Endoscopic mucosal biopsies from 323 patients (201 from upper gastrointestinal tract and 122 from lower gastrointestinal tract) were studied to correlate the diagnostic efficacy of histology and imprint cytology in the diagnosis of malignant lesions of gastrointestinal tract. Of these 71 were from normal controls, 113 from benign lesions and 131 from malignant lesions. Histology showed no false positive reports but it was false negative in 6 cases (3 in oesophagus, 1 in stomach and 2 from colon). Imprint was false positive in 3 cases (2 oesophagus, 1 colon) and false negative in 2 cases (both oesophagus). The overall diagnostic accuracy of histology and imprint cytology in oesophagus, stomach and lower gastrointestinal tract was 95%, 98%, 98% and 95%, 100%, 98% respectively. When combined, the diagnostic accuracy increased to 98%, 100% and 100% in oesophagus, stomach and lower gastrointestinal tract respectively. The sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy for histology and cytology irrespective of the site was 96%, 100%, 100%, 94%, 97% and 98.5%, 97%, 98%, 98%, 98% respectively. Thus imprint cytology can act as an adjunct to bioptic histology to increase the diagnostic efficacy and save the time but definitely it cannot replace it as chances of false positives are high.

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Two cases of papillary carcinoma of thyroid with clinically unsuspected Hashimoto's thyroiditis were diagnosed on Fine Needle Aspiration Cytology (FNAC) in females aged 22 yrs, and 57 yrs., who presented with a solitary thyroid nodule. The frequency of carcinoma in Hashimoto's thyroiditis varies between 0.5 to 23.7%, depending on the stringency of diagnostic criteria applied. We believe that this possibility must be kept in mind when ever an aspirate of a solitary nodule shows profuse lymphocytes and Hurthle cells.

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During a period of four years three cases of solid and cystic (papillary) tumour of the pancreas were encountered. The patients presented predominantly with chief complaints of lump abdomen associated with dull aching pain in right hypochondrium. Radiologically diagnosis was suspected in two cases. Excessive bleeding during surgery was observed in two cases. In two survivors no recurrence or distant metastasis was noted after surgical excision (follow up 6 months to 3.5 years), third patient died after eight hours of operation.

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Tests to evaluate haemostatic function bleeding time (BT), prothrombin time (PT) partial thromboplastin time with kaolin (PTTK), thrombin time (TT), platelet count, platelet function tests (platelet adhesiveness and microthrombus index) and plasma fibrinogen levels were performed in 30 patients of coronary artery disease (14 myocardial infarction, 16 angina pectoris) and 20 age and sex matched controls. There was no statistically significant difference in platelet adhesiveness and mean microthrombus index in patients and controls. The BT, PT, PTTK and TT were normal in all patients and controls. Stepwise logistic regression analysis showed that plasma fibrinogen was an independent risk factor in the production of CAD.

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Argyrophilic nucleolar organizer regions (Ag NORs) were counted in biopsies from 203 cases of various lesions of the cervix. The mean number of Ag NORs per nucleus was significantly higher in CIN (4.05 +/- 0.04) and malignancy (5.50 +/- 0.65) as compared to squamous metaplasia (1.74 +/- 0.32) and chronic cervicitis (1.54 +/- 0.42). Adenocarcinomas had higher Ag NOR counts compared to other carcinomas. Estimation of Ag NORs can be helpful in distinguishing benign lesions from CIN and malignancy of the cervix.

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An elderly person presented with exertional dyspnoea, cough, rhinorrhea and multiple swelling in submandibular region. This case was found to have marked eosinophilia with upper, as well lower respiratory tract involvements. Erroneous treatment patient received in past for pulmonary tuberculosis without any beneficial result. Open lung biopsy was undertaken, revealed evidence of vascultitis and perivascular inflammatory changes. The case findings and histopathological discussions are reviewed briefly.

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Six patients, consisting of 4 males and 2 females with mean average age fo 29.20 years, with variable picture of multifocal choroiditis were serologically investigated for their association with Epstein-Barr Virus (EBV) infection. IgG and IgM antibodies to EBV-Virus Capsid Antigen (VCA) were assayed by immunoperoxidase method on EBV infected lymphoblast cells (P3HR-1 Burkitt's lymphoma cell line). In these patients definite serological evidence of EBV infection with high titres of IgG and IgM antibodies to EBV-VCA was demonstrated suggestive of active continuing or persisting EBV infection.

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Alkaline phosphatase have been demonstrated histochemically in the cytoplasm of neutrophils. Altered LAP activity has been observed in a number of conditions. Increased values are found in various inflammatory lesions where as in different malignancies LAP falls. Our study was aimed to see the alteration in LAP activity in case of squamous cell carcinoma. The study was carried out in peripheral blood smears of 185 cases (110 cases of squamous cell carcinoma and 75 of normal persons). After histochemical staining, LAP scoring was done. LAP score in Squamous cell carcinoma (mean +/- SD = 57.41 +/- 16.9). No significant difference in LAP score was found according to the site and grade of carcinoma, and in relation to metastasis. 43 cases were followed up after variable periods of treatment. LAP score was found to be significantly raised following treatment, (mean +/- SD = 21.14 +/- 5.94, p < 0.001). It is concluded that LAP scoring might be used as a cheap and simple technique to diagnose occult malignancies and to assess the response to therapy.

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A case of osteoclastoma like giant cell tumour of thyroid is reported in a patient who presented with dysphagia and swelling in the neck. The light microscopy showed numerous osteoclast-like giant cells embedded in mononuclear stromal cells, the overall appearance resembling that of giant cell tumour of bone.

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Two cases of persistence of Müllerian duct structures in phenotypic male patients are reported. One of these was aged 16 years and the other 10 months. Both patients had cryptorchidism and inguinal hernia for which they were operated upon. In both patients parts of uterus and fallopian tubes were identified in the hernial sac. Endocrine evaluation was normal. Karyotyping was performed in the second case which revealed a normal male genotype of 46 XY.

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Full text not available  [PDF]  [PubMed]