Online ISSN: 2515-8260

Keywords : carcinoma


A RETROSPECTIVE HISTOLOGICAL STUDY OF GALLBLADDER DISEASE

Aashish Gupta, Amod Kumar, Payal Kumari, Monica

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2510-2514

Background: Gallbladder disease is known to affect a substantial number of people throughout the world. In India, the disease prevalence is on the rise, largely attributable to dietary & lifestyle changes, thus causing a significant disease burden. The purpose of this study is to evaluate the varied histological manifestations of gallbladder pathology and their association with cholelithiasis.
Materials & methods: This retrospective study was conducted in a tertiary medical centre in Patna from January 2020 to December 2020. The clinical data and the histopathological changes were evaluated.
Results: Of the 156 cases which were studied, 120 cases (77%) had gallstones. The mean age was 47 years. Females had a slight preponderance for gallbladder diseases with the Male: Female ratio being 1:2. 138 cases (88.5%) were diagnosed as chronic cholecystitis. 1.92% cases were diagnosed to have invasive malignancies.
Conclusion: A diverse spectrum of diseases affect the gallbladder encompassing inflammatory conditions, parasitic infections, pseudoneoplastic lesions and neoplasms. Routine cholecystectomy specimens should be evaluated meticulously as incidental findingss and diagnosis can be transformative.

COMPARISON OF PIPELLE ENDOMETRIAL SAMPLING VERSUS DILATATION AND CURETTAGE IN CASES OF ABNORMAL UTERINE BLEEDING

Kesavachandra Gunakala, P.M. Rekharao, Seshadri Sahaja, Vennela Mude

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 2338-2359

Background: Pipelle endometrial sampling versus Dilatation and curettage in collecting a sufficient endometrial sample for histopathological diagnosis was the subject of this observational clinical correlation diagnostic study. Aim: The present study is done in our hospital to know if Pipelleaspiration endometrial sampling can replace D&C for histological examination in cases of AUB.
Materials and Methods: This was an observational clinical correlation diagnostic study designed to compare the efficacy of Pipelle endometrial sampling with Dilatation and curettage in obtaining an adequate endometrial sample for histopathological diagnosis. After obtaining informed consent to participate and determining fitness for the procedure, 100 patients who reported with AUB to the Department of Obstetrics &Gynaecology at Government Medical College, Kadapa, were enrolled in the study. The study was carried out from October 2019 to September 2021. The patient underwent a thorough clinical evaluation in the outpatient department, which included a history, physical examination, and baseline investigations. Prior to the procedure, TAS/TVS were done. Endometrial sampling was performed using the Pipelle device, followed by a diagnostic reference standard and D&C endometrial sampling under anaesthesia.
Results: The most common age group presented with AUB is between 41 and 45 years. Most of the patients (45%) had < 6months duration of AUB. Pre and perimenopausalwomen made up 94% of the study population, whereas postmenopausal women made up 6%. Among the study group, 4% were nulliparous, and the remaining 96% were parous women. Of the study group, the ET thickness varies as - 13 had < 6mm, 18 had ET between 6.1- 9mm, 50 had ET between 9.1-12mm, 13 had ET between 12.1-15mm, 4 constitute between 15.1-18mm, 2 had >18mm ET. In Pipelle and D & C, sampling inadequacy was significantly more in menopausal women compared to pre-menopausal women. (P<0.05). In 16 cases, Pipelle sampling was deemed challenging. Sampling was difficult in nulliparous women when compared to parous women. Histopathology reports were obtained in 93 of the 100 Pipelle samples and 94 of the 100 D&C samples in current study.  The most frequent endometrial pattern observed was Hyperplasia without atypia (21%) , followed by proliferative phase of the endometrium (20%), no evidence of malignancy (14%), Secretory phase (11%),  disordered proliferative phase (11%), atrophic endometrium (4%), nonsecretory phase in (4%), endometrial polyp (2%), Hyperplasia with atypia (2%), early secretory phase (1%), endometrial carcinoma (1%), late secretory phase (1%), Endometrial glandular hypertrophy (1%). When comparing Pipelle to D&C, the chi-square test shows that Pipelle has a sensitivity of 98.9% for retrieving sufficient tissue and a specificity of 100%. The positive predictive value is 100 percent, while the negative predictive value is 85.7%. The p-value estimated is< 0 .001, which is statistically significant. Out of 100 cases that had Pipelle sampling, 91 had no complications. 5 had pain, and 4 had bleeding. Out of 100 cases that had D & C, 59 had no complications, 29 had pain, 5 had bleeding, and 7 had both pain and bleeding.
Conclusion: Pipelle sampling can be used as an effective screening procedure in the outpatient department.

HISTOMORPHOLOGICAL STUDY OF PREMALIGNANT AND MALIGNANT EPITHELIAL LESIONS OF THE UTERINE CERVIX

S Shameem Begum, Vishal Parekar, Swetha Koshika

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 2908-2925

Background: Cervical cancer is the most common type of carcinoma in Indian women, and it develops after years of morphologically defined precancerous lesions. The diagnostic criteria for intraepithelial neoplasia and microinvasion vary greatly. In addition, in cases of frank malignancy, histomorphological studies aid in lesion typing, establishing stages of development and determining the extent of involvement, this is critical for prognosis and clinical management. The present study is undertaken to examine the histomorphological characteristics of premalignant and malignant lesions of the uterine cervix and to characterize them based on microscopy.
Materials and Methods: The present study was a prospective study done from June 2021 to May 2022. All histologically verified premalignant and malignant epithelial lesions of the uterine cervix received at the Department of Pathology at Kamineni Institute of Medical Sciences Narketpally were studied and classifed them using the WHO classification, examined accompanying morphological changes, and graded these lesions.
Results: There were 30 premalignant and 35 malignant uterine cervix lesions. The most common premalignant lesion was high grade squamous intraepithelial lesion (HSIL) constituting 16(53.34%) cases followed by 14 (46.66%) cases of low grade squamous intraepithelial lesion (LSIL). IHC analysis reveals p16 positivity in 7 (23.3%) cases of premalignant condition and 6 (20%) cases showed koilocytic change. Among the 35 malignant tumors, all were epithelial carcinomas. 30(85.72%) cases were Squamous Cell carcinoma, 3 (8.58%) were Adenocarcinoma and 1 (2.85%) each were neuroendocrine carcinoma and adenosquamous carcinoma.
Conclusion: Cervical cancer remains the most frequent malignancy in women in underdeveloped countries. Most of the factors associated with invasive cervical cancer in previous epidemiological studies were discovered to be connected to carcinoma in situ and dysplasia of the cervix, such as early age at first intercourse, multiple sexual partners, and pregnancy outside marriage. Histopathological examination is considered the gold standard for the identification of intraepithelial neoplasia and cervical cancer, and it should be undertaken as early as possible to provide a better prognosis, treatment, and protection against invasive cervical carcinoma.

Clinicopathological study of abnormal uterine bleeding in perimenopausal women attending a tertiary care district hospital

Dr. Gayathri BN, Dr. Mallikarjun A Pattanashetti, Dr. Somashekar HK

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1759-1764

Background: Abnormal Uterine Bleeding (AUB) is defined as any bleeding that does not correspond with the frequency, duration or amount of blood flow of a normal menstrual cycle. Endometrial biopsy is important in perimenopausal age group women (40-55 years) to rule out endometrial pathology and malignancy. This study was done to assess Clinicopathological aspects and different histopathological patterns related to Abnormal Uterine Bleeding as no studies have been done in this region of Karnataka, India.
Methods: This is a cross sectional study done from 2019 to 2020. All female patients in the perimenopausal age group presenting with symptoms of AUB were included. Patients less than 40 years of age and endometrial tissues inadequate for opinion on microscopy were excluded. Relevant history and clinical data regarding pattern and duration of abnormal uterine bleeding was retrieved. Endometrial biopsy tissues was processed and stained by H&E. The diagnosis was done and results analysed.
Results: Present study included 94 biopsies of which 6 biopsies were inadequate for opinion. The most common age group presenting with AUB was 40-45 years (53.40%). The most common symptom was menorrhagia. The commonest histopathological pattern among all the perimenopausal age was disordered proliferative endometrium followed by simple hyperplasia without atypia. Other patterns were proliferative endometrium, secretory endometrium, simple hyperplasia, carcinomas etc. The commonest etiology of AUB was Dysfunctional Uterine Bleeding (46.59%) followed by Endometrial hyperplasias. (23.86%)
Conclusions: Correlation with clinical history, radiological investigations along with endometrial biopsy establishes etiology and diagnosis for patients with AUB.

Fibro-epithelial Hyperplasia Mimicking Oral Squamous Papilloma in an 8-year-old child - A Rare Case Report

Dr Ellana Jermiah Joseph, BDS; Dr Razia Haidrus, BDS; Dr Anupama Nayak P, MDS; Dr. Sangeeta U Nayak, MDS; Dr. Srikant Natarajan, MDS; Dr. Arathi Rao, MDS; Dr. Deepa G Kamath, MDS

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1586-1590

Oral mucosa is affected by various papillary lesions. Any oral lesion raises concern because of its clinical appearance. This case report describes the management of an 8-year-old girl with an exophytic papillary growth on the palatal aspect of 64. The lesion clinically resembled an oral squamous papilloma but did not show any signs of a virally infected lesion histopathologic ally or on immunohistochemistry analysis which was unique with this case.

Assessment of radiological prognostic factors in patients with carcinoma cervix treated with concurrent chemoradiation: A clinical study

Manraj Singh Kang; Taranjeet kaur; Gaurav Jaswal; D P Singh; Gagandeep Singh; Khusbu Goyal

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 3001-3006

Aims & Objective: The present study was undertaken for assessing the radiological
prognostic factors in patients with carcinoma cervix treated with concurrent
chemoradiation.
Materials & methods: A total of 40 patients were included. Only those patients were
included which had histological proven diagnosis of carcinoma of cervix. Patients were
within the age range of 19 to 60 years. Complete demographic and clinical details of all the
patients were obtained. Thorough physical examination of all the patients was carried out.
Treatment planned was 3-dimensional conformal radiotherapy with concurrent
chemotherapy followed by radiotherapy and follow-up for 6 months.
Results: Out of 40 patients, 25 patients had NED after 6 months while in 15 patients were
of residual after 6 months. Among the patients with NED, 16 patients had parametrical
extension of less than lateral pelvic wall while disease dimension was more than 6 cm in 17
patients. Hyponephrosis was present in 2 patients. Among the patients with residual, 10
patients had parametrical extension of less than lateral pelvic wall while disease dimension
was more than 6 cm in 15 patients. Hyponephrosis was present in 5 patients.
Conclusion: Patients with higher parametrical extension upto pelvic wall, hydronephrosis
and greater dimension were associated with pelvic failure of disease at follow-up.

Evaluation of Anticancer effect of Ethanolic extract of Lepidagathis pungens Nees., Whole Plant By MTT Assay- An In Vitro Study

Manoharan Dhanalakshmi; Subramaniam AnandaThangadurai

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 1027-1038

Extracts from natural products, especially plants, have served as a valuable source of diverse molecules in many drug discovery efforts and led to the discovery of several important drugs. Lepidagathis pungens Nees., (L.pungens) is a herb of tropical Asia belonging to the family Acanthaceae. The present study deals with the in vitro anticancer activity of ethanolic extract of L.pungens against L6, Ehrlich Ascites Carcinoma (EAC), human breast cancer cells ( MCF 7), human cervical cells (He La) and human hepatocellular carcinoma cell lines (Hep G2). MTT assay was used to assess the in vitro anticancer activity. The extract at various doses were treated against all the cell lines. The parameters analyzed were percentage of cytotoxicity, percentage of cell viability and IC50 values. In results the ethanolic extract of L.pungens showed more potent activity against MCF 7 and EAC cell lines but moderate activity against He La and Hep G2 cell lines. The anticancer nature of the ethanolic extract is due to the presence of phytoconstituents like flavanoids, alkaloids, phenolic compounds, terpenoids, etc. However, further indepth studies are required before final conclusion on the mechanisms involved could be drawn to explain the observed activity. In conclusion, the ethanolic extract of L.pungens possess anticancer activity against various types of cancer cells, correlated to their total phenolic content.