Browsing by Author "Basnet, D"
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Publication Appendiceal Neuroendocrine Tumor Mimicking Acute Appendicitis(Kathmandu University, 2022) Gautam, N; Makaju, R; Basnet, D; Lama, B; Maharjan, PB; Dahal, SABSTRACT Appendiceal carcinoids are the most frequent tumors arising from the appendix, comprising between 32 and 57% of all the appendiceal tumors. The gross appearance of the appendix showed perforation at the tip with 30 ml of periappendicular collection. On histopathological examination, carcinoid tumor on the tip of appendix was found with tumor cells arranged in tubules, acini and nests infiltrating the muscularis propria and sub serosa. Perineural and vascular invasion was not seen. Immunohistochemistry for Synaptophysin was positive with Ki-67 labelling index of 2%. We present a case of appendiceal neuroendocrine tumor with the chief complaint of acute appendicitis. KEY WORDS Appendectomy, Appendix, Carcinoid tumorPublication Association of Allergic Biomarkers in Patients with Chronic Rhinosinusitis With or Without Asthma(Kathmandu University, 2025) Pangeni, RP; Pokharel, M; Vaidya, N; Sapkota, P; Karki, S; Bhusal, M; Basnet, D; Dhakal, A; Sapkota, B; Madhup, SABSTRACT Background Chronic rhinosinusitis and asthma are considered under unified airway diseases which describes the shared epidemiologic and pathophysiologic relationship among the chronic inflammatory diseases of the upper and lower airways Objective To assess the asthma in patients with chronic rhinosinusitis and determine the relationship of allergic biomarkers, tissue eosinophilia and radiological bone changes in patients with chronic rhinosinusitis with or without asthma. Method Prospective study involving 74 adult patients attending the Department of Otorhinolaryngology and Pulmonology at the Kathmandu University Dhulikhel Hospital for treatment of chronic rhinosinusitis and / or asthma and for functional endoscopic sinus surgery between May 2023 and May 2024. Absolute eosinophil count, total serum IgE and spirometry tests were performed. Radiological evidence of osteitis and tissue eosinophilia from surgical samples was evaluated. Correlations between allergic biomarkers,spirometry values, tissue eosinophilia, and radiological bone changes were determined in patients of chronic rhinosinusitis with or without asthma using the Mann Whitney U test, Student t test and the chi square test. Result A positive association was observed between the radiological bone score with tissue eosinophilia (p=.018), and smoking (p < 0.001) in between the two groups. Chronic eosinophilic rhinosinusitis was observed in 39 (52.7%) patients. 15 patients with Chronic rhinosinusitis had asthma ,and among these asthmatic patients 11 had eosinophilic chronic rhinosinusitis. Mild osteitis was evident in 34 (45.9%) ,moderate osteitis in 39 (52.7%) and severe in 1 (1.4%). Among 15 asthmatic patients, 10 had moderate osteitis and 5 had mild osteitis. Conclusion A rigorous exentration of osteitic bony nidus appears necessary for successful treatment outcomes in all chronic rhinosinusitis patients and to prevent acute exacerbation in the asthmatic group of chronic rhinosinusitis patients. KEY WORDS Asthma, Chronic rhinosinusitis, OsteitisPublication Cartilaginous Choristoma of Tonsil: A hidden clinical entity(Kathmandu University, 2021) Gautam, N; Makaju, R; Basnet, D; Lama, B; Maharjan, PBABSTRACT Choristoma is a tumor like mass which is an ectopic rest of normal tissue due to embryological developmental defect. The presence of choristoma in tonsil is extremely rare. On histopathological examination, mature hyaline cartilage were found surrounded by lymphoid follicles. We present a case of cartilaginous choristoma with the complaint of recurrent tonsillitis. KEY WORDS Cartilaginous choristoma, TonsilPublication Endometriosis of Groin Mimicking Neoplasm(Kathmandu University, 2021) Maharjan, PB; Makaju, R; Makaju, S; Dhakal, R; Lama, B; Basnet, D; Dhakal, BABSTRACT Endometriosis is principally a disease of women in active reproductive life. Although it is rare, foci of endometrial tissue may be seen in the bowel, the umbilicus, abdominal surgical scars and in the lungs. Inguinal endometriosis is challenging to the clinicians and pathologist and often diagnosed accidentally. We present a case of inguinal endometriosis mimicking neoplasm. A 40 year old woman presented with a swelling in the right inguinal region associated with cyclical pain. In view of presence of atypical cells in fine needle aspiration cytology, metastatic carcinoma was rendered as diagnosis. Histopathological examination revealed endometrial glands and stroma which was further confirmed by immunohistochemistry. Diagnosis of inguinal endometriosis is difficult and often challenging because of unusual site. The clinician must have high index of suspicion with any patient who has cyclical symptoms. A good history and physical examination can guide clinical diagnosis of endometriosis. KEY WORDS Endometriosis, Groin mass, Inguinal endometriosisPublication Gastric Neoplasm: A Clinicopathological Study in the Tertiary Care Center of Nepal(Kathmandu University, 2024) Basnet, D; Makaju, R; Gurung, RB; Gautam, N; Shrestha, B; Maharjan. PB; KC, PABSTRACT Background Gastric carcinoma is the commonest upper gastrointestinal malignancy contributing to global burden of cancer morbidity and mortality. Objective The objective is to study distribution of the gastric neoplasm according to age, sex, symptom, gross appearance, histological type and degree of differentiation. Method This was a retrospective study done from January 2022 to December 2023 in the Department of Pathology, Dhulikhel Hospital - Kathmandu University Hospital (DH - KUH). Relevant clinical data of the patients were obtained from the histopathological records of the patient from the pathology department and biopsies stained with Haematoxylin and Eosin were studied under the light microscope. Result A total of 40 cases of gastric neoplasm were studied out of which 36(90%) were malignant and 4(10%) were benign epithelial tumors and precursor lesions. Most frequent presentation was dyspepsia, abdominal pain, vomiting, dysphagia, anemia, anorexia and weight loss. Male to female ratio was 1.4:1. The age of the patient ranged from 33 to 89 years with mean age of 63.3 ± 13.4 years. Most common site of gastric neoplasm was pyloric antrum. Ulceroproliferative growth was most common gross morphology. Malignant neoplasm were more common. Intestinal type adenocarcinoma consisted of 28 (70%) cases followed by diffuse type 6 (15%) and mixed type 1 (2.5%). Diffuse adenocarcinoma was more common in females. Moderately differentiated adenocarcinoma was the most common differentiation. Conclusion The present study provided a fair insight into the clinciopathological features of gastric neooplasm in our institution. KEY WORDS Adenocarcinoma, Diffuse type, Gastric, Intestinal typePublication Hashimoto’s Thyroiditis with Squamous Metaplasia(Kathmandu University, 2024) Dahal, S; Makaju, R; Basnet, D; Dhakal, B; Shrestha, B; Maharjan, PBABSTRACT Hashimoto’s thyroiditis is an autoimmune inflammatory disease. Although rare, squamous metaplasia can be seen in Hashimoto’s thyroiditis. We present a case of 19 years female who presented with chief complaint of anterior neck swelling for three months. Thyroid Stimulating Hormone (TSH) was 3.93 mIU/L. Ultrasonography neck showed TIRADS (Thyroid Imaging Reporting and Data Systems) 5 lesion. Fine Needle Aspiration Cytology showed Papillary Thyroid Carcinoma. Histopathological examination revealed numerous lymphoid follicles of variable size with clusters of squamous metaplastic cells within the germinal centers of lymphoid follicles and surrounding fibrosis. Some cells showed nuclear clearing. Diagnosis of Hashimoto’s thyroiditis with squamous metaplasia was further confirmed by immunohistochemistry. The case presented here is rare and there are very few cases reported in literature so far. KEY WORDS Hashimoto’s thyroiditis, Squamous metaplasia, Thyroid glandPublication Pitfalls in diagnosing Gallbladder Carcinoma – A Single Center Histopathology Study(Kathmandu University, 2025) Dhakal, B; Makaju, R; Maharjan, P; Basnet, D; Shrestha, BABSTRACT Background Gallbladder carcinoma is a rare cancer with incidence of less than 2 per 100,000 populations worldwide. It is the fifth most frequent gastrointestinal malignancy. Radiological or gross examination of majority of gallbladder carcinoma detects no mass. This may lead to under or over diagnosis of cases in histological examination. Objective To identify pathologic features that contribute to the difficulty in diagnosis of gallbladder carcinoma. Method Between 2018 and 2023, 22 patients with gallbladder carcinoma were identified using the histopathology registry book at the department of pathology. Blocks, slides, reports and history of those cases were retrieved and reviewed. The slides were analyzed by two or more pathologist noting some of the diagnostic difficulties which could have been encountered. The number and percentage with interpretations of the cases were noted. Result Nine of 22 primary gallbladder carcinoma cases had tumor masses. Nine cases in histological examination provided diagnostic challenges. The major pitfalls encountered while diagnosing gallbladder carcinoma was mistakenly making a diagnosis of carcinoma when only deeply penetrating Rokitansky–aschoff sinuses are present. Similarly, pathologists misdiagnose carcinoma with minimal disease as benign disease, Adenomyosis as Adenocarcinoma. Under sampling of specimen, grossly occult disease, misinterpreting extracellular mucin pools were other potential pitfalls. Conclusion Deeply penetrating Rokitansky-aschoff sinus or Adenomyosis can be mistakenly diagnosed as gallbladder carcinoma. Careful attention to any evidence of mural thickening and close examination of deeply situated glandular structures were crucial for proper diagnosis of gallbladder carcinoma. KEY WORDS Adenomysois, Gallbladder carcinoma, Histology, Necrosis, Pitfalls, Rokitansky– Aschoff sinusesPublication Plexiform Schwannoma Clinically Masquerading as Thrombosed Vein(Kathmandu University, 2024) Basnet, D; Makaju, R; Gautam, N; Shrestha, B; Budhathoki, AABSTRACT Plexiform schwannoma is a rare benign nerve sheath tumor usually located in trunk, head, neck, upper extremities and occasionally in lower extremities. It is usually less than 2 cm in size and generally affects young adults. The tumour is composed of schwann cells and exhibit a plexiform growth pattern both in gross or histologic examination and is frequently accompanied by multinodularity causing serpentine distortion. Plexiform neurofibroma commonly mimics plexiform schwannoma and it is important to differentiate between them, as recurrence and malignant potential are more common with plexiform neurofibroma. We present the case of a 14-year-old female with history of a nodular soft tissue mass over his right foot measuring 11 cm in length. A Doppler scan of the foot was suggestive of thrombosed superficial vein in right foot. The histological evaluation of the mass revealed Plexiform schwannoma. S-100 immunostaining is diffuse and strong confirming the diagnosis of Plexiform schwannoma. KEY WORDS Hematoxylin and eosin, Histopathology, Plexiform, SchwannomaPublication Retroperitoneal Cyst of Mullerian Type(Kathmandu University, 2023) Basnet, D; Makaju, R; Gautam, N; Shretsha, BABSTRACT Retroperitoneal mullerian cysts are rare, benign neoplastic cyst of urogenital subtype. They are usually asymptomatic and may present with symptoms if they grow considerably in size with pressure over the adjacent organ or follow infection, hemorrhage or rupture. Histologically, these cyst are lined with benign ciliated columnar epithelium. We present the case of a 30-year-old female with history of abdominal distension and epigastric pain. The mass excised was in retroperitoneal space and microscopic examination revealed benign cyst of mullerian origin. KEY WORDS Microscopic examination, Mullerian cyst, Retroperitoneum