Histomorphological and morphometrical changes of placental terminal villi of normotensive and preeclamptic mothers.

Placental morphology and cellular arrangement are altered in maternal diseases such as preeclampsia (PE) in which oxygen delivery from the mother to the fetus is greatly disturbed, ultimately resulting in cellular oxidative stress. The present study was conducted at the Department of Anatomy and included 112 placentas (56 each from mothers with and without PE [controls]) collected at the Department of Obstetrics and Gynecology. A histological study was performed using hematoxylin and eosin staining. The morphology of stem and terminal villi (TV) was studied, and the surface area and diameter of TV and capillaries were measured. The gross placental morphometrical study revealed that the mean placental weight, thickness, diameter, and surface area were significantly lower in placentas with PE than in controls. The histomorphometrical findings of the villous surface area and diameter were lower in placentas with PE, whereas the TV density was higher in placentas with PE than in controls, and the differences were significant (P<0.0001). In these TV, the diameter and density of fetal blood vessels of placentas with PE were significantly lower than those of controls (P<0.05). In conclusion, the both morphological and histological changes in PE placentas are indicative of the pathogenesis of maternal and fetal morbidity and mortality in women with PE. The observed and comparative histomorphometrical changes indicate a decline in all aspects of the PE placenta, except the number of TV.

Vasculosyncytial membrane in relation to syncytial knots complicates the placenta in preeclampsia: a histomorphometrical study.

The vasculosyncytial membrane (VSM), primary site of fetomaternal exchange is formed when syncytiotrophoblast surrounds the terminal villi and make a close contact with capillaries. Some syncytiotrophoblast forms thin single layer of villous and some syncytial nuclei become piled up to form the syncytial knots (SKs). Undoubtedly there is a clear-cut inverse relation between villous VSM and fetal hypoxia. In preeclampsia (PE) the hypoxia injury disrupts the syncytial architecture which in turn initiates other complications of PE. Present study was designed to observe the morphological and histomorphometric features of 84 placentas from control and PE (42 each) collected from Department of Obstetrics and Gynecology. Neonatal weight and placental weight were reduced in PE than the controls but the feto-placental index did not differ. The SK density and VSM thickness was found to be increased and was statistically significant in PE cases. In relation to SKs, the VSM thickness was twofold increased than the controls and was statistically significant. The SKs in the present study were classified as type-1, 2a, 2b, and 3. Type 1 was found to be 62% in control and 47% in PE, type 2a and 2b were 38% in control and 37% in PE, and type 3 was in 8% of PE cases. All the parameters of present study reveal the adverse effects of PE influencing on both morphological and microscopical features of the placenta resulting in fetal hypoxia.

Surgery in Hashimoto's thyroiditis: indications, complications, and associated cancers.

BACKGROUND: Indications for surgery in Hashimoto's thyroiditis (HT) patients are compressive symptoms and suspicion of malignancy. A high incidence of thyroid malignancy has been reported in patients with HT. The effect of surgery on discomfort in swallowing and tightness in the neck has not been properly evaluated. AIMS: The aim of our study is to compare the indications, complications, and associated cancers in patients operated for HT with those surgically treated for other benign goitres. The effect of surgery on minor symptoms like tightness in the neck and discomfort in swallowing is included. SETTING AND DESIGN: This was a retrospective case-control study at a tertiary care centre. PATIENTS AND METHODS: A total of 271 patients who had undergone surgery for benign thyroid diseases were included. Group A consisted of 35 patients who had HT and Group B consisted of patients operated for other benign thyroid diseases (236 patients). STATISTICAL ANALYSIS: Data were analyzed using SPSS 12 software. Independent group's t-test was used to compare the means and Fisher's exact test was used for categorical data. RESULTS: In Group A, the common indications for surgery were discomfort associated with swelling (45.7%), cosmesis (34.3%), and pain with swelling (11.4%) whereas in Group B, the indication was predominantly cosmetic (80%). A total of 22.9% patients of Group A and 6% of Group B were hyperthyroid. The sensitivity of FNAC for diagnosing thyroiditis was 62.8% (n = 22). Postoperative complication rates were similar in both the groups. The mean operating time was higher in Group A even though the gland was smaller. Incidental malignancy was 3.4% in Group B whereas there was none in Group A. Discomfort in swallowing and tightness in the neck were relieved at 3 months after surgery. CONCLUSIONS: Large, euthyroid and apparently asymptomatic HT occasionally need surgical intervention. Discomfort in swallowing and tightness in the neck are relieved after surgery. Thyroidectomy is safe to perform and has a low incidence of permanent complications. There was no associated malignancy in our series of HT.

Trichoadenoma of Nikolowski.

Trichoadenoma of Nikolowski is a rare benign cutaneous tumor, which is usually solitary, nodular and occurs on the face or buttocks any time during adult life. The morphological differentiation of trichoadenoma is situated between a trichofolliculoma and a trichoepithelioma with hair follicle-like direction of differentiation. We report this case of trichoadenoma in a 28-year-old man who presented with a solitary nodular and ulcerated swelling in the gluteal region, gradually increasing in size. Excision biopsy revealed characteristic features consistent with trichoadenoma. We report this case in view of its rarity.

Osteochondroma-like parosteal osteosarcoma.

Parosteal osteosarcoma is a well-differentiated, predominantly fibro-osseous variant of osteosarcoma, accounting for 5% of all osteosarcomas. We report a case of parosteal osteosarcoma in the metaphyseal area of right femur, of 2 years' duration in a male aged 35 years. It was mistaken for osteochondroma in the initial biopsy, and the possibility of bizarre parosteal osteochondromatous proliferation (BPOP) was also considered. Subsequent excision of the tumor showed it to be a parosteal osteosarcoma. The patient had recurrence of the lesion after 1 year, and he attended a cancer institute. Follow-up showed metastases of the tumor on bone scan.