Journal of Pathology of Nepal https://www.nepjol.info/index.php/JPN <p>The Journal of Pathology of Nepal is the official publication of the Association of Clinical Pathologists of Nepal (ACPN) and all the published articles are Open Access. Please go through the author guidlenes for necessary information and fee for submission, processing, and publication,&nbsp;</p> <p><a href="http://creativecommons.org/licenses/by/4.0/" rel="license"><img style="border-width: 0;" src="https://i.creativecommons.org/l/by/4.0/88x31.png" alt="Creative Commons Licence"></a><br>All articles published in the Journal of Pathology are licensed under a <a href="http://creativecommons.org/licenses/by/4.0/" rel="license">Creative Commons Attribution 4.0 International License</a>.<br>Journal of Pathology of Nepal is indexed on&nbsp;<a title="Index Copernicus-JPN" href="https://journals.indexcopernicus.com/search/details?id=45557">Index Copernicus</a>,&nbsp;<a title="DOAJ-JPN" href="https://doaj.org/toc/2091-0908" target="_blank" rel="noopener">DOAJ.</a></p> Association of Clinical Pathologists of Nepal (ACPN) en-US Journal of Pathology of Nepal 2091-0797 Inherited bone marrow failure syndromes. An overview https://www.nepjol.info/index.php/JPN/article/view/31635 <p>Inherited bone marrow failure syndromes are a diverse set of genetic disorders characterized by insufficient&nbsp;blood cell production leading to cytopenias/pancytopenia. Bone marrow failure can be restricted to one&nbsp;or two blood cell lineages, with symptoms specific to the particular cell lineage or it can affect all cell&nbsp;lineages, causing clinical symptoms similar to aplastic anemia. Inherited bone marrow failure syndromes are genetically heterogeneous diseases resulting from germline mutations that affect key cellular pathways namely ribosomal biogenesis, telomerase biology, DNA repair, and structural proteins. Common Inherited bone marrow failure syndromes are Diamond-Blackfan anemia, Fanconi anemia, Dyskeratosis&nbsp;Congenita, and Shwachman-Diamond syndrome. These different syndromes have variable prognoses and&nbsp;risks of developing hematological or solid malignancies. Thus the accurate diagnosis of these diseases&nbsp;differentiating it from other Inherited bone marrow failure syndromes and other causes of bone marrow&nbsp;failure is of utmost importance for management and surveillance of long-term squeal of the disease.&nbsp;Other causes of BMF can be acquired. The most common forms of Bone marrow failure can occur from&nbsp;chemicals, radiation, drugs, viral infections, immune disorders, myelodysplastic syndrome, paroxysmal&nbsp;nocturnal hemoglobinuria, or large granular lymphocytic leukemia. Moreover, these Inherited bone&nbsp;marrow failure syndromes are often heritable, affecting other family members, thus requiring insightful&nbsp;genetic counseling. This review discusses the frequent Inherited bone marrow failure syndromes along&nbsp;with their differential diagnosis.</p> Shovana Karki Copyright (c) 2020 Shovana Karki 2021-03-20 2021-03-20 11 1 1873 1880 10.3126/jpn.v11i1.31635 Isocitrate dehydrogenase 1and 2 gene mutation status– a critical parameter in the diagnosis and prognosis of adult gliomas https://www.nepjol.info/index.php/JPN/article/view/28992 <p>Isocitrate dehydrogenase 1 and 2 mutations are known to be early events in gliomagenesis and have&nbsp;a definite role in tumor progression.Isocitrate dehydrogenase1/2 mutation status is considered to be&nbsp;one of the most powerful independent positive predictor of outcome amongst all molecular markers&nbsp;described in association with gliomas. The inclusion of this parameter in the 2016 update of the World&nbsp;Health Organization Classification of Tumors of The Central Nervous System reinforced its importance&nbsp;in glioma classification and prognostication. As a result, now there is enough evidence to prove that&nbsp;Isocitrate dehydrogenase-mutant and Isocitrate dehydrogenase- wildtypegliomas are two biologically&nbsp;distinct categories of gliomas with likely different pathways of tumorigenesis, different clinical outcomes, and respond differently to similar treatment strategies. Increasing knowledge aboutthe role of IDH1/2&nbsp;mutation in gliomagenesis has resulted in many novel targeting strategies being developed and evaluated&nbsp;forusefulness in the clinical setting. This literature review aims to highlight the diagnostic and prognostic&nbsp;importance of Isocitrate dehydrogenase1/2 gene mutations in adult gliomas.&nbsp;</p> Poornima Vijayan Laila Ilias Anupama Ponniah Copyright (c) 2021 Poornima Vijayan 2021-03-20 2021-03-20 11 1 1881 1885 10.3126/jpn.v11i1.28992 Study of histomorphological spectrum of eyelid lesions https://www.nepjol.info/index.php/JPN/article/view/31244 <p><strong>Background:</strong> Eyelid pathologies are the most common surgical specimens encountered among all of the&nbsp;ophthalmic lesions and constitute a wide range of diseases by their unique histologic features. This study aims to find out the histopathological spectrum of eyelid lesions, their demographic distribution, and preferential location prevalent in our community.<br><strong>Materials and Methods:</strong> This is an observational study in which we retrospectively evaluated the data of 692 patients retrieved from the histopathology department of National Reference Laboratory, Kathmandu,&nbsp;from May 2016 to April 2019.<br><strong>Results:</strong> A total of 701 histologic diagnoses comprised of benign, precursor, and malignant lesions and accounted for 86.6%, 2.6%, and 10.8% respectively with preponderance in females. The common benign lesions included melanocytic nevus (17.7%), epidermal cyst (11%), hemangioma (8.9%), dermoid cyst&nbsp;(8.2%), chalazion (6.7%), and squamous papilloma (6.4%). Tumour of epidermal origin was the most&nbsp;common neoplastic lesion accounting for 31.2%. Basal cell carcinoma (50%) followed by sebaceous&nbsp;carcinoma (27.6%) and squamous cell carcinoma (14.5%) constituted the majority of malignant lesions&nbsp;prevalent above the age of 60 years with the preferential site of the upper eyelid for basal cell carcinoma&nbsp;and squamous cell carcinoma; and lower eyelid for sebaceous carcinoma.<br><strong>Conclusions:</strong> Benign eyelid lesions are more prevalent than malignant ones with overall female&nbsp; preponderance. Epidermal tumours are common among neoplasms. A malignant tumour, a disease of&nbsp; an elderly individual, is predominated by basal cell carcinoma followed by sebaceous carcinoma, an aggressive tumour with a high recurrence rate in our population.</p> Reshmi shrestha Gita Sayami Copyright (c) 2021 reshmi shrestha 2021-03-20 2021-03-20 11 1 1790 1802 10.3126/jpn.v11i1.31244 Role of cation-exchange high-performance liquid chromatography in detection of hemoglobinopathies- a study of 500 cases in a tertiary care hospital https://www.nepjol.info/index.php/JPN/article/view/29511 <p><strong>Background:</strong> Abnormalities of hemoglobin synthesis are among the most common inherited disorders.&nbsp;Cation exchange high-performance liquid chromatography offers a reliable tool for early, accurate detection&nbsp;thereby aiding in the prevention and management of thalassemia major and various hemoglobinopathies.&nbsp;</p> <p><strong>Materials and methods:</strong> This was a retrospective study carried out in the Department of Pathology, GCSMC Hospital and Research center, Ahmedabad over six years from August 2013 to August 2019. 500&nbsp;cases were studied for the identification of various hemoglobin disorders in patients referred for screening&nbsp;and detection of hemoglobinopathies.<br><strong>Results:</strong> Abnormal hemoglobin fractions were seen in 104/500 (20.8%) cases. The β thalassemia trait was the predominant abnormality with a total of 69 cases (66.3%). β thalassemia major, β thalassemia&nbsp;intermedia, Hb D Punjab- β thalassemia, Acquired Hb F and Hereditary persistence of fetal hemoglobin/δβ thalassemia trait was found in 1 case (0.96%) each. Sickle cell heterozygous was found in 9 cases&nbsp;(8.6%), Sickle cell homozygous in 5 cases (4.8%), and Sickle-ß thalassemia in 6 cases (5.8%). Other&nbsp;variants detected included Hb Q India heterozygous and Hb D Punjab heterozygous in 3 cases (2.9%)&nbsp;each and 2 cases (1.9%) of Hb E heterozygous and Hb J each.&nbsp;</p> <p><strong>Conclusions:</strong> Cation exchange high-performance liquid chromatography is an ideal and widely used methodology for routine clinical laboratory because of the simplicity of the automated system. The majority of the abnormal cases are diagnosed with it except a few inconclusive cases for which molecular and genetic studies are required.</p> Sneha Samir Babaria Puja Bhavesh Jarwani Sadhana Lalit Kothari Shantibhai Patel Copyright (c) 2020 Puja Bhavesh Jarwani 2021-03-20 2021-03-20 11 1 1803 1810 10.3126/jpn.v10i2.29511 A study of histomorphology and immunohistochemistry of papillary squamotransitional cell carcinoma: A rare variant of squamous cell carcinoma of cervix. https://www.nepjol.info/index.php/JPN/article/view/32820 <p><strong>Background:</strong> Papillary squamotransitional cell carcinoma is a histopathological subcategory of squamous<br>cell carcinoma of the uterine cervix that often resembles transitional cell carcinoma of the urinary tract.<br>Histologically, it can be misdiagnosed as transitional cell carcinoma or other papillary lesions of the<br>cervix. Stromal invasion on biopsy is difficult to diagnose due to the exophytic papillary growth of the<br>tumor. It also has a propensity for local recurrence and late metastasis. The study is performed to diagnose<br>and categorize this uncommon variant of carcinoma cervix.<br><strong>Materials and Methods:</strong> Eighteen cases of Papillary squamotransitional cell carcinoma were diagnosed<br>on a punch biopsy specimen on routine hematoxylin and eosin-stained sections. The tumors were<br>categorized into three groups according to the percentage of squamous and transitional components.<br>Further, immunohistochemical evaluation for cytokeratin7 and cytokeratin20 was done.<br><strong>Results:</strong> The mean age of the patients was 51.61 years (range 37-62 years). The most common clinical<br>presentation was postmenopausal bleeding. All the cases showed papillary architecture with fibrovascular<br>cores. The papillae were lined by three cell types: clear, intermediate, and basaloid. Stromal invasion<br>was seen in all the cases. All the cases showed positive immunostaining for cytokeratin7 and negative<br>immunostaining for cytokeratin20.<br><strong>Conclusions:</strong> Papillary squamotransitional cell carcinoma deserves accurate pre-operative biopsy<br>diagnosis due to the risk of misdiagnosis as benign papillary or malignant transitional lesions.<br>Immunohistochemistry plays an important role in the diagnosis of these tumors and is recommended in<br>every case. Late recurrence and metastasis warrants a longer duration of follow up.</p> <p>&nbsp;</p> Avani Tiwari Harendra Kumar Ajay Singh Thakur Amit Choraria Vivek Chodhary Copyright (c) 2021 Avani Tiwari 2021-03-20 2021-03-20 11 1 1811 1817 10.3126/jpn.v11i1.32820 Clinicopathological study of lepromatous leprosy and histoid leprosy in a tertiary care institute https://www.nepjol.info/index.php/JPN/article/view/31929 <p><strong>Background:</strong> Lepromatous leprosy is a clinical course seen in patients with inefficient cellular immunity&nbsp;against Mycobacterium leprae, resulting in anergy. A highly bacilliferrous type of lepromatous leprosy is&nbsp;histoid leprosy. Histoid leprosy was initially reported to manifest after the failure of long-term dapsone&nbsp;monotherapy, irregular therapy, or inadequate therapy. However, it is now well known that histoid leprosy&nbsp;develops de-novo as well. This study was undertaken to know the incidence and clinicopathological&nbsp;characteristics of lepromatous leprosy and histoid leprosy.<br><strong>Materials and Methods:</strong> This was a combined (both retrospective and prospective) study of lepromatous&nbsp;and histoid Leprosy, undertaken in the Department of Pathology, Karnataka Institute of Medical Sciences,&nbsp;Hubballi, over 42 months from January 2013 to June 2016.<br><strong>Results:</strong> Out of the 16 clinically diagnosed lepromatous leprosy cases, only 5 were histologically&nbsp;proven to be the same. Of the seven clinically diagnosed histoid leprosy cases, 4 were histoid leprosy on&nbsp;histopathology and the remaining 3 were lepromatous leprosy. All 4 patients of histoid leprosy were cases&nbsp;of De- Novo histoid leprosy. The commonest skin lesion encountered were erythematous patches (9/16)&nbsp;in lepromatous leprosy and nodules (5/7) in histoid leprosy.<br><strong>Conclusions:</strong> Lepromatous leprosy when diagnosed in an early stage, interrupts the epidemiological&nbsp;chain and avoids the associated disabilities and psychological effects for the patient and family. Histoid&nbsp;leprosy is a rare entity that can also present with no history of prior anti-leprosy treatment, the diagnosis&nbsp;of “de-novo histoid leprosy” should be kept in mind.</p> SindhuShree N Copyright (c) 2021 Sindhu shree N 2021-03-20 2021-03-20 11 1 1818 1824 10.3126/jpn.v11i1.31929 Hemogram components and platelets count variation in anemic patients attending Birat Medical College and Teaching Hospital, Morang, Nepal https://www.nepjol.info/index.php/JPN/article/view/30385 <p><strong>Background:</strong> Anemia being the expression of the underlying disease is a global public health problem<br>affecting both developing as well as developed countries. The RBC indices and platelet count variation<br>among anemic patients are important to know their association for clinical implications.<br><strong>Materials and Methods:</strong> A hospital-based cross-sectional study among anemic patients with hemoglobin<br>&lt;10 gm%, attending Birat Medical College Teaching Hospital, Nepal from 15 May to 15 July 2020 were<br>analyzed for RBC indices and platelet count variation. Demographic data, RBC indices, platelet count<br>variation, and types of anemia were evaluated. Pearson’s correlation coefficient was used for correlating<br>the platelet count with RBC indices. A Chi-square test was used to know about the association between<br>the types of anemia and platelet count variation.<br><strong>Results:</strong> Out of 150 anemic patients, the female to male ratio was 1.5:1, with the most common age<br>group between 40-49 years. There exist high differences between minimum and maximum individual<br>RBC indices (Hb, MCV, MCH, MCH) and platelet count values. The platelet count variation with RBC<br>values and MCV had a statistically significant positive and negative correlation respectively. However,<br>the correlation between platelet count variation with hemoglobin concentration level and type of anemia<br>was positive but statistically not significant.<br><strong>Conclusion:</strong> Findings suggest that platelet count variation with RBC indices and types of anemia<br>correlated well among anemic patients. Such association will enable the clinicians for diagnosing and<br>treatment purposes.</p> <p>&nbsp;</p> Santosh Upadhyaya Kafle Mrinalini Singh Neeta Kafle Amrita Sinha Copyright (c) 2021 Santosh Upadhyaya Kafle, Mrinalini Singh, Neeta Kafle, Amrita Sinha 2021-03-20 2021-03-20 11 1 1825 1829 10.3126/jpn.v11i1.30385 Histopathological spectrum of salivary gland lesions in rural India https://www.nepjol.info/index.php/JPN/article/view/32442 <p><strong>Background:</strong> Salivary gland lesions are of a wide spectrum and affect all the major and minor salivary glands in&nbsp;varying proportions. This study, performed in a rural medical college in Maharashtra, India is intended to see the histopathologic spectrum of salivary gland lesions in the rural population and how it is related to the data from other parts of the country and of the world.&nbsp;</p> <p><strong>Materials and Methods:</strong> This is a retrospective study done in the Department of Pathology of a rural-based medical college, Indian Institute of Medical Science and Research, Warudi, Maharashtra, India for a period of 6 years, from January 2014 to January 2020. Age, sex, location of the lesion, gross and microscopic findings were noted.<br><strong>Results:</strong> A total of 71 lesions were received in the department of pathology during this period. Samples were received from age 11 years to 75 years. Female preponderance with a male: female ratio of 1:1.15 was seen. 57.7% (n=41) were benign, 15.5% (n=11) were malignant and the rest (n=19) were inflammatory in nature. A maximum number of lesions (50.7%) were detected in the Parotid gland. The most common lesion seen was Pleomorphic adenoma (36.62%, n=26) and the most common malignant lesion was Mucoepidermoid carcinoma.<br><strong>Conclusions:</strong> Present study showed benign and non-neoplastic lesions outnumbering the malignant lesions, with female predominance, and a low mean age for malignant lesions of 38.2years. Comparison with other studies within and outside India showed a similar pattern of distribution of salivary gland lesions in the rural population.&nbsp;</p> Deepu Mathew Cherian Rahul M Jadhav Shaikh Murtuza Tooba Fatima Kashinath S Bhople Copyright (c) 2021 Deepu Mathew Cherian, Rahul M Jadhav 2021-03-20 2021-03-20 11 1 1830 1836 10.3126/jpn.v11i1.32442 Blood glucose concentration measured in EDTA/F plasma and serum in a referral clinical laboratory in Nepal https://www.nepjol.info/index.php/JPN/article/view/32351 <p><strong>Background:</strong> Sodium fluoride tubes or serum separator tubes are mostly used for blood glucose&nbsp;estimation in the clinical laboratories of Nepal. The study aimed to investigate the stability of glucose in&nbsp;samples collected in serum separator tubes and sodium fluoride/sodium ethylenediaminetetraacetic tubes by comparing the glucose concentration at 30 minutes and 4 hours collected and handled differently to&nbsp;simulate prolonged sample transport between venipunctures, centrifugation, and measurement.<br><strong>Materials and Methods:</strong> Samples were collected from healthy volunteers into two different serum separator tubes and two different sodium fluoride/sodium ethylenediaminetetraacetic tubes. Glucose&nbsp;concentration was measured at 30 minutes after venipuncture and compared with results from the same&nbsp;samples analyzed at four hours and with the results from tubes centrifuged with a delay of 4 hours.&nbsp;Differences between baseline and respective delayed analyzed glucose values for each tube type were&nbsp;tested using the Student’s paired t-test and Deming regression.<br><strong>Results:</strong> When comparing plasma glucose at 30 minutes, glycolysis caused a relative reduction of the&nbsp;glucose concentration in serum at 30 minutes of 3.1 %, which is only slightly less than at 4 hours (3.7 %).&nbsp;This is still substantially more than the reduction in plasma at 4 hours (1.3 %). Surprisingly, the difference&nbsp;between plasma glucose at 30 minutes and serum glucose at 4 hours was only 1.9% which is not clinically&nbsp;significant.<br><strong>Conclusions:</strong> The Na-F/Na2 EDTA tubes and serum separator tubes can be used interchangeably for&nbsp;analysis of blood glucose up to 4 hours if centrifuged within 30 minutes.</p> Vivek Pant Keyoor Gautam Santosh Pradhan Devish Pyakurel Abha Shrestha Copyright (c) 2020 vivek pant, Keyoor Gautam, Santosh Pradhan, Devish Pyakurel, Abha Shrestha 2021-03-20 2021-03-20 11 1 1837 1841 10.3126/jpn.v10i2.32351 Identification of types and frequency of pre-analytical errors in hematology laboratory at a tertiary hospital of Nepal https://www.nepjol.info/index.php/JPN/article/view/32399 <p><strong>Background:</strong> In the laboratory, errors can occur at any stage of sample processing; pre-analytical,&nbsp;analytical, and post-analytical. Since the pre-analytical phase is the most common source of laboratory&nbsp;errors, the goal of this study is to identify the types and frequency of pre-analytical errors in the hematology&nbsp;laboratory.<br><strong>Materials and Methods:</strong> This is a cross-sectional descriptive study done at Nepal Medical College&nbsp;Teaching hospital for a duration of nine months (January 2020 to September 2020). All blood samples&nbsp;received at the hematology laboratory were included whereas biochemistry and special tests blood samples&nbsp;were excluded. Samples were checked for misidentification (incorrectly labeled vials/vials without&nbsp;labels/incorrectly filled forms), incorrect samples (wrong choice of vials), clotted samples, inadequate&nbsp;samples, diluted samples, hemolyzed samples. The errors that occurred in these samples (both inpatient and outpatient) were noted down and measures were taken accordingly before analyzing the sample.<br><strong>Results:</strong> The total number of samples received was 15,337. Pre-analytical errors were seen in 857 samples&nbsp;(5.5%). Inadequate samples (25%) were the most common error followed by incorrect samples (20%),&nbsp;hemolyzed samples (20%), misidentification (14%), clotted samples (12%), and diluted samples (9%). Complete blood count test was most affected. Samples from the inpatient department were most affected.<br><strong>Conclusions:</strong> The preanalytical error rate in the hematology unit was 5.5% with an inadequate sample being the commonest error. Most of the errors were seen in the test requested for a complete blood count.&nbsp;Samples from the inpatient department showed the most errors.</p> Kricha Pande Prabesh Dahal Laxman Pokharel Copyright (c) 2021 Kricha Pande 2021-03-20 2021-03-20 11 1 1842 1846 10.3126/jpn.v11i1.32399 The Frequency of micronuclei in oral mucosal smears of female municipal sweepers with betel quid chewing practice https://www.nepjol.info/index.php/JPN/article/view/31677 <p><strong>Background:</strong> Oral cancer is common worldwide. Study of micronuclei in exfoliated buccal mucosal cells&nbsp;holds great scope in bio monitoring their carcinogenic potential. Betel quid chewing is one of the most&nbsp;common factors contributing to oral cancers. Ours being a developing country, a study was undertaken&nbsp;among female municipal sweepers, majority of who are betel quid chewers, unaware of the harmful&nbsp;effects of the same. We attempted to cytologically access the presence and compare the proportion of&nbsp;micronuclei in the right, left buccal mucosa and hard palate of female municipal sweepers with and&nbsp;without betel quid chewing practice.<br><strong>Materials and Methods:</strong> This was a cross sectional study with purposive sampling. Buccal smears were&nbsp;analysed from 30 betel quid chewers &amp; non chewer females for micronuclei. Mean and standard deviation<br>were calculated. Independent T test was used for comparison between groups. P value less than 0.05 was considered statistically significant.<br><strong>Results:</strong> Frequency of micronuclei in betel quid chewers and non-chewers was 26.80+/-11.96 and 7.76+/-4.73. The frequency of total micronuclei per 250 cells in cases was 9.3+/-5.37 in right buccal mucosa,&nbsp;9.43+/-5.66 in left buccal mucosa, 9.43+/- 5.66 in hard palate and 3.33+/- 2.88 in right buccal mucosa,&nbsp;2.96+/-3.31 in left buccal mucosa, and 2.96+/-3.31 in hard palate in controls.&nbsp;<br><strong>Conclusions:</strong> The mean number of micronuclei in buccal mucosal cells of female municipal sweepers with betel quid chewing practice was significantly higher compared to controls reaffirming their carcinogenic&nbsp;potential and highlighting the need of early screening for oral cancer in susceptible groups.&nbsp;</p> Archana Shetty Chahita Verma Vijaya Chowdappa Copyright (c) 2021 Archana Shetty 2021-03-20 2021-03-20 11 1 1847 1851 10.3126/jpn.v11i1.31677 A study of hematological parameters in patients with COVID-19 infection at a tertiary care centre https://www.nepjol.info/index.php/JPN/article/view/31401 <p><strong>Background:</strong> The corona virus disease 2019 is caused by the virus SARS-CoV-2 and is declared as a&nbsp;global pandemic by World Health Organization. Alterations in various hematological parameters have&nbsp;been recently documented in the world literature in SARS-Cov-2 infection. However, still there is paucity&nbsp;of hematological data in these patients. Hence this study is an attempt to evaluate the pattern of the&nbsp;hematological parameters in COVID-19 patients in the Indian population in our region. The objective of&nbsp;the study is to see the pattern of alteration in hematological parameters with emphasis on total leukocyte&nbsp;count, absolute lymphocyte count and platelet count in COVID 19 positive patients.<br><strong>Materials and Methods:</strong> This is an observational study in 50 patients with laboratory-confirmed&nbsp;COVID-19 status admitted to G.K. General Hospital &amp; Gujarat Adani Institute of Medical Sciences,&nbsp;Bhuj, from 1st April 2020 to 30th June 2020. Statistical analysis of the data was carried out, and relevant&nbsp;findings were presented.<br><strong>Results:</strong> Among the 50 patients, there were 35 (70%) males and 15 (30%) females with an age range from&nbsp;6 months to 82 years with twenty-five patients above 50 years. There was lymphopenia in 18 patients&nbsp;(36%), leukopenia in 2 patients (4%) and thrombocytopenia in 8 (16%) patients.<br><strong>Conclusions:</strong> Majority of the patients were elderly, and there was a male predominance. There was&nbsp;moderate to severe lymphopenia and mild thrombocytopenia.</p> Keval Arvindbhai Patel Bimal Patel Riddhi A Parmar Bhawana S Sharma Mansi Thacker Navin Patel Copyright (c) 2021 Keval Arvindbhai Patel 2021-03-20 2021-03-20 11 1 1852 1858 10.3126/jpn.v11i1.31401 Histomorphological Mimickers of benign prostatic lesions with prostatic adenocarcinoma https://www.nepjol.info/index.php/JPN/article/view/29009 <p><strong>Background:</strong> The prostate is a walnut-sized organ that surrounds the urethra. More than 99% of prostate&nbsp;cancers are prostatic adenocarcinoma. It is the second most commonly occurring cancer in men and the&nbsp;fourth most commonly occurring cancer in India and all over the world. Numerous lesion of the prostate are very similar to prostate cancer, hence awareness is very important. This study aimed to determine the histopathological features of prostate adenocarcinoma and its common mimickers.<br><strong>Materials and Methods:</strong> A retrospective study of histopathological features of radical prostatectomy and transurethral resection of the prostate specimens, sent to the department of pathology for a period of one year. A brief clinical history and serum prostate-specific antigen levels were noted.<br><strong>Results:</strong> The surgical specimens of 303 cases of prostatic diseases were studied. Benign prostatic hyperplasia was the most frequent diagnosis in 192 patients followed by Prostate adenocarcinoma seen&nbsp;in 80 patients. Prostatic intraepithelial neoplasia formed the predominant mimicker (5.9%), followed by&nbsp;basal cell hyperplasia (3.0%). Serum prostate-specific antigen was seen in the range of 1.73 - 100 ng/ml&nbsp;in the cases of adenocarcinoma. In the mimics, prostate-specific antigen was in the range of 1.2- 18ng/ml.<br><strong>Conclusions:</strong> Biopsy remains a gold standard for the diagnosis of adenocarcinoma and its mimickers. The lesions in this study were diagnosed on hematoxylin and eosin staining.</p> Priyanka Sangappa Murgod Preeti Rajeev Doshi Amit Ravindra Nisal Ravindra Chandrashekar Nimbargi Copyright (c) 2020 Preeti Rajeev Doshi, Priyanka Sangappa Murgod, Amit Ravindra Nisal, Ravindra Chandrashekar Nimbargi 2021-03-20 2021-03-20 11 1 1859 1863 10.3126/jpn.v10i2.29009 Neuronal hyperplasia in clinically diagnosed acute appendicitis: A histopathological study in tertiary care centre https://www.nepjol.info/index.php/JPN/article/view/31402 <p><strong>Background:</strong> Acute appendicitis is one of the most common general surgical emergencies. Around&nbsp;20-25% of patients who have an appendectomy done are found not to have acute appendicitis on histopathological examination. There is increasing evidence of the involvement of the enteric nervous&nbsp;system, in the immune regulation and monitoring the inflammatory responses. The present study was&nbsp;done to elucidate if neuronal changes in the appendix could be the cause of clinical acute.<br><strong>Materials and methods:</strong> Hospital records of 60 cases who were diagnosed as acute appendicitis clinically&nbsp;and who underwent appendectomy either laparoscopic or open, were reviewed. Histopathological records&nbsp;of these resected appendices submitted to the department of histopathology, GAIMS, G.K. General&nbsp;Hospital Bhuj were reviewed for one year for the presence or absence of acute appendicitis or neuronal&nbsp;hyperplasia. Routine Haematoxylin and Eosin stain and S-100 protein staining was done on all these 60&nbsp;cases.<br><strong>Results:</strong> Out of these 60 specimens of appendices received, histopathological examination revealed&nbsp;neuronal hyperplasia in the submucosa and muscularis layer on all the 60 cases. Grading of neuronal&nbsp;hyperplasia was done in all the cases. Out of these 60 specimens of appendices, histopathological&nbsp;examination revealed 48 cases of histopathologically positive acute appendicitis and 12 cases of&nbsp;histopathologically negative acute appendicitis.<br><strong>Conclusions:</strong> Neuronal hyperplasia has an important role in the pathogenesis of appendiceal colic in patients with both histopathologically positive acute appendicitis and histopathologically negative acute&nbsp;appendicitis</p> Riddhi A Parmar Riti P Dixit keval Arvindbhai patel Bhawana S Sharma Jigna Dave Copyright (c) 2021 Riddhi A Parmar, Riti P Dixit, keval Arvindbhai patel, Bhawana S Sharma, Jigna Dave 2021-03-20 2021-03-20 11 1 1864 1867 10.3126/jpn.v11i1.31402 Cyclin D1 expression and its correlation with clinicopathological variables in colorectal carcinoma https://www.nepjol.info/index.php/JPN/article/view/29291 <p><strong>Background:</strong> This study was conducted to evaluate the expression of Cyclin D1 in colorectal carcinoma,&nbsp;and to correlate Cyclin D1 positivity with the grade of the tumor along with other parameters such as age,&nbsp;tumor location, lymph node metastasis, and vessel invasion.<br><strong>Materials and Methods:</strong> The present cross-sectional study was conducted on 40 proven cases of&nbsp;colorectal carcinoma from October 2015 to October 2017. The tissues were fixed, processed, and stained&nbsp;with hematoxylin and eosin followed by immunohistochemical staining with Cyclin D1 using monoclonal&nbsp;antibodies.<br><strong>Results:</strong> 75% of the cases were conventional adenocarcinoma while the rest were mucinous adenocarcinoma. Of the total colorectal carcinomas,12.5% were Grade I, 50% were Grade II and 37.5%&nbsp;cases were Grade III. Cyclin D1 positivity was seen in 60% of cases with the most positivity in grade II&nbsp;tumors. A statistically significant correlation of Cyclin D1 was seen with age group (5th- 6th decade) and&nbsp;histological type of tumor. No significant correlation was seen of Cyclin D1 with lymph node involvement,&nbsp;depth of invasion, vascular invasion, or perineural invasion. A significant statistical correlation was seen&nbsp;with Crohn’s-like reaction and peritumoral lymphocytic response.<br><strong>Conclusions:</strong> Thus, it was concluded that a highly statistically significant correlation was seen with age group (5th- 6th decade) and histological type of tumor. No significant correlation was seen with Cyclin&nbsp;D1 expression with lymph node involvement, depth of invasion, vascular invasion, or perineural invasion.</p> Neha Sharma Taranveer Singh Arshdeep Kaur Mridu Manjari Shazia Bashir Copyright (c) 2021 Neha Sharma, Taranveer Singh, Arshdeep Kaur, Mridu Manjari, Shazia Bashir 2021-03-20 2021-03-20 11 1 1868 1872 10.3126/jpn.v11i1.29291 A decade of Journal of Pathology of Nepal: Challenges and opportunities https://www.nepjol.info/index.php/JPN/article/view/36402 Shiva Raj K.C. Gopi Aryal Copyright (c) 2021 Shiva Raj K.C., Gopi Aryal http://creativecommons.org/licenses/by/4.0 2021-03-20 2021-03-20 11 1 10.3126/jpn.v11i1.36402 Mucinous Carcinoma of the breast with micropapillary pattern and psammomatous calcification: A case study. https://www.nepjol.info/index.php/JPN/article/view/30950 <p>Mucinous carcinoma with a micropapillary pattern is an unusual form of Invasive breast cancer exhibiting&nbsp;dual mucinous and micropapillary differentiation. The present case is of a 47-year-old nulliparous female&nbsp;who presented with an incidental finding of a hard lump in her left breast. Mammography revealed a&nbsp;BIRADS 4 lesion. Modified radical mastectomy was done and the specimen was grossed, revealing a&nbsp;tumor of 3x2.6x2.6 cm in the outer quadrant. Microscopy revealed the tumor having extracellular mucin&nbsp;pools with floating psammoma bodies and focal micropapillary pattern. Four of the twenty-six lymph&nbsp;nodes sampled were found to have tumor deposits. The micropapillary pattern was maintained in the&nbsp;metastatic deposits. Immunohistochemistry revealed ER and PR positivity and Her2Neu negativity. EMA&nbsp;corroborated the findings. It is important to recognize the micropapillary pattern in mucinous carcinomas&nbsp;of the breast as these tumors tend to be more aggressive than pure mucinous breast lesions.&nbsp;</p> Koushiki Bhattacharjee Manna Valiathan Copyright (c) 2021 Koushiki Bhattacharjee 2021-03-20 2021-03-20 11 1 1886 1890 10.3126/jpn.v11i1.30950 Mixed adenoneuroendocrine tumour with squamous differentiation: a case report https://www.nepjol.info/index.php/JPN/article/view/29031 <p>Mixed adenoneuroendocrine carcinoma is a rare neoplasm with both epithelial and neuroendocrine&nbsp;components. To date, only a few cases of this neoplasm have been reported in the literature among&nbsp;which gastric mixed adenoneuroendocrine carcinoma is very rare. We are reporting a case of gastric&nbsp;mixed adenoneuroendocrine carcinoma with squamous cell differentiation. Histopathological features,&nbsp;biological behaviour and the treatment of this rare tumour type have been discussed briefly.</p> Irene Thomas Divya Surendran Joy Augustine Copyright (c) 2021 Irene Thomas, Divya Surendran, Joy Augustine 2021-03-20 2021-03-20 11 1 1891 1894 10.3126/jpn.v11i1.29031 Analogous feature of cemento-ossifying fibroma and bone pathology: a clinico-pathological correlation https://www.nepjol.info/index.php/JPN/article/view/31217 <p>Intra-osseous pathology of the craniofacial region is microscopically characterized by hypercellular fibroblastic stroma with a variable amount of bone or cementum like calcified structures. The overlapping histopathological features are not limited to lesions under one classification of similar origin rather it imbricates the lesions of entirely different origin as well. &nbsp;The only possible way out then becomes the clinicopathological correlation. Hence, in an out of entire clinical, a radiographic, surgical, and histopathological feature reframes the building block for confirmatory diagnosis of a bone lesion<strong>. </strong></p> Toniya Raut Shashi Keshwar Anju Pradhan Ashish Shrestha Copyright (c) 2020 Toniya Raut, dr, Shashi Keshwar, Dr, Ashish Shrestha 2020-12-28 2020-12-28 11 1 1895 1897 10.3126/jpn.v10i2.31217 Struma ovarii-A rare entity https://www.nepjol.info/index.php/JPN/article/view/30587 <p>Struma ovarii, also known as goiter of the ovary is a rare disease.1 Considering the rarity of this tumor and&nbsp;constrained literature in Nepal’s context, we hereby present a case of a 46-year-old female, asymptomatic, with normal blood parameters who presented with an abdominal mass. She was suspected of malignant ovarian mass on an ultrasonogram. Intraoperative frozen section examination revealed a benign tumor suggestive of dermal tumor versus struma ovarii. Postoperatively, histopathological examination was performed to assess the percentage of thyroid tissue and a diagnosis of benign struma ovarii was made which was confirmed by thyroglobulin positivity on immunohistochemistry. No features of immature&nbsp;teratoma and malignancy were identified.</p> Moushami Singh Raghu Ram Bhandary Jitendra Pariyar Swechha Maskey Hari Prasad Dhakal Copyright (c) 2021 Moushami Singh 2021-02-25 2021-02-25 11 1 1898 1901 10.3126/jpn.v11i1.30587