An Oncocytic Variant of Papillary Thyroid Carcinoma Mimicking As Metastatic Adenocarcinoma: A Diagnostic Challenge.

Papillary thyroid carcinoma is the most common type of thyroid carcinoma, diagnosed on the basis of a predefined set of distinctive nuclear features. There are about 15 known variants of papillary thyroid carcinoma, and the oncocytic variant is not one of the commonly encountered prototypic conventional papillary thyroid carcinoma. We hereby report an unusual case of a 48-year-old woman presenting with thyroid swelling, which proved to be a diagnostic crisis.

IMAGES: Ectopic thymic cyst: a rare case report.

Ectopic thymic tissue in the neck is rarely reported in medical literature. Being uncommon, they are rarely included in the clinical diagnosis of cervical cystic masses and are misdiagnosed by surgeons as branchial cysts, lymphatic malformations, epidermoid cysts, dermoid cysts or thyroglossal cysts, lymphadenitis or neoplastic masses. Although it is rare, cervical thymic cyst should be considered in the differential diagnosis of a lateral cystic neck mass. Here we report a rare case of thymic cyst in a young 15-year-old male child on the left side of the neck. Histopathology of the excised cyst revealed thymic tissue composed of prominent Hassall's corpuscles, cholesterol clefts, lymphoid aggregates and cyst lined by cuboidal and squamous cells.

Cutaneous mercury granuloma.

Cutaneous mercury granuloma is rarely encountered. Clinically it may pose difficulty in diagnosis. Here, we report a 23-year-old male presented with erythematous, nodular lesions over the forearm and anterior aspect of chest wall. Metallic mercury in tissue sections appear as dark black, opaque, spherical globules of varying size and number. They are surrounded by granulomatous foreign-body reaction. It is composed of foreign body giant cells and mixed inflammatory infiltrate composed of histiocytes, lymphocytes, plasma cells, and few eosinophils.

A rare case of inflammatory myofibroblastoma of diaphragm.

Inflammatory myofibroblastoma is a distinctive pseudosarcomatous lesion that occurs primarily in the viscera and soft tissue of children and young adults. It is composed of myofibroblastic spindle cells accompanied by an inflammatory infiltrate of plasma cells, lymphocytes, and eosinophils. We report a 41-year-old man who presented with progressive dyspnea and pain in the right hypochondrium for 6 months. USG abdomen revealed a well-defined hypoechoic rounded mass in the subdiaphragmatic region. CT thorax and abdomen revealed a large hypodense mass in posterosuperior aspect of the right lobe of liver, right pleural effusion and basal consolidation of the right lung. Right thoracotomy was performed. The tumor mass was arising from the right side of diaphragm. Total surgical excision was done. On histomorphology and immunohistochemical analysis, a diagnosis of inflammatory myofibroblastoma was done. Following excision the patient was completely relieved of dyspnea and pain. There was no recurrence on follow-up for 2 years.

FNAC in the diagnosis of lymph node malignancies: A simple and sensitive tool.

CONTEXT: Fine needle aspiration cytology (FNAC) of the lymph node is a simple diagnostic tool to diagnose suspected and unsuspected secondary and primary lymph node malignancy. AIM: To study the utility of FNAC in the diagnosis of clinically suspected and unsuspected lymph node malignancy. DESIGN: A cross-sectional hospital based study on 50 patients diagnosed to have primary or secondary lymph node malignancy by cytology, and confirmed by histopathology. MATERIALS AND METHODS: Lymph node aspirate smears reported as malignant were studied and the findings were correlated with histopathology. Clinical and radiological data were also noted. STATISTICAL ANALYSIS: The data were tabulated as per the involvement of the various lymph node groups and the types of secondary and primary lymph node malignancies involved. RESULTS: 45 cases of metastatic malignancy and five cases of lymphomas were diagnosed by FNAC of lymph nodes. Histopathological correlation was available in all cases. Malignancy was clinically unsuspected in nine cases (18%). CONCLUSION: FNAC of lymph nodes is a very useful, simple and sometimes the only tool in the diagnosis of lymph node malignancies.

A rare case of disseminated cysticercosis.

Cysticercosis is a common tropical disease. One of the uncommon manifestations and a rare complication is its disseminated form (DCC). Neurocysticercosis (NCC) is the common parasitic disease of the central nervous system. Human cysticercosis is caused by the dissemination of the embryo of Taenia solium in the intestine via the hepatoportal system to the tissues and organs of the body. The organs most commonly affected are the subcutaneous tissues, skeletal muscles, lungs, brain, eyes, liver, and occasionally the heart, thyroid, and pancreas. Widespread dissemination of the cysticerci can result in the involvement of almost any organ in the body. We report here a case of a 36-year-old-male with disseminated cysticercosis. He visited our hospital with symptoms of multiple palpable nodules, dementia, and confusion. After the investigations he was diagnosed with disseminated cysticercosis involving the brain, subcutaneous tissues all over the body, and the skeletal muscles. The patient was initially treated with Albendazole in a private hospital, but there was no response. Then he was treated with Praziquantel and steroids.

Carcinoma en cuirasse : a rare presentation of breast cancer.

Carcinoma en cuirasse is a form of cutaneous metastasis. Although this condition is rare, it is most commonly associated with breast carcinoma with local recurrence after mastectomy. Cutaneous metastasis presents most commonly a few months or years after the primary has been diagnosed. Less frequently a metastasis is diagnosed at the same time as the primary tumor or presents as the first manifestation of the disease. We report a case of carcinoma en cuirasse in a 50-year-old female who presented with elevated, finely nodular, indurated skin lesions on left anterior chest wall, axillary region and keloid - like patch on left upper arm. On further examination a breast mass was detected. Fine needle aspiration of all the lesions was performed. Cytodiagnosis was given as infiltrating duct carcinoma of breast with metastatic carcinoma involving left anterior chest wall, axilla and left upper arm. We should not disregard keloid-like or indurated patches on skin which should be investigated thoroughly.