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Biomedical subjects

N Jayaram

Publications and source records attributed to N Jayaram.

15 recordsLinked to original sources

Telepathology in India.

Telepathology is the most recent addition to the pathologist's diagnostic tools. It is the acquisition of macroscopic and microscopic images for electronic transmission for diagnosis, consultation and/or education. With the addition of the personal computer at the pathologist's desktop, the stage has been set for one of the greatest advantages the Internet has to offer. Telepathology in India is in infancy, and we at PathoIndia (www.Pathoindia.com) have started a series of publication images from interesting cases in the form of weekly quiz. After cases are published, hundreds of pathologists from around the world are invited by e-mail to send in their diagnosis and comments. The responses to this quiz suggest that telepathology is catching on in the pathology community. Another intention of this series is to identify and select qualified international and Indian pathologists who would be willing to help colleagues from India requesting second opinions online.

Humans↗

Tumours and tumour-like conditions of the para-testicular region--a study of morphological features.

Twenty two patients with tumours or tumour-like conditions of the para-testicular region (PTR) were diagnosed over a 5 year period. Of these, 16 (73%) were benign with only one true neoplasm (papillary cystadenoma). The tumour-like conditions were comprised of 6 cases of adenomatous hyperplasia of epididymis, 4 cases of spermatic granuloma, 2 cases each of spermatocele and nodular-fibrous proliferation and one mesothelial cyst. Three patients with spermatic granuloma gave a history of trauma. No case of adenomatoid tumour was encountered. Six malignant neoplasms were diagnosed (27%) all of which were sarcomas. Five were primary to the PTR and one was a metastatic deposit from a primary leiomyoblastoma of the mesentery. Among the 5 primary sarcomas were 2 cases each of rhabdomyosarcoma and leiomyosarcoma, and 1 case of liposarcoma. The patient with leiomyoblastoma presented first with a measenteric mass which was followed a month later by a rapidly growing mass in the scrotum. Immunohistochemical staining (IHC) and Electron microscopy (EM) were done in this case. Intra-cytoplasmic myofilaments as well as desmosomes were observed. The patients ranged from 14 to 65 years of age and most presented with painless mass in the scrotum. Follow-up was not possible due to practical difficulties.

Adenoma↗

Langerhans cell histocytosis--a clinicopathological spectrum.

Langerhans cell Histiocytosis--a lesion characterised by proliferation of a variant of epidermal dendritic cell is one of the several syndromes in which histiocytes play a principal role in pathogenesis outside the context of inflammatory and metabolic storage disease. Seven cases were diagnosed as Langerhans cell Histiocytosis over a period of six years. The mode of diagnosis was Fine needle aspiration in 2 cases, open biopsy in four, and both biopsy and FNAC in one. The age range was from 2 months to 58 years and four of the seven patients were males. The lesion was unifocal in 3 cases (two in bone and one involving skin and soft tissue), multifocal in 3 and systemic in one. Electron microscopy was done in one case to demonstrate Birbeck granules. Immunohistochemical demonstration of S 100 protein was done in one case. The clinicopathologic spectrum of Langerhans cell Histiocytosis is brought out in this presentation of seven cases.

Adolescent↗

Persistent müllerian duct syndrome. A report of two cases.

Two cases of persistence of Müllerian duct structures in phenotypic male patients are reported. One of these was aged 16 years and the other 10 months. Both patients had cryptorchidism and inguinal hernia for which they were operated upon. In both patients parts of uterus and fallopian tubes were identified in the hernial sac. Endocrine evaluation was normal. Karyotyping was performed in the second case which revealed a normal male genotype of 46 XY.

Adolescent↗

Urine culture sensitivity pattern in a private laboratory setup.

During a two year study period, 6163 samples of urine among a total of 10366 miscellaneous samples received for culture, were analysed. Of these 1488 samples (24.15%) showed evidence of infection. In our study, E. Coli was found most frequently (61.40%) followed by Klebsiella (17.1%). The pattern of antibiotic sensitivity was analysed. Ciprofloxacin and Norfloxacin proved to be the most promising among the new generation of antibiotics. Results with Cloxacillin, Colistin and Lincomycin were found to be disappointing. The study serves to analyse the pattern of urinary infection in our setup and also dwells upon the emergence of strains resistant to even the newer antibiotics.

Bacterial Infections↗

Angiolymphoid hyperplasia with eosinophilia (Kimura's disease).

Angiolymphoid hyperplasia with eosinophilia (AHE) is a rare disease entity which usually presents as subcutaneous nodules, sometimes simulating lymphadenopathy or even angiosarcoma. We present here the histopathological aspects of a case which manifested as a subcutaneous forehead nodule, along with the relevant review of literature concerning this rare entity.

Angiolymphoid Hyperplasia with Eosinophilia↗

Fine-needle aspiration cytology in the diagnosis of cysticercosis presenting as palpable nodules.

The cytologic findings in the fine-needle aspirate of 30 cases of cysticercosis presenting as palpable nodules are described. Essential for a diagnosis are identification of parasitic fragments. These include bluish fibrillary structures sometimes with honeycombing, tegument of parasite thrown into rounded wavy folds, and scolex with hooklets and hyaline membrane surrounding it. The inflammatory reaction consisted of eosinophils, neutrophils, lymphocytes, histiocytes, epithelioid cells, and giant cells in varying proportions.

Adolescent↗

Auto-antibody profile in systemic lupus erythematosus.

Thirty cases of systemic lupus erythematosus (SLE) were selected on the basis of revised ARA criteria (American Rheumatology Association) and their sera examined for the presence of various auto-antibodies. The male to female ratio was 1:5 and joint manifestations were the commonest mode of presentation. The frequency of various manifestations was found to differ between the two sexes. Renal lesions were observed in 9 (nine) cases. ANF was detected in 28 of the 30 cases and the diffuse pattern was the commonest (11 cases) (37.7%). Six cases had very high titres (a titre of more than 1:1280) of antinuclear factor. Antibodies to DNA were detected in 9 cases (30%). These patients tended to have more severe disease, with high titres of ANF and low complement levels. Presence of antibodies to DNA, however, could not be correlated with the severity of renal lesions. Anti Sm antibody was found in 8 cases (26.7%), anti nRNP antibody in 19 cases (63.3%) and antihistone antibodies in 22 cases (73.3%). Patients harbouring any of these three antibodies tended to have a milder clinical disease.

Antibodies, Antinuclear↗

The value of fine-needle aspiration biopsy in the cytodiagnosis of salivary gland lesions.

Fine-needle aspiration cytology (FNAC) was performed on 195 cases of salivary gland lesions. The smears were technically adequate in 178 cases. Tissue examination was available for subsequent histocytologic correlation in 57 cases. The cytodiagnosis included inflammatory lesions (59) and benign (68) and malignant (51) tumors (total, 119). The accuracy of cytodiagnosis was 87.7% with a sensitivity of 80.9% and a specificity of 94.3%. Exact histologic typing was possible in 61.9% of the malignant tumors. Mucoepidermoid tumors and cellular-atypical pleomorphic adenoma posed difficulties in cytodiagnosis.

Adenoma↗

Fine-needle aspiration cytology of sacrococcygeal chordoma.

The fine-needle aspiration cytology (FNAC) of four cases of chordoma that were diagnosed preoperatively is presented. One of the cases showed anaplastic components along with the classical features of chordoma; this is probably the second case diagnosed with these features on FNAC. The cytologic features of classical chordoma include conspicuous extracellular matrix in the background. Polygonal cells, dissociated and in small groups, were identified in all cases. Physaliphorous cells were also prominently found in these cases. In addition, the case with anaplastic features showed very bizarre cells with profound multinucleation and the presence of intranuclear cytoplasmic inclusions. The diagnosis of chordoma was possible because of a high index of suspicion on clinical grounds and the use of special staining for confirmation.

Aged↗

Fine needle aspiration cytology of intrathoracic lesions--a repraisal.

FNAC was performed in 186 cases. Inadequate material was obtained in 41 cases. A definite diagnosis of malignancy could be made in 120 cases. In five cases a diagnosis "suspicious" of malignancy could be made. No serious complication was encountered with the technique. FNAC is of definite help in diagnosing the intra thoracic lesion whether malignant or inflammatory in nature. It also avoids unnecessary thoracotomy for diagnostic purposes.

Biopsy, Needle↗

Toxoplasma lymphadenitis. Analysis of cytologic and histopathologic criteria and correlation with serologic tests.

OBJECTIVE: To identify cases of Toxoplasma lymphadenitis by light microscopic examination of fine needle aspiration cytology (FNAC) smears and paraffin sections and to correlate the result with those of serologic tests. STUDY DESIGN: The study group consisted of 19 cases of Toxoplasma lymphadenitis, 7 of which were diagnosed by FNAC, 9 on excision biopsy and 3 on FNAC followed by biopsy. Nineteen cases of reactive lymphadenitis, tuberculosis and infectious mononucleosus composed the control group. Sera from all 38 patients were screened for antibodies to Toxoplasma. RESULTS: Eleven of 19 cases (58%) of Toxoplasma adenitis had very high titers of antibody (> 300 ELISA units/ml), and 6 cases (31%) had antibody titers in a range suggestive of active infection (210-300 ELISA units/mL) and required demonstration of rising titers. Overall, 89% of patients with Toxoplasma lymphadenitis showed significant levels of antibody. All patients from the control group showed consistently low levels of antibody to Toxoplasma. CONCLUSION: Though serologic tests are mandatory for the diagnosis of Toxoplasma lymphadenitis, a high index of suspicion can be obtained by means of light microscopy alone.

Adolescent↗