Background: Chronic subdural hematoma is a common neurosurgical condition, particularly in the elderly, characterized by the gradual accumulation of blood in the subdural space. Its pathogenesis involves recurrent microbleeding, inflammation, and neovascularization within encapsulating membranes. Histopathological evaluation of both the outer and inner membranes helps determine disease chronicity, activity, and potential for recurrence. This study was done to analyze the histopathological spectrum of the outer and inner membranes in chronic subdural hematoma and classify them based on inflammatory activity, fibrosis, vascular proliferation, and hemorrhagic changes. Materials and Methods: A retrospective observational study was conducted over one year in the Department of Pathology, Siddaganga Medical College and Research Institute. Outer and inner membrane samples obtained during burr-hole evacuation were examined histologically and classified into four types: Type I (non-inflammatory), Type II (inflammatory), Type III (hemorrhagic inflammatory), and Type IV (scar inflammatory). Data were analyzed using descriptive statistics, with categorical variables reported as frequencies and percentages. Results: Among the 36 chronic subdural hemorrhage cases, the outer membrane most frequently exhibited an inflammatory pattern (Type II) in 48.4% of cases. The inner membrane predominantly showed hemorrhagic inflammatory (Type III) in 35.5%. Overall, most membranes displayed active inflammation and vascular proliferation, indicating ongoing membrane activity and potential risk for recurrence. Statistical analysis confirmed a significant difference in the distribution of membrane types between outer and inner membranes (p < 0.05). Conclusions: This study shows that inflammatory and hemorrhagic inflammatory patterns are the predominant histopathological findings in both the outer and inner membranes of chronic subdural hematoma. Type II membranes were most frequently observed in the outer membrane, while Type III membranes predominated in the inner membrane.
We report a 58-year female diagnosed with acute promyelocytic leukemia, initially PML-RARA positive by RT-PCR. Following initiation of all- trans retinoic acid-based therapy, the emergence of RUNX1- RUNX1T1 (t (8;21)) was detected in peripheral blood and bone marrow. Molecular studies via nested and real-time PCR confirmed dual translocation, with a bcr1 variant of PML-RARA and 260 bp AML1- ETO fusion product. This case highlights the importance of comprehensive molecular surveillance during acute promyelocytic leukemia treatment to detect early clonal evolution, which may affect prognosis and therapeutic decisions.
Background: Fine-needle aspiration biopsy is the most commonly used procedure due to its cost-effectiveness and reliability. This study aimed to categorize breast specimens according to the International Academy of Cytology Yokohama classification system and to assess and calculate the risk of malignancy, diagnostic accuracy as compared to histopathological diagnosis, identify the system’s pitfalls, and evaluate its implications in low-resource or financially constrained settings. Materials and Methods: A total of 160 breast were studied over a period of six months in patients presenting with palpable breast lumps. The cytology slides were re-categorized using the IAC Yokohama system into five categories. Follow-up histopathology was available for 102 cases. Results: FNAB specimens were categorized according to the IAC Yokohama system as: insufficient 6.2% (n = 4), benign 72.5% (n = 70), atypical 6.2% (n = 8), suspicious of malignancy 2.5% (n = 2), and malignant 12.5% (n = 18). The risk of malignancy in the benign category was 2%, and in the malignant category was 100%, while sensitivity of the fine needle aspiration cytology was: 90.9%, specificity: 100%, positive predictive value: 100%, negative predictive value 97.1%, and the diagnostic accuracy 97.7%. Conclusions: Yokohama system aligns well with the histopathological diagnosis, with histopathology considered the gold standard. The IAC Yokohama protocol has shown significant improvement and standardization in the reporting of breast.
Chordomas are rare, slow-growing, locally invasive malignant tumors with a very low incidence rate. The present case report of saccrococcygeal chordoma in a 46-years female who presented to our institute, was diagnosed on histopathological grounds, and subsequently confirmed with immunohistochemistry. This report also reinforces the role of histopathological examination and Brachyury expression in the diagnosis of chordoma.
Background: Lymph node aspirate cytopathology lacks a uniform reporting format due to the multitude of diseases it encompasses. To address this issue, The Sydney system was introduced to improve the reporting of lymph node cytopathology, with five diagnostic categories to standardize the reporting of lymph node fine needle aspirates. Our study aimed to assess the risk of malignancy associated with each diagnostic category of the Sydney system. Materials and Methods: The present study is a retrospective cross-sectional analysis of lymph node aspirates obtained through fine-needle aspiration cytology over the past four years. The aspirates were categorized using The Sydney System into five groups from L1 to L5. To measure the risk of malignancy for each diagnostic category, the diagnoses were correlated with the corresponding histopathological diagnoses wherever available. The statistical tools used were sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and risk of malignancy. Results: 238 cases of lymph nodes FNACs were recorded. These were grouped into five categories using the Sydney system L1(16), L2(148), L3(20), L4(18), and L5(36). Out of these 238 cases, histopathology correlation was available only for 60 cases, which included three cases in L1, 28 cases in L2, four cases in L3, nine cases in L4, and 16 cases in L5 categories, and the risk of malignancy were found to be 0%, 3.57%, 75%, 100%, and 100% for L1, L2, L3, L4, and L5 categories, respectively. Conclusions: The findings of this study highlight the significant role of the Sydney system in enhancing the reliability of lymph node cytological diagnoses. The Sydney system helps pathologists to standardize reporting for better clinical and surgical management.
