Papers by Anoushika Mehan
Unusual presentation of an uncommon disease
Leprosy Review, Dec 1, 2018
Journal of Laboratory Physicians, 2021
Introduction Cancer immunotherapy targeting the programmed cell death ligand 1 (PD-L1) and progra... more Introduction Cancer immunotherapy targeting the programmed cell death ligand 1 (PD-L1) and programmed cell death-1 (PD-1) axis has revolutionized cancer therapy. PD-L1 also serves as a predictive marker for such therapy. To assess the potential of such therapy in any cancer, the positivity of PD-1 and PD-L1 in such cancers needs to be assessed. However, such studies for breast cancer are lacking in South Asia. We aimed to estimate the positivity of PD-L1 and PD-1 receptors in breast cancer and its various clinicopathological groups in our patient population. Materials and Methods We studied the immunoexpression of PD-1 and PD-L1 in 103 histologically proven invasive carcinoma breast cases from October 2018 to April 2019. The percent positivity of PD-1 and PD-L1 with 95% confidence intervals (CI) was estimated for all the cases as well as groups defined by stage, grade, molecular subtype, hormone receptor status, Ki-67, and age. Results PD-1 positivity was seen in 72 (69.9%) cases (9...
Accuracy of Breast Fine-Needle Aspiration Biopsy Using the International Academy of Cytology Yokohama System in Clinico-Radiologically Indeterminate Lesions: Initial Findings Demonstrating Value in Lesions of Low Suspicion of Malignancy
Acta Cytologica, 2021
Background: Fine-needle aspiration biopsy (FNAB) in breast lesions offers accurate results in dif... more Background: Fine-needle aspiration biopsy (FNAB) in breast lesions offers accurate results in differentiating benign and malignant lesions. However, its role is unclear when core-needle biopsy (CNB) is available, the latter providing additional information regarding tumor grade, invasion, and hormone receptor status in malignant lesions. In benign breast lesions, especially in BIRADS category 4a and 4b, FNAB, and CNB provide similar pathological information, whereby FNAB may serve as a more rapid and cost-effective investigation. The study was planned to reevaluate the diagnostic accuracy of FNAB in BIRADS category 4a, 4b, and 4c lesions. Materials and Methods: FNAB and biopsy reports of all patients with breast lesions sent between September 1, 2018, and November 30, 2020, were collected and the International Academy of Cytology (IAC) Yokohama category and BIRADS score were recorded for each case. The rate of malignancy and the accuracy of FNAB in diagnosing malignancy were calcula...
Diagnostic Cytopathology, 2020
Background: The International Academy of Cytology (IAC) Yokohama system is a recently proposed sy... more Background: The International Academy of Cytology (IAC) Yokohama system is a recently proposed system for reporting breast cytology by fine needle aspiration biopsies (FNAB). Multiple studies are needed to confirm the risk of malignancy (ROM) of the various reporting categories of this system. The present article studies the accuracy of the IAC Yokohama system in our center. Methods: Over a period of 1 year (September 2018-August 2019), all cases of breast masses assessed by FNAB and histological correlation were studied retrospectively. Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) and overall accuracy of the IAC Yokohama system for diagnosing malignancy were assessed. The rates of malignancy (ROM) of each diagnostic category were also estimated. Results: Three hundred and twenty-one FNABs had cyto-histological correlation. The percent sensitivity (with 95% Confidence Intervals) when the atypical, suspicious of malignancy and the malignant categories were regarded as positive for malignancy were 98.2% [95.5%, 99.5%], 96.0% [92.5%, 98.2%], and 86.7% [81.5%, 90.8%] respectively. The percent specificity (with 95% Confidence intervals) for the same categories in the same order were 59.5% [47.4%, 70.7%], 91.9% [83.2%, 97.0%], and 100% [95.1%, 100%] respectively. The area under curve (AUC) for diagnosing malignancy was 0.981[0.963, 0.993]. The ROM for the benign, atypical, suspicious of malignancy and malignant category were 8.3% [2.3%, 20.0%], 17.2% [5.8%, 35.8%], 77.8% [57.7%, 91.4%], and 100% [98.1%, 100%] respectively. Conclusion: The IAC Yokohama system is suitable for accurately reporting breast lesions on FNAB.
ABSTRACTIntroductionEstimates of Within-Subject and between subject biological variation in South... more ABSTRACTIntroductionEstimates of Within-Subject and between subject biological variation in South Asia are sorely lacking. Therefore, we attempted to estimate the short-term estimates of the same for Differential Counts (DC).MethodsThe study was conducted on twenty eight healthy volunteers (15 males and 13 females). After morning collection of blood in K3-EDTA vials analysis was conducted in triplicate on the Sysmex XN-1000 analyzer for six consecutive days. The Within subject, between subject and analytical coefficient of variation of the DC was calculated from the results by nested repeated measures ANOVA after outlier exclusion. The Reference change values (RCV) were also calculated.ResultsThe within-subject variation for Eosinophil Count in our group from South Asia was greater than the published European and American studies. The between-subject variation in monocytes and basophils were also increased. Males and females showed similar biological variation for DC. The Within-sub...
BackgroundClassification of breast leasions into different cytological groups (1-5) can accuratel... more BackgroundClassification of breast leasions into different cytological groups (1-5) can accurately be done using the International Academy of Cytology (IAC) Yokohama System for reporting breast cytopathology. Fine needle aspiration biopsy (FNAB) of breast leasions has been considered to be the primary investigation in detecting breast cancers, especially in low-cost settings. The main objective of this study was to prospectively re-confirm the diagnostic accuracy of breast FNAB using the IAC Yokohama system. Additionally, separate separate secondary subgroup analysis was done to confirm the accuracy of breast FNAB excluding lymph-node positive and lymphadenopathy positive tumors.Material and methodsA prospective study was done in a tertiary care centre in North India on patients undergoing core-needle /incisional/excisional biopsy of breast lesions between 1st September 2019 to 30th November,2020 (519 biopsies on 487 unique patients). Of these 519 histopathology biopsies, 505 had co...
International Journal of General Medicine, 2009
Extrapulmonary manifestations of sarcoidosis often go undiagnozed. Sarcoidosis should be consider... more Extrapulmonary manifestations of sarcoidosis often go undiagnozed. Sarcoidosis should be considered in the differential diagnosis of cases presenting with parotid gland swelling, renal failure, and hypercalcemia. It's imperative to confirm the diagnosis with a tissue biopsy, as the condition is easily treatable with steroids.
Polish Journal of Surgery, 2020
Gall bladder small cell carcinoma (scc) comprises of 0.5% of all GB cancers. It carries a poor pr... more Gall bladder small cell carcinoma (scc) comprises of 0.5% of all GB cancers. It carries a poor prognosis in view of its aggressive nature. We here report a case of small cell carcinoma GB 55-year old lady presented with features of obstructive jaundice with significant weight loss. Examination revealed hard lump in right upper abdomen with multiple scratch marks all over the body. Clinically she had jaundice. Blood investigations revealed hyperbilirubinemia. Tumour markers showed raised CA 19-9. Staging CECT thorax and Abdomen reported polypoidal enhancing wall thickening of gall bladder with multiple metastatic deposits close to pancreatic head encasing main portal vein and common bile duct. Histopathology was suggestive of small cell carcinoma. Patient was referred to Oncology department and is receiving palliative cisplatin-etoposide chemotherapy
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Papers by Anoushika Mehan