BACKGROUND In cases of sudden death, myocarditis is not an unusual finding especially when communicable diseases of viral origin are on the rise. Detection of myocarditis poises a diagnostic challenge to clinicians due to the absence of specific symptoms and there is a possibility of this being masqueraded as myocardial infarction. Examination of autopsy specimens are of utmost importance to detect the underlying etiology. For diagnosis of myocarditis histopathological examination of cardiac tissue is the gold standard. This is carried out based on Dallas criteria. Aim-This study was done to assess the, gross and histopathology findings in myocarditis in post mortem specimens in a tertiary care hospital in Kerala over a span of 4 years. METHODS This is a descriptive observational study. All cases of Myocarditis diagnosed in the Department of Pathology, Medical College, Kottayam during the period of 4 years from January 2012 to December 2015 were included. Age distribution, gross and histopathologic findings were studied using the registers, post mortem specimens and histopathology slides in the department. Immunohistochemical studies were done in paraffin blocks of all newly diagnosed cases of myocarditis and some previously diagnosed cases the data was analyzed using SPSS. RESULTS We received a total of 82 cases of myocarditis. The age distribution ranged from 75 days to 83 years. There was greater predilection for males accounting for 62% of cases. Inflammation was found in all cases and the predominant inflammatory cells were lymphocytes seen in 73% of cases. Myocyte necrosis was found in majority of the cases (98%). CONCLUSIONS Myocarditis was found to be an important cause of sudden death accounting for 0.15%.The age group affected was more in the 3 rd and 4 th decade,which was comparable with other similar studies. Viral myocarditis constituted the majority of cases and mononuclear inflammation was seen in myocardium. Myocarditis was seen as part of systemic inflammation in 70% of cases. Application of Dallas criteria was helpful in diagnosis but correlation with clinical details and meticulous examination of coronaries are also needed to exclude conditions which may mimic myocarditis.
Background: Cystic lesions of pancreas consist of a broad spectrum of reactive, benign and malignant conditions. The most common among cystic pancreatic lesions is pseudocyst of pancreas. Cystic tumours of pancreas are less common than solid one’s accounting for less than 1% according to some studies. Literature review showed only a few extensive studies on cystic lesions of pancreas, especially from South India.Methods: Our research is a descriptive histopathological analysis of 38 cases of cystic lesions of pancreas, done in the department of pathology of our institution, over a period of 5 years.Results: We received a total of 38 cases of cystic lesions of pancreas. The age distribution ranged from 17 to 77 years. Male to female ratio was 24: 14. There were neoplastic and non neoplastic entities. Pseudocyst of pancreas was the most common cystic lesion (12 cases). Benign neoplasms included serous cystadenomas, mucinous cystadenomas and lymphangiomas. Ductal adenocarcinomas with cystic degeneration and adenocarcinomas with mucinous component were some of the malignant cystic lesions.Conclusions: Cystic pancreatic lesions accounted for 24% of all the pancreatic lesions received in our institution during the period of this study. 24 cases (63%) were benign lesions and 14 cases (37 %) were malignant. Though cystic lesions of pancreas especially neoplasms are less frequent than solid neoplasms, it is important to study their diagnostic features since the management differs. Imaging studies may be similar in some cystic lesions. A proper clinicoradiological correlation and detailed investigational work up will aid in the correct diagnosis.
BACKGROUND Pancreatic neoplasms consist of a broad spectrum of benign and malignant tumors, with pancreatic ductal adenocarcinoma accounting for 85% of malignant cases. The poor prognosis of pancreatic ductal adenocarcinoma may be due to its insidious growth often presenting late in the clinical disease process. It is estimated that at initial diagnosis of disease, approximately 50% of patients will have distant metastases, while only 10% will have tumours localized to the pancreas. Pancreatic ductal adenocarcinoma (PDAC) carries a dismal prognosis. It is important to identify prognostic subtypes of pancreatic carcinoma to predict clinical and therapeutic outcomes accurately. The purpose of this study is to assess the histopathological features and expression of the proliferation marker Ki-67 in pancreatic neoplasms, in a tertiary care hospital in Kerala over a span of 6 years. METHODS This is a descriptive observational study. All pancreatic neoplasms diagnosed in the Department of Pathology, Medical College, Kottayam during the period of 6 years from January 2011 to December 2016 were analysed. Age distribution, morphologic features and Ki-67 expression were studied using the registers, histopathology slides and immunohistochemistry slides in the department. The data was analysed using SPSS. RESULTS We received a total of 111 neoplastic lesions of pancreas. 95% were malignant and 5 % were benign. The age distribution ranged from 17 to 85 years. Males were more affected 55.9% (62 cases) than females 44.1% (49 cases). Epithelial neoplasms accounted for 94% of the cases. Ductal adenocarcinomas constituted 78% the total lesions and 82.1% of malignancies. Benign neoplasms included serous cystadenomas, mucinous cystadenomas and lymphangiomas. CONCLUSIONS Pancreatic adenocarcinomas constituted the majority of lesions. The most commonly affected age group was 5 th to 6 th decade, whereas certain studies showed a predominant involvement in 7 th decade. Moreover, predominant types were well differentiated adenocarcinomas. Ki-67 expression was high in neoplasms with lymph node metastasis and low in better differentiated neoplasms. The gender predilection, lymph node involvement, lymphovascular invasion and perineural invasion were compatible with other studies.
BACKGROUND Joint disease is a common problem, which affects all age groups. Delay in proper diagnosis may lead to inability to control the disease process, leading to irreversible damage to the joints. Synovial biopsy is an important investigation, which is a useful adjunct to confirm the diagnosis. The objective of this study is to describe the morphological features of synovial biopsy specimens in various joint diseases. MATERIALS AND METHODS A descriptive study was conducted on 77 cases of synovial biopsy specimens received in the Department of Pathology, Government Medical College, Kottayam during a period of 18 months (May 2016-November 2017). RESULTS Among 77 cases, 67 were monoarticular and 10 were polyarticular. Knee joint was the most commonly involved joint in 48 cases (62.3%) followed by hip and ankle joint in 7 cases each (9.1% each). Infectious arthritis (septic arthritis) with chronic joint disease was the most common lesion diagnosed (42%) followed by Osteoarthritis (OA) (14%), Tubercular arthritis (TBA) (12%) and Rheumatoid arthritis (RA) (10%). Synovial fluid was analysed in 31 cases. Among that 25 cases were infectious arthritis, 3 ca ses were OA, 1 case was RA, 1 case was TBA and 1 case was Gouty arthritis (GA). Radiological diagnosis by x-ray has got the highest sensitivity (100%) in diagnosing Giant cell tumour (GCT), Charcot joint and GA followed by OA (90.9%). CONCLUSION Infectious arthritis with chronic joint disease was the most common lesion diagnosed (42%) followed by osteoarthritis (14%), TBA (12%) and RA (10%). Synovial biopsy may give conclusive diagnosis where clinical diagnosis is equivocal.
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