Study of Thyroid Lesions: Co-Relation of TIRADS with Bethesda System
Dr. Bhavana Grandhi, Dr. K. Durga, Dr. N. Mohan Rao, Dr. B. Syamasundara Rao, Dr.M.Vijayalakshmi, Dr. G.V. Sunandha Lakshmi
Page Numbers : 128-131
DOI : 10.36348/sjpm.2021.v06i04.002
Thyroid lesions are a common encounter in clinical practice. Standardisation in the reporting of these cases in radiology and cytology is a recent advance. TIRADS system is the standard in the reporting of radiology and Bethesda system (TBSRTC) has been used as the benchmark in cytology. We have undertaken this study with the aim of studying the patterns of thyroid lesions in cytology and compare the same with reporting system in radiology (TIRADS). All the cases coming to the Departments of Endocrinology & Surgery were included and we have 47 cases with a female predominance, 43.7 years was was the mean age of presentation with female predominance, only 2 cases were seen in males. Benign lesions (80%) was predominant over the malignant cases (10%). Most of the cases come under category II in the TBSRTC system in cytology which includes nodular colloid goiter, adenomatous goiter & thyroiditis. Taking the TIRADS system into consideration, most of the cases were included under category 3(probably benign) with the malignancy rate as low as 5%.Maximum concordance was seen between TIRADS 3 and TBSRTC IIresults. Thus our results were in par with other similar studies. Fine needle aspiration can thus be performed only in cases which belong to TIRADS IV or V and thus avoid unnecesary aspirations.
Original Research Article
April 8, 2021
Human Papillomavirus and p16 Expression in the Female Genital Tract and Its Value in Diagnosis
Dr. Divya Srivastava, Dr. Praveen Kumar
Page Numbers : 132-137
DOI : 10.36348/sjpm.2021.v06i04.003
Introduction: The p16 gene is a tumor suppressor gene located at chromosome 9p21, that is a cyclin-dependent kinase inhibitor and is essential in regulating the cell cycle. In human papilloma virus (HPV) infection, the HPV oncogenes E6 and E7 can inactivate pRB and thus lead to p16 overexpression. Materials and Methods: This is prospective and descriptive study conducted in the Department of Pathology, IMS, BHU and HIMS over a period of 1 year from 1st January 2016 to 31st December 2016. Archival, formalin fixed tumour specimens from patients were retrieved from the department of pathology for immunohistochemical staining by means of an anti-p16 monoclonal antibody. In total, there were 90 patients. We evaluated p16 expression for its clinicopathological significance. Result: HPV types and status in correlation with clinical parameters and expression of p16. Eighty five out of 90 patients with primary carcinoma of the vagina (PCV) could be evaluated for HPV status. 26 were positive for high-risk HPV and 59 were HPV negative. The majority (17 out of 26, 65%) of HPV-positive patients were positive for HPV16. The others were positive for HPV45 (4 patients, 16.6%), HPV18 (2 patient, 8.3%), HPV35 (1 patient), HPV56 (1 patient), and HPV68 (1 patient). Human papillomavirus positivity was significantly correlated with strong p16 expression (p= 0.045). In all, 7 out of the 59 HPV-negative patients were negative for p16 immunostaining, while the remaining 83% showed varying expression: 39 out of 59 (60.9%) showed moderate or strong p16 expression. Conclusion: The vast majority of HPV positive vaginal cancers showed p16 overexpression, suggesting active involvement of HPV in the malignant transformation process. More in-depth studies are needed to understand the molecular carcinogenesis pathway in these p16-negative tumors and to improve outcomes for this population.
April 6, 2021
Spindle Cell / Sclerosing Rhabdomyosarcoma in Childhood: About A Case and Review of the Literature
Chadi Fadwa, Rouas Lamiaa, Lamalmi Najat
Page Numbers : 125-127
DOI : 10.36348/sjpm.2021.v06i04.001
Rhabdomyosarcoma is a malignant mesenchymal tumor with striated muscle differentiation. Most commonly developing in children or adolescents. Previously three subtypes have been described: embryonic, alveolar and pleomorphic. Spindle cell / sclerosing rhabdomyosarcoma is a rare new subtype described in the latest edition of the WHO soft tissue, it develops in children and adults and it is subdivided into 3 genomic groups with different prognosis according to the latest advances in cytogenetics. We report a case of sclerosing rhabdomyosarcoma in a 15-year-old boy with painful swelling of the forearm that has progressed for 3 months. Microscopic examination shows entirely tumor fragments, consisting of an eosinophilic hyaline matrix delimiting tumor lobules and nests, sometimes with a pseudo-vascular and alveolar appearance. Tumor cells have small, irregular and hyperchromatic nuclei with coarse chromatin and eosinophilic cytoplasm. Rare rhabdomyoblast cells are noted. Immunohistochemistry shows expression of Desmine; Myogenin; CD99; Myo D1 and loss of SMA expression.
Original Research Article
March 28, 2021
A Study of Prevalence and Most Common Genotypes of HPV (Human Papilloma Virus) by Molecular Methods and its Comparison to Pap smear, VIA and VILI Methods
Page Numbers : 119-124
DOI : 10.36348/sjpm.2021.v06i03.007
Background: Infection with high-risk genotypes of Human papillomaviruses (HPV) is the major factor in the pathogenesis of cervical cancer. HPV genotypes 16,18,31,45 causes 90 % of cervical cancer and these high-risk HPV genotypes cause nearly 100% of invasive cervical cancer. Cervical cancer can be prevented by vaccination against HPV high-risk genotypes. Effective cancer treatment programmes can improve survival rates for cervical cancer. Materials and Method: This study was aimed to evaluate the prevalence of HPV high-risk genotypes, so that high-risk individuals could be targeted, and specific genotypes associated with cervical cancer to be included in the vaccine preparations. Symptomatic patients visiting Gynaecology OPD of tertiary care hospital in India were recruited and Conventional PCR assay was done for detection of High-Risk genotypes of HPV causing cervical cancer. Statistical Analysis was done with PASW 18.0 (Predictive Analysis Software) by statistician. P value obtained by Chi Square test and p<0.05 was considered significant. Results: Out of the 72 symptomatic cases PCR was positive in 17 patients (23.6 %). In asymptomatic cases PCR positivity was 10.7%. Out of the100 patient’s PCR was positive in 20% of the cases. Among the symptomatic PCR was positive in 17 cases. HPV -16 (9.7 %) was the most common genotype among them. Infection with multiple genotypes 16 and 18 was positive in 6 cases (8.3 %), HPV -31 &45 was positive in 2 cases (2.8 %.) HPV -18 was positive in 2 cases (2.8 %) Among the asymptomatic HPV 16 in one case (3.5%), HPV-31 in one case (3.5 %), HPV -31&45 in one case (3.5 %). Conclusion: Our study results suggested inclusion of HPV 31 and 45 genotypes in HPV vaccine available and marketed in India.
March 26, 2021
Ileal Duplication Cyst: A Case Report
Dr. Sreelekshmi S. N, Dr. Lillykutty Pothen, Dr. Sankar S
Page Numbers : 116-118
DOI : 10.36348/sjpm.2021.v06i03.006
Gastrointestinal duplications are rare congenital malformations that may vary greatly in presentation, size, location and symptoms. They can present as solid/cystic tumors, intussusception, perforation or bleeding. A high index of suspicion is needed in all such cases. Radiologic studies may not be enough for a diagnosis. We present a case of ileal duplication cyst in a 2 month old baby who presented with features of abdominal obstruction. Suspecting it to be an infected mesenteric cyst from radiological studies, surgical excision with anastomosis of the ileal segment was done. The histopathological examination of the resected specimen diagnosed it as an enteric duplication cyst.
Original Research Article
March 21, 2021
Histomorphological Spectrum of Orbito-Ocular Lesions at Tertiary Care Center
Dr. Anu Sahjlan, Dr. Anita Harsh, Dr. Sapna Gandhi, Dr. Kusum Mathur, Dr. Ranjana Solanki
Page Numbers : 110-115
DOI : 10.36348/sjpm.2021.v06i03.005
Eye is a special sensory organ which exhibits diverse histological structures. It shows wide spectrum of pathologies ranging from trauma, degenerative, inflammatory, and neoplastic conditions. So this study was done to determine the pattern and proportion of different ophthalmic lesions in hospital. Total 95 biopsies and specimens of orbito-ocular lesions were received and were examined after H & E staining and immunohistochemistry was applied whenever required. This study was carried out in the Department of Pathology, SMS Medical College, Jaipur, for the duration of 1 year. It was found that females 50 (52.63%) were more commonly affected than male 45 (47.36%) with male to female ratio of 0.9: 1. The orbito-ocular lesions were highest 20 (21.05%) in age group of 0-10 years. The lesions were categorised as Non-neoplastic 7 (7.36%), Benign 40 (42.10%) and Malignant 48 (50.52%). Eyelid 48 (50.52%) was the most commonly involved site followed by conjunctiva, and was the significant finding. Most common benign lesion was epidermoid cyst 10 (25%). Among malignant lesions squamous cell carcinoma 12 (25%) was most common. Retinoblastoma was the commonest intraocular malignancy in paediatric age group. All surgically resected ophthalmic lesions should always be subjected to histopathological examination to establish the accurate diagnosis for further management.
Original Research Article
March 21, 2021
Evaluation of the Impact of Smoking on Spondyloarthritis: Data from the Moroccan Biotherapy Register (RBSMR)
Bouayad S, Rostom S, Hmamouchi I, El Binoune I, Amine B, Abouqal R, Achemlal L, Allali F, El Bouchti I, El Maghraoui A, Ghozlani I, Hassikou H, Harzy T, Ichchou L, Mkinsi O, Niamane R, Bahiri R
Page Numbers : 105-109
DOI : 10.36348/sjpm.2021.v06i03.004
Objective: The aim of our study was to determine the prevalence of smoking and its impact on the various parameters of spondyloarthritis based on collected data from the Moroccan biotherapy register. Materials and methods: This is a multicenter study based on data from the Moroccan biotherapy register related to patients suffering from spondyloarthritis. An analysis of the socio-demographic parameters as well as an evaluation of the variables associated with the disease were performed. Univariate and multivariate logistic regressions were conducted to assess what the impact of smoking is on the various spondyloarthritis parameters. p<0.05 was set to be the significant threshold. Results: The study is based on data collected from 194 patients (21 smokers and 173 non-smokers) suffering from AS included in the Moroccan biotherapy register. The prevalence of smoking was 10.8%. Male gender was associated with smoking (63% of men in non-smoking group versus 90% of men in the smoking group) (p = 0.006). In addition, a higher CRP: 8 [2-17] was observed in the smoking group compared to 5.5 [2-28] in the non-smoking group (p = 0.048). No significant difference between the 2 groups was statistically noted in terms of the disease activity evaluated by the BASDAI and ASDAS CRP score which were respectively 2.77 +/- 1.82 and 2.25 ± 1.66 in the smoking group and 3.24 +/- 2.15 and 2.09 ± 1.7 in the non-smoking one. Furthermore, our results did not reveal a significant correlation between smoking and the functional impact of spondyloarthritis. No correlation was established between smoking and the structural progression of the disease. Conclusion: Our study suggests that male gender and a higher CRP are statistically associated with tobacco consumption. Larger scale studies are needed to support these results.