Rupali Mandal

Transfusion transmissible infections among blood donors from a sub-Himalayan rural tertiary care centre in Darjeeling, India

Background In modern health services, blood transfusion is an essentially life-saving manoeuvre. With this situation healthy donor compilation is the cornerstone of transfusion medicine. Henceforth, a provision for strict criterion in recruitment and deferral of blood donors, particularly emphasizing transfusion transmissible infections (TTI), may improve safe transfusion practice. Objectives The present study was executed to assess the prevalence of TTIs within blood donors at a sub-Himalayan rural tertiary care institution in Darjeeling, India; which can ultimately aid in determination of the population subset to be targeted for enhancing donor pool. Methods The present study was a three-year (2010–2012) retrospective study. Data was accumulated and analysed from blood bank records, pertaining to all donors who were screened for various TTIs using respective immunological methods. Then the tabulated seropositive donors were correlated with relevant epidemiological profiles. Results Total 28,364 blood donors were examined, comprising of 25,517 (89.96%) males and 20,985 (73.98%) voluntary donors. Cumulative seroprevalence of HIV, HBV, HCV and syphilis were 0.42%, 1.24%, 0.62% and 0.65% respectively; with solitary malaria-infected donor. The overall seroreactivity in present study significantly diminished through successive years. Conclusions Deployment of implicit inclusion-exclusion criteria is high on demand for reducing the prevalence of TTIs, to increase the donor subpopulation strength and ultimately to institute a safe transfusion protocol.

Cytopathological and Microbiological Profile of Tuberculous Lymphadenitis in HIV-Infected Patients with Special Emphasis on Its Corroboration with CD4+ T-Cell Counts

Objectives: The present study was performed to evaluate various cytological patterns and acid fast bacillus (AFB) grades in HIV-infected patients with tuberculous lymphadenitis and to correlate these with each other as well as with peripheral CD4+ T-cell counts. Study Design: Ninety-two HIV-seropositive patients, cytologically diagnosed with tuberculous lymphadenitis, were evaluated. Fine needle aspiration cytology was performed as an outpatient procedure. Sonographic guidance was sought for internally sited lymph nodes. Cytopathological details were assessed on routinely stained and Ziehl-Neelsen-stained smears. Appropriate AFB grades were assigned. CD4+ T-cell counts were obtained immediately. Finally, the cytopathological findings, AFB grades and CD4+ T-cell counts were corroborated with each other. Results: Epithelioid cell granuloma in the presence of caseation appeared to be the most frequent (66.3%) cytomorphology on aspirated smears. AFB grades 3+ (37%) and 4+ (35.9%) were the commonest patterns of bacillary involvement. The mycobacterial density and cytological features significantly correlated with CD4+ T-cell counts. Conclusions: In HIV-associated tuberculous lymphadenitis, AFB grade and CD4+ T-cell counts worsen with the appearance of necrosis. Here, the peripheral CD4+ T-cell counts inversely correlated with bacillary load. Collectively, peripheral CD4+ T-cell counts, cytological findings and AFB grade exemplify the immune status in these patients.

Pitfalls in the cytological diagnosis of tenosynovial giant cell tumor: An illustration of eight discordant cases

Tenosynovial giant cell tumor (TSGCT) is a highly recurrent benign tumor of the extremities. Wide local excision is usually sufficient to achieve its recurrence‐free outcome. However, that needs a confident pre‐operative cytological diagnosis as TSGCT. Aspirates from this tumor express the characteristic polymorphic cytological pattern, enough to impose a definite diagnosis. However rarely so, inadequate sampling from smaller tumors or due to faulty techniques, and selective sampling from topographic clusters of any individual component may lead to wrong interpretation. An unorthodox location near the larger limb joints further complicates the diagnostic misery on occasions. Such tumors are amenable to incomplete removal and risk for future recurrence. In this report, we describe eight cases of TSGCTs that were cytologically diagnosed otherwise. The cytological features of these discrepant tumors and the factors attributable to such dilemma are elaborated. Finally, a possible remedy has been proposed at conclusion in order to avoid future inconveniences.

A Rare Report of Concurrent Serous and Mucinous Cystadenomas in Bilateral Ovaries

Epithelial tumors in the ovary primarily originate from its surface epithelium or any of its inclusion cysts. These tumors comprise about 60% of all ovarian neoplasms. The epithelium has the potential to differentiate into serous, mucinous, endometrioid, clear cell, or transitional epithelium, and thus any benign, borderline, or malignant tumor thereof. Serous and mucinous tumors are its commonest derivatives, which together reckon for approximately 30% of all ovarian neoplasms. Around 25–50% of the serous tumors are bilateral, most of which are borderline tumors (SBT). But simultaneous involvement of both ovaries with primary tumors of different histology is highly unusual [1]. Krishnendu Mondal as Consultant Pathologist at Sonoscan Healthcare, Malda, West Bengal, India; Tarak Banik as Consultant Pathologist at Malda Medical Centre, Malda, West Bengal, India; Rupali Mandal as Consultant Pathologist at Sonoscan Healthcare, Malda, West Bengal, India.

An inter-correlative study on clinico-pathological profile and different predisposing factors of oral leukoplakia among the ethnics of Darjeeling, India

Context: Idiopathic leukoplakia is the most common potentially malignant disorder of oral cavity. Owing to the year-wide cold environment in Darjeeling, here the indigenous ethnic people practice a distinct addiction pattern that strongly predisposes them to oral leukoplakia. Aims: The purpose of the present study was to assess the clinico-pathological profile and various predisposing factors involved in oral leukoplakia, and to correlate its exfoliative cytological appearances with the histopathological diagnoses. Materials and Methods: A total of 53 patients were clinically diagnosed with oral leukoplakia during the study period. All information − clinical data pertaining to the patient and the patch, their personal history including addiction and diet, and the cyto-histopathological features of the lesion − was evaluated and methodically compared with each other using the statistical software, Statistical Package for the Social Sciences version 16.0. Results: The female-dominated cohort was chiefly affected with thin leukoplakia (67.9%) involving their buccal mucosa (66.1%). Smokeless tobacco (49.1%) was the most popular addiction. Alcoholism and smoking, increasing daily frequency of tobacco misuse, and verrucous and granular leukoplakias were significantly associated with dysplastic transformation (P < 0.05). Out of 16 (30.2%) dysplastic lesions, exfoliative cytology correctly diagnosed only six (11.3%) cases with a sensitivity of 37.5% only. Conclusion: Verrucous and granular variants are the most detrimental forms of oral leukoplakia. Dysplastic transformation frequently occurs in people addicted to smoking and alcoholism, and verrucous and granular leukoplakia. Lastly, exfoliative cytology poorly predicts the dysplastic evolution within a leukoplakic patch.

Follicular hybrid cyst with rare juxtaposition of epidermal cyst and steatocystoma

Any cutaneous cyst differentiating toward two or more pilosebaceous components is known as follicular hybrid cyst (FHC). A combination of epidermal and trichilemmal cyst is its most frequent example. Other combinations of pilosebaceous derivatives occur uncommonly as well. The histogenesis of this condition has been controversial. In this latest report, we describe an unusual FHC from the earlobe of a 19-year-old male, which expressed the cohabitation of epidermal cyst and steatocystoma. A sharp transition was noted between the two kinds of epithelial components.

Bilateral lung metastases unveils an asymptomatic sacrococcygeal yolk sac tumor

Sacrococcygeal yolk sac tumor is an uncommon pediatric neoplasm. It usually presents with intra-abdominal or gluteal pain and mass. At later stage, it disseminates to regional nodes and distant organs. We describe one such neoplasm in an 18-month-old male child who turned symptomatic with multiple bilateral lung metastases. The tumor produced the least deformity to his physique, to become detectable on routine inspection and clinical examination. Finally, a combined approach through clinical, radiological, pathological, and biochemical perspectives established the diagnosis.

Multiple noduloulcerative lesions over extremities: Can cytology be diagnostic?

DOI: 10.4103/ijd.IJD_460_16 A 51-year-old man presented with numerous mobile, skin-colored, tender, subcutaneous nodules over the extensor aspects of his superior and inferior extremities for the past 2 years. These nodules measured between 1 and 5 cm in diameter. Some of the right pretibial lesions were ulcerated and oozed chalky substances. The associated small joints of hands and feet were disfigured [Figure 1]. Their mobility was partially compromised. However, the skin overlying these distorted peripheral joints lacked any inflammatory changes. On further interrogation, he also recalled few episodes of asymmetric arthritis involving hands and feet during the past 15 years. Family history of gout as well as personal history of diabetes, hypertension, alcoholism, purine-rich diet, and exposure to chemicals/heavy metals was negative.

Acute Appendicitis Caused by an Echinococcal Brood Capsule Unmasks an Asymptomatic Hepatic Hydatid Cyst

Hydatidosis is an endemic helminthic disease in the cattle-grazing regions of Asia. It is usually caused by the cestode Echinococcus granulosus. Internal organs, particularly the liver and lungs, are predominantly affected, but the appendix is only rarely involved with the formation of characteristic hydatid cyst. We present a unique case of appendiceal hydatidosis in an 18-year-old woman with acute appendicitis. Her preoperative abdominal ultrasound revealed an asymptomatic hydatid cyst in the liver. An echinococcal brood capsule was detected postoperatively within the appendicular lumen under microscope.

Herpes zoster manifesting as isolated oral thin leukoplakia in an immunocompetent host

Herpes zoster (HZ) has long been considered as a disease of immunocompromised elders. It is usually caused by the revitalized varicella; remaining dormant within the sensory ganglia of sacral dermatomes since an early childhood stint at chickenpox. Trigeminal nerve is rather uncommonly infested. Characteristic zoster lesions appear as unilateral mucocutaneous vesiculobullous rashes, preceded by intense radiating neuralgic pain for few days. This article emphasizes on an immunocompetent man, in his early sixties, presenting with two painful leukoplakic patches over buccal mucosa as the sole manifestation of HZ.