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Debdatta Basu

Publications and source records attributed to Debdatta Basu.

17 recordsLinked to original sources

Immunophenotyping of Hodgkin's disease--an aid to its classification.

Based on morphological, phenotypic, genotypic and clinical findings, Hodgkin's disease has recently been classified into two subtypes: Nodular lymphocyte predominant and classical Hodgkin's disease. Forty-two cases of Hodgkin's disease were subjected to detailed morphological assessment and immunophenotyping. The commonest subtype was Nodular Sclerosis seen in 27 cases. The panel of antibodies used was CD 15, CD 30, CD 3, CD 20, CD 45 and Epithelial Membrane Antigen. Immunophenotyping was done by Streptavidin Biotin Peroxidase complex technique. CD 30 was expressed in 86% and CD 15 in 76% cases. Immunophenotype helped reclassify two cases, according to the WHO classification scheme. Although morphology remains the gold standard in the diagnosis of Hodgkin's disease, immunophenotype is a useful adjunct in differentiating prognostically distinct subtypes.

Adolescent↗

Immunohistochemical typing of non-Hodgkin's lymphoma-comparing working formulation and WHO classification.

The recent WHO classification of non-Hodgkin's lymphoma is based on the morphology and immunohistochemical expression of the lymphoma cells and to a lesser extent, on the molecular and cytogenetic findings. Fifty-three cases of non-Hodgkin's lymphoma were included in the study. Of these, seven cases were primary extra nodal lymphomas. Twenty two patients had peripheral blood and/or bone marrow involvement. A detailed morphological assessment was done and classified using the International working formulation. The two most common types encountered were diffuse large cell lymphoma and small lymphocytic lymphoma. Immunohistochemistry was done using labeled streptavidin-biotin peroxidase complex with CD3, CD20, CD15, CD30, CD 45 (leukocyte common antigen), Cyclin D1, EMA (epithelial membrane antigen). 38 cases (72%) showed B cell expression and 12 cases (22.5%) showed T cell expression. Three cases did not express either marker. B-cell diffuse large cell lymphoma (26%) was found to be the predominant B cell non-Hodgkin's lymphoma. The commonest T-cell lymphoma was T lymphoblastic lymphoma (67%) followed by peripheral T cell angioimmunoblastic lymphoma (25%). Immunohistochemistry is a useful and necessary diagnostic modality and helps subdivide prognostically different types of non-Hodgkin's lymphoma.

Adolescent↗

Interfollicular Hodgkin's disease: an uncommon pattern that may cause diagnostic difficulty.

Interfollicular Hodgkin's Disease is characterised by reactive follicular hyperplasia with involvement of the interfollicular area of lymph node by Hodgkin's lymphoma. It represents a peculiar pattern of focal involvement of lymph node and does not constitute a classical subtype. Its importance rests in the fact that it can be misinterpreted as one of the many causes of reactive hyperplasia of lymph node and not as Hodgkin's disease. Eleven cases of interfollicular Hodgkin's disease were diagnosed in a period of five years. Majority of the patients were less than twenty years and all had localised lymphadenopathy. Lymph node biopsy showed follicular hyperplasia with expanded interfollicular area. Careful search of the interfollicular area showed infiltration by inflammatory cells and scattered Reed-Sternberg and Hodgkin's cells. Immunohistochemistry with CD 15 and CD 30 highlighted the atypical cells. This report emphasises on the problems in diagnosis of interfollicular Hodgkin's disease.

Adolescent↗

Fetus in fetu or differentiated teratomas?

Two cases of congenital teratoma were operated upon. In view of the high degree of organoid differentiation of the teratomas with rudimentary limbs, intestine, brain-like and pulmonary tissues, it was difficult to distinguish it from fetus-in-fetu. In the light of the data obtained and extensive review of related literature, we consider that fetus-in-fetu and teratoma may not be unrelated entities. Our cases support the view held that fetuses in fetu are highly differentiated teratomas.

Abdomen↗

Angioimmunoblastic T-cell lymphoma obscured by concomitant florid epithelioid cell granulomatous reaction--a case report.

Epithelioid cell granuloma occurs in association with many neoplasms including lymphoma. However they have rarely obscured the microscopic features of a lymphoma. We report on a case where a florid epithelioid cell granulomatous reaction caused difficulty in interpretation and delayed the final diagnosis of a case of peripheral T cell lymphoma of the angioimmunoblastic type. We draw attention to this unusual phenomenon because of its practical implications.

Diagnosis, Differential↗

Mantle cell lymphoma--a clinicopathological study of 13 cases.

Mantle cell lymphoma is an uncommon non-Hodgkin's lymphoma. In a period of four years, 13 cases of mantle cell lymphoma were diagnosed in our department, comprising 3.1% of all non-Hodgkin's lymphoma diagnosed. The mean age of presentation was 52 years with a slight male preponderance. The disease was nodal in twelve and extra-nodal in tonsil in one. Five patients had bone marrow involvement. Five cases showed a nodular pattern on lymph node biopsy while the remaining eight had a diffuse pattern. Immunophenotyping showed positivity for CD20 and cyclin D1. Despite certain morphological similarity to other low-grade lymphomas, mantle cell lymphoma has a characteristic appearance of its own. It is more aggressive than other low-grade lymphomas and hence needs to be accurately diagnosed.

Adult↗

Granulomas in bone marrow--a study of fourteen cases.

Granulomas in bone marrow are an infrequent finding and several diseases are associated with granuloma formation. Clinicopathological details of fourteen cases showing granulomas in bone marrow were studied. Fever was the commonest clinical presentation and anaemia was seen in all cases. Only one case showed epithelioid cells in the bone marrow aspirate smear while trephine biopsy was diagnostic in all cases. Granulomas were seen mainly in the paratrabecular space. Acid fast bacilli were demonstrated in five biopsies and serological test for Human Immunodeficiency virus was positive in five cases. Tuberculosis was more common in the present study as compared to others, probably due to the endemicity of tuberculosis in this region. Bone marrow biopsy is useful in the investigation of pyrexia of unknown origin as it leads to an aetiological diagnosis in most cases.

Adult↗

Value of nucleated red blood cells in predicting severity and outcome of perinatal asphyxia.

The objective of the study was to assess nucleated red blood cell counts in cord blood in a group of asphyxiated infants, and to determine its predictive value for short-term outcome. A prospective case control study was undertaken on cord blood samples collected from fifty six term neonates with perinatal asphyxia and an equal number of normal appropriately matched controls for cord blood pH and nucleated RBC counts. Babies were followed up in nursery till discharge. Statistical analysis employed were ANOVA test, logistic and linear regression analysis. There was a significant increase in the number of nucleated red blood cells in cases as compared to controls. Low Apgar, cord blood pH and neonatal outcome correlated well with nucleated RBC counts. Nucleated red blood cell count at birth is a useful predictor of severity and short-term outcome of perinatal asphyxia.

Apgar Score↗

Lymphoplasmacytic lymphoma with IgA paraproteinemia mimicking Waldenstrom's Macroglobulinemia.

Central to the diagnosis of Waldenstrom's Macroglobulinemia is the demonstration of bone marrow infiltration by lymphoplasmacytic lymphoma with Ig M monoclonal gammopathy. We describe a patient who presented with a clinical and haematological picture, highly suggestive of Waldenstrom's Macroglobulinemia, but whose serum monoclonal immunoglobulin belonged to Ig A class. Ig A secreting lymphoplasmacytic lymphoma undoubtedly exist but are exceedingly uncommon and their relationship to Waldenstrom's Macroglobulinemia needs to be clarified.

Diagnosis, Differential↗

Plasma cell leukemia--a case report.

Plasma cell leukemia, occurring either de novo or in patients with long standing multiple myeloma, is the least common type of plasma cell dyscrasia. Histogenetically plasma cell leukemia is derived from terminally differentiated B cells. It is diagnosed by presence of absolute plasma cell count >2000/cm or >20% circulating plasma cells. Two cases of plasma-cell leukemia are reported here. Clinical spectrum and course of the disease, are discussed. Both cases (of primary plasma cell leukemia) had abrupt onset of disease, poor response to therapy and short survival time. Both presented with fatiguability and weakness. Evidence of organomegaly and radiological and hematological evidence of plasma cell leukemia, with thrombocytopenia and evidence of visceral involvement with leukemic cells, was seen in one case.

Bone Marrow↗

Bone marrow cryptococcosis: a case report.

A 35-year-old male presented with fever and bilateral cervical and axillary lymphadenopathy. Peripheral blood film examination revealed thrombocytopaenia. Bone marrow aspiration and trephine biopsy, done for evaluation of thrombocytopaenia and pyrexia showed presence of ill-defined granulomas along with cryptococcal yeast forms. Fine needle aspiration of lymph nodes, cerebrospinal fluid and sputum analyses also showed cryptococci. ELISA for Human Immunodeficiency Virus (HIV) antigen was positive. Granulomas, when found in bone marrow aspiration smears and trephine biopsy, are a valuable histological clue to an opportunistic infection. Disseminated fungal infection such as cryptococcosis should raise the possibility of immunosuppression, especially Acquired Immunodeficiency Syndrome. Bone marrow examination is a useful method of diagnosing opportunistic fungal and mycobacterial infections in patients with fever, anaemia or thrombocytopaenia and underlying HIV infection.

AIDS-Related Opportunistic Infections↗

Histiocytic necrotizing lymphadenitis (Kikuchi Fujimoto Disease)--a report of four cases.

Four cases of histiocytic necrotizing lymphadenitis without granulocytic infiltration (Kikuchi-Fujimoto Disease) are described. All the cases were seen in young women who presented with cervical lymphadenopathy with mild or no fever. Histology of the lymphnode revealed paracortical necrotizing lesions with abundant karyorrhexis. Neutrophils were conspicuous by their absence. Diagnosis of Kikuchi-Fujimoto disease was considered after ruling out connective tissue disorders. Three of the four cases that were followed up showed a self-limiting course. It is important to differentiate this rare cause of febrile disease with enlargement of lymphnodes, from other causes of febrile disease with enlargement of lymphnodes, from other causes of lymphadenopathy, especially lymphoma.

Adolescent↗

Malignant melanoma metastatic to bone marrow.

Bone marrow aspiration and biopsy is a useful means of detecting systemic involvement in patients with non haematological malignancy. Metastases of malignant melanoma may be detected in the bone marrow in a small percentage of patients. Two cases of malignant melanoma, with metastasis to marrow at the time of presentation, are described. In one case, bone marrow was the first site where the malignancy was identified. Subsequent investigations revealed an anal melanoma. In the second case, the patient had widespread dissemination from a tonsillar melanoma to many organs of the body, including bone marrow.

Adult↗

Congenital leukaemia in Down Syndrome--a case report.

A 17 days old male infant, who had features of Down Syndrome, presented with fever, refusal to feed and seizures. He had papular, crusted skin lesions, moderate hepatosplenomegaly and a rapid downhill course. Peripheral blood and bone marrow aspirate showed features of acute leukaemia. Congenital Leukaemia is a rare malignancy associated with a very poor prognosis. Paradoxically, many cases of Congenital Leukaemia, especially in infants with Down Syndrome, show spontaneous remission.

Acute Disease↗

Bone marrow trephine biopsy findings in chronic myeloid leukemia.

Sixty patients with chronic myeloid leukemia (CML) underwent bone marrow trephine biopsy at presentation. All the biopsies were decalcified, paraffin-embedded and stained with H&E, Gomori's reticulin and Masson Trichrome. A detailed study of the histology including the morphology and topographic distribution of megakaryocytes was done. 55 patients presented in chronic phase. Of these there were 37 cases (67%) of CML-granulocytic (CML-G) type and 18 cases (33%) of CML-granulocytic megakaryocytic (CML -GM) type. Five cases presented in blast crisis. 73% of CML-G had low-grade fibrosis while 83% of CML-GM had high-grade fibrosis. This was statistically significant. On follow-up 25% of CML-G went into blast crisis while all the CML-GM patients remained stable to date. Bone marrow biopsy is a useful investigation in patients of CML at diagnosis as it provides prognostic information. Evaluation of megakaryopoiesis, grading of fibrosis and localization of blasts are possible on a trephine biopsy.

Biopsy↗

Detecting mycobacteria in Romanowsky-stained cytologic smears. A case report.

BACKGROUND: Cytologic features of mycobacterial infections are granulomatous inflammation with or without caseous necrosis and the demonstration of acid-fast bacilli with special stains. However, immuno-compromised patients might not mount the expected response. CASE: A routinely used Romanowsky (Leishman) stain was used for the presumptive diagnosis of mycobacterial infection in a 30-year-old man with AIDS. The mycobacteria were identified as inclusions, described as "negative images," in the cytoplasm of macrophages in smears of bone marrow aspirate. They were then confirmed to be acid-fast bacilli with Ziehl-Neelsen stain. CONCLUSION: Negative images of mycobacteria may be seen in Romanowsky-stained cytologic smears from patients with immunodeficiency. This is a rapid and cost-effective way of detecting the mycobacteria before more specific results are available. Such a search should be undertaken routinely in all patients suspected to have such infections.

AIDS-Related Opportunistic Infections↗