No abstract

Background: Automated hematology analyzers have a low degree of accuracy in predicting platelet counts in patients with thrombocytopenia. Hence automated platelet counts should be crosschecked by reviewing the peripheral blood smear in cases of thrombocytopenia. However existing methods for platelet count estimation from peripheral blood smears have certain drawbacks. Hence we suggest a new method to estimate platelet count from peripheral smear and compared it with the existing methods. Conclusion:Platelet count estimation based on platelet/RBC ratio in ten oil immersion fields and total RBC count is a simple and reliable method to estimate platelet counts from peripheral smears.

IntroductionDetermining the histological grade of breast carcinomas before mastectomy is necessary to decide about neoadjuvant chemotherapy. Core needle biopsies used for this purpose often under-grade the tumour. The grade obtained from fine needle aspiration cytology samples will help in such situations and whenever biopsy is not done, as in a resource-poor setup. Many studies are being done to find out the cytological grading system that correlates well with histological grading. MethodsThis study was done between 2016 and 2019 including the cases in which both modified radical mastectomy and fine needle aspiration of the tumour had been done. Robinson's cytological grading was done in Papanicolaou and haematoxylin & eosin (H&E) stained cytology smears and correlated with modified Bloom-Richardson histologic grading done in modified radical mastectomy specimens. We also studied the prognostic significance of Robinson's method by studying the association between cytological grade and lymph node metastasis. ResultsSixty cases were studied. The two methods had the same grade in 49 (81.7%) cases. They showed a significant positive correlation (Spearman correlation coefficient 0.848, p-0.0001), significant association (Chi-square test, p-0.0001), and substantial agreement (kappa value 0.72). Multiple regression analysis showed chromatin score and nucleoli score as the most influential parameters. Lymph node metastasis showed significant association with cytological grade (p-0.0003), cell dissociation score (p-0.0001), nucleoli score (p-0.01), and chromatin score (p-0.04). ConclusionRobinson's cytological grading is a simple, reliable adjunct/alternative to core needle biopsies for grading breast carcinomas before mastectomy. Hence, it can be made a part of routine cytology reporting of breast carcinomas. Further long-term studies will help in confirming its prognostic significance.

Background: Hashimoto’s thyroiditis is an autoimmune disorder of thyroid gland. It is one of thecommon causes of hypothyroidism and is common in females. Generally, Hashimoto’s thyroiditisclinically presents as diffuse enlargement of the thyroid and nodular lesions are uncommon. But fewrecent studies from South India have shown that Hashimoto’s frequently presents as nodularenlargement of the thyroid. Such lesions can be easily confused with nodular goitre. Objectivesand Aim: Aim of the study is to study the clinicopathological features of Hashimoto’s thyroiditis andto estimate the frequency of nodular lesions in Hashimoto’s thyroiditis in a tertiary care healthcentre in coastal South India. Materials and Methods: The present study was done retrospectivelyon patients diagnosed as Hashimoto’s thyroiditis by fine-needle aspiration cytology during the periodJune 2017 to June 2020. Their clinical details, clinical examination findings including diffuse/nodularnature of the swelling, thyroid hormone status and ultrasound findings were studied. Results: In thepresent study, 102 cases of Hashimoto’s thyroiditis were included, which includes 91 females and 11males. Patients age ranged from 15 to 63 years with a peak in the fourth decade. Fifty-five cases(53.9%) were hypothyroid and 43 (42.2%) were euthyroid. Fifty cases (49%) presented as nodularlesion out of which 47 cases had multiple nodules. Conclusion: Nodular enlargement of the thyroidis a common finding in Hashimoto’s thyroiditis patients. Such cases should not be mistaken fornodular goitre as there is a risk of malignancy in Hashimoto’s thyroiditis.

Background: Determining histological grade of breast carcinomas before mastectomy is necessary to decide about neoadjuvant chemotherapy. Grade obtained from fine needle aspiration cytology samples will help in such situations particularly when core needle biopsy is not done routinely as inresource-poor setups. Methods for doing such gradingare still under study. We performedgrading of breast carcinomas in Fine Needle Aspiration smearsby Howell's method and correlatedthe resultswith modified Bloom-Richardson histological grade in mastectomy specimens. For the first time, we also studied the prognostic significance of Howell's grade by studying its association with lymph node metastasis. Materials and methods: Fifty cases of Invasive carcinoma-no special type of breast in which both mastectomy and fine needle aspiration cytology were done between 2013 and 2015 were included in our study. Howell's grading was done in Papanicolaou, Haematoxylin & eosin and May-Grunwald Giemsa stained cytology smears and correlated with modified Bloom Richardson histological grading in mastectomy specimens. Results: The two methods had same grade in 34 cases (68%) and a kappa agreement value of 0.505. They showed a good positive correlation (Spearman correlation coefficient 0.732) and significant association (chi-square test, p-0.0001). 12 cases were under-graded and four were over-graded. Lymph node metastasis significantly increased with increase in Howell's cytological grade (p-0.018). Conclusion: Howell's cytological grading is a simple method to grade breast carcinomas before mastectomy. This method has a good concordance with histological grading.The strong association with lymph node metastasis indicates the prognostic significance of this grading method.