Dear all, Pathologybasics is out with a new series of power point presentations on general Pathology.. Following is link presentation on seventh and the most difficult to understand chapter of robbins.. chapter 7,neoplasia. Any suggestions/feedback/constructive criticism are welcome on facebook.com/pathologybasics or pathologybasics@gmail.com
Dear all, Pathologybasics is out with a new series of power point presentations on general Pathology.. Following is link presentation on seventh and the most difficult to understand chapter of robbins.. chapter 7,neoplasia. Any suggestions/feedback/constructive criticism are welcome on facebook.com/pathologybasics or pathologybasics@gmail.com
Different types of vasculitis have characteristic patterns of blood vessel involvement.However vasculitis is a systemic illness.The symptoms of vasculitis depend on the particular blood vessels that are involved by the inflammatory process
Vasculitis syndrome an approach -and-basic principles of treatmentSachin Verma
Vasculitides are a hetrogenous group of conditions characterized by inflammation and necrosis of blood vessels.
A broad group of syndromes may result from this process,since any type,size, and location of vessel may be involved.
A case report of a patient with AML who had undergone allogeneic stem call transplantation. She relapsed within 6 months post transplant with lineage switch to ALL. this is follwed by a sfort review of Lineage switch in acute leukemia
Touraine–Solente–Gole syndrome also known as Pachydermoperiostitis(PDP ) is defined by – the presence of digital clubbing, pachyderma (thickening of the skin), and periostosis (swelling of periarticular tissue and subperiosteal new bone formation ) It is a familial disorder inherited as an autosomal dominant trait with variable expression. PDP is a rare genetic disease. [ 1] At least 204 cases of PDP have been reported.
This is a presentation on most common applications of immunohistochemistry in breast lesions. Prepared by Dr Ashish Jawarkar, Assistant professor in pathology, Parul Institute of Medical sciences and research Vadodara
GROUP 1 Case 967-- A Teenage Female with an Ovarian MassCLI.docxgilbertkpeters11344
GROUP 1: Case 967-- A Teenage Female with an Ovarian Mass
CLINICAL HISTORY
A teenage female presented with secondary amenorrhea (https://www.healthline.com/health/secondary-amenorrhea#causes). The patient had 1 menstrual cycle 3 years ago and has had no menses since. Laboratory work-up was negative for pregnancy test, mildly increased calcium level (11.7 mg/dL, normal range: 8.5-10.2 mg/dL) and CA 125 (43 Units/ml, normal range: 0-20 Units/ml). Prolactin, TSH, AFP, Inhibin A, Inhibin B and CEA were normal. Imaging revealed a 13 x 11.8 x 8.6 cm, predominately cystic left pelvis mass, with multiple internal septations. Her past medical history was not contributory. Patient underwent left salpingo-oophorectomy (https://www.healthline.com/health/salpingo-oophorectomy), omentectomy (https://moffitt.org/cancers/ovarian-cancer/omentectomy/) and tumor debulking (https://en.wikipedia.org/wiki/Debulking) with intraoperative frozen section consultation.
GROSS EXAMINATION
The 930.9 g tubo-ovarian complex consisted of a 20.0 x 16.0 x 8.0 cm large mass, with no recognizable normal ovarian parenchyma grossly and an unremarkable fallopian tube. The cut surface was gray, "fish-flesh", soft with foci of hemorrhage and necrosis.
MICROSCOPIC EXAMINATION
Microscopically, the majority of main tumor was growing in large nests, sheets and cords with focal follicle-like structures and geographic areas of necrosis. It was predominantly composed of small cells with hyperchromatic nuclei, round to oval nucleus with irregular nuclear contour, inconspicuous to occasional conspicuous nucleoli and minimal cytoplasm. This component was variably admixed with a population of larger cells, which as the name implies composed of cells with abundant eosinophilic cytoplasm, with central or eccentric round to oval nuclei, pale chromatin and prominent nuclei. Both, the small and large cell components demonstrated brisk mitotic activity. All staging biopsies and omentectomy were composed of large cell component.
An extensive panel of immunohistochemical stains was performed. Overall, the staining pattern was strong and diffuse in small cell component compared to patchy weak staining pattern in the large cell component.
FINAL DIAGNOSIS
Small cell carcinoma (https://en.wikipedia.org/wiki/Small-cell_carcinoma) of the ovary, hypercalcemic type (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939673/)
DISCUSSION
Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is an aggressive and highly malignant tumor affecting the women under 40. It was first described as a distinct entity by Dickersin et al in 1982 (1). Fewer than 500 cases have been described in the literature and it accounts for less than 1% of all ovarian cancer diagnoses. Due to the initial consideration of epithelial origin, the term of SCCOHT has been used to distinguish this entity from its mimicker, the neuroendocrine or pulmonary type (2). In fact epithelial origin of SCCOHT was recently challenged as new imm.
Subclassification into type 1 and type 2 is no longer recommended.
PRCC has classic morphology historically in type 1 category.
Criteria of foamy histiocytes and psammoma bodies is not required.
Many tumors previously diagnosed as type 2 PRCC now constitute independent entities
Histopathological Interpretation of Breast Cancer.pptxMunmun Kulsum
This lecture was prepared while opening of 'Breast Clinic' in Department of surgery , Cumilla Medical college Hospital, Cumilla, Bangladesh. This was delivered by Dr. Umme Kulsum Munmun, as a resource person in the seminar regarding opening of breast clinic.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
3. INTRODUCTION
Lobular neoplasia (introduced by Haagensen
in 1978) to defines the spectrum of
proliferative changes encompassing:
- Atypical lobular neoplasia (ALH)
- Lobular carcinoma in situ (LCIS).
Both ALH are often multifocal and bilateral.
Increased risk of developing invasive
carcinoma.
4. Recent evidence of identical molecular
changes in coexistent invasive and in situ
lesions and an over representation of
invasive lobular cancers in subsequently
developing tumours provide support for the
direct precursor model.
5. Until relatively recently, cases of atypical or
morphologically ambiguous LCIS were
referred to as ducto-lobular in situ carcinoma
“florid” LCIS or carcinoma with indeterminate
features.
6. The advent of new molecular techniques and
the introduction of more reliable IHC markers
have led to the recognition of a number of
variant subtypes permitting more precise sub
classification of problematic cases.
7. CLASSICAL LCIS
Premenopausal women (40 and 50 years of
age).
Incidence is between 0.5 and 3.8%
The acini of a lobule are filled with the
characteristic monomorphic cells leaving no
central lumina.
Lobular neoplasia is characterized by loss of
cellular cohesion.
8. TWO CELL TYPES
Type A cells: the acini are distended by
small uniform cells with bland nuclei and
scant cytoplasm
Type B cells: the cells are larger with more
cytoplasm and mild to moderate
cytological atypia.
9. CLASSICAL LOBULAR CARCINOMA IN SITU (LCIS).
A mammary lobule filled and distended by the characteristic uniform
dyscohesive lobular carcinoma cells.
10. RISK OF SUBSEQUENT INVASIVE CARCINOMA
LCIS carries a higher risk for subsequent
development of breast cancer within 15-20 years
Risk for atypical lobular hyperplasia (ALH) is half that
of LCIS
Traditionally, the increased risk was recognized to be
Three times more likely to arise within the same
breast.
LCIS is now considered both a marker of increased
risk anda non-obligate precursor of breast cancer.
11. PLEOMORPHIC LOBULAR CARCINOMA IN SITU
(PLCIS)
Relatively new entity, increasingly being
diagnosed through mammographic
screening.
Seen with invasive pleomorphic lobular
carcinoma (IPLC) in 45% cases but may also
occur as an isolated lesion.
Non-obligate precursor of invasive lobular
carcinoma.
More aggressive than conventional LCIS.
12. HISTOLOGY OF PLCIS
Cytological and architectural features of both
classic LCIS and DCIS.
solid proliferation of dyscohesive cells which fill
and distend terminal duct lobular units (TDLUs).
Intermediate or high grade nuclei but as yet
there are no consensus criteria for diagnosis.
Considerable nuclear enlargement (on average
nuclei 4 size of a lymphocyte) and nuclear
pleomorphism with a 2 to 3 fold variation in
nuclear size.
13. Eccentric nuclei, irregularities of the nuclear
membrane and oftenprominent nucleoli
Necrosis is reported in a majority of cases,
mitotic figures
Cells can appear plasmacytoid, a sub-
variant consisting almost entirely of signet
ring cells has been reported.
In the majority of cases these is coexisting
classic LCIS
E- CADHERIN NEGATIVE
14. PLEOMORPHIC APOCRINE LCIS (PALCIS)
Large dyscohesive cells with abundant
eosinophilic cytoplasm which imparts an
apocrine appearance.
The cells frequently show intracytoplasmic
vacuolation which may result in the formation
of signet ring forms.
All 10 cases in a study showed necrosis and
luminal calcification and were E-cadherin
negative and GCDFP-15 positive.
15. (a) PLCIS with central comedo necrosis and luminal calcification. It comprises large
eosinophilic cells showing cellular dyscohesion and nuclear
pleomorphism. (b) The cells are E-cadherin negative confirming the lobular nature. (c)
PLCIS comprising dyscohesive markedly pleomorphic cells with
prominent intracytoplasmic vacuoles. There is adjacent invasive lobular carcinoma. (d)
PALCIS: a solid proliferation of large apocrine cells showing
nuclear pleomorphism. Note the prominent cellular dyscohesion.
16. CLINICAL AND IMAGING FINDINGS OF PLCIS
Classic LCIS – postmenopausal
PLCIS occurring in a slightly older age group (mean
age 55 years)
PALCIS however in older population with (average
age at presentation of 60 years)
classic LCIS is typically incidental finding without a
clinical or mammographic correlate,
PLCIS usually presents as an abnormal
mammographic finding (Calcification)
The high density mammographic calcification may
appear similar to that usually associated with the
comedo necrosis of DCIS
17. BIOMARKER EXPRESSION
In contrast to classical LCIS, PLCIS is often
negative for ER and PR but shows a higher
proliferation rate as measured by Ki-67
proliferation index and increased frequency
of HER2 overexpression.
Positive for Androgen Receptor (AR) with
those showing apocrine morphology
demonstrating particularly strong positivity.
18. MOLECULAR CHARACTERISTICS
Matched PLCIS and invasive PLC show similar
genetic alterations with both showing the
hallmark features of lobular carcinomas namely
loss of chromosome 16q and 17p with gain of
1q emphasizing a close relationship with classic
lobular in situ neoplasia and suggesting clonal
evolution via a similar pathway.
PLCIS and invasive PLC however typically
display additional genetic aberrations.
19. IMMUNOHISTOCHEMICAL PROFILE OF PLCIS
(a) The lesion is ER
negative. The admixed classical LCIS is ER strongly positive. (b) Her2
positive PLCIS with adjacent negative classical LCIS.
20. MANAGEMENT IMPLICATIONS
Controversial
With conventional LCIS the risk of concurrent
invasive malignancy in a screen detected
populations may be as low as 1%
Some units advocate further non-operative
sampling by large volume mammotome rather
than immediate open surgical biopsy.
Followed by continued mammographic
surveillance if no invasive malignancy is then
found.
21. Other reports show an associated higher
grade lesions in up to 21% of classic LCIS
cases and therefore recommend a diagnostic
excision.
Core biopsies containing PLCIS are usually
categorized as B5a (as for DCIS)) rather
than B3 (as for LCIS) according to NHSBSP
guidelines.
22. Excision with clear margins is recommended
in order to remove something with a
significant potential for progression to
invasive disease. (same as DCIS)
Currently no evidence to support adjuvant
endocrine/radiotherapy.