Cytological diagnosis of primary cutaneous histoplasmosis with hemophagocytosis in immunocompetent patient - A rare case from non endemic region.

Histoplasma capsulatum is an opportunistic dimorphic fungus caused by inhalation of spores present in the soil. It is extremely rare in the northern Himalayan region of India and is usually asymptomatic. It may rarely progress to disseminated histoplasmosis which is usually observed in immunocompromised patients associated with malignancy, acquired immunodeficiency syndrome or diabetes. The present case is being reported because of unusual cutaneous presentation of disseminated histoplasmosis in an immunocompetent patient of non-endemic region. The case also highlights the importance of fine needle aspiration cytology for its precise early diagnosis and avoiding of further complications.

Malaria positivity among blood donors: an important index to assess blood safety.

Blood transfusions carry the potential for causing increased morbidity & mortality both in terms of transfusion reactions as well as transfusion transmitted infections. It is therefore mandatory to test for transfusion transmitted diseases before any unit is transfused to a patient. In India it is mandatory to screen all units for HIV, HBsAg, HCV, Syphilis and Malaria. This study was done to study the incidence of malaria among blood donors at the blood bank of a tertiary care centre of Uttarakhand, India over a period of 2 years and also to analyse any associated factors. Any sample found positive was retested for confirmation by blood smear examination & using another kit. A total of 17,209 donors donated blood over a 2 year period and 14 donors (0.08 %) were found to test positive for malaria parasite. Only one case was a voluntary donor and the remaining 13 were replacement donors. It was seen that there was a peak in the months of September and October.

Round Cell Vaginal Malignant Melanoma: A rare entity.

Malignant melanoma is predominantly a skin disease but in rare instances it may occur at other sites. A vaginal melanoma is a rare clinical entity and the round cell type is an uncommon variant. Although the present case was clinically diagnosed as a urethral caruncle, on histopathological examination and immunostaining it was diagnosed as a round cell pigmented malignant melanoma. The patient refused radical surgery and was given a full course radiotherapy treatment but died a year later. Malignant vaginal melanoma carries a very poor prognosis even when lesion is localised at the time of presentation. The five-year survival rate ranges from 10-20% with the prognosis being influenced by tumour size. A tumour size ≥3cm has a poor prognosis. Age, mitotic count, stage, and location of the lesion do not influence survival rates.