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In China, Wuhan City became the epicentre of unexplained cases of pneumonia in December 2019 and was temporarily labelled as, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). World Health Organization renamed it to coronavirus disease 2019 (COVID-19) in February 2020. In COVID-19 patients hematological profile showed increased total leukocyte count (TLC) and neutrophilic count, while decrease in other hematological parameters. The mild increase in TLC was found in severe disease patients; however significant increase was associated with clinical worsening and poor outcome. Significant elevation of various biochemical and inflammatory markers was noticed among COVID-19 patientsWe conducted a retrospective study on RT-PCR confirmed 239 COVID-19 patients who were hospitalized in various COVID-19 facilities from Sept 2020 to Dec 2020. The laboratory data is used in de-identified form and doesn’t reveal identity of any subjects.A total of 239 cases were examined, out of which 176(73.7%) were male and 63(26.3%) were female (M:F ratio= 2.79:1). We found that 104 cases had Hb level ≥ 12gm/dl. We found that maximum patients (175) had TLC level >11000/cumm, 187 patients had ANC level > 7000/cumm. We found that 160 cases had serum urea of >43mg/dl, 134 case with serum creatinine of >1.4gm/dl.134 cases had ALT level of >40IU/L and 143 cases had AST levels of >42IU/L In this study out of 239 cases 126 cases were found to have increased level of all inflammatory markers levels. We found a significant association of various inflammatory markers with haematological and biochemical parameters in COVID-19 patients.

Introduction: The appropriate diagnosis of intra-abdominal lesions is difficult and often requires histopathological confirmation. Image guided Fine Needle Aspiration Cytology (FNAC) is a simple, readily available, safe, inexpensive, time saving, rapid procedure which prevent unnecessary surgical interventions. Aim: The study was conducted to determine the diagnostic efficacy of image guided FNAC in the assessment of intra- abdominal lesions and to determine age and sex distribution. Materials and Methods: This cross-sectional study was conducted in Department of Pathology SN Medical College Agra (from September 2019 to September 2021. Two hundred and seven patients who were detected to have abdominal lesions by Ultrasonography (USG) or Computed Tomography (CT), image guided Fine Needle Aspiration (FNA) was performed under all aseptic condition. The sample was spread onto slides, air-dried and stained with Giemsa and was fixed in 95% ethanol and stained with Papanicolaou’s stain. The cyto-histopathological association was done wherever possible, the overall accuracy, sensitivity, specificity, the Negative Predictive Value (NPV) and Positive Predictive Value (PPV) was calculated. Results: Out of 207 patients, 110 were males and 97 were females with male to female ratio of 1.13:1. Out of 207 cases, the aspirate was satisfactory in 201 (97%) cases. Unsatisfactory aspirate was obtained in 06 (3.0%) of cases. Among 207 cases, most common lesions were malignant 170(82.1%) cases, followed by inflammatory 31 (14.9%) cases and unsatisfactory 06 (3.0%) cases. Most common age group for malignant lesions was 59-68 years with 45 (26.4%) cases followed by 49-58 years with 41 (24.1%) cases. The majority of aspirates were from liver 78 cases (38.2%), followed by 47 cases (22.71%) from gall bladder and 44 cases (21.30%) from the lymph nodes. The sensitivity was 92.3% while specificity was 100%. The Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were 100% and 91.4%, respectively. The diagnostic accuracy of image guided FNAC was 95.8%. Conclusion: FNA of abdominal lesions guided by ultrasound is a quick, low-cost, safe, highly accurate, and minimally invasive approach for getting a tissue diagnosis in solid localised lesions of the abdomen.

Introduction: Medullary thyroid carcinoma is an uncommon primary thyroid tumour (5-10% of all thyroid malignancies) arising from parafollicular cells or C-cells. Most tumours are sporadic (75-80%) and familial syndrome multiple endocrine neoplasia; MEN-2A, MEN-2B and familial MTC in 20 to 25% cases. Case Report: We report a case of primary medullary thyroid carcinoma in a 30 years old male patient presented with complaint of midline neck swelling. On fine needle aspiration cytology diagnosis of medullary carcinoma was suggested with a differential of SETTLE (spindle epithelial tumor with thymus like differentiation). The swelling was excised and send for histopathological examination which revealed polygonal to plump spindle shaped tumor cells, arranged in lobules separated by fibrous septa, having abundant eosinophilic granular cytoplasm with round to oval nuclei, finely stippled nuclear chromatin and indistinct nucleoli and diagnosed as primary medullary thyroid carcinoma, confirmed on immunohistochemistry. Conclusion: MTC is the first human malignancy known to be associated with tumour marker and hormone calcitonin. Immunohistochemistry has definite role in confirmation of diagnosis. Keywords: Amyloid, Medullary carcinoma, Procalcitonin, Synaptophysin.

Introduction: Ovary is the most common site of neoplastic and non neoplastic lesion, can present in childhood to postmenopausal age group and remain the most lethal of all gynaecological malignancies. Tumour Protein (p53) gene mutations or deletions are most common in ovarian carcinoma. However, Wilms' Tumor gene1 (WT1) and p16 expression are also seen in serous ovarian carcinoma. These Immunohistochemistry (IHC) marker are useful in the differential diagnosis of serous ovarian carcinomas. Aim: To study histomorphology of ovarian neoplasm along with expression of p53 and WT1 in surface epithelial tumours and to assess the prevalence of various ovarian neoplasms in different age groups. Materials and Methods: This cross-sectional study was conducted in Department of Pathology, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India, over a period of two years (from September 2018-September 2020). A total of 78 ovarian specimen received in histology laboratory was studied for gross and microscopic features. The p53 and WT1 IHC expression pattern was studied in surface epithelial tumours. Statistical significance was calculated in relation to p53 and WT1 expression with histological type and grade of tumour using Chi-square test. Results: A total of 78 cases were studied, out of which benign tumours were the most common 40 (51.3%) cases, followed by malignant tumours 32 (41.0%) cases and borderline malignancy 6 (7.7%) cases. The most common benign lesions were mucinous cystadenoma 20 (50%) cases. Serous carcinomas were most common malignant tumours 19 (59.3%) cases followed by Germ Cell Tumours (GCT) 5 (15.6%) cases. All benign and borderline epithelial ovarian tumours were found p53 and WT1 negative. Out of 22 cases of malignant surface epithelial tumour, 14 (63.6%) and 12 (54.4%) were positive for p53 and WT1 respectively and all were serous carcinomas. Conclusion: Ovarian lesions present with wide spectrum of histomorphological features. The p53 and WT1 show different rates of expression and staining pattern in various epithelial ovarian carcinomas. Hence routine gross, proper histological examination and correct IHC interpretation is required for specific diagnosis.

Granular Cell Tumour (GCT) of nasal and paranasal area is an extremely rare entity, while the most common site is the tongue in oral cavity. GCT was first time described by Abrikossoff in 1926, which occurs in 3rd to 5th decades of life and most frequently involving the head and neck region. Abrikossoff in 1926, first time described GCT, to be derived from smooth muscle and gave the term myoblastomas, also known as Abrikossoff’s tumours. Schwann cell origin of GCT was demonstrated on immunohistochemistry through positive S100 protein identification. Herein, the authors report a case of GCT arising from right nasal vestibule in a 28- year-old female who presented with swelling since three months. On gross examination, the specimen revealed firm red and white pieces of tissue measuring 0.8x0.8x0.5cm. Diagnosis was made by histopathological examination which was confirmed by PAS special stain and S100 immunohistochemistry. Author also abridge the clinical information, microscopic features, treatment and patient status after follow-up. This case is believed to be the 7th reported case of GCT as primary lesion at this location.

Previously, Solitary Fibrous Tumour (SFT) was thought to originate from the pleura, a relatively rare mesenchymal neoplasm with an indolent course. Vulva is the very uncommon site of extrathoracic SFT. This is the report of a very uncommon case of vulval SFT in a 30-year-old female with complaint of a swelling over vulval region. Fine Needle Aspiration Cytology (FNAC) of the growth was attempted twice and only blood was aspirated. The swelling was excised completely. On histological examination, the sections revealed a cellular tumour of ovoid-to-fusiform spindle cells with indistinct cell borders, with haphazard arrangement or patternless pattern along with proliferation of variable sized blood vessels. The diagnosis was finalised to be a benign stromal tumour (most probably SFT), which was confirmed on immunohistochemical examination using Cluster of Differentiation 34 (CD34), CD99 and Signal Transducer and Activator of Transcription 6 (STAT6) markers.

Introduction: Gastrointestinal tract is uncommon location for lipomas. If present, 90% are seen submucosally and 10% in subserosal location. Mostly located in the colon, but they can be found in the esophagus, small intestine, and rarely in the stomach. The vast majority of cases with intestinal lipomatosis are usually asymptomatic and some of the cases present with intermittent obstruction, colonic perforation and rarely intussusception. Case Report: A 20 year male presented in emergency department with history pain in abdomen 15 days back, progressively increasing in intensity and no passage of stool from 4 days. On the basis of history, examination and computed tomography scan of abdomen, possible diagnosis of ileoileal intussusception was made. Patient was admitted in emergency department of surgery and planned for surgery and exploratory laparotomy with resection of ileum 5 cm on both sides was done. A growth was seen in ileal intussusceptum area within 5cm margin and sent for histopathological examination to the department of pathology. On histopathologic examination, a diagnosis of lipoma was made. Conclusion: Lipomas are benign tumours with no risk of recurrence. They should always be kept in the differential diagnosis of sessile polypoid lesions. Surgery is usually curative. Keywords: Ileoileal intussusception, Ileal lipoma.

Myeloid sarcoma, also known as chloroma, granulocytic sarcoma, extramedullary Acute Myeloid Leukaemia (AML), myeloblastoma or extramedullary myeloid tumour, is a rare manifestation, characterised by the proliferation of immature myeloid cells, myeloblasts or monoblasts occurring as one or more tumour at an extramedullary site. It is associated with disruption of normal architecture of tissue in which it is found. Monoblastic sarcoma is a rare variant of myeloid sarcoma. Hereby, the authors report a rare case of primary monoblastic sarcoma in a 64-year-old male patient presented with complaint of swelling over right side lower cervical region. He had no history of AML. On physical examination, the swelling was over medial one-third of right clavicle measuring 6×5.8×3 cm. The swelling was excised and sent for histopathological examination, which was diagnosed as monoblastic sarcoma, and confirmed on immunohistochemistry.

Introduction: The granulomatous reaction is defined as a distinctive inflammatory pattern characterised by the granuloma. The term Granuloma was first coined by Virchow in 1864. The granuloma is characterised by collection of activated histiocytes, epithelioid cells and multinucleate giant cells that may or may not be rimed by lymphocytes and/or show central necrosis. The pattern of skin disease varies from one country to another and across different parts within same country. The granulomatous lesions of skin are a common and intriguing problem in developing countries. Aim:To study the histomorphological spectrum of granulomatous lesions of skin. Materials and Methods: This cross-sectional study was conducted in Department of Pathology, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India, over a period of two years (from September 2018 to September 2020). All skin biopsies coming to The Department of Pathology werefixed in 10% neutral buffered formalin for duration of 12 to 24 hours. Paraffin wax blocks were made and 3-4 micrometer section were taken and stained with Haematoxylin and Eosin (H&E), showing granulomas on histology were included in the study. On H&E, stained slide, granulomas were studied for type, morphology and site. Special stains were used for further evaluations and analysis. Results: Out of total 124 cases studied, the maximum patients 34 (27.41%) were of 11-20 years age group. The epithelioid granuloma was the most common type in 76 (61.29%) cases followed by histiocytic granuloma in 24 (19.35%). The infectious granulomatous dermatoses were the most common histological type in which tuberculosis was most common followed by leprosy. Most commonly the lesions were found to involve the whole dermis in 74 (59.68%) cases, followed by upper and mid dermis in 35 (28.23%) cases. Out of 40 cases of leprosy, 17(42.50%) cases were found Wade-Fite Stain positive. Out of total 57 cases of tuberculosis, 31 (54.38%) cases were found Acid-Fast Bacillus (AFB) positive. Conclusion: We concluded that major cause of granulomatous dermatoses in developing countries is still infectious, tuberculosis and leprosy being the leading causes. Histopathology is gold standard for diagnosis and categorisation of granulomatous dermatoses. Special stains are useful in cases of any dilemma.