INTRODUCTION

The Department of Pathology is one of the biggest departments in Kidwai with a total permanent staff strength of 100. It forms the backbone on which cancer therapy is based.

The department offers mainly diagnostic services for cancer in Surgical Pathology, Haematopathology, Cytopathology and Cytogenetics, with a limited infrastructure for cancer research. The department is recognized by MCI for MD Pathology subspeciality course by sanctioning 4 seats and in addition  RGUHS recognized fellowship course (4 seats) for  duration of 1 ½ years is also run by the Department. MCI in the year 2019 recognized the Department for DM Oncopathology Superspeciality course (2 seats), only the third Institute to get recognition in India. 

The various sections under Pathology department are:

1. Histopathology
2. Cytopathology
3. Cytogenetics
4. Haematology

The details of each section are enclosed.

Histopathology Unit:

In the histopathology section, the sample load is around 13,000 TO 14,000 annually inclusive of referred slides from other hospitals for opinion.

Frozen section is being done as a routine. This facilitates an accurate diagnosis in cases where there is a diagnostic problem and in grey zone areas. Immunohistochemistry with around 100 markers and FISH with 15 probes are being done when necessary to provide accurate diagnoses and subcategorisation and for prognosis of cancers.

Achivements:

Staff of Surgical pathology are well trained in Oncopathology. In addition, most of them have specialized training in molecular techniques both in India and abroad. Postgraduate Fellowship in Oncopathology/Tumour pathology was started with 4 candidates the course being affiliated to RGUHS. DM Oncopathology course was started with 2 students enrolling every year from 2019, approved by NMC.

Major equipments added during the year

• Tissue Processor

 Research activities/projects/completed projects, ongoing and new projects

 Dr. Usha Amritham

• Co-invastigator in Understanding the influence of type 2 diabetes on Breast cancer in India using machine learning model based on Biomedical data. Collaborative project of IISC.
• Ongoing PhD research Project: Exploration of Aberrations in ESR1 gene and its clinical significance in hormone receptor positive progressive breast cancers, KMIO, Bengaluru.
• Neoadjuvent Chemotherapy followed by Surgery Versus Surgery followed by Adjuvent Chemotherapy for Resectable Gastric Adenocarcinoma Phase 3 Multicentric randomized control trial

 Dr. Champaka G

• “VNOCT” National Oral Cancer Project, DBT Project on Oral cancer stem cells 2022.
• Ongoing Project-DBT with IISC, Bengaluru “Functional analysis of microRNA-198”. Co-investigator-Oral Project.

Dr. Akkamahadevi Patil

• Evaluation of BRCA 1 dysfunction by estimation of BRCA1 and its repressors by multimodality testing in high grade serous ovarian cancer project.

Principal investigator of RGUHS project, on going.

Dr. Suma M N

• Principal Investigator Collaborative project funded from RGUHS titled Molecular sub typing of endometrial Cancer using microRNA. Collaborative project funded from RGUHS collaborated with Centre for Human Genetics, Bengaluru-On going.
• Co-invastigator in Understanding the influence of type 2 diabetes on Breast cancer in India using machine learning model based on Biomedical data. Collaborative project of IISC.

Participation in conference / seminars / workshops during the year

Dr. Champaka G

• 30 Nov 2022 Delivered talk on Interesting cases of Ovarian tumour in FGT workshop, KCIAPM, APON 2022.
• Delivered lecture on Latest WHO Updates on FGT tumour, KCIAPM, APCON 2022”.
• 23 April 2022, attended Urogenital Oncopathology CME at Shankara hospital, Bengaluru.

 Dr. Akkamahadevi Patil

• 30 Nov 2022 Delivered talk on Interesting cases of Cervical tumour in FGT workshop, KCIAPM, APON 2022.
• APCON conference in Dec 2022.

Dr. Ashwini Nargund

• 22 May 2020 Talk on Update in Hodgkins Lymphoma and its clinical application at AROI Karnataka, Bengaluru.
• 23 April 2022 attended Urogenital Oncopathology CME at Shankara hospital, Bengaluru.
• 30 Nov 2022 delivered talk on Interesting cases of Germ cell tumour in FGT workshop, KCIAPM, APON 2022.
• 1-4 Dec 2022 attended APCON-2022 at M S Ramaiah Medical college, Bengaluru
• 14-15 Jan 2023 Lymphoma Pathology Update-TMH Mumbai.

Dr. Geetha V Patil Okaly

• 23 April 2022 attended Urogenital Oncopathology CME at Shankara hospital, Bengaluru.
• 30 Nov 2022 delivered talk on Interesting cases of Sex cord stromal tumour in FGT workshop, KCIAPM, APON 2022.
• 1-4 Dec 2022 attended APCON-2022 at M S Ramaiah Medical College, Bengaluru.
• Faculty and resource person at CME on Immunohistochemistry and aid to resolve diagnostic quandary “Role of IHC and FISH in Breast Cancer”.

Dr. Suma M N

• Faculty for Gynaec Oncopathology- Basics to Bedside KCIAPM workshop, 29^th Sept 2021, Shankara Cancer foundation, Bengaluru, Grossing and interesting case discussion.
• Attended virtual webinar on “Female genital tract Pathology” conducted by IAPM kerala chapter on 12^th and 12^th August 2022.
• Organizing faculty for FGT workshop-clinching the diagnosis in Gynaec oncopathology, APCON, 30^th November 2022, Kidwai memorial Institute of Oncology. Grossing techniques and slide seminar.
• Attended 70^th Annual Conference of IAPM at MS Ramaiah medical college and Research Hospital, Bengaluru from 1^st December to 4 th December 2022.
• Faculty for Chatisgarh Chapter of Indian association of Pathologist and Microbiologists, 4^th and 5^th February 2023 at Pt. JNM Medical college, Raipur. Delivered a talk on approach to endometrial biopsies and molecular updates in endometrial cancers.

Related Statistics of the Department 

Staff Details

Papers published in National and International Journals.

 Apoorva Kanthaje, Usha Amirtham, M. C. Suresh Babu, Shivalingaiah Maregowda, Pramod Adiga, C. Ramachandra. Penile Ulcer as the Unusual Initial Presentation of Nasal NK/T Cell Lymphoma. Journal of Health and Allied Sciences, Vol. 13 No. 1/2023, 2022.

 Apoorva, Akkamahadevi Patil, Usha Amirtham, V. R. Pallavi  & H. V. Raghavendra . “Synchronous Bilateral Ovarian Teratoma with Malignant Transformation: A Rare Occurrence”. Indian Journal of Gynecologic Oncologyvolume 20, Article number: 17 (2022).

 Dr.Apoorva. K, Dr. Akkamahadevi Patil*, Dr.Usha Amirtham, Dr.Champaka. G, Dr.Pallavi.V.R and  Dr.Raghavendra. H.V. Ovarian sex cord stromal tumors in children and adolescents: an institutional-based study. International journal of scientific research, Volume – 11, Issue – 02, February – 2022.

 Akkamahadevi Patil ,  Sharada Patil , Anupama CE , Savitha Rajarajan , Vidya Prasad Nimbalkar, Usha Amirtham, Champaka G, Suma MN, Geetha V Patil1, Ashwini Nargund , Pallavi VR , Linu Jacob , Premalatha CS ,Jyothi S Prabhu. BRCA1 expression, its correlation with clinicopathological features and response to neoadjuvant chemotherapy in high grade serous ovarian cancer from an Indian centre. bioRxiv preprint doi: https://doi.org/10.1101/2023.01.11.523693; this version posted January 16, 2023.

 Aparna Devi C, Ashwini Nargund, Geeta V Patil Okaly, Usha Amirtham. Angiomatoid Fibrous Histiocytoma, A Great Mimicker – A Short Series of 3 Cases with EWSR1 Fusion. Iran J Pathol. 2023; 18(1): 108-115.

 Ashwini Nargund, Mohit Agrawal, Priya Dharmalingam, Usha Amirtham, Malathi Mukunda Pai. Primary Hepatoid Adenocarcinoma of the Lung: A Study of Two Cases with Review of Literature. Indian Journal of Medical and Paediatric Oncology. Volume 41, Issue 4, July-August 2020.

 Aparna Devi C, Ashwini Nargund, Geeta V Patil Okaly, Usha Amirtham, Akkamahadevi S Patil, Champaka G, Suma M N, Arun Kumar AR. Childhood Histiocytic Disorders — A wolf in Sheep's Clothing : Experience from a Cancer Institute in south India. Journal of Indian Medical Association Vol 120, No 11, November 2022.

 Suresh Babu M.C, Akansha Choudhary, Sreevalli A, Linu Abraham Jacob, Lokesh K.N., Rudresha A.H., Rajeev L.K., Smitha Saldanha, Champaka G. Ewing Sarcoma of Phalanx—A Common Tumor with an Uncommon Presentation. Indian Journal of Medical and Paediatric Oncology Vol. 43 No. 2/2022.

 S Singh, Malathi M, Akkamahadevi patil et al. Image guided fine needle aspiration cytology of Thymic lesions:A four-year study .The Indian journal of Chest diseases and allied sciences 61(1);19-23.

 Geetha V Patil Okaly, C Akshatha,  N Sandhya, Akina Prakash,  M N Suma,  Ashwini Nargund, Shankar Anand, C Ramachandra, Libin Babu Cherian.  Revisiting Metaplastic Carcinoma of Breast: An Emphasis on the Clinico-pathological and Immunohistochemical Variables Analyzed at a Tertiary Cancer Centre in South India. Iran J Pathol  2022 Summer;17(3):268-274. doi: 10.30699/IJP.2022.541798.2757. Epub 2021Aug 12.

 Geetha V Patil Okaly Clinicopathological study with risk stratified staging of pediatric hepatoblastoma  - 5year experience from a tertiary cancer centre.

 Koppikar*, A. Oaknin, K. Govind Babu, D. Lorusso S, Gupta, L.Y, Wu, W. Rajabto, K. Harano, S.-H. Hong, R. A. Malik, H. Strebel, I. M. Aggarwal, C.-H. Lai1, T. Dejthevaporn, S. Tangjitgamol,W. F. Cheng,W. Y. Chay, D. Benavides, N. M. Hashim, Y. W. Moon, M. Yunokawa, T. D. Anggraeni, W. Wei, G. Curigliano,A. Maheshwari27, U. Mahantshetty, S. Sheshadri, S. Peters, T. Yoshino & G. Pentheroudakis. Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with endometrial cancer. ESMO open Journal : Vol 8, Issue 1, January 2023.

 Kishan R. Bharadwaj , Kuheli Dasgupta, Suma Mysore Narayana, C. Ramachandra, Suresh M.C. Babu, Annapoorni Rangarajan, Rekha V. Kumarr. PD-1 and PD-L1 Expression in Indian Women with Breast Cancer. Eur J Breast Health 2022; 18(1): 21-2.

CYTOPATHOLOGY UNIT

The Cytology unit was started in the year 1974, it offers cytodiagnostic services to all patients of Kidwai, and also to those referred from other hospital and Institutions. It also caters to cancer detection camps conducted by Community Oncology department of KMIO in various parts of Karnataka and neighboring states.

The Cytology unit handles and average of 12,000 specimens per year, half of which are Fine needle aspiration cytology specimens comprising of routine FNA, ultrasound and CT guided FNA. The other half includes Gynaec Cytology and Non-gynaec Cytology consisting of fluid Cytology, brushing and washings from various sites (Statistics enclosed).

The department also offers short term the technical training to cytotechnicians, Cytotechnologists, Pathologists and post graduates in the department of Pathology and Gynaecology. The unit has external quality control participation with the Indian Academy of Cytologists.

Major equipments added during the year

Liquid Based Cytology analyzer with Integrated Imager (Hologic)

Related Statistics of the Department

 Staff Details

Papers published in National and International Journals.

 Narayan Hemavathi and Honnappa Sridhar.2022, P53 Expression in Oral Squamous Epithelial Lesions with Histopathological Correlation. Int J Recent Sci Res. 13(02), pp. 324-329. DOI:http://dx.doi.org/10.24327/ijrsr.2022.1302.0064.

Lucas and Dr Aamarpali. To Evaluate The Protective Effect Of Protein Of Piper Longum Linn On Cell Viability Of Human Peripheral Lymphocytes Against Damage Induced By Hydrogen Peroxide And Tertiary Butyl Hydroperoxide. IDC November January_2022.

HAEMATOLOGY UNIT

The Haematology unit performs haemograms for all cancer patients and those attending Cancer Detection Clinic. These include 80-120 pediatric and 150-250 adult haemograms per day. The division takes part in the external quality assurance program conducted by AIIMS, New Delhi. 10-20 bone marrow aspirates and biopsy are processed and reported. These include new cases and follow up of haematological malignancies. Detailed characterization of leukemias with the full range of cytochemistry is being done. Flow Cytometry for acute and chronic leukaemias is being done. In addition, clinical pathology tests are performed. Teaching of DNB (Path), B.Sc. (MLT) and MD (Path) students is under taken.

 Related Statistics of the Department

Staff Details

CYTOGENETICS UNIT

The cytogenetics facility at Kidwai memorial Institute of Oncology was established in 1989 as a subsection of the Pathology department. Major contributions were made to the establishment of chromosomal changes in patients with various forms of hematological malignancies and solid tumors. The facility offers cytogenetic analysis of hematological malignancies and solid tumors to the department of medical, paediatrics and surgical oncology departments in the form of routine diagnosis for the patients on therapy to see the cytogenetic response. Also, we receive samples of clinical cases from other referral hospitals. GTG banding is used routinely for karyotyping. Visual and automated karyotyping is routinely in practice. The unit is involved in substantial research activities and publications in national and international journals. In addition, training is offered periodically in the above subject by qualified and resourceful staff.

Achievements:

Chromosomal analysis has been performed and diagnosis of the disease is made on over  on bone marrow, peripheral blood and FNA samples. In addition, the unit has academic achievements in publishing papers in reputed journals.  

Conferences / Seminars/ Workshops conducted by the Department 

Hands on Training in Karyotyping workshop and CME” Conducted at MVJ Medical college in association with Cytogenetics unit of Kidwai Memorial Institute of Oncology. 30 Nov 2022.

Hands on Training in Cytogenetis workshop” Conducted at Cytogenetics unit at Kidwai Memorial Institute of Oncology as part of Pre-Conference workshop of APCON 2022.

Related Statistics of the Department 

 Staff Details