Background: In spite of the Bethesda system 2001 (TBS 2001), formulating strict guidelines for reporting cervical smears, intra observer and inter observer variations are unavoidable and can be considered an inherent part of the reporting system. The implications of this variation are in the quality of performance of the reporting laboratory and in the patient management. Rescreening is a tool to reduce the variations and improve the quality of both the laboratory staff and laboratory as such. Rescreening by two or more experienced observers has helped in identifying new cases better. The present study aims to rescreen cervical smears by two independent observers, to compare the results of the two independent observers and to understand the implications of this variability on the quality of cervical smear reporting.Methods: 1000 consecutive cervical smears were rescreened by two experienced cyto-pathologists independently. Their findings were charted out and analyzed statistically for kappa value.Results: Initial reporting had identified 20 cases of neoplastic nature. First observer identified, in addition, 6 new cases and second observer identified 12 new cases. The inter observer variability of 6 cases showed a kappa value of 0.89.Conclusions: Rescreening is a safe way of picking up missed cases. Rescreening by two or more observers is better in identifying new cases. This helps in improving the quality of reporting personnel and the laboratory as well as in improving patient care.
BACKGROUNDGerm cell tumours of ovary comprise a heterogeneous group of tumours with distinct morphological features. Diagnosis of tumours like teratoma can be made on morphological basis, but that of other germ cell tumours would need additional help of immunohistochemical (IHC) markers. But many a time, IHC markers fail to yield the expected results.The aim of this study is to compare the results of the various conventional IHC stains used as markers in common ovarian germ cell tumours. MATERIALS AND METHODSOvarian germ cell tumours which were reported from the Department of Pathology, Government Medical College, Trivandrum during a period of one year were reviewed and chosen for this case series study. Routine Haematoxylin and Eosin staining and later a panel of selected immunohistochemical markers like PLAP, CD-117, OCT-4, CK, CD-30 and AFP were used in each case. RESULTSFifty-five cases of germ cell tumours were received during the study period. Teratoma was the most common tumour (65.45%). There were nineteen cases of malignant germ cell tumours, of which thirteen cases were chosen for immunohistochemical study. Every tumour was stained with all the above-mentioned markers and their results were compared with the expected findings in each case. Positivity of Dysgerminoma for its IHC markers-PLAP, CD-117 and OCT-4 were 66.6%, 44.4% and 77.7% respectively. Among the three cases of Yolk sac tumour, only one was positive (33.3%) for AFP; 66.6% cases of Embryonal Carcinoma were positive for OCT-4, whereas none was positive for CD-30. CONCLUSIONTeratoma, the commonest germ cell tumour was not included in the study due to the minimal role played by IHC in its diagnosis. Germ cell tumours other than Teratoma were relatively rare. The usual IHC markers employed in their diagnosis were found to be not specific and yielded aberrant results. This fact calls for the use of newer, more specific markers for the diagnosis of ovarian germ cell tumours.
Background: Pancytopenia is a clinical condition which poses diagnostic challenge to the haematologist. The aetiology of pancytopenia is varied and depends on many factors. A bone marrow study is highly indicated in cases of pancytopenia and it provides information regarding the underlying disease process. This study was done to learn the causes of pancytopenia and to document how each case was evaluated and followed up.Methods: The present study is a descriptive retrospective one year study on bone marrow samples received in the laboratory. Bone marrow samples included aspirate smears, imprint and trephine and their findings were correlated to arrive at a final diagnosis.Results: Out of the total 28 patients with pancytopenia, 35.71% were from the age group between 61 and 80 years. A male female ratio of 1.5:1 was observed. Most common presenting complaint documented was easy fatiguability. Anisocytosis with macrocytes and ovalocytes were the most common peripheral smear finding. In current study, a cellular marrow was described in 24 (85.71%) cases and hypocellularity in two (7.14%) cases. Final diagnosis was evident in 16 cases, in which the most common cause was acute leukaemia (14.28% each) followed by lymphoma infiltration and myelodysplastic syndromes in 3 cases (10.71%).Conclusions: Bone marrow study helps to arrive at a diagnosis of pancytopenia. But proper technique for sampling, good clinical workup and history taking and clinico haematological correlation is mandatory for the proper diagnosis of a pancytopenia case.
BACKGROUND Ovarian cancer is the 6th most common cancer in women worldwide.1 According to Indian Cancer registries, ovaries are the third leading sites of cancer among women.2 2/3rd of all ovarian neoplasms are surface epithelial tumours and the majority of endometrioid and clear cell carcinomas and some serous tumours show a poor prognosis. p16, a protein encoded by the gene, CDKN2A, located in chromosome 9p21.3, plays a major role in cell cycle regulation by hindering its progression through phase G1 to S. Many studies have found a significant prognostic implication of p16 on surface epithelial tumours and thereby identify such tumours and initiate early therapy. Our study was conducted to find out any significant association of p16 expression in ovarian surface epithelial tumours. METHODS This was a cross-sectional study, done in the Department of Pathology, Government Medical College, Thiruvananthapuram from March 2018 to March 2019. 118 cases were selected, IHC analysis was done and the data were analysed using statistical software SPSS version 20.0. RESULTS 118 cases of ovarian surface epithelial tumours were chosen for the study of which 60 cases were benign, 28 were malignant and 20 were borderline tumours. Strong p16 expression was found in 50 % of malignant tumours and 81.6 % of benign tumours had weak expression. This was found to be statistically significant (P=0.000). Also, a comparison of p16 expression among the various subtypes of surface epithelial tumours was found to be statistically significant (P < 0.01). CONCLUSIONS The present study found a positive correlation between p16 expression in tumour cells and histopathological grades of surface epithelial ovarian tumours, with the highest expression noted in malignant tumours. A significant relation was observed between p16 expression and the subtypes of surface epithelial tumours with endometrioid and clear cell carcinomas showing the highest expression. KEY WORDS Surface Epithelial Tumours, Immunohistochemistry, p16 Expression
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