Assistant Professor, Pathology & Laboratory Medicinefirstname.lastname@example.org
Ravi Hari Phulware/All India Institute of Medical Sciences Rishikesh
More than 10 years of experience in the field of Pathology
More than 50 PubMed publication in various International and National Journals
PGDM Executive (NIHFW) Hospital Management
Pathology and Forensic Medicine, Histology, Oncology, Nephrology
There is limited information on an exome scale about the germline molecular alteration leading to urinary bladder cancer in young patients in India. Patients from Uttarakhand and Western Uttar Pradesh are usually from low socioeconomic strata and come with advanced stages of tumor. Hence there is a felt need of doing exome profiling study to pick up the gene mutations in this region. This will add to the understanding of the pathogenesis of disease and will help in making a gene panel for early screening and detection.
Pooja Semwal, Rishi Bolia, Nikhil Rajvanshi, Ravi Hari Phulware, and Nowneet Kumar Bhat Springer Science and Business Media LLC
Ravi Hari Phulware, Amrita Talwar, and Arvind Ahuja Editora Cubo
Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 1 All India Institute of Medical Sciences, Department of Pathology and Laboratory Medicine, Rishikesh, Uttarakhand, India 2 ABVIMS, PGIMER & Dr Ram Manohar Lohia Hospital, Department of Pathology, New Delhi, India Cavernous hemangioma of the parotid gland
Pallavi Verma, Shalini Rajaram, Raj Kumar Kottayasamy seenivasagam, and Ravi Hari Phulware BMJ
Growing teratoma syndrome (GTS) is a tumour growth, which contains mature teratomatous elements during or after chemotherapy for malignant germ cell tumours. Surgery is the only potential treatment option for GTS because these growing teratomas are resistant to chemotherapy and radiation therapy. Extensive surgeries may be needed in GTS with multivisceral resections to achieve no residual disease status. This report presents a case of GTS treated with multiple surgical resections in a woman with malignant immature teratoma ovary in her early thirties; she is disease free after 1 year of treatment.
Durre Aden, Ravi Hari Phulware, Manju Kaushal, and Arvind Ahuja Wiley
Myxoid liposarcoma variant of liposarcoma which constitutes around 15% to 20% to one-fourth of all liposarcoma (LPS). 1 They are most commonly seen in the thigh in the deeper soft tissue with rare cases found in the foot (1.3% – 2.7%) or leg (6.7% – 13.5%). 2 The male to female ratio is 1.1:1 with age ranging between 17 and 76 years and a mean age of 52 years. The size ranges between 2 and 32 cm (mean: 9.7 cm). 1 As per the recent WHO 2020 there are five types of liposarcomas namely well-differentiated, myxoid, round cells, pleomorphic and the newly introduced myxoid pleomorphic liposarcoma. 1 – 3 They present as a rapidly enlarging, painless mass; 30% of patients may have dull aching pain or tenderness with few giving a history of trauma in the affected area. 1 There is no specific diagnostic finding on MRI and it may mimic a ganglion cyst at times. Soft-tissue sarcomas are generally restricted to one
Anu Singh, Ravi Hari Phulware, Arvind Ahuja, Ankur Gupta, and Manju Kaushal Springer Science and Business Media LLC
Ravi Hari Phulware, Rimlee Dutta, Priyadarshini Subramanian, Suchita Singh, and Prasenjit Das Springer Science and Business Media LLC
Anupama Bahadur, Rajlaxmi Mundhra, Pallavi Verma, and Ravi Hari Phulware BMJ
Primary ovarian leiomyosarcoma is a very uncommon and aggressive neoplasm. We presented a right-sided ovarian leiomyosarcoma in a woman in her late 40s. No case has been described in the literature till now of primary ovarian leiomyosarcoma in a woman with uterovaginal prolapse. A total abdominal hysterectomy with bilateral adnexectomy, metastasectomy, excision of large tumour deposit over small intestine followed by resection with ileo-ileal anastomosis and omentectomy was performed. The diagnosis was made based on morphology along with immunohistochemistry. The patient was given adjuvant chemotherapy during postoperative period. Due to rarity, there is a dearth of information on the clinical behaviour and best treatment options for these tumours. This case report highlighted the importance of clinical awareness and aimed to provide a baseline to guide clinical practice as well as future research.
Adarsh Barwad, Brusabhanu Nayak, RaviH Phulware, and Ekta Dhamija Medknow
Amrita Talwar, A. Ahuja and R. Phulware
Small intestinal medullary carcinoma (MC) is a newly recognized subclass of small intestinal carcinomas and is an exceptional entity for this site. A search of the literature for similar cases arising in the small intestine revealed only six previously reported cases. Here we present a case of MC arising in the jejunum of a 65-year-old male. The patient presented to the emergency with features of perforation peritonitis with liver metastasis and no known predisposing factors like inflammatory bowel disease and celiac disease. Studies conducted on this tumor's colonic counterpart have shown microsatellite instability (MSI) and B-type Raf kinase (BRAF) mutations; however, few exceptions are known. Also, this subtype of carcinoma is known to have a better prognosis than its other histological subtypes.
Arvind Ahuja and Ravi Hari Phulware Springer Nature Singapore
Ravi Hari Phulware, Rohan Sardana, Devender Singh Chauhan, Arvind Ahuja, and Minakshi Bhardwaj Springer Science and Business Media LLC
D. Aden, R. Phulware, S. Mittal and A. Ahuja
Myocardial bridging (MB) is a relatively uncommon congenital anomaly where a segment of the coronary artery dips inside the myocardium and takes a tunneled course under a bridge of the myocardium. This leads to the compression of the coronary artery during systole resulting in hemodynamic changes and their clinical manifestations. However, it is an incidental finding but can present with multiple complications like myocardial ischemia, infarction, and sudden death, primarily when associated with other risk factors like left ventricular hypertrophy of the heart. Therefore, a careful examination of the heart is essential for evaluating the clinical significance of the MB. Here, we presented a case of a 30-year-old young female who had a sudden death, and her histological examination of the heart showed MB of left anterior descending coronary artery (LAD).
Tapas Bandyopadhyay, Shivani Deswal, Arti Maria, Ravi Hari Phulware, Prasenjit Das, and Arvind Ahuja Informa UK Limited
Abstract Microvillous inclusion disease (MVID), also known as congenital microvillus atrophy remains an important differential diagnosis of intractable secretory diarrhea in neonatal period. The condition is inherited as an autosomal recessive disorder with no sex predilection and more commonly reported in those tribes with consanguineous marriages. The pathognomonic electron microscopic findings includes villous atrophy with the formation of intracellular microvillous inclusions. Definite treatment includes either isolated small bowel or combined small bowel and liver transplantation. Herein, we are describing a case of intractable diarrhea in a preterm neonate with MVID phenotype presented on second day of life with intractable diarrhea. The diagnosis was established by classical electron microscopic findings in the intestinal biopsy sample.
Ankur Majumder, Ravi Hari Phulware, Arvind Ahuja, Anurag Singla, and Pawan Kumar Springer Science and Business Media LLC
AbstractBackgroundRenal angiomyoadenomatous tumor (RAT) is a recently described rare renal neoplasm with variations in the presentation, gross, and microscopic findings, and having a benign course and good prognosis. It is characterized microscopically by the admixture of three components—epithelial cells arranged in tubules and nests, angiomyomatous stroma, and capillary-sized interconnecting vascular channels in close association with the epithelial cell clusters. Microscopically, these tumors can be confused with clear cell carcinoma, papillary carcinoma, mixed epithelial and stromal tumors, and angiomyolipoma. RAT differs from conventional clear cell carcinomas, which can rarely be associated with an identical leiomyomatosis stroma occasionally forming abortive vascular structures. RAT is a distinct morphologic entity, being different morphologically, immunohistochemically, and genetically from all renal tumors including conventional clear cell carcinoma and mixed epithelial and stromal tumor of the kidney.Case presentationHere, we report a case of a 21-year-old man with renal angiomyoadenomatous tumor, a rare neoplasm with only a few previous cases reported in the literature. Unlike our case, most tumors have been identified in middle-aged males; they present as well-circumscribed, encapsulated tan-brown masses with variably prominent cystic areas.ConclusionDiagnosis of RAT is challenging because of the rarity of the disease and common presenting symptoms to other renal pathology and is supplemented with histopathology and immunohistochemistry. A multidisciplinary team approach for diagnosis and management along with long-term follow-up are warranted.
Shruti Agrawal, Abhijeet Singh, Bhinyaram Jat, and Ravi Hari Phulware Wiley
A 43-year-old lady with Eastern Cooperative Oncology Group performance status (ECOG PS) was referred to us with complaints of insidious onset and gradually progressive right anterior paramedian neck swelling for the past 2-3 months. The initial evaluation revealed an enlarged 5x3 cm right lobe of the thyroid gland which was moving with deglutition and not with tongue protrusion. There were no palpable significant central or peripheral lymphadenopathy.
Pakesh Baishya, Swarnava Tarafdar, N. Goyal and R. Phulware
Ravi Hari Phulware, Ekta Dhamija, Rambha Pandey, Sameer Rastogi, and Adarsh Barwad Springer Science and Business Media LLC
Seetadevi Mirajkar, Amrita Talwar, Himanshu Sharma, and Ravi Hari Phulware Springer Science and Business Media LLC
Ravi Hari Phulware, Amrita Talwar, Arvind Ahuja, and Vaishali Bhardwaj Springer Science and Business Media LLC
Shruti Agrawal, Monika Singh, and Ravi Hari Phulware Wiley
Lymphatic filariasis prevails as one of the significant socio-economic threats in the tropical and subtropical regions of the world, with around 40% of the cases occurring in India alone, despite considerable progress made in the diagnosis and treatment of the disease over the past decade. Wuchereria bancrofti continues to be the predominant species accounting for more than 90% of the national burden. The slender thread-like parasites can be conveniently demonstrated in the peripheral smear examination with the subtle morphological distinction between the different species. Although W. bancrofti is known for its occurrence in various sites such as the thyroid, breast, lungs, lymph nodes, and body fluids, its presence in the subcutaneous tissue is uncommonly heard. Thus, the index case emphasizes the rarity of its occurrence so that clinicians would be familiar with such a presentation.
Ajay Choudhary, Kaviraj Kaushik, Arvind Ahuja, Rahul Varshney, Rajesh Sharma, and Ravi Hari Phulware Elsevier BV
Shruti Agrawal and Ravi Hari Phulware Editora Cubo
ABSTRACT Viral or bacterial co-infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported in the literature. However, the knowledge on Aspergillus co-infection among patients with coronavirus disease 2019 (COVID-19) is limited. COVID‐19‐associated pulmonary aspergillosis (CAPA) has been seen in critically ill COVID-19 patients with acute respiratory distress syndrome (ARDS), which has raised concerns about the worsening disease course of COVID-19 and increasing mortality. We describe a clinical case of CAPA infection and acute respiratory distress syndrome (ARDS) with a deathly outcome in a previously well, non-immunocompromised pregnant woman with intrauterine death of the fetus. Hence, we suggest that clinicians and pathologists keep alerting the possible occurrence of pulmonary aspergillosis in severe/critical COVID-19 patients, and aggressive investigations should be done to rule out the possibility of CAPA so that early treatment can be administrated.
R. Phulware, M. Roy, Neeta Singh, Sunesh Kumar and S. Mathur
Desmoplastic small round cell tumor (DSRCT) is a rare, aggressive neoplasm of uncertain histogenesis that preferentially involves the abdominal and pelvic cavities. DSRCT mainly develops in adolescent and young adults with a strong male predominance; the male to female ratio is 4:1. Ovarian location is exceptional. DSRCT generally develops in the abdomen and have a tendency towards peritoneal spread, with subsequent metastasis to distant lymph nodes, liver and lungs. It is a poorly understood malignancy with a very characteristic morphology, immunophenotype, cytogenetic features, and poor prognosis. This tumor can co-express epithelial, neuronal, and mesenchymal markers. Despite intensive therapy, including surgery, radiotherapy and chemotherapy, and immunotherapy; the 5-year survival is less than 15%.