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Kundu R, Kollabathula A, Gupta N, Rohilla M, Rana SS, Nada R, Kalra N, Basher RK, Gupta P, Dey P, Gupta R, Dutta U, Srinivasan R. The WHO system versus the Papanicolaou society of cytopathology system for reporting pancreaticobiliary cytology for risk stratification-which is better? Diagn Cytopathol 2024; 52:145-155. [PMID: 38059418 DOI: 10.1002/dc.25258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Recently, the World Health Organization (WHO) has proposed a reporting system for pancreaticobiliary cytopathology. We applied this classification for pancreatic lesion samples by fine needle aspiration (FNA) and compared the results to the previous classification of the Papanicolaou Society of Cytopathology (PSC) system for risk stratification. METHODS The computerized database was searched for all pancreatic endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and transabdominal ultrasound-guided FNA (TUS-FNA) samples from 2016 to 2020 and cases were reassigned as per the PSC and the WHO diagnostic categories. Cases with follow-up, clinicoradiological, and/or histopathology were included in the study. The risk of malignancy (ROM) was calculated across all diagnostic categories based on clinical data, imaging data, and histopathology wherever available. RESULTS There were a total of 625 pancreatic FNA. In 230 cases, follow-up information was available which included 116 EUS and 114 TUS-FNA samples. The ROM for PSC categories I-VI was 40%, 19.7%, 28.6%, 57.1%, 94.7%, and 97.9% and for the WHO categories (I-VII), it was 60%, 21.3%, and 35.7%, not representative, not applicable, 94.7% and 94.9%. The overall sensitivity and specificity of PSC was 68.2% and 96.2% when categories V and VI were taken as positive and 78.9% and 93.3% for WHO when categories VI and VII were taken as positive. CONCLUSIONS Pancreatic FNA samples reported as per the WHO system showed better sensitivity as compared to the PSC system resulting in better risk stratification and consequently better patient management. The overall high specificity and moderate sensitivity reaffirm the utility of FNA in pancreatic lesions.
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Affiliation(s)
- Reetu Kundu
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arpitha Kollabathula
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nalini Gupta
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manish Rohilla
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Surinder Singh Rana
- Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritambhra Nada
- Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naveen Kalra
- Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajender Kumar Basher
- Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Parikshaa Gupta
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pranab Dey
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajesh Gupta
- Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Usha Dutta
- Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Radhika Srinivasan
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Gupta P, Kaur H, Rompally S, Muthu V, Kollabathula A, Sharma A, Srivastava S, Rudramurthy SM. Disseminated Cryptococcosis and Pulmonary Mucormycosis: Dealing with Dual Mycoses in a Renal Transplant Patient. Mycopathologia 2022; 188:163-167. [PMID: 36583799 DOI: 10.1007/s11046-022-00700-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/02/2022] [Indexed: 12/31/2022]
Abstract
We describe a 36-year-old post-renal transplant patient diagnosed with a rare dual infection by Cryptococcus neoformans and Lichtheimia ramosa. The case highlights the significance of invasive samples and accurate interpretation of fungal biomarkers in the diagnosis of fungal infections in immunosuppressed patients. The mortality in such cases is high owing to delay in diagnosis, inability to perform surgical management or antifungal resistance.
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Affiliation(s)
- Parakriti Gupta
- Department of Microbiology, Government Medical College and Hospital, Chandigarh, India
| | - Harsimran Kaur
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - Satwika Rompally
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Valliappan Muthu
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arpitha Kollabathula
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arun Sharma
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sonakshi Srivastava
- Department of Microbiology, Integral Institute of Medical Sciences and Research, Lucknow, India
| | - Shivaprakash M Rudramurthy
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
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Kollabathula A, Sharma S, Kumar N, Ahluwalia J, Das R, Varma N, Rana SS. Plasminogen Activator Inhibitor-1 4G/5G Promoter Polymorphism in Adults with Splanchnic Vein Thrombosis: A Case-Control Study. Indian J Hematol Blood Transfus 2022; 38:169-172. [PMID: 35125725 PMCID: PMC8804071 DOI: 10.1007/s12288-021-01454-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/03/2021] [Indexed: 01/03/2023] Open
Abstract
The role of PAI-1 4G/5G polymorphism in venous thrombosis is unclear. PAI-1 4G/4G genotype is associated with elevated levels of PAI-1 resulting in a hypofibrinolytic state and hence increased thrombotic risk. In this study, we assessed the role of PAI-1 4G/5G promoter polymorphism in adult patients with splanchnic vein thrombosis. A total of 40 cases (portal vein thrombosis and Budd-Chiari syndrome) and 40 healthy controls were evaluated for the PAI-1 4G/5G polymorphism by amplification refractory mutation system polymerase chain reaction along with thrombophilia workup. The frequency of PAI-1 4G/4G homozygous, 4G/5G heterozygous and 5G/5G homozygous genotypes were 17.5%, 42.5% and 40%, respectively among cases and 22.5%, 50% and 27.5%, respectively among controls and the difference was not statistically significant (p = 0.61). The PAI-1 4G/4G genotype was significantly associated with the cases with deranged thrombophilic risk factor (both inherited and acquired) (p = 0.02). SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12288-021-01454-5.
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Affiliation(s)
- Arpitha Kollabathula
- Department of Pathology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
| | - Saniya Sharma
- Department of Hematology, Level 5, Research Block A, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
| | - Narender Kumar
- Department of Hematology, Level 5, Research Block A, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
| | - Jasmina Ahluwalia
- Department of Hematology, Level 5, Research Block A, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
| | - Reena Das
- Department of Hematology, Level 5, Research Block A, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
| | - Neelam Varma
- Department of Hematology, Level 5, Research Block A, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
| | - Surinder Singh Rana
- Department of Gastroenterology, Postgraduate Institute of Medical Education & Research, Sector 12, Chandigarh, 160012 India
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Mehta H, Bishnoi A, Vinay K, Kaushik A, Kumaran MS, Kollabathula A, Chatterjee D, Nahar Saikia U, Parasad D. Prurigo Pigmentosa: Dermoscopic Evaluation. Dermatol Pract Concept 2021; 11:e2021115. [DOI: 10.5826/dpc.1104a115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 10/31/2022] Open
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Kollabathula A, Gupta P, Das CK, Awasthi D, Srinivasan R. Malignant uterine perivascular epithelioid cell tumor: histopathologic and immunohistochemical characterization of a rare tumor in a post-menopausal woman. Int J Clin Exp Pathol 2021; 14:993-999. [PMID: 34646418 PMCID: PMC8493258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/30/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Perivascular epithelioid cell tumors (PEComas) are rare, mesenchymal neoplasms composed of epithelioid cells exhibiting myogenic and melanocytic differentiation. The uterus is an infrequent site of involvement. The most common histopathologic mimics include leiomyosarcoma, endometrial stromal sarcoma, undifferentiated uterine sarcoma, and malignant melanoma. Rendering an accurate histopathologic diagnosis is essential, owing to the prognostic and therapeutic implications. CASE A 65-years-old post-menopausal woman presented with post-menopausal bleeding, abdominal pain, and heaviness for the last four months. Ultrasound abdomen revealed a large uterine mass replacing the endometrial cavity. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. RESULT Microscopically, a circumscribed tumor with tumor cells arranged in sheets and interlacing fascicles, with interspersed fine capillary network, was seen. The individual tumor cells were epithelioid to spindle with moderate pleomorphism, round nuclei, vesicular chromatin, prominent macronucleoli, and moderate cytoplasm. Mitosis was 2-3/50 HPFs. On immunohistochemistry, tumor cells were positive for HMB-45, Melan-A, and smooth muscle actin and were negative for h-caldesmon, TFE3, S-100, CD10, and pan-cytokeratin. Based on the histopathologic and immunohistochemical features, a final diagnosis of malignant uterine PEComa was rendered. CONCLUSIONS This index report describes the characteristic histopathologic and immunohistochemical features of malignant uterine PEComa and highlights the salient features that distinguish it from other commonly encountered histopathologic mimics.
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Affiliation(s)
- Arpitha Kollabathula
- Department of Pathology, Post Graduate Institute of Medical Education and ResearchChandigarh, India
| | - Parikshaa Gupta
- Department of Cytology and Gynecologic Pathology, Post Graduate Institute of Medical Education and ResearchChandigarh, India
| | - Chandan Krushna Das
- Department of Radiotherapy, Post Graduate Institute of Medical Education and ResearchChandigarh, India
| | - Divya Awasthi
- Department of Obstetrics and Gynecology, Fortis HospitalMohali, Punjab, India
| | - Radhika Srinivasan
- Department of Cytology and Gynecologic Pathology, Post Graduate Institute of Medical Education and ResearchChandigarh, India
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Kollabathula A, Vishwajeet V, Gupta K, Mitra S, Sharma V, Ray P, Bhalla A. Chronic brucellosis with hepatic brucelloma and AA amyloidosis in a patient with autosomal dominant polycystic kidney disease. Autops Case Rep 2019; 10:e2019128. [PMID: 32039060 PMCID: PMC6945304 DOI: 10.4322/acr.2019.128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 09/20/2019] [Indexed: 02/03/2023] Open
Abstract
We describe an autopsy case of a 45-year-old male diagnosed with autosomal dominant polycystic kidney disease who presented with complaints of altered sensorium. The autopsy revealed multiple tumor-like masses in the liver, which on histological examination depicted multiple large suppurative granulomas with the presence of variable acid-fast coccobacilli (consistent with Brucella spp.). Interestingly, extensive amyloid deposition in multiple organs was noted. To the best of our knowledge, this is the first case of chronic brucellosis causing tumor-like abscesses in the liver accompanied by secondary systemic amyloidosis in a patient with underlying autosomal dominant polycystic kidney disease.
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Affiliation(s)
- Arpitha Kollabathula
- Postgraduate Institute of Medical Education and Research, Department of Histopathology. Chandigarh, India
| | - Vikarn Vishwajeet
- Postgraduate Institute of Medical Education and Research, Department of Histopathology. Chandigarh, India
| | - Kirti Gupta
- Postgraduate Institute of Medical Education and Research, Department of Histopathology. Chandigarh, India
| | - Suvradeep Mitra
- Postgraduate Institute of Medical Education and Research, Department of Histopathology. Chandigarh, India
| | - Vibhav Sharma
- Postgraduate Institute of Medical Education and Research, Department of Internal Medicine. Chandigarh, India
| | - Pallab Ray
- Postgraduate Institute of Medical Education and Research, Department of Medical Microbiology. Chandigarh, India
| | - Ashish Bhalla
- Postgraduate Institute of Medical Education and Research, Department of Internal Medicine. Chandigarh, India
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