Ashumi Gupta - Academia.edu (original) (raw)

Papers by Ashumi Gupta

NATIONAL JOURNAL OF LABORATORY MEDICINE

Sebaceous Carcinoma is a rare locally aggressive tumour of adnexal epithelium with a potential to... more Sebaceous Carcinoma is a rare locally aggressive tumour of adnexal epithelium with a potential to metastasize to regional lymph node and distant organs. It constitutes between 1.5 to 5% of all eyelid malignant tumours. After basal cell and squamous cell carcinomas, it ranks third in incidence. Sebaceous carcinoma is seen more commonly in elderly females with average age at diagnosis in mid-sixties. Few cases have been reported in paediatric age group. Sebaceous Gland Carcinoma (SGC) is a slowly progressive tumor that arises usually from the meibomian gland in the eyelid, and has a locally aggressive nature with a tendency for pagetoid spread. The neoplasm is known to masquerade other benign and less malignant lesions. The non-specific clinical symptoms may lead to a delay in diagnosis of sebaceous carcinoma of the eyelid. Less than 120 cases of extra-occular sebaceous cell carcinoma have been reported so far. Here, the authors present a case of 60 years old female patient, who prese...

Tropical Journal of Pathology and Microbiology, 2019

Background: An underlying inflammatory state is an important contributor to carcinogenesis and pr... more Background: An underlying inflammatory state is an important contributor to carcinogenesis and progression of tumors. Many of the etiological factors in development of lung cancer are linked to persistent inflammation. Neutrophil lymphocyte ratio (NLR) and Platelet lymphocyte ratio (PLR) are markers of systemic inflammatory response that have shown clinical significance in cancer, according to recent research. Objective: To evaluate NLR and PLR in lung cancer and compare these parameters in healthy controls. Materials and Methods: Clinicopathological details and hematological parameters of complete blood counts were recorded for 106 patients of lung cancer and 106 healthy controls retrospectively. NLR and PLR values were evaluated and compared in the two groups. Results: NLR and PLR were significantly elevated in lung cancer patients (NLR 4.44±2.98; PLR 162.72±96.15) as compared to control group (NLR 1.90±0.67, PLR 115.15±29.15) with p value <0.05. NLR showed a sensitivity of 74.5% and specificity 85.8% at optimal cut off value (2.5), as per Receiver operating characteristics (ROC) curve analysis. ROC curve analysis for PLR showed sensitivity 48.1% and specificity 87.8% at optimal cut off value (148.7). Conclusion: NLR and PLR are significantly raised in lung cancer. This reflects an underlying inflammatory state that may contribute to development and progression of neoplastic disease in lung. NLR a more sensitive than PLR and may provide useful diagnostic and prognostic information in a country like India that bears a high load of lung cancer cases.

Annals of Pathology and Laboratory Medicine, 2017

Adrenal myelolipomas are benign, uncommon neoplams that are being increasingly detected due to fr... more Adrenal myelolipomas are benign, uncommon neoplams that are being increasingly detected due to frequent use of imaging studies. They are lipomatous tumours, that are usually asymptomatic and sometimes associated with endocrinological dysfunction. We present a case of middle aged gentleman, with accidentally detected adrenal mass and no hormonal disturbances. The patient was evaluated initially for fever. Laboratory investigations revealed evidence of urinary tract infection, which was conservatively managed. Ultrasound abdomen showed a hyperechoeic mass in suprarenal region with a hypoechoeic component. On further work up, MRI showed a well defined suprarenal mass with hyperintensity, possibly adrenal myelolipoma. The tumour was removed laparoscopically and histopathology revealed features of myelolipoma. The patient was discharged after an uneventful postoperative period. Adrenal myelolipomas are rare, benign tumours of adrenal gland diagnosed incidentally. Careful evaluation is important including imaging studies and endocrinological testing. Larger or symptomatic tumours can be excised surgically. Laparoscopic resection is a safe procedure in tumours considered for surgery, with favourable patient outcome.

Asian Journal of Medical Sciences, 2021

Background: Ovarian cancer forms a significant proportion of cancer-related mortality in females.... more Background: Ovarian cancer forms a significant proportion of cancer-related mortality in females. It is often detected late due to non-specific clinical presentation. Radiology and tumor markers may indicate an ovarian mass. However, exact diagnosis requires pathological evaluation, which may not be possible before surgery. Intraoperative frozen section (FS) is, therefore, an important modality for the diagnosis of ovarian masses. Aims and Objectives: This study was conducted to study step-by-step approach along with diagnostic utility and accuracy of intraoperative FS in diagnosis of ovarian masses. Materials and Methods: Retrospective comparative analysis was done to determine the diagnostic accuracy of FS as compared to routine histopathology in the pathology department of a tertiary care hospital. Diagnostic categorization was done into benign, borderline, and malignant. Overall accuracy, sensitivity, and specificity of FS technique were calculated. Results: Out of 51 cases, FS ...

BMJ case reports, Jan 18, 2013

Solitary fibrous tumours (SFTs) are a heterogeneous group of rare spindle-cell tumours. Classical... more Solitary fibrous tumours (SFTs) are a heterogeneous group of rare spindle-cell tumours. Classically they presented as a solitary pleural-based mass. Pulmonary parenchymal SFT is rare and multiple bilateral lesions are extremely rare. We present the clinical, imaging and histological features of SFT which are presented as multiple nodular lesions of the lung and pleura with probable distant metastasis.

Journal of Oral and Maxillofacial Pathology, 2013

Myoepithelial carcinoma is characterized by nearly exclusive myoepithelial differentiation and ev... more Myoepithelial carcinoma is characterized by nearly exclusive myoepithelial differentiation and evidence of malignancy. It may arise de novo or in preexisting benign tumors including pleomorphic adenoma and benign myoepithelioma. A 39-year-old lady presented with painless progressive swelling on the right cheek and right side of palate. On surgery, there was a mass in right maxillary sinus which was surgically excised and diagnosed on histopathology as pleomorphic adenoma. Subsequently, there were two recurrences. The first recurrence was in the right maxilla after 2 years that was removed surgically and diagnosed as pleomorphic adenoma. One year later, she came with rapidly progressive swelling in bilateral cheeks and face. Intraoperatively, there was a large tumor in both maxillary sinuses with extensive local infiltration. Histologically, it was diagnosed as myoepithelial carcinoma. Carcinoma ex pleomorphic adenoma is usually a high grade malignancy. It occurs most commonly in parotid gland followed by submandibular glands, minor salivary glands and occasionally in sublingual gland. To the best of our knowledge, this is the first case of myoepithelial carcinoma arising in a recurrent pleomorphic adenoma in the maxillary sinus.

Asian Pacific Journal of Health Sciences

Abnormal uterine bleeding is one of the most common gyenocological problems that affects women wo... more Abnormal uterine bleeding is one of the most common gyenocological problems that affects women worldwide. We studied patterns of endometrial biopsy pathology in abnormal uterine bleeding in a tertiary care hospital in a metropolitan city. Retrospective study of 518 cases of endometrial samples were studied in patients presenting with abnormal uterine bleeding. Clinical data and endometrial biopsy findings were recorded. The age of the patients varied, ranging from 18 years to 70 years. Maximum number of patients presented in the age group 40-49 years (49.2%), followed by 30-39 years (34.9%). The patients presented most commonly as menorrhagia (48.6%). Cyclical pattern was the most common finding on endometrial biopsy including secretory (33.4%) followed by proliferative pattern (31.3%), gestational causes (9.8%), endometrial hyperplasia (7.1%) chronic endometritis (4.0%), endometrial polyp (3.0%), irregular endometrium (4.2%), malignancy (1.7%) and atrophic endometrium (0.6%). Endometrial hyperplasias and malignancy were more frequently seen in patients presenting ≥40 yrs of age. Pregnancy associated causes of abnormal bleeding were more common in patients of reproductive age group i.e. <40yrs. Endometrial biopsy is the usual investigation performed in abnormal uterine bleeding and it can help to determine the etiology and decide the management in these cases. Patients in reproductive age group may have an underlying pregnancy associated cause of abnormal bleeding. Endometrial hyperplasia and malignancy must be excluded in patients presenting at or above 40 yrs of age.

Journal of clinical and diagnostic research : JCDR, 2016

Bcl-2 is a marker recently studied in thyroid tumours and proposed to have prognostic significanc... more Bcl-2 is a marker recently studied in thyroid tumours and proposed to have prognostic significance. p63 is expressed in a proportion of papillary thyroid carcinoma cases and may have a role in tumour progression. To study expression of Bcl2 and p63 in thyroid tumours and correlation of Bcl-2 with diagnostic markers including Thyroglobulin, Calcitonin and Carcinoembryonic antigen. Cytology smears of 35 cases of thyroid cancer were studied over a period of 18 months. In 20 cases histopathology was available. Immunocytochemistry for Bcl-2 and p63 was done, and diagnostic markers were applied as and when required. p63 showed focal nuclear expression in 46.1% of papillary thyroid carcinoma cases, and was negative in all other tumours. Bcl-2 was positive in 88.9% of follicular carcinomas, 100% of papillary carcinomas and 83.3% of medullary carcinoma cases, and showed focal weak expression in 40% of Anaplastic Carcinoma (ATC) cases, thereby signifying down regulation (p-value = 0.001). The...

Indian Journal of Endocrinology and Metabolism, 2013

Primary hyperparathyroidism (PHP) with pheochromocytoma and neurofibromatosis type 1 is a rare cl... more Primary hyperparathyroidism (PHP) with pheochromocytoma and neurofibromatosis type 1 is a rare clinical association. We present a case of PHP and pheochromocytoma occurring in a 33-year-old male with familial cutaneous neurofibromatosis.

BMJ case reports, 2013

Solitary fibrous tumours (SFTs) are a heterogeneous group of rare spindle-cell tumours. Classical... more Solitary fibrous tumours (SFTs) are a heterogeneous group of rare spindle-cell tumours. Classically they presented as a solitary pleural-based mass. Pulmonary parenchymal SFT is rare and multiple bilateral lesions are extremely rare. We present the clinical, imaging and histological features of SFT which are presented as multiple nodular lesions of the lung and pleura with probable distant metastasis.

Indian Journal of Pathology and Microbiology, 2013

Angiomyolipomas are rare benign tumors derived from perivascular epithelioid cells that occur fre... more Angiomyolipomas are rare benign tumors derived from perivascular epithelioid cells that occur frequently in kidney and rarely in the liver. We present a case of hepatic angiomyolipoma, with various clinical and radiological differential diagnoses. A 34-year-old male was found to have a palpable mass on the left side of the abdomen. Imaging showed heterogeneously enhancing mass lesion 15 cm Χ 7 cm, in the left lobe and segment 4 of the liver. Various benign and malignant diagnoses were entertained. The needle biopsy did not reveal any evidence of malignancy. Patient underwent resection of the lesion in view of the large size, which was diagnosed as angiomyolipoma. Angiomyolipoma is a benign tumor and accurate diagnosis is important to prevent overtreatment. Histology and immunohistochemistry may help in clinching the diagnosis, in proper clinical setting.

Journal of Oral and Maxillofacial Pathology, 2013

Myoepithelial carcinoma is characterized by nearly exclusive myoepithelial differentiation and ev... more Myoepithelial carcinoma is characterized by nearly exclusive myoepithelial differentiation and evidence of malignancy. It may arise de novo or in preexisting benign tumors including pleomorphic adenoma and benign myoepithelioma. A 39-year-old lady presented with painless progressive swelling on the right cheek and right side of palate. On surgery, there was a mass in right maxillary sinus which was surgically excised and diagnosed on histopathology as pleomorphic adenoma. Subsequently, there were two recurrences. The first recurrence was in the right maxilla after 2 years that was removed surgically and diagnosed as pleomorphic adenoma. One year later, she came with rapidly progressive swelling in bilateral cheeks and face. Intraoperatively, there was a large tumor in both maxillary sinuses with extensive local infiltration. Histologically, it was diagnosed as myoepithelial carcinoma. Carcinoma ex pleomorphic adenoma is usually a high grade malignancy. It occurs most commonly in parotid gland followed by submandibular glands, minor salivary glands and occasionally in sublingual gland. To the best of our knowledge, this is the first case of myoepithelial carcinoma arising in a recurrent pleomorphic adenoma in the maxillary sinus.

NATIONAL JOURNAL OF LABORATORY MEDICINE

Sebaceous Carcinoma is a rare locally aggressive tumour of adnexal epithelium with a potential to... more Sebaceous Carcinoma is a rare locally aggressive tumour of adnexal epithelium with a potential to metastasize to regional lymph node and distant organs. It constitutes between 1.5 to 5% of all eyelid malignant tumours. After basal cell and squamous cell carcinomas, it ranks third in incidence. Sebaceous carcinoma is seen more commonly in elderly females with average age at diagnosis in mid-sixties. Few cases have been reported in paediatric age group. Sebaceous Gland Carcinoma (SGC) is a slowly progressive tumor that arises usually from the meibomian gland in the eyelid, and has a locally aggressive nature with a tendency for pagetoid spread. The neoplasm is known to masquerade other benign and less malignant lesions. The non-specific clinical symptoms may lead to a delay in diagnosis of sebaceous carcinoma of the eyelid. Less than 120 cases of extra-occular sebaceous cell carcinoma have been reported so far. Here, the authors present a case of 60 years old female patient, who prese...

Tropical Journal of Pathology and Microbiology, 2019

Background: An underlying inflammatory state is an important contributor to carcinogenesis and pr... more Background: An underlying inflammatory state is an important contributor to carcinogenesis and progression of tumors. Many of the etiological factors in development of lung cancer are linked to persistent inflammation. Neutrophil lymphocyte ratio (NLR) and Platelet lymphocyte ratio (PLR) are markers of systemic inflammatory response that have shown clinical significance in cancer, according to recent research. Objective: To evaluate NLR and PLR in lung cancer and compare these parameters in healthy controls. Materials and Methods: Clinicopathological details and hematological parameters of complete blood counts were recorded for 106 patients of lung cancer and 106 healthy controls retrospectively. NLR and PLR values were evaluated and compared in the two groups. Results: NLR and PLR were significantly elevated in lung cancer patients (NLR 4.44±2.98; PLR 162.72±96.15) as compared to control group (NLR 1.90±0.67, PLR 115.15±29.15) with p value <0.05. NLR showed a sensitivity of 74.5% and specificity 85.8% at optimal cut off value (2.5), as per Receiver operating characteristics (ROC) curve analysis. ROC curve analysis for PLR showed sensitivity 48.1% and specificity 87.8% at optimal cut off value (148.7). Conclusion: NLR and PLR are significantly raised in lung cancer. This reflects an underlying inflammatory state that may contribute to development and progression of neoplastic disease in lung. NLR a more sensitive than PLR and may provide useful diagnostic and prognostic information in a country like India that bears a high load of lung cancer cases.

Annals of Pathology and Laboratory Medicine, 2017

Adrenal myelolipomas are benign, uncommon neoplams that are being increasingly detected due to fr... more Adrenal myelolipomas are benign, uncommon neoplams that are being increasingly detected due to frequent use of imaging studies. They are lipomatous tumours, that are usually asymptomatic and sometimes associated with endocrinological dysfunction. We present a case of middle aged gentleman, with accidentally detected adrenal mass and no hormonal disturbances. The patient was evaluated initially for fever. Laboratory investigations revealed evidence of urinary tract infection, which was conservatively managed. Ultrasound abdomen showed a hyperechoeic mass in suprarenal region with a hypoechoeic component. On further work up, MRI showed a well defined suprarenal mass with hyperintensity, possibly adrenal myelolipoma. The tumour was removed laparoscopically and histopathology revealed features of myelolipoma. The patient was discharged after an uneventful postoperative period. Adrenal myelolipomas are rare, benign tumours of adrenal gland diagnosed incidentally. Careful evaluation is important including imaging studies and endocrinological testing. Larger or symptomatic tumours can be excised surgically. Laparoscopic resection is a safe procedure in tumours considered for surgery, with favourable patient outcome.

Asian Journal of Medical Sciences, 2021

Background: Ovarian cancer forms a significant proportion of cancer-related mortality in females.... more Background: Ovarian cancer forms a significant proportion of cancer-related mortality in females. It is often detected late due to non-specific clinical presentation. Radiology and tumor markers may indicate an ovarian mass. However, exact diagnosis requires pathological evaluation, which may not be possible before surgery. Intraoperative frozen section (FS) is, therefore, an important modality for the diagnosis of ovarian masses. Aims and Objectives: This study was conducted to study step-by-step approach along with diagnostic utility and accuracy of intraoperative FS in diagnosis of ovarian masses. Materials and Methods: Retrospective comparative analysis was done to determine the diagnostic accuracy of FS as compared to routine histopathology in the pathology department of a tertiary care hospital. Diagnostic categorization was done into benign, borderline, and malignant. Overall accuracy, sensitivity, and specificity of FS technique were calculated. Results: Out of 51 cases, FS ...

BMJ case reports, Jan 18, 2013

Solitary fibrous tumours (SFTs) are a heterogeneous group of rare spindle-cell tumours. Classical... more Solitary fibrous tumours (SFTs) are a heterogeneous group of rare spindle-cell tumours. Classically they presented as a solitary pleural-based mass. Pulmonary parenchymal SFT is rare and multiple bilateral lesions are extremely rare. We present the clinical, imaging and histological features of SFT which are presented as multiple nodular lesions of the lung and pleura with probable distant metastasis.

Journal of Oral and Maxillofacial Pathology, 2013

Myoepithelial carcinoma is characterized by nearly exclusive myoepithelial differentiation and ev... more Myoepithelial carcinoma is characterized by nearly exclusive myoepithelial differentiation and evidence of malignancy. It may arise de novo or in preexisting benign tumors including pleomorphic adenoma and benign myoepithelioma. A 39-year-old lady presented with painless progressive swelling on the right cheek and right side of palate. On surgery, there was a mass in right maxillary sinus which was surgically excised and diagnosed on histopathology as pleomorphic adenoma. Subsequently, there were two recurrences. The first recurrence was in the right maxilla after 2 years that was removed surgically and diagnosed as pleomorphic adenoma. One year later, she came with rapidly progressive swelling in bilateral cheeks and face. Intraoperatively, there was a large tumor in both maxillary sinuses with extensive local infiltration. Histologically, it was diagnosed as myoepithelial carcinoma. Carcinoma ex pleomorphic adenoma is usually a high grade malignancy. It occurs most commonly in parotid gland followed by submandibular glands, minor salivary glands and occasionally in sublingual gland. To the best of our knowledge, this is the first case of myoepithelial carcinoma arising in a recurrent pleomorphic adenoma in the maxillary sinus.

Asian Pacific Journal of Health Sciences

Abnormal uterine bleeding is one of the most common gyenocological problems that affects women wo... more Abnormal uterine bleeding is one of the most common gyenocological problems that affects women worldwide. We studied patterns of endometrial biopsy pathology in abnormal uterine bleeding in a tertiary care hospital in a metropolitan city. Retrospective study of 518 cases of endometrial samples were studied in patients presenting with abnormal uterine bleeding. Clinical data and endometrial biopsy findings were recorded. The age of the patients varied, ranging from 18 years to 70 years. Maximum number of patients presented in the age group 40-49 years (49.2%), followed by 30-39 years (34.9%). The patients presented most commonly as menorrhagia (48.6%). Cyclical pattern was the most common finding on endometrial biopsy including secretory (33.4%) followed by proliferative pattern (31.3%), gestational causes (9.8%), endometrial hyperplasia (7.1%) chronic endometritis (4.0%), endometrial polyp (3.0%), irregular endometrium (4.2%), malignancy (1.7%) and atrophic endometrium (0.6%). Endometrial hyperplasias and malignancy were more frequently seen in patients presenting ≥40 yrs of age. Pregnancy associated causes of abnormal bleeding were more common in patients of reproductive age group i.e. <40yrs. Endometrial biopsy is the usual investigation performed in abnormal uterine bleeding and it can help to determine the etiology and decide the management in these cases. Patients in reproductive age group may have an underlying pregnancy associated cause of abnormal bleeding. Endometrial hyperplasia and malignancy must be excluded in patients presenting at or above 40 yrs of age.

Journal of clinical and diagnostic research : JCDR, 2016

Bcl-2 is a marker recently studied in thyroid tumours and proposed to have prognostic significanc... more Bcl-2 is a marker recently studied in thyroid tumours and proposed to have prognostic significance. p63 is expressed in a proportion of papillary thyroid carcinoma cases and may have a role in tumour progression. To study expression of Bcl2 and p63 in thyroid tumours and correlation of Bcl-2 with diagnostic markers including Thyroglobulin, Calcitonin and Carcinoembryonic antigen. Cytology smears of 35 cases of thyroid cancer were studied over a period of 18 months. In 20 cases histopathology was available. Immunocytochemistry for Bcl-2 and p63 was done, and diagnostic markers were applied as and when required. p63 showed focal nuclear expression in 46.1% of papillary thyroid carcinoma cases, and was negative in all other tumours. Bcl-2 was positive in 88.9% of follicular carcinomas, 100% of papillary carcinomas and 83.3% of medullary carcinoma cases, and showed focal weak expression in 40% of Anaplastic Carcinoma (ATC) cases, thereby signifying down regulation (p-value = 0.001). The...

Indian Journal of Endocrinology and Metabolism, 2013

Primary hyperparathyroidism (PHP) with pheochromocytoma and neurofibromatosis type 1 is a rare cl... more Primary hyperparathyroidism (PHP) with pheochromocytoma and neurofibromatosis type 1 is a rare clinical association. We present a case of PHP and pheochromocytoma occurring in a 33-year-old male with familial cutaneous neurofibromatosis.

BMJ case reports, 2013

Solitary fibrous tumours (SFTs) are a heterogeneous group of rare spindle-cell tumours. Classical... more Solitary fibrous tumours (SFTs) are a heterogeneous group of rare spindle-cell tumours. Classically they presented as a solitary pleural-based mass. Pulmonary parenchymal SFT is rare and multiple bilateral lesions are extremely rare. We present the clinical, imaging and histological features of SFT which are presented as multiple nodular lesions of the lung and pleura with probable distant metastasis.

Indian Journal of Pathology and Microbiology, 2013

Angiomyolipomas are rare benign tumors derived from perivascular epithelioid cells that occur fre... more Angiomyolipomas are rare benign tumors derived from perivascular epithelioid cells that occur frequently in kidney and rarely in the liver. We present a case of hepatic angiomyolipoma, with various clinical and radiological differential diagnoses. A 34-year-old male was found to have a palpable mass on the left side of the abdomen. Imaging showed heterogeneously enhancing mass lesion 15 cm Χ 7 cm, in the left lobe and segment 4 of the liver. Various benign and malignant diagnoses were entertained. The needle biopsy did not reveal any evidence of malignancy. Patient underwent resection of the lesion in view of the large size, which was diagnosed as angiomyolipoma. Angiomyolipoma is a benign tumor and accurate diagnosis is important to prevent overtreatment. Histology and immunohistochemistry may help in clinching the diagnosis, in proper clinical setting.

Journal of Oral and Maxillofacial Pathology, 2013

Myoepithelial carcinoma is characterized by nearly exclusive myoepithelial differentiation and ev... more Myoepithelial carcinoma is characterized by nearly exclusive myoepithelial differentiation and evidence of malignancy. It may arise de novo or in preexisting benign tumors including pleomorphic adenoma and benign myoepithelioma. A 39-year-old lady presented with painless progressive swelling on the right cheek and right side of palate. On surgery, there was a mass in right maxillary sinus which was surgically excised and diagnosed on histopathology as pleomorphic adenoma. Subsequently, there were two recurrences. The first recurrence was in the right maxilla after 2 years that was removed surgically and diagnosed as pleomorphic adenoma. One year later, she came with rapidly progressive swelling in bilateral cheeks and face. Intraoperatively, there was a large tumor in both maxillary sinuses with extensive local infiltration. Histologically, it was diagnosed as myoepithelial carcinoma. Carcinoma ex pleomorphic adenoma is usually a high grade malignancy. It occurs most commonly in parotid gland followed by submandibular glands, minor salivary glands and occasionally in sublingual gland. To the best of our knowledge, this is the first case of myoepithelial carcinoma arising in a recurrent pleomorphic adenoma in the maxillary sinus.