Evaluation of Histologically and Histochemically Proven Cases of Vitiligo and its Correlation with CD4+ and CD8+ Lymphocyte Counts using Flow Cytometry.

INTRODUCTION: Vitiligo is an acquired cutaneous disorder characterized by progressive and selective destruction of melanocytes from the epidermis. Autoimmunity is strongly implicated in its pathogenesis. The destruction of melanocytes has a correlation with the peripheral blood lymphocyte imbalance mainly including Cytotoxic T cells (CD8+cells) and Helper T cells (CD4+cells). The progression of vitiligo is associated with higher CD8+ counts and lower CD4+ counts thus, altering CD4+: CD8+ ratio. AIM: To evaluate the clinically suspected cases of vitiligo histopathologically and histochemically and to establish the co-relation of autoimmunity with the flow cytometric analysis of CD8+ and CD4+ lymphocyte counts. MATERIALS AND METHODS: In this study, 40 patients with proven vitiligo were taken. The destruction of melanocytes was confirmed by Haematoxylin & Eosin (H & E) and by histochemical stains using Dihydroxyphenylacetic Acid (DOPA) reaction. Blood sample from these vitiligo patients and 10 control subjects was taken. Flow Cytometry was used for the determination of CD8+ and CD4+ counts in the vitiligo patients and control subjects. Then CD4+: CD8+ ratio was calculated and comparison between vitiligo patients and control subjects was done. T-test was used for the statistical analysis. RESULTS: There was statistically significant decrease in CD4+: CD8+ ratio. CD4+: CD8+ ratio was decreased in 57.5% cases of vitiligo with increase in CD8+ counts and decreased CD4+ counts. CONCLUSION: It was concluded from this study that cellular immunity might have a role to play in the pathogenesis of vitiligo causing the destruction of melanocytes.

To evaluate the role of bone marrow aspiration and bone marrow biopsy in pancytopenia.

BACKGROUND: Pancytopenia is not a disease entity but a triad of findings that may result from various disease processes, primarily or secondarily involving the bone marrow. Bone marrow aspiration and biopsy evaluation along with good clinical correlation is of utmost importance to evaluate the causes of pancytopenia and planning further investigations. AIMS: The present study was a prospective clinicohaematological study undertaken to analyse the various causes of pancytopenia by evaluating bone marrow aspiration and biopsy and correlating with clinical findings, complete blood counts and peripheral blood picture. MATERIALS AND METHODS: Fifty patients of pancytopenia were included in the study in which relevant history and physical examination findings were recorded. Bone marrow aspiration and biopsy were performed simultaneously in all cases. Perl's stain was done in all cases and special stains like MPO, PAS and reticulin were also done wherever necessary. RESULTS AND CONCLUSION: The maximum cases of pancytopenia were in the age group of 10 to 30 y with male preponderance. Aplastic anaemia was found to be the most common aetiology of pancytopenia followed by normoblastic erythroid hyperplasia, megaloblastic anaemia, acute leukemias, myelofibrosis, lymphoid neoplasia and iron deficiency anaemia. It was concluded from the study that although the advantages of bone marrow aspiration and biopsy differ, both are complimentary to each other and should be performed simultaneously for a complete bone marrow work up and evaluation. It is only through the correlation of clinical, hematological and bone marrow examination findings that proper evaluation and management of patients of pancytopenia can be made.

Primary chondrosarcoma of male breast: a rare case.

Sarcomas of the breast are relatively rare and account for 1% of all primary malignant tumors of the breast. Pure and primary chondrosarcoma of the male breast is an extremely rare tumor. It may arise either from the breast stroma itself or from underlying bone or cartilage. Differential diagnoses include cystosarcoma phyllodes and breast metaplastic carcinoma with chondroid differentiation.