CONGENITAL DYSERYTHROPOIETIC ANEMIA: CASE REPORT OF THREE CASES

Congenital dyserythropoietic anemias (CDA) belong to a group of inherited disorders that are characterized by maturation arrest during erythropoiesis and an inappropriate reticulocyte production in contrast with erythroid hyperplasia in the bone marrow. They show specific morphological abnormalities that allowed for morphological classification of these conditions termed CDA type I and II. With advances in genetic analysis, some altered proteins were found to be involved in chromatin assembly, such as codanin 1 in CDA type I and SEC 23B in CDA type II. CDA type III was characterized later with the presence of gigantoblast in the bone marrow. However, even in the absence of genetic analysis, CDAs can be diagnosed if the history of the patient, clinical examination, and profile is taken into account and a high index of suspicion is maintained if specific morphological abnormalities are found in the bone marrow and peripheral blood

Study of diagnostic accuracy of fine needle aspiration cytology of lymph nodes over 6 years in a tertiary care hospital

Background: Lymph node fine needle aspiration cytology (FNAC) is the first line investigation for evaluation of lymph node disease. Existing literature reports high degree of correlation between lymph node FNAC and histological examination. The aim of the present study is to re-evaluate the diagnostic accuracy of FNAC in view of frequent discordance between FNAC and diagnosis on biopsy.Methods: Among a total of 495 lymph node FNACs and 291 biopsies, 69 adequate FNACs which were followed up with biopsy were evaluated with standard statistical methods for assessment of diagnostic accuracy.Results: The commonest diagnosis on biopsy was reactive lymph node (34.71%) followed by granulomatous disease (26.12%) and lymphoid neoplasms (20.96%). Reactive lymphadenitis and granulomatous disease were also the two commonest categories on FNAC (34.34% and 24.85% respectively). However, the sensitivity of FNAC in diagnosis of granulomatous disease was found to be 45.83%, which increases to 70.03% if necrosis is included as a marker of granulomatous disease. The greatest sensitivity was achieved in diagnosis of metastatic disease (88.89%), followed by lymphoid neoplasms (69.23%).Conclusions: FNAC is a useful tool for excluding specific categories of lymph node diseases, esp. metastatic disease. However, the technique needs improvement as to sample more representative areas of the node, to improve its sensitivity

MIXED PHENOTYPE ACUTE LEUKEMIA OF T/MYELOID TYPE WITH RARE MULTIPLE CYTOGENETIC ABNORMALITY OF CHROMOSOME 8, 9, 11, 12, 16 AND MARKER CHROMOSOME AND DUAL BLAST POPULATION: A RARE CASE

Mixed phenotypic acute leukemia (MPAL) represents a very rare and heterogeneous group of acute leukemias comprising 2-5 % of all leukemias. Although WHO 2008 laid down stringent criteria for diagnosis these still pose a diagnostic challenge as It encompasses leukemias having separate populations of blasts of more than one lineage or a single population of blasts which co-express antigens of more than one lineage. Cytogenetics plays a major role not only in diagnosis but also determines the therapy and prognosis. We present a case of far unreported karyotype aberration in this type of acute leukemia 45, XY, -8, del (9)(p21),-11,add(12)(p13),add (16)(p13.3),+mar[20]with therapy-resistant course

Correlation of serology with morphological changes in gastric biopsy of H. pylori infection

Background: Helicobacter pylori is involved in many gastrodeudonal complications and many diagnostic tests are available for its identification. The present study was done with the objective to evaluate the morphological changes induced by H. pylori in the gastric mucosa and to correlate them with the severity of the infection.Methods: This study was conducted in a tertiary care hospital from July 2013 to June 2014. 60 patients with symptoms of dyspepsia and requiring an upper gastrointestinal endoscopy were included in the study. Upper gastrointestinal endoscopy was performed on all patients. Hematoxylin and Eosin staining (H and E), modified Giemsa staining were performed on tissue sections and examined microscopically for gastritis and presence and absence of H. pylori.Results: Out of 60 patients, 33 were male and 27 were females. Serology by immunochromatography technique was positive in 41 patients. Serology was found to have a sensitivity and specificity of 90.90% and 59.25% respectively. H. pylori was positive in 28 cases on H and E. With a sensitivity and specificity of 84.84% and 100% respectively. H. pylori was positive in 33 cases on modified Giemsa with a sensitivity and specificity of 100%.Conclusions: Simultaneous morphologic and serological detection of H. pylori helps in its complete distribution and identification of its precancerous morphological nature

Post-mortem findings in Staphylococcus aureus acute infective endocarditis

Infective endocarditis (IE) is a microbial infection of the heart valves or the mural endocardium that leads to the formation of vegetations composed of thrombotic debris and microorganisms often associated with the destruction of the cardiac tissues. Most of the infections are bacterial (bacterial endocarditis), although fungi and other microorganisms can be etiological agents. Causative organisms differ among the major high-risk groups. Virulent microorganisms like Staphylococcus aureus, commonly found on the skin, can infect normal or deformed valves and are responsible for 20-30% of all IE cases. Staphylococcus aureus is the major offender in IE among intravenous drug abusers. Acute infective endocarditis is typically caused by infection of a previously normal heart valve by a highly virulent organism (e.g., Staphylococcus aureus) that rapidly produces necrotizing and destructive lesions. These infections may be difficult to cure with antibiotics, and despite appropriate treatment, death can ensue within days to weeks. Here we present autopsy findings of a 31-yearold male patient who died of acute infective endocarditis caused by Staphylococcus aureus as the causative organism