Cutaneous Lymphoma in a Tertiary Skin Hospital and Referral Centre in Nepal.

BACKGROUND: Primary cutaneous lymphomas are a distinct group of rare lymphoid neoplasms with absence of extracutaneous lymphomas at the time of presentation. They are rare in Nepal and no data on cutaneous lymphoma have been published from this country till date. METHODS: This retrospective study included 15 cases of cutaneous lymphomas retrieved from the records of department of Dermatopathology, DI Skin Hospital and Referral Centre, Bansbari, Kathmandu, Nepal. Patients were diagnosed according to the current WHO classification for cutaneous lymphoma. RESULTS: A total of 15 cases were studied with median age of 45 years (range: 22 to 81 years) and male to female ratio of 1.5:1. Primary cutaneous lymphomas constituted 13 cases out of 15 and the most common type of cutaneous lymphoma was mycosis fungoides and variants 5 (33%), followed by CD30 positive primary cutaneous anaplastic large cell lymphoma constituting 2 (13%). T-cell cutaneous lymphoma constituted 13 (87%) and B-cell cutaneous lymphoma 2 (13%). CONCLUSIONS: Cutaneous T-cell lymphomas were more frequent than cutaneous B-cell lymphomas in Nepalese patients. Mycosis fungoides and variants are commonest type of primary cutaneous lymphomas.

Primary Cutaneous Melanoma in a Tertiary Hospital: A Retrospective Study.

BACKGROUND: Malignant melanoma, the most aggressive form of skin cancer worldwide is much often talked about in the western world and in Caucasian population as it is seen to be a rare disease in South Asians. This study aims to provide a better assessment on the spectrum of cutaneous melanomas in our context. METHODS: This was a retrospective, 11-year hospital-based study done in the Department of Pathology, Tribhuvan University Teaching Hospital. The data collected included age, sex, anatomical site, Breslow thickness in millimeter, Clark's level of invasion, presence of ulceration, Tumor infiltrating lymphocytes and melanoma subtypes. The anova test was used to compare the relationship between age and staging, whereas pearson's chi square test was used to determine the relationships of sex and histopathological subtype with staging. RESULTS: Out of total, 44 cases of primary cutaneous melanoma were seen, 23 (52.27%) were males and 21 (47.27%) were females. The mean age was 61.29 year with the majority in the age groups 61-70 and 71-80 comprising 11 cases each (25%). Lower extremity was the most frequent site (23 cases, 52.27 %). The largest group (18 cases) was composed of Nodular melanoma, followed by acral melanoma (17 cases). Nodular melanoma tended to occur at a higher stage than other types. Age and sex showed no correlation with staging. A significant association was found with histopathological type. CONCLUSIONS: Primary melanoma is a commonly encountered malignancy. It is commomly appreciated equally among both gender among elderly populations. Nodular melanoma present late and is the commonest variety with lower extremity being the commonest site Keywords: Breslow thickness; clark's level; cutaneous melanoma; nodular melanoma.

Fine needle aspiration cytology as a preliminary diagnostic tool in chondroid syringoma: a case report and review.

We report a case of chondroid syringoma (CS) in a 44-year-old male. He presented with a firm asymptomatic nodule in his left upper lip of 2-year duration. The initial clue to the diagnosis was made on fine needle aspiration cytology (FNAC), and a final diagnosis was based on histopathological examination. The case highlights the importance of FNAC in providing clues to the diagnosis of suspected cases of chondroid syringoma before performing large excisions and repair, which would require more skill and time. We have also reviewed the cytological findings of all the cases of benign CS reported until the current date.

Tungiasis: A Rare Parasitic Infestation in Genitals of a Native Male from Kathmandu.

Tungiasis is a common parasitic infection inmany parts of the world, including South and Central America and parts of Africa. It is rare in other places, such as in India and Pakistan and imported cases have been reported in Taiwan, Italy, the United States of America, etc. Our diagnosis was made based on histopathologiocal features of the parasite, which corresponds too ther reports and description of tungiasis.1-3 It was treated by surgical excision alone. The fact that the disease has never been reported in Nepal makes it difficult to diagnose clinically, but should be considered in the future. Histopathology can aid in diagnosingthis rare condition.

Kikuchi-Fujimoto disease in Nepal: a study of 6 cases.

CONTEXT: Kikuchi-Fujimoto disease is a benign disorder, predominantly affecting young women with a predilection for cervical lymphadenopathy. Although the disease has been recognized worldwide, to our knowledge no cases have been reported previously from Nepal. OBJECTIVES: To determine the prevalence of Kikuchi-Fujimoto disease in Nepal and to analyze clinicopathologic features. METHODS: We reviewed 6 cases of Kikuchi-Fujimoto disease recorded at 3 different hospitals in Nepal during a period from June 1998 to June 2002. Clinical data and histopathology are presented. RESULTS: This study included 5 females and 1 boy, aged 13 to 32 years. These patients presented with prolonged fever and lymphadenopathy. The 5 female patients had cervical lymphadenopathy, and the boy had axillary lymphadenopathy. Complete blood counts revealed raised erythrocyte sedimentation rates in all patients and anemia in 2 patients. The size of excised lymph nodes (in greatest dimension) ranged from 1.5 to 5 cm. Typical histologic features were seen, namely, architectural effacement due to presence of pale nodular lymphohistiocytic foci with karyorrhectic debris, coagulation necrosis, eosinophilic debris, and absence of granulocytic infiltration. In a follow-up of the cases, disease recurrence was not found. CONCLUSION: Our study emphasizes that Kikuchi-Fujimoto disease should be considered as one of the differential diagnoses in patients with prolonged fever and cervical lymphadenopathy and that it should be differentiated from tuberculous lymphadenitis in regions where tuberculosis is prevalent.