Background: Chromosomal instability (CI) is critical for carcinogenesis. The morphological markers of CI include multipolar mitosis (MPM), chromatin bridge (CB), micronuclei (MN), and nuclear bud (NB). These represent an underlying genetic instability and can be studied in routine cytological specimens. The aim of this study was to evaluate the significance of morphological markers of CI in differentiating malignant and benign effusion smears. Materials and Methods: In this retrospective observational pilot study, 25 cases of benign and 25 cases of malignant effusion smears were selected. All of the malignant cases were reconfirmed by histopathology for primary sites. One thousand cells in May–Grunwald–Giemsa-stained smears were counted for MPM, CB, MN, and NB. The significance of these markers of CI was compared between the benign and malignant cases. Results: The mean numbers of MPM, CB, MN, and NB in malignant cases were 10.52, 7.72, 1.36, and 0.40 per 1000 cells counted, compared to 0.7, 0.5, 0.3, and 0 per 1000 cells counted in benign cases, respectively. The Student's t-test showed highly significant differences between the benign and malignant effusion smears for the CI markers, with P < 0.000001, < 0.000001, and <0.00001 for MN, NB, and MPM, respectively. Conclusion: There were significant differences in the scores of morphological markers of CI in cytological smears between malignant and benign effusions. This is a convenient and reliable method to differentiate between malignant and benign effusions and can be used in conjunction with cytomorphology if a larger study is able to establish the significance in effusions.

Background: Histopathological diagnosis of a specimen requires good histoprocessing. It ultimately depends on sample preparation and staining, which is time consuming by routine tissue processing technique. The objective of the present study was to compare the reliability of kitchen microwave for tissue processing and staining with the standard conventional processing and staining in different tissue samples. Materials and Methods: The study sample included 204 specimens from different parts of the body. Three set of tissues were processed and three set of slides from each sample were stained by routine as well as microwave method and the quality of microscopic features was compared. Results: No significant difference was found in nuclear and cellular characters in case of staining by both methods. While, in case of processing, mean scoring for nuclear characters for routinely processed and microwave-stained (RM) slides was 6.95 ± 0.09 (confidence interval [CI] 6.83–0.09), for microwave-processed and microwave-stained (MM) slides, it was 6.82 ± 0.07 (CI 6.74–6.90) by observer 1 (P = 0.068). The mean score of cellular character of RM slides was 7.85 ± 0.06 (CI 7.76) and for MM slides, it was 7.65 ± 0.17 (CI 7.47–7.88) by observer 2 (P = 0.076). The microwave method was better for both processing (P = 0.001) and staining (P = 0.003) in case of small biopsies (P = 0.057). The microwave method was as good as routine method for processing of aorta and staining of breast and kidney tissues (P = 0.23, 0.32, and 0.38, respectively). The time taken by the microwave method is considerably less for both processing and staining. Conclusion: The microwave method requires less time when compared with the routine method, thus reducing the overall turnaround time which ultimately helps in rapid same-day diagnosis and patient management. Microwave can be preferred method for smaller biopsies when compared with large biopsies. Lack of automation and requirement of more manpower remain the major disadvantages for use of microwave method in large turnover histopathology laboratories.

Respiratory epithelial adenomatoid hamartoma (REAH) is a rare subtype of hamartoma which consist of the proliferation of glandular spaces and is lined by ciliated epithelium or goblet cells. Here, we report the case of REAH in a 45-year-old male who presented with bilateral nasal blockage in the past 1 year. The bilateral polypoidal nasal mass was excised. Microscopically, the proliferation of glandular spaces lined by ciliated epithelium and goblet cells and thickened eosinophilic basement membrane was seen. Immunohistochemistry showed positivity for pancytokeratin. One should always consider REAH as one of the differential diagnoses of a symptomatic polypoidal sinonasal mass.

Gastrointestinal stromal tumors are the most common mesenchymal tumors of gastrointestinal tract which comprise <1% of all primary gastrointestinal malignancies. These tumors show mutations in the KIT gene or platelet-derived growth factor receptor-A gene and usually stains positively for CD117. Very few cases of extragastrointestinal GIST (EGIST) have been reported in literature which originate from omentum and mesentery as per our knowledge. Here, we report a case of EGIST arising from omentum with no connection to gastrointestinal tract organs in a 60-year-old woman who presented with abdominal pain for 2–3 months. Intraoperative findings showed the presence of multiple globular masses and nodules in the peritoneal cavity. Microscopically, the spindled tumor cells were arranged in interlacing fashion. Immunohistochemistry showed positivity for CD117 and negativity for smooth muscle actin (SMA). Thus, EGIST should always be considered as a differential diagnosis for nodular mesenteric masses.

Background:In modern health-care system, practicing safe and appropriate transfusion services is essential. Care should be taken at all three phases of transfusion practices, i.e. pretransfusion, transfusion, and posttransfusion. The blood unit should be appropriately used by the clinicians.Aims:The aim of this study was to evaluate blood transfusion practices at pretransfusion level at blood center as well as bedside and posttransfusion practices.Settings and Design:This was a prospective observational study.Materials and Methods:A total of 15022 requisition forms were received in our blood center for a total of 19904 units of blood and blood products during the study period of 21 months.Statistical Analysis Used:The data were recorded using Microsoft Excel and analyzed using the IBM Corp. Released 2011. The categorical variables were expressed in terms of number and percentage.Results:During the study period, blood bank received transfusion request for a total of 12840 units of blood bag for cross matching. Out of which only 9907 blood units were transfused to the recipients while rest of 2573 blood units were not transfused to the recipient and thus it was ordered excessively for cross match. When looked for overall utilization trends, we found that crossmatch-to-transfusion ratio was 1.26, transfusion probability was 79.38, and transfusion index was 0.79. There were 65 transfusion reactions, out of which only 27.69% (n= 18) reactions were reported and 72.31% (n= 47) were not reported to our blood center.Conclusions:It is important to sensitize the clinicians about the importance of ordering blood unit only when it is absolutely indicated along with correctly and completely filled blood transfusion request forms to lessen the transfusion reactions. It will ultimately improve the clinical practices in the hospital.