Publications by authors named "Poojan Agarwal"

29 Publications

  • Page 1 of 1

Aberrant expression of multiple T cell markers on diffuse large B cell lymphoma: a case report.

J Egypt Natl Canc Inst 2021 Jun 15;33(1):14. Epub 2021 Jun 15.

Department of Laboratory and Transfusion Services, Rajiv Gandhi Cancer Institute & Research Centre, Sector 5, Rohini, Delhi, 110085, India.

Background: Aberrant T cell antigen expression has been well documented in diffuse large B cell lymphomas. However, co-expression of multiple T cell antigens including CD3, which has been considered a specific marker for T cells is extremely rare. Awareness about such aberrant expression is important so as not to misdiagnose or wrongly classify a lymphoma. The aim of this article is to report such a case.

Case Presentation: A 68-year-old postmenopausal lady, diabetic and hypertensive, presented with an axillary lump of one week's duration. There was no other relevant medical history. Ultrasonography revealed multiple hypoechoic cystic lesions varying in size from 3.9 to 4.2 cm. Aspiration was suggestive of an infective pathology. Excision biopsy of the mass was diagnosed as diffuse large B cell lymphoma with aberrant T cell antigen expression. She received 4 cycles of chemotherapy after which she was lost to follow-up.

Conclusion: The case presented as a diagnostic dilemma for the pathologist. The predicament lies in classifying it as a B cell lymphoma with an aberrant expression of T cell markers versus a T cell lymphoma with an aberrant B cell marker expression which has a significant implication on the treatment offered. This can be solved by looking at the expression of the B cell specific transcription factors. The key to diagnosis lies in the knowledge of their existence and the application of a panel of markers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s43046-021-00071-7DOI Listing
June 2021

Cutaneous Histoplasmosis in HIV Seronegative Patients: A Clinicopathological Analysis.

Dermatology 2021 24;237(6):934-939. Epub 2021 Feb 24.

Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. RML Hospital, New Delhi, India.

Background: Diagnosis of extrapulmonary histoplasmosis in HIV seronegative and immunocompetent patients is often challenging, so a high index of suspicion is required. Cutaneous manifestation of infection shows a wide spectrum of lesions including erythematous plaques; maculopapules; crusted, verrucous, or desquamative papules and nodules; abscesses; and mucocutaneous ulcers among others. Due to the variations in its clinical presentation, histopathology plays a very important role in the detection of spores and the confirmation of diagnosis.

Objectives: The aim of our study was to analyze clinicopathological characteristics of cutaneous manifestations of biopsy-proven histoplasmosis in HIV seronegative individuals. We also examined the utility of Fite stain for the diagnosis of Histoplasma capsulatum on tissue biopsy sections.

Methods: This was a retrospective, observational study on 7 patients who were HIV seronegative and clinically manifested with isolated cutaneous lesions or disseminated disease. Skin biopsy from the lesions was performed on all 7 patients. In addition to H&E staining and special stains for detecting fungus, Fite staining was performed on all of the cases to study its utility in detecting H. capsulatum spores.

Results: The skin lesions were widely disseminated in all patients and the most common cutaneous lesions were papules, present in all 7 patients. On review of the H&E-stained slides, the most common pattern was histiocytic lobular panniculitis-like infiltrate observed in 4 cases. Fite stain highlighted the yeast as magenta-colored spores on a blue background in all cases, except for 1 with a granulomatous pattern.

Conclusion: A primary cutaneous manifestation of H. capsulatum infection in non-HIV-infected individuals is extremely rare. Fite stain could aid in differentiating the spores of H. capsulatum from those of other fungi, Cryptococcus and Candida in particular.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000513399DOI Listing
February 2021

An unusual scrotal mass: Morphological clues.

Asian J Urol 2021 Jan 10;8(1):140-142. Epub 2019 Dec 10.

Department of Laboratory Services, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ajur.2019.12.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7859362PMC
January 2021

Liquid-based cytology of amoebic cervicitis clinically mimicking cervical cancer.

Diagn Cytopathol 2021 Mar 31;49(3):433-435. Epub 2020 Oct 31.

Department of Cytopathology, Sir Ganga Ram Hospital, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/dc.24628DOI Listing
March 2021

Plastic Bronchitis: A Manifestation of Dander Hypersensitivity.

Indian Pediatr 2020 08;57(8):760-761

Department of Pathology, Sir Ganga Ram Hospital, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
August 2020

Synchronous malignancies: A tale of two different tumors.

Indian J Pathol Microbiol 2020 Jan-Mar;63(1):147-149

Department of Pathology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/IJPM.IJPM_468_18DOI Listing
October 2020

Predictive biomarkers in nonsmall cell carcinoma and their clinico-pathological association.

South Asian J Cancer 2019 Oct-Dec;8(4):250-254

Department of Molecular Diagnostics and Cell Biology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.

Background: Lung cancer is the leading cause of cancer-related mortality worldwide. Genome-directed therapy is less toxic, prolongs survival and provides a better quality of life. Predictive biomarker testing, therefore, has become a standard of care in advanced lung cancers. The objective of this study was to relate clinical and pathological features, including response to targeted therapy (TT) and progression-free survival (PFS) with positive driver mutation.

Materials And Methods: Archival data of nonsmall cell carcinoma patients with Stage IV disease were retrieved. Those who tested positive for one of the four biomarkers (epidermal growth factor receptor [EGFR], anaplastic lymphoma kinase [ALK], MET, and ROS) were included. Patient demographics and clinical features were reviewed. Tumor histomorphology was correlated with oncological drivers. Treatment response, PFS, and overall survival were studied in three subcohorts of patients who received computed tomography (CT), CT followed by TT and those who received TT in the first line.

Results: A total of 900 patients underwent biomarker evaluation of which 288 tested positive. Frequency of the four biomarkers observed was 26.6% (229/860), 6.6% (51/775), 6.6% (5/75), and 5.1% (3/59) for EGFR, ALK, MET, and ROS-1, respectively. The median PFS for EGFR-mutated cohort was 12 months, whereas it was 21 months for ALK protein overexpressing cases. Patients treated with first-line tyrosine kinase inhibitors performed better compared to those who were switched from chemotherapy to TT or those who received chemotherapy alone ( < 0.05).

Conclusion: Biomarker testing has improved patient outcome. Genome-directed therapy accords best PFS with an advantage of nearly 10 months over cytotoxic therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/sajc.sajc_373_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852638PMC
December 2019

Allergy Testing - An Overview.

Indian Pediatr 2019 11;56(11):951-957

Division of Pediatric Emergency, Critical Care, Pulmonology and Allergic Disorders, Department of Pediatrics, Institute of Child Health, Sir Ganga Ram Hospital, Rajinder Nagar, Delhi, India.

Childhood allergies pose huge economic burden and adverse effects on quality of life. Serum IgE has been considered a surrogate allergy marker for decades. Availability of several over-the-counter allergy tests add to confusion of partially trained caregivers. The present review focuses on current status of allergy testing in Indian scenario. Various in-vitro and in-vivo diagnostic modalities are available for allergy detection. Skin prick tests are useful for aero-allergies whereas oral challenge tests are best for identifying suspected food allergies. An allergy test should be individualized based on clinical features, diagnostic efficacy, and cost-benefit analysis.
View Article and Find Full Text PDF

Download full-text PDF

Source
November 2019

EUS-guided sampling of thickened pleura.

Gastrointest Endosc 2019 07 15;90(1):158-159. Epub 2019 Mar 15.

Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences, Sir Ganga Ram Hospital, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.gie.2019.03.005DOI Listing
July 2019

Benefits of Pre-harvest Peripheral Blood CD34 Counts Guided Single Dose Therapy with PLERIXAFOR in Autologous Hematopoietic Stem Cell Transplantation: A Retrospective Study at a Tertiary Care Institute in India.

Indian J Hematol Blood Transfus 2019 Jan 2;35(1):72-76. Epub 2018 Jul 2.

1Department of Laboratory Medicine, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi India.

Peripheral blood is a convenient source of stem cells for hematopoietic stem cell transplantation. However, in autologous transplants, the harvest failure rates are high because of inadequate mobilization using G-CSF alone. Plerixafor is a potent mobilizer when used with G-CSF. However, its routine use is limited by high cost. This is a retrospective study done at a tertiary care oncology centre in India. All the harvest records were analyzed between Jan 2015 and Nov 2017. May 2016 onwards pre-harvest peripheral blood CD34 count was done in all cases of autologous transplants on day 4 of G-CSF therapy and they were given a single dose of Plerixafor if counts were < 20 cell per cumm. The results were compared amongst various groups. A total of 321 cases were analyzed. 172/321 were allogenic transplant cases of which 5% (n = 7) failed to achieve a target live stem cell dose of > 2 million per kg of the recipient. The overall failure rate in autologous group (n = 149) was 27% (n = 41) ( ≤ 0.001 auto vs. allo). The failure rate was higher (36%, n = 28/77) when no intervention with Plerixafor was done. The overall failure rate in the group treated with pre-harvest 34 count based single dose therapy of Plerixafor was 18% (n = 13/72,  = 0.01). However, within this intervention group, the patients who had pre-harvest peripheral blood CD34 above the desired cutoff had a higher failure rate of 21% ( = 0.13). Pre-harvest CD34 count based intervention with Plerixafor help optimizing the cost.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12288-018-0979-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369067PMC
January 2019

Bladder Carcinoma Presenting as Paget's Disease of Vulva: An Uncommon Entity.

Indian J Dermatol 2018 Nov-Dec;63(6):518-520

Departments of Laboratory Services, Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India.

Paget's disease of the vulva is a rare intraepithelial neoplasm, accounting for <5% of all vulvar lesions. The underlying mechanisms of this disease are still poorly understood, however, diagnosing a Pagetoid lesion early is of prime importance as it may forewarn an underlying systemic malignancy. We discuss the case of an elderly female who was being conservatively treated for infectious lesion of the lower urinary tract and vulva for months. She was subsequently confirmed on histopathology with vulvar Paget's and underlying urothelial carcinoma, with the help of an extensive panel of immunohistochemistry.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijd.IJD_126_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233051PMC
December 2018

Spectrum of clinicohematological profile and its correlation with average parasite density in visceral leishmaniasis.

Cytojournal 2018 27;15:19. Epub 2018 Aug 27.

Address: Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India.

Background: Leishmaniasis is the prevalent in tropical and subtropical regions of the world. Demonstration of Leishman-Donovan (LD) bodies in the bone marrow aspirates (BMA) is vital to diagnosis of visceral leishmaniasis (VL). In the present study, we studied the clinicohematological parameters encountered in VL and correlated them with parasite load on BMA.

Methods: Retrospective analysis over 3 years was done; clinical details, biochemical profile, complete hemogram with peripheral smear findings, and BMA smears were reviewed and average parasite density (APD) calculated in each case. Multivariate analysis and tests of significance were applied.

Results: The study included 28 patients. Splenomegaly showed a positive trend with APD. rK39 antigen detection test was 100% positive in select cases. A strong negative correlation was observed between albumin to globulin ratio and grade of APD. BMA revealed hemophagocytosis (HPS) in 78.57% cases and it had a significant strong correlation with APD ( = 0.014). A significant correlation was also observed between APD and bone marrow plasma cell percentage ( = 0.01). LD bodies were noted in unusual locations such as within myelocytes (14.2%), plasma cells (7.1%), and megakaryocytes (10.7%).

Conclusion: HPS and bone marrow plasmacytosis were two statistically significant findings, which showed positive correlation with parasite load. The presence of these two findings should prompt hematopathologists for more focused search of hemoparasites in BMA to arrive at a definitive diagnosis. This will avoid unnecessary workups and improve the prognosis. To the best of our knowledge, a statistical correlation between APD and clinicohematological parameters has never been previously studied.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/cytojournal.cytojournal_38_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6118117PMC
August 2018

Blastic Plasmacytoid Dendritic Cell Neoplasm: Still an Enigma.

Indian J Hematol Blood Transfus 2018 Jul 14;34(3):568-572. Epub 2018 Feb 14.

Department of Pathology and Lab Services, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12288-018-0930-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6081318PMC
July 2018

Bisalbuminemia: A Rare Finding on Serum Electrophoresis.

Indian J Hematol Blood Transfus 2018 Jul 5;34(3):558-559. Epub 2018 Jan 5.

Department of Laboratory Medicine, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi India.

Bisalbuminemia is an uncommon finding that is seen as bifid albumin peak on serum protein electrophoresis. We report here this unusual finding in an adult male diagnosed with multiple myeloma on routine workup.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12288-017-0911-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6081336PMC
July 2018

Non Cutaneous, Non Langerhans Cell Histiocytoses: A Diagnostic Dilemma.

Indian J Hematol Blood Transfus 2018 Jul 29;34(3):553-555. Epub 2018 Jan 29.

Department of Laboratory Medicine, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12288-018-0925-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6081328PMC
July 2018

Plasmablastic light chain myeloma presenting as pancytopenia: An unusual presentation.

Natl Med J India 2017 Sep-Oct;30(5):266-267

Department of Pathology, Postgraduate Institute of Medical Education and Research, Dr Ram Manohar Lohia Hospital, New Delhi 110001, India.

Light chain myeloma (LCM) is an unusual neoplasm accounting for about 1 8% of all plasma cell myelomas. It is characterized by the absence of a detectable M protein in the serum and urine protein electrophoresis, altered free light chain ratio, bone marrow plasmacytosis and related organ or tissue damage. We report a 60-year-old man with LCM presenting with pancytopenia. Urine Bence Jones proteins were negative and serum protein electrophoresis did not reveal an M-band. However, bone marrow biopsy showed plasmablastic morphology. Subsequent immunohistochemistry showed lambda restriction and cells positive for CD138 and IgM.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0970-258X.234393DOI Listing
December 2018

Study of Proliferating cell nuclear antigen expression and Angiogenesis in Urothelial neoplasms: Correlation with tumor grade and stage.

Urol Ann 2018 Apr-Jun;10(2):209-214

Department of Urology, PGIMER, Dr. RML Hospital, New Delhi, India.

Background: Urinary bladder carcinoma ranks ninth in worldwide cancer incidence. About 74,000 new cases were diagnosed in 2015 alone and 16,000 persons died of the disease. Since histopathology is considered gold standard for diagnosis, it is prudent to look for potential tumor proliferation and predictive markers in such a prevalent malignancy so as to alert surgical and medical oncologists for timely intervention and provide better patient-tailored therapy.

Aims: This study is to analyze the role of potential biomarkers-proliferating cell nuclear antigen (PCNA) and angiogenesis using CD31 in urothelial neoplasms in relation to tumor grade and stage.

Methods: Histopathology slides were prepared from transurethral resection of bladder tumor chips and assessed by three independent observers as per the WHO/International Society of Urologic Pathology criteria 2016. Representative sections were subjected to immunohistochemistry. PCNA labeling index (PCNA LI) and mean vessel density (MVD) were calculated.

Statistical Analysis: Tests of analysis were applied as appropriate. A statistical < 0.05 was considered significant.

Results: Forty-nine patients were analyzed. PCNA LI increased with grade and stage. PCNA was significantly higher in noninvasive papillary urothelial carcinoma high grade (NIPUCHG) than in noninvasive papillary urothelial carcinoma low grade (NIPUCLG) and in infiltrating urothelial carcinoma as compared to NIPUCLG. MVD also increased with tumor grade and stage; however, a significant difference was observed only between infiltrating urothelial carcinoma and papillary urothelial neoplasm of low malignant potential. A cutoff value of 73% for PCNA and 49 vessels/high-power field for CD 31 showed 100% accuracy to differentiate between noninvasive papillary urothelial carcinoma high grade and NIPUCLG. No association was observed between tumor recurrence and PCNA or CD31 expression.

Conclusion: PCNA and CD31 when used together are valuable markers to help classify urothelial neoplasms in limited tumor material. However, larger prospective studies are required for better prognostication.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/UA.UA_167_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5907333PMC
May 2018

Urothelial carcinoma of urinary bladder with exclusive heterologous component of epithelioid rhabdomyosarcoma at metastatic site.

Indian J Pathol Microbiol 2018 Apr-Jun;61(2):258-260

Departments of Laboratory Services, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.

Urothelial carcinoma of urinary bladder with divergent differentiation into rhabdomyosarcoma (RMS) is an extremely uncommon aggressive phenomenon. We present a case of a 74-year-old male with bladder carcinoma which metastasized to the abdominal wall as epithelioid RMS. To the best knowledge of our literature searches, an oligometastasis of exclusive heterologous component has not been described before. The clinical, radiological, and immunohistochemistry profile of the patient supported the monoclonal nature of the tumor.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/IJPM.IJPM_785_17DOI Listing
October 2018

Primary Intracranial Extraosseous CNS Ewing's Sarcoma: A Distinct Entity.

J Pediatr Neurosci 2017 Oct-Dec;12(4):396-398

Department of Neurosurgery, PGIMER, Dr. RML Hospital, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jpn.JPN_9_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890571PMC
April 2018

Budding Yeast Forms on Peripheral Blood Smear: An Intriguing Finding.

Indian J Hematol Blood Transfus 2018 Apr 26;34(2):377. Epub 2017 Jul 26.

Department of Laboratory Medicine, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12288-017-0850-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5884972PMC
April 2018

Primary cutaneous non-Hodgkin's lymphoma, clinically mimicking a soft tissue sarcoma.

Cytojournal 2018 25;15. Epub 2018 Jan 25.

Department of Surgery, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India.

Primary cutaneous B-cell lymphomas (PCBCL) are a heterogeneous group of neoplasms with distinct biology and clinical course when compared to their nodal counterparts. They usually present as violaceous, erythematous plaques, and nonulcerated nodules, which are confined to skin at the time of presentation. We present an unusual case of primary cutaneous diffuse large B-cell lymphoma, clinically mimicking a sarcoma. This case highlights the uncommon aggressive behavior and ulcerated type of nodular lesions seen in PCBCL and also revisits the cytomorphological findings of the same.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/cytojournal.cytojournal_41_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5806413PMC
January 2018

Extensively Metastasizing Leiomyosarcoma: A Diagnostic Challenge.

J Midlife Health 2017 Jul-Sep;8(3):148-150

Department of Neurosurgery, Dr. RML Hospital, PGIMER, New Delhi, India.

Uterine leiomyosarcoma (ULMS) is a rare malignancy of the female genital tract and carries an extremely poor 5-year survival rate. It is known to metastasize early and to distant sites owing to a high propensity for hematogeneous spread. Lung, peritoneum, liver, and bone are relatively common sites of metastasis. Patient age, tumor size, FIGO stage, and grade of the tumor are important criteria for predicting metastasis. The incidence of ULMS is increasing, probably due to the use of improved imaging techniques and as a result of cancer patients' prolonged life expectancy. An early well thought diagnosis is only made possible if even in otherwise seemingly unsuspected cases, the histopathology slides are extensively screened and the treating clinician is alerted timely. We hereby report a case of an elderly female who underwent hysterectomy for resection of multiple fibroids in the uterus and later presented with distant metastasis to brain with the erosion of overlying skull bone, chest wall, and lungs. Microscopic features along with an extensive immunohistochemistry panel were used to ascertain tumor origin.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jmh.JMH_60_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5625581PMC
October 2017

Indian visceral leishmaniasis with extensive lymphadenopathy - An unusual presentation: A case report with literature review.

Cytojournal 2017 28;14. Epub 2017 Apr 28.

Department of Medicine, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India.

Visceral leishmaniasis (VL), also known as kala-azar, is a life-threatening systemic disease caused by the obligate intracellular protozoan, , and transmitted to humans by the female phlebotomine sand fly (). The disease is fatal, if left untreated. We report a case of a patient clinically suspected of disseminated tuberculosis, but fine needle aspiration cytology of cervical and axillary lymph nodes yielded a diagnosis of leishmaniasis. Diagnosis of VL was challenging as the disease closely mimicked tuberculosis in the setting of extensive lymphadenopathy including conglomerate of mesenteric lymph nodes, on and off fever, and granulomatous lymphadenitis on aspiration. Bone marrow examination was further performed. A detailed workup revealed patient to be severely immunocompromised and newly diagnosed human immunodeficiency virus (HIV) positive. Worldwide, India has the largest number of VL cases, accounting for 40%-50% of world's disease burden and the second largest HIV-infected population, accounting for approximately 10% of the global disease burden. HIV increases the risk of developing VL by 100-2320 times in endemic areas and concurrently VL promotes the clinical progression of HIV disease. Co-infection with HIV alters the body's immune response to leishmaniasis thus leading to unusual presentations. This case highlights the diagnostic problem in the aforesaid setting. Moreover, co-infection with HIV in VL can be a potential source of drug resistance. An early diagnosis and intensified treatment is the key to patient management.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/1742-6413.205312DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5430503PMC
April 2017

Ciliated Foregut Cyst of Gallbladder: A First in Childhood and Review of Literature.

Fetal Pediatr Pathol 2017 Apr 9;36(2):149-153. Epub 2016 Dec 9.

b Department of Pediatric Surgery , Dr Ram Manohar Lohia Hospital , New Delhi , India.

Ciliated foregut cyst (CFC) is a rare developmental anomaly. We report first case of CFC of gallbladder diagnosed in a 9-year-old child. CFCs are usually located above the diaphragm, commonly in a bronchus or oesophagus. A duplex gallbladder was originally suspected, but histology confirmed the CFC. gallbladder.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/15513815.2016.1259278DOI Listing
April 2017

Cytology of primary vaginal melanoma: An unusual report on fine needle aspiration.

Diagn Cytopathol 2017 Mar 11;45(3):252-256. Epub 2016 Nov 11.

Department of Pathology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India.

Primary malignant melanoma of the vagina is an extremely uncommon malignancy comprising of less than 10% malignancies of the female genital tract and 0.3% of all melanomas. Melanoblasts are neural crest derivatives and are notorious for causing primary cutaneous neoplasms. However, they involve virtually every organ of the body including eye, intestines and ocular mucosa, probably due to aberrancies in cell migration. Vagina is a rare site and primary melanoma of the vagina occurs in postmenopausal women with vaginal discharge, bleeding, or mass as common presenting complaints. Only a handful of case reports are available describing this entity on biopsy and PAP smear samples; however, fine needle aspiration has seldom been discussed. In the present report we discuss a case of an elderly female who complained of mass protruding through the vaginal opening, FNAC was done from the mass as well as from the right inguinal lymph node. An extensive clinicoradiological workup, and immunohistochemical confirmation is essential to rule out metastatic lesions and confirm primary. Diagn. Cytopathol. 2017;45:252-256. © 2016 Wiley Periodicals, Inc.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/dc.23637DOI Listing
March 2017

Primary Malignant Melanoma of Pleura: A Case Report and Literature Review.

Diagn Cytopathol 2016 Jul 11;44(7):648-52. Epub 2016 May 11.

Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India.

Malignant melanoma is one of the most aggressive and treatment resistant skin cancers. India enjoys a low incidence of melanoma, and age specific incidence rates for cutaneous malignant melanoma (CMM) are being less than 0.5 per 1,000,000. This could be due to under-reporting of melanoma on account of a low index of suspicion by clinicians and pathologists alike. Most common site for origin of primary melanoma is skin, accounting for about 91.2% of all reported primary malignant melanoma cases. Other primary sites are relatively uncommon. Primary pleural melanoma is a very rare tumor and to the best of our knowledge, only seven cases have been reported so far worldwide. We hereby discuss a new case, only second from India. Our patient also had coexistent congenital hairy nevus, an unusual association also noted in two previously reported cases. Excluding primary cutaneous melanoma with pleural metastasis was a diagnostic challenge in this case but multiple cutaneous biopsies together with clinical and findings helped us arrive at this unusual diagnosis. Unfortunately, the patient succumbed to his illness. Diagn. Cytopathol. 2016;44:648-652. © 2016 Wiley Periodicals, Inc.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/dc.23497DOI Listing
July 2016

Invasive pulmonary mycosis due to Chaetomium globosum with false-positive galactomannan test: a case report and literature review.

Mycoses 2016 Mar 22;59(3):186-93. Epub 2015 Dec 22.

Department of Microbiology, Post Graduate Institute of Medical Research (PGIMER), Chandigarh, India.

In this case, the authors report Chaetomium globosum as a cause of invasive pulmonary infection in a patient with Wegener's granulomatosis. Fungal hyphae (KOH and Calcofluor) were seen on direct microscopy of lung biopsy sample and bronchoalveolar lavage (BAL) sample. C. globosum isolated on culture clinched the diagnosis of invasive pulmonary infection by Chaetomium spp. A positive galactomannan of serum and BAL was repeatedly seen and was utilised for follow-up and as prognostic marker in patient management. The patient was successfully treated with liposomal amphotericin B followed by voriconazole. All the Chaetomium infections reported till date since 1980 are reviewed. Chaetomium spp. with its unique ecology has a hidden clinical potential to cause invasive mould infections.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/myc.12446DOI Listing
March 2016

An Unusual Presentation of Disseminated Histoplasmosis: Case Report and Review of Pediatric Immunocompetent Patients from India.

Mycopathologia 2015 Dec 1;180(5-6):359-64. Epub 2015 Jul 1.

Department of Pediatrics, Safadarjung Hospital, Vardhmaan Mahavir Medical College, Delhi, India.

Histoplasmosis is a progressive disease caused by dimorphic intracellular fungi and can prove fatal. Usually, it is present in immunocompromised individuals and immunocompetent individuals in the endemic zones. We report an unusual presentation of progressive disseminated histoplasmosis. The patient in the present case report was immunocompetent child and had fever, bone pains, gradual weight loss, lymphadenopathy and hepatosplenomegaly. Disseminated histoplasmosis (DH) was diagnosed on microscopic examination and fungal culture of bone marrow, blood, skin biopsy and lymph node aspirate. The patient died on seventh day of amphotericin B. In the absence of predisposing factors and classical clinical presentation of febrile neutropenia, lung, adrenal and oropharyngeal lesions, the disease posed a diagnostic challenge. Progressive disseminated histoplasmosis in children can be fatal despite timely diagnosis and therapy. In India, disseminated histoplasmosis is seen in immunocompetent hosts. All the pediatrics immunocompetent cases from India are also reviewed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11046-015-9917-yDOI Listing
December 2015
-->