Atypical Hansen's Disease Mimicking Xanthogranuloma: Role of Cytology.

Fine needle aspiration cytology is a simple, safe, and effective technique that can be used in the diagnosis of cutaneous diseases. Here, we present a case of Hansen's disease with an erythematous dermal nodule mimicking xanthogranuloma clinically. In our scenario, since leprosy is considered eliminated in India, the presentation of patients with classical signs and symptoms is becoming rare. Atypical manifestation of leprosy is increasing day by day, so it is necessary to have a high suspicion of leprosy in every case.

Xanthogranulomatous epididymo-orchitis: A single-institutional case series and systematic review.

Introduction: Xanthogranulomatous inflammation is a rare nonneoplastic and chronic inflammatory process, characterized by proliferation of foamy macrophages resulting in damage and necrosis of the affected tissue. Involvement of the testis/epididymis by the disease is a rare event. Methods: A case series of four male patients diagnosed with xanthogranulomatous epididymitis/orchitis (XGEO) at our institute was reviewed. In addition, a systematic review of XGEO was carried out using PRISMA Guidelines 2020. Twenty-nine articles describing 38 patients of XGEO were included in the study. Results: XGEO usually has a subacute or chronic presentation and affects male individuals in the 5th or 6th decades of life. The disease is also known to occur in the pediatric age group. The patients present with swelling, tenderness, or pain in the scrotal region. Bilateral involvement has also been documented. Thirty patients were known to have one or more causal risk factors including diabetes mellitus (23.7%), spinal cord injury/neuropathic bladder (7.9%), prostatectomy (7.9%), trauma (4.1%), and transurethral resection of prostate procedure (4.1%). Complications observed were scrotal fistula, adhesions, and abscess formation. Radiological features reported are nonspecific and include heterogeneous echotexture, hypoechoic areas, and/or scrotal wall collections. Bacterial microorganisms isolated from the affected tissue demonstrated the presence of Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. Histological subtypes of XGEO are diffuse and focal. In the diffuse subtype, which is more common, there is extensive parenchymal destruction by inflammatory process accompanied by widespread ischemic necrosis. Conclusion: The mainstay of treatment in XGEO cases is surgical excision preferably orchidectomy. Conservative management has been attempted in young individuals and in patients with focal XGEO, but there is limited supporting evidence. We present data of four cases along with detailed systematic review of the disease examining its clinicopathological behavior and associated risk factors followed by operative approach.

Extensive mucoepidermoid carcinoma-like differentiation in follicular carcinoma of the thyroid.

Mucoepidermoid carcinoma (MEC) is a rare malignant thyroid neoplasm. Cases of MEC with papillary, insular, and anaplastic thyroid carcinoma have been reported. Here, we present a case of follicular carcinoma with extensive MEC-like differentiation. A 62-year-old female presented with complaint of thyroid swelling for 10 years. Cytological features were suggestive of follicular neoplasm. Contrast-enhanced computed tomography showed metastasis to lung and vertebrae. Salivary glands and breasts were normal on examination and imaging. Subtotal thyroidectomy with bilateral neck dissection surgery was performed. The specimen was submitted for histopathological examination. Microscopy showed features of follicular carcinoma with capsular and vascular invasion along with an additional MEC-like morphology. Follicular carcinoma with extensive MEC-like differentiation is a rare observation. Since the tumor was sparing salivary glands and breasts, we considered it as mucoepidermoid differentiation over a collision tumor. However, immunohistochemistry and molecular analysis were the limitations.

Histopathologic spectrum and clinical correlation of lesions of jaw - a series of 60 cases.

Odontogenic tumors have the potential for the development of malformations of the teeth as well as the surrounding tissue. Sound knowledge of various types of jaw lesions and their characteristics will help the clinician with timely measures and management. Our main aim was to study the histopathological nature of various jaw lesions retrieved from biopsies and resected specimens. Consecutive 60 cases of jaw lesions were analyzed. Odontogenic cyst, odontogenic tumor, fibro-osseous lesions, and giant cell lesions were included in this study. Lesions of the oral cavity, soft tissue lesions, secondary and inflammatory lesions of the jaw were excluded. H&E stained slides were examined by light microscopy. A total of 60 jaw lesions were analyzed for histologic type. Odontogenic cysts (55%) were found to be most common followed by odontogenic tumors (25%), fibro-osseous lesions (10%), giant cell lesions (05%), and non-odontogenic cysts (05%). The most commonly affected age groups were between 20-40 years. The mandible was more commonly involved bone. To conclude, based only on histology, the distinction between odontogenic cysts is difficult and almost impossible when they are secondarily infected. For definitive diagnosis clinical-radiological correlation is needed.