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Background: Breast carcinoma is one of the most common cancer among women globally. Increased vimentin expression has been reported in triple negative breast carcinoma (TNBC) cases. This study showed the expressi Aims And Objective: on of vimentin in TNBC cases and its correlation with various prognostic factors such as age, tumor size, histological grade and lymph node status. This study Materials And Method: was conducted at Department of Pathology, Gandhi Medical College, Bhopal from January 2021 to June 2022. Total 60 breast cancer specimens (mastectomy, lumpectomy, biopsy) were submitted for histopathological diagnosis and Estrogen receptor (ER), Progesteron receptor (PR) and HER2/neu expression. Out of 60 cases, 21 cases were showing triple negativity and selected for vimentin expression study. Results: In the present study out of 21 TNBC cases, 19 cases (90.5%) had shown positive vimentin expression. The mean age of cases was 52.6years and tumor size >2cm. Signicant correlation was seen between vimentin expression and tumor size, as the tumor size increases vimentin expression also increases. Majority of cases (76.2%) were positive for nodal metastasis. In TNBC cases with positive vimentin expression, 47.6% cases belonged to grade III, 42.9% cases grade II, and 9.5% cases of grade I. As the grade of tumor increases, vimentin expression also increases. Conclusion: The vimentin expression in the present TNBC cases demonstrated signicant vimentin expression which can be helpful in detection of metastasis and disease prognosis

BACKGROUNDHematological disorders encompass a broad spectrum of disorders affecting blood & bone marrow. Among a myriad of diagnostic tests that can be applied to the analysis of hematological diseases, bone marrow examination is one of the most valuable diagnostic tools. The Bone marrow aspirate and imprint & trephine biopsy specimens are complementary and when both are obtained, provide a comprehensive evaluation of the bone marrow. AIMS/PURPOSE To compare the cellular morphology of Bone marrow aspiration and imprint smears for diagnosis of hematological disorders and compare with biopsy which is taken as gold standard. METHODS A total number of 60 cases in whom bone marrow examination was indicated were evaluated by Bone marrow aspiration (BMA), bone marrow imprint (BMI) and bone marrow biopsy (BMBx). The diagnosis of BMI correlated with t RESULTS he diagnosis of BMBx in 92% cases, which was higher than the value observed with BMA smears (75%). The spreading quality was better and cytological details were better appreciated in BMI as compared to BMA. All of these ndings were reected in the higher diagnostic accuracy of BMI than BMA. CONCLUSION Bone marrow aspiration and biopsy are important tools for evaluating haematological disorders. Bone marrow imprint should be a standard practice in bone marrow sampling procedure

Context: Breast cancer is the most common cancer among women and second leading cause of cancer death worldwide. P53 is a tumor suppressor gene located on chromosome 17p13 with germ line mutations that convey a high risk for breast cancer. P53 is antiproliferative, helps in angiogenesis and causes programmed cell death but due to genotoxic stress or mutation, P53 loses its function thereby causing abnormal cell growth. To study the expression of P53 a tumor suppressor gene and its clinicopathologica Aim: Settings And l correlation in breast cancer cases. Designs: Material and methods: A Cross Sectional Study (Retrospective and Prospective). 50 cases of breast tumors studied over the period of 18 months from January 2021 to June 2022. Samples were received and reported in Department of Pathology, Gandhi Medical College Bhopal, Madhya Pradesh. A total of 50 cases of breast carcinoma were included in this Results: study predominated by inltrating ductal carcinoma (78%). High Immunohistochemistry expression of P53 was statistically signicant (p value

Background: This study aims to detect association of SARS-COV-2 infection in terms of histopathological changes in the third trimester placenta. Methods: SARS COV 2 positive placenta cases received in Department of Pathology, Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh. 7 cases were sent for histopathological examination. Clinical details, history, details of relevant investigation like D-dimer, blood reports etc. was taken from the electronic medical records and requisition form received in the Department of Pathology. Histopathological findings were analyzed and recorded. Result: This is a case series depicting various histopathological changes in term placenta of 7 SARS Corona Virus 2 (COV-2) positive women in the age group of 20 years to 35 years exhibiting symptoms ranging from mild to severe degree. The major histopathological finding noticed is under perfusion of placenta of maternal side in greater extent as compared to fetal side under perfusion followed by signs of inflammation of membranes viz chorionitis and chorioamnionitis. Hence, through the study, we want to highlight micro vasculopathy as one of the pathophysiological features of SARS Corona Virus 2 (COV-2) which might be leading to these histopathological findings and its correlation with elevated levels of D – Dimer. Conclusion: Covid 19 positive women with third trimester of placenta do not express any specific histomorphological findings. Our study shows only signs of maternal and fetal vascular under perfusion with mild acute chorionitis which might have a relationship to a microvascular disease induced by SARS COVID 19 virus, yet this cannot be ruled out consistently proven several associated factors.

BACKGROUND Thrombosis is a well-recognized and common complication in patients with malignant disease and can contribute significantly to the morbidity and mortality of this disease. We wanted to compare the coagulation parameters in benign and malignant neoplasms. METHODS A comparative study was done and a total of 230 cases (75 benign and 155 malignant) and 120 controls were evaluated. After processing the blood samples, various tests like complete blood count, platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrin degradation product (FDP), and D-Dimer were done. RESULTS Significant differences were noted in the coagulation parameters of both the groups. Malignant cases show abnormal coagulation parameters as compared to control group. Mean platelet count - control - 250 +/- 61, cases - 375 +/- 100, mean PT – control - 14.1 +/- 6 s, cases - 15.2 +/- 1.2 s, mean APTT- control - 29.5 +/- 1.3 s, cases - 34.8 +/- 2.5 s. CONCLUSIONS Cancer is associated with a high risk of thrombotic complications. Altered coagulation parameters significantly correlate with malignant nature of tumour and also their spread. Preventing this complication is clinically relevant because it significantly contributes to morbidity and mortality in these patients. KEY WORDS Coagulation, Neoplasm, FDP, D-Dimer, Thrombosis

Background: The International Academy of Cytology (IAC) Yokohama System to report breast cytopathology can effectively categorize breast diseases into different cytological groups. Fine needle aspiration (FNAC) from the lesions in the breast has been regarded as an effective method of diagnosing breast cancer, particularly in rural settings. The principal purpose of this study was to validate the diagnostic accuracy of breast FNA utilizing the IAC Yokohama system in future endurances. Histopathological evaluation was also performed to corroborate the correctness of the FNA of the breast.Methods: Research on patients getting core-needle/incisional/excisional biopsy of breast lesions between January 1st, 2021, and December 31st, 2021, was conducted at a tertiary care center in central India. 216 breast FNAs were recorded utilizing the IAC Yokohama system, and the most appropriate category was assigned for every case.Results: The new “International Academy of Cytology (IAC) Yokohama system” was used to categorize 216 patients into five categories based on the cytologic diagnosis. That C1: insufficient material (8.7%), C2: benign (65.7%), C3: atypical (1.8%), C4: suspicious of malignancy (2.7%), and C5: malignant (20.8%). To examine diagnostic accuracy, FNACs were associated with ancillary testing and histological diagnosis. The overall specificity, sensitivity, negative predictive value, and positive predictive value, along with the accuracy, were calculated with the risk of malignancyConclusion: With high specificity and sensitivity, for each type of situation, for all tumors, and each analyzed BIRADS category show that the IAC Yokohama system provides excellent accuracy for Breast FNA.

BACKGROUND Understanding various risk factors associated with breast cancer can help in early identification & prompt treatment of patients with breast cancer. Apart from clinical parameters like age, disease presentation and menopausal status, important prognostic indicators in histopathology are size and extent of tumour, histologic type,histologic grade and lymph node status. Also, there are other factors which are not only predictive of outcome, but also direct therapies against particular molecular targets. These factors are oestrogen receptor (ER) status, progesterone receptor (PR) status, HER2 / neu status, Ki-67 proliferation index & androgen receptor (AR) status. We wanted to analyse various hormone receptors & their correlation with prognostic factors. In addition, androgen receptor expression is also studied in triple negative breast cancer cases. METHODS The study included 50 cases over a period of 18 months from January 2018 to June 2019 received in the Department of Pathology, Gandhi Medical College, Bhopal, India. These cases were subjected to histopathological & immunohistochemistry (IHC) evaluation. RESULTS Among the 50 cases studied, the most common subtype was infiltrating ductal carcinoma (NOS - no special type, 84 %). Majority of patients were ER, PR, HER2 / neu negative (48 %) and among those triple negative cases, 25 % of cases were androgen receptor positive. CONCLUSIONS Expression of the hormone receptor (ER and PR) and HER2 status may provide significant information in directing patient management. Since traditional pathological methods and IHC remain standard for guiding the use of treatment, clinicians may be challenged with equivocal results that directs towards additional testing for definitive diagnosis and, better patient outcome. The most used therapy for advanced breast cancers is based on the use of AR antagonists, such as bicalutamide and enzalutamide, first- and second-generation AR antagonists respectively. Gene signatures, bioinformatics, and other clinical trials are also beneficial for clinician in estimating the benefits expected from adjuvant chemotherapy. KEY WORDS Breast Cancer, Oestrogen Receptor, Androgen Receptor, Triple Negative

Introduction: Cervical lesions constitute one of the major health problems in Indian women accounting for major morbidity and mortality. To study p 53 and Ki 67 immunoexpression is cervical lesions is an interesting area of research. Aims: To study immunohistochemical expression of p53 and Ki 67 in lesions of cervix and its correlation with various histopathological diagnosis and assess their utilIty in segregating high risk cases and to explore its use as diagnostic tool in suspicious cases. Materials and Methods: Retrospective and prospective study was undertaken in Department Of Pathology in our institute from 1st January 2014- January 2016.60 cervical biopsies with known histopathological diagnosis were randomly selected and stained for immunohistochemistry expression of p 53 and Ki 67 and results were correlated with various parameters. Data was analyzed using appropriate statistical tests .Age difference was examined using on way analysis of variance (ANOVA), chi square test is applied, and for quantitative data student [t] test is applied. P value is considered significant if p Results: 42.5% benign and 50 % of neoplastic cervical lesion had p53 positivity. For Ki 67, among chronic non specific cervicitis, a score of 2 and 3 was observed in 8 and 3 cases respectively. The chronic cervicitis cases with score 3 in retrospect had histomorphology suspicious of dysplasia but were inconclusive ,a high proliferative score helped us to objectify our findings and reclassified as 2 cases of CIN2 and 1 of CIN 3 respectively .Theses results were statistically significant (p correlating with its histological diagnosis. Conclusions: Ki 67 is a helpful marker to objectify cases with inconclusive histomorphological pattern and p53 may help segregate cases into high and low risk for follow up. Keywords: Cervix, Immunohistochemistry, Ki 67, p53. Key Messages: Lesions of cervix especially those which are pre neoplastic and dysplasia have to be followed up closely for possib

Background: Ovarian tumors represent about 30% of all cancers of the female genital system and show a wide spectrum of histological types and clinical behaviour. Ovarian cancer is the leading cause of mortality of female gynaecological cancers and ranks seventh as the most common cancer worldwide. The increasing life expectancy has led to increase in its burden exponentially now even in developing countries but limited knowledge is there about the pattern of ovarian tumours. The present study was done with the aim of studying the histopathological pattern of the ovarian tumors in women of various age groups. Methods: This was retrospective analysis of all cases of ovarian cancer, and benign ovarian neoplasms received during 5 year period from january 2014 to december 2018 at pathology department of gandhi medical college and hamidia hospital, Bhopal (M.P). Data regarding age and tumor histology were collected from medical records. Routine H/E staining was performed. Immunohistochemistry (IHC) was done in difficult cases. Result: Of 350 cases 245 (45.2%) were benign, 27 (4.9%) were borderline / uncertain and 78 (14.4%) were malignant tumors. For all age groups, benign tumors were more common than malignant ones. Most ovarian tumors were seen between 21-50 years (272, 77.7%). Surface epithelial tumors were most common (253, 72.2%) followed by germ cell tumors (70, 12.9%). Conclusion: The present study has revealed a spectrum of ovarian tumors over a wide range from adolescent to late reproductive to menopausal and late menopausal age grooup. Benign tumors are more common than malignant ones.

Introduction:- There is always possibilities of transmission of transfusion transmissible diseases. Blood transfusion can transmit Human immunodeciency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV), through infected blood. Even Routine serological screening test and ELISA [Enzyme-linked Immunosorbent Assay] can not detect all infected blood units. Hence, to overcome this drawback and to minimise the risk, NAT [Nucleic Acid Testing] provides additional protection with higher sensitivity and specicity. Screening of Aim/Objective:- transfusion transmissible infections {HIV, Hepatitis B &C} using NAT technique to determine occurrence of seropostive blood donors in ELISA negative individuals. An observational study was conducted in Department of Pathol Methodology:- ogy Blood Bank, Gandhi Medical College and Associated Hospitals, Bhopal, where NAT investigation was conducted in all ELISA negative blood donors over the course of 1 year (04 Feb 21 to 04 Feb 22). 12- month data was compiled using Ms excel and analysed using Epi Statistical Analysis:- Result:- info 7.2. All the ELISA Negative(1271) blood units were tested by NAT. NAT was positive in 5 out of 1271 for HBV (0.4% cases). NAT was positive in 1 out of 1271 for HCV (0.1% cases). Dual testing of blood and blood products using high sensitivity serologic Conclusion:- al tests like NAT, aids in the detection of potentially infectious diseases in all stages of infection of HIV, HEPATITIS B and HEPATITIS C. In order to reduce overall treatment cost and boost effectiveness of healthcare system, it is advised to perform NAT in all ELISA negative blood donor samples.

BACKGROUND Functional Independence Score in Haemophilia (FISH) is a performance-based assessment tool, to objectively measure the patient’s functional disability. The present study was done to assess the functional abilities of haemophiliac patients presenting to a tertiary care centre. METHODS This hospital based observational study was performed on all patients (100) diagnosed as haemophilia referred to Hamidia Hospital from 1 st March 2017 to 30th June 2018. Patients with other bleeding disorders and patients on medication which can alter coagulation profile were excluded. RESULTS Mean FISH for mild, moderate and severe haemophilia was 25.26±2.62, 23.65±3.67 and 21.81±2.65 and overall mean was 23.51±3.23. CONCLUSIONS The functional components like transfer and locomotion were mainly determined by joint bleeds and total joint score respectively which were observed by the positive correlation between the respective components. Hence more the bleed and joint score, higher the dependence for transfer and locomotion.

Aim: To study the clinicopathological spectrum of cervical cancers in tertiary care center to assess scenario in Central India. Materials and Methods: Retrospective study in the Department of Pathology in our institution to evaluate cases of cervical cancers from January 2014 to August 2015. Histopathological diagnosis was correlated with age, symptoms, gravida, Federation of Gynecology and Obstetrics staging, and other relevant clinical details wherever deemed necessary. The biostatical analysis was performed for quantitative data student’s t-test was applied. P value was considered statistically significant if P < 0.05. Results: A total of 180 cases were of neoplasia cervix. Majority of cases were squamous cell carcinoma type, i.e., 96.6% (174 cases) followed by adenocarcinoma constituting only 2.8% (5 cases) with a mean age of 50.7 years and average gravida of 3.78. Majority of cases (50.01%) complained of postmenopausal bleeding followed by abnormal spotting (26.67%) and lower abdominal pain (7.78%). The most common presentation was in Stage IIB with 45.56% (82) cases. Conclusion: Histomorphology remains the mainstay of diagnosis of cervical cancers. In low compliance settings such as ours, colposcopy-guided biopsy is the preferred course of management, especially in elderly females to be definite to rule out or diagnose neoplasia. National level cervical cancer program is immediate need of the hour and should include human papilloma virus vaccine, awareness, and screening programs as well as treatment assistance for low socioeconomic strata.

Background: Late detection and diagnosis of oral and oropharyngeal carcinomas are responsible for the related increased morbidity and mortality. Understanding the risk factors and patterns of malignancy can help early identification and prompt treatment of patients with oral cancers. In the current study, we aimed to study the pattern of oral dysplastic and neoplastic lesions in tertiary care centre in central India and study its association with various risk factors. Methods: The oral biopsy tissues received in the Department of Pathology, GMC, Bhopal for histopathological evaluation during the duration of one and a half years were included in the study. The data was analysed by appropriate statistical tests (software SPSS). Result: A total of 334 cases presented for oral neoplastic lesions during the study period with mean age of presentation of malignant lesions and premalignant lesions being 51 years and 46 years respectively. 78.3% cases were reported as malignant lesions with majority being Well Differentiated Squamous Cell carcinomas (57%) among oral cavity lesions and Moderately Differentiated Squamous Cell Carcinoma (41%) among oropharyngeal lesions. 87% of patients reported use of tobacco chewing smoking and alcohol, either alone or in combination. Conclusion: High risk individuals included males more than 35 years of age indulging in tobacco chewing, smoking and alcohol with exclusive tobacco chewing associated more with oral malignant lesions whereas the smoking and alcohol along with tobacco chewing associated more with oropharyngeal lesions. Substance abuse awareness programs and screening early lesions in high risk individuals are recommended to curtail oral malignancies.

Mycobacterium leprae causes leprosy, which is a chronic infectious disease. It mostly affects the body's cooler portions, such as the skin and peripheral nerves. Leprosy causes a variety of biochemical and immunological alterations in the body, as well as trace metals including zinc, copper, and magnesium. Zinc is the second most abundant trace element in the body, after iron. This study aimed to correlate with clinical manifestations wherever possible and to look into the level of serum zinc in leprosy patients. A total of 63 people with newly diagnosed leprosy were included in the study.The cases were then divided into clinical subgroups and compared to the controls. Venous blood samples were taken, and serum zinc levels were estimated using serum. The majority of patients (26.9) had Intermediate Leprosy, while the minority (1.58) had Histoid Leprosy. Pure tuberculoid and indeterminate leprosy patients had the lowest serum zinc levels, whereas pure lepromatous and Erythema nodosum leprosum patients had the highest, indicating that leprosy patients with higher bacterial loads had lower serum zinc levels. This suggests that there could be a correlation between serum zinc levels and bacillary load.

Background Trend analysis in cancer quantifies the incidence rate and explains the trend and pattern. Breast and cervical cancers are the two most common cancers among Indian women which contributed 39.4 % to the total cancer in India for the year 2020. This study aimed to report the time trends in cancer incidence of breast and cervical cancer using Age–Period–Cohort (APC) model from five Population Based Cancer Registries (PBCRs) in India for the period of 1985–2014. Method Age-Period-Cohort model was fitted to five PBCRs of Bangalore, Chennai, Delhi, Bhopal and Barshi rural for breast and cervical cancer for 25−74 age-groups. The Estimated Annual Percent Change (EAPC) was calculated. Rate Ratio (RR) of cohort effects were estimated with a constraint of period slope to be zero (p = 0) since cohort has a stronger association with incidence than period. Result A significant increase was noted in breast cancer in all PBCRs (EAPC, Range: Delhi, 1.2 % to Bangalore, 2.7 %) while significant decrease in cervical cancer (EAPC, Range: Bangalore -2.5 % to Chennai, -4.6 %) from all the PBCRs including Barshi rural during the period. RR estimates for breast cancer showed increasing trend whereas cervical cancer showed decreasing trend in successive birth cohorts across all five PBCRs. Conclusion In both breast and cervical cancers, a significant age, cohort and period effect was noted in Bangalore, Chennai and Delhi. Despite period effect, the cohort effect was predominant and it may be attributed to the generational changes in risk factors among cancer breast and cervix.

The ectopic kidneys are a rare developmental disorder. The ectopic kidneys are the result of the cessation of normal migration. The incidence of ectopic kidney is 1/12,000 clinical cases and 1/900 post-mortem cases. Such kidneys may be asymptomatic, show vague symptoms, or remain undetected for life. However, early detection of ectopic kidneys can prevent long-term complications. Here were present a case of 17-year-old adolescent with an ectopic kidney presented with an episode of intermittent pain in her left umbilical region for one year. A physical examination revealed a tender lump in the umbilical region of the abdomen. The USG showed a mass on the left side of the umbilical region, which could be an ectopic kidney. Computer tomography showed an ectopic kidney in the midline of the umbilical region. In addition, DTPA scans of the kidney showed that the left kidney showed inadequate function with delayed upper inflow tract. Urinalysis revealed urinary tract infection. Patient had mild degree of anaemia with low serum iron levels. The ectopic kidney was removed and sent to us in our lab. Histo-pathological examination was done and it revealed normal parenchyma of kidney. Ectopic kidneys should be included in the differential diagnosis in patients with abdominal pain and palpable lump in the abdomen. Early detection can prevent long term complications.

ObjectivesConvalescent plasma (CP) as a passive source of neutralizing antibodies and immunomodulators is a century-old therapeutic option used for the management of viral diseases. We investigated its effectiveness for the treatment of COVID-19.DesignOpen-label, parallel-arm, phase II, multicentre, randomized controlled trial.SettingThirty-nine public and private hospitals across India.ParticipantsHospitalized, moderately ill confirmed COVID-19 patients (PaO2/FiO2: 200-300 or respiratory rate > 24/min and SpO2 ≤ 93% on room air).InterventionParticipants were randomized to either control (best standard of care (BSC)) or intervention (CP + BSC) arm. Two doses of 200 mL CP was transfused 24 hours apart in the intervention arm.Main Outcome MeasureComposite of progression to severe disease (PaO2/FiO2< 100) or all-cause mortality at 28 days post-enrolment.ResultsBetween 22ndApril to 14thJuly 2020, 464 participants were enrolled; 235 and 229 in intervention and control arm, respectively. Composite primary outcome was achieved in 44 (18.7%) participants in the intervention arm and 41 (17.9%) in the control arm [aOR: 1.09; 95% CI: 0.67, 1.77]. Mortality was documented in 34 (13.6%) and 31 (14.6%) participants in intervention and control arm, respectively [aOR) 1.06 95% CI: −0.61 to 1.83].InterpretationCP was not associated with reduction in mortality or progression to severe COVID-19. This trial has high generalizability and approximates real-life setting of CP therapy in settings with limited laboratory capacity. A priori measurement of neutralizing antibody titres in donors and participants may further clarify the role of CP in management of COVID-19.Trial registrationThe trial was registered with Clinical Trial Registry of India (CTRI); CTRI/2020/04/024775.

Background: Ascitic fluid usually forms slowly as a result of obstruction of proximal vascular systems (Venous, lymphatic). It may also form directly in response to disease involving the peritoneum. Differentiation between malignancy related and non-malignantascites is a challenge that is not always met satisfactorily. Both malignant and tuberculous ascites are exudative in nature with lymphocytic predominance and low Serum Ascitic Fluid Albumin Gradient values can not be differentiated easily form each other. Studies have shown that parameters like ascitic fluid cholesterol have been superior to the conventional method of ascitic fluid analysis in discriminating ascites caused by malignancy from others. Method: This study was conducted in the Department of Pathology, Shyam Shah Medical College, Rewa during the period from May 2009 to October 2011. The study comprised of 100 patients with different causes of ascites admitted to wards of S.G.M.H. Rewa. Result: Cases were divided in to 3 groups. Groups I consists of patents(39 male and 31 female) with ascites due to chronic liver disease and other non tubercular and non neoplastic diseases, Group II consists of 20 patients (4 male and 16 female) with ascites due to tuberculosis, Group III consists of 10 patients (4 male and 6 female) with ascites due to malignant diseases. Ascitic fluid cholesterol level was found to be 32.9571±7.1183mg%,0.05±9.047gm%, 74.1±16.1707mg% in Group I, Group II and Group III respectively. On comparing Group III with I and II values were found to be highly significant (p 0.05). The value of ascitic fluid cholesterol level found in Group III was comparatively higher (>54.5mg%) than Group I and Group II with an exception in one case, where we found a higher level of cholesterol. Conclusion: In our study we found a significant raised cholesterol level (74.1 ±16.1707mg%) well above the cut off value (54.5mg%) and it has got a good differentiating potential for determining malignant ascites from non-malignant ascites. DOI: 10.21276/APALM.1371

Introduction: Expression of ER, PR and Ki 67 in epithelial ovarian tumors and their histopathological correlation analyzed by immunohistochemistry. Methods: This study was conducted on 60 ovarian specimens received in Department of Pathology, Gandhi Medical College, Bhopal for ovarian tumors from 1st January 2012 -31st august 2016. Results: The expression of ER was more in malignant tumor 21/26 than borderline 5/9 and benign tumors 5/25. The PR expression was more in benign tumors 14/25 than malignant 13/26 and borderline 2/9 tumors. The Ki67 expression was more in malignant tumors 22/26 than borderline 7/9 and benign 1/25 tumors. Conclusion: In our study ER and Ki-67 positivity was maximally seen in malignant cases. This shows that ER was enhanced in ovarian carcinoma and Ki67 was proliferative marker. PR expression was maximally seen in benign tumors. This showed protective role of PR marker in ovarian carcinoma.

Background: To segregate the causes of pancytopenia which are easily treatable, from those requiring sophisticated investigations & vigorous treatment, based on clinico-hematological profile of the patients and affordable diagnostic mathods. Materials and Methods: 180 Pancytopenic patients were evaluated clinically along with hematological parameters, peripheral smears and bone marrow aspiration in the Department of Pathology, GMC, Bhopal for 3 years. Result: Age range was 5 months-70 years (mean- 26.6 years), with Male preponderance (M: F: 1.76:1). Commonest symptoms were weakness (97.8%), breathlessness (75%) and signs were pallor (98.3%) and splenomegaly (25.5%). Patients who presented with per rectal bleeding, in 46.2% diagnosis was dimorphic anemia thus per rectal bleeding was cause of associated iron deficiency. Commonest peripheral smear finding was microcytic hypochromic picture (27.22 %) & bone marrow was hypercellular (70.00%). Bone marrow aspiration revealed commonest cause was megaloblastic anemia (25%) followed by dimorphic anemia (17.2%) and infections (17.2%). In our study MCV was

Introduction: Study was planned to investigate PTEN gene expression in endometrial hyperplasia and carcinoma as analyzed by immunohistochemistry. Material and Method: This study was conducted on 80 endometrial samples in the Department of Pathology, Gandhi Medical College, Bhopal (January 2012 to August 2016) Results: 5 out of 5 cases of proliferative endometrium, 3 out of 5 cases of secretory endometrium, 37 [84%] out of 44 cases of simple and complex endometrial hyperplasia without atypia, 8 out of 15 cases of simple and complex endometrial hyperplasia with atypia and 3 out of 11 cases of endometrial carcinoma showed positive PTEN expression. Conclusion: PTEN is a major gene involved in the pathogenesis of endometrial carcinoma. Our data suggest that decreased PTEN expression was a marker of earliest endometrial pre-cancer lesion and we propose that use of PTEN immunostaining in a clinical setting may be informative in identifying premalignant lesions that are likely to progress to carcinoma.

Background: Cytokeratin-5 which stains the basal cell layer of the of the prostatic glands and Ki-67 which is a proliferation marker and stains the proliferative population of the lesion has been employed as markers of two different categories viz. basal cell marker and proliferative markers respectively in various studies. Aim of this study was to evaluate the utility of cytokeratin-5 and Ki-67 in differentiating and diagnosing the benign lesion like Benign prostatic hyperplasia and malignant lesion i.e. Carcinoma Prostate. Material and Methods: 90 cases of prostatic adenocarcinoma, BPH and prostatic inflammatory conditions were taken. Immunohistochemical staining for Ki67 and CK-5 was performed along with appropriate positive controls for each marker. Ki67 scoring classified as Negative, Low grade & High grade. Cytokeratin-5 scoring classified as Diffuse, Focal & Negative. Results: Cytokeratin-5 expression was found positive in 96.71% cases of BPH. Out of these 78.68% cases were diffusely positive and 18.03% cases were focal positive. Expression of Cytokeratin-5 in Carcinoma Prostate was 40%, 6.66% and 0% in well, moderate and poorly differentiated carcinomas respectively, whereas no expression of the marker in 60%, 93.33% and 100% cases of well, moderate and poorly differentiated carcinomas respectively. Ki-67 showed low grade expression in mere 8.20% cases of BPH. In Carcinoma Prostate Ki67 expression was shown by 60%, 79% and 100% cases of well, moderate and poorly differentiated carcinomas respectively. Conclusion: Diffuse Cytokeratin-5 expression was found in majority of BPH cases, while maximum Carcinoma prostate cases were negative. Ki-67 expression was found positively correlated with increasing Gleason’s grade in carcinoma prostate, while expression in benign lesion was not significant.

Background: Ki-67 expression is strictly associated with cellular proliferation and is an excellent marker for determining the growth fraction of a given cell population. It may be considered as alternative to mitotic counts in grading schemes and as a single parameter that can be used in fine needle aspirates and small biopsies. The aim of this study was to evaluate proliferative fraction of Ki67 expression in invasive breast carcinoma and to find out the correlation between Ki67 expression and clinico-pathological prognostic factors such as tumor size, lymph node status, histological grade and Nottingham prognostic index. Materials and Methods: Seventy cases of infiltrating ductal carcinoma breast were studied. Immunohistochemistry using the anti-Ki-67 antibody [MIB-1] was performed on all cases and Ki-67 staining was categorized as low and high grade. Result: High expression of Ki-67 was found in 71.05% cases of breast tumor with positive lymph node metastasis and 92.31% cases of Grade III tumor. Ki-67 expression was significantly associated with nodal status (p

BACKGROUND: Iron deficiency anemia is one of the most prevalent forms of malnutrition. The list of diagnostic tools is quite long starting from the basic hemogram, p.s for comment, reticulocyte count to iron studies including serum ferritin, serum iron, total iron binding capacity. Evaluation of the bone marrow iron stores is the gold standard. AIM: To perform a correlation study between Perl's Prussian blue stained bone marrow aspirate smears and serum iron and serum ferritin. MATERIALS AND METHODS: A descriptive study of Perl's Prussian blue stained bone marrow aspirate smears of 40 adult patients with moderate to severe anemia was performed at the Department of Pathology, Gandhi Medical College, Bhopal. Bone marrow was assessed by Gale's method and correlated with serum ferritin and serum iron. RESULTS: Gale's grading method revealed decreased iron stores in 30%; normal iron stores in 55% cases, and 15% cases had increased iron stores. The co-relational coefficient between bone marrow iron grade and serum ferritin came out to be 0.59 with an F- test value of 55.10.The correlation coefficient between bone marrow grade and serum iron is 0.76 and the F-test value -117.7. CONCLUSION: Although bone marrow iron grading is still gold standard but there exists a positive correlation between bone marrow iron with serum ferritin and serum iron thus iron status can be assessed by serum ferritin and serum iron, bone marrow being an invasive procedure can be avoided, also it will be helpful

BACKGROUND: The evaluation and management of discrete hepatic masses is a clinical problem. Ultrasound guided fine needle aspiration cytology (FNAC) is a rapid, accurate and safe diagnostic procedure that can be used in various neoplastic and non‐neoplastic diseases of the liver. AIM: To assess the sensitivity and specificity of ultrasound guided FNAC of liver tumors. MATERIALS AND METHODS: Ultrasound‐guided fine needle aspiration and true cut liver biopsies were performed on 52 patients clinically suspected of having hepatic lesion. Results of cytology were compared with histology. RESULTS: Malignancy was detected in 50 cases. The primary malignancies consisted of 15 cases of hepatocellular carcinoma (HCC), 4 cases of cholangiocarcinoma and 2 of hepatoblastoma. There were 29 metastatic lesions, which included 26 cases of adenocarcinoma, 2 cases of squamous cell carcinoma and 1 of lymphoma. The sensitivity and specificity of FNA for malignancies was found to be 96% and 100% respectively. Accuracy of FNAC was found to be 96.1 % with no false positive diagnosis. CONCLUSIONS: FNA of hepatic lesions is an effective, safe and well accepted practice with good sensitivity and specificity. It is recommended that image directed FNAC should be the primary diagnostic modality for assessing potential malignancy in any patient with a localized hepatic mass.

Lipids have a key role in the maintenance of cell integrity. Hypolipidemia is related with increased risk of cancer and mortality. Elevated calcium and alkaline phosphatase has also been seen in cancer patients having metastasis. Alteration in serum proteins also has been reported. Hence present study was undertaken in 100 histopathologically confirmed head and neck cancer patients, in Department of Pathology Gandhi Medical College Bhopal, after taking informed written consent and ethical clearance. Lipid Profile, Serum Calcium, Alkaline Phosphatase, Serum Protein with Albumin were estimated and compared with age and sex matched healthy controls. Statistical analysis was done using chi square test. Total cholesterol (TC), high density lipoprotein-cholesterol (HDLC), low density lipoprotein-cholesterol (LDLC), Very low density lipoprotein- cholesterol (VLDLC) all decreased in head & neck cancer patients. Hypercalcemia was seen in 35% of patients. Raised Alkaline phosphatase (ALP) was seen in 8 % cancer patients. Serum calcium was found to be increasing with advancing stage. Further studies should be carried out in large number of patients to confirm the role of these parameters with special attention to modifiable ones and their relation with staging and grading of cancer, which can be used as prognostic markers.

BACKGROUND: Hematological diseases are quite frequent in population and mostly present with anemia. Although diagnosed mostly by clinical examination and simple investigations, bone marrow examination is confirmatory for the diagnosis. Bone marrow aspiration is simple and safe invasive procedure. Spectrum of hematological diseases in the developing countries is different from those observed in developed countries. OBJECTIVE: There is a lack of information about the exact relative prevalence of hematological disorders especially in Central India that’s why this study was undertaken to correlate clinico-hematological and bone marrow findings. MATERIAL AND METHODS: It is a retrospective study of 345 cases who underwent bone marrow examination in Department Of Pathology, Gandhi Medical College, Bhopal. RESULTS: In our study age range of cases was 2-80 years with male: female ratio of 1.28:1. Most common diseases observed were megaloblastic anemia (41.81%), dimorphic anemia (16.72%), hypoplastic anemia (9.09%), ITP (8.36%) and infective pathology (4.72%). In Hematological malignancies (20.28%), most common were AML (6.95% of overall & 34.28% of malignant diseases %) followed by ALL (4.92 % overall and 24.28% % of malignancies). 3 cases of Gaucher’s disease were also reported.96.81% patients were anemic while 44.92% were pancytopenic. Most common presenting symptoms were fever (44.92%) and bleeding manifestations (30.14%) which include ecchymosis, epistaxis, petechiae, melena, hematuria and hematemesis. Splenomegaly, hepatomegaly and lymphadenopathy were found in 35.65%, 21.15% and 14.78% of cases respectively. CONCLUSION: In our study final diagnosis could be made in majority of cases (92.76%) by bone marrow examination, although having varied clinical presentations such as fever, bleeding manifestations, ascites, hepatomegaly, splenomegalyetc and usually associated with anemia / pancytopenia/ thrombocytopenia.All hematological cases must undergo bone marrow examination to conclude the exact underlying pathology for appropriate treatment.

BACKGROUND: Pancytopenia is an important clinicohematological entity having varying presentations and underlying cause ranging from megaloblastic anemia to fatal bone marrow aplasia and leukemias. Underlying pathology determines the treatment and prognosis.In majority of cases it is megaloblastic anemia which is readily treatable. OBJECTIVE: In our country causes of pancytopenia are not very well defined especially in Central India, so the present study has been undertaken to evaluate various causes and to correlate the peripheral blood finding with bone marrow. MATERIAL AND METHOD: It was a retrospective study of 155 cases presented with pancytopenia and evaluated clinically with hematological parameters and bone marrow aspiration in Department of Pathology, Gandhi Medical College, Bhopal during the period 2009-2012. RESULTS: Among 155 cases studied, age ranged from 2-80 years with mean age of 28 years with preponderance in male under 14 years age and female in 20-40 years age group. Generalised weakness and pallor were noted in all cases. Other common presentations were fever followed by bleeding manifestations. Splenomegaly was more common followed by hepatomegaly. Majority of patients had severe anemia, haemoglobin

Hematopoietic malignancies have a close association with viral infections which further increases secondary to immune-suppression in the post chemotherapy phase. High prevalence of HBV in cases of leukemia and relation of HCV with ALL, NHL& AML have been reported in several case series, however association of HBV with RAEB, CML, AML are reported in very few cases. We report 5 rare cases of HBV positivity in 2 cases of AML, one of which is AML M7,1 case of RAEB and 2 cases of Aplastic anemia.

Acute Megkaryoblastic Leukemia (AMKL) is a rare entity accounting for 1-2% of all Acute myeloblastic Leukemia (AML) (1). It is known as a distinct entity since a very long time but still difficult to diagnose correctly due to lack of distinct clinical features and morphological criteria. Here we present the clinical, morphological, cytochemical features of five cases of AMKL. Certain morphological features such as presence of abnormal platelet count, giant platelets and cytoplasmic blebbing in blasts were found to be important pointers towards the diagnosis.

Background: Understanding the markers for predicting degree of dysplasia and progression to malignancy can help early identification and prompt treatment of patients with oral cancers. In this study, we aim to identify and characterize different tumor suppressor genes such as p-53 and p-16 and proliferation marker Ki-67 in defining stages of dysplasia of oral mucosa and grading of tumor. Settings and Design: Oral biopsy tissues (for neoplastic lesions) received for histopathological evaluation were included in the study. The sections were processed for H&E staining, and 112 cases were chosen for immunohistochemical study. The data were analyzed by Chi-square and z-tests using software SPSS. Results: We found significant correlation between degree of dysplasia and p-16 immunoexpression with 16.7% of cases showing positivity in oral intraepithelial neoplasia (OIN) I cases as compared to 25% in OIN II and 77.8% in OIN III. Ki-67 immunoexpression correlated significantly with both histological type and grade of tumor with increased expression and intensity seen in malignant cases (66.3%) as compared to benign (10%) and premalignant cases (37%) and higher Ki-67 immunoexpression in poorly differentiated tumors (75%) than well-differentiated tumors (12.2%). Regarding p-53 immunoexpression, positive staining was seen in only malignant cases and premalignant cases. Conclusions: Ki-67 and p-16 can be useful as a marker of degree of dysplasia and transformation to malignancy. Ki-67 can also serve as a marker of degree of differentiation of tumors. Hence, they can serve as important ancillary markers to analyze the transition to carcinoma, dysplasia and progression of tumor.

Classification of skeletal angiomatosis into aggressive and nonaggressive types is on the basis of their clinical behavior and pattern of skeletal involvement (regional and disseminated). Gorham′s disease (massive osteolysis) is an aggressive form of skeletal angiomatosis that shows regional involvement, frequently involving the shoulder and hip areas. Cystic angiomatosis is a nonaggressive form of skeletal angiomatosis with multifocal involvement, predominantly affecting the trunk bones. The imaging modalities gave the diagnosis of cystic angiomatosis of humerus showing multicystic lytic areas. The histopathological differential diagnosis was cystic angiomatosis and Gorham′s disease, as microscopically both are indistinguishable from each other. Both represent a complex network of dilated thin-walled capillaries growing in the marrow space associated with the destruction of bone and infiltration into the adjacent soft tissues. The case is presented because of its extreme rarity and due to the diagnostic dilemma, whether to label it as Gorham′s disease or as cystic angiomatosis. Considering the site involved and its aggressiveness, the diagnosis is in favor of Gorham′s vanishing bone disease as cystic angiomatosis is multicentric and nonaggressive, involving mostly vertebrae and skull with multicystic lytic lesions.

Background One of the most prevalent gynaecological cancers in developed nations is Endometrial Carcinoma. Endometrial hyperplasia, Atypical Endometrial Hyperplasia and nally fully developed, well-differentiated Adenocarcinoma are regarded to be the progression of premalignant lesions into Endometrial Carcinoma. The p53 signalling pathways are crucial in the development of Endometrial Cancer. Expression of p53 is associated with Atypical Endometrial Hyperplasia and Endometrial Carcinomas. T Aim & Objective o study the expression of p53 as molecular biomarker in Normal, hyperplastic and neoplastic lesions of endometrium. Material & Methods A total of 50 cases of endometrial biopsies were collected over a period of 18 months from January 2020 to June 2021. Samples were received and reported in Department of Pathology Gandhi Medical College, Bhopal, Madhya Pradesh. A total of 50 cases of e Results ndometrial lesion were studied. p53 expression was observed in 80% cases of the Endometrial Carcinoma and 50% cases of Atypical Endometrial Hyperplasia. It was mostly negative in Normal and Endometrial Hyperplasia. Expression of p53 in Atypical Endometrial Hyperplasia and Endometrial Carcinomas helps to detect the progression and predicting the response to targeted therapies against carcinogenic pathways. Conclusion p53 expression is mainly seen in Endometrial Cancer and Atypical Endometrial Hyperplasia. And it is almost absent in Normal and Endometrial Hyperplasia. The dysregulation appears to be most evident in the Atypical Endometrial Hyperplasia. This expression pattern suggests that p53 over-expression could be the origin of endometrial cancer

Congenital epulis, also known as congenital gingival granular cell tumor, is a rare benign intraoral tumor found only in the new born. It can be solitary or multiple and may occur in the mandible, maxilla or tongue and may or may not be associated with other congenital anomalies. The size of the mass varies and if very large may interfere with respiration and feeding at birth, thus necessitating the immediate surgical resection at birth to maintain patency of the airways. Antepartum detection by careful imaging and coordination of multidisciplinary team of maternal-fetal medicine, neonatal-perinatal medicine, anesthesiology and otolaryngology and finally the histopathologists who confirm the diagnosis is essential as the histology differentiates it from other congenital intraoral masses like haemangioma, fibroma, rhabdomyoma, rhabdomyosarcoma, lymphangioma, osteogenic and chondrogenic sarcomas.