INTRODUCTION:Bone marrow examination is a useful investigative tool for the diagnosis of many hematological and nonhematological disorders. Bone marrow aspiration (BMA) provides information about the numerical and cytological features of marrow cells, whereas bone marrow trephine biopsies (BMB) provide excellent appreciation of spatial relationships between cells and of overall bone marrow structure. We conducted this study with the objective of comparing the accuracy of BMA with BMB in the diagnosis of various hematological disorders.MATERIALS AND METHODS:Both BMA and BMB were performed on a total of 130 cases and a comparative evaluation was performed in 100 cases to see the complementary role of both the procedures. However, 30 cases were excluded due to inadequate BMA, BMB, or both. Immunohistochemistry (IHC) was employed whenever required.RESULTS:In our study of 100 cases, 87% of cases were confirmed on bone marrow biopsy and in remaining 13% of cases final diagnosis was achieved with the help of other ancillary investigations. These cases were excluded for calculation of concordance rate between BMA and BMB. The concordance and disconcordance rate between BMA and BMB was 72.4% and 27.6%, respectively.CONCLUSION:BMA cytology and trephine biopsy histopathology complement each other and the superiority of one method over the other depended on the underlying disorder. Furthermore, application of ancillary techniques such as flow cytometery and IHC proved to be an additional advantage in further typing of various diseases.

Aspergillus is a common cause of invasive mycosis, especially in immunocompromised individuals. We report the case of a 62-year-old male who was hospitalized after suffering severe physical injuries and died after few weeks of hospitalization. A medicolegal autopsy was conducted, and various organs were sent for histopathological examination of which heart, lungs, and kidneys showed extensive involvement by aspergillus. Thus, a diagnosis of disseminated invasive aspergillosis was made on autopsy, which itself is a rare entity. This case report illustrates a prolonged stay in the intensive care unit as a possible risk factor for the development of disseminated aspergillosis.

Introduction: Gastrointestinal tract is a uncommon site for lipomas. Intestinal lipomas are most common benign nonepithelial intestinal tumors, found incidentally. Symptomatic diffuse submucosal intestinal lipomatosis is a rare entity. Here, we present a rare case of intestinal submucosal lipomatosis, which presented as intestinal obstruction. Case report: On laparotomy, intussusception of a segment of gut was identified and sent for histopathological examination. On gross examination, intussusception of a part of gut segment with distally gangrenous gut segment was identified. On cutting open, multiple soft, yellowish polypoidal growths identified. On histopathology, multiple submucosal lipomas were identified. Conclusion: Diffuse intestinal lipomatosis is a rare condition and can lead to intestinal obstruction and should be kept as a differential diagnosis in a case of intussusceptions.

Pregnancy and the postpartum period carry high risk of thromboembolic phenomenon which increases manifold postpartally. Multiple predisposing risk factors, usually acting in combination, add up to this risk. All three of the Virchow's triad conditions predisposing to vascular thrombosis, i.e., endothelial injury, venous stasis and hypercoagulability, are present in pregnancy. The deaths caused by pulmonary embolism may become the subject of medicolegal investigation due a sudden and unexpected fatal outcome. A thorough dissection, documentation and ancillary investigations pertaining to pulmonary emboli are important components of evaluating such fatalities. The investigation requires a dependable protocol that should include a proper evaluation of the timing of the embolus along with the residual and other thrombi, whenever discovered. Because of the pathophysiology and propagation of thrombus over a range of time period, one may see a broad histological range of thrombosis and organization. The present case pertains to the sudden death of a young female in the postpartum period who suffered a massive pulmonary embolism about 6 weeks after delivery. An extensive dissection of the lower limbs showed multiple deep venous thrombi in the calf and femoral regions while moderate to large coiled emboli were found in the pulmonary arterial vasculature. An additional histopathological dating of the thrombi as well as pulmonary embolus was performed that helped in elucidating the time range of their development.

No abstract