords: PTEN, Cyclin D1, endometrial hyperplasia, endometrial carcinoma, endometrioid endometrial carcinomas.
Background: Renal diseases are an important cause of morbidity worldwide. Nephrectomy is a common surgical procedure done in neoplastic as well as many non- neoplastic conditions affecting the kidney. It is performed in a wide range of clinical conditions that leads to irreversible kidney damage like chronic infections, obstruction, calculus disease, severe traumatic injury, pyelonephritis, nephrosclerosis and renal cell carcinoma. In a developing country like ours chronic pyelonephritis and its variants still continue to be the leading cause of nephrectomies. ToObjective : determine the frequency of occurrence of different histomorphological kidney lesions observed in Nephrectomy specimens over a period of ve years in a tertiary care center. A hospital based ve-year study (Jan 2017 to March 2022) that included 93 cases of NephrectomyMethods : specimens received in the Department of Pathology, RIMS was taken into consideration. The gross and the microscopic ndings were studied for determining the relative frequency and spectrum of different lesions affecting the kidney. Out of 93 nephrectomy specimens, 83 (89.2%)Results : were non neoplastic and 10 (10.8%) were neoplastic cases. Out of the 83 non neoplastic cases 75 (90.3%) were of chronic pyelonephritis and out of the 10 neoplastic cases 8 (80%) were of clear cell RCC and 2 (20%) were papillary urothelial carcinoma (renal pelvis). The neoplastic cases were seen equally in both the genders. The females (67.7%) were more commonly affected then the males (32.3%). The peak age range was between 51- 60 (26.9%) years. Right sided (59.1%) lesions were more common than the left side (40.9%). 35 cases (46.7%) were associated with nephrolithiasis. Chronic pyelonephritis is the most common non neoplastic lesion affecting the kidney which in its early stage is aConclusions: treatable cause for which nephrectomy could be prevented. Therefore, a better insight of the various etiologies needs to be further studied which will help in better patient management.
Background: Coronavirus disease 2019 (COVID-19) is a novel infectious disease caused by SARS-CoV-2 which was rst recognized in Wuhan, China, in December 2019. Patient of COVID-19 presents with wide range of hemostatic abnormalities. The aim of this study is to evaluate the pattern of the hematological parameters in COVID-19 patients. Method: A cross-sectional study was conducted in Department of Pathology, RIMS, Imphal from May 2020 to May 2021. Total of 594 COVID-19 positive cases were included, data collected in IBM SPSS Statistics 21 was statistically analysed. Results:Among the 594 patients, 366 (61.6%) were male, 228 (38.4%) female with an age range of 1 to 90 years(Mean±SE, 44.21±18.52). COVID -19 was most common in the age group of 21-30 years and 31-40 years. Low hemoglobin was seen in 191 cases(32.2%), lymphopenia in 217 cases(36.5%), leukocytosis in 163 cases(27.4%) and thrombocytopenia in 160 cases(26.9%). Conclusion: Lymphopenia, neutrophilic leukocytosis, decreased hemoglobin and thrombocytopenia were common ndings in Covid-19 patients with a male predominance.
Thrombotic thrombocytopenic purpura (TTP) is a syndrome characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological abnormalities, fever and renal dysfunction. Early clinical suspicion and presumptive diagnosis of TTP helps in timely initiation of treatment modalities specic for TTP which may prove to be lifesaving and thus augment in reducing the mortality rate of TTP which is estimated to be 80 – 90 % if left untreated. We report a case of a known case of multiple myeloma who developed TTP which proved fatal despite plasmapheresis. Signicant autopsy ndings of presence of microthrombi in the microvasculature of multiple organs is also highlighted.
BACKGROUND Diseases of the prostate are common causes of morbidity and mortality in adult males. Benign prostatic hyperplasia is an extremely common disorder in men over the age of 50. Other frequently encountered diseases affecting the prostate are prostatitis, benign prostatic hyperplasia and prostatic cancer. Histopathological examination of prostate biopsy specimen is required to rule out the benign or malignant enlargement of prostate gland in older men. We wanted to study the histopathological patterns of prostatic diseases in prostatectomy specimens in RIMS Hospital. METHODS A 5-year cross sectional study was carried out between October 2007 and October 2012 in the Department of Pathology, RIMS. All the prostate specimens received for histopathological examination during the period of study were fixed, processed, and stained with Haematoxylin and Eosin, and examined for various prostatic lesions.
Background: The prostate is a retroperitoneal organ encircling the neck of the bladder and urethra. Though the diagnosis of the prostatic lesions are analyzed through histopathological examination (HPE), sometimes, diagnosis can be challenging, when pathologist are faced with certain problems such as small foci of Ca or benign mimickers. In such situation, immunohistochemical (IHC) detection of basal cells are widely used. To Objectives: assess the expression of basal cell markers (p63 and 34betaE12) in various prostatic glandular proliferations and to differentiate suspicious glandular lesions as benign or malignant. A two year cross-sectional s Methods: tudy (Sept'2016 –Aug'2018) , total of 52 cases of both TURP and prostate biopsy specimens sent to the department of Pathology, RIMS for HPE were studied using IHC markers p63 and 34betaE12, following H&E stain and the expressions of the markers were studied. Results: Out of 52 cases, 41(78.8%) cases were diagnosed as Benign proliferative hyperplasia (BPH), 8(15.4%) cases as prostatic carcinoma, 2(3.8%) cases as high grade prostatic intraepithelial neoplasia (HGPIN) and one (1.9%) case of adenoleiomyobromatous hyperplasia (AMFH) on H&E section with age range of 51 to 90 years (mean age: 72 years). Following IHC staining, 43 (97.7%) benign cases were positive for both p63 and 34betaE12, one (2.3%) case of benign lesion was negative for both the IHCs. 8(100%) cases of malignant lesions were negative for both the IHCs. A p-value of 1.000 was observed indicating that there is no signicant difference in the sensitivity of p63 and 34betaE12. In this cross- Conclusion: sectional study of 52 cases of prostatic lesions, HPE and the role of basal cell specic IHC markers p63 and 34beta12 were studied. No signicant difference was observed in the sensitivity between the two markers. Further comparative study with larger sample size is needed to comprehend the differences in the utility of p63 and 34etaE12 in diagnosing suspicious prostatic lesions.
Background: Distinction between reactive mesothelial cells, malignant mesothelioma and carcinoma is challenging in both biopsy and cytologic material. This study was conducted to differentiate benign/ reactive mesothelial proliferation from malignant mesothelial proliferations and metastatic adenocarcinoma by using immunohistochemical (IHC) markers Desmin (DES), Epithelial membrane antigen (EMA) and Calretinin (CAL) in pleural uid cell block (CB) preparations. A two year descriptive study (Oct.2016- Sept.2018). 46 pleural uids samples sentMethods : to the Dept. of Pathology, RIMS for routine examination and histopathological examination by CB preparation were studied using IHC markers EMA,DES and CAL following H & E stain. Out of 46 cases, 9(19.6%) cases were diagnosed as benign, 23(50.0%) as reactive andResults: 14(30.4%) as adenocarcinoma on H & E section by CB preparations within an age range 34 to 80 years (Mean±SE, 60.32±12.13). Following IHC staining with EMA, DES & CAL, 11(23.9%) cases were conrmed as benign, 17(37.0%) as reactive, 16(34.8%) as adenocarcinoma and 2(4.3%) cases as malignant mesothelioma. This study showed that EMA, DES and CAL helpful in conrming benign or reactive mesothelialConclusions: and malignant mesothelial with epithelial cells which will be helpful in providing appropriate diagnosis in difcult cases and provide better patient management.
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