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Biomedical subjects

S Krishnamurthy

Publications and source records attributed to S Krishnamurthy.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

Fine needle aspiration cytology of a skeletal metastasis of adult Wilms' tumor. A case report.

BACKGROUND: Nephroblastoma (Wilms' tumor) is the most common malignant tumor of the kidney in children but is rare in adults. The stage and histopathology of the tumor are the most important prognostic indicators. The common sites of metastasis are lung, liver and lymph nodes. Skeletal metastasis is exceedingly rare in both pediatric and adult nephroblastoma. We report an unusual case of a skeletal metastasis of adult nephroblastoma that developed nine years after the diagnosis of a typical nephroblastoma of favorable histology and that was diagnosed by computed tomography (CT)-guided fine needle aspiration cytology. CASE: Following a right radical nephrectomy for adult nephroblastoma and two local recurrences two and three years later, a 74-year-old woman presented with low back pain. CT and magnetic resonance imaging revealed lytic lesions in the 10th and 12th thoracic vertebrae. Smears prepared from specimens obtained through CT-guided fine needle aspiration biopsy were moderately cellular, with small, round cells arranged singly and in loosely cohesive clusters. These cells had inconspicuous nucleoli and scanty to moderate amounts of cytoplasm. The cells were also positive for cytokeratin and vimentin and appeared similar to areas of blastema in the original tumor. CONCLUSION: A definitive diagnosis of metastatic adult nephroblastoma in thoracic vertebrae was made possible by CT-guided fine needle aspiration cytology in conjunction with clinical and radiologic findings and by using ancillary modalities, such as immunohistochemical studies.

Adult↗
PubMedDate not supplied

Emperipolesis as a key feature in imprint cytology of the thymus. A report of two cases.

BACKGROUND: Imprint cytology of the thymus has not received much attention. Cytology of the thymus is important because the uninvolved thymus may be needled during aspiration procedures. CASES: In two cases, during surgery for carcinoma of the thyroid, we received thymic tissue mistakenly sampled as a pretracheal lymph node for frozen section to rule out metastasis. Imprint smears were studied. The presence of thymocytes in the cytoplasm of thymic epithelial cells (emperipolesis) was the most significant feature in the imprints. However, it was not detected on histology. CONCLUSION: Thymic epithelial cells provide mechanical support and play a major role in the maturation of lymphocytes (thymocytes). They are observed as emperipolesis on imprint cytology. Its utility in identifying thymic cells in aspiration cytology needs to be investigated.

Adult↗
PubMedDate not supplied

Fine needle aspiration cytology of clear cell sarcoma of the kidney. A case report.

BACKGROUND: Fine needle aspiration cytology is an established method for cytodiagnosis. Its application is particularly suited to the pediatric age group. A correct cytodiagnosis of especially large tumors can result in timely cytoreductive chemotherapy, thereby facilitating surgery. While the cytomorphology of Wilms' tumor is well documented, there is a paucity of literature concerning other uncommon pediatric renal tumors. CASE: A 2-year-old female underwent surgery for a renal mass following aspiration cytology. The histologic diagnosis was clear cell sarcoma of the kidney (CCSK). The cytologic smears were cellular and pleomorphic. The main feature of cytologic interest was the presence of deep nuclear indentations and grooves in many of the tumor cells. CONCLUSION: The cytologic features of CCSK are distinct and different from those of other renal tumors in children. Its recognition in cytology is important because its behavior is more aggressive than that of Wilms' tumor. A correct diagnosis can result in the institution of appropriate treatment.

Biopsy, Needle↗
PubMedDate not supplied

Stromal fragments in invasive carcinoma. Source of diagnostic difficulty in aspiration cytology.

OBJECTIVE: To analyze three cases of stromal fragments in invasive carcinoma that created diagnostic difficulty in aspiration cytology. STUDY DESIGN: A retrospective review of fine needle aspiration cytology (FNAC) smears of a breast tumor, scalp tumor and neck mass. Cytomorphologic features of all the smears were reviewed after histology became available. RESULTS: FNAC smears revealed a biphasic pattern: a carcinomatous component and a stromal component that was either discrete or in close apposition to the carcinoma. The cytopathologist had suggested the diagnosis of a biphasic tumor in each case--phyllodes, malignant skin adnexal and salivary gland tumor. Histopathology revealed an invasive carcinoma with altered stroma in the first two cases and metastatic lymph node with perinodal soft tissue extension in the third case. CONCLUSION: Stromal changes in response to infiltrating carcinoma are well documented in surgical pathology. However, these may also be encountered in FNAC smears. The above cases stress the importance of recognizing stromal fragments in aspiration cytology in order to avoid diagnostic errors.

Aged↗
PubMedDate not supplied

Hepatic sickling crisis mimicking recurrent cholangitis.

A 22-year-old man with homozygous sickle cell disease presented with recurrent fever, right upper quadrant pain and jaundice. Liver biopsy confirmed the diagnosis of hepatic sickling crisis; the symptoms responded to hydroxyurea therapy. Hepatic vasocclusive crisis can diagnosed on liver biopsy, and need not be a diagnosis of exclusion.

Adult↗
PubMedDate not supplied

Metastasis of osteosarcoma to the maxilla--a case report.

Secondary osteosarcomas of the maxilla/premaxilla are extremely rare. We describe a case of a 24-year-old man with a metastasis of osteosarcoma to the premaxilla. The patient had undergone hip disarticulation followed by adria based chemotherapy for chondroblastic osteosarcoma of the proximal right femur ten years ago. The metastatic work up did not show liver or lung metastasis. The patient underwent premaxillectomy in February 1999. The histopathology revealed a chondroblatic osteosarcoma consistent with metastasis in the clinical setting. The patient was disease free at the end of five months.

Adult↗
PubMedDate not supplied

The Kveim test in leprosy.

The response to lepromin and Kveim antigens was compared and studied in 15 leprosy patients who were tuberculin negative. Of the 11 lepromin positive tuberculoid patients, 4 were Kveim positive, 1 was equivocal, and the rest were negative. Of the four lepromin negative lepromatous patients, one gave a positive Kveim test while the other three were negative. It has been shown that false-positive Kveim reactions are found in a higher percentage of South Indian leprosy patients than in those of other backgrounds, such as Japanese and Malaysian Chinese patients. It is also suggested that no definite relationship exists between the reaction of leprosy patients to lepromin and Kveim antigens. We further suggest that the anergy exhibited by lepromatous patients to the antigen of M. leprae is specific, as evidenced by the positive Kveim response in one lepromatous patient.

China↗
PubMedDate not supplied

Factors affecting in vitro lipid peroxidation of rat brain homogenate.

Peroxidation of the unsaturated lipid of tissue homogenates is an established method to assess the antioxidant or vitamin E status of animals. In the present study the spontaneous lipid peroxidation in air of rat brain homogenates is reported. The effects of various factors like pH, time, concentration of tissues, temperature, ferrocompounds and catalysis by added tissues like liver are described. Rat brain homogenates appear to be a suitable preparation for in vitro studies of lipid peroxidation.

Animals↗
PubMedDate not supplied

Potential years of life lost by major childhood cancer deaths in Bombay.

BACKGROUND: Over the last two decades mortality from childhood cancers has declined in the West, possibly due to advances in chemotherapy. Unfortunately, poor countries cannot afford these drugs as they are costly and scarce. We undertook this study in Bombay to help us make rational choices in this area. METHODS: We studied the mortality, incidence and years of potential life lost by premature death from specific cancers in children under 15 years of age. RESULTS: Leukaemia accounted for 30% to 50% of premature life lost by death from cancers regardless of gender or age, i.e. if such loss was avoided by timely diagnosis and therapy, up to 50% gain of person-life would occur. It constituted nearly one-third of the childhood cancers, with age-adjusted rates comparable with American blacks and whites in boys, but less in girls. Incidence and decline of mortality due to leukaemia from 1964 was lower in girls than in boys. CONCLUSIONS: A focus on leukaemia treatment would increase productive person-life by nearly 50%. A triaging system might be the best method for allocating treatment till data on cost of such therapy are available. There is a need to increase morphological diagnoses in girls. Concentrating on treating girls with leukaemia older than 5 might contribute most in terms of gain in human potential and would be a cost-effective use of scarce resources.

Adolescent↗