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Evaluating the Importance of Apoptotic Index, Mitotic Index and Turnover Index in Premalignant and Malignant Lesions of Cervix  [PDF]
Subhash Bhardwaj, Farooq Ahmed Wani
Open Journal of Pathology (OJPathology) , 2015, DOI: 10.4236/ojpathology.2015.52005
Abstract: Aim: To evaluate the premalignant and malignant lesions of the uterine cervix on light microscopy for apoptosis. To calculate and correlate the apoptotic index (AI), mitotic index (MI) and turnover index of the lesions. Materials and methods: A 2-year retrospective (November 2007 to October 2009) and 1-year prospective study (November 2009 to October 2010). A total of 95 cases of premalignant and malignant lesions of cervix were studied. The hematoxylin-eosin stained slides were screened for apoptosis under oil immersion lens. Apoptotic index (AI) was calculated as the number of Apoptotic cells and Apoptotic bodies, expressed as percentage of total no. of tumour cells counted in each case. Mitotic index (MI) was calculated by counting mitosis among 1000 tumour cells. Turnover index (TOI) was obtained by adding MI and AI, i.e., (TOI = MI + AI). After calculating, all these indices were correlated with different grades of the cervical lesions. Results: Premalignant lesions were divided into four subgroups. On statistical analysis, it was found that the difference in the apoptotic indices and turnover indices in all the four subgroups was not statistically significant. However for mitotic indices, significant statistical difference was found in Subgroup II (mild dysplasia vs. moderate dysplasia) with a p value of 0.03 and in subgroup IV (squamous metaplasia vs. moderate/severe dysplasia) with a p value of 0.0005. Within the malignant group, we compared well differentiated with less well differentiated subgroup. Statistical analysis revealed a significant difference in TOI between the two subgroups of malignant tumours (p = 0.04). Statistical comparison between premalignant and malignant group of lesions showed a highly significant difference between the AI, MI and TOI with p value of 0.0001. Conclusion: We conclude that proliferative and apoptotic indices are useful in distinguishing between benign and malignant lesions of the cervix. Proliferative activity of a lesion is a reliable indicator of its malignant potential and together with apoptotic count gives an idea about the net growth of a tumour.
Lymphangiectasia of small intestine presenting as intussusception
Katoch Pervez,Bhardwaj Subhash
Indian Journal of Pathology and Microbiology , 2008,
Abstract: Intussusception is defined as telescoping of a segment of gastrointestinal tract into an adjacent one. In small children, it is the commonest cause of intestinal obstruction. More than 90% of childhood intussusceptions are idiopathic. We report a rare case of localized small intestinal lymphangiectasia, presenting as intussusception in a 6-month-old male child. The child presented with features of acute intestinal obstruction for which he was later operated. The gross examination of excised ileocecal mass revealed intussusception. Histopathologic examination revealed lymphangiectasia of small intestine, which acted as a lead point for ileocecal intussusception. Postoperative period was uneventful.
Renal Cell Carcinoma in a Child
Subhash Bhardwaj, Aruo Gupta
JK Science : Journal of Medical Education & Research , 1999,
Abstract: Renal cell carcinoma (RCC) is an uncommon malignancy in childhood.So far, only a few caseshave been reported in the world literature. We present a case of RCC in a five year old boy.
Wegener's Granulomatosis Presenting as Nasal Polyp
Amn Gupta, Subhash Bhardwaj
JK Science : Journal of Medical Education & Research , 1999,
Abstract: Not available
Pneumatosis Cystoides Intestinalis
Subhash Bhardwaj, Arun Gupta
JK Science : Journal of Medical Education & Research , 1999,
Abstract: Pneumatosis cystoides intestinalis is a rare condition. Presented here is a case report of apatient who was admitted with acute abdomen and was operated upon. The gross morphologyand histological features of the specimen were consistent with Pneumatosis cystoides intestinalis.
Filariasis of The Breast
Subhash Bhardwaj, Deepti Mahajan,MRAttri*
JK Science : Journal of Medical Education & Research , 2007,
Abstract: Filariasis of the breast presenting as a breast lump and clinically simulating a breast cancer is an unusualpresentation. The present case is of a 42 year old female whose breast lump was excised and histopathologyrevealed filariasis.
Metastatic Squamous Cell Carcinoma of The Cervix Presenting As A Splenic Cyst
Subhash Bhardwaj,Deepti Mahajan,Yudh Vir Gupta
JK Science : Journal of Medical Education & Research , 2008,
Abstract: Squamous cell carcinoma metastatic to the spleen is a rare occurrence and has been reported mostly inautopsy series. Only two cases of carcinoma cervix with solitary metastasis to the spleen have beenreported in living patients. Among these, the tumour was confined to the spleen in only one case, where asin the other it had extended to involve the pancreas and the left kidney and adrenal. We present a case ofa 50 year old patient with carcinoma cervix, treated with radiotherapy in 1997. Four years after completionof primary treatment, she presented with a painful mass in the left hypochondrium. Exploratory laparotomyrevealed a splenic cyst which on pathological examination was diagnosed as metastatic squamous cellcarcinoma. The patient received chemotherapy and was alive four years later, at the time of writingof this report.
Inflammatory Fibroid Polyp of Ileum
Jyotsna Suri, Subhash Bhardwaj, Vivek Gandotra*
JK Science : Journal of Medical Education & Research , 2006,
Abstract: Inflammatory fibroid polyps are uncommon but well documented solitary polypoid lesions occurringin gastrointestinal tract ; most commonly in stomach followed by ileum and rarely in colon ,duodenumand oesophagus. Polyps in ileum most commonly present with acute intestinal obstruction asaresult of intussusception. The lesions are characterized by variable proliferation of fibroblasts andsmall vessels which may involve the whole thickness of the bowel wall .Mast cells and Eosinophilsare also seen in the polyp.
Rosai-Dorfman Disease
Sindhu Sharma, Subhash Bhardwaj, Deepa Hans
JK Science : Journal of Medical Education & Research , 2010,
Abstract: Rosai-Dorfman Disease (RDD) or Sinus Histiocytosis with massive lymhadenopathy (SHML) is a rare,benign proliferative disorder of histiocytes, sometimes showing familial incidence. It is mainly characterizedby painless bilateral cervical lymph node enlargement and is often associated with fever and leucocytosis.It presents in the first or second decades of life, though any age group can be affected. Without theawareness about RDD, the diagnosis of RDD is unexpected especially in South East Asian Countrieswhere certain lymphadenopathies such as tuberculosis, metastatic nasopharayngeal carcinoma andlymphomas are common. RDD is commonly missed and so its revision would seem worthwhile, this caseillustrating the disappearance of the lymphadenopathy without treatment.
Primary Adenocarcinoma of Appendix Presenting as Omental Metastasis
Arun Gupta, Subhash Bhardwaj, Jyotsna Suri
JK Science : Journal of Medical Education & Research , 2001,
Abstract: The adenocarcinoma of appendix is a rare entity The patients present usually with symptoms ofappendicitis, a palpable abdominal mass or rarely as a complication of pseudomyxoma peritonei,We report a case who presented with lump abdomen and ascitis and revealed a tiny infiltrativegrowth at the base of appendix at laparotomy
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