Publications by authors named "Biswajit Dey"

92 Publications

Cerebral Astroblastoma: A Rare Tumor.

Cureus 2021 Jul 12;13(7):e16323. Epub 2021 Jul 12.

Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, IND.

Astroblastoma is a rare neuroepithelial tumor of the central nervous system, which accounts for only 0.45-2.8% of all neuroglial tumors. These tumors have distinct radiological, histopathological, immunohistochemical, and molecular features. We describe a case of astroblastoma of the left temporal lobe in a 38-year-old female, who presented with complaints of headache and occasional episodes of vomiting.
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http://dx.doi.org/10.7759/cureus.16323DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8355865PMC
July 2021

Tumour Behaviour of Low-Grade Papillary Urothelial Carcinoma: A Single-Centre Retrospective Study.

Cureus 2021 Jun 29;13(6):e16012. Epub 2021 Jun 29.

Urology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, IND.

Background and objective Carcinoma of the urinary bladder is the most common urological cancer, and it accounts for 3.9% of all cancer cases in men. Patients with the subset of noninvasive low-grade papillary urothelial carcinoma (LG-UrCa) are at higher risk for tumour recurrence. In this study, we aimed to analyse the histopathological features of LG-UrCa and to correlate those with recurrence potential as well as disease stage and grade progression. Materials and methods We conducted a retrospective study from January 2016 to December 2018. All cases with presenting biopsy initially reported as LG-UrCa were included in the study. All cases with initial biopsy reported as high-grade papillary urothelial carcinoma (HG-UrCa) were excluded from the study. We used the 2016 World Health Organization/International Society of Urological Pathology (WHO/ISUP) guidelines for the classification of papillary urothelial neoplasm. Results A total of 48 initially diagnosed cases of LG-UrCa were identified. Two out of 48 cases were reclassified as high-grade urothelial carcinoma and were excluded from the study. The mean age of patients at presentation was 56.7 years. The mean duration of follow-up was 19.8 months. The mean size of initial tumours was 3.4 cm. Tumour recurrence was encountered in 14 (30.4%) of 46 patients. Out of the four patients who had high-grade progression (8.7%), two also developed TNM stage progression. These two patients eventually underwent radical cystectomy. Patients with larger initial tumour sizes were found to have an increased tumour recurrence rate (p=0.009). Patients with multiple lesions at initial diagnosis had a significantly higher tumour recurrence rate than those with a single tumour (p=0.02). There was no significant difference with regard to intravesical Bacillus Calmette-Guérin (BCG) and tumour recurrence (p=0.065). None of the clinicopathological parameters were significantly associated with the grade and/or stage progression. Conclusion Based on our findings, patients with larger initial tumour size and tumour multiplicity at presentation had an increased tumour recurrence rate.
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http://dx.doi.org/10.7759/cureus.16012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8319871PMC
June 2021

IgA nephropathy superimposed on diabetic nephropathy: A case report with review of literature in eight Indian studies.

J Family Med Prim Care 2021 Jun 2;10(6):2419-2422. Epub 2021 Jul 2.

Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, India.

Diabetes mellitus is one of the foremost diseases in the modern era and diabetic nephropathy contributes to a major percentage of end-stage kidney disease. Although diabetic nephropathy is difficult to revert back, detection of nondiabetic renal disease (NDRD) is important to detect as most of them are treatable. We describe a case of a 62-year-old female with long-standing diabetes mellitus presenting with massive proteinuria and clinical features of nephrotic syndrome. The kidney biopsy showed class III diabetic nephropathy along with focal proliferative glomerulonephritis with crescent formations. The immunofluorescence study showed strong mesangial IgA deposition with the predominance of lambda stain. This confirmed the diagnosis of diabetic nephropathy with superimposed IgA nephropathy. We reviewed eight Indian studies herewith to demonstrate NDRD spectrum in the Indian diabetic scenario.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_1962_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284210PMC
June 2021

Association of Co-dominant Immunoglobulin G Deposit in Immunoglobulin A Nephropathy With Poor Clinicopathological and Laboratory Parameters.

Cureus 2021 Jun 21;13(6):e15813. Epub 2021 Jun 21.

Internal Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, IND.

Introduction: Immunoglobulin A (IgA) nephropathy is the commonest primary glomerulonephritis with a wide range of clinical presentations and laboratory findings. There is a paucity of studies regarding the significance of co-dominant immunoglobulin G (IgG) deposition in IgA nephropathy.

Methods: The study included retrospective and prospective biopsy-proven cases of IgA nephropathy from 2013-2020 with a minimum of eight glomeruli. Clinical and laboratory parameters were analysed for the IgA and IgG co-dominant cases as compared to those of the non-IgG group.

Results: A total of 58 cases of IgA nephropathy were included in the study out of which 25 biopsies (43.1%) were categorized as IgA plus IgG, and the rest 33 biopsies (56.8%) as the non-IgG group. A significant correlation was noted amongst the IgA plus IgG group with respect to the elevated mean arterial pressure (MAP) (p=0.038) and proteinuria (p=0.002) as compared to the non-IgG group. Amongst the MEST-C (mesangial hypercellularity, endocapillary hypercellularity, segmental sclerosis, tubular atrophy/interstitial fibrosis, crescents) variables, endocapillary hypercellularity correlated with elevated MAP (p=0.04), raised serum creatinine (p=0.005), and decreased estimated glomerular filtration rate (eGFR) (p=0.002).

Conclusion: Co-dominant IgG deposit serves as an adverse marker pointing towards a deranged renal function in IgA nephropathy.
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http://dx.doi.org/10.7759/cureus.15813DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8294770PMC
June 2021

Disseminated Indeterminate Dendritic Cell Tumor: A Rare Presentation.

Indian Dermatol Online J 2021 May-Jun;12(3):462-464. Epub 2021 May 12.

Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Mawdiangdiang, Shillong, Meghalaya, India.

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http://dx.doi.org/10.4103/idoj.IDOJ_371_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202498PMC
May 2021

Expression of PDL1 and Her2neu in Gastric and Gastroesophageal Junction Adenocarcinoma.

Indian J Surg Oncol 2021 Apr 16;12(Suppl 1):144-151. Epub 2020 Oct 16.

Department of Medical Oncology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, India.

The process of tumorigenesis in gastric carcinoma involves multiple genetic alterations including overexpression of PD-L1, amplification of Her2neu, and mutation of p53. In the present study, the expressions of PD-L1 and Her2neu were analyzed in relation to clinicopathological parameters including p53 in gastric and gastroesophageal junction adenocarcinoma. We examined 100 biopsy and resection samples of gastric and gastroesophageal junction carcinomas for PD-L1, Her2neu, and p53 protein expressions using immunohistochemistry. Scorings were done based on intensity and percentage of tumor cells expressing the markers. Follow-up and survival analyses were done wherever data was available. PD-L1 and Her2neu were seen in 37% and 38% respectively. The analysis showed PD-L1 expression was significantly associated with depth of invasion ( = 0.0007), nodal metastasis ( = 0.0003), and AJCC staging ( = 0.0085). Her2neu negative including equivocal expression was significantly associated with histological grading ( = 0.0043), Lauren classification ( = 0.0042), depth of invasion ( = 0.04), and nodal metastasis ( = 0.017). Combined analysis of PD-L1 and Her2neu showed significant association with histological grading ( = 0.017), Lauren classification ( = 0.005), depth of invasion ( = 0.0035), and nodal metastasis ( = 0.00073). Univariate Cox regression analysis showed that depth of invasion, nodal metastasis, distant metastasis, AJCC staging, and p53 were negative prognostic factors for patients' overall survival. In multivariate analysis, distant metastasis and Her2neu negativity including equivocal cases were independent prognostic factors. PD-L1 positivity was seen in cases with advanced pathological features, which suggest its role in the tumorigenesis of gastric and gastroesophageal junction adenocarcinoma. Her2neu positivity showed no correlation with advanced pathological features as well as no prognostic significance, which could be attributed to tumor heterogeneity, endoscopic nature of the biopsies, and non-confirmation of equivocal cases by fluorescent in situ hybridization.
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http://dx.doi.org/10.1007/s13193-020-01245-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119584PMC
April 2021

Identification and Evaluation of Apoptosis-Inducing Activity of Ipomone from : A Novel, Unusual Bicyclo-[3.2.1] Octanone Containing Gibberic Acid Diterpenoid.

ACS Omega 2021 Mar 15;6(12):8253-8260. Epub 2021 Mar 15.

Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi 221005, Uttar Pradesh, India.

Ipomone (), a novel diterpenoid along with seven known compounds (-), was isolated for the first time from the acidified hydroalcoholic extract of seeds. The structures of the isolated compounds were elucidated via comprehensive NMR spectroscopic data. The absolute configuration of was ascertained through NOESY, NMR, and ECD analyses. Compound was found to contain an unusual bicyclo-[3.2.1] octanone, which appeared first time in any natural product that might be an artifact resulting from the acid-catalyzed 1,2 alkyl shift/rearrangement. The novel compound was screened for cytotoxic activity against a panel of 12 human cancer cell lines and exhibited weak cytotoxicity with IC values in the range of 34-86 μM (except for HEK-293 cells). Microscopic studies revealed that compound induced apoptosis and autophagy in A549 cells. To further explore the signaling pathway involved, immunoblot analysis was performed that confirmed inhibition of apoptotic proteins PARP-1 and caspase-3 expression and upregulation of LC3B expression by compound . The compound was further subjected to molecular docking studies to evaluate its binding affinity with p110α, PARP-1, and caspase-3 proteins.
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http://dx.doi.org/10.1021/acsomega.0c06304DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8015099PMC
March 2021

Low-Grade Chondrosarcoma of Petrous Apex Diagnosed by Intraoperative Crush Smear Cytology.

J Cytol 2020 Oct-Dec;37(4):212-213. Epub 2020 Oct 31.

Department of Radiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India.

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http://dx.doi.org/10.4103/JOC.JOC_96_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984511PMC
October 2020

Giant Endometrial Polyp in a Postmenopausal Woman.

Cureus 2021 Jan 19;13(1):e12789. Epub 2021 Jan 19.

Pathology, All India Institute of Medical Sciences, Rishikesh, IND.

Endometrial polyps are the benign localized overgrowth of endometrial tissue composed of a variable amount of gland, fibroblast-like spindle cells stroma, and thick-walled blood vessels. They develop as a result of unbalanced estrogens and progestin. Polyps greater than 4 cm are considered giant polyps. We report a case of giant endometrial polyp in a postmenopausal woman who presented with postmenopausal bleeding without any history of hormone or drug intake. However, the possible cause may be the age and use of phytoestrogens in the daily routine diet for a long time.
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http://dx.doi.org/10.7759/cureus.12789DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891803PMC
January 2021

Granulomatous interstitial nephritis in granulomatosis with polyangiitis mimicking leprosy: A case report.

J Family Med Prim Care 2020 Nov 30;9(11):5783-5786. Epub 2020 Nov 30.

Department of General Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong.

Granulomatous polyangiitis (GPA) is a small vessel vasculitis commonly affecting the upper and lower respiratory tracts and kidneys. About 90% of the cases are associated with ANCA, namely, PR3-ANCA and MPO-ANCA. Herein, we describe a patient of GPA who presented with anasarca, sensory neuropathy, recurrent upper airway congestion, epistaxis, and rapidly progressive glomerulonephritis. Granulomatous interstitial nephritis and necrotizing granulomatous inflammation of the nasal septum were found on biopsy of the kidney and nasal septum, respectively both of which are rare findings. PR3-ANCA and MPO-ANCA were negative. Fulfilling the ACR criteria, this case of GPA proves that biopsy is still the gold standard of diagnosis.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_1070_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7842479PMC
November 2020

Malignant Epithelioid Soft Tissue Tumours- A Pathologist's Perspective With Review of Literature.

Cureus 2020 Dec 24;12(12):e12263. Epub 2020 Dec 24.

Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND.

Background Soft tissue tumours with epithelioid morphology have many differential diagnoses, which include epithelioid sarcoma, malignant extrarenal rhabdoid tumour, epithelioid malignant peripheral nerve sheath tumour, epithelioid leiomyosarcoma, epithelioid angiosarcoma and sclerosing epithelioid fibrosarcoma. There are other rare entities also. They often express characteristic patterns of immunohistochemical markers that can be used to identify these tumours. Materials and methods This retrospective study comprises 22 cases of malignant soft tissue tumours with epithelioid differentiation diagnosed over a period of four years. Findings regarding clinical presentation, cytological findings, histopathological findings and immunohistochemical profile of the tumours were noted and analyzed. Results A total of 22 cases were included in the study including five cases of epithelioid sarcoma (conventional and proximal), three cases of epithelioid angiosarcoma and epithelioid myxofibrosarcoma, two cases of epithelioid malignant peripheral nerve sheath tumour, epithelioid gastrointestinal stromal tumour and clear cell sarcoma each, one case of epithelioid leiomyosarcoma, sclerosing epithelioid fibrosarcoma, malignant extrarenal rhabdoid tumour, monophasic synovial sarcoma and malignant and malignant perivascular epithelioid cell tumour each. Conclusion Pathologists should be aware of the various differential diagnoses of soft tissue tumours with epithelioid morphology. Over and above the clinical findings and morphological features, ancillary methods like immunohistochemistry help to arrive at a definitive diagnosis in most cases.
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http://dx.doi.org/10.7759/cureus.12263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834554PMC
December 2020

Ovarian hydatid cyst mimicking an ovarian neoplasm.

Autops Case Rep 2020 Jun 5;10(3):e2020177. Epub 2020 Jun 5.

North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Radiology. Shillong, India.

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http://dx.doi.org/10.4322/acr.2020.177DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7703271PMC
June 2020

Angiomyolipoma of the broad ligament.

Autops Case Rep 2020 Jul 1;10(3):e2020173. Epub 2020 Jul 1.

North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India.

Angiomyolipoma is a benign mesenchymal neoplasm of the renal parenchyma, accounting for 1% of all renal parenchymal tumors. However, this entity may rarely occur in extrarenal sites. Extrarenal angiomyolipoma has been documented in various sites of the body, but angiomyolipoma of the broad ligament was reported in only two cases. We report the reputed third case of angiomyolipoma of the broad ligament in a 33-year-old female, who presented clinically with abdominal distension. With a working diagnosis of low-grade neoplasm, an excision of the left broad ligament mass was performed. Based on histopathology and immunohistochemistry, a diagnosis of the classical variant of angiomyolipoma of the left broad ligament was made. The post-operative period was uneventful with no recurrence after 6 months of follow-up.
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http://dx.doi.org/10.4322/acr.2020.173DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7703467PMC
July 2020

Metanephric Adenoma with cystic changes- An uncommon presentation of a rare tumor in a young adult.

Autops Case Rep 2020 Jun 5;10(3):e2020148. Epub 2020 Jun 5.

North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India.

Metanephric adenoma (MA) is a rare benign neoplasm of the kidney that is usually asymptomatic and incidentally diagnosed. MA usually present as a solid mass; however, a cystic presentation has been reported. The main differential diagnosis of MA is the epithelial predominant Wilms tumor (e-WT) and the solid variant of papillary renal cell carcinoma (pRCC). The presence of the BRAF gene mutation has recently been reported in 85% of MA, and less than 10% of cases of MA do not express this specific gene mutation. Herein we report a 22-year-old man who presented with back pain and abdominal discomfort with a renal mass on the computed tomographic scan. The diagnosis of metanephric adenoma was confirmed histopathologically. In our case, the tumor presented as a solid and cystic mass hence mimicking a papillary renal cell carcinoma. The VE1 protein, which correlates with BRAF gene mutation, did not show any significant expression. We want to highlight that MA can present as a cystic lesion that should be taken into account to avoid unnecessary radical nephrectomy. Also, we demonstrated that a subset of MA might not harbor the BRAF gene and, they are classified as the BRAF wild type MA.
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http://dx.doi.org/10.4322/acr.2020.148DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7703257PMC
June 2020

Pediatric multifocal histiocytic sarcoma- a fatal diagnosis not to miss!

Autops Case Rep 2020 May 6;10(2):e2020170. Epub 2020 May 6.

North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Department of Radiotherapy and Oncology. Shillong, India.

Histiocytic sarcoma (HS) is a rare hematolymphoid malignant neoplasm with an aggressive clinical course. It can arise de novo or from low-grade B-cell lymphoma. We describe the case of a 16-year-old boy referred to our hospital with generalized lymphadenopathy, weight loss, and decreased appetite for one month. The patient died undiagnosed on the 7 day of hospitalization. Lymph node and bone marrow biopsies were performed one day before the patient died. The lymph node biopsy revealed an architectural effacement with a diffuse proliferation of large pleomorphic neoplastic cells containing large, multilobulated nuclei, coarse vesicular chromatin, prominent nucleoli, and a moderate amount of eosinophilic cytoplasm. The bone marrow aspiration smears and biopsy also showed evidence of infiltration by these above-mentioned cells. Based on the morphology, along with the exclusion of many differential diagnoses by an extensive panel of immunohistochemical markers, a diagnosis of HS was made. This case report aims at evaluating all the clinical and immunophenotypic features of a case of HS with multifocal presentation and an aggressive clinical course in order to give a correct and definite diagnosis at the proper time.
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http://dx.doi.org/10.4322/acr.2020.170DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7703460PMC
May 2020

Krukenberg tumor.

Autops Case Rep 2020 Apr 2;10(2):e2020163. Epub 2020 Apr 2.

North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Department of Pathology. Shillong, India.

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http://dx.doi.org/10.4322/acr.2020.163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7703453PMC
April 2020

Giant cell reparative granuloma of the nasal cavity: a rare site of presentation with review of literature.

Autops Case Rep 2020 May 12;10(2):e2020158. Epub 2020 May 12.

North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India.

Giant cell reparative granuloma (GCRG) was first described in the 1950s. It is an uncommon and benign reactive tumor that is believed to occur after trauma or inflammation. It most commonly occurs in the maxilla and mandible and rarely affects the nasal cavity. It is often seen in children and during the second to third decades of life, predominantly seen among females. Histopathologically, GCRG shows many osteoclast-like multinucleated giant cells scattered in a background of mononuclear stromal cells and spindle-shaped fibroblasts also associated with areas of hemorrhage. The distinction between GCRG and giant cell tumors (GCT)is crucial since both have a similar clinical and histological presentation, but both have different management. GCTs have malignant potential, may metastasize, and have a high rate of recurrence. Surgical excision is the mainstay therapy of GCRG to ensure a low rate of recurrence. Here we discuss two cases GCRG, both presenting as nasal mass.
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http://dx.doi.org/10.4322/acr.2020.158DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7703395PMC
May 2020

A Retrospective Study of Placenta Accreta, Percreta, and Increta in Peripartum Hysterectomies in a Tertiary Care Institute in Northeast India.

Cureus 2020 Nov 9;12(11):e11399. Epub 2020 Nov 9.

Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, IND.

Background: Abnormal placentation such as placenta accreta, increta, and percreta are frequent causes of post-partum hemorrhage, which results in maternal morbidity and mortality. A previous history of cesarean section, placenta previa, and pre-eclampsia are the important risk factors for abnormal placentation. A reliable antenatal diagnosis and planned surgical approach can reduce the incidence of maternal morbidity and mortality from massive hemorrhage.

Aim: To study the incidence of abnormal placentation and the association of various risk factors with abnormal placentation.

Material And Methods: A retrospective study over a period of eight years in patients with peripartum hysterectomies due to abnormal placentation presenting with massive hemorrhage.

Results:  We received a total of 10 emergency hysterectomy specimens during an eight‑year period. Of the cases, placenta accreta accounted for 40% (4/10), increta up to 40% (4/10), and percreta 20% (2/10). Analysis of these findings with parity showed 20% of the women were uniparous (2/10), and 80% were multiparous (8/10). Risk factor analysis showed previous cesarean sections in 40% (4/10), placenta previa in 50% (5/10), and pre‑eclampsia in 10% (1/10).

Conclusion: The present study highlights the incidence of abnormal placentation in a tertiary care institute in Northeast India. Placenta accreta and increta constituted the major forms of abnormal placentation. Multiparous women with placenta previa followed by previous lower segment cesarean section were more at risk of having abnormal placentation. These findings will guide in antenatal care by risk prioritization and management planning of these patients.
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http://dx.doi.org/10.7759/cureus.11399DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7725421PMC
November 2020

Hypercholesterolemic arthritis: A case report with emphasis on synovial fluid cytology.

J Family Med Prim Care 2020 Aug 25;9(8):4428-4430. Epub 2020 Aug 25.

Department of Hematology, All India Institute of Medical Sciences, New Delhi, India.

Hyperlipidemia is a risk factor of osteoarthritis. In the present case report, a case of hypercholesterolemic arthritis secondary to diabetes mellitus is described in a 40-year-old male along with the cytological features of synovial fluid.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_610_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7586627PMC
August 2020

Fine-needle aspiration cytology of mediastinal masses: An institutional experience.

J Family Med Prim Care 2020 Aug 25;9(8):4205-4209. Epub 2020 Aug 25.

Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.

Introduction: Mediastinal masses are uncommon in clinical practice. Fine-needle aspiration cytology (FNAC) is an important and useful investigation and is considered next to imaging in the diagnosis of mediastinal lesions.

Aim: To analyze the mediastinal masses diagnosed on FNAC.

Materials And Methods: We retrospectively retrieved twenty-five cases, which underwent FNAC under ultrasound or computed tomography (CT) guidance for mediastinal masses, over a period of 4 years. Histopathological correlations were done in cases wherever available.

Results: Among twenty-five cases, which were diagnosed through FNAC, eighteen were males and seven were females with age ranging from 6 to 85 years. Ultrasonography (USG)-guided FNAC was performed in three patients, while CT-guided FNAC was performed in twenty-two patients. Out of twenty-five cases, seventeen cases were malignant, six were benign, and two cases were inadequate. FNAC was useful in the diagnosis of 83.3% of cases. Biopsy and/or cell block correlations were available in fourteen cases. In the malignant category, mediastinal invasion by either squamous cell carcinoma or adenocarcinoma constituted the highest number with eight (47%) out of seventeen cases. Among the nonneoplastic conditions, nonspecific inflammation was the most common cause with two cases (8%) out of total cases followed by one case each of tuberculosis, schwannoma, thymoma, and cystic lesion.

Conclusion: USG or CT-guided FNAC is a safe, minimally invasive, and cost-effective procedure, which can provide a precise diagnosis in the mediastinal masses, and may obviate the need for an invasive surgical approach.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_656_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7586570PMC
August 2020

Occult Esophageal Squamous Cell Carcinoma Presenting with Multiple Bony Osteolytic Lesions Clinically Mimicking Multiple Myeloma: A Diagnostic Dilemma.

J Lab Physicians 2020 Mar 24;12(1):76-78. Epub 2020 Jul 24.

Department of General Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India.

Bone metastasis as an initial presentation of esophageal carcinoma is uncommon. In the absence of typical presentations like dysphagia, these cases may lead to diagnostic dilemmas both for the clinicians and pathologists. Here, we report a case of disseminated metastasis of esophageal squamous cell carcinoma to the bone in a 47-year-old female, who presented with multiple osteolytic lesions and clinically mimicking multiple myeloma. A detailed diagnostic work-up established the diagnosis of esophageal squamous cell carcinoma.
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http://dx.doi.org/10.1055/s-0040-1714193DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7419164PMC
March 2020

Prostate-Specific Antigen Density: A Measurement to Differentiate Benign Hypertrophy of Prostate from Prostate Carcinoma.

J Lab Physicians 2020 Mar 24;12(1):44-48. Epub 2020 Jul 24.

Department of Microbiology, Silchar Medical College, Silchar, Assam.

 Determination of isolated prostate-specific antigen (PSA) in asymptomatic individuals has not demonstrated sufficient sensitivity and specificity to be useful in the routine evaluation of prostate disease. To enhance the accuracy of serum PSA we have used a proportion of serum PSA and prostate volume, which we refer to as prostate-specific antigen density (PSAD). Prostate volume in this study was calculated using transrectal ultrasonography (TRUS).  A total of 106 patients with prostatic disease clinically confined to the prostate glands were evaluated.  The mean PSAD for prostate cancer was 0.15 ± 0.01 while that for benign hypertrophy of the prostate (BPH) was 0.11 ± 0.02 ( < 0.05). Significant difference ( < 0.05) was noted in the prostate volume in these two groups with the mean prostate volume measured by TRUS in the BPH to be 53.85 ± 9.71 mL compared with 58.14 ± 7.48 mL in the carcinoma. PSA density of 0.13 ng/mL can be used as a cutoff for the individual in our set-up who should go for prostate biopsy with sensitivity and specificity of over 90%.  These results suggest that PSAD may be useful in distinguishing BPH and prostate cancer.
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http://dx.doi.org/10.1055/s-0040-1714195DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7419169PMC
March 2020

Down syndrome presenting with different hematological manifestations: A case series of four cases.

J Family Med Prim Care 2020 May 31;9(5):2569-2572. Epub 2020 May 31.

Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.

Children with Down syndrome (DS) are found to have an increased risk of developing various hematological disorders. Particularly, they have an increased predisposition to acute leukemia, predominantly the myeloid type known as myeloid leukemia of Down syndrome (ML-DS). The major morphological subtype is acute megakaryoblastic leukemia. Approximately 10% of the neonates with DS show a unique disorder known as transient leukemia or transient abnormal myelopoiesis (TAM). Their clinical and morphological features are indistinguishable from acute myeloid leukemia (AML); however, they regress spontaneously within the first few months of life. Here we present a series of four cases with different hematological conditions in children with DS. Of the four cases, two presented with AML-M7, one with TAM, and one case was diagnosed as AML-M2 subtype. This case series highlights the spectrum of hematological disorders in children with DS. Although the majority of the case studies show that TAM and AML-M7 are strongly associated with DS, this case series brings to focus that other AML subtypes may occur as well.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_326_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7380744PMC
May 2020

Eccrine Porocarcinoma with Squamous Differentiation in a Patient with Oculocutaneous Albinism.

Indian Dermatol Online J 2020 May-Jun;11(3):398-400. Epub 2020 May 10.

Department of Surgical Oncology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.

Eccrine porocarcinoma is a rare malignant skin appendage tumor of sweat gland origin. Eccrine porocarcinoma arising in a patient of oculocutaneous albinism is extremely rare and only two cases have been reported in English literature to the best of our knowledge. Out of the two cases of eccrine porocarcinoma in oculocutaneous albinism, one case had squamous differentiation. We report a case of eccrine porocarcinoma with squamous differentiation in a 39-year-old male, who presented with a nodular lesion on the upper left chest wall. He also had nodal and distant cutaneous metastasis.
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http://dx.doi.org/10.4103/idoj.IDOJ_223_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7367583PMC
May 2020

Systemic lupus erythematosus-myositis overlap syndrome with lupus nephritis.

J Family Med Prim Care 2020 Apr 30;9(4):2104-2106. Epub 2020 Apr 30.

Department of General Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.

Systemic lupus erythematosus-myositis overlap syndrome is rare with prognostic implications. Reports suggest that systemic lupus erythematosus-myositis overlap syndrome with lupus nephritis has a variable clinical outcome. We report a case of systemic lupus erythematosus-myositis overlap syndrome with lupus nephritis in a 28-year-old female, who presented with facial puffiness, proximal muscle weakness, and proteinuria.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_186_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7346913PMC
April 2020

Blast crisis of chronic myeloid leukemia initially presenting as severe acute intracerebral hemorrhage.

J Family Med Prim Care 2020 Feb 28;9(2):1266-1269. Epub 2020 Feb 28.

Department of Pathology, NEIGRIHMS, Shillong, Meghalaya, India.

Intracerebral hemorrhage (ICH) is frequent pathology in emergency department. Coagulopathy leading to ICH are rare. Intracerebral hemorrhage is a leading cause of mortality among patients diagnosed with chronic myelogenous leukemia (CML). In this report we discussed the case of a previously healthy male patient, who presented with fatal ICH, newly diagnosed with blast crisis in CML.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_940_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7114033PMC
February 2020

A Zn(II)-Coordination Polymer for the Instantaneous Cleavage of C-C Bond and Simultaneous Reduction of Ketone to Alcohol.

Inorg Chem 2020 Apr 1;59(8):5350-5356. Epub 2020 Apr 1.

Department of Chemistry, Visva-Bharati University, Santiniketan-731235, India.

Two coordination polymers of Zn(II) and Cu(II) with -butylmalonic acid have been achieved in this work. The crystallographic structural descriptions along with the sedimentary rock-type microstructural morphology of these two coordination polymers (CPs) have been explored. The reactivity of β-hydroxy ketones with these two CPs has also been investigated. The Zn(II)-CP shows a specific reactivity with β-hydroxy ketone at room temperature and in open air conditions. Through a microcolumn-based filtration technique, the Zn(II)-CP shows the capability to break the C-C σ bonds of β-hydroxy ketone and simultaneously reduce the associated ketone to alcohol. Such conversion has been progressed without the use of any additional external reducing agent and any chemical workup or column chromatographic purification protocol. Other similar type CPs of Cu(II) and Mn(II) with -butylmalonic acid completely failed to show similar reactivity with β-hydroxy ketone. On the basis of much experimental evidence, the most possible mechanistic pathway of the reactivity between β-hydroxy ketone and Zn(II)-CP has also been proposed through this work.
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http://dx.doi.org/10.1021/acs.inorgchem.9b03441DOI Listing
April 2020

Triethylenetetramine-Based Semiconducting Fe(III) Metallogel: Effective Catalyst for Aryl-S Coupling.

ACS Omega 2020 Feb 10;5(6):2680-2689. Epub 2020 Feb 10.

Department of Chemistry, Visva-Bharati University, Santiniketan 731235, India.

A fascinating way to originate a mechanically stable metallogel of ferric ions with metal-coordinating organic ligand triethylenetetramine through direct mixing of their water solutions in a stoichiometric ratio is achieved under ambient conditions. The rheological study established the mechanical property of the Fe(III) metallogel. A cashew-shaped microstructure of the metallogel was observed by FESEM analysis. The electrical property of the Fe(III) metallogel was also carefully scrutinized. The semiconducting features like the Schottky barrier diode property of the Fe(III) metallogel were explored. The catalytic role of the Fe(III) metallogel was also critically explored. The Fe(III) metallogel shows an excellent catalytic property toward the synthesis of aryl thioethers via a C-S coupling reaction under mild reaction conditions without the use of any organic solvent.
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http://dx.doi.org/10.1021/acsomega.9b03194DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033679PMC
February 2020

Ulcerative Lupus Vulgaris Primarily Involving the Ear Lobule.

Indian Dermatol Online J 2019 Nov-Dec;10(6):729-731. Epub 2019 Nov 1.

Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Mawdiangdiang, Shillong, Meghalaya, India.

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http://dx.doi.org/10.4103/idoj.IDOJ_436_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859763PMC
November 2019

A semiconducting supramolecular Co(ii)-metallohydrogel: an efficient catalyst for single-pot aryl-S bond formation at room temperature.

Dalton Trans 2019 Nov;48(46):17388-17394

Department of Chemistry, Visva-Bharati University, Santiniketan 731235, India.

A novel mechanically stable supramolecular Co(ii)-metallohydrogel has been synthesized. Cobalt(ii) nitrate hexahydrate and monoethanolamine, as a low molecular weight organic gelator, are used to get the gel. The mechanical stability of the supramolecular hydrogel was analyzed. The morphology of the supramolecular metallohydrogel was scrutinized. The semiconducting features of the metallohydrogel were studied. The conducting properties of the Co(ii)-metallohydrogel establish a Schottky barrier diode type nature. The catalytic nature of the Co(ii)-metallohydrogel based room temperature single pot aryl-S coupling reaction was explored. Most interestingly, the Co(ii)-metallohydrogel based catalytic aryl-S coupling reaction does not require any column-chromatographic purification protocol to get pure aryl-thioethers. Thus, through this work a semiconducting Schottky barrier diode application and catalytic role in the room temperature single pot aryl-S coupling reaction of a supramolecular Co(ii)-metallohydrogel have been explored.
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http://dx.doi.org/10.1039/c9dt03373dDOI Listing
November 2019
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