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Objective: the frequency of bone marrow infiltration by Hodgkin lymphoma is low and varies from 3 to 18%. Hence there exists a dilemma whether bone marrow staging should be done only in the high risk cases. this study aims to study the clinicopathological features and the histomorphology of bone marrow infiltration by Hodgkin lymphoma. Material and Method:Bone marrow aspirates and biopsies from cases of Hodgkin lymphoma diagnosed between 2007 and 2015 were studied. immunohistochemistry with CD15 and CD30 were done in necessary cases. Bone marrow infiltration was correlated with various clinicopathological parameters.Results: ten of the 81 cases (12.3%) studied showed infiltration by Hodgkin lymphoma in the bone marrow biopsy sections. all the aspirates were negative. Bone marrow in the involved cases showed Reed-Sternberg cells and/or mononuclear Hodgkin cells positive for CD30 in a polymorphous inflammatory background. Cases of lymphocyte depleted subtype (66%) and those with leucopenia/ thrombocytopenia (100%) were frequently associated with bone marrow infiltration. B-symptoms, anemia and mixed cellularity were the other risk factors. However none of these risk factors were noted in two out of the ten cases with bone marrow infiltration.Conclusion: as the role of bone marrow aspirate is minimal in the staging of Hodgkin lymphoma, bone marrow biopsy should be the method of choice. immunohistochemistry helps in the doubtful cases. Bone marrow involvement was frequent but not confined to the high risk groups. Our findings suggest that bone marrow staging should not be restricted to the high risk cases alone.

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.

Context: Breast carcinoma is a heterogenous disease with varied clinicopathological features andresponse to therapy. Molecular classification through gene studies helps in planning therapy but haseconomic constraints. Hence immunohistochemical subtyping of breast carcinomas has been used asa surrogate method. Criteria for this subtyping has undergone many modifications since it wasoriginally proposed. Objectives: To immunohistochemically subtype breast carcinomas based onSt.Gallen 2017 guidelines and analyse the differences in clinicopathological parameters like age,tumour size, histopathological grade and lymph node staging between the various subtypes.Materials and methods: The study was done retrospectively at a tertiary care health centre inSouth India on breast carcinoma patients from January 2017 to June 2020. Immunohistochemistrywas done with antibodies to the Estrogen receptor, Progesterone receptor, Human epidermal growthfactor receptor-2 (HER-2) and Ki-67. Immunohistochemical Subtypes were correlated withClinicopathological features. Results: The study had 107 cases. Hormone receptor (HR) positiveHER-2 negative was the most common subtype (55 cases, 51.4%). This subtype frequentlypresented without nodal metastasis (58.2%) and in >50 years of age (56.4%). Triple-negativesubtype frequently presented with grade III (69.2%), highest nodal metastasis stage (38.5%) andin < 50 years of age (69.2%). Conclusion: St.Gallen 2017 guidelines for immunohistochemicalsubtyping classified breast carcinomas into groups that differed significantly in theirclinicopathological features. Further studies on differences in treatment response and survival ratedifferences between these different subtypes are needed.

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.

Introduction: Low Birth Weight (LBW) in the newborn is a major health problem in our country and across the world. Identifying the pathological changes in placenta can help in understanding the pathogenesis of LBW babies. Aim: To compare histological changes in placenta of LBW baby and normal birth weight baby and to find out the maternal risk factors associated with LBW baby. Materials and Methods: A case-control study was done on a total of 140 samples which were collected in the study period of August 2017-August 2019 in SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India, with 70 placentas from LBW delivery and 70 placentas from normal birth weight delivery. Placentas from preterm delivery were excluded from this study. Histological changes in placenta were assessed in both the groups. Statistical analysis was done with Statistical Package for the Social Sciences (SPSS) version 17. Independent sample Student’s t-test and Chi-square test were used for comparison between two groups. Results: Histological changes like chorioamnionitis, syncitial knots, calcification, Perivillous Fibrin Deposition (PVFD), stromal fibrosis and basement membrane thickening were observed more frequently in placentas from LBW delivery. The commonest histological finding in present study was villous stromal fibrosis in 58 cases (82.9%) followed by excessive syncytial knots in 57 cases (81.4%). In this study, anaemia was the commonest maternal risk factor associated with LBW baby. Conclusion: The structure of placenta has strong relationship with the pregnancy outcome. There are few significant histological changes in placenta of LBW neonates. These changes have an impact in the development of the baby. Study about these changes provides a scope for prevention of certain morbidities in subsequent pregnancies.

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.

Introduction: Diabetes Mellitus (DM) is a global health problem, characterised by high levels of glucose in blood with impairment of carbohydrate, fat and protein metabolism. Patients with DM have a high risk of developing atherothrombotic events. This leads to initiation and progression of microvascular and macrovascular complications. Aim: To compare the coagulation profile parameters in patients with Type 2 DM with good glycaemic control (Glycated Haemoglobin (HbA1c) <7) and poor glycaemic control (HbA1c ≥7) and to evaluate the association of coagulation profile and glycaemic control in diabetic patients. Materials and Methods: This study was conducted in a tertiary care hospital of Southern India on 84 patients among which 42 were Type 2 Diabetics with good glycaemic control and 42 were Type 2 Diabetics with poor glycaemic control. Blood samples were collected from the individuals chosen for the study and analysed for coagulation profile including Bleeding Time, Platelet Count, Prothrombin Time (PT), activated Partial Thromboplastin Time (aPTT), fibrinogen and d-Dimer. Statistical analysis was done by unpaired student’s t-test using SPSS 21.0. Results: In the present study, it was observed that Bleeding Time, aPTT and fibrinogen concentration were increased (statistically significant, p<0.05) in Type 2 Diabetics with poor glycaemic control when compared with Type 2 Diabetics with good glycaemic control. No significant changes were noted in Platelet Count, PT and d-Dimer among the two study groups. Conclusion: The alteration in coagulation profile of Type 2 Diabetic people has shown that hyperglycaemia leads to abnormalities in the coagulation and Type 2 Diabetic patients with poor glycaemic control are at high risk for developing atherothrombotic and haemorrhagic events. So, evaluation of coagulation profile in diabetic patients may help the clinicians in early intervention to prevent the initiation of microvascular and macrovascular disease at the earliest.