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153. Primary Wilms tumor of the urinary bladder

Author

Parkhi, Mayur, Peyam, Srinivasan, Peters, Nitin James, Sodhi, Kushaljit Singh, Trehan, Amita, and Bal, Amanjit

Subjects
Urinary Bladder, Antineoplastic Agents, Cystectomy, Wilms Tumor
Abstract

Wilms tumor (WT) can occur at various extrarenal sites; however, the urinary bladder as the primary site is occasional. A 4-year-old-female child presented with difficulty in micturition for the past month. The contrast-enhanced magnetic resonance imaging with magnetic resonance (MR) urography revealed a polypoidal, heterogeneous mass in the urinary bladder with no abnormality in the kidneys. Cystoscopy-guided biopsy was reported as an extrarenal Wilms tumor (ERWT) with triphasic components. Post-chemotherapy, a computed tomography scan revealed a residual tumor for which she underwent partial cystectomy. The diagnosis of ERWT was confirmed. She received adjuvant chemotherapy and remained well at the 9th month post completion of chemotherapy. The primary bladder WT must be considered in the differential of a small blue round cell tumor at an extrarenal site in the pediatric age group. The diagnosis is especially challenging in small biopsy material, although it has immense significance in management and prognosis.

Published
2022

161. Incidence, prevalence, and national burden of interstitial lung diseases in India: Estimates from two studies of 3089 subjects

Author

Dhooria, Sahajal, primary, Sehgal, Inderpaul Singh, additional, Agarwal, Ritesh, additional, Muthu, Valliappan, additional, Prasad, Kuruswamy Thurai, additional, Kathirvel, Soundappan, additional, Garg, Mandeep, additional, Bal, Amanjit, additional, Aggarwal, Ashutosh Nath, additional, and Behera, Digambar, additional

Published
2022
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163. A real-world study of the dosing and tolerability of pirfenidone and its effect on survival in idiopathic pulmonary fibrosis

Author

Dhooria, Sahajal, Agarwal, Ritesh, Sehgal, Inderpaul Singh, Prasad, Kuruswamy Thurai, Muth, Valliappan, Garg, Mandeep, Bal, Amanjit, Aggarwal, Ashutosh Nath, and Behera, Digambar

Subjects
interstitial lung disease, interstitial pneumonia, Male, Original Article: Clinical Research, drug safety, Dose-Response Relationship, Drug, Maximum Tolerated Dose, Pyridones, lung fibrosis, antifibrotic, Anti-Inflammatory Agents, Non-Steroidal, Vital Capacity, Recovery of Function, Middle Aged, Idiopathic Pulmonary Fibrosis, diffuse lung disease, Treatment Outcome, Forced Expiratory Volume, Humans, Female, Patient Safety, Prospective Studies, Lung, Aged
Abstract

Background: Patients with idiopathic pulmonary fibrosis (IPF) often do not tolerate pirfenidone in the recommended dose of 2400 mg/day. The proportion of patients requiring dose reduction and its impact on survival in the real-world remain unclear. Methods: Consecutive subjects with IPF were enrolled between March 2017 and June 2019. The maximum tolerated dose of pirfenidone (primary outcome) and adverse drug reactions (ADRs) were recorded. A post hoc logistic regression analysis was performed to evaluate the predictors of drug discontinuation due to ADRs. We also compared survival between the full-dose (2400 mg/day), reduced-dose (< 2400 mg/day), and the no-pirfenidone groups, with age and percentage of the predicted forced vital capacity (%pred FVC) as covariates. Results: Of the 128 subjects (mean age, 67.4 years; 77.3% men) included, 115 were initiated on pirfenidone. Forty-nine (42.6%) and 51 (44.3%) subjects tolerated the full dose and reduced doses, respectively. Ninety-six (83.5%) subjects developed at least one ADR; anorexia dyspepsia, and nausea being the most common. Twenty-two subjects discontinued the drug; 15 of them due to ADRs. Body mass index < 20 kg/m2 was the only predictor of drug discontinuation due to ADRs. Among subjects newly initiated on treatment during the study period (n = 80), survival was longer (hazard ratio [interquartile range], 0.19 [0.04-0.96]; p = 0.045) in the full-dose but not the reduced-dose group (p = 0.08) compared with the no-pirfenidone group, after adjusting for covariates. Conclusion: Pirfenidone was tolerated in the full dose in a minority of patients with IPF and appears to improve survival only with the full dose. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (2): 148-157)

Published
2020

180. Cystic lung lesion following transbronchial lung cryobiopsy: Case report and systematic review.

Author

Malegaonkar, Srikant Kashinath, Sehgal, Inderpaul Singh, Muthu, Valliappan, Agarwal, Ritesh, Bal, Amanjit, and Dhooria, Sahajal

Subjects
LUNG diseases, LUNGS, COMPUTED tomography, DISEASE exacerbation, INTERSTITIAL lung diseases
Abstract

Transbronchial lung cryobiopsy (TBLC) is a technique used to sample the lungs for diagnosing diffuse lung diseases. A sizeable tissue is sheared off the lung parenchyma during TBLC leading to a defect in the lung, which might result in a cystic lesion on imaging. Computed tomography (CT) performed for other reasons might incidentally reveal such a cyst. We report a 75‑year‑old patient who underwent TBLC and developed significant intraprocedural bleeding. Chest CT performed for worsening breathlessness revealed an acute exacerbation (AE) of the underlying interstitial lung disease, and incidentally showed a new cyst in the biopsied lung lobe. The patient recovered clinically after the administration of high‑dose methylprednisolone. A chest CT performed nine months later showed resolution of the lung cyst. A systematic review of the literature revealed that cysts/pneumatoceles/cavities may appear in 50% of patients following TBLC. About 90% are due to biopsy trauma and mostly resolve spontaneously. Rarely, a cavity may be due to infection; antimicrobial agents should be administered in such cases. [ABSTRACT FROM AUTHOR]

Published
2023
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181. [68Ga]Ga-Pentixafor PET/CT imaging for in vivo CXCR4 receptor mapping in different lung cancer histologic sub-types: correlation with quantitative receptors' density by immunochemistry techniques.

Author

Watts, Ankit, Singh, Baljinder, Singh, Harmandeep, Bal, Amanjit, Kaur, Harneet, Dhanota, Ninjit, Arora, Sunil K., Mittal, Bhagwant R., and Behera, Digambar

Subjects
CHEMOKINE receptors, POSITRON emission tomography, LUNG cancer, IMMUNOCHEMISTRY, FLOW cytometry
Abstract

Purpose: In vivo CXCR4 receptor quantification in different lung cancer (LC) sub-types using [68Ga]Ga-Pentixafor PET/CT and to study correlation with quantitative CXCR4 receptors' tissue density by immunochemistry analyses. Methods: [68Ga]Ga-Pentixafor PET/CT imaging was performed prospectively in 94 (77 M: 17F, mean age 60.1 ± 10.1 years) LC patients. CXCR4 receptors' expression on lung mass in all the patients was estimated by immunohistochemistry (IHC) and fluorescence-activated cell sorting (FACS) analyses. SUVmax on PET, intensity score on IHC, and mean fluorescence index (MFI) on FACS analyses were measured. Results: A total of 75/94 (79.8%) cases had non-small cell lung cancer (NSCLC), 14 (14.9%) had small cell lung cancer (SCLC), and 5 (5.3%) had lung neuroendocrine neoplasm (NEN). All LC types showed increased CXCR4 expression on PET (SUVmax) and FACS (MFI). However, both these parameters (mean SUVmax = 10.3 ± 5.0; mean MFI = 349.0 ± 99.0) were significantly (p = 0.005) higher in SCLC as compared to those in NSCLC and lung NEN. The mean SUVmax in adenocarcinoma (n = 16) was 8.0 ± 1.9 which was significantly (p = 0.003) higher than in squamous cell carcinoma (n = 54; 6.2 ± 2.1) and in not-otherwise specified (NOS) sub-types (n = 5; 5.8 ± 1.5) of NSCLC. A significant correlation (r = 0.697; p = 001) was seen between SUVmax and MFI values in squamous cell NSCLC as well as in NSCLC adenocarcinoma (r = 0.538, p = 0.031) which supports the specific in vivo uptake of [68Ga]Ga-Pentixafor by CXCR4 receptors. However, this correlation was not significant in SCLC (r = 0.435, p = 0.121) and NEN (r = 0.747, p = 0.147) which may be due to the small sample size. [68Ga]Ga-Pentixafor PET/CT provided good sensitivity (85.7%) and specificity (78.1%) for differentiating SCLC from NSCLC (ROC cutoff SUVmax = 7.2). This technique presented similar sensitivity (87.5%) and specificity (71.4%) (ROC cutoff SUVmax = 6.7) for differentiating adenocarcinoma and squamous cell variants of NSCLC. Conclusion: The high sensitivity and specificity of [68Ga]Ga-Pentixafor PET/CT for in vivo targeting of CXCR4 receptors in lung cancer can thus be used effectively for the response assessment and development of CXCR4-based radioligand therapies in LC. [ABSTRACT FROM AUTHOR]

Published
2023
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182. Infectious granulomatous dermatitis: A clinico pathological study

Author

Bal Amanjit, Mohan Harsh, and Dhami G

Subjects
Granulomatous, dermatitis, Dermatology, RL1-803
Abstract

Granulomatous dermatitis frequently presents a diagnostic challenge to dermatopathologists as an identical histologic picture is produced by several causes. Present study aims at classifying infectious granulomatous dermatitis based on etiology and morphology of granulomas, and to highlight significance of clinical correlation in making a specific diagnosis. A retrospective analysis of skin biopsies was done and cases of infectious granulomatous dermatitis diagnosed on histopathological examination were retrieved. A total of 586 cases of granulomatous dermatitis were retrieved; out of these, on the basis of clinico-pathological findings, 515 cases (87.8%) were categorized as infectious granulomatous dermatitis. The age of the patients ranged from 7-80 years with a male to female ratio of 1.5:1. Majority of the cases were of leprosy (373 cases, 72.4%) which were further classified into sub-groups according to Ridley and Jopling. Second largest group was of cutaneous tuberculosis including tuberculids (119 cases, 23.1%). Fungal dermatitis was diagnosed in 17 cases (3.3%) and 6 cases (1.16%) were diagnosed as post kala-azar dermal leishmaniaisis based on the lympho-histiocytic and plasma cell inflitrate. Infections form an important cause of granulomatous dermatitis with leprosy and tuberculosis as the leading causes. Adequate clinical data and workup in combination with pathological resources can help in elucidation of specific etiology and good clinicopathologic correlation.

Published
2006

198. Pulmonary Artery Pseudoaneurysm in COVID-19-Associated Pulmonary Mucormycosis: Case Series and Systematic Review of the Literature

Author

Pruthi, Himanshu, primary, Muthu, Valliappan, additional, Bhujade, Harish, additional, Sharma, Arun, additional, Baloji, Abhiman, additional, Ratnakara, Rao G, additional, Bal, Amanjit, additional, Singh, Harkant, additional, Sandhu, Manavjit Singh, additional, Negi, Sunder, additional, Chakrabarti, Arunaloke, additional, and Singhal, Manphool, additional

Published
2021
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