Dr Richa’s path lab and cancer diagnostic Center

25/04/2025

Happy lab week to all lab professionals 🧪

16/01/2025

Cml

CML is a slow-growing type of leukemia that occurs due to an abnormal chromosome (Philadelphia chromosome) that leads to uncontrolled production of abnormal white blood cells.

Chronic Myeloid Leukemia (CML) symptoms :

1. Feeling tired all the time (extreme fatigue).

2. Losing weight without trying.

3. Frequent fevers or sweating at night.

4. Loss of appetite or feeling full after eating little.

5. Pain or discomfort on the left side of the belly (from an enlarged spleen).

6. Looking pale and feeling breathless during simple activities.

7. Frequent infections or falling sick easily.

8. Unusual bruises or bleeding (like nosebleeds or bleeding gums).

9. Bone or joint pain that doesn’t go away.

10. Tiny red spots on the skin (called petechiae).

If you notice several of these symptoms together, seek medical attention.

14/01/2025

#40 year male presented with hard lump
(x2 years)
Not seeking medical advice earlier due to lack of awareness .

This is a common scenario in male breast cancer cases. Men often mistake early symptoms of breast cancer for gynecomastia (a benign enlargement of male breast tissue) and delay seeking medical attention.

Myth: Males can’t have carcinoma of the breast.

Reality: Both males and females can develop breast cancer.
However, it is rare in males, accounting for less than 1% of all breast cancer cases.

Key Facts:
• Incidence: Less common in men but still possible.

• Awareness: Many men remain unaware they can develop breast cancer, leading to delayed diagnosis.

Importance of Awareness:

• Male breast cancer often gets diagnosed at later stages due to lack of awareness.

• Early detection is key to better outcomes.

Encouraging both men and women to recognize symptoms and seek timely medical advice can save lives.

Why Early Medical Attention Is Crucial

• Misdiagnosis Risk: Assuming a lump is benign (gynecomastia) delays proper diagnosis.

• Progression: Breast cancer can spread to lymph nodes and other organs if untreated.

When to Seek Medical Attention

Men should seek medical attention if they notice:
1. A persistent lump in the breast.
2. Ni**le changes (discharge, inversion, or scaling).
3. Skin changes over the breast (redness, dimpling).
4. Enlarged lymph nodes in the armpit or collarbone area.

Timely evaluation by a healthcare provider is critical to differentiate gynecomastia from cancer.

13/01/2025

Happy lohri

10/01/2025

A Barr body in neutrophils refers to the presence of a small, drumstick-shaped projection attached to the nucleus of certain neutrophils in females.

This projection is the inactivated X chromosome and is a feature seen in polymorphonuclear leukocytes (neutrophils) of females, but not males.

Key Points:

1. Appearance:
• In neutrophils, the Barr body appears as a small, knob-like appendage attached to the nuclear lobe.
• It is sometimes called a “drumstick appendage.”

2. Significance:
• This is a cytological marker of female s*x in blood smears.
• It reflects the presence of two X chromosomes, with one being inactivated.

3. Frequency:
• About 1–5% of neutrophils in a typical blood smear from females may exhibit Barr bodies.
• Rarely seen or absent in males, except in cases of Klinefelter syndrome (47, XXY) where they have an extra X chromosome.

4. Diagnostic Use:
• Useful for identifying the chromosomal s*x of an individual.
• Can be an indicator in cases of genetic abnormalities like XXY or XO syndromes.

29/12/2024

Imprint smear cytology

is a minimally invasive diagnostic technique used to evaluate cellular abnormalities from superficial lesions or ulcers.

It has particular importance in the diagnosis of oral cancer and non-healing ulcers due to the following reasons:

Advantages in Diagnosing Oral Cancer:

1. Early Detection:
• Imprint smear cytology allows for the identification of abnormal or malignant cells, aiding in the early detection of oral cancer, especially in cases where biopsy is delayed or challenging.

2. Non-Invasive and Quick:
• The method is simple, quick, and non-invasive, making it suitable for patients with ulcers or lesions where surgical biopsy may not be immediately feasible.

3. Screening Tool:
• It can be used as a first-line screening tool in populations at high risk for oral cancer (e.g., smokers, to***co users, or patients with chronic irritation).

4. Evaluation of Non-Healing Ulcers:
• Chronic, non-healing ulcers may indicate underlying malignancies. Cytology helps in ruling out cancer or guiding further diagnostic interventions.

5. Pre-Biopsy Assessment:
• Provides a preliminary diagnosis that can help in planning more invasive procedures like excisional or incisional biopsies.

Procedure:

• A slide is pressed gently against the lesion or ulcer to transfer cellular material.

• The sample is stained (e.g., with Papanicolaou or Giemsa stains) and examined under a microscope for cytological changes, such as:

• Hyperchromasia
• Increased nuclear-cytoplasmic ratio
• Pleomorphism
• Presence of mitotic figures

Clinical Importance:

Imprint smear cytology serves as an adjunct to biopsy in diagnosing oral cancer and non-healing ulcers.
It is not a definitive diagnostic tool but is valuable for:
• Early detection
• Mass screening
• Monitoring known lesions
• Identifying cases that require urgent biopsy and intervention.

This method helps bridge the gap between clinical suspicion and histopathological confirmation.

28/12/2024

Hypersegmented neutrophils can appear as an early indicator of vitamin B12 deficiency, even before serum B12 levels drop significantly.

This occurs because vitamin B12 is essential for DNA synthesis, and its deficiency primarily affects rapidly dividing cells like those in the bone marrow.

The impaired DNA synthesis leads to nuclear-cytoplasmic asynchrony in developing blood cells, resulting in characteristic morphological changes such as hypersegmentation of neutrophils.

Hypersegmented neutrophils are often seen in the peripheral blood smear during early megaloblastic anemia caused by B12 or folate deficiency.

They are typically defined as neutrophils with five or more nuclear lobes or more than 3% of neutrophils with at least five lobes.

This finding can precede clinical symptoms and biochemical markers of deficiency, making a blood smear a valuable diagnostic tool.

22/12/2024

20/12/2024

Microphotograph shows-reticulocytes

The reticulocyte count
is a test that measures the number of reticulocytes (immature red blood cells) in the blood.
It is often expressed as a percentage of the total red blood cell (RBC) count or as an absolute reticulocyte count.

Why is it done?

This test helps to evaluate:

• Bone marrow function and its ability to produce red blood cells.

• Causes of anemia (low RBC count).

• Response to treatments like iron supplements or erythropoietin.

Normal Range:
• Relative Reticulocyte Count: 0.5% to 2.5%.

High Reticulocyte Count (Reticulocytosis):

• Blood loss (e.g., after an injury or surgery).

• Hemolytic anemia (destruction of RBCs).

• Recovery from anemia due to iron, vitamin B12, or folate deficiency.

• Treatment with erythropoietin.

Low Reticulocyte Count:

• Bone marrow disorders (e.g., aplastic anemia, leukemia).

• Chronic kidney disease (reduced erythropoietin production).

• Nutritional deficiencies (iron, vitamin B12, folate).

• Chemotherapy or radiation therapy effects.

19/12/2024

Microphotograph shows KOH preparation of skin scrapping showing fungal elements..

Skin Fungal Infection: awareness

A skin fungal infection occurs when fungi (yeasts or molds) overgrow on the skin, causing various symptoms.
These infections thrive in warm, moist environments and are common in areas like the feet, groin, underarms, and folds of the skin.

Causes and Risk Factors
• Causes: Dermatophytes, yeast (e.g., Candida), or molds.

Risk Factors:
• Excessive sweating.

• Poor hygiene.

• Humid climates.

• Tight or synthetic clothing.

• Compromised immune system (e.g., diabetes, HIV).

Symptoms
• Itching or burning sensation.

• Redness, scaling, or peeling skin.

• Blisters or sores in severe cases.

• Discolored or thickened skin.

Diagnosis
1. Clinical Examination: Visual inspection by a doctor.
2. KOH test

Prevention
• Wear breathable clothing.

• Dry skin thoroughly after bathing.

• Avoid sharing personal items like towels or shoes.

• Use antifungal powder in humid conditions.

A KOH (Potassium Hydroxide) test

is a simple diagnostic test used to detect fungal infections of the skin, hair, or nails.

Purpose of the KOH Test
• It helps identify fungal elements in cases of suspected ringworm, athlete’s foot, candidiasis, tinea versicolor, or other fungal infections.

How It Is Performed

The healthcare provider scrapes a small amount of skin, nail, or hair from the lesion.

Advantages
• Quick and inexpensive.
• Provides confirmation of a fungal infection.

17/12/2024

Breast cancer awareness

Early diagnosis and treatment is key to cancer survival

This is a microphotograph showing carcinoma breast (FNAC)

Patient is postmenopausal female (60years age) presented with painless hard lump that was present for more than one year.

Upon history taking:-
she jokingly said
This lump is harmless because it’s painless
And I am taking homeopathic medicine as well.
So I know it’s nothing to worry about.

This is a myth:-
That painless lumps are harmless
Rather it’s early sign.

Early Signs and Symptoms of Breast Cancer

Breast cancer can present with a range of symptoms, though in its early stages, it may not cause any noticeable changes. Some common early signs include:

1. Lump or Thickening in the Breast or Underarm

• A hard, painless lump that feels different from the rest of the breast tissue.

2. Changes in Breast Shape or Size

• Swelling or distortion of one part of the breast.

3. Skin Changes on the Breast

• Dimpling or puckering resembling the texture of an orange peel.

• Redness, warmth, or scaly skin.

4. Ni**le Changes

• Inversion (ni**le turning inward).

• Unexplained discharge (bloody or clear fluid).

5. Pain in the Breast or Ni**le Area

• Persistent or unusual discomfort.

6. Swelling in the Armpit

• Swollen lymph nodes even if no lump is felt in the breast.

When to Consult a Doctor

You should seek medical attention promptly if you notice any of the following:

• Persistent Lump: Any new lump or thickening in the breast or armpit that doesn’t go away after your menstrual cycle.

• Visible Changes: Alterations in breast size, shape, or skin texture.

• Unusual Discharge: Especially if it is bloody or occurs without squeezing.

• Pain: Unexplained pain in the breast or ni**le that persists.

• Family History: If you have a family history of breast or ovarian cancer, consult a doctor for preventive screening.

Early detection through regular self-exams and screenings can significantly improve treatment outcomes.

If you’re unsure, consult your doctor.