PubMed Health⌕ Search

Biomedical subjects

Pranab Dey

Publications and source records attributed to Pranab Dey.

At least 19 recordsLinked to original sources
PubMed2007

Time for evidence-based cytology.

Evidence-based medicine (EBM) is a fashionable and an extremely hot topic for clinicians, patients and the health service planners. Evidence-based cytology (EBC) is an offshoot of EBM. The EBC is concerned with generating a reproducible, high quality and clinically relevant test result in the field of cytology. This is a rapidly evolving area with high practical importance. EBC is based entirely on research data. The various professional bodies on cytology design and recommend guidelines on the basis of evidences. Once the guideline is implemented and practiced then the experiences of the practicing cytopathologists may be used as a feed back to alter the existing guideline. The various facets of EBC are sampling and specimen adequacy, morphological identification and computer based expert system, integrated reporting, identification of the controversial areas and high quality researches for evidences. It is the duty of the individuals and institutions to practice EBC for better diagnosis and management of the patients. In this present paper, the various aspects of EBC have been discussed.

Journal Article↗
PubMed2006

Malignant atypical cell in urine cytology: a diagnostic dilemma.

AIMS: The aim of this study was to find out the characteristic morphology of malignant atypical cells which were missed on routine cytology of urine. MATERIALS AND METHODS: In this retrospective study, we examined detailed cytomorphology of 18 cases of atypical urinary cytology which were missed on routine examination and were further proved on histopathology as transitional cell carcinoma (TCC) of bladder. The cytological features of these cases were compared with 10 cases of benign urine samples. RESULTS: There were 11 cases of high grade TCC and 7 cases of low grade TCC on histopathology of the atypical urine samples. Necrosis in the background and necrosed papillae were mostly seen in malignant atypical cells. The comet cells and cells with India ink nuclei (single cells with deep black structure-less nuclei) were only observed in malignant atypical cells. The most consistent features in malignant atypical cells were: i) high nuclear and cytoplasmic (N/C) ratio ii) nuclear pleomorphism iii) nuclear margin irregularity iv) hyperchromasia and v) chromatin abnormalities CONCLUSION: The present study emphasizes that nuclear features such as high N/C ratio, hyperchromasia and chromatin abnormalities are particularly useful for assessing the malignant atypical cells. Other cytological features such as comet cells and cells with India ink nuclei are also helpful for diagnosis but have limited value because they are less frequently seen.

Journal Article↗
PubMed2006

Combined applications of fine needle aspiration cytology and flow cytometric immunphenotyping for diagnosis and classification of non Hodgkin lymphoma.

AIMS AND OBJECTIVES: In this present study we have evaluated the feasibility of sub-classification of non-Hodgkin's lymphoma (NHL) cases according to World Health Organization's (WHO) classification on fine needle aspiration cytology (FNAC) material along with flow cytometric immunotyping (FCI) as an adjunct. MATERIALS AND METHODS: In this five years study, only cases suggested or confirmed as NHL by FNAC were selected and FCI was performed with a complete panel of antibodies (CD3, CD2, CD 4, CD5, CD8, CD7, CD10, CD19, CD20, CD23, CD45, kappa and lambda) by dual color flow cytometry. Both cytologic findings and FCI data were interpreted together to diagnose and sub-classify NHL according to WHO classification. Wherever possible the diagnoses were compared with cytology. RESULTS: There were total 48 cases included in this study. The cases were classified on FNAC as predominant small cells (12), mixed small and large cells (5) and large cells (26). In five cases a suggestion of NHL was offered on FNAC material and these cases were labeled as NHL not otherwise specified (NHL-NOS). Flow cytometry could be performed in 45 cases (93.8%) and in rest of the three cases the material was inadequate because of scanty blood mixed aspirate. Light chain restriction was demonstrated in 30 cases out of 40 cases of B-NHL (75%). There were 15 cases each of kappa and lambda light chain restriction in these 30 cases. With the help of combined FCI and FNAC, it was possible to sub-classify 38 cases of NHL (79%) according to WHO classification. Combined FNAC and FCI data helped to diagnose 9 cases of small lymphocytic lymphoma (SLL), 2 cases of mantle cell lymphoma (MCL), 4 cases of follicular lymphoma (FL), 17 cases of diffuse large B lymphoma (DLBL) and 6 cases of lymphoblastic lymphoma. Histopathology diagnosis was available in 31 cases of NHL out of which there were 14 recurrent and 17 cases of primary NHL. Out of 15 DLBL cases diagnosed on FCI and FNAC, histology confirmed 14 cases and one of these cases was diagnosed as Burkitt's lymphoma on histology. Cases of FL (4), SLL (3) and MCL (2) were well correlated with histopathology. Out of the five cases suggestive of NHL on cytology, histopathology was available in four cases. Histology diagnosis was given as DLBL (1), SLL (1), anaplastic large cell lymphoma (1) and FL transformed into large cell NHL (1). Considering histopathology as gold standard, diagnostic specificity of combined FNAC and FCI was 100% (31/31) and sensitivity in sub-classification was 83.8% (26/31). CONCLUSION: FNAC combined with FCI may be helpful in accurately sub-classifying NHL according to WHO classification. Many of the subtypes of NHL such as FL and MCL which were previously recognized as a pure morphologic entity can be diagnosed by combined use of FNAC and FCI. Other ancillary investigations such as chromosomal changes, cell proliferation markers etc. may be helpful in this aspect.

Journal Article↗
PubMed2006

Chromatin remodeling, cancer and chemotherapy.

DNA in eukaryotic nucleus is highly condensed with histone proteins as nucleosomes. Three dimensional arrangements of nucleosomes give rise to the formation of chromatin. Extensive studies in the recent years have highlighted that the structure of chromatin plays a critical role in gene expression. Post translational modifications (such as acetylation, deacetylation, methylation and phosphorylation etc.) of tails of histones may occur with the help of various histone modifier proteins which may lead to architectural changes of nucleosomes and chromatin remodeling. Chromatin remodeling may finally enhance or repress gene transcriptions. The neoplastic cells selectively take the advantages of histone modifications for the cell proliferation, differentiation and evasion of apoptosis. There are enough experimental and clinical evidences that various histone modifiers are linked with many human malignancies. The thorough knowledge of manipulation of histone modifiers by cancer cells may help us to design newer anti-neoplastic drugs in future. There is considerable interest in histone deactylase inhibitors as antineoplastic agents and various clinical trials are in progress. This article reviews a general overview of chromatin remodeling proteins, their role in carcinogenesis and the future potential of the histone deacetylase inhibitors in cancer chemotherapy.

Acetylation↗
PubMed2005

Chromatin pattern alteration in malignant cells: an enigma.

Alteration of chromatin pattern is one of the most important clues to detect the malignant cell. However, the exact cause of change of chromatin pattern still is not clearly known. Recently, in last 20 yr, modern advanced technologies, such as fluorescent in situ hybridization (FISH), chromosome painting, green fluorescent protein (GFP) fusion technology, fluorescent recovery after photobleaching (FRAP), confocal microscopy, and multicolor four-dimensional imaging of living cell, have unfolded the mystery of the chromatin structure and dynamics. In this study, I have discussed the possible causes of chromatin change in malignant cells based on available recent information. Multiple factors are responsible for alteration of chromatin pattern in malignant cells. The important factors in this respect are chromatin relocation, DNA aneuploidy, change of nuclear matrix protein (NMP), histone protein alteration, abnormal nuclear lamin-chromatin interaction, and nuclear pore dysfunction. It is not impossible that the chromatin pattern alteration may be just a secondary change due to the interaction of fixative with chromatin and nonchromatinic substances in the nucleus.

Chromatin↗
PubMed2005

Fine-needle aspiration cytology of metastatic transitional cell carcinoma.

In this article we described the fine-needle aspiration cytology (FNAC) of five cases of metastatic transitional cell carcinoma (TCC). There were four cases of metastatic lymph nodes and one case of metastatic skin lesion. All of the TCC cases were primarily in the urinary bladder and were high grade on histopathology (grade 3). Three cases showed bladder muscle involvement and two cases showed superficial TCC at the time of primary diagnosis. FNAC smears showed abundant cellularity. The cells were present in discrete and small syncytial clusters. Nuclear position of the cell was central to eccentric. Many cells showed prominent nucleoli. Cercariform cells (CCs) were noted in four cases. These cells are malignant cells with a nucleated globular body and a unipolar nontapering cytoplasmic process. Two cases showed intranuclear inclusions. Prominent cytoplasmic vacuoles were noted in three cases. In addition, cell cannibalism and attempted pearl formations were noted in two cases.In conclusion, clinical history along with the certain cytological features such as the presence of CCs, cells with eccentric nuclei, and intranuclear inclusions are helpful to diagnose metastatic TCC on FNAC material.

Aged↗
PubMed2005

Comparative study of myelodysplastic syndromes and normal bone marrow biopsies with conventional staining and immunocytochemistry.

OBJECTIVE: To study the histomorphometric features of megakaryocytic elements in bone marrow trephine biopsies of various subtypes of myelodysplastic syndrome (MDS). STUDY DESIGN: Comparative image morphometry using hematoxylin-eosin-stained and CD 61-stained trephine biopsies was carried out on 40 cases of MDS and 10 normal subjects to analyze the megakaryocytes objectively. The various variables analyzed were number of megakaryocytes and micromegakaryocytes, area, perimeter and diameter of the megakaryocytic elements. RESULTS: The mean number of megakaryocytes was lower in cases of MDS as compared to the normals in all except for a single case of hypoplastic MDS, in which the megakaryocytes were more abundant (3.6 per high-power field [hpf]). No micromegakaryocytes were observed in the 2 cases of chronic myelomonocytic leukemia. The mean area, perimeter and diameter of megakaryocytes decreased significantly on immunostaining with CD 61. CONCLUSION: The mean number of megakaryocytes per hpf was lower in the cases of MDS as compared to normal cases on hematoxylin-eosin. However, on CD 61 staining the number of megakaryocytes per hpf increased in cases of MDS. Micromegakaryocytes were seen in scanty numbers in the normals but increased in MDS cases and increased significantly on CD 61 immunostaining. The mean area, perimeter and diameter of megakaryocytes decreased significantly on immunostaining with CD 61, indicating the increased numbers of micromegakaryocytes in MDS. Hence, immunostaining is an efficient method of detecting increased numbers of megakaryocytes and micromegakaryocytes that would ordinarily be missed by using routine hematoxylin-eosin staining.

Anemia, Aplastic↗
PubMed2005

Basic principles and applications of fractal geometry in pathology: a review.

The basic principles and prospects of fractal geometry in pathology are promising. All articles found with a PubMed search with the keywords fractal dimension (FD) and related to pathology were reviewed. All fractal objects have FDs, commonly calculated with box counting. Fractal geometry has been applied to measure the irregularities of nuclear and glandular margins to distinguish malignant lesions from benign ones, to measure the infiltrative margin of a malignant tumor, to assess tumor angiogenesis and to measure the distribution of collagen in tissue. Fractal geometry has also been applied to assess the irregular distribution of chromatin in malignant cells. Biologic model formation is possible with fractal geometry. In the future, fractal geometry may help with the diagnosis, understanding of pathogenesis and management of lesions. It may also provide new insights into disease processes.

Animals↗
PubMed2004

Cytologic features of central giant-cell granuloma of the jaw.

In this present series, we studied in detail the cytologic features of five histopathologically verified cases of central giant-cell granuloma (CGCG). All the patients in this series were female, with an age range of 11-60 years. There were three cases with involvement of the lower jaw and two cases had upper jaw involvement. Cytology smears showed dispersed single cells in the background. Nuclei of the individual cells were round to ovoid with fine chromatin and inconspicuous nucleoli. The cytoplasm of these cells was moderate in amount with indistinct cell borders. Many randomly scattered multinucleated giant cells with 10-20 nuclei were present in the background. Combination of clinical features, radiologic pictures, and cytologic features may be helpful for diagnosis of CGCG on fine-needle aspiration cytology.

Adolescent↗
PubMed2004

Fine-needle aspiration cytology of malignant peripheral nerve sheath tumors.

The histopathologic features of malignant peripheral nerve sheath tumors (MPNSTs) have been well described. There have been limited studies on the cytologic features of MPNST. In this present study, we have retrospectively reviewed eight histopathology confirmed cases of MPNST over a 5-year period. Detailed cytomorphological analysis of these cases was carried out individually by two observers. On cytology, these cases were diagnosed as benign spindle-cell tumor (two), spindle-cell tumor possibly benign (one), spindle-cell tumor possibly malignant (one), malignant spindle-cell tumor (two), spindle-cell tumor, and neural origin (two). The cardinal cytomorphologic features were loosely cohesive clusters and fascicular arrangement of spindle cells with rounded ends. The kinking of nuclei was not a conspicuous finding. Fibrillary background was noted in two of the cases. Nuclear pleomorphism was ranged from mild to moderate degree. One case exhibited extensive intranuclear pseudoinclusions. Mitotic figures (including atypical forms) were present in almost all the cases. Possibly a constellation of cytologic features such as clusters of short and long fascicles of cells admixed with dissociated spindle cells of round-ended nuclei and prominent nucleoli on myxoid or fibrillary background and frequent mitosis may be helpful in diagnosis of MPNSTs. The cytomorphologic features along with clinical correlation are necessary to increase the diagnostic accuracy of MPNST on aspiration cytology.

Adult↗
PubMed2004

Urinary markers of bladder carcinoma.

PURPOSE: Transitional cell carcinoma of bladder is one of the most common tumors of genitourinary tract. Cystoscopy along with cytology is the mainstay for diagnosing bladder cancer. Cytology is specific for diagnosis of bladder carcinomas but less sensitive particularly in low-grade disease. Cystoscopy on the other hand is invasive and relatively costly technique and may also be inconclusive at times particularly in case of cystitis. A simple noninvasive marker for detecting bladder cancer would be helpful. A clinically useful urinary marker should be easy to perform, should have minimum requirements for sample preparations and should have high sensitivity and specificity in diagnosis. In this review we discussed the various urinary markers and their role in detection of bladder cancer. MATERIALS AND METHODS: We reviewed the literature on urinary markers and tests that may have clinical usefulness. RESULTS: Several urinary markers and tests such as BTA Stat, BTA TRAK, NMP22, telomerase, HA and HAse tests, Immunocyt, Quanticyt, FDP, BLCA-4, FISH, CYFRA-21-1 have enough potential for future clinical use. BTA stat, NMP22 (bladder check)and AccuDX (FDP) tests are presently point of care tests. The rest of the tests are laboratory-based and may need trained technicians. Majorities of the urinary markers have higher sensitivity and specificity than cytology. However, voided urinary cytology has the highest specificity. CONCLUSIONS: Till now there is no urinary marker or test that can replace the need of cystoscopy. However, some markers have the potential for future clinical use.

Antigens, Neoplasm↗
PubMed2004

Mean nuclear volume in ovarian papillary serous cystadenocarcinoma.

OBJECTIVE: To measure mean nuclear volume (MNV), estimated by the stereologic intercept method, in ovarian serous carcinomas and to compare that between omentum-positive cases (cases with omental metastasis) and -negative cases. STUDY DESIGN: This retrospective study consisted of 29 cases (stage I and II = 13 cases, and stage IIIb = 16 cases) of ovarian papillary serous cystadenocarcinoma. MNV of all cases (at primary and metastatic sites) was estimated with an image cytometer. The nuclear point intersection method was used to measure nuclear volume. Mean intercepted diameters of at least 50 nuclei were measured. MNV was correlated with histologic grade, International Federation of Gynecology and Obstetrics (FIGO) staging of ovarian malignancy and primary tumor versus metastatic deposits. RESULTS: MNVs estimated in omentum-negative (FIGO stage I and II) and omentum-positive (FIGO stage IIIb) cases were 1,022.48 +/- 608.45 and 2,152 +/- 1,317.51 microns 3 (P = .05, Student t test), respectively. Significant differences in MNV were also observed among the different grades of tumor. However, no significant difference was observed between MNVs of primary and metastatic tumors in omentum-positive cases. CONCLUSION: Estimates of MNV on conventional histopathology sections may provide objective and useful criteria for relatively subjective histopathology grading and staging (FIGO stage I and II vs. IIIb).

Cell Nucleus↗
PubMed2004

Image morphometry of acute leukemias. Comparison between lymphoid and myeloid subtypes.

OBJECTIVE: To determine if image morphometry has any role in distinguishing blasts of acute lymphoblastic leukemia (ALL-L2) from those of acute myeloid leukemia (AML-M1) and (AML-M2). STUDY DESIGN: Ten cases each of ALL-L2, AML-M1 and AML-M2 diagnosed according to the French-American-British criteria were studied. In all cases May-Grünwald-Giemsa-stained bone marrow aspiration smears were obtained. At least 100 blast cells from each case were subjected to analysis randomly with an image cytometer using Leica Quantimet 600 software (Cambridge, U.K.). The area, convex area, length, width, perimeter, convex perimeter, roundness, total optical density, average optical density and pixel grey value variance of the nuclei were measured by random selection of cells using a 40:1 objective (1 pixel = 0.446 micron). RESULTS: Mann Whitney's nonparametric test showed that there was considerable overlap of morphometric variables between the 3 subtypes. Though statistical significance was found in "roundness" between blasts of AML-M1 and ALL-L2, power analyses (sample size of 100 blasts of each subtype) did not show sufficient power for this variable. However, between blasts of ALL-L2 and AML-M2, "average optical density" and "pixel grey value variance" were statistically significant with full power using power analyses. CONCLUSION: Image morphometry may be helpful in differentiating blasts from lymphoid and myeloid leukemic subtypes.

Biopsy, Needle↗
PubMed2004

Mean nuclear volume in squamous cell carcinoma of the vulva.

OBJECTIVE: To compare mean nuclear volume (MNV) estimated by the stereologic intercept method in lymph node-positive and -negative cases of squamous cell carcinoma of the vulva. STUDY DESIGN: This retrospective study consisted of 53 cases (lymph node metastasis, n = 19; cases without lymph node metastasis, n = 34) of squamous cell carcinoma of the vulva. MNV was estimated with the help of an image cytometer. The nuclear point intersection method was used to measure MNV. The mean nuclear volumes of both lymph node-positive and -negative cases were compared. RESULT: MNV in the lymph node-negative and -positive cases was 717.0 +/- 533.1 and 1,961.4 +/- 1,369.6 microns 3, respectively (P < .000, Mann-Whitney U test). There was a significant difference in MNV between the 2 groups of tumors. CONCLUSION: The observations from the present study suggest that estimation of MNV of malignant squamous cells from the vulva on conventional histopathology sections may provide an objective and useful diagnostic tool in predicting lymph node metastasis.

Carcinoma, Squamous Cell↗
PubMed2004

Correlation between VEGF expression and angiogenesis in breast carcinoma.

OBJECTIVE: To analyze the role of vascular endothelial growth factor (VEGF) secreted by tumor cells in angiogenesis of breast carcinoma using image morphometry. STUDY DESIGN: Thirty-four cases of node-negative breast carcinoma were used in the study. There were 6 grade 1, 20 grade 2 and 8 grade 3 tumors. For each case, 2 consecutive sections from the same block were cut. Immunostaining for VEGF and CD31 was carried out, and areas of highest staining density were marked. Those marked "hot spots" for CD31 and VEGF for each case were subsequently compared morphometrically. The area and intensity of immunostaining on each slide were also scored. RESULTS: The total scores for VEGF and CD31 were 5.15 and 3.79, respectively. All 34 cases showed cytoplasmic positivity for VEGF within the tumor cells. The average number of hot spots for VEGF and CD31 were 2.41 and 2.47, respectively, and the average number of hot spots that matched between these 2 groups were 0.79. Statistical analysis using Pearson's coefficient of correlation showed no significant match between the hot spots for CD31 and VEGF. Also, there was no significant difference between the total scores of CD31 and VEGF. CONCLUSION: VEGF is expressed in most breast carcinomas. However, the lack of topographic correlation between microvessel density and VEGF expression supports the notion that multiple angiogenic factors may play a role along with VEGF in the angiogenic process.

Breast Neoplasms↗