Acinic Cell Carcinoma is a rarest malignant epithelial neoplasm arising from pleuripotent stem cells. ACC constitute 6% of all salivary gland tumor. Most common site is parotid. It is slowly growing tumor with female preponderance most commonly occur during fifth and sixth decades of life. Diagnosis by imaging study are complex, but USG is helpful in evaluating tumor. We are presenting a 9year female, complaint of a painless, freely movable, atraumatic swelling on left cheek measuring 2x1cm2, slowly enlarging since, 8 months. FNAC was performed from the swelling and routine stain (H and E, MGG, Pap) and special stain (PAS) was performed. On cytological smears, overall findings are suggestive of papillary-cystic variant of ACC which is difficult to diagnosed in cytology. PAS stain showed positivity for both intra-cytoplasmic granules and extra-cellular secretions. ACC is a slowly growing multi-potent malignant salivary gland tumor. Management is with surgery.

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INTRODUCTIONPancytopenia is a relatively common hematological entity which is encountered routinely. Pancytopenia is a disorder in which all three formed elements of blood; red blood cells, white blood cells and platelets decreased than normal. Pancytopenia is not a disease entity but a triad of finding that may results from number of disease processes. Pancytopenia develops from variety of mechanism. It could be associated with decrease in hematopoietic cell production either due to destruction of marrow tissue by toxins or replacement by malignant or abnormal cells or suppression of normal growth and differentiation. Other mechanism including ineffective haematopoiesis with cell death in the marrow, formation of defective cells which are rapidly removed from circulation, sequestration and/or destruction of cells by the action of antibodies or, trapping of normal cells in a hypertrophied and over-reactive reticuloendothelial system.1 Bone marrow cellularity varies depending upon the cause. Marrow is hypocellular in primary production defect while in case of ineffective erythropoiesis, increased peripheral utilization or destruction of cell and bone marrow with malignant infiltration are associated with hypercellular and normocellular marrow. The presenting symptoms are usually attributable to the anemia or the thrombocytopenia. Leucopenia is an uncommon cause of initial presentation of the patient, but can become the most serious threat to life during the subsequent course of the disorder. 2 The frequency of underlying pathology causing pancytopenia varies considerably depending upon various factors including geographic distribution. Marrow aspiration is assessed for cytology and trephine biopsy provides overall cellularity, detection of focal lesion and infiltration. The severity of pancytopenia and ABSTRACT Background: Pancytopenia is a relatively common hematological entity. This study was undertaken to find out the various causes of pancytopenia by bone marrow examination of patients admitted to New civil hospital, Surat, Gujarat, India. Methods: This was a prospective study carried out to identify the causes of pancytopenia based on bone marrow examination. Bone marrow examinations were performed in 144 cases for different indications over a period of one year 2015, out of which 40 cases have fulfilled the criteria of pancytopenia. Results: Total 40 cases of pancytopenia were examined during period of one year. The commonest cause of pancytopenia was megaloblastic anemia (35%) followed by aplastic anemia (32.5%). other cause includes acute leukemia, myelodysplastic syndrome (MDS) and round cell tumor. Conclusions: Bone marrow aspiration coupled with trephine biopsy can diagnosed majority cases of pancytopenia. Megaloblastic anemia and aplastic anemia are the commonest causes of pancytopenia. A comprehensive clinical and hematological study of patients with pancytopenia will help in the identification of underlying cause.

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Background: Fine needle aspiration cytology is an inexpensive, minimally invasive, outpatient diagnostic procedure. FNA of salivary gland is easier to perform as the site is superficial and repeat FNAC can be perform. As compared to biopsy methods, FNA is a very smooth, cheaper, outpatient procedure helping clinician to save his time for earlier diagnosis and treatment. Though anatomical structure of the gland is very simple, it is subjected to a diverse and heterogenous range of tumors.Methods: The present study on “Cytomorphological features of salivary gland lesion by FNAC” was carried out on department of pathology from June 2015 to June 2017. 65 patients with salivary gland lesions who were sent to pathology department for FNAC were aspirated and correlated histopathologically.Results: Benign salivary gland lesions contribute to majority of cases (54%). Pleomorphic Adenoma was the most common benign salivary gland lesions and Mucoepidermoid Carcinoma was most common malignant lesion. Parotid gland was the most commonly involved in benign tumors and submandibular gland was commonly involved by malignant tumors. Commonly affected age group by benign salivary gland lesion was 31-40 years and those with malignant salivary gland lesion was 41-50 years.Conclusions: FNA cytology provides useful information for the management of salivary gland lesions and prevents unnecessary surgery in cases of nonneoplastic lesions and identification of malignancy helps the surgeon in deciding type and extent of surgery.

Background: Malaria is a major health problem and infects many individuals despite of various efforts to control it. The present study was aimed to observe characteristics of malaria, seasonal variation and prevalence of malaria in our region. Methods: This retrospective study was conducted in our institute from period of January 2012 to December 2012. All the fever cases undergone investigations for malarial parasites were included in present study for defined time period. All the laboratory data of the patients having fever were retrieved from the Pathology Laboratory of our institute. Results: out of total 32674 reports studied 4907(15.01%) were positive for malaria with overall Slide positivity rate and slide falciparum rate were 15.01% and 38.29% respectively. Incidence of malaria occurs throughout year with increased incidence of P. falciparum in monsoon. Conclusion: In the present study incidence of malaria was higher in monsoon in comparison to other seasons. But throughout the year no declining trends in incidence of malaria was observed. P. vivax malaria was more commonly observed in our study but incidence of P. falciparum increased in monsoon.

Background: Sudden death has plagued mankind from time Immemorial. Clinical presentations include wide spectrum from symptom complex to completely asymptomatic. Sudden cardiac death in many cases, ‘first and only symptom. The high incidence, sudden, unexpected nature, combining with the low successful rate of resuscitation, make sudden cardiac deaths a major unsolved problem. Therefore, this study was conducted to illustrate etiolopathology, risk factors and triggers of sudden death with the expectation to provide new insight in epidemiological aspects of sudden death, which will help in care of patients, and prevention of premature cardiac deaths.Methods: A study of 50 cases of sudden death was conducted at tertiary care hospital. After evaluating detailed history from the family members, autopsy has been performed to find out cause of sudden death.Results: Principal culprit of sudden death is cardiovascular disease. Highest numbers of sudden death are in middle age group and having male preponderance might be due to presence of multiple risk factors, which have added or multiplicative effect. There are few autopsy negative cases, which are unexplained sudden death.Conclusions: Sudden and unexpected deaths in young population frequently become the subject of pathologic investigation to determine the cause of death.

Background: Sickle cell disease (SCD) has a high mortality rate with unexpected sudden death. So, the purpose of the study was to analyze clinical and/or autopsy findings at the time of death among sickle cell disease (SCD) patients. Methods: This is a retrospective study of SCD patients who died between January 2011 to December 2011 and the morphological evidence of the cause of death was studied in a tertiary care hospital of south Gujarat. The clinical data, including the age, gender, symptoms and the major autopsy findings and cause of death were obtained for each patient that included histopathological examination. Results: A total of 472 autopsies were performed, out of which sickled erythrocytes were detected in 40 cases. The mean age at death was 30 years and a male/female ratio of 3:1 and peak mortality was in the 2 nd and 3 rd decades of life. The common causes of death in this study include vaso-occlusive crisis (45%), infection (40%). The terminal infection was heralded by upper respiratory tract (43.7%) and by gastroenteritis (31.2%). Other causes of death included intracranial haemorrhage (2.5%) and cirrhosis (2.5%). Among the cases of SCD, 10% of deaths were nonhaemoglobinopathy related such as fall (accidental), organophosphorus poisoning and snake bite. Conclusion: This study is to precise analysis of causes of death is needed to focus and improve morbidity and mortality in sickle cell disease especially in highly prevalent area and will impact on the overall survival of these patients.