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Patterns of extrapulmonary tuberculosis and the role of cartridge based nucleic acid amplification test in the diagnosis of extrapulmonary tuberculosis

2026-03-01T00:00:00Z

Title: Patterns of extrapulmonary tuberculosis and the role of cartridge based nucleic acid amplification test in the diagnosis of extrapulmonary tuberculosis Authors: Shivanand Gundalli, Surekha U. Arakeri Abstract: Background: Extrapulmonary tuberculosis (EPTB) was underdiagnosed due to its varying and nonspecific symptoms and limited diagnostic tools. Recent data suggest that there is an increase in the incidence of EPTB due to the availability of the newer diagnostic tools. Objectives: This study aims to evaluate the patterns and role of newer diagnostic tools, such as cartridge‑based nucleic acid amplification test (CBNAAT), in EPTB. Methods: Six hundred and thirty‑six patients with a presumptive diagnosis of EPTB were subjected to diagnostic tools, such as cartridge‑CBNAATs, Ziehl–Neelsen (Z–N) stain, and cytology or histopathology. Results: Out of 636 presumptive cases of EPTB, 116 cases were positive for tuberculosis. The cartridge‑CBNAAT showed positivity in all 116 cases. Out of these 116 EPTB cases, only 10 cases were positive on Z–N stain, and 24 cases were positive on cytology and histopathology. The most common sites affected were the lymph nodes and the pleural cavities. Conclusion: Cartridge‑CBNAAT gives a rapid result and plays a significant role in the diagnosis of EPTB.

Role of immunohistochemistry in the diagnosis and clinicopathological stratification of gliomas

2026-03-01T00:00:00Z

Title: Role of immunohistochemistry in the diagnosis and clinicopathological stratification of gliomas Authors: Pragya Jaiswal , Mamatha K , Basavaraj Badadal Abstract: Introduction Gliomas are common primary brain tumors. Immunohistochemical components, such as isocitrate dehydrogenase (IDH) mutations, GFAP (glial fibrillary acidic protein), ATRX (alpha-thalassemia/mental retardation, X-linked), and Ki-67, play a pivotal role in glioma diagnostic classification and risk stratification in prior literature. This study aimed to evaluate the association of IDH1 (R132H) IHC as a surrogate marker within the World Health Organization (WHO) integrated framework and to correlate the expression of IDH1 (R132H) with clinicopathological parameters in gliomas. Methods A hospital-based cross-sectional study was conducted on 30 histologically confirmed glioma cases, with an age range from 1 to 70 years. Clinicopathological parameters such as age of the patient, gender, tumor location, histological type, and World Health Organization tumor grade were recorded. Immunohistochemistry for IDH1 (R132H), Ki-67, GFAP, and ATRX was performed. Associations were assessed using Fisher's exact test (2×2 tables) and Fisher-Freeman-Halton exact test (r×c tables), with p < 0.05 considered significant. Results IDH1 (R132H) immunopositivity was seen in 19 cases (63.3%). ATRX retention was observed in 63.3% of cases, GFAP positivity in 93.3%, and a high Ki-67 index in 50% of cases. IDH1 (R132H) IHC status showed a statistically significant association with age, histological type, and WHO grade. No statistically significant association was observed with gender, ATRX, GFAP, or Ki-67 expression. Conclusion IDH1 (R132H) immunohistochemical expression showed a significant association with established clinicopathological indicators, including patient age, histological type, and WHO tumor grade. In this hospital-based cross-sectional study, IDH1 (R132H) IHC-negative status was more frequently observed in higher-grade tumors. These findings support the use of immunohistochemistry as an accessible adjunct in glioma diagnosis and clinicopathological stratification; outcome-based prognostic significance requires longitudinal follow-up.

Immunohistochemical expression of mlh1 and msh2 in colorectal carcinoma and its correlation with clinicopathological parameters

2026-03-01T00:00:00Z

Title: Immunohistochemical expression of mlh1 and msh2 in colorectal carcinoma and its correlation with clinicopathological parameters Authors: Chokkapu Pragnya , Vijayalaxmi Patil Abstract: Introduction Colorectal carcinoma (CRC) is a major health problem worldwide and is one of the top causes of cancer deaths. Defects in DNA mismatch repair (MMR) are responsible for a few cases of CRC, and the defect mainly involves MLH1 and MSH2, which leads to microsatellite instability (MSI). Finding MMR deficiency is important for predicting outcomes, screening for hereditary conditions like Lynch syndrome, and choosing treatments such as immune checkpoint inhibitors. However, there is limited data on MMR protein expression and its clinical associations in Indian patients. The objective of this study was to evaluate the immunohistochemical expression of mismatch proteins MLH1 and MSH2 in colorectal carcinoma, and to correlate MLH1 and MSH2 expression with clinicopathological parameters such as age, gender, tumor site, histological type of tumor, and histological grade. Materials and methods This retrospective cross-sectional study included 45 histologically confirmed cases of CRC. Immunohistochemical staining for MLH1 and MSH2 was performed on formalin-fixed, paraffin-embedded tissue sections. Complete absence of nuclear staining in tumor cells, with intact internal controls, was interpreted as loss of expression, indicating MMR deficiency and MSI. Retained expression of both proteins was interpreted as MMR-proficient based on MLH1 and MSH2 expression, although complete assessment of microsatellite instability ideally requires evaluation of all four mismatch repair proteins (MLH1, MSH2, MSH6, and PMS2). Statistical analysis was performed to determine correlations with clinicopathological variables such as age, gender, tumor site, histological type, and histological grade. Results The mean patient age was 56 ± 14 years. The majority of patients (n=27, 60%) were female. The colon was the most common tumor site (n=25, 55.6%), and conventional adenocarcinoma was the main type (n=44, 97.8%). Most tumors were moderately differentiated adenocarcinomas, comprising 35 (77.8%) patients. Overall, 21 patients (46.7%) were classified as MSI (MMR-deficient), while 24 (53.3%) were MSS (MMR-proficient). MLH1 loss occurred in 19 (42.2%) patients, and MSH2 loss in nine (20%). MLH1 loss was significantly linked to patients under 50 years of age (p = 0.009). MSH2 expression did not show a significant correlation with clinical or pathological factors. Conclusion Many CRC cases in this study showed loss of MLH1 and/or MSH2, which suggests MMR deficiency and MSI. MLH1 loss was closely linked to early-onset CRC and may point to a hereditary risk. Regular testing for MMR proteins can help with diagnosis, screening for Lynch syndrome, and choosing the best treatment

Correlation of mucin1 expression with various grades and stages of colorectal carcinomas

2025-10-01T00:00:00Z

Title: Correlation of mucin1 expression with various grades and stages of colorectal carcinomas Authors: Kezia Anna Jacob , Surekha U Arakeri Abstract: Background: Carcinoma of the colon and rectum is one of the commonest causes of cancer-related deaths globally. In India, the incidence of carcinoma of the colon and rectum is high due to genetic factors, lifestyle, and environmental factors. Over 50% of cases are diagnosed in the late stage, which leads to limitations in treatment and worsens prognosis. Biomarkers such as Carcinoembryonic Antigen and Mucin-1 (MUC1) play a crucial role as prognostic markers in Colorectal Carcinoma (CRC). Aim and Objectives: To evaluate and correlate MUC1 expression with the grading and staging of CRC. Material and Methods: A hospital-based cross-sectional study was done on 40 specimens received in the histopathology section of the department of pathology. Tumor tissue blocks on which diagnosis of CRC was made were evaluated for MUC1 expression and were correlated with grading and staging of CRC. Results: MUC1 expression showed score 3+ positivity in 70% cases of moderately differentiated adenocarcinoma, 50% cases of well-differentiated adenocarcinoma and in all cases of poorly differentiated adenocarcinoma. In 78.57% of T3 cases and 75% of T4 cases, score 3 MUC1 expression was observed. Score 3+ MUC1 expression was noted in 60% of N0, 82% of N1 and 100% of N2. The maximum number of cases showing the depth of invasion in the subserosa showed the highest score, that is, score 3, amounting to 85.71%. Conclusion: Overexpression of MUC1 is associated with the aggressiveness and progression of the tumor, and it can aid clinicians in intensifying chemotherapy in cases of CRC with high MUC1 expression.