Kavita Sahai - Academia.edu (original) (raw)

Papers by Kavita Sahai

Annals of Indian Academy of Neurology, 2010

International Journal of Oral Health Sciences, 2018

The predominant histological type of oropharyngeal cancer is squamous cell carcinoma and approxim... more The predominant histological type of oropharyngeal cancer is squamous cell carcinoma and approximately 9 times more frequent when compared with other types. Adenocarcinoma common histopathology for digestive system is very rarely reported in this region. In literature, there are limited data about the clinical presentation, histopathology, and treatment modalities for the primary adenocarcinoma of the base of the tongue (BOT). To the best of our knowledge, five cases of adenocarcinoma of the BOT with colonic differentiation have been reported in the world literature till date, and this is the first case report from India. The challenge in these type of cases is to differentiate between the primary adenocarcinoma of BOT which is extremely rare, metastatic lesion to this site from any other site, or its origin from minor salivary glands which is a more common possibility because all these situations have different treatment implications.

Medical journal, Armed Forces India, Oct 1, 2019

BackgroundTimely initiation of appropriate antimicrobial can improve the outcome in terms of redu... more BackgroundTimely initiation of appropriate antimicrobial can improve the outcome in terms of reduced morbidity and mortality in addition to reduced health-care costs. Availability of early preliminary Antimicrobial Susceptibility Test (AST) report will be useful in directing antimicrobial therapy. The aim of the study was to correlate AST by disc diffusion method, directly from positively flagged blood culture bottles, with the AST by automated method.MethodsA total of 144 aerobic blood culture bottles flagged positive by the automated blood culture system were processed. The bacteria were pelleted by two-step centrifugation of the broth from the bottle and used to make a smear for Gram stain as well as an inoculum for antimicrobial sensitivity testing by Kirby Bauer disc diffusion method. Automated identification and AST were also carried out.ResultsOn direct staining, 94 samples showed gram-negative bacilli, 39 showed gram-positive cocci, and 11 showed yeasts or polymicrobial growth. In the case of gram-negative bacteria, there was 99% categorical agreement between direct sensitivity testing and automated sensitivity testing with 1% disagreement. Among the gram-positive cocci, there was 96% categorical agreement with 4% disagreement between the two methods.ConclusionHigh degree of agreement between the two methods is promising and applicable to situations where automated sensitivity testing is not available. Even if the systems are available, this method would prove useful as an adjunct to standard AST reporting. This sensitivity report can be generated earlier than the conventional AST, enabling choice of appropriate antimicrobial.

Medical journal, Armed Forces India, Oct 1, 2021

Indian journal of dermatopathology and diagnostic dermatology, 2015

PubMed, Jul 1, 2003

Polymorphous Low Grade Adenocarcinoma (PLGA) arises characteristically in the minor salivary glan... more Polymorphous Low Grade Adenocarcinoma (PLGA) arises characteristically in the minor salivary glands. Histological diagnosis of this tumour has improved following awareness and well characterized histologic features. However cytologic diagnosis is difficult. Ten cases of PLGA were identified on review of 61 cases of palatal salivary gland tumours aspirated over a 17 year period. Seven of these had been diagnosed as salivary gland tumours but had not been further characterized, while two cases had been diagnosed as adenoid cystic carcinoma initially. In only one case a differential diagnosis between pleomorphic adenoma and PLGA had been considered. Cytologic diagnosis of PLGA is difficult but possible if an attempt is made to identify specific cytologic criteria.

Journal of Digestive Endoscopy, 2014

Adenomatous polyps of the stomach are rare tumors and comprise <10% of gastric polyps. They are u... more Adenomatous polyps of the stomach are rare tumors and comprise <10% of gastric polyps. They are usually located in the antrum and arise in a background of chronic gastritis and intestinal metaplasia. These tend to remain asymptomatic, but do carry significant risk of malignant change wherein underlies their importance. The magnitude of the risk of malignancy is not precisely defined, but is considered to be in the range of 5-15%, which increases with the size of the tumor. In this case report, we would like to highlight a large adenoma of stomach measuring 9 cm. This is the first case to the best of our knowledge to have attained such a huge dimension without any associated gastric pathology. Since synchronous carcinomas are known to exist in a large percentage of adenomas greater than 4 cm in size, this association should be kept in mind by both the gastroenterologist and pathologist so that any focus of malignancy if present, is not advertently missed.

Medical journal, Armed Forces India, Jun 1, 2022

Medical journal, Armed Forces India, 2011

Introduction: DitTuse large B cell lymphomas (DLBCL) eneompass a pathogenetically heterogeneous g... more Introduction: DitTuse large B cell lymphomas (DLBCL) eneompass a pathogenetically heterogeneous group of aggressive tumours that are rapidly fatal if untreated. Gene expression prof'iling studies have identified distinct molecular subtypes of DLBCL, one witb an expression profile similar In normal germinal centre B cells (GCB subtype) and a second mimicking activated peripheral blood B cells (ABC subtype) baving dilTerent prognostic significance allowing risk stratification of lymphoma patients and development of specific therapeutic strategies. Methods: Twenty cases of DLBCL were included in the slndy and categorized inln germinal centre and non germinal centre subtypes using the following antibody panel. CDI0, Bcl~, MUMI and CD138. The germinal centre and non germinal centre subtypes were defined as under Germinal centre (DLBCL) CDI0 + and/or Bcl-6 +, MUMI-, CD138-and Non germinal centre (DLBCL) CDtO, Bcl~ ±, MUMI ±, CDt38 ±. Result: In our study of twenty cases thirteen were germinal centre DLBCL while seven of the twenty cases were non germinal centre type of DLBCL. 75 % of the nodal cases and 62.5 % of extra nodal cases were germinal centre B cell type. Overall survival in the GCB and non GCB groups was 91 % and 14 % respectively and the dilTerence was highly significant statistically. Conclusion: This study validates the existence of prognostic subgroups of DLBCL in the Indian population.

PubMed, Nov 1, 2005

Thirty years female underwent allogenic peripheral blood stem cell transplantation for chronic my... more Thirty years female underwent allogenic peripheral blood stem cell transplantation for chronic myeloid leukaemia--chronic phase. She developed grade II acute skin graft-versus-host disease (GVHD) which was treated with cyclosporine and a short course of steroids. She developed extensive chronic GVHD of the skin and liver three hundred days post-transplant. She was managed with the standard immunosuppressants with partial response of liver dysfunction but no response of skin lesions. She showed a good response to therapy with resolution of skin lesions after treatment with thalidomide.

Medical journal, Armed Forces India, Dec 1, 2016

These bacteria exhibit an extraordinary metabolic versatility, allowing their adaptation to a wid... more These bacteria exhibit an extraordinary metabolic versatility, allowing their adaptation to a wide range of environments and emerged in the 1980s as life-threatening and difficult-to-treat pathogens among patients suffering from cystic fibrosis. 2 It is a non-fermenting, m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 7 2 (2 0 1 6) s 5 0-s 5 3

Diagnostic Cytopathology, 2001

Metastatic tumor deposits in the umbilicus are not uncommon. Fine‐needle aspiration cytology is a... more Metastatic tumor deposits in the umbilicus are not uncommon. Fine‐needle aspiration cytology is an important, simple, cost‐effective diagnostic tool for delineating the value of umbilical nodules. However, only a few reviews and case reports of diagnosis of umbilical metastases by fine‐needle aspiration cytology are available. A review of 52 cases of umbilical nodule aspirates over a 16‐yr period forms the basis of this brief report. Diagn. Cytopathol. 25:309–310, 2001. © 2001 Wiley‐Liss, Inc.

Medical journal, Armed Forces India, 2008

Background: There is a great deal of disparity in the incidence of breast cancer in rural and urb... more Background: There is a great deal of disparity in the incidence of breast cancer in rural and urban India on one hand and between India and Western population on the other. Methods: We analysed steroid receptor status in cases of breast cancer in a small sample of patients in armed forces. Infiltrating duct carcinomas of breast recorded histologically in mastectomy specimens in last two years were accessioned in the present study with reference to patient and tumour characteristics. Result: In contrast to the higher rates reported in western literature, only 33 % of the tumours expressed estrogen receptors (ER) and progesterone receptors (PR), of which 24% were ER positive and 30% PR positive. Negative steroid receptor status did not correlate with presence or absence of metastatic nodes, however it was predominant amongst the high grade infiltrating duct carcinomas in this study. Necrosis and lymphovascular invasion demonstrated an inverse relationship with the ER/ PR reactivity. 70% of the node positive cases expressed Her-2/ Neu, reflecting a higher immunoreactivity in this subset of patients. Aneusomy for chromosomes 1, 11 and 17 was common in node positive cases. Conclusion: Evaluation of chromosomal aberrations by Fluorescent In Situ Hybridization (FISH) technique correlates well with traditional histological parameters.

Clinical Cancer Investigation Journal, 2015

Annals of Pathology and Laboratory Medicine, Nov 6, 2016

Introduction: About 300 million people worldwide have chronic hepatitis B virus (HBV) infection w... more Introduction: About 300 million people worldwide have chronic hepatitis B virus (HBV) infection with varying degree of liver damage. The presence of continuing viral replication correlates with continuing disease activity and is associated with Hepatitis B e antigen (HBeAg) and hepatitis B virus DNA (HBV-DNA) in serum. Subsequently, the patient may undergo a spontaneous or therapy induced remission, which is accompanied by loss of HBV-DNA and HBeAg. This prospective study was undertaken to correlate all the above parameters so as to have an insight to monitoring of therapy in HBeAg positive chronic hepatitis B (CHB). Aims and objectives: 1. To determine changes in biochemical, serological and virological profile in HBeAg positive CHB with therapy. 2. Determination of histology in liver biopsies in all cases and correlation with immunohistochemical detection of HBsAg and HBcAg with above parameters. Methods: 42 patients of HBeAg positive CHB were enrolled and were followed up for 24 months. Blood samples were collected for alanine aminotransferase (ALT), hepatitis B surface antigen (HBsAg), Anti-hepatitis B core antigen (HBcAg), HBeAg and HBV-DNA. Liver biopsies were done in all individuals. Immunohistochemical staining for HBsAg and HBcAg were done where indicated. The statistical analysis was done using SPSS (Statistical Package for Social Sciences) Version 15.0 statistical Analysis Software. Results: There was a statistically significant improvement in the biochemical, serological and virological profile of the patients after therapy. However, the necroinflammatory activity showed improvement but was not statistically significant. Immunohistochemistry showed good correlation with viral load.

Clinical Cancer Investigation Journal, 2015

Synovial sarcoma (SS) is a morphologically characteristic sarcoma of uncertain lineage, typically... more Synovial sarcoma (SS) is a morphologically characteristic sarcoma of uncertain lineage, typically containing both epithelial and mesenchymal elements. The most common location is the extremities, and very few cases have been reported from the head and neck region. The monophasic spindle cell variant often poses a diagnostic challenge as it mimics poorly differentiated carcinoma or sarcoma. We report a case of monophasic SS of tongue in a 74-year-old female. On Immunohistochemistry, the tumor cells showed strong, diffuse positivity for vimentin, Bcl-2, CD99, and focal positivity for epithelial membrane antigen. Tumor cells were negative for pan cytokeratin, smooth muscle actin, S100, HMB-45, CD34. A high index of clinical suscipicion is required to reach an accurate diagnosis for institution of appropriate therapy.

The Annals of Thoracic Surgery, Jul 1, 2018

Calcified amorphous tumors (CATs) of the heart are rare, nonneoplastic, intracavitary lesions, pr... more Calcified amorphous tumors (CATs) of the heart are rare, nonneoplastic, intracavitary lesions, previously thought of as pseudotumors, hamartomas, or calcified thrombi, only reported in few adults in the available literature. This report describes a case of a pedunculated oscillating CAT arising from the left atrial appendage that prolapses through the mitral valve and causes severe mitral regurgitation in a newborn. This is the only case of cardiac CAT described in a neonate.

Postgraduate Medical Journal, Mar 1, 2002

Journal of Cancer Research and Therapeutics, 2015

Angiomyofibroblastoma is a very rare benign mesenchymal tumor of the superficial soft-tissues. Mo... more Angiomyofibroblastoma is a very rare benign mesenchymal tumor of the superficial soft-tissues. Most of the cases have been reported in the vulva. It presents usually in the reproductive age group. Histologically it is characterized by alternating hypo and hypercellular areas admixed with thin walled blood vessels with a perivascular concentration of stromal cells. We report a case of this lesion arising in the vagina in a 46-year-old woman.

Annals of Indian Academy of Neurology, 2010

International Journal of Oral Health Sciences, 2018

The predominant histological type of oropharyngeal cancer is squamous cell carcinoma and approxim... more The predominant histological type of oropharyngeal cancer is squamous cell carcinoma and approximately 9 times more frequent when compared with other types. Adenocarcinoma common histopathology for digestive system is very rarely reported in this region. In literature, there are limited data about the clinical presentation, histopathology, and treatment modalities for the primary adenocarcinoma of the base of the tongue (BOT). To the best of our knowledge, five cases of adenocarcinoma of the BOT with colonic differentiation have been reported in the world literature till date, and this is the first case report from India. The challenge in these type of cases is to differentiate between the primary adenocarcinoma of BOT which is extremely rare, metastatic lesion to this site from any other site, or its origin from minor salivary glands which is a more common possibility because all these situations have different treatment implications.

Medical journal, Armed Forces India, Oct 1, 2019

BackgroundTimely initiation of appropriate antimicrobial can improve the outcome in terms of redu... more BackgroundTimely initiation of appropriate antimicrobial can improve the outcome in terms of reduced morbidity and mortality in addition to reduced health-care costs. Availability of early preliminary Antimicrobial Susceptibility Test (AST) report will be useful in directing antimicrobial therapy. The aim of the study was to correlate AST by disc diffusion method, directly from positively flagged blood culture bottles, with the AST by automated method.MethodsA total of 144 aerobic blood culture bottles flagged positive by the automated blood culture system were processed. The bacteria were pelleted by two-step centrifugation of the broth from the bottle and used to make a smear for Gram stain as well as an inoculum for antimicrobial sensitivity testing by Kirby Bauer disc diffusion method. Automated identification and AST were also carried out.ResultsOn direct staining, 94 samples showed gram-negative bacilli, 39 showed gram-positive cocci, and 11 showed yeasts or polymicrobial growth. In the case of gram-negative bacteria, there was 99% categorical agreement between direct sensitivity testing and automated sensitivity testing with 1% disagreement. Among the gram-positive cocci, there was 96% categorical agreement with 4% disagreement between the two methods.ConclusionHigh degree of agreement between the two methods is promising and applicable to situations where automated sensitivity testing is not available. Even if the systems are available, this method would prove useful as an adjunct to standard AST reporting. This sensitivity report can be generated earlier than the conventional AST, enabling choice of appropriate antimicrobial.

Medical journal, Armed Forces India, Oct 1, 2021

Indian journal of dermatopathology and diagnostic dermatology, 2015

PubMed, Jul 1, 2003

Polymorphous Low Grade Adenocarcinoma (PLGA) arises characteristically in the minor salivary glan... more Polymorphous Low Grade Adenocarcinoma (PLGA) arises characteristically in the minor salivary glands. Histological diagnosis of this tumour has improved following awareness and well characterized histologic features. However cytologic diagnosis is difficult. Ten cases of PLGA were identified on review of 61 cases of palatal salivary gland tumours aspirated over a 17 year period. Seven of these had been diagnosed as salivary gland tumours but had not been further characterized, while two cases had been diagnosed as adenoid cystic carcinoma initially. In only one case a differential diagnosis between pleomorphic adenoma and PLGA had been considered. Cytologic diagnosis of PLGA is difficult but possible if an attempt is made to identify specific cytologic criteria.

Journal of Digestive Endoscopy, 2014

Adenomatous polyps of the stomach are rare tumors and comprise <10% of gastric polyps. They are u... more Adenomatous polyps of the stomach are rare tumors and comprise <10% of gastric polyps. They are usually located in the antrum and arise in a background of chronic gastritis and intestinal metaplasia. These tend to remain asymptomatic, but do carry significant risk of malignant change wherein underlies their importance. The magnitude of the risk of malignancy is not precisely defined, but is considered to be in the range of 5-15%, which increases with the size of the tumor. In this case report, we would like to highlight a large adenoma of stomach measuring 9 cm. This is the first case to the best of our knowledge to have attained such a huge dimension without any associated gastric pathology. Since synchronous carcinomas are known to exist in a large percentage of adenomas greater than 4 cm in size, this association should be kept in mind by both the gastroenterologist and pathologist so that any focus of malignancy if present, is not advertently missed.

Medical journal, Armed Forces India, Jun 1, 2022

Medical journal, Armed Forces India, 2011

Introduction: DitTuse large B cell lymphomas (DLBCL) eneompass a pathogenetically heterogeneous g... more Introduction: DitTuse large B cell lymphomas (DLBCL) eneompass a pathogenetically heterogeneous group of aggressive tumours that are rapidly fatal if untreated. Gene expression prof'iling studies have identified distinct molecular subtypes of DLBCL, one witb an expression profile similar In normal germinal centre B cells (GCB subtype) and a second mimicking activated peripheral blood B cells (ABC subtype) baving dilTerent prognostic significance allowing risk stratification of lymphoma patients and development of specific therapeutic strategies. Methods: Twenty cases of DLBCL were included in the slndy and categorized inln germinal centre and non germinal centre subtypes using the following antibody panel. CDI0, Bcl~, MUMI and CD138. The germinal centre and non germinal centre subtypes were defined as under Germinal centre (DLBCL) CDI0 + and/or Bcl-6 +, MUMI-, CD138-and Non germinal centre (DLBCL) CDtO, Bcl~ ±, MUMI ±, CDt38 ±. Result: In our study of twenty cases thirteen were germinal centre DLBCL while seven of the twenty cases were non germinal centre type of DLBCL. 75 % of the nodal cases and 62.5 % of extra nodal cases were germinal centre B cell type. Overall survival in the GCB and non GCB groups was 91 % and 14 % respectively and the dilTerence was highly significant statistically. Conclusion: This study validates the existence of prognostic subgroups of DLBCL in the Indian population.

PubMed, Nov 1, 2005

Thirty years female underwent allogenic peripheral blood stem cell transplantation for chronic my... more Thirty years female underwent allogenic peripheral blood stem cell transplantation for chronic myeloid leukaemia--chronic phase. She developed grade II acute skin graft-versus-host disease (GVHD) which was treated with cyclosporine and a short course of steroids. She developed extensive chronic GVHD of the skin and liver three hundred days post-transplant. She was managed with the standard immunosuppressants with partial response of liver dysfunction but no response of skin lesions. She showed a good response to therapy with resolution of skin lesions after treatment with thalidomide.

Medical journal, Armed Forces India, Dec 1, 2016

These bacteria exhibit an extraordinary metabolic versatility, allowing their adaptation to a wid... more These bacteria exhibit an extraordinary metabolic versatility, allowing their adaptation to a wide range of environments and emerged in the 1980s as life-threatening and difficult-to-treat pathogens among patients suffering from cystic fibrosis. 2 It is a non-fermenting, m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 7 2 (2 0 1 6) s 5 0-s 5 3

Diagnostic Cytopathology, 2001

Metastatic tumor deposits in the umbilicus are not uncommon. Fine‐needle aspiration cytology is a... more Metastatic tumor deposits in the umbilicus are not uncommon. Fine‐needle aspiration cytology is an important, simple, cost‐effective diagnostic tool for delineating the value of umbilical nodules. However, only a few reviews and case reports of diagnosis of umbilical metastases by fine‐needle aspiration cytology are available. A review of 52 cases of umbilical nodule aspirates over a 16‐yr period forms the basis of this brief report. Diagn. Cytopathol. 25:309–310, 2001. © 2001 Wiley‐Liss, Inc.

Medical journal, Armed Forces India, 2008

Background: There is a great deal of disparity in the incidence of breast cancer in rural and urb... more Background: There is a great deal of disparity in the incidence of breast cancer in rural and urban India on one hand and between India and Western population on the other. Methods: We analysed steroid receptor status in cases of breast cancer in a small sample of patients in armed forces. Infiltrating duct carcinomas of breast recorded histologically in mastectomy specimens in last two years were accessioned in the present study with reference to patient and tumour characteristics. Result: In contrast to the higher rates reported in western literature, only 33 % of the tumours expressed estrogen receptors (ER) and progesterone receptors (PR), of which 24% were ER positive and 30% PR positive. Negative steroid receptor status did not correlate with presence or absence of metastatic nodes, however it was predominant amongst the high grade infiltrating duct carcinomas in this study. Necrosis and lymphovascular invasion demonstrated an inverse relationship with the ER/ PR reactivity. 70% of the node positive cases expressed Her-2/ Neu, reflecting a higher immunoreactivity in this subset of patients. Aneusomy for chromosomes 1, 11 and 17 was common in node positive cases. Conclusion: Evaluation of chromosomal aberrations by Fluorescent In Situ Hybridization (FISH) technique correlates well with traditional histological parameters.

Clinical Cancer Investigation Journal, 2015

Annals of Pathology and Laboratory Medicine, Nov 6, 2016

Introduction: About 300 million people worldwide have chronic hepatitis B virus (HBV) infection w... more Introduction: About 300 million people worldwide have chronic hepatitis B virus (HBV) infection with varying degree of liver damage. The presence of continuing viral replication correlates with continuing disease activity and is associated with Hepatitis B e antigen (HBeAg) and hepatitis B virus DNA (HBV-DNA) in serum. Subsequently, the patient may undergo a spontaneous or therapy induced remission, which is accompanied by loss of HBV-DNA and HBeAg. This prospective study was undertaken to correlate all the above parameters so as to have an insight to monitoring of therapy in HBeAg positive chronic hepatitis B (CHB). Aims and objectives: 1. To determine changes in biochemical, serological and virological profile in HBeAg positive CHB with therapy. 2. Determination of histology in liver biopsies in all cases and correlation with immunohistochemical detection of HBsAg and HBcAg with above parameters. Methods: 42 patients of HBeAg positive CHB were enrolled and were followed up for 24 months. Blood samples were collected for alanine aminotransferase (ALT), hepatitis B surface antigen (HBsAg), Anti-hepatitis B core antigen (HBcAg), HBeAg and HBV-DNA. Liver biopsies were done in all individuals. Immunohistochemical staining for HBsAg and HBcAg were done where indicated. The statistical analysis was done using SPSS (Statistical Package for Social Sciences) Version 15.0 statistical Analysis Software. Results: There was a statistically significant improvement in the biochemical, serological and virological profile of the patients after therapy. However, the necroinflammatory activity showed improvement but was not statistically significant. Immunohistochemistry showed good correlation with viral load.

Clinical Cancer Investigation Journal, 2015

Synovial sarcoma (SS) is a morphologically characteristic sarcoma of uncertain lineage, typically... more Synovial sarcoma (SS) is a morphologically characteristic sarcoma of uncertain lineage, typically containing both epithelial and mesenchymal elements. The most common location is the extremities, and very few cases have been reported from the head and neck region. The monophasic spindle cell variant often poses a diagnostic challenge as it mimics poorly differentiated carcinoma or sarcoma. We report a case of monophasic SS of tongue in a 74-year-old female. On Immunohistochemistry, the tumor cells showed strong, diffuse positivity for vimentin, Bcl-2, CD99, and focal positivity for epithelial membrane antigen. Tumor cells were negative for pan cytokeratin, smooth muscle actin, S100, HMB-45, CD34. A high index of clinical suscipicion is required to reach an accurate diagnosis for institution of appropriate therapy.

The Annals of Thoracic Surgery, Jul 1, 2018

Calcified amorphous tumors (CATs) of the heart are rare, nonneoplastic, intracavitary lesions, pr... more Calcified amorphous tumors (CATs) of the heart are rare, nonneoplastic, intracavitary lesions, previously thought of as pseudotumors, hamartomas, or calcified thrombi, only reported in few adults in the available literature. This report describes a case of a pedunculated oscillating CAT arising from the left atrial appendage that prolapses through the mitral valve and causes severe mitral regurgitation in a newborn. This is the only case of cardiac CAT described in a neonate.

Postgraduate Medical Journal, Mar 1, 2002

Journal of Cancer Research and Therapeutics, 2015

Angiomyofibroblastoma is a very rare benign mesenchymal tumor of the superficial soft-tissues. Mo... more Angiomyofibroblastoma is a very rare benign mesenchymal tumor of the superficial soft-tissues. Most of the cases have been reported in the vulva. It presents usually in the reproductive age group. Histologically it is characterized by alternating hypo and hypercellular areas admixed with thin walled blood vessels with a perivascular concentration of stromal cells. We report a case of this lesion arising in the vagina in a 46-year-old woman.