Asunto(s)
Citodiagnóstico , Lipoma/diagnóstico , Neoplasias de las Glándulas Salivales/diagnóstico , Biopsia con Aguja Fina , Humanos , Lactante , Lipoma/patología , Lipoma/cirugía , Masculino , Neoplasias de las Glándulas Salivales/patología , Neoplasias de las Glándulas Salivales/cirugía , Glándulas Salivales/patologíaRESUMEN
OBJECTIVE: To analyse clinicopathological features of acute respiratory distress syndrome (ARDS) in disseminated tuberculosis (TB) at autopsy. METHODS: A retrospective analysis of an autopsy database of disseminated TB from 1990 to 2010 was conducted. ARDS cases were assessed for histological changes of diffuse alveolar damage (DAD) and other pathological pulmonary features. RESULTS: Disseminated TB was diagnosed in 196 cases. The clinical diagnosis of disseminated TB was made in 67% of cases. Of the 196 cases, 10 met the clinical criteria for ARDS, 60% of whom showed histological evidence of DAD. One case of DAD was diagnosed on histology alone. DAD was thus found in 7/196 cases of disseminated TB. Other pulmonary changes included necrotising granulomas (n = 10), tuberculous bronchopneumonia (n = 4), tuberculous vasculitis (n = 3), infarction (n = 1) and aspergilloma (n = 1). Histopathological diagnosis other than DAD was found in 4/10 cases and disseminated TB was presumed clinically in only 4/10 cases of ARDS. CONCLUSION: Disseminated TB may be clinically missed and diagnosed only post mortem. Disseminated TB is a relatively uncommon cause of ARDS; however, it should always be presumed clinically as it is a potentially treatable cause. DAD is a rare histological feature of disseminated TB and there may not always be a clinicopathological correlation between ARDS and DAD.
Asunto(s)
Alveolos Pulmonares/patología , Síndrome de Dificultad Respiratoria/patología , Tuberculosis Miliar/patología , Tuberculosis Pulmonar/patología , Adulto , Autopsia , Causas de Muerte , Bases de Datos Factuales , Femenino , Humanos , Lactante , Masculino , Microscopía , Persona de Mediana Edad , Alveolos Pulmonares/microbiología , Síndrome de Dificultad Respiratoria/microbiología , Síndrome de Dificultad Respiratoria/mortalidad , Estudios Retrospectivos , Factores de Riesgo , Tuberculosis Miliar/complicaciones , Tuberculosis Miliar/microbiología , Tuberculosis Miliar/mortalidad , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/microbiología , Tuberculosis Pulmonar/mortalidad , Adulto JovenRESUMEN
BACKGROUND: Hirschsprung's disease (HD) is an anomaly characterized by the absence of myenteric and submucosal ganglion cells (GC) in the distal alimentary tract. Diagnosis of HD is made by the absence of GC and missing out on even a single ganglion cell can be very devastating. Acetylcholinesterase (AChE) histochemistry, done on frozen sections is said to be a very useful ancillary technique in the diagnosis and in aiding the operative procedures of HD. METHODS: To assess this, 73 samples from 42 suspected/known cases of HD were subjected to frozen section analysis with rapid haematoxylin and eosin, toluidin blue stain along with AChE histochemistry. The remnant sample was paraffin embedded for routine haematoxylin and eosin staining. RESULTS: On frozen section analysis, 33 samples showed absence of ganglion cells, AChE histochemistry showed a positive staining pattern in 17 samples and paraffin embedded routine, H&E stained sections showed absence of ganglion cells in 19 samples. Sensitivity and specificity of both tests ie frozen section rapid H&E/AChE histochemistry in the diagnosis of HD, were calculated taking paraffin embedded H&E stained sections as the gold standard. Sensitivity of frozen section rapid H&E in the diagnosis of HD is 57.57 % and specificity is 79.10 %. The p-value is <0.0001, which is significant. The sensitivity of AChE histochemistry in the diagnosis of HD is 90.47 % and specificity is 96.36 %. The p-value is <0.0001, which is significant. CONCLUSIONS: Acetylcholineesterase (AChE) histochemistry is a very useful ancillary technique in the diagnosis and in aiding the operative procedures of HD. It acts as a double check in the diagnosis of HD.
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Acetilcolinesterasa/metabolismo , Enfermedad de Hirschsprung/diagnóstico , Enfermedad de Hirschsprung/patología , Biopsia/métodos , Niño , Preescolar , Femenino , Secciones por Congelación/métodos , Hematoxilina , Enfermedad de Hirschsprung/metabolismo , Humanos , Lactante , Recién Nacido , Masculino , Sensibilidad y Especificidad , Coloración y Etiquetado/métodosAsunto(s)
Astrocitoma/patología , Neoplasias Encefálicas/patología , Transformación Celular Neoplásica/patología , Neoplasias Neuroepiteliales/patología , Adulto , Astrocitoma/radioterapia , Astrocitoma/secundario , Astrocitoma/cirugía , Neoplasias Encefálicas/cirugía , Humanos , Imagen por Resonancia Magnética , Masculino , Neoplasias Neuroepiteliales/diagnóstico por imagen , Neoplasias Neuroepiteliales/cirugía , Radiografía , Resultado del TratamientoAsunto(s)
Neoplasias del Tronco Encefálico/diagnóstico , Ángulo Pontocerebeloso/patología , Hemangiopericitoma/diagnóstico , Neoplasias del Tronco Encefálico/patología , Diagnóstico Diferencial , Trastornos Neurológicos de la Marcha/etiología , Hemangiopericitoma/patología , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Persona de Mediana EdadRESUMEN
A 30-year-old man was admitted in PGIMER with the complaints of fever, altered sensorium and seizures. Magnetic resonance imaging (MRI) showed bilateral symmetrical temporal and frontal hyperintensities, which were highly suggestive of herpes simplex encephalitis. However, brain autopsy revealed it to be tuberculous meningo-encephalitis.
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Encefalitis por Herpes Simple/diagnóstico , Meningoencefalitis/diagnóstico , Meningoencefalitis/microbiología , Tuberculosis Meníngea/diagnóstico , Adulto , Corteza Cerebral/patología , Resultado Fatal , Humanos , Imagen por Resonancia Magnética , Masculino , Meningoencefalitis/patologíaRESUMEN
The lipomatous differentiation occurring within neurocytoma has more frequently been reported in neurocytoma of cerebellar origin as case reports and short series. This case report describes the clinical, radiological, histopathological and ultrastructural findings of supratentorial central neurocytoma with lipomatous differentiation in a 45-year-old female. Magnetic resonance imaging (MRI) revealed an intraventricular lesion in the right trigone which was isointense on T1 and hyperintense on T2 weighted images. There were small cystic areas and it enhanced brilliantly and homogenously on contrast. The rare lipomatous differentiation occurring in neurocytoma in the supratentorial location lends it a distinct morphological profile and thus recommends its designation as "central liponeurocytoma".
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Neurocitoma/patología , Neoplasias Supratentoriales/patología , Femenino , Humanos , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
Rosai-Dorfman disease is a rare, benign histiocytic proliferative disorder, which commonly affects the lymph nodes. Cutaneous Rosai-Dorfman disease is a rare form of Rosai-Dorfman disease limited to the skin. We report a case of cutaneous Rosai-Dorfman presenting with bilateral eyelid swelling in a child.
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Edema/patología , Enfermedades de los Párpados/patología , Histiocitosis Sinusal/patología , Índice de Severidad de la Enfermedad , Biopsia , Niño , Femenino , HumanosRESUMEN
The acquisition of immunity following subclinical or resolved infection with the intracellular parasite Leishmania donovani suggests that vaccination could prevent visceral leishmaniasis. The characteristics and in vitro stimulating capability of the recombinant proteins expressed by previously identified clones on the basis of their capacity to stimulate an indigenously established Leishmania-specific cell line leading to high level of IFN-gamma suggested these to be potential candidates for immunoprophylaxis against leishmaniasis. In this study, we investigated the protective efficacy of purified recombinant proteins from two of the identified cDNA clones along with the adjuvant MPL, in a hamster model of experimental leishmaniasis. We demonstrate here that the immunization of animals with one of the recombinant proteins (rF14) having 97% similarity to C1 clone of L. chagasi ribosomal protein gene P0 (rLiP0) along with MPL provided partial protection against the virulent challenge of L. donovani. The absence of antigen-specific lymphoproliferative responses in these immunized animals may be responsible for the lack of complete and long-lasting protection.
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Leishmania donovani/inmunología , Leishmaniasis Visceral/prevención & control , Vacunas Antiprotozoos , Adyuvantes Inmunológicos/administración & dosificación , Animales , Anticuerpos Antiprotozoarios/biosíntesis , Antígenos de Protozoos/inmunología , Cricetinae , Citocinas/biosíntesis , Modelos Animales de Enfermedad , Femenino , Granuloma/etiología , Hipersensibilidad Tardía , Inmunoglobulina G/biosíntesis , Lípido A/administración & dosificación , Lípido A/análogos & derivados , Hígado/parasitología , Hígado/patología , Activación de Linfocitos , Masculino , Mesocricetus , Nitritos/metabolismo , Tamaño de los Órganos , Bazo/inmunología , Bazo/parasitología , Bazo/patología , Superóxidos/metabolismo , Vacunas SintéticasRESUMEN
AIM: The role of CXC chemokine, interferon-gamma-inducible protein-10 and its receptor CXCR3 in pathophysiology of chronic pancreatitis (CP) is not very clear. Hence, this study was carried out to analyze the expression of CXCL10 and CXCR3 in CP tissues. METHODS: Pancreatic tissues from 25 histopathologically graded CP cases (11 alcohol associated CP, 5 confirmed idiopathic and 9 of undefined nature) and 10 normal cases were studied. Tissues were subjected to real-time PCR, immunohistochemistry, and Western blot analysis for CXCL10 and CXCR3 expression. RESULTS: Real-time (RT)-PCR revealed increased expression of CXCL10 (13-fold) and CXCR3 (7-fold) in CP tissue. The immunohistochemistry and Western blot analysis of the same showed significant increased protein expression and correlated well with the histopathological grades. The CXCL10 was localized mainly in the cytoplasm of pancreatic acinar cells and expression increased from grade I to grade II and declined in grade III while no expression was recorded in normal. The CXCR3 was expressed strongly at the acinar cell membrane in CP as compared to normal. Further, comparative analysis by semiquantitative RT-PCR analysis was performed for other CXC/CC chemokines (CXCL9, CXCL11, CCL3, CCL4, CCL5) and receptor (CCR5) which revealed their upregulation in the diseased state. CONCLUSION: The existence of CXCL10 and CXCR3 with other CXC/CC chemokine signature in CP is suggestive of their vital role in the progression of chronic inflammation.
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Quimiocina CXCL10/biosíntesis , Pancreatitis Crónica/metabolismo , Receptores CXCR3/biosíntesis , Adolescente , Adulto , Western Blotting , Femenino , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Pancreatitis Crónica/patología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Regulación hacia ArribaAsunto(s)
Granuloma de Células Plasmáticas/diagnóstico , Neoplasias Laríngeas/diagnóstico , Recurrencia Local de Neoplasia/patología , Ruidos Respiratorios/etiología , Niño , Granuloma de Células Plasmáticas/complicaciones , Granuloma de Células Plasmáticas/metabolismo , Granuloma de Células Plasmáticas/patología , Humanos , Inmunohistoquímica , Inflamación/patología , Neoplasias Laríngeas/complicaciones , Neoplasias Laríngeas/metabolismo , Neoplasias Laríngeas/patología , Laringoscopía , Masculino , Tomografía Computarizada por Rayos XRESUMEN
A 25-year-old male presented with features of acute airways obstruction. He was diagnosed to have a lower tracheal mass with near total tracheal obstruction and complete obstruction of the left main bronchus. The tumour was resected successfully using a two-step method of ventilation. Histopathology of the mass revealed it to be a spindle cell sarcoma. Subsequently, local irradiation and systemic chemotherapy was given.
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Obstrucción de las Vías Aéreas/etiología , Sarcoma/patología , Neoplasias de la Tráquea/patología , Adulto , Humanos , MasculinoRESUMEN
Central neurocytomas are benign neuronal tumours generally found in the lateral or third ventricles. They are rare, comprising < 1% of all brain tumours. It is frequently confused with other tumours of the central nervous system particularly oligodendroglioma. The present study was done to analyse the histopathological features including immunohistochemical profile of these rare tumours. Eight cases were taken up for the study. Seven of the cases had an intraventricular location and one was located outside the ventricles. Increased intracranial pressure was the most common presenting symptom. Microscopically all tumours were composed of small uniform cells with perinuclear halos and regular round nuclei. The tumour in extraventricular location showed atypical features. Immunohistochemistry showed positivity for neuronal markers. The present series highlights the characteristic clinical and pathological findings of this rare brain tumour. Immunostaining for neuronal markers are essential for distinguishing them from other small round cell tumours of the brain.
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Neoplasias del Ventrículo Cerebral/patología , Neoplasias del Ventrículo Cerebral/fisiopatología , Neurocitoma/patología , Neurocitoma/fisiopatología , Neuronas/metabolismo , Adolescente , Adulto , Preescolar , Femenino , Humanos , Inmunohistoquímica , Hipertensión Intracraneal , Masculino , Proteínas del Tejido Nervioso/metabolismo , Sinaptofisina/metabolismoRESUMEN
BACKGROUND: Demyelinating diseases can present as space occupying lesions with in the brain. It is clinically and radiologically difficult to differentiate them from primary neoplasms. Histopathologically they mimic astrocytic neoplasms closely and identifying these lesions correctly has a profound impact in treatment and prognosis of these patients. AIMS AND OBJECTIVES: The objective was to determine the histopathologic features of such acute focal demyelinating disease that clinically presented as brain tumors. MATERIAL AND METHODS: Seven cases were included for the study. Detailed histopathological examination including stains for myelin and axon were performed. The histopathological keys in arriving at the right diagnoses included a well demarcated lesion that contains uniform distribution of foamy macrophages in the absence of any associated coagulative necrosis, sheets of gemistocytic astrocytes in the white matter that show well-formed processes, perivascular chronic inflammatory cell infiltration and total absence of myelin with relative preservation of axons within these areas. CONCLUSION: The degree of suspicion (clinical, radiological and histopathological) should be high to diagnose these group of lesions. The above-mentioned diagnostic keys should help in arriving at the correct histopathological diagnoses of such cases.
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Neoplasias Encefálicas/patología , Glioma/patología , Esclerosis Múltiple/patología , Adulto , Diagnóstico Diferencial , Femenino , Hematoxilina , Humanos , Indoles , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Reacción del Ácido Peryódico de Schiff , Sinaptofisina/ultraestructuraRESUMEN
Snake bite is an important cause of mortality and morbidity in India, with an estimated 35,000 to 50,000 fatal bites occurring annually. The neurological consequences of snake bite are predominantly the result of inhibition of neuromuscular transmission. We describe the first documented case of autopsy proven acute disseminated encephalomyelitis following treated snake bite in a young female.
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Encefalomielitis Aguda Diseminada/etiología , Mordeduras de Serpientes/complicaciones , Adulto , Encefalomielitis Aguda Diseminada/diagnóstico por imagen , Encefalomielitis Aguda Diseminada/patología , Resultado Fatal , Femenino , Humanos , India , Mordeduras de Serpientes/terapia , Tomografía Computarizada por Rayos X/métodosRESUMEN
Chondrosarcoma is distinctly uncommon and tends to be located often in the extremities in young patients more than in its adult counterpart. Cartilaginous tumors involving the small bones of the hands and feet are benign tumors such as enchondromas, chondromyxoid fibroma (CMF), and chondroblastoma. Chondrosarcomas involving calcanaeum in young adults are largely covered in the literature as single case reports. A young 12-yr-male patient presented with complaints of pain and mild swelling in the ankle. Radiological examination revealed a dense irregular lesion in the calcanaeum. Fine-needle aspiration was performed and a possibility of chondrosarcoma was suspected, which later was confirmed on histopathological examination. The cytopathologist should be aware of the occurrence of malignant chondroid tumors in the younger age group at this rare site. Correlation to radiological findings is essential in these cases.
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Neoplasias Óseas/patología , Calcáneo/patología , Condrosarcoma/patología , Biopsia con Aguja Fina , Niño , Humanos , MasculinoRESUMEN
Primary malignant fibrous histiocytoma (MFH) of the central nervous system (CNS) is uncommon. We report cases of two young patients of MFH arising from the cranial meninges and involving the adjacent skull and scalp. There was infiltration of the brain in one case. Both the lesions were excised and primary scalp repair was performed.
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Histiocitoma Fibroso Benigno/patología , Neoplasias Craneales/patología , Adulto , Femenino , Histiocitoma Fibroso Benigno/cirugía , Humanos , Masculino , Procedimientos Neuroquirúrgicos , Cuero Cabelludo/patología , Cuero Cabelludo/cirugía , Neoplasias Craneales/cirugía , Tomografía Computarizada por Rayos XRESUMEN
Botryomycosis is characterized by a chronic suppurative lesion with distinctive fungus-like grains that resemble the sulphur granules of actinomycosis. Both integumentary and visceral forms of the disease are recognized. The visceral involvement occurs predominantly in the lungs. Botryomycosis may develop in apparently healthy individuals as well as the immunologically compromised. Six cases of botryomycosis, affecting various sites in the bodies of immunocompetent individuals, are described. In each of the six cases, the initial clinical diagnosis was of an abscess or malignancy.