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DEPT OF LABORATORY MEDICINE
JPNATC, AIIMS, NEW DELHI
Histopathology, Cytopathology Hematology, Biochemistry
and Forensic Pathology,
HEMATOLOGY
PARAMETERS NO. OF SAMPLES PROCESSED
Hb/TLC/Hct/RBC count 45,014 each
MCV/MCH/MCHC/RDW 45,014 each
DLC 44,350
Platelet count 45,363
Reticulocyte count 1,435
ESR 3,328
Peripheral Blood Smears 5,022
Hemato-progenitor cells (HPC) 24,350
Immature platelet fraction (IPF) 1,435
TOTAL 4,85,395
COAGULATION TESTS
PARAMETERS NO. OF SAMPLES
PROCESSED
PT 25622
APTT 25593
INR 25600
TT 3,836
Fibrinogen 3,628
D-dimer 3,475
Thromboelastogram (TEG) 4,274
TOTAL 54,428
FLUIDS (CSF/PERITONEAL/PLEURAL), URINE ANALYSIS
PARAMETERS NO. OF SAMPLES
PROCESSED
Urine R/M 7392
Urine Myoglobin 809
Urine Fat globules 43
CSF/ pleural/ ascitic fluid 902
TOTAL 9,146
P Vivax
 Patient X,41 yr/M
 Hb-7.7 gm/dl
 TLC- 59,460/cmm
 PBS- target cells,
 NRBC- 80/100 WBC
 cTLC-17500/cmm
 s/o Thalassemia
BIOCHEMISTRY
TEST
SAMPLES PROCESSED
S. Sugar 12461
S. Urea/Creatinine 39976/39976
S. Ca++/Phos- 33756/33674
S. Uric acid 21108
S. Na+/K+ 38797/38794
T.BIL./Direct BIL 24341/24110
T.Protein/Albumin 24367/24369
ALP 24361
S. Cholesterol 3528
S. Amylase/Lipase 3005/16
S. HDL/LDL/TG/VLDL 761 Each
BIOCHEMISTRY
S. CK 350
S. Mg 1124
CK-MB 21
CSF-SUGAR/T Protein 860/831
Peritoneal fluid- Sugar/Protein 26/29
Drain fluid Amylase 29
24 hour Urine protein/ sugar 25/25
Urinary Calcium 626
Urine Creatinine 527
Urine osmolarity 11
Serum osmolality 12
ABG ANALYSIS
PO2/CO2/PH 4500 each
Na+/K+/Ca++/Cl-
4500 each
Biochemistry
Total test: 4,80,083
TOTAL TESTS IN HEMATOLOGY & BIOCHEMISTRY
4.3
4.9 4.8
5.3 5.4
4.2
4.6
4.9 4.9 4.8
2012 2013 2014 2015 2016
Hemat (lacs) Biochem (lacs)
369
1120
1291
0
200
400
600
800
1000
1200
1400
Specimens Tissue blocks Histo slides
Number
369
1120
1291
Histopathology
257
62
50
177
General Sx
Neurosurg
Ortho
Forensic
HISTOPATHOLOGYSTATISTICS AS PER
DEPARTMENTS
13
12
21
12
19
11
5
11
10
General Surgery- Frequency of specimens
specimen
GENERAL SURGERY- FREQUENCY OF SPECIMENS
disc material
synovial/ fibrous tissue
bone
membranes
others(sequestrum.loos
e bodies)
ORTHOPEDICS- SPECIMENS
Series 1
6 8
22
14
5 7
Numberofcases
Type of specimen
NEURO SURGERY
13 12
21
12
19
11
5
11 10
14
81
Forensic
pathology
CYTOPATHOLOGY
0
5
10
15
20
25
30
cytopathology
2015 2016
HISTOPATHOLOGY CASES
Orthopedics
 Intraosseous haemangioma
 Osteochondroma
 Infantile fibromatosis
 Tuberculosis vertebrae
Neurosurgery
 Growing skull fracture
 Meningeocele
 Traumatic neuroma, Schwannoma
 Tubercular brain abscess
Surgery
 Nasal glioma
 Marjolin ulcer- Sq cell CA
 BCC
 Glomus tumor, Pyogenic granuloma
 Mature cystic teratoma
 Forensic pathology
 Lungs- aspiration pneumonia, Difffuse alveolar
hemorrhage, TB.
 Heart- coronary atherosclerosis
 Liver- Hepatitis, liver fibrosis, fatty liver
 Kidney- Diabetic nephropathy
INTERESTING HISTOPATHOLOGY CASES
PAPILLARY CARCINOMA THYROID METASTASIS IN
A CERVICAL LYMPH NODE
 37-year-old male, alleged
h/o RTA,
 cervical vertebra (C6) burst
fracture with anterolisthesis
grade I.
 No palpable thyroid mass
 Clinical- granulation tissue
with d/d of heterotopic
thyroid gland/ Koch’s
disease was made.
 Biopsy 1. granulation tissue 0.8 ×
0.4 × 0.2 cm ) 2. cervical lymph
node ( 0.5 × 0.5 × 0.2 cm)
brownish
ECTOPIC PANCREAS IN STOMACH
 55 year, M, h/o trivial
trauma
 Had c/o pain in
abdomen- 2 day, h/o
malena- 3 episode
 Exploratory laprotomy
was done for gastric
perforation
 On IHC: CK+
 Chromogranin -
 Ki-67 -low
ECTOPIC PREGNANCY IN TRAUMA VICTIM
 A 32 year F h/o of assault
by her husband
 FAST positive with mild
pericardial effusion,
 UPT was positive,
 Ultrasound- ruptured
ectopic
 Histopath- products of
conception confirmed
MOLLUSCUM CONTAGIOSUM
 Mass on left, lower eye lid-
3 months
 Gross- 7 mm to 5 mm
tissue
5. INFECTION
Gastric perforation margin for
HPE- Candida
Right upper limb skin biopsy-
Degloving injury, Mucor
6. PULMONARY METASTASIS OF DFSP
 K/C/O Recurrent
DFSP- scalp
 CT chest- Left lower
lobe tumor
 IHC- CD34+
AUTOPSY- NEUROCYSTICERCOSIS
 Deceased 70 year F
 h/o recurrent seizure- 3
years
 MRI (AIIMS)- s/o
Neurocysticercosis, 1
month back
 Sudden death
AUTOPSY- FAT EMBOLISM
 Brought death case
 Died after Ilizarov
procedure
 Suspicious of Fat
embolism
AUTOPSY- PTTM IN A CASE OF CA COLON
(PULMONARY TUMOR THROMBOTIC MICROANGIOPATHY)
 23 year, M
 presented with alleged h/o found
unconscious
 Clinical diagnosis- refractory sepsis
with ventilator associated
pneumonia with acute kidney
injury.
 Past h/o- known case of IBD and t/t
with Azathioprim and prednisolone
 Lost to follow up since last 8 month
 HPE- pulmonary tumor cell emboli
with recanalization and intimal
fibrocellular proliferation of small
arteries.
 A postmortem diagnosis of poorly
differentiated signet ring cell
carcinoma of colon with PTTM
COMPLETED PROJECTS
 Identification of circulating procoagulant markers in traumatic brain
injury patients and their involvement in development of Early Trauma
Induced Acute Coagulopathy (ETIC). ICMR 2012-12610, 1.6.14 to
30.5.16
 Histopathological evaluation of Traumatic brain injury (TBI) induced
gastro intestinal injury (Institute project) (2014-15)
ONGOING PROJECTS
 Identification of novel circulating procoagulant microparticles in
traumatic brain injury patients and their involvement in
Pathophysiology of Early Trauma Induced Acute Coagulopathy
(DBT)
 Study of coagulation response in thrombocytopenic Head injury
patients receiving platelet transfusion (ICMR)
 Assessment of platelet function in patients with acute traumatic Brain
injury (Institute)
 Utility on novel Coated Platelets as a marker for early
prognostication of neurocognitive impairment following traumatic
injury (DST, Cognitive science research initiative (CSRI))
Lab medicine audit 2016

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Lab medicine audit 2016

  • 1. DEPT OF LABORATORY MEDICINE JPNATC, AIIMS, NEW DELHI Histopathology, Cytopathology Hematology, Biochemistry and Forensic Pathology,
  • 2. HEMATOLOGY PARAMETERS NO. OF SAMPLES PROCESSED Hb/TLC/Hct/RBC count 45,014 each MCV/MCH/MCHC/RDW 45,014 each DLC 44,350 Platelet count 45,363 Reticulocyte count 1,435 ESR 3,328 Peripheral Blood Smears 5,022 Hemato-progenitor cells (HPC) 24,350 Immature platelet fraction (IPF) 1,435 TOTAL 4,85,395
  • 3. COAGULATION TESTS PARAMETERS NO. OF SAMPLES PROCESSED PT 25622 APTT 25593 INR 25600 TT 3,836 Fibrinogen 3,628 D-dimer 3,475 Thromboelastogram (TEG) 4,274 TOTAL 54,428
  • 4. FLUIDS (CSF/PERITONEAL/PLEURAL), URINE ANALYSIS PARAMETERS NO. OF SAMPLES PROCESSED Urine R/M 7392 Urine Myoglobin 809 Urine Fat globules 43 CSF/ pleural/ ascitic fluid 902 TOTAL 9,146
  • 6.  Patient X,41 yr/M  Hb-7.7 gm/dl  TLC- 59,460/cmm  PBS- target cells,  NRBC- 80/100 WBC  cTLC-17500/cmm  s/o Thalassemia
  • 7. BIOCHEMISTRY TEST SAMPLES PROCESSED S. Sugar 12461 S. Urea/Creatinine 39976/39976 S. Ca++/Phos- 33756/33674 S. Uric acid 21108 S. Na+/K+ 38797/38794 T.BIL./Direct BIL 24341/24110 T.Protein/Albumin 24367/24369 ALP 24361 S. Cholesterol 3528 S. Amylase/Lipase 3005/16 S. HDL/LDL/TG/VLDL 761 Each
  • 8. BIOCHEMISTRY S. CK 350 S. Mg 1124 CK-MB 21 CSF-SUGAR/T Protein 860/831 Peritoneal fluid- Sugar/Protein 26/29 Drain fluid Amylase 29 24 hour Urine protein/ sugar 25/25 Urinary Calcium 626 Urine Creatinine 527 Urine osmolarity 11 Serum osmolality 12
  • 9. ABG ANALYSIS PO2/CO2/PH 4500 each Na+/K+/Ca++/Cl- 4500 each Biochemistry Total test: 4,80,083
  • 10. TOTAL TESTS IN HEMATOLOGY & BIOCHEMISTRY 4.3 4.9 4.8 5.3 5.4 4.2 4.6 4.9 4.9 4.8 2012 2013 2014 2015 2016 Hemat (lacs) Biochem (lacs)
  • 11. 369 1120 1291 0 200 400 600 800 1000 1200 1400 Specimens Tissue blocks Histo slides Number 369 1120 1291 Histopathology
  • 15. disc material synovial/ fibrous tissue bone membranes others(sequestrum.loos e bodies) ORTHOPEDICS- SPECIMENS
  • 16. Series 1 6 8 22 14 5 7 Numberofcases Type of specimen NEURO SURGERY
  • 19. HISTOPATHOLOGY CASES Orthopedics  Intraosseous haemangioma  Osteochondroma  Infantile fibromatosis  Tuberculosis vertebrae Neurosurgery  Growing skull fracture  Meningeocele  Traumatic neuroma, Schwannoma  Tubercular brain abscess
  • 20. Surgery  Nasal glioma  Marjolin ulcer- Sq cell CA  BCC  Glomus tumor, Pyogenic granuloma  Mature cystic teratoma
  • 21.  Forensic pathology  Lungs- aspiration pneumonia, Difffuse alveolar hemorrhage, TB.  Heart- coronary atherosclerosis  Liver- Hepatitis, liver fibrosis, fatty liver  Kidney- Diabetic nephropathy
  • 23. PAPILLARY CARCINOMA THYROID METASTASIS IN A CERVICAL LYMPH NODE  37-year-old male, alleged h/o RTA,  cervical vertebra (C6) burst fracture with anterolisthesis grade I.  No palpable thyroid mass  Clinical- granulation tissue with d/d of heterotopic thyroid gland/ Koch’s disease was made.  Biopsy 1. granulation tissue 0.8 × 0.4 × 0.2 cm ) 2. cervical lymph node ( 0.5 × 0.5 × 0.2 cm) brownish
  • 24. ECTOPIC PANCREAS IN STOMACH  55 year, M, h/o trivial trauma  Had c/o pain in abdomen- 2 day, h/o malena- 3 episode  Exploratory laprotomy was done for gastric perforation  On IHC: CK+  Chromogranin -  Ki-67 -low
  • 25. ECTOPIC PREGNANCY IN TRAUMA VICTIM  A 32 year F h/o of assault by her husband  FAST positive with mild pericardial effusion,  UPT was positive,  Ultrasound- ruptured ectopic  Histopath- products of conception confirmed
  • 26. MOLLUSCUM CONTAGIOSUM  Mass on left, lower eye lid- 3 months  Gross- 7 mm to 5 mm tissue
  • 27. 5. INFECTION Gastric perforation margin for HPE- Candida Right upper limb skin biopsy- Degloving injury, Mucor
  • 28. 6. PULMONARY METASTASIS OF DFSP  K/C/O Recurrent DFSP- scalp  CT chest- Left lower lobe tumor  IHC- CD34+
  • 29. AUTOPSY- NEUROCYSTICERCOSIS  Deceased 70 year F  h/o recurrent seizure- 3 years  MRI (AIIMS)- s/o Neurocysticercosis, 1 month back  Sudden death
  • 30. AUTOPSY- FAT EMBOLISM  Brought death case  Died after Ilizarov procedure  Suspicious of Fat embolism
  • 31. AUTOPSY- PTTM IN A CASE OF CA COLON (PULMONARY TUMOR THROMBOTIC MICROANGIOPATHY)  23 year, M  presented with alleged h/o found unconscious  Clinical diagnosis- refractory sepsis with ventilator associated pneumonia with acute kidney injury.  Past h/o- known case of IBD and t/t with Azathioprim and prednisolone  Lost to follow up since last 8 month  HPE- pulmonary tumor cell emboli with recanalization and intimal fibrocellular proliferation of small arteries.  A postmortem diagnosis of poorly differentiated signet ring cell carcinoma of colon with PTTM
  • 32. COMPLETED PROJECTS  Identification of circulating procoagulant markers in traumatic brain injury patients and their involvement in development of Early Trauma Induced Acute Coagulopathy (ETIC). ICMR 2012-12610, 1.6.14 to 30.5.16  Histopathological evaluation of Traumatic brain injury (TBI) induced gastro intestinal injury (Institute project) (2014-15)
  • 33. ONGOING PROJECTS  Identification of novel circulating procoagulant microparticles in traumatic brain injury patients and their involvement in Pathophysiology of Early Trauma Induced Acute Coagulopathy (DBT)  Study of coagulation response in thrombocytopenic Head injury patients receiving platelet transfusion (ICMR)  Assessment of platelet function in patients with acute traumatic Brain injury (Institute)  Utility on novel Coated Platelets as a marker for early prognostication of neurocognitive impairment following traumatic injury (DST, Cognitive science research initiative (CSRI))