Background:Salivary gland lesions, especially the neoplastic lesions constitute a highly heterogeneous histopathologic group. Several studies have reported a significant difference in the global distribution of salivary gland tumors, but no formal study has been carried out in this part of the globe.Objectives:To document the pattern of various salivary gland tumors in Manipur, a state in North Eastern India.Materials and Methods:This is a 10 years (2002-2011) retrospective study of all salivary gland specimens received at our referral teaching hospital in Manipur, India. All the histopathology slides of salivary gland specimens during the study period were reviewed and clinical details were obtained from the archives. Restaining of slides and fresh sections of tissue blocks were performed whenever required. Data thus collected were analyzed.Results:A total of 104 cases of salivary gland lesions were studied during the study period. Age ranged from 5 years to 78 years with an overall slight female preponderance (M:F = 1:1.08). Parotid (56.65%) was the commonest gland involved followed by submandibular gland (31.73%).Neoplastic lesions comprised of 78 (75%) cases and non-neoplastic lesions constituted 25% (26 cases). Among the neoplastic lesions, benign lesions (53.85%) predominated over malignant lesions (21.15%). Pleomorphic adenoma was the commonest benign neoplastic lesion and mucoepidermoid carcinoma was the commonest malignant tumor. Chronic sialadenitis was the predominant lesion in the non-neoplastic group.Conclusion:The principal site for salivary gland tumors was the parotid gland and pleomorphic adenoma outnumbered all the other tumors. Females are more affected in the malignant group.

Objective: To review the demographic, clinical and histomorphological aspects of xanthogranulomatous inflammation (XGI) in different organs. Material and methods: All the cases diagnosed as XGI by histopathology from the specimens received in the department of Pathology, Regional Institute of Medical Sciences, Imphal, Manipur, India over the period of 10 years from January 2001 to December 2010 were included in the study. All the available data including age, sex, organ of involvement, association with stone etc. were collected and analyzed retrospectively. All the slides were reviewed. The results were recorded and analyzed. Results: A total of 98 cases of XGI were diagnosed out of a total of 9755 specimens received, constituted by 5382 of gall bladder, 4298 of appendix, 41 of kidney and 24 of tube and tubo-ovarian mass making an overall incidence of 1%. The incidence of XGI in kidney was 12.19%, followed by 4.16% in tube and tubo-ovarian mass, 1.5% in gall bladder and 0.25% in appendix. Maximum number of cases were in the age group of 41-50 years with 33.67%. The female to male sex ratio was 2.5: 1. 90.2% cases in kidney and 86.6 % in gall bladder were associated with calculi. One case was associated with adenocarcinoma of gall bladder. Conclusion: Xanthogranulomatous inflammation which often mimics malignancy clinically and morphologically, is increasingly recognized in different anatomic locations. An accurate diagnosis will relieve the psychological panic of suspected malignancy and prevent the patient from aggressive treatment. DOI: http://dx.doi.org/10.3329/bjms.v13i3.16266 Bangladesh Journal of Medical Science Vol.13(3) 2014 p.302-305

Background: Peripartum hysterectomy is a life saving procedure performed for intractable obstetric haemorrhage. Uterine atony, rupture, abnormal placentation, retained products etc. are common indications. With the rise of caesarean sections, the incidences of peripartum hysterectomies are increasing worldwide. The aim of the present study is to evaluate the histomorphological findings in peripartum hysterectomy specimens received during a five year period. Material and Method: In this hospital based cross-sectional study during a five year period (Jan 2014 –Dec 2018), 64 peripartum hysterectomy specimens received in the department of Pathology, RIMS, Imphal, Manipur were included. The gross and histomorphological findings were evaluated, studied, statistically analysed and compared with other studies. Results and Observation: The various histomorphological findings were abnormal placentation 28 (43.7%), uterine atony 15 (23.5%), uterine rupture 14 (21.8%), retained placenta/product 6 (9.3%) and subinvolution 1(1.5%).  Abnormal Placentation and Placenta cretas were the most common finding in the present study. The lower uterine segment was the most common abnormal site of placental implantation. The age ranged from 21 to 45 years, with majority of the cases were in the          30-39years age group. History of previous caesarean section was noted in 20 cases (31.2%). The relative risk of abnormal placentation was 2.5 times higher in those cases with prior history of caesarean section. Rupture was most commonly associated with multiparous women. Co-morbid overlapping features were seen in few cases. Conclusion: Histopathological diagnosis not only confirmed the clinico-radiological impression, but also highlighted the other co-morbid associations that caused the intractable haemorrhage which warranted a peripartum hysterectomy.   Keywords: Peripartum Hysterectomy, Abnormal placentation, caesarean section, chorionic villi.

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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 Caesarean section delivery, in spite of its popularity has its short-and long-term complications like infections, haemorrhage, adhesions, abnormal placentation, uterine rupture and hysterectomy. Many studies have shown an increasing incidence of abnormal placentation which includes placenta previa, placenta accreta, placenta increta and placenta percreta to be related with the rising trend of caesarean section delivery. Again, abnormal placentation is a life-threatening condition often associated with massive postpartum haemorrhage and in recent studies it is the most common indication for peripartum hysterectomy. Deliveries by caesarean section are also increasing in our institute. METHODS In this hospital based cross-sectional study, 91 peripartum hysterectomy cases received in the Department of Pathology, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, during a ten-year study period (January, 2009 to December, 2018) were included in the study. The gross and microscopic histopathological findings were statistically analysed in relation to age, parity, number of previous caesarean sections using SPSS software. Significance of the risk of abnormal placentation between cases of previous caesarean section and vaginal deliveries was evaluated by chi-square test (p-value of ≤ 0.05) and odds ratio (OR). RESULTS During the ten years study period, 91 peripartum hysterectomy cases were selected and studied. The overall rate of peripartum hysterectomy was 1.27 per 1000 births. The age of the cases ranged from 20 to 45 years and 81.3 % were multiparous (parity two and above). The main pathological lesions were abnormal placentation-41 (45.05%), ruptured uterus-16 (17.58%), uterine atony-21 (23.07%) and retained product of conception-13 (14.28%). In 32 (35.16%) cases, there was history of previous caesarean section once in 14 and twice in 18, of which 23 (71.88%) cases had abnormal placentation pathology comprising of placental praevia 12 (37.50%), placental accreta 4 (12.5%), placental increta 5 (15.62%) and 2 (6.25%) placental percreta. CONCLUSIONS Abnormal placentation which includes placenta praevia, placenta accreta, placenta increta and placenta accreta is one of the most important causes of intractable postpartum haemorrhage necessitating a peripartum hysterectomy. Previous caesarean delivery has a 5.82 times higher risk of developing placentation abnormalities in subsequent pregnancies than previous vaginal delivery.

Most of the chronic kidney diseases will not produce any symptoms till it reaches an advanced stage. In medicolegal autopsies most of the cases are brought with an unknown pathology. This cross sectional study was conducted to assess the gross and histopathological findings of kidney in medicolegal autopsies in the Department of Forensic Medicine and Toxicology of a tertiary care teaching institute in Imphal from 2018 to 2020. Kidney samples from a total of 170 medicolegal cases, comprising of 135 males and 35 females (M:F = 3.8:1), were examined. The prevalence of kidney findings in the present study was 77%. The commonest kidney pathology encountered was tubular necrosis (51.8%) followed by glomerulosclerosis (15.9%). Acute tubular necrosis was found more commonly in deaths due to trauma resulting in shock, haemorrhage and asphyxia. Incidental findings included a case of right solitary kidney and a rare case of right crossed fused renal ectopia. Even though these conditions of the kidneys were not directly responsible for the death of the individuals, they could have contributed to these deaths up to some extent.