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Ruchika Gupta

Publications and source records attributed to Ruchika Gupta.

14 recordsLinked to original sources
PubMed2006

Bilateral micropapillary serous carcinoma of the ovary: a case report.

BACKGROUND: Micropapillary serous carcinoma (MPSC), a recently described entity in the group of serous borderline tumor, needs to be recognized and separated from serous borderline tumor of usual type (SBT) as MPSC has a worse prognosis. CASE REPORT: We report the case of a 21-year-old female with gradually increasing lump abdomen for 6 months. Ultrasonography showed bilateral ovarian enlargement with cysts. Laparotomy revealed both ovaries to be enlarged and right ovary showed capsular breach. With a per-operative diagnosis of bilateral malignant ovarian tumor, total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Multiple sections from both ovaries showed non-invasive micropapillary serous carcinoma with right ovary showing surface growth but no definite capsular breach. The final histological diagnosis was bilateral micropapillary serous carcinoma. The patient has been asymptomatic in 10-month follow-up. CONCLUSION: MPSC, classified as serous borderline tumor, needs to be differentiated from APST as well as conventional serous carcinoma. It is diagnosed according to strict criteria laid down. Multiple sections should be studied to exclude invasion. Adequate peritoneal sampling should be performed to look for implants, which is of prognostic significance.

Adult↗
PubMed2006

Bilateral encapsulated adipocytic prosoplasia of ovary with fat necrosis: a case report.

Mature adipose tissue is not a normal component of ovarian cortical stroma. Rarely, it is seen as a phenomenon termed adipocytic prosoplasia of ovarian stroma, which occurs as an unencapsulated collection of mature adipocytes. The lesions in differential diagnosis of adipocytic prosoplasia can range from reactive/benign to aggressive conditions. The exact diagnosis of this entity is essential, since no further intervention is required. We describe a case of a 45-year-old female presenting with uterine leiomyomata. Bilateral ovaries were normal on gross inspection. Microscopy of both ovaries showed circumscribed encapsulated subcapsular foci of adipose tissue with focal necrosis and calcification, suggestive of fat necrosis. No teratomatous elements were found on multiple sections examined, and a diagnosis of bilateral adipocytic prosoplasia with fat necrosis was considered. We report this case due to its intriguing and interesting finding, with an emphasis on the various differential diagnoses to be considered in such a case. Extensive examination, special stains and clinico-pathological correlation help in arriving at a proper diagnosis. Our case is the first report of an ovarian adipocytic prosoplasia with fat necrosis.

Adipose Tissue↗
PubMed2006

Spindle cell carcinoma of head and neck: an immunohistochemical and molecular approach to its pathogenesis.

BACKGROUND: Spindle cell carcinoma (SpCC) is a rare microscopic type of cancer of the mouth and oropharynx. Although SpCC is thought to arise from squamous cell carcinoma (SCC), it carries a worse prognosis. AIM: To find out the difference in immunohistochemical expression of cytokeratin, vimentin and smooth-muscle actin, and mutational alterations in the K-ras oncogene between the two tumours, in an attempt to characterise SpCC. METHODS: Immunohistochemical analysis was performed by standard avidin-biotin complex method in 35 cases each of SpCCs and SCCs. DNA extracted from paraffin wax-embedded tumours was used for PCR followed by single-strand conformation polymorphism for mutational analysis of K-ras exon 1 and exon 2. RESULTS: In the SpCC group, cytokeratin positivity was significantly higher in epithelial areas (52.2%) than in spindle cell areas (16.1%), whereas vimentin was more positive in spindle cell areas (18.7%) than epithelial areas (2.7%). Cells intermediate between epithelial and spindle cell areas were consistently positive for both cytokeratin and vimentin. Cytokeratin was found to be significantly more positive in SCC (72.6%) than the squamous component and spindle cell component of SpCC. In this study, no mutation was detected in the K-ras gene of either the SpCC or SCC group. CONCLUSIONS: The spindle cell component of SpCC is intermixed with cells that are morphologically mesenchymal but express dual antigen-positivity characteristic of epithelial (cytokeratin) and mesenchymal (vimentin) cells. These, possibly, are cells in transition suggesting that SpCC may be a sarcomatous metaplasia of SCC.

Actins↗
PubMed2006

Persistent splenomegaly in an adult female with homozygous sickle cell anemia.

Sickle cell anemia (SCA) is associated with repeated episodes of erythrostasis in the spleen, which lead to thrombosis and infarction of the spleen resulting in "autosplenectomy" which is usually complete by 8 years of age. We present a case of a 22-year-old female who presented with complaints of fever, bone pain and joint swelling. On examination she had pallor, icterus and moderate splenomegaly. Her hemoglobin was 7.5 g/dl. Peripheral smear showed many sickled red cells. Slide test for sickling was positive with 2% sodium metabisulphite. Hemoglobin electrophoresis revealed a single band in the hemoglobin S, D, and G region. No band was seen in the HbA & HbA(2) region. HbF level was 0%. USG showed an enlarged spleen with few defined hypoechoeic lesion. We present this case because of rarity of association of homozygous SCA with splenomegaly in this age group, the confusion that echogenic lesions in spleen can create and to emphasize the risk of sequestration crises, which remains in such cases.

Adult↗
PubMed2005

Clinico-pathological profile of 12 cases of chorangiosis.

Chorangiosis is one of the vascular lesions that involves terminal chorionic villi. It is commonly associated with various feto-maternal conditions like pre-eclampsia, diabetes etc. However, the clinical significance of this pathological finding has not been studied extensively. The aim of this study was to identify the various conditions associated with chorangiosis and to determine its clinical significance. A retrospective study to identify the cases of placentas diagnosed with chorangiosis was carried out and the clinical and morphological details of these cases were reviewed. Immunostaining for CD34 and muscle-specific actin was also performed to confirm chorangiosis and to exclude chorangiomatosis. A total of 12 cases of chorangiosis were retrieved, most of them were of term gestation. Five of these 12 cases were associated with various maternal conditions including syphilis (2 cases) and single cases of pre-eclampsia, diabetes and jaundice. One case in each had abruptio placenta and non-immune hydrops. Of these 12 cases, seven were stillborn. Microscopically, all 12 cases showed extensive chorangiosis involving terminal villi. In addition, two cases showed focal infarction and one had extensive calcification. Immunostaining for CD34 confirmed increased number of capillaries while muscle-specific actin was negative, excluding chorangiomatosis. The clinico-pathological profile presented in this study suggests that chorangiosis has characteristic pathological features for its recognition and needs to be differentiated from similar conditions like chorangioma and chorangiomatosis. Also, chorangiosis has potential clinical significance and should be mentioned in the pathology report and the patient should be investigated for associated conditions like syphilis, pre-eclampsia, diabetes etc.

Adult↗
PubMed2004

Leiomyomatosis peritonealis disseminata with malignant change in a post-menopausal woman.

BACKGROUND: Leiomyomatosis peritonealis disseminata (LPD) is a rare condition characterized by multiple subperitoneal nodules of benign smooth muscle. The lesion usually occurs in women of childbearing age. CASE: A 55-year-old woman with a history of panhysterectomy 8 years ago presented with an abdominal lump. Ultrasonographic and peroperative finding of multiple omental nodules led to a clinical impression of disseminated malignancy. Only the largest nodule was excised, histopathology of which revealed a cellular leiomyoma. Seven months later, she developed an omental leiomyosarcoma. An omentectomy was done and the multiple smaller nodules were all confirmed to be composed of benign leiomyocytes. CONCLUSION: Malignant transformation in LPD in post-menopausal patients is an exceptional event that has been documented only twice previously in English literature.

Cell Transformation, Neoplastic↗
PubMed2004

Multicystic nephroma--report of two cases.

Multicystic Nephroma (MCN) is an uncommon renal pathology, characterized by the presence of usually unilateral circumscribed focal lesion consisting of multiple thin walled cysts. The etiology and pathogenesis of multicystic nephroma is not clear, and it is considered as a neoplastic lesion by many authors. To the best of our knowledge it has not yet been reported from India. We report first two pediatric cases of MCN from India. Computerized Tomography (CT) scan in both the cases revealed a unilateral cystic lesion in the lower pole of kidney. Keeping in mind the age, clinical presentation and radiological appearance, a possibility of Wilm 's tumour with cystic change could not be ruled out preoperatively and both children underwent nephrectomy. Since MCN has a benign behaviour it must be differentiated from focal cystic neoplastic lesions, including Cystic Partially Differentiated Nephroblastoma (CPDN), which has a low but distinct capability for local recurrence, and from Wilm's tumour with cystic change. Segmental form of unilateral renal dysplasia also needs to be considered in the clinical and radiological differential diagnoses.

Child, Preschool↗
PubMedDate not supplied

Recurrent calcifying epithelial odontogenic tumor of the maxilla: report of a case with cytologic diagnosis.

BACKGROUND: Calcifying epithelial odontogenic tuor (CEOT) occurs rarely in the maxilla and lacks classical clinicoradiologic features. The cytologic features in conjunction with the radiologic picture can be helpful in making a preoperative diagnosis and guiding management. CASE: A young man with a progressively increasing left cheek swelling and proptosis of the left eye was referred for fine needle aspiration cytology. The smears were paucicellular and showed clusters of mildly pleomorphic squamoid cells; abundant, amyloidlike, pink material; and occasional concentric calcification. A provisional diagnosis of CEOT was given and confirmed on histopathology. CONCLUSION: The characteristic cytologic findings in association with radiologic features can help the cytopathologist in rendering a firm preoperative diagnosis of CEOT even at atypical sites such as the maxilla.

Adult↗
PubMedDate not supplied

Tubercular dactylitis: Fine needle aspiration cytology as a diagnostic modality.

OBJECTIVE: To evaluate the efficacy of aspiration cytology in the early diagnosis of tuberculous dactylitis and describe the spectrum of cytomorphologic features in these cases. STUDY DESIGN: We studied 12 cases of dactylitis diagnosed as of tubercular etiology by fine needle aspiration cytology (FNAC) over a period of 6 years and assessed the clinicoradiologic features. The stained slides were reviewed and the spectrum of features noted. RESULTS: The most common clinical presentation was an indurated swelling of the involved digit (100%). On radiography, most often an expansile, lytic lesion along with soft tissue swelling was noted in 83% of cases. However, the clinical diagnosis did not consider a tubercular (TB) etiology. FNAC of these cases showed variable features; the most common was granulomas with or without necrosis (75% in total). Two cases showed acute suppurative cytology, and 1 revealed only fibroblasts and afew neutrophils. On the basis of suspicion, staining for acid-fast bacilli (AFB) was done in all cases, and bacilli were identified in all of them after a thorough search. These patients were soon started on antituberculous therapy, with significant improvements. CONCLUSION: FNAC can serve as an inexpensive and comparatively less invasive procedure for early diagnosis of TB dactylitis, permitting timely initiation of specific therapy. This study also highlighted the unusual cytomorphology in some cases. Clinicians and pathologists should maintain a high index of suspicion in cases of dactylitis and stain for AFB in all cases.

Antitubercular Agents↗
PubMedDate not supplied

Follicular carcinoma of the thyroid with hyperthyroidism. A case report.

BACKGROUND: Follicular carcinoma of the thyroid in association with hyperthyroidism is rare. The malignant lesion may remain occult for a long time. Certain clinical and cytologic features may be helpful in raising the alarm. CASE: An elderly male with a history of occupational exposure to X rays, long-standing toxic multinodular goiter and clinical hyperthyroidism presented with a rapidly enlarging mass in the neck. Cytologic smears showed a prominent microfollicular pattern, scanty colloid, anisonucleosis and nuclear overlapping. The noteworthy feature was the presence of marginal vacuoles. The cytologic diagnosis of follicular neoplasm with highly suggestive malignancy was made. Subsequently, multiple pulmonary nodules provided radiologic evidence of possible metastatic spread. CONCLUSION: This case report demonstrates the rare association of follicular carcinoma of the thyroid with hyperthyroidism and analyzes certain high-risk clinical and cytologic features to be considered in the follow-up of long-standing hyperfunctioning multinodular goiter.

Adenocarcinoma, Follicular↗
PubMedDate not supplied

Complete gastric duplication cyst.

We report a 13-year-old boy who was detected to have an abdominal mass on ultrasonography. A possibility of tuberculous lymph nodes was considered in view of history of pain, low fever, and anorexia. Histology of the excised mass showed complete gastric duplication cyst.

Adolescent↗