Manasa Rasaputra

Bio: Manasa Rasaputra is an academic researcher from Andhra Medical College. The author has contributed to research in topics: Serous fluid & HER2/neu. The author has an hindex of 2, co-authored 2 publications receiving 5 citations.

Histopathology of endometrium in abnormal uterine bleeding, in correlation with thyroid profile and ultrasonography findings -

Abstract: Background: Abnormal uterine bleeding is the cause for many disturbances in women who are in the reproductive age group. Frequent and prolonged periods will lead to morbidity, social embarrassment, diminished quality of life and compromise of the sexual life. Methods: It is a hospital based cross sectional study conducted in the department of pathology, Andhra medical college. A total of 270 patients in the age group of 18 to 45 years were included in this study. Endometrial samples were obtained and histopathological examinations were conducted. All the clinical details and investigation reports were collected. Results: The age group of patients in this study ranged from 18 to 45 years. Maximum numbers of cases (169) were in the age group of 36 to 45 years (62.6%). Most of the patients were multipara (244 cases, 90.37%) and most common presenting complaint was heavy menstrual bleeding (198 cases, 73.3%). Majority of the patients were euthyroid (247 cases, 91.5%). Normal cyclical endometrium was found to be the commonest histopathological pattern with proliferative endometrium in 45.56% and secretory endometrium in 32.59% cases. Leiomyomas were found to be the commonest cause of abnormal uterine bleeding (15.56%). Bulky / enlarged uterus (77%) and type-IV (hyperechoic) endometrium, depicting the secretory endometrial pattern (36.66%) was the most common finding on transvaginal sonography (TVS). Conclusions: Histopathological examination is the gold standard for studying the pattern of endometrium in various causes of abnormal uterine bleeding.

Clinicopathological and IHC study (estrogen receptors, progesterone receptor, HER2/NEU) in malignant ovarian tumors

Abstract: Background: Ovarian cancer is the second most common gynaecologic malignancy, most common cause of gynaecologic cancer death and has worst prognosis among all gynecological malignancies. The clinical significance of ER and PR content in ovarian carcinomas has not been well established in the literature. Methods: A prospective study was conducted over a period of 2 years (2013-2015) in the department of pathology, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India. The study includes 42 cases of ovarian cancers. Representative 3-4μm sections were taken and IHC was performed with specific antibodies. Results: The mean age at presentation was 39.5 years, majority of the ovarian carcinomas occurred in the age group of third and fifth decade (20/42). The commonest clinical presentation was mass per abdomen. The commonest histological type was malignant surface epithelial tumors (25/42, 59.55%) of which serous cystadenocarcinioma was the predominant tumor followed by germ cell tumors (9/42, 21.42%). Ascites was associated with higher grade and higher stage of tumors. Majority of the ovarian carcinomas were of grade 2 (57.14%) and stage 3 (35.7%). ER was positive in (9/42) 21.42%, PR was positive in (10/42) 23.8% and Her2/neu was equivocal in (3/42) 7.14% of ovarian carcinomas. ER, PR and Her2 showed similar expression, with higher expression in cases of advanced disease. Conclusions: The expression of steroid hormonal receptors in ovarian cancers paves way for antihormonal therapy/ targeted therapy and this requires more number of studies with larger sample size.

A reterospective study on the endometrial biopsy of AUB correlated to thyroid abnormalities and endometrial thickness

Abstract: Aim: To study the histopathological patterns, to categorise the causes of bleeding according to age group and to correlate it with the thyroid profile and with the thickness of endometrium. Materials and Methods: Strategies:It is a review study directed by the branch of pathology in our institute. An aggregate of 80 cases were taken from the age gathering of 18-60 years. Histopathological patterns were recorded from the endometrial biopsy along with the biochemical and radiological records. Results: The commonest age group presented with AUB was 40-49 years which shows the perimenopausal period. Most of the histopathological pattern showed normal cyclic endometrium with (42.5%) of proliferative phase followed by(23.7%) of secretory phase. Higher incidence of AUB was seen in the euthyroid cases (65%). ET > 15mm was mostly related towards endometrial hyperplasia. Conclusion: Endometrial biopsies helpin analyzing the diverse causes of abnormal menstrual bleeding. Keywords: Bleeding, Endometrium.

Evaluation of surface epithelial ovarian tumors and its correlation with preoperative serum CA125 levels in a tertiary care centre

Abstract: Introduction: Ovarian cancer is ranked third most frequent female cancer in India. The incidence varies between 2. 2 to 7. 8 per lakh population in various parts of India and there is steady increase in age standardized incidence rate of ovarian carcinoma. 1 The present study was aimed to evaluate the histomorphology of epithelial ovarian tumors and to find the relationship between serum CA-125 levels with histopathology and staging of these neoplasms. Material & Methods: 105 cases of surface epithelial ovarian tumors were evaluated over a period of one year from July 2018 to June 2019 in the Department of Pathology I.G.M.C Shimla. Preoperative serum CA125 levels were noted .Malignant tumors were staged using FIGO staging. Results: Serous tumors were the most common tumors reported in the study constituting 67 cases (63.8%). Benign tumors (64.76%) comprised the major group followed by malignant tumors (29.52%) and borderline tumors (5.7%).. Serum CA125 concentration in benign, borderline and malignant tumors were compared and statistically significant difference was found (p=0.000). CA125 showed positive correlation with the stage (p=0.024) of ovarian cancer. However no significant correlation was found between subtype of benign, borderline and malignant tumors with serum CA125 levels. Conclusion: Patients with borderline /malignant epithelial tumors had higher preoperative serum CA125 value as compared to benign ovarian tumors.

Correlation of Abnormal Uterine Bleeding (AUB) with Thyroid Profile and Endometrial Biopsy

Abstract: Abnormal uterine bleeding (AUB) is defined as any change in the frequency of menstruation, duration of flow or amount of loss. Menstrual disturbances and different endometrial pattern may accompany and precede thyroid dysfunction. The objective of the study was to correlate thyroid profile with endometrial biopsy in cases of AUB. This study was conducted on 74 patients who presented with AUB, had undergone TFT and endometrial biopsy/hysterectomy. Among 74 patients, thyroid disorders were identified in 26 patients. Maximum number of patients with AUB belonged to the category of hypothyroidism (27%) and 8.1% of cases had hyperthyroidism. In the present study 29 (39.1%) had proliferative endometrium, followed by secretory pattern in 21 (28.4%) patients. Hormone induced changes was seen in 3 (4.1%) patients. Disordered proliferative endometrium and endometrial hyperplasia was observed in 6 patients (8.1%) each. Malignant lesion was not common and it comprised of only 1.4% cases. AUB is frequently seen in patients with thyroid dysfunction. Thyroid function test is a cost effective, easily available test and can detect a possibly curable cause of AUB and avoid unnecessary intervention like hormonal treatment and hysterectomy. AUB due to endometrial cause is an age related pathology. Histopathological examination of endometrial biopsy is a major diagnostic tool in evaluation of AUB. It helps the physician to plan therapy for successful management of AUB. Corresponding author Dr. Shraddha Koirala, Lecturer, Department of Pathology, Nepal Medical College Teaching Hospital, Attarkhel, Gokarneshwor-8, Kathmandu, Nepal, Email: shraddhaa46@gmail.com Orcid No: https://orcid.org/0000-0001-5155-8184 DOI: https://doi.org/10.3126/nmcj.v23i4.42227

Cliniopathological profile in women with abnormal uterine bleeding

Abstract: Introduction: Abnormal uterine bleeding is a challenging gynecological problem caused by various endometrial pathologies and is a major clinical problem among women in peri and postmenopausal age groups. The problem is common worldwide but causes may vary from one region to another. Aims and Objectives: The main objective was to evaluate pathological spectrum of different endometrial lesions in abnormal uterine bleeding and to correlate with clinical history and diagnosis. Materials and Methods: The study was a prospective study done from August 2017 to July 2019. The specimens received from endometrial biopsy were included in the study. All the specimens were fixed in formalin and processed through paraffin wax embedding method. Sections were cut at 3-5 micrometer thickness and stained by Hematoxylin and Eosin (H&E) stain and were examined under light microscope. Result: A total no. of 247 cases were studied. Out of these, 57 cases were of Proliferative endometrium, 33 cases of Secretory endometrium, 34 cases of simple hyperplasia without atypia, 11 cases of cystic glandular hyperplasia, 17 cases of complex hyperplasia with atypia, 09 cases of menstrual phase endometrium, 07 cases of irregular shedding, 06 cases of endometrial polyp and anovulatory cycle, 04 cases of endometritis, 03 cases each of simple hyperplasia with atypia, progesterone exposed endometrium and inadequate secretory phase, 02 cases each of complex hyperplasia without atypia, atrophic endometrium, products of conception and inadequate proliferative phase and 01 case each of stromal hyperplasia. 45 samples were inadequate. Maximum cases of abnormal uterine bleeding were seen between 31-40 years of age. Interpretation and Conclusion: Abnormal uterine bleeding is one of the commonest condition for which patients seek advice in the gynecological outpatient department. Analysis of histopathology of endometrium in abnormal uterine bleeding helps in management of patients and to know th