Dr. Shruti Vimal
@siu.edu.in
Professor, Pathology
Symbiosis medical college of Women
EDUCATION
MBBS MD Pathology
RESEARCH INTERESTS
Histopathology, Immunohistochemistry, Cytology, Haematology, transfusion Medicine
Scopus Publications
Scopus Publications
Shruti Vimal, Vidya Vishwanathan, and Arpana Dharwadker
Medic Scientific
Undifferentiated acute febrile illness is a common presentation specially during monsoons in India.The overlapping presentations of arboviruses and vector borne diseases have been noted in endemic areas with increasing incidences. There have been rare reports of these presentations with overlapping symptoms making the final nailing of diagnosis further difficult. The exact incidence of dengue and typhoid co-infection is not known and the similarity of symptoms, makes accurate clinical diagnosis and treatment difficult without a laboratory confirmation. Meticulous history taking, careful clinical examination and right choice of laboratory tests for the diagnosis of these co-infections not only helps in timely diagnosis but also prevents fatal outcomes. Keywords: Concurrent infection, Dengue, Febrile, Typhoid.
Vidya Vishwanathan, Aditi Malhotra, Arpana Dharwadkar, Shruti Vimal, Charusheela Gore, and Harsh Kumar
Medknow
Disorders of the stomach are frequently seen as clinical diseases. Of all the lesions of the stomach, inflammatory conditions and neoplastic lesions are most common. Primary malignant lymphoma of the stomach accounts for only a small percentage (about 10%) of all malignant tumors of the stomach, and majority of them arise from B-cells. Most common among these are indolent extranodal marginal zone lymphomas, and in the stomach, they are called MALTomas. Occasionally, gastric lymphomas of one type or another are seen adjacent to adenocarcinoma. Sometimes, lymphoma precedes carcinoma by several years. The aim was to study the microscopic patterns of gastric biopsies and mastectomy specimens received for the case in our department. Multiple gastric biopsy specimens as well as gastrectomy specimens were received in our department. Multiple sections were taken and stained with hematoxylin and eosin. Immunohistochemical (IHC) stains were used as applicable. Studies posed a diagnostic difficulty by showing picture of gastritis from biopsy of the cardia; signet ring cell adenocarcinoma was seen in small gastrointestinal biopsies from lesser curvature and gastric lymphoma with gross picture of linitis plastica on gastrectomy specimen. For confirmation and to know the type of gastric lymphoma, multiple B- and T-cell IHC markers were used. CD20, CD10, BCL2, and c-Myc were positive in tumor cells, CD3 positivity was seen in reactive T-cells, and MIB1 positivity was seen in 70%–75% of tumor cells. Hence, it was confirmed to be high-grade large cell lymphoma (double-expresser type). Hence, it can be concluded that IHC markers are necessary to solve the diagnostic difficulties.
ArchanaC Buch, Namrata Patro, MuktaD Naik, Shruti Vimal, and ShirishS Chandanwale
Medknow
Background: The automated hematology analyzers have replaced the traditional manual methods for assessing hematological parameters. Most of the automated hematology analyzers are programmed to identify abnormalities in the form of “suspect flags.” Aims: The aim of the study was to correlate white blood cell (WBC) and platelet (PLT) flag messages provided by automated analyzers with their respective peripheral blood smear (PBS) findings. Materials and Methods: A descriptive cross-sectional study was undertaken on 100 patients who showed WBC and PLT suspect flags and/or abnormal peripheral smears. The flag messages were analyzed with their respective PBS findings. Pearson's Chi-square test was used for the statistical analysis. Results: Analyzer and PBS showed WBC defects (n = 46, 32), PLT defects (n = 39, 54), and combined defects (n = 36, 43) respectively. WBC defects included leukocytosis (n = 27, 22), leukopenia (n = 20, 18), immature granulocytes (n = 10, 3), left shift (n = 3, 2), myeloblast blast (n = 2, 1), and eosinophilia (n = 4, 4) on analyzer and PBS. Correlation between the WBC suspect flags and their peripheral smears was found to be statistically significant (P = 0.006). PLT defects included thrombocytopenia (n = 22, 30), thrombocytosis (n = 13, 17), giant PLTs (n = 10, 15), PLT clumps (n = 8, 12), and PLT debris (n = 2, 5) on analyzer and PBS. Correlation between the PLT characteristics in analyzers and in peripheral smears was statistically significant (P = 0.042). Conclusion: Suspect flags should be used as a screening tool to pick up pathological samples. These should then be followed up with a PBS examination for definitive diagnosis.
V. Viswanathan, A. Koshy, Arpana A. Dharwadkar and Shruti Vimal
Schwannoma or neurilemmomas are benign, encapsulated, slow growing nerve sheath tumors of ectodermal origin derived from schwann cells of the nerve sheath. It is commonly seen in the head and neck region. It mainly arises from vestibulocochlear nerve (80%) and rarely in oral cavity (1%), tongue being the most common site in the oral cavity. Palate is a rare site for schwannoma. Herein, we report a rare case of schwannoma of the hard palate in a 21-year-old male. It was excised intraorally. A histopathological diagnosis of schwannoma was made. Immunohistochemistry with S-100 and vimentin were positive which confirmed the diagnosis of schwannoma.
Arpana Dharwadkar, Shruti Vimal, NarayananKrishnakutty Panicker, ShirishS Chandanwale, Vidya Viswanathan, and Harsh Kumar
Medknow
Introduction: A bone marrow examination is a critical part of the evaluation of patients with a variety of hematopoietic and nonhematopoietic diseases. A Perls' or Prussian blue stain demonstrates hemosiderin in bone marrow macrophages and iron within sideroblasts. Examination of iron stain allows detection not only of an increased or decreased proportion of sideroblasts but also of abnormal sideroblasts. We undertook this study to evaluate the iron stores in bone marrow as judged by Perls' stain. Materials and Methods: A Prospective analysis of 55 bone marrow aspirates in a tertiary care center. Results: Sideroblasts were present in all the cases. They were decreased in iron deficiency anemia (IDA), and few other chronic diseases whereas normal to increase in megaloblastic anemia. According to Gale's method, cases of IDA had absent or decreased iron stores while those of megaloblastic anemia or normoblastic marrows showed normal to increased stores. Grading by the recent intensive method showed combined functional and iron stores deficiency. Conclusion: Perls' stain on bone marrow aspirates is an important tool not only for assessing the iron stores, increased or decreased but also to study abnormal sideroblasts.
Shruti Vimal, Arpana Dharwadkar, ShrishS Chandanwale, Vidya Vishwanathan, and Harsh Kumar
Medknow
Introduction: As components of peripheral or secondary lymphoid organs, lymph nodes are an important part of immune system. Their enlargement is noted in a wide spectrum of diseases, including infections and malignancy, they are a common finding in clinical practice. Therefore, peripheral lymphadenopathy is common in all age groups and management of cases depends on lymph node pathology, which can be studied by collecting material through fine-needle aspiration or excision biopsy. Objectives: The study was undertaken to assess the cytomorphological features and incidence of various lymph node diseases on fine-needle aspiration cytology (FNAC) and to analyze the utility and diagnostic importance of FNAC in lymph node diseases. Materials and Methods: In the study total of 187 patients were selected who had presented with lymph node enlargement at Department of Pathology in our Tertiary Care Centre. Results: Reactive lymphoid lesions comprised the majority (33.69%) followed by tubercular lymphadenitis, metastatic malignancies, acute suppurative lymphadenitis, and lymphomas, respectively. Conclusion: Reactive lymphoid and tubercular lesions were the most common among the lymph node swellings presentations. FNAC is a simple, safe, reliable, and inexpensive method in early detection of lymph node lesions, which has been proven once again in this study.
ShirishS Chandanwale, ShrinathM Kshirsagar, ShrutiS Vimal, and ArchanaC Buch
Medknow
Cryptococcosis is a systemic infectious disease caused by Cryptococcus neoformans which is a yeast-like fungus. It can be one of the opportunistic infections in AIDS. Lymph node involvement is usually a part of disseminated disease. Isolated cryptococcal supraclavicular lymphadenitis alone is a very uncommon primary manifestation in AIDS. Once it disseminates, it can be life-threatening. Early diagnosis by fine needle aspiration is essential and reduces the morbidity and mortality.
Dakshayani Pandit and Padmakar Pandit
Medknow
Shruti Vimal, ArpanaP Dharwadkar, NarayananK Panicker, and ArchanaC Buch
Medknow
Microfilariaemia presenting with subcutaneous nodule is rare. We report a case of a 22-year-old female patient who presented with a subcutaneous nodule on right forearm. Fine-needle aspiration cytology from the nodule showed many sheathed motile microfilaria on wet mount preparation during day time. Wuchereria loa loa is known to be associated with soft tissue swellings as reported earlier. Nocturnal motility and cytomorphological features differentiate Wuchereria bancrofti from Wuchereria loa loa .