Publications by authors named "Rau Aarathi"

24 Publications

  • Page 1 of 1

A Correlation of the Platelet Count with D-Dimer Levels as an Indicator for Component Therapy in Children with Dengue Hemorrhagic Fever.

Indian J Hematol Blood Transfus 2017 Jun 24;33(2):222-227. Epub 2016 May 24.

Department of Pediatrics, MS Ramaiah Medical College, Bangalore, 560054 India.

Dengue Fever (DF) may evolve into two life threatening forms-Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). DHF is associated with increased vascular permeability and plasma leakage causing thrombocytopenia and loss of clotting factors into the third space and may result in bleeding initially due to thrombocytopenia and later due to disseminated intravascular coagulation (DIC), often as a terminal event. Prompt recognition and treatment of minor bleeds in DF children with incipient DIC with component therapy may be associated with improved survival while failure to do so is usually catastrophic. A sensitive marker for early DIC is the presence of D-dimer (DD) in the blood. To determine the correlation between the severity of thrombocytopenia and early DIC in children with DHF. The impact of additional factors like age and shock will also be evaluated. Case control prospective study of 60 DHF sero -positive children (1-15 years) with thrombocytopenia. After clinical evaluation they were divided into two equal groups based on the degree of thrombocytopenia (more than/less than 30,000/mm). PT/APTT and DD levels were estimated in all children of both groups and statistical correlation was done. There was no significant difference in the DD levels between the two groups. However, children in either group, presenting with clinical features of shock and thrombocytopenia had significantly higher DD levels. Empirical component therapy in children with DHF based purely on their low platelet counts may not be justified. However, in DHF children with thrombocytopenia and features of shock, aggressive component therapy may prevent subsequent bleeding and may be justified.
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http://dx.doi.org/10.1007/s12288-016-0686-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442049PMC
June 2017

HER2 Expression in Gastric Adenocarcinoma-a Study in a Tertiary Care Centre in South India.

Indian J Surg Oncol 2016 Mar 4;7(1):18-24. Epub 2015 Jul 4.

Department of Pathology, M S Ramaiah Medical College, M S R Nagar, Bangalore, Karnataka 560054 India.

According to the literature available, HER2(human epidermal growth factor 2)status in gastric carcinoma has been studied worldwide, however there is a paucity of published data from India. Hence, this study was taken up to evaluate HER2 overexpression in gastric adenocarcinoma patients and to assess the relationship between its expression and clinicopathological tumor parameters. Prospective study was conducted in a teaching hospital over a period of 27 months. Total or subtotal gastrectomy resection specimens and small biopsies were included in the study. Immunohistochemistry (IHC) was carried out on all the cases to evaluate the expression of HER2 in formalin-fixed paraffin-embedded tissue samples. Fluorescence Insitu Hybridization (FISH) was done for equivocal cases on IHC. The data was analyzed using Chi square test / Fisher's Exact Test. Odds ratio was computed between HER2 and other pathologic variables. HER2 overexpression was confirmed in 16 (27.6 %) cases of which 15 (93.8 %) cases were of intestinal type whereas only 1 (6.2 %) case of diffuse type adenocarcinoma. Hence, HER2 positivity was significantly more common in the intestinal type of gastric cancer compared to the diffuse type (p = 0.045). Positivity of HER2 was more in small biopsies as compared to the resection specimens in this study but the p value was not significant. There was no difference in HER2 overexpression in relation to the age, gender, tumor site, tumor differentiation and stage. HER2 overexpression is more prevalent in the intestinal subtype. The relatively high percentage of HER2 positive tumors may provide a useful target for immunotherapy of these cancers.
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http://dx.doi.org/10.1007/s13193-015-0436-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4811822PMC
March 2016

Lipofibromatous Hamartoma of the Median Nerve in Association with or without Macrodactyly.

Turk Patoloji Derg 2018 ;34(1):87-91

Department of Pathology, Kasturba Medical College, Manipal University, Mangalore, KARNATAKA, INDIA.

Lipofibromatous hamartoma is a rare tumour-like condition involving the peripheral nerves, particularly the median nerve. It commonly affects the volar aspect of the hands, wrists and forearms of young adults. Most patients present either early with macrodactyly or later with a forearm mass lesion or symptoms consistent with compressive neuropathy of the involved nerve. The clinical and histomorphological findings of five patients with lipofibromatous hamartoma of the median nerve are analysed. The presentation, pathological features and differential diagnosis of neural lipofibromas are discussed along with a brief review of the literature. Of the five cases of lipofibromatous hamartoma, all were seen to involve the median nerve, occurring in four women and one man. Three of these cases had associated macrodactyly which was congenital in two and was seen from childhood in one. Microscopic examination showed fibrofatty tissue surrounding and infiltrating along the epineurium and perineurium. The nerve bundles were splayed apart by the infiltrating adipose tissue. Neural fibrolipomatous hamartoma is a benign condition. Most respond to conservative management with surgical exploration, biopsy and carpal tunnel release to decompress the nerve. Correct diagnosis of this uncommon lesion is important as surgical excision of the lesion may lead to loss of neurological function.
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http://dx.doi.org/10.5146/tjpath.2014.01282DOI Listing
August 2018

Cytopenia and Bone Marrow Dysplasia in a Case of Wilson's Disease.

Indian J Hematol Blood Transfus 2014 Sep 7;30(Suppl 1):433-6. Epub 2014 Sep 7.

Department of Paediatrics, MS Ramaiah Medical College, Bangalore, 560054 India.

We describe a sixteen year old with Wilson's disease on copper chelation and subsequent high dose oral zinc who developed severe anemia and neutropenia. Bone marrow aspirate done to evaluate the cause of bicytopenia revealed trilineage dysplasia. Correlating the clinical context with bone marrow and biochemical parameters, copper deficiency was suspected and he was given a trial of therapy, following which the hematological parameters improved. This case highlights hypocupremia as a reversible cause of bone marrow dysplasia in patients with Wilson's disease on chelation, where serum copper levels are not useful in the diagnosis. We also believe that monitoring of the blood counts in patients on copper chelation may provide a clue to impending copper deficiency.
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http://dx.doi.org/10.1007/s12288-014-0456-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4192249PMC
September 2014

Paratesticular liposarcoma-masquerading as a testicular tumour.

J Clin Diagn Res 2014 Feb 3;8(2):165-6. Epub 2014 Feb 3.

Professor, Department of Pathology, M.S. Ramaiah Medical College , India .

Paratesticular liposarcomas are rare tumours which account for 12% of all liposarcomas. Probably there are about 186 cases which have been reported till date. They must be differentiated from tumours of testicular origin which have extension to the spermatic cord. We are reporting a case of a 50-year-old male who had presented with a painless swelling in the right hemiscrotum, which was of 20 years' duration. Inititally, a clinical diagnosis of testicular tumour was made; however, CT of the scrotum revealed paratesticular tumour? liposarcoma and testis being normal and displaced postero-inferiorly. Metastatic work-up, which included CT of the abdomen and pelvis, thorax and whole body scan, did not reveal any distant metastasis. Patient underwent high orchidectomy, hemiscrotectomy. Histopathological studies confirmed the diagnosis of well-differentiated liposarcoma (atypical lipomatous tumour of sclerosing type).
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http://dx.doi.org/10.7860/JCDR/2014/8147.4045DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972547PMC
February 2014

Pleomorphic undifferentiated sarcoma of urinary bladder with calcified pulmonary metastasis: A rare entity.

Indian J Urol 2013 Jul;29(3):253-6

Department of Urology, M. S. Ramaiah Medical College and Hospital, Bangalore, Karnataka, India.

We report the case of a 29-year-old male who presented to us with hematuria, dysuria and bilateral flank pain. On evaluation, the patient was found to have primary pleomorphic undifferentiated sarcoma of bladder with calcified pulmonary metastasis, confirmed with computerized tomography scan and immunohistochemistry.
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http://dx.doi.org/10.4103/0970-1591.117263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3783709PMC
July 2013

Nutritional assessment of children with hematological malignancies and their subsequent tolerance to chemotherapy.

Ochsner J 2012 ;12(3):197-201

Department of Medical Oncology, Nizams Institute of Medical Sciences, Hyderabad, India.

Background: Our research goals were to assess the prevalence of malnutrition in children with cancer, observe malnutrition's effect on tolerance to chemotherapy, and establish malnutrition at onset as one of the prognostic factors in children with hematological malignancies.

Methods: This prospective study examined children ages 1-15 years with a confirmed diagnosis of acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma. Each child was subjected to a detailed history, anthropometric examination, and laboratory investigations. Based on the anthropometric measurements that used weight-for-age Z scores, we divided the children into 4 groups: group 1, without malnutrition; group 2, mild malnutrition; group 3, moderate malnutrition; and group 4, severe malnutrition. We analyzed data for each group regarding the behavior of blood indices, the quantum of hematological support, bone marrow remission status on day 28, adherence to protocol schedules, and complications in the first 4 months of intensive chemotherapy.

Results: Of the 34 patients in the study (mean age, 7.1 years; male:female ratio, 1.6:1), 79% had deficient calorie intake and 74% had deficient protein intake. Packed cell requirements and complications were significantly higher in malnourished children, whereas the requirement for platelet transfusions was statistically insignificant. Also, 50%, 40%, 38%, and 44% of children in groups 1, 2, 3, and 4, respectively, completed chemotherapy within the specified time period. At the end of the induction phase, 92%, 60%, 87%, and 77% of the patients in groups 1, 2, 3, and 4, respectively, achieved bone marrow remission. No deaths occurred in group 1; 1 death each occurred in groups 3 and 4, and 2 in group 2. When these deaths were extrapolated to the weight/height ratio (acute malnutrition), we found that all occurred in children with malnutrition, a statistically significant result.

Conclusions: Malnutrition is widely prevalent in children with ALL in India and has a significant bearing on the occurrence of life-threatening complications and short-term outcomes in these children. Malnutrition is also a significant factor influencing treatment planning and therapeutic decisions.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3448240PMC
October 2012

Poorly differentiated (insular) thyroid carcinoma arising in a long-standing colloid goitre: A cytological dilemma.

J Cytol 2012 Jan;29(1):97-9

Department of Pathology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.

Poorly differentiated (insular) thyroid carcinoma (PDITC) is an uncommon thyroglobulin producing neoplasm intermediate in aggressiveness between well-differentiated carcinomas of follicular cell origin and undifferentiated anaplastic carcinoma. Its cytomorphological recognition is essential for planning surgery and subsequent management as it is known for its aggressive behavior, advanced stage at presentation, local recurrences and rapid dissemination. We report a case of PDITC arising in a long-standing goiter, in which presence of microfollicular structures and minimal necrosis resulted in difficulty in distinguishing it from a follicular neoplasm of thyroid.
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http://dx.doi.org/10.4103/0970-9371.93237DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307470PMC
January 2012

Pesticide (endosulfan) levels in the bone marrow of children with hematological malignancies.

Indian Pediatr 2012 Feb 30;49(2):113-7. Epub 2011 Jul 30.

Department of Pediatrics and #Pathology, MS Ramaiah Medical College, Bangalore, MD, USA.

Objectives: (1) To confirm the presence of Pesticide (Endosulfan) residues in the bone marrow (BM) of children with acute hematological malignancies and compare them with controls. (2) To ascertain if children with Endosulfan in their marrow reside in areas sprayed with Endosulfan.

Study Design: Case control study

Setting: Pediatric oncology unit of a medical college teaching hospital in Dakshina Kannada district of Karnataka.

Subjects: 26 patients with proven hematological malignancy and 26 age matched controls suffering from benign hematological disease.

Methods: Endosulfan residues in the BM were estimated by gas chromatography mass spectrometry (Minimum detection limit 10ng/mL). The subjects geographical area of location (residence) was determined to see whether they belong to sprayed area or not. The Chi-square test was applied to see an association between exposure status and hematological malignancy.

Results: A total of 52 children were enrolled of which 26 were study cases and 26 were controls. Of the study and control groups, 84.7% ;and 73.1%, respectively were from exposed areas. The major (88.4%) illness in the study group was ALL, while ITP (50%) occurred most frequently in the control group. Six out of 26 study cases tested positive for endosulfan in the BM, against 1 out of 26 controls (P = 0.042). The Odds ratio was 7.5. All children who had endosulfan in the bone marrow originated from areas, where endosulfan is still being used.

Conclusions: Children with hematological malignancy had raised levels of endosulfan in the bone marrow compared to those without. All the children with raised bone marrow Endosulfan levels were found to be from areas exposed to the pesticide.
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http://dx.doi.org/10.1007/s13312-012-0025-5DOI Listing
February 2012

"The inside out appendix"--report of 2 cases.

Trop Gastroenterol 2010 Jan-Mar;31(1):55-6

Department of Pathology, Kasturba Medical Ccollege, Mangalore.

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November 2010

HIV lymphadenitis of the salivary gland: A case with cytological and histological correlation.

J Cytol 2009 Oct;26(4):146-8

Department of Pathology, Kasturba Medical College, Light House Hill Road, Mangalore - 575 001, Karnataka, India.

Human immunodeficiency virus infection associated lymphadenitis of the salivary glands (HIVLSG) and benign lymphoepithelial cysts are described as early events in HIV patients. The diagnosis is not usually made clinically as it mimics a salivary gland tumor. We present here a patient with two painless nodules in the right parotid and submandibular glands. The cytological diagnosis was florid reactive lymphoid hyperplasia. Histopathology revealed features of HIVLSG with multiple, small, cystic, benign lymphoepithelial lesions.
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http://dx.doi.org/10.4103/0970-9371.62184DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168000PMC
October 2009

Bone marrow biopsy in non-Hodgkin lymphoma: a morphological study.

Indian J Pathol Microbiol 2009 Jul-Sep;52(3):332-8

Department of Pathology, Kasturba Medical College, Mangalore, Karnataka, India.

Context: Bone marrow (BM) biopsy is an integral part of staging work-up for non-Hodgkin lymphoma (NHL).

Aims: To study the characteristics of BM involvement in NHL with respect to incidence, histologic pattern and morphology of infiltration and its discordance with the histology of primary anatomic site.

Settings And Design: Forty-nine cases of NHL in which BM biopsy was performed for staging were included in this study, the primary site being classified according to the WHO classification for NHL.

Materials And Methods: A prospective study of 49 cases was conducted. Bilateral BM biopsy was obtained from the posterior superior iliac spine. The biopsies were fixed in 10% buffered formalin solution and decalcified using 10% formal - formic acid for 4 - 6 h followed by routine processing. The serial sections were stained by hematoxylin and eosin and reticulin stains.

Results: BM biopsy showed involvement by lymphoma in 27 cases (55.10%). Unilateral positivity was found in four cases (14.81% cases). The overall incidence of marrow involvement by NHL was 55.1%. The incidence of involvement was higher in T-cell lymphomas when compared with B-cell lymphomas and predominant pattern of involvement was mixed. Diffuse large B-cell lymphomas had the lowest incidence in all the B-cell lymphomas. A discordant histology between BM and primary anatomic site was found in 29.63% (8/27) of the cases, where it was seen more in follicular lymphomas and diffuse large B-cell lymphomas.

Conclusions: Critical examination of BM biopsies can increase the diagnostic accuracy, thereby contributing to the prognosis and appropriate treatment modalities.
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http://dx.doi.org/10.4103/0377-4929.54987DOI Listing
October 2009

Morphological evaluation of cystitis glandularis.

Indian J Pathol Microbiol 2009 Apr-Jun;52(2):203-5

Department of Pathology, Kasturba Medical College, Mangalore, India.

Cystitis cystica and cystitis glandularis (CG) are relatively common appearances in the urinary bladder though CG may occasionally mimic a neoplasm. Microscopically, two types of CG are recognized, the usual type and intestinal type. This study was undertaken to study the morphology of CG and to highlight the differences in morphology between CG and adenocarcinoma. Eleven cases of CG were seen, of which 3 cases showed predominantly CG, usual type and eight cases showed CG of intestinal type. One case of primary adenocarcinoma was included in this study, where the adjacent bladder mucosa showed CG. Evaluation of the histological features of CG, especially intestinal type helps in correct categorization of this lesion and differentiation from adenocarcinoma of the bladder.
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http://dx.doi.org/10.4103/0377-4929.48918DOI Listing
May 2009

Imprint cytology of pancreatoblastoma: a case report and review of the literature.

Diagn Cytopathol 2009 Apr;37(4):290-2

Department of Pathology, Kasturba Medical College, Mangalore, Karnataka, India.

Pancreatoblastoma is a rare tumor with approximately 60 cases described in the English literature and only five case reports illustrating the cytologic findings, four by fine-needle aspiration cytology and one by imprint cytology. We herein report the sixth case diagnosed by imprint cytology. Both the cytologic and histopathologic literatures are reviewed, and the pathologic variations observed in our case are also documented.
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http://dx.doi.org/10.1002/dc.21016DOI Listing
April 2009

Apocrine (cutaneous) sweat gland carcinoma of axilla with signet ring cells: a diagnostic dilemma on fine-needle aspiration cytology.

Diagn Cytopathol 2008 Oct;36(10):739-41

Department of Pathology, Kasturba Medical College, Mangalore, Karnataka, India.

Carcinoma arising in the apocrine sweat glands is rare and there are few reports describing the cytological features of this neoplasm. We describe the cytological features of a histologically confirmed apocrine carcinoma occurring in a 55-year-old man who presented with an ulcerated mass in the right axilla. Fine-needle aspiration cytology revealed features of a signet ring adenocarcinoma. The significance of this infrequently encountered neoplasm lies in its potential for diagnostic confusion with more common lesions containing signet ring cells. In an axillary mass lesion, cytological features along with clinical correlation are essential to distinguish primary apocrine carcinoma from mammary neoplasms with signet ring cells and other metastatic adenocarcinomas.
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http://dx.doi.org/10.1002/dc.20889DOI Listing
October 2008

Wegener's granulomatosis mimicking paraneoplastic syndrome.

Indian J Chest Dis Allied Sci 2008 Jul-Sep;50(3):295-7

Department of Pathology, Kasturba Medical College, Mangalore, India.

Wegener's granulomatosis is a distinct clinico-pathological entity characterised by a triad of upper and lower respiratory disease and renal involvement, although atypical presentations can be seen. These patients characteristically have small vessel vasculitis and or granulomatous vasculitis and are usually anti-neutrophilic cytoplasmic antibody (ANCA) positive. We present a case of Wegener's granulomatosis that clinically mimicked a lung neoplasm with a paraneoplastic syndrome. Biopsy and histopathological evaluation of a readily accessible subcutaneous nodule showed small vessel vasculitis. Correlation with clinical data and ANCA positivity led to a definite diagnosis.
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September 2008

Clinicopathological study of Kikuchi's disease.

Indian J Pathol Microbiol 2007 Jul;50(3):485-8

Department of Pathology, Kasturba Medical College, Mangalore, Karnataka.

Kikuchi's disease (KD) is a necrotizing lymphadenopathy with a self-limiting course commonly affecting young people. We conducted a clinico-pathological study of 20 cases of KD received at our department between July 2000 and December 2003. Our study confirmed that KD commonly involves the cervical lymph nodes of young adults, with a female predominance. One patient had associated cutaneous involvement. The hematological parameters were non-specific. The histological features were distinctive and included easy fragmentation on handling, karyorrhexis, crescentic histiocytes and the absence of neutrophils. The differential diagnosis on histology is also discussed.
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July 2007

Cytomorphology of subcutaneous panniculitic T-cell lymphoma (SPTCL)--a case report.

Indian J Pathol Microbiol 2006 Apr;49(2):246-8

Department of Pathology, Kasturba Medical College & Department of Surgery, Government Wenlock Hospital, Mangalore.

T cell lymphomas account for approximately 60% of cutaneous lymphomas. The annual incidence of cutaneous lymphoma is estimated to be from 0.5 to 1 per 1,00,000 persons per year. We present one case of cutaneous lymphoma, an eighteen year old male who presented with multiple swellings all over the body of one month duration. On examination, multiple, subcutaneous, mobile, non tender nodules were seen ranging from 0.5 cm to 5 cm in diameter. FNAC revealed non-Hodgkin's lymphoma morphologically in favour of cutaneous T-cell lymphoma. A biopsy and immunohistochemistry confirmed SPTCL.
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April 2006

Tissue effects of fine needle aspiration on salivary gland tumours.

Indian J Pathol Microbiol 2006 Apr;49(2):226-8

Department of Pathology, Kasturba Medical College, Mangalore.

Fine needle aspiration cytology (FNAC) is a widely used diagnostic procedure to evaluate lesions in the salivary glands. Though regarded as a safe and reliable procedure ,a variety of histological changes following FNAC have been reported. We studied the FNAC related tissue changes in 50 neoplasms of the salivary gland and the impact on subsequent histological evaluation. FNAC induced changes were found in 34% (17/50) with needle tract (10/50)and infarction (7/50) as the commonest changes . These changes did not interfere with the subsequent histological evaluation of the tumours. We conclude that knowledge of a previous FNAC and awareness of its effects on histology may avoid potential misdiagnosis, though the incidence of significant changes is small.
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April 2006

Case reports of basaloid squamous cell carcinoma--an aggressive variant of squamous cell carcinoma.

Indian J Pathol Microbiol 2005 Jan;48(1):31-3

Department of Pathology, Kasturba Medical College, Mangalore.

Basaloid squamous cell carcinoma (BSCC) is a high grade variant of Squamous Cell Carcinoma with a predilection for the aero-digestive tract. The typical microscopic features of carcinoma with a basaloid pattern in intimate association with a squamous component helps in diagnosis of this tumour. There are few reports in the Indian literature and we report three cases, including one in the sinonasal region. This study discusses the differential diagnosis of BSCC, as recognition of this tumour may have therapeutic implications.
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January 2005

Tigroid background in fine-needle aspiration cytology of clear cell sarcoma.

Diagn Cytopathol 2006 May;34(5):355-7

Department of Pathology, Kasturba Medical College, Light House Hill Road, Mangalore, Karnataka, India 575001.

Clear-Cell Sarcoma (CCS) is a rare malignant soft tissue tumor of young adults that often metastasizes to the lymph nodes. The fine needle aspirate cytology (FNAC) findings of CCS have been described previously and it is included in the cytological category of polygonal soft tissue tumors. We describe the cytology of a case of CCS, with emphasis on the so called "tigroid background." Though this tigroid background is a nonspecific feature and has been described in various other tumors, to the best of our knowledge, it has not been described in CCS. This feature may be useful in the recognition of CCS.
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http://dx.doi.org/10.1002/dc.20368DOI Listing
May 2006

Metastatic lobular mammary carcinoma diagnosed in cervicovaginal smears: a case report.

Diagn Cytopathol 2003 Nov;29(5):300-2

Department of Pathology, Kasturba Medical College, Mangalore, Karnataka, India.

Lobular carcinoma of the breast uncommonly metastasizes to the cervix. We report a case of lobular carcinoma of the breast with an abnormal cervicovaginal smear caused by metastasis in the cervix. We also discuss the differential diagnosis of primary genital and secondary adenocarcinomas in abnormal cervicovaginal smears.
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http://dx.doi.org/10.1002/dc.10385DOI Listing
November 2003

Infarction of acinic cell carcinoma in a patient infected with HIV: a complication of fine-needle aspiration cytology obscuring definitive diagnosis.

Diagn Cytopathol 2003 Oct;29(4):222-4

Department of Pathology, Kasturba Medical College, Mangalore, Karnataka, India.

Infarction of salivary gland tumors has been reported following fine-needle aspiration cytology (FNAC) and, rarely, as a spontaneous event. Patients infected with the human immunodeficiency virus (HIV) often have salivary gland lesions and FNAC plays a role in the preliminary investigation of such swellings. We report a case of a parotid swelling in a patient infected with HIV where infarction of acinic cell carcinoma following FNAC lead to difficulty in cytological evaluation of the subsequent aspirate.
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http://dx.doi.org/10.1002/dc.10229DOI Listing
October 2003
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