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Papers by Mamata Guha Mallick Sinha

Indian Journal of Hematology and Blood Transfusion

INDIAN JOURNAL OF NEONATAL MEDICINE AND RESEARCH

Hydatid cyst of brain in an extremely rare entity. A case of primary hydatidosis of brain without... more Hydatid cyst of brain in an extremely rare entity. A case of primary hydatidosis of brain without any involvement of other areas is even rarer. Most commonly involved areas are liver and lung because of rich vascularity and vicinity to portal circulation. Central Nervous System (CNS) or most importantly cases of hydatid cysts of brain are very rare. This case report is about a 7-year- old girl, from eastern India, who presented with multiple hydatid cysts in cranial cavity. She presented with headache, sudden loss of balance, short time memory loss. On Magnetic Resonanace Imaging (MRI), multiple cystic lesions were noted in cranial cavity. Magnetic Resonance (MR) Spectroscopy findings were suggestive of hydatid disease. These cysts were removed through neurosurgical intervention. The diagnosis was confirmed by gross and microscopic examination. Importance of keeping hydatidosis as a differential diagnosis while working up cases of cystic Space-occupying Lesion (SOL) of the brain in ...

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH

Introduction: Gliomas are most common primary Central Nervous System (CNS) neoplasm in adult popu... more Introduction: Gliomas are most common primary Central Nervous System (CNS) neoplasm in adult population. Gliomas predominantly arise from brain parenchyma. Invasion of adjacent normal parenchyma is a prominent feature. Aim: To study the epidemiological incidence of glial tumours and the viability and accuracy of intraoperative cytology in diagnosis and grading glial tumours. Materials and Methods: A cross-sectional study was done on 30 patients who underwent excision surgery at Department of Neurosurgery at Institute of Postgraduate Medical Education and Research IPGMER and SSKM, Kolkata, West Bengal, India. Clinically, radiologically confirmed cases of Space Occupying Lesion (SOL) of brain with a history of neurosurgical intervention were included. Patients medically unfit for surgery or without radiological evidence of SOL in the brain were excluded from the study. Intraoperative imprint touch cytology of the specimens was done. Part of the tissue was kept for Formalin Fixation an...

Tropical Journal of Pathology and Microbiology, 2021

Background: Human immunodeficiency virus can involve almost any organ system. Anemia is themost c... more Background: Human immunodeficiency virus can involve almost any organ system. Anemia is themost common hematological manifestation in HIV/AIDS patients. Bone marrow changes includevarying degrees of dysplasia in one or more cell lines, plasmacytosis, opportunistic infections andhematological malignancies. There are only a few studies where hematological manifestations ofHIV/AIDS patients had been described. Materials and Methods: 100 HIV positive patients, agedbetween 12-65 years were enrolled in this hospital-based cross-sectional study. The study wasconducted from March 2016 to March 2018. A complete blood count, CD4 counts were done, besidesa thorough history and clinical examination. HIV positive patients were classified as those havingAIDS and Non-AIDS, according to NACO criteria. Written informed consent was taken from patientsand bone marrow aspiration was done. Results: Total number of patients included in the study was100. We were able to do a CD4 count of 91 patients. As p...

Histoid Leprosy (HL) is a rare variant of Lepromatous Leprosy, occurring in long-standing cases, ... more Histoid Leprosy (HL) is a rare variant of Lepromatous Leprosy, occurring in long-standing cases, mostly in a background of acquired drug resistance. Patients usually present with sudden onset multiple nodules and plaques, most often involving the skin and subcutaneous tissue of trunk and lower limbs. Here we report an unusual case of de novo (without any history of prior anti-leprotic therapy) HL, arising as multiple nodules in the face. The histopathology of the lesion showed collection of spindled macrophages in the dermis, oriented in a storiform-like pattern. A possibility of HL was considered and the diagnosis was confirmed by performing a modified ZN stain (WadeFite stain) on the biopsy material, which revealed the presence of acid-fast bacilli (AFB) with a bacillary index of 6. Then the patient was put on multibacillary multi-drug chemotherapy and was thereby cured.

Introduction: The health care burden related to breast carcinoma has been steadily mounting and h... more Introduction: The health care burden related to breast carcinoma has been steadily mounting and has become one of the leading cause of death among women in the world . Cell block study has emerged as a reproducible method for diagnosing breast carcinomas while core needle biopsy is becoming increasingly popular. The purpose of the study was to evaluate the diagnostic efficacy of various types of breast carcinomas by FNAC, cell block preparations and core-needle biopsy (CNB). Materials and Methods: In 60 patients with a clinical suspicion of breast carcinoma, fine needle aspirations, cell block and core needle biopsy were carried out using standard technique and were evaluated by observational study with cross sectional design. The excision biopsy was taken as the gold standard of diagnosis. Results: Out of 60 cases, diagnostic accuracy of FNAC, Cell Block and CNB were 93%, 95% and 96% respectively. Conclusions: Cell block technique accurately compare well with the histology with the...

Scholars Journal of Applied Medical Sciences, 2021

Case Report Carcinoma of gallbladder is the most common malignancy of biliary tract and 5 th most... more Case Report Carcinoma of gallbladder is the most common malignancy of biliary tract and 5 th most common malignancy of gastrointestinal tract. Most common histological type being Adenocarcinoma. Though areas of squamous differentiation may be found in adenocarcinoma, pure squamous cell variant is very rare which accounts to less than 1% of all gallbladder carcinoma. To rule out adenosquamous variant the whole specimen must be meticulously studied. Gallbladder carcinoma is more common in women and usually seen in patients older than 50 years of age. Most are asymptomatic but at later stages It usually presents with pain abdomen mimicking features of cholecystitis. Although common mode of investigations is ultrasonography and CT scan, gallbladder cancer is commonly diagnosed incidentally after routine cholecystectomy. Gallbladder cancer carries a poor prognosis specially the squamous cell variant. In most cases at the time of diagnosis it already metastasizes to liver silently but 5 y...

International Journal of Surgery Case Reports, 2021

Introduction Mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) is a rare tumour of the pan... more Introduction Mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) is a rare tumour of the pancreas which can mimic groove pancreatitis. Case report We present a 49-year-old Indian male presented with constant, dull-aching epigastric pain for last 6 months radiating to back, not associated with jaundice, gastrointestinal bleed, fever or weight loss. He also had history of alcohol abuse for last 15 years. Physical examination was unremarkable. Laboratory investigations were within normal limits. Contrast enhanced computed tomography (CT) of the abdomen was suggestive of groove pancreatitis. CA 19.9, CEA and IgG4 levels were normal. Upper gastrointestinal endoscopy revealed an oedematous mucosa with narrowing of second part of duodenum. Endoscopic ultrasound (EUS) showed bulky pancreas with ill-defined heteroechoic head with periduodenal soft tissue thickening. EUS guided fine needle aspiration revealed chronic inflammatory cells. Based on the endoscopic findings and imaging, we suspected the diagnosis to be groove pancreatitis. He underwent open Whipple's pancreaticoduodenectomy. Histopathological evaluation revealed well differentiated neuroendocrine tumour and immunohistochemistry revealed features which was consistent with mixed neuroendocrine-non-neuroendocrine tumour (MiNEN). Post-operative period was uneventful and he was discharged on post-op day 7. A PET-CT scan was done to look for any silent metastasis and it was negative. He recieved 4 cycles of cisplatin-based chemotherapy. He was symptom free and doing well on 12 months follow up with no evidence of recurrence in surveillance CT imaging. Discussion Pancreatic MiNEN is characterised by presence of two malignant tissues, adenocarcinoma and NET, with one constituent involving at least 30% of the tumour. We report the pitfalls in diagnostic work-up which can lead to misdiagnosis of this rare entity. Specially due to admixture of different kinds of tissue, radiological investigations can be misleading. Conclusion Our case highlights the fact that MiNEN of pancreas can mimic a benign condition like groove pancreatitis. If routine histopathological and immunohistochemical evaluation is not done on the resected samples, relying on radiological and fine-needle aspiration cytology evidences, the actual diagnosis could be missed.

Indian Journal of Dermatology, 2016

Histoplasmosis is a systemic fungal infection caused by dimorphic fungus, Histoplasma capsulatum.... more Histoplasmosis is a systemic fungal infection caused by dimorphic fungus, Histoplasma capsulatum. Immunocompetent individuals usually have self-limiting or localized disease whereas immunocompromised individuals develop disseminated disease. The occurrence of progressive disseminated histoplasmosis in juvenile systemic lupus erythematosus is extremely rare with only one reported case in literature showing such association. Therefore, we report a case of severe opportunistic fungal infection caused by Histoplasma in a 13-year-old girl who was diagnosed with juvenile lupus erythematosus, subsequently developed septic shock and died of the disease despite of aggressive antifungal therapy.

Iosr Journal of Dental and Medical Sciences, Apr 29, 2013

Journal of Cytology, 2015

The role of aspiration cytology has largely been ignored in pediatric population. The present stu... more The role of aspiration cytology has largely been ignored in pediatric population. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) in non-hematological neoplasms in children in our institution, which is a rural tertiary care center. A total of 88 cases of non-hematological pediatric mass lesions were studied in which cytopathological diagnosis could be corroborated with histopathology. Out of all the cases, 70 (80%) cases were benign tumors and 18 (20%) were malignant tumors. Fibroadenoma (37.9%) comprised the majority of cases in the benign category while small round cell tumors (SRCTs) (44.4%) comprised the majority of cases in the malignant category. Definite diagnosis could be offered based on the cytomorphology in 79.5% cases, while in 20.5% of cases only a broad cytological classification could be offered. Among the malignant lesions, FNAC showed 100% sensitivity while a specific diagnosis was made in 90% of cases. FNAC proved to be a rapid and fairly accurate tool in diagnosing non-hematological tumors in the pediatric age group.

Journal of Basic and Clinical Reproductive Sciences, 2012

Background: Tuberculosis remains a global health problem and is an important cause of morbidity a... more Background: Tuberculosis remains a global health problem and is an important cause of morbidity and mortality. Female genital tuberculosis (FGTB), though rare in western world, is relevant in developing countries like India. Aims and Objective: The aim of this study was to determine histologic findings of different parts of female genital tract affected by TB and to correlate it with clinical and other features. Materials and Methods: A total number of 110 cases of FGTB from 92 patients were included over a period of 15 years. (April, 1997 to March, 2012) The age range of the patients was 17 to 45 years with mean of 26.3 years. The diagnostic procedures used were curettage biopsy, hysterectomy, histologic examination, culture, Mycobacterium tuberculosis-polymerase chain reaction, laparoscopy, hysterosalpingography, and ultrasonography. Patients of FGTB presented with infertility (65-70%), pelvic/ abdominal pain (50-55%), and menstrual disturbances (20-25%). Results: FGTB involved vulva (2), vagina (1), cervix (5), endometrium (66), fallopian tube (24), and ovaries (12). Out of 66 endometrial TB, proliferative, secretory endometrium, and atrophic endometrium were seen in 53, 09, and 04 cases. HIV co-infection was found only in 5 cases, and acid-fast bacilli in tissue sections were detected in 7 cases. Conclusions: FGTB is not uncommon in developing countries and is an important cause of infertility. Though fallopian tube was the most common site in many studies, in this study, endometrium emerges as the commonest site.

Journal of Cytology, 2014

Adrenocortical carcinoma (ACC) is a rare malignancy and cytodiagnosis of this tumor is not routin... more Adrenocortical carcinoma (ACC) is a rare malignancy and cytodiagnosis of this tumor is not routinely encountered by a cytopathologist. Here, we report a case of ACC initially diagnosed by computed tomography (CT)-guided fine needle aspiration cytology (FNAC) with the help of immunocytochemistry. A 48-year-old lady presented with flank pain and abdominal mass for the last 6 months. A CT scan of her abdomen revealed a large mass arising from the upper part of the left kidney. CTguided FNAC was performed. Cytologic smears showed pleomorphic large cells arranged discretely and in small aggregates against a myxoid background. The cells had a high nucleocytoplasmic ratio, anisonucleosis and conspicuous nucleoli. Based on cytomorphology, differential diagnoses of ACC and renal cell carcinoma (RCC) were made. On immunocytochemistry, the tumor cells were synaptophysin, inhibin, vimentin and Melan-A positive but cytokeratin and epithelial membrane antigen negative. Thus, a cytodiagnosis of myxoid ACC was made and histopathologic examination was suggested. Subsequent histologic examination and immunohistochemistry proved the case to be myxoid ACC.

Indian Journal of Hematology and Blood Transfusion, 2013

Fanconi anemia (FA), commonly inherited as an autosomal recessive trait, is the commonest cause o... more Fanconi anemia (FA), commonly inherited as an autosomal recessive trait, is the commonest cause of inherited bone marrow failure syndrome often accompanied by skeletal deformities, genitourinary abnormalities and an increased risk of malignancies especially acute myeloid leukemia. Haemoglobin E (b26 Glu?Lys) is common haemoglobin variant in the northeastern part of India and the northern part of West Bengal. Here, we report a case of FA with concomitant haemoglobin E-trait in a 5-year-old child who presented with weakness, epistaxis, malaena and intermittent fever. She had a hyper-pigmented patch over the nape of neck and polydactyly. Complete blood counts revealed pancytopenia. The bone marrow aspiration and trephine biopsy showed marrow hypoplasia. Chromosome analysis showed chromatid and chromosome breaks in 22 % cells suggestive of FA. The results were corroborated with MMC stress test. Thus, we present the first reported case of FA with haemoglobin E-trait.

Journal of Cytology, 2014

Diagnosis of retroperitoneal lesions is one of the most difficult areas in surgical pathology. Bo... more Diagnosis of retroperitoneal lesions is one of the most difficult areas in surgical pathology. Both primary and metastatic tumors can grow silently in retroperitoneum before the appearance of clinical signs and symptoms. Guided aspiration cytology has shown a promising role in diagnosis of lesions in this region. This study was undertaken to evaluate the reliability of guided fine-needle aspiration cytology (FNAC) in the diagnosis of retroperitoneal masses and to study the spectrum of retroperitoneal lesions in a rural tertiary care hospital. This study was done on 71 patients presenting with retroperitoneal masses over a period of 20 months in a tertiary care hospital. Ultrasound-guided FNAC was done and the smears were stained by MGG and H and E stains. Histopathological corroboration could be done on all neoplastic lesions along with some non-neoplastic lesions. Out of 71 cases, 48 cases (67.6%) were found to be neoplastic. Malignant tumors (35 cases) were more common than benign ones (13 cases). Malignant lesions were predominantly composed of lesions of lymph node (17 cases i.e. 48.57%) followed by sarcomas (5 cases) and germ cell tumors. Some uncommon retroperitoneal lesions like adrenal myelolipoma, renal angiomyolipoma, Burkitt's lymphoma and adrenocortical carcinoma were found in our study. Guided FNAC could diagnose all the malignant lesions with 100% accuracy except in 2 cases of poorly differentiated carcinoma which came out to be non-Hodgkin lymphoma on subsequent biopsies. Guided FNAC is an inexpensive, rapid and reliable method for diagnosis of retroperitoneal masses.

Indian Journal of Otology, 2013

ABSTRACT

Cytopathology, 2004

In this study, we evaluated the usefulness of fine needle aspiration cytology (FNAC) in the diagn... more In this study, we evaluated the usefulness of fine needle aspiration cytology (FNAC) in the diagnosis of soft tissue tumours. We have also assessed the various pitfalls of FNAC of soft tissue tumours. This was a retrospective study and here we analysed only 82 histopathology proven cases of FNAC of soft tissue tumours diagnosed in a five and half year period. On histopathological examination, 55 of these cases were malignant and 27 were benign. There was a total of 15 recurrences and histopathology was available prior to FNAC in only eight of these cases. Therefore, excluding these eight cases, malignant tumours were primarily diagnosed by FNAC in 47 cases. The sensitivity, specificity and positive predictive value of FNAC in diagnosis of soft tissue tumours were 91.5%, 92.5% and 95.5%, respectively. Only 22 of 47 cases (46.8%) were correctly categorized. There were two falsepositive and four false-negative cases. One case each of fibromatosis and schwannoma were reported as sarcoma. False-negative cases were fibrosarcoma (1), malignant nerve sheath tumour (2) and haemangiopericytoma (1). FNAC was very useful in distinguishing benign from malignant soft tissue tumours. However, it was not so effective in exact categorization of tumours.

Annals of Pathology and Laboratory Medicine, 2016

Introduction: Gastric cancer is the second leading cause of cancer mortality in the world and its... more Introduction: Gastric cancer is the second leading cause of cancer mortality in the world and its management, especially in advanced stages, has evolved relatively little. In particular, no targeted modality has so far been incorporated for treatment. HER2 over-expression is increasingly recognized as a frequent molecular abnormality, driven as in breast cancer by gene amplification. There is mounting evidence of the role of HER2 over-expression in patients with gastric cancer, and it has been strongly correlated to poorer outcomes and a more aggressive disease. Aims and objective: The purpose of this study is to establish the clinicoepidemiological, histopathological and immunohistochemical particularities of the gastric carcinomas, and to identify the factors with a prognostic value. Methods: The present study included 54 cases of gastric carcinoma, who had undergone endoscopy guided biopsy or gastrectomy. Expression of HER2 oncoprotein by immunohistochemistry and detection of H...

Indian Journal of Hematology and Blood Transfusion

INDIAN JOURNAL OF NEONATAL MEDICINE AND RESEARCH

Hydatid cyst of brain in an extremely rare entity. A case of primary hydatidosis of brain without... more Hydatid cyst of brain in an extremely rare entity. A case of primary hydatidosis of brain without any involvement of other areas is even rarer. Most commonly involved areas are liver and lung because of rich vascularity and vicinity to portal circulation. Central Nervous System (CNS) or most importantly cases of hydatid cysts of brain are very rare. This case report is about a 7-year- old girl, from eastern India, who presented with multiple hydatid cysts in cranial cavity. She presented with headache, sudden loss of balance, short time memory loss. On Magnetic Resonanace Imaging (MRI), multiple cystic lesions were noted in cranial cavity. Magnetic Resonance (MR) Spectroscopy findings were suggestive of hydatid disease. These cysts were removed through neurosurgical intervention. The diagnosis was confirmed by gross and microscopic examination. Importance of keeping hydatidosis as a differential diagnosis while working up cases of cystic Space-occupying Lesion (SOL) of the brain in ...

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH

Introduction: Gliomas are most common primary Central Nervous System (CNS) neoplasm in adult popu... more Introduction: Gliomas are most common primary Central Nervous System (CNS) neoplasm in adult population. Gliomas predominantly arise from brain parenchyma. Invasion of adjacent normal parenchyma is a prominent feature. Aim: To study the epidemiological incidence of glial tumours and the viability and accuracy of intraoperative cytology in diagnosis and grading glial tumours. Materials and Methods: A cross-sectional study was done on 30 patients who underwent excision surgery at Department of Neurosurgery at Institute of Postgraduate Medical Education and Research IPGMER and SSKM, Kolkata, West Bengal, India. Clinically, radiologically confirmed cases of Space Occupying Lesion (SOL) of brain with a history of neurosurgical intervention were included. Patients medically unfit for surgery or without radiological evidence of SOL in the brain were excluded from the study. Intraoperative imprint touch cytology of the specimens was done. Part of the tissue was kept for Formalin Fixation an...

Tropical Journal of Pathology and Microbiology, 2021

Background: Human immunodeficiency virus can involve almost any organ system. Anemia is themost c... more Background: Human immunodeficiency virus can involve almost any organ system. Anemia is themost common hematological manifestation in HIV/AIDS patients. Bone marrow changes includevarying degrees of dysplasia in one or more cell lines, plasmacytosis, opportunistic infections andhematological malignancies. There are only a few studies where hematological manifestations ofHIV/AIDS patients had been described. Materials and Methods: 100 HIV positive patients, agedbetween 12-65 years were enrolled in this hospital-based cross-sectional study. The study wasconducted from March 2016 to March 2018. A complete blood count, CD4 counts were done, besidesa thorough history and clinical examination. HIV positive patients were classified as those havingAIDS and Non-AIDS, according to NACO criteria. Written informed consent was taken from patientsand bone marrow aspiration was done. Results: Total number of patients included in the study was100. We were able to do a CD4 count of 91 patients. As p...

Histoid Leprosy (HL) is a rare variant of Lepromatous Leprosy, occurring in long-standing cases, ... more Histoid Leprosy (HL) is a rare variant of Lepromatous Leprosy, occurring in long-standing cases, mostly in a background of acquired drug resistance. Patients usually present with sudden onset multiple nodules and plaques, most often involving the skin and subcutaneous tissue of trunk and lower limbs. Here we report an unusual case of de novo (without any history of prior anti-leprotic therapy) HL, arising as multiple nodules in the face. The histopathology of the lesion showed collection of spindled macrophages in the dermis, oriented in a storiform-like pattern. A possibility of HL was considered and the diagnosis was confirmed by performing a modified ZN stain (WadeFite stain) on the biopsy material, which revealed the presence of acid-fast bacilli (AFB) with a bacillary index of 6. Then the patient was put on multibacillary multi-drug chemotherapy and was thereby cured.

Introduction: The health care burden related to breast carcinoma has been steadily mounting and h... more Introduction: The health care burden related to breast carcinoma has been steadily mounting and has become one of the leading cause of death among women in the world . Cell block study has emerged as a reproducible method for diagnosing breast carcinomas while core needle biopsy is becoming increasingly popular. The purpose of the study was to evaluate the diagnostic efficacy of various types of breast carcinomas by FNAC, cell block preparations and core-needle biopsy (CNB). Materials and Methods: In 60 patients with a clinical suspicion of breast carcinoma, fine needle aspirations, cell block and core needle biopsy were carried out using standard technique and were evaluated by observational study with cross sectional design. The excision biopsy was taken as the gold standard of diagnosis. Results: Out of 60 cases, diagnostic accuracy of FNAC, Cell Block and CNB were 93%, 95% and 96% respectively. Conclusions: Cell block technique accurately compare well with the histology with the...

Scholars Journal of Applied Medical Sciences, 2021

Case Report Carcinoma of gallbladder is the most common malignancy of biliary tract and 5 th most... more Case Report Carcinoma of gallbladder is the most common malignancy of biliary tract and 5 th most common malignancy of gastrointestinal tract. Most common histological type being Adenocarcinoma. Though areas of squamous differentiation may be found in adenocarcinoma, pure squamous cell variant is very rare which accounts to less than 1% of all gallbladder carcinoma. To rule out adenosquamous variant the whole specimen must be meticulously studied. Gallbladder carcinoma is more common in women and usually seen in patients older than 50 years of age. Most are asymptomatic but at later stages It usually presents with pain abdomen mimicking features of cholecystitis. Although common mode of investigations is ultrasonography and CT scan, gallbladder cancer is commonly diagnosed incidentally after routine cholecystectomy. Gallbladder cancer carries a poor prognosis specially the squamous cell variant. In most cases at the time of diagnosis it already metastasizes to liver silently but 5 y...

International Journal of Surgery Case Reports, 2021

Introduction Mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) is a rare tumour of the pan... more Introduction Mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) is a rare tumour of the pancreas which can mimic groove pancreatitis. Case report We present a 49-year-old Indian male presented with constant, dull-aching epigastric pain for last 6 months radiating to back, not associated with jaundice, gastrointestinal bleed, fever or weight loss. He also had history of alcohol abuse for last 15 years. Physical examination was unremarkable. Laboratory investigations were within normal limits. Contrast enhanced computed tomography (CT) of the abdomen was suggestive of groove pancreatitis. CA 19.9, CEA and IgG4 levels were normal. Upper gastrointestinal endoscopy revealed an oedematous mucosa with narrowing of second part of duodenum. Endoscopic ultrasound (EUS) showed bulky pancreas with ill-defined heteroechoic head with periduodenal soft tissue thickening. EUS guided fine needle aspiration revealed chronic inflammatory cells. Based on the endoscopic findings and imaging, we suspected the diagnosis to be groove pancreatitis. He underwent open Whipple's pancreaticoduodenectomy. Histopathological evaluation revealed well differentiated neuroendocrine tumour and immunohistochemistry revealed features which was consistent with mixed neuroendocrine-non-neuroendocrine tumour (MiNEN). Post-operative period was uneventful and he was discharged on post-op day 7. A PET-CT scan was done to look for any silent metastasis and it was negative. He recieved 4 cycles of cisplatin-based chemotherapy. He was symptom free and doing well on 12 months follow up with no evidence of recurrence in surveillance CT imaging. Discussion Pancreatic MiNEN is characterised by presence of two malignant tissues, adenocarcinoma and NET, with one constituent involving at least 30% of the tumour. We report the pitfalls in diagnostic work-up which can lead to misdiagnosis of this rare entity. Specially due to admixture of different kinds of tissue, radiological investigations can be misleading. Conclusion Our case highlights the fact that MiNEN of pancreas can mimic a benign condition like groove pancreatitis. If routine histopathological and immunohistochemical evaluation is not done on the resected samples, relying on radiological and fine-needle aspiration cytology evidences, the actual diagnosis could be missed.

Indian Journal of Dermatology, 2016

Histoplasmosis is a systemic fungal infection caused by dimorphic fungus, Histoplasma capsulatum.... more Histoplasmosis is a systemic fungal infection caused by dimorphic fungus, Histoplasma capsulatum. Immunocompetent individuals usually have self-limiting or localized disease whereas immunocompromised individuals develop disseminated disease. The occurrence of progressive disseminated histoplasmosis in juvenile systemic lupus erythematosus is extremely rare with only one reported case in literature showing such association. Therefore, we report a case of severe opportunistic fungal infection caused by Histoplasma in a 13-year-old girl who was diagnosed with juvenile lupus erythematosus, subsequently developed septic shock and died of the disease despite of aggressive antifungal therapy.

Iosr Journal of Dental and Medical Sciences, Apr 29, 2013

Journal of Cytology, 2015

The role of aspiration cytology has largely been ignored in pediatric population. The present stu... more The role of aspiration cytology has largely been ignored in pediatric population. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) in non-hematological neoplasms in children in our institution, which is a rural tertiary care center. A total of 88 cases of non-hematological pediatric mass lesions were studied in which cytopathological diagnosis could be corroborated with histopathology. Out of all the cases, 70 (80%) cases were benign tumors and 18 (20%) were malignant tumors. Fibroadenoma (37.9%) comprised the majority of cases in the benign category while small round cell tumors (SRCTs) (44.4%) comprised the majority of cases in the malignant category. Definite diagnosis could be offered based on the cytomorphology in 79.5% cases, while in 20.5% of cases only a broad cytological classification could be offered. Among the malignant lesions, FNAC showed 100% sensitivity while a specific diagnosis was made in 90% of cases. FNAC proved to be a rapid and fairly accurate tool in diagnosing non-hematological tumors in the pediatric age group.

Journal of Basic and Clinical Reproductive Sciences, 2012

Background: Tuberculosis remains a global health problem and is an important cause of morbidity a... more Background: Tuberculosis remains a global health problem and is an important cause of morbidity and mortality. Female genital tuberculosis (FGTB), though rare in western world, is relevant in developing countries like India. Aims and Objective: The aim of this study was to determine histologic findings of different parts of female genital tract affected by TB and to correlate it with clinical and other features. Materials and Methods: A total number of 110 cases of FGTB from 92 patients were included over a period of 15 years. (April, 1997 to March, 2012) The age range of the patients was 17 to 45 years with mean of 26.3 years. The diagnostic procedures used were curettage biopsy, hysterectomy, histologic examination, culture, Mycobacterium tuberculosis-polymerase chain reaction, laparoscopy, hysterosalpingography, and ultrasonography. Patients of FGTB presented with infertility (65-70%), pelvic/ abdominal pain (50-55%), and menstrual disturbances (20-25%). Results: FGTB involved vulva (2), vagina (1), cervix (5), endometrium (66), fallopian tube (24), and ovaries (12). Out of 66 endometrial TB, proliferative, secretory endometrium, and atrophic endometrium were seen in 53, 09, and 04 cases. HIV co-infection was found only in 5 cases, and acid-fast bacilli in tissue sections were detected in 7 cases. Conclusions: FGTB is not uncommon in developing countries and is an important cause of infertility. Though fallopian tube was the most common site in many studies, in this study, endometrium emerges as the commonest site.

Journal of Cytology, 2014

Adrenocortical carcinoma (ACC) is a rare malignancy and cytodiagnosis of this tumor is not routin... more Adrenocortical carcinoma (ACC) is a rare malignancy and cytodiagnosis of this tumor is not routinely encountered by a cytopathologist. Here, we report a case of ACC initially diagnosed by computed tomography (CT)-guided fine needle aspiration cytology (FNAC) with the help of immunocytochemistry. A 48-year-old lady presented with flank pain and abdominal mass for the last 6 months. A CT scan of her abdomen revealed a large mass arising from the upper part of the left kidney. CTguided FNAC was performed. Cytologic smears showed pleomorphic large cells arranged discretely and in small aggregates against a myxoid background. The cells had a high nucleocytoplasmic ratio, anisonucleosis and conspicuous nucleoli. Based on cytomorphology, differential diagnoses of ACC and renal cell carcinoma (RCC) were made. On immunocytochemistry, the tumor cells were synaptophysin, inhibin, vimentin and Melan-A positive but cytokeratin and epithelial membrane antigen negative. Thus, a cytodiagnosis of myxoid ACC was made and histopathologic examination was suggested. Subsequent histologic examination and immunohistochemistry proved the case to be myxoid ACC.

Indian Journal of Hematology and Blood Transfusion, 2013

Fanconi anemia (FA), commonly inherited as an autosomal recessive trait, is the commonest cause o... more Fanconi anemia (FA), commonly inherited as an autosomal recessive trait, is the commonest cause of inherited bone marrow failure syndrome often accompanied by skeletal deformities, genitourinary abnormalities and an increased risk of malignancies especially acute myeloid leukemia. Haemoglobin E (b26 Glu?Lys) is common haemoglobin variant in the northeastern part of India and the northern part of West Bengal. Here, we report a case of FA with concomitant haemoglobin E-trait in a 5-year-old child who presented with weakness, epistaxis, malaena and intermittent fever. She had a hyper-pigmented patch over the nape of neck and polydactyly. Complete blood counts revealed pancytopenia. The bone marrow aspiration and trephine biopsy showed marrow hypoplasia. Chromosome analysis showed chromatid and chromosome breaks in 22 % cells suggestive of FA. The results were corroborated with MMC stress test. Thus, we present the first reported case of FA with haemoglobin E-trait.

Journal of Cytology, 2014

Diagnosis of retroperitoneal lesions is one of the most difficult areas in surgical pathology. Bo... more Diagnosis of retroperitoneal lesions is one of the most difficult areas in surgical pathology. Both primary and metastatic tumors can grow silently in retroperitoneum before the appearance of clinical signs and symptoms. Guided aspiration cytology has shown a promising role in diagnosis of lesions in this region. This study was undertaken to evaluate the reliability of guided fine-needle aspiration cytology (FNAC) in the diagnosis of retroperitoneal masses and to study the spectrum of retroperitoneal lesions in a rural tertiary care hospital. This study was done on 71 patients presenting with retroperitoneal masses over a period of 20 months in a tertiary care hospital. Ultrasound-guided FNAC was done and the smears were stained by MGG and H and E stains. Histopathological corroboration could be done on all neoplastic lesions along with some non-neoplastic lesions. Out of 71 cases, 48 cases (67.6%) were found to be neoplastic. Malignant tumors (35 cases) were more common than benign ones (13 cases). Malignant lesions were predominantly composed of lesions of lymph node (17 cases i.e. 48.57%) followed by sarcomas (5 cases) and germ cell tumors. Some uncommon retroperitoneal lesions like adrenal myelolipoma, renal angiomyolipoma, Burkitt's lymphoma and adrenocortical carcinoma were found in our study. Guided FNAC could diagnose all the malignant lesions with 100% accuracy except in 2 cases of poorly differentiated carcinoma which came out to be non-Hodgkin lymphoma on subsequent biopsies. Guided FNAC is an inexpensive, rapid and reliable method for diagnosis of retroperitoneal masses.

Indian Journal of Otology, 2013

ABSTRACT

Cytopathology, 2004

In this study, we evaluated the usefulness of fine needle aspiration cytology (FNAC) in the diagn... more In this study, we evaluated the usefulness of fine needle aspiration cytology (FNAC) in the diagnosis of soft tissue tumours. We have also assessed the various pitfalls of FNAC of soft tissue tumours. This was a retrospective study and here we analysed only 82 histopathology proven cases of FNAC of soft tissue tumours diagnosed in a five and half year period. On histopathological examination, 55 of these cases were malignant and 27 were benign. There was a total of 15 recurrences and histopathology was available prior to FNAC in only eight of these cases. Therefore, excluding these eight cases, malignant tumours were primarily diagnosed by FNAC in 47 cases. The sensitivity, specificity and positive predictive value of FNAC in diagnosis of soft tissue tumours were 91.5%, 92.5% and 95.5%, respectively. Only 22 of 47 cases (46.8%) were correctly categorized. There were two falsepositive and four false-negative cases. One case each of fibromatosis and schwannoma were reported as sarcoma. False-negative cases were fibrosarcoma (1), malignant nerve sheath tumour (2) and haemangiopericytoma (1). FNAC was very useful in distinguishing benign from malignant soft tissue tumours. However, it was not so effective in exact categorization of tumours.

Annals of Pathology and Laboratory Medicine, 2016

Introduction: Gastric cancer is the second leading cause of cancer mortality in the world and its... more Introduction: Gastric cancer is the second leading cause of cancer mortality in the world and its management, especially in advanced stages, has evolved relatively little. In particular, no targeted modality has so far been incorporated for treatment. HER2 over-expression is increasingly recognized as a frequent molecular abnormality, driven as in breast cancer by gene amplification. There is mounting evidence of the role of HER2 over-expression in patients with gastric cancer, and it has been strongly correlated to poorer outcomes and a more aggressive disease. Aims and objective: The purpose of this study is to establish the clinicoepidemiological, histopathological and immunohistochemical particularities of the gastric carcinomas, and to identify the factors with a prognostic value. Methods: The present study included 54 cases of gastric carcinoma, who had undergone endoscopy guided biopsy or gastrectomy. Expression of HER2 oncoprotein by immunohistochemistry and detection of H...