Showing papers by "Jaishree Jagirdar published in 2015"

Incidence and aetiologies of pulmonary granulomatous inflammation: a decade of experience.

Abstract: Background and objective Granulomatous lung disease (GLD) is caused by a wide range of conditions Often there is a need to correlate pathological findings with clinical, microbiological or radiological data to determine an aetiology The aim of this study was to determine the different aetiologies of GLD over the past decade Methods Among 2228 consecutive lung specimens from 1999 to 2011, 226 cases (101%) were positive for GLD One hundred ninety patients were retrospectively reviewed and diagnoses were assigned based on availability of histological/clinical/microbiological correlation Results A confident, probable and uncertain diagnosis was made in 684%, 132% and 184% patients The aetiologies comprised infectious, non-infectious and uncertain in 547%, 268% and 184% patients Mycobacterial infections constituted 27% of all patients, and included atypical, tuberculous and unclassified mycobacteria in order of frequency Acid-fast bacilli (AFB) were visualized in tissue sections in 29% cases and cultured in 73% cases Fungal infections comprised 27% of all cases, which included Coccidioides, Cryptococcus, Aspergillus and Histoplasma in order of frequency Fungi were visualized in tissue sections with Gomori methenamine silver (GMS) stain in 83% patients and cultured in 52% cases Sarcoidosis was the major non-infectious aetiology, constituting 21% of all patients Necrosis in granulomas was associated with the presence of infection (P < 0001) Conclusions The aetiology in necrotizing GLD with negative AFB and GMS stains is most likely infectious due to atypical mycobacteria Coccidioidomycosis was the most common fungal infection The aetiology in non-necrotizing GLD is most likely non-infectious, probably sarcoidosis

Cytologic findings of NUT midline carcinoma in the hilum of the lung.

Abstract: Nuclear protein in testis (NUT) midline carcinoma (NMC) is a clinically lethal malignancy affecting all age group often located in the midline structures such as mediastinum, larynx and nasopharynx. It is characterized by chromosomal translocation between chromosomes 15 and 19 with the formation of chimeric gene BRD-NUT. We present the cytologic findings of NMC including the immunohistochemical stains performed. The patient is a 34-year-old man who presented with 1 month history of dyspnea and interscapular pain followed by nonproductive cough a week before consultation. He was initially diagnosed with pneumonia. Due to progression of symptoms, a chest CT scan was performed revealing a large hilar mass and mediastinal adenopathy. A core biopsy with touch preparations of the hilar mass was performed which revealed cohesive malignant cells with ovoid to elongated nuclei, fine to coarse chromatin pattern, irregular nuclear contour, prominent nucleoli, and scant ill-defined cytoplasm arranged in sheets and focally pseudoglandular pattern. Although focal nuclear overlapping and crush artifact were identified, karyorrhectic debris and mitotic figures were rare. Squamous differentiation was absent. The core biopsy showed discohesive malignant cells with tumor necrosis. No nuclear molding, glandular or squamous differentiation was identified. The tumor was immunoreactive for p63 and NUT with high Ki-67 (>80%). The tumor was negative for keratin, lymphoid, myeloid, neuroendocrine markers and S-100. This case emphasizes that cytologic features of NMC can mimic poorly differentiated, undifferentiated and neuroendocrine carcinomas and the importance of immunohistochemical stains especially NUT monoclonal antibody in arriving at the diagnosis.