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D K Shome

Publications and source records attributed to D K Shome.

At least 19 recordsLinked to original sources
PubMed2005

Infection-associated haemophagocytosis: the tropical spectrum.

Reactive proliferation and inappropriate activation of mature histiocytes with haemophagocytosis (HP) may occur in association with a wide variety of infections, neoplasms, collagen vascular diseases, and acquired and inherited immunodeficiency states. The association with infections is particularly important because overwhelming HP can obscure the typical clinical features of the primary disease and negatively affects outcome. A high index of suspicion is required for early recognition of associated HP as the cause of cytopenias. Institution of specific therapy is crucial for survival. This study highlights the wide spectrum of tropical diseases that can have associated reactive HP. Thirty cases with documented prominent HP on bone marrow aspiration smears were reviewed. Twenty-one (69%) of the marrows were from patients who had common tropical infections: malaria, typhoid and visceral leishmaniasis and 11 of 15 patients (73%) who were followed up improved on specific infection-directed and supportive measures. The presence of severe HP in bone marrow smears correlated with marked cytopenias. Recognition of HP in this geographical region should stimulate the search for one of these infections as early institution of specific therapy is crucial for patient survival.

Bone Marrow Examination↗
PubMed2004

Histomorphology of multiple myeloma on bone marrow biopsy.

In a retrospective study, 49 bone marrow biopsies (BMB) of patients with multiple myeloma (MM) were studied for its role in diagnosis and to determine histological parameters of prognostic significance. Sections were analyzed by 2 observers and classified according to: 1. Cytological grading according to differentiation of the neoplastic cells as plasmacytic, pleomorphic and plasmablastic. 2. Volume of infiltration: quantitating the percentage of myeloma cells in the biopsy. 3. Pattern of neoplastic infiltration. The overall marrow cellularity, presence of marrow fibrosis, micro-osteolesions and normal haematopoeisis were also studied. The bone marrow biopsy (BMB) was diagnostic for myeloma in five cases, where the aspirates were hypocellular: four had early myeloma and one had extensive marrow fibrosis. The pattern of infiltration was interstitial in 19 cases (39%), nodular in 19 cases (39%), and diffuse in 11 cases (22%). In majority of the cases (49%), the cell type was plasmacytic (24 cases), plasmablastic in 10 cases and pleomorphic in 15 cases. All cases of poorly differentiated cell type (plasmablastic) had a diffuse or nodular pattern of infiltration, whereas majority of the well-differentiated cell type had an interstitial pattern. The plasma cell burden in biopsy i.e the volume of infiltration was <10% in 8 cases, <50% in 19 cases and >50% in 22 cases and was used for histological staging of MM. Fibrosis was present in 30% of cases. Follow up was available in 11 cases, and cases with poorly differentiated myeloma, diffuse pattern of infiltration and dense fibrosis had survival less than one year. Cases of well differentiated myeloma, interstitial pattern of infiltration and plasma cell load less than 20% with absence of fibrosis had a more than 5-year survival. Different series have quoted that all these histological parameters provide valuable prognostic information, wherever other modalities like beta 2 microglobulin and IL-6 levels, etc are not available. The effects of therapy can also be monitored by sequential biopsies.

Adult↗
PubMed2001

The association of antiphospholipid antibodies with ischaemic stroke and myocardial infarction in young and their correlation: a preliminary study.

AIM: The possible etiological role of antiphospholipid antibodies (APA) in thrombotic events on arterial side has become subject of interest. The present study was undertaken to determine the association and possible etiological role of APA in young Indian patients with acute ischaemic stroke and myocardial infarction (MI). MATERIAL AND METHODS: Forty six patients < 40 years of age including 22 with ischaemic stroke (excluding those with rheumatic heart disease and SLE), 24 with an acute MI and 21 age and sex matched healthy controls were enrolled in the study. All the patients and the controls were tested for the presence of lupus anticoagulant (LA) by a lupus sensitive activated partial thromboplastin time (APTT) and kaolin clotting time (KCT) and anti-caridiolipin antibodies (aCL) of IgM and IgG types using an ELISA technique. RESULTS: The screening tests for LA with APTT and KCT were negative in all the patients and the normal controls. In the stroke subgroup 18.18% patients (4/22) and in MI subgroup 4.16% (1/24) patients had raised aCL titers with statistically significant association only for stroke subgroup (p=0.0201) and not for MI subgroup. Significantly higher proportion of aCL positive cases were found in patients without any risk factor for atherosclerosis (4/12), compared to patients with one or more risk factor for atherosclerosis (1/34), p=0.001. CONCLUSION: Younger patients without identifiable risk factors for atheroscerosis presenting with stroke, are more likely to have an underlying antiphospholipid syndrome (APLS) as the etiology, and should be screened for it. No such association however was observed for MI patients.

Adolescent↗
PubMed1999

Distinctive AgNOR patterns of myeloid and lymphoid blasts in acute leukemia.

Bone-marrow aspiration smears of 38 cases of acute leukemia (19 acute lymphoblastic leukemia, 19 acute nonlymphocytic leukemia) were stained for argyrophilic nucleolar organiser regions (AgNOR). AgNOR were assessed numerically and morphologically. There were highly significant differences in AgNOR morphology between acute lymphoblastic leukemia and acute nonlymphocytic leukemia ANLL: lymphoblast AgNORs were usually small (<3 microm) "dots/chips," whereas myeloblasts showed larger "blebs," or a combination of the two types (complex structures). AgNOR number was significantly less in acute lymphoblastic leukemia. In acute nonlymphocytic leukemia cases, AgNOR number also showed direct correlation with Ki67 reactivity of leukemic blasts.

Bone Marrow↗
PubMed1994

Cutaneous T-cell lymphoma diagnosed by fine-needle aspiration: a case report with clinical, cytological, and immunophenotypic features.

A case study of cutaneous T-cell lymphoma in a 40-yr-old Indian male is presented. Prominent clinical features consisted of large skin tumours, lymphadenopathy, and a rapidly progressive course of development. Aspiration smears from tumours, lymph nodes, and bone marrow showed pleomorphic Sezary cells and lymphoid blasts. The neoplastic cells stained positively with anti-HLA DR, CD1, and CD2 antibodies and showed lack of T-cell subset antigens CD4 and CD8. Numerous proliferating cells were identified with 56% of bone marrow cells and 57% of cells in the dermis staining positively with Ki-67 and PC10 antibodies, respectively. This case is reported in view of its uncommon features.

Adult↗
PubMed1992

Orbital granulocytic sarcomas (myeloid sarcomas) in acute nonlymphocytic leukemia.

In a series of 89 patients with acute leukemia, orbital granulocytic sarcomas were observed in 7. All these patients had acute nonlymphocytic leukemia, and they were all children. The orbital involvement usually was bilateral, and the patients had proptosis, conjunctival hemorrhage, and chemosis. Morphologic, cytochemical, and immunophenotypic analyses did not show a predilection for any particular myeloid cell type. Two patients had biphenotypic leukemias with myeloid components. The ocular manifestations responded well to chemotherapy irrespective of the hematologic response.

Adolescent↗
PubMed1986

Glycosylated haemoglobin (Hb A1) in normal rhesus monkeys (Macaca mulatta).

Glycosylated haemoglobins were measured in 23 healthy juvenile rhesus monkeys by the use of commercially available minicolumn chromatography (Quick Sep., Isolab Inc., Ohio, USA) to establish the normal range. Values obtained (mean +/- 1 standard deviation (SD) 1.57 +/- 0.68%) were significantly lower than that of 17 adult healthy human volunteers by the use of the same method of estimation (mean +/- 1 SD of 5.34 +/- 0.78%).

Animals↗