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Background : Recent SIOPEL studies have shown cisplatin monotherapy to be equally effective in management of Standard risk Hepatoblastoma (SRHB)as compared to PLADO. Aims and Objectives: To study the chemotherapy, response and outcomes in children with SRHB. Material and Methods: A retrospective study was conducted and all children with SRHB who presented to us from June 2007 to December 2017 were included. All patients with standard risk hepatoblastoma who had received at least 2 cycles of chemotherapy were included. Data regarding the demographics, PRETEXT stage, chemotherapy, response to chemotherapy and outcomes were recorded. Kaplan Meier survival analysis was performed to calculate 5 year overall survival (OS) and event free survival (EFS). Results: Thirty two children were included in the study. The disease was PRETEXT I in 5 (15.6%), II in 9 (28.1%) and 18 (56.2%). Nineteen children (59.4%) received Cisplatin monotherapy and of these 6 patients (all PREXT III) had poor response and the chemotherapy was upgraded to PLADO. The remaining 13 (40.6%) received upfront PLADO chemotherapy. Only 31 patients could be operated. Tumor recurred in 5 patients, 2 who had upfront PLADO and 3 patients had been upgraded to PLADO. The 5 year OS and EFS was 100% in the monotherapy group (n=13), 92% and 69% in the upfront PLADO group (n=13), and 62% and 22% in the upgraded to PLADO group (n=6). Patients with PRETEXT III disease in whom chemotherapy was upgraded to PLADO had significantly lower survival (p=0.036) compared to those who received upfront PLADO chemotherapy. Conclusion: Two thirds of patients with PRETEXT stage III who received cisplatin monotherapy showed poor response and were upgraded to PLADO chemotherapy. These patients had a significantly poorer outcome compared to the rest of the cohort. PRETEXT stage III standard-risk hepatoblastoma may benefit from PLADO chemotherapy instead of cisplatin monotherapy.

Abstract This work is intended to understand the variation of pressure and flow at the pump inlet of liquid rocket engine. The opening and closure of the valve upstream of the pump features complex phenomenon. The opening and closing of the valve cause pressure and flow variations at the pump inlet which may lead to combustion instabilities in combustion chamber of engine, hydraulic transients in feedlines, and off-design operation of turbo-pumps which are fundamental to the efficient testing and operation of engine. A numerical model to predict the pressure and flow transients across a control valve for different rate of opening in fluid feed systems has been developed using first-order finite difference technique. In case of flow in pipes, the velocity and pressure is governed by momentum and continuity equations. A computer code for the prediction of fluid transients is developed based on method of characteristics for one-dimensional fluid flow in pipelines and compared with test data for validation. The control valve is considered to be in-line with the feed line and modeled based on the valve coefficient vs. percent opening of valve. This model can subsequently be used to predict the effect of opening/closing time of the valve on pressure surges across the control valve and corresponding flow rate in the feedline for different opening of the valve.

Background: Anaplastic large-cell lymphoma (ALCL) is a rare subtype of non-Hodgkin's lymphoma (NHL) characterized by the presence of unusual giant cells. It is a CD30+lymphoma of T-cells lineage, which shows anaplastic lymphoma kinase-nucleophosmin (ALK-NPM) rearrangement. ALCL on fine needle aspiration cytology (FNAC) shows unusually large and bizarre tumor cells. Materials and Methods: All aspirates seen over a 6-year period from November 2009 to November 2015 in which a diagnosis of ALCL or Hodgkin's lymphoma (HL) with bizarre giant cells were suspected on cytomorphology were prospectively selected. Twenty such aspirates were subjected to CD-30 and ALK-1 immunocytochemistry (ICC). Subsequent biopsy was available in all cases. Results: Out of 20 cases, seven cases, suspected to be ALCL on FNAC, were confirmed on biopsy. ALK-1 was positive in both cytology and biopsy of 6/7 of these. Two cases suspected to be ALCL on cytomorphology were HL (1) and diffuse large B-cell lymphoma (DLBCL) (1) on biopsy, both of which were ALK-1 negative on cytology. Eight cases of HL and three cases of large-cell NHL, which were all ALK negative on cytology, were confirmed on biopsy. Conclusion: ICC for ALK and CD30 is useful in aspiration cytodiagnosis of ALCL. One CD30 positive DLBCL and one ALK negative ALCL showed concordant results of ICC on cytology and histology.

Background: Conventional transbronchial needle aspiration (c-TBNA) is an underutilized bronchoscopic modality. Endobronchial ultrasound (EBUS) guided-TBNA though efficacious is an expensive modality, facilities of which are available at only limited centers. c-TBNA is cost-effective and has potential for wide utilization especially in resource-limited settings. Rapid on-site evaluation (ROSE) improves the yield of c-TBNA. Materials and Methods: A retrospective review of the bronchoscopy records (May 2012 to July 2014) was performed. The patients who underwent c-TBNA with ROSE were included in the study and their clinical details were extracted. Convex probe EBUS-TBNA was being regularly performed during the study period by the operators performing c-TBNA. Results: c-TBNA with ROSE was performed in 41 patients with mean age of 42.4 (16.2) years. The most frequently sampled node stations (>90% patients) were the subcarinal and lower right paratracheal. Representative samples could be obtained in 33 out of the 41 patients (80.4%). c-TBNA was diagnostic in 32 [tuberculosis (TB)-8, sarcoidosis-9, and malignancy-15] patients out of the 41 patients. The overall diagnostic yield (sensitivity) of c-TBNA with ROSE was 78%. Mean procedure duration was 18.4 (3.1) min and there were no procedural complications. Conclusion: c-TBNA with ROSE is a safe, efficacious, and cost-effective bronchoscopic modality. When it was performed by operators routinely performing EBUS-TBNA, diagnostic yields similar to that of EBUS-TBNA can be obtained. Even at the centers where EBUS facilities are available, c-TBNA should be routinely performed.

Background: Solid pseudopapillary tumor of pancreas (SPTP) is a rare pancreatic tumor of uncertain histogenesis usually affecting young women. Though these tumors have characteristic cytomorphology, it is sometimes difficult to differentiate them from neuroendocrine tumors of the pancreas. We reviewed cases of SPTP to delineate the diagnostic cytological features and also observed utility of CD 99 (MIC 2) immunostaining to aid in the diagnosis of this tumor. Aims: This study was designed to demonstrate the utility of CD 99 immunostaining along with cytological features for making a pre-operative diagnosis and delineating it from the neuroendocrine tumor of pancreas which is a close mimic. Materials and Methods: Cytomorphological features of 11 cases of solid pseudopapillary neoplasm diagnosed by pre-operative fine-needle aspiration cytology (FNAC) at our institute were reviewed. Immunocytochemistry for CD 99 was also performed on the smears. Results: All the cases had cellular smears with monomorphic cells lying singly, as loosely cohesive clusters as well as forming delicate pseudopapillae. Presence of intra and extra-cellular basement membrane material, background foamy macrophages and nuclear grooves were the other salient features. Immunocytochemistry for CD 99 could be performed on eight cases and demonstrated typical paranuclear dot-like positivity. Conclusions: Pre-operative early diagnosis of SPTP can be made by FNAC which can further be aided by CD 99 immunocytochemistry.

Aims and Objectives: To analyze testicular histopathology in men diagnosed as idiopathic obstructive azoospermia (IOA) based on normal spermatogenesis on fine needle aspiration cytology (FNAC) but with absence of sperms in the epididymis during surgical exploration. Materials and Methods: Men presenting with infertility due to IOA during the study period from July 2008 to July 2010 were prospectively evaluated. Clinical examination, semen analysis, serum follicle stimulating hormone (FSH), and testicular FNAC were done. Men with normal volume azoospermia with normal spermatogenesis on FNAC and palpable vas were offered scrotal exploration for microsurgical vasoepididymal anastomosis (VEA). Patients in whom reconstruction was not feasible intraoperatively were analyzed for the causes of failure. The FNAC, FSH and biopsy of these patients were compared. Results: 77 men fulfilled the inclusion criteria. In 38 men, sperm was present in the epididymal fluid and VEA was performed. In 39 men, reconstruction was not feasible. Thirty-four of these 39 men had normal FSH and testicular volume. In 5 of these 39 men, serum FSH was high (mean 17.48 mIU/ml) and testes were small in size (mean volume 14.5 ml). Testicular biopsy in two of these five men showed patchy areas of atrophy, while the other three men had hyalinized seminiferous tubules with thickened basement membrane, maturation arrest and normal spermatogenesis, respectively. Conclusion: FNAC was discordant with histopathological examination (HPE) in four out of five patients of negative surgical exploration with raised FSH. Therefore, among men with idiopathic azoospermia, only those with both normal FSH and normal FNAC should be diagnosed as obstructive azoospermia and explored.

Filariasis is a widespread public health problem seen commonly in tropical countries. Microfilariae have been reported in aspiration smears from various sites. However, it is very rare to detect these organisms in voided centrifuged urine cytology. We, report this rare finding in a 25-year-old patient who presented with achylous hematuria.

Byline: Leema. Cornelius, E. Neeraj, K. Venkateswaran, K. Gopinathan Sir, Melioidosis is a tropical infection caused by Burkholderia pseudomallei and is endemic in South East Asia and Northern Australia.[1] Central [...]

Introduction: Hepatocellular carcinoma (HCC) is a common primary malignancy of the liver but is rare in the paediatric age group; thus, it may be misdiagnosed as the more common tumour, hepatoblastoma. Management varies in both these tumours, and pathological diagnosis thus plays an important role for definitive therapy. Only a few case reports available in the literature have described the cytological characteristics of paediatric HCC. The present study was thus planned to evaluate the cytomorphological features of paediatric HCC. Methods: Cases diagnosed with HCC on ultrasound‐guided fine needle aspiration cytology over a period of 14 years were retrieved. The cases were evaluated for detailed cytological features including cellularity, architecture, sinusoidal wrapping, trabecular thickness, necrosis, anisonucleosis, chromatin, nucleoli, nuclear contours, bi‐ or multinucleation, intranuclear and intracytoplasmic inclusions, naked nuclei, extra‐medullary haematopoiesis, monomorphism, and nuclear overlapping. Results: Twelve cases of HCC were included in the study. The median age at diagnosis was 10 years. Serum alpha‐fetoprotein level was raised in most of them. Five of the 12 cases were characterised as moderately differentiated, three as poorly differentiated, two as well differentiated, and two as the fibrolamellar type of HCC. Cytohistological correlation was performed in seven cases. Conclusions: Ultrasound‐guided fine needle aspiration serves as a useful tool to diagnose paediatric HCC and differentiate it from other primary hepatic malignancies, especially hepatoblastoma which closely mimics HCC in this age group, as serum alpha protein levels and imaging findings are unable to distinguish these two tumours. [ABSTRACT FROM AUTHOR]