Browsing by Author "Parajuli, Sharmila"
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Publication Clinico-Pathological Characteristics of GIST of Stomach along with Evaluation of their Immunohistochemical Features(Public Health Concern Trust-Nepal (phect-NEPAL), 2024) Koirala, Udaya; Parajuli, SharmilaAbstract: Introduction: Gastrointestinal stromal tumors (GISTs) are the most common neoplasms and they originate in the interstitial cells of Cajal. Determining morphological and immunohistochemical features remains paramount in the diagnostic approach to patients with GIST suspicion. The most common histopathological subtype is the spindle cell type followed by epithelioid cell type. Current important immunohistochemical panel for GIST includes CD117, DOG-1, SMA and CD34; with CD117 (C-Kit) being the most sensitive and specific marker for GIST. Methods: We studied 31 cases of GIST of stomach diagnosed in combined Haemotoxylin and Eosin and immunohistochemistry. Immunohistochemistry for Ki-67 (Proliferative index) along with CD 117, DOG-1 and CD34 were evaluated and the results were recorded. Results: The age group ranged from 40 year to 80 years with an average of 53 years. Out of the 31 cases; the male to female ratio was 1.3:1. The average diameter of the tumor was 8.7cm. On histological examination; spindle cell pattern was the most common accounting for 77.41% of the cases followed by epithelioid pattern accounting for 11.90% of the cases. Most of the cases showed positivity for CD117; 27 cases (87.09%). 4 cases (12.90%) which were CD 117 negative showed positivity for DOG-1. CD34 was seen in 45% of the cases. Conclusion: The commonest histomorphological pattern was spindle cell pattern accounting for 77.41% of the cases. C-Kit immunostaining showed positivity in 87.09 % of the tumors in this study. The immunohistochemical results in our study on stomach GIST are comparable to both local and international studies.Publication Granulomatous Inflammation of Gall Bladder(Public Health Concern Trust-Nepal (phect-NEPAL), 2015) Dangol, Nixon; Basnet, Ranga Bahadur; Parajuli, Sharmila; Amatya, RitiAbstract: Granulomatous cholecystitis is a condition affecting the gallbladder that is often confused with cancers and other types of cholecystitis, which poses a diagnostic challenge for medical professionals. We share a case of granulomatous cholecystitis in a 51-year-old man with resolving acute pancreatitis and hypertension. Imaging showed thickening of the gallbladder wall and presence of gallstones. Laparoscopic cholecystectomy was performed and histopathological examination confirmed that the patient had granulomatous cholecystitis, characterized by presence of epithelioid histiocytes and multinucleated giant cells. The case highlights the importance of considering granulomatous cholecystitis in the differential diagnosis of gallbladder diseases, especially in patients presenting with chronic inflammation and gallstones. This report underscores the need for high clinical suspicion to differentiate granulomatous cholecystitis from other gallbladder pathologies.Publication Histo-morphological Spectrum of Cystoscopic Biopsies in Kathmandu Model Hospital(Public Health Concern Trust-Nepal (phect-NEPAL), 2025) Amatya, Riti; Basnet, Ranga Bahadur; Parajuli, Sharmila; Dangol, NixonAbstract: Introduction: Urinary bladder lesions are commonly encountered medical problems. Both non-neoplastic and neoplastic lesions are significant causes of morbidity. However, malignant lesions usually result in mortality. Cystoscopy guided biopsy determines the nature of lesion and thus helps in further management of patients. The objectives of this study were to find out the histo-pathological diagnosis and features of various bladder lesions and their frequencies. Methods: This cross-sectional study was carried out in the Department of Pathology, Kathmandu Model Hospital. All the cystoscopic biopsies received from January 2021 to December 2023 were included in the study. Preserved tissue slides were examined under a light microscope by the primary investigator. The histo-pathological diagnosis of each lesion was recorded, along with specific features such as tumor type, grade and depth of invasion. Results: Total 47 cystoscopic biopsies were studied. The majority of patients 12 (25.5%) were in age group 70-80 years and predominant 31 (66%) were male. Neoplastic lesions were more common 31 (66%) and infiltrating and non-invasive urothelial carcoinoma constituted equal in number 14 each (45%). Among the non-neoplastic lesions, non-specific cystitis was the commonest 13 (82%). Conclusion: Neoplastic lesions are more common than non-neoplastic lesions. Neoplastic lesions are more common in male and in age group 70-79 years. Infiltrating and non-invasive urothelial carcinoma are equally common. Non-specific cystitis is the commonest among the non-neoplastic lesions.