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Ambāla, India

Khabra N.C.,MMIMS and R Mullana | Garg L.N.,MMIMS and R Mullana | Bansal H.,MMIMS and R Mullana | Nauhria S.,MMIMS and R Mullana | And 2 more authors.
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2015

Gastrointestinal stromal tumors(GISTs) are a heterogeneous group of tumors, previously thought to be tumors of smooth muscle differentiation, but now considered to arise from the interstitial cells of Cajal, that act as pace makers for peristalsis. Most frequent site is stomach (95%) followed by small intestine and less frequently involves esophagus, colon, rectum and rarely retro peritoneum respectively. GISTs are rare mesenchymal tumors, slightly more common in males; with peak age of 60 yrs. Majority of the GISTs have oncogenic mutations of the gene encoding tyrosine kinase c-KIT (CD 117). They are classified as tumors of low and high risk of malignancy depending on the size (>5cms) and mitotic count (>5/50 hpf) and associated features like tumor site and metastasis are also significant prognostic parameters. Other macroscopic alterations are tumor necrosis, mucosal ulceration, cystic degeneration, myxoid change and area of hemorrhage and calcification. Histologically, most GISTs are spindle cell tumors (67%) followed by other variants as epithelioid (13%), mixed and myxoid forms respectively and very rarely signet ring cell and extremely rare GANT variant. Other microscopic secondary alterations include cytonuclear pleomorphism, presence of multinucleated giant cells, inflammatory infiltrate and metastasis respectively. Criteria for assessment of degree of malignancy is number of mitoses per 50 hpf as major prognostic factor and tumor size in centimeters. They are further sub classified as tumors having very low degree of malignancy (9%), low degree (21%), intermediate degree and high degree as (47%). IHC study shows CD 117 positivity (97%), CD 34 positivity (63%) and high specificity for two types of antibodies namely SMA specific for smooth muscle tumors (24%) and S-100 for peripheral nerve sheath tumors (13%) respectively, because these tumors are often misdiagnosed as GISTs. Source


Chand N.,MMIMS and R Mullana | Singla S.,MMIMS and R Mullana | Sangwan K.,MMIMS and R Mullana | Bansal H.,MMIMS and R Mullana | And 3 more authors.
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2015

In today's era of advanced diagnostic procedures in the field of hematology, it is important to have proper diagnosis of various hematological and non-hematological disorders. It is the bone marrow examination that is considered an important valuable diagnostic tool, for evaluation and final diagnosis of various hematological and non-hematological disorders. This may directly or indirectly involve complete bone marrow analysis. Various indications for bone marrow examination include proper diagnosis, staging and therapeutic monitoring of different hematological disorders like disorders of hemopoiesis, leukopoiesis, lymphoproliferative disorders, myeloproliferatives disorders and plasma cell dyscrasias like multiple myeloma respectively. The non-hematological disorders include granulomatous disorders (tuberculosis and sarcoidosis), infection like AIDS as a cause of unexplained fever of unknown origin, parasitic infestations like malaria, leishmaniasis, histoplasmosis and various other disseminated fungal infections. It also includes certain storage diseases and metastatic secondary deposits from different malignancies respectively. A thorough bone marrow examination includes peripheral blood film (PBF), direct particle, buffy coat, bone marrow aspiration (BME) smears, BM trephine biopsy imprints and marrow volumetric data respectively. Other disorders like focal myeloma, lymphoma and marrow fibrosis can also be studied, but BM trephine biopsy is essential. To diagnose hematological and non-hematological disorders using BM aspiration and trephine biopsy was carried out. Study was conducted in the department of pathology MMIMS&R, (MMU) Mullana, Ambala (HR). Sixty cases were taken, during the period from June 2010 to Dec 2011. Both inclusion and exclusion criteria strictly followed. Clinical data, hematological investigations and BM analysis details were recorded and analyzed. Bone marrow aspiration included a study of wide spectrum of hematological and non-hematological disorders, but it has some limitations. In disorders like focal myeloma, lymphoma and marrow fibrosis, BM aspiration study alone fails to demonstrate disease processes. For these cases, BM trephine biopsy is essential. Hypocellular marrow, unexplained pancytopenias, leukoerythroblastic blood picture and marrow fibrosis are also strong indications for B M biopsy. Source


Khabra N.C.,MMIMS and R Mullana | Gulati B.,MMIMS and R Mullana | Bedi S.,MMIMS and R Mullana | Garg L.N.,MMIMS and R Mullana | And 3 more authors.
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2015

Ovaries are common site for non-neoplastic and neoplastic lesions,that vary in their incidence, clinical presentation and exhibit a wide range of histological features. These lesions sometimes behave adversely and generally escape detection, until they attain a large sized pelvic mass and sometime associated with abnormal hormonal manifestations. Ovarian lesions have adverse histopathologies reflecting different cells of their origin. To distinguish a non-neoplastic lesion from neoplastic clinically, is a great challenge. It is also important for guiding appropriate therapy and future outcome. To study and characterize various ovarian lesions and to provide a specific diagnosis based on Histomorphological features using special stains and serological markers. Fifty Oophorectomy specimens of all age groups were received in Pathology department, over a period of two yrs. All clinical, gross and histological findings were recorded, compiled and analyzed to achieve a final diagnosis. All Specimens were formalin fixed overnight, processed and stained with H & E stain. Special staining procedures like Reticulin, PAS, mucicarmine, Alcian blue and IHC markers were also used. Out of 50 cases, 62% were neoplastic and 38% non-neoplastic respectively. Majority of neoplastic lesions (62%) were found in women aged between 31-50 years. Commonest non neoplastic lesion was follicular cyst (36.84%) followed by endometriosis (31.57%). Among neoplastic tumors, largest proportion was benign (70.96%) and malignant (29.03%) respectively. Primary ovarian malignancies were more common than secondaries. Overall surface epithelial tumors constituted majority of primary neoplasms accounting for 51.61%, followed by germ cell tumors (32.25%) and sex cord stromal tumors (6.45%). Serous cyst was commonest benign tumor followed by mature cystic teratoma and mucinous cyst adenoma. Commonest malignant tumor was serous cystadenocarcinoma. Histological assessment of ovarian lesions remains mainstay of final diagnosis till date. With proper histological categorization in conjunction with other diagnostic modalities like Ultrasound examination, special staining & CA-125 biomarker study, a more accurate diagnosis can be made, that may be helpful for proper management and improving prognosis. Source

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