Palmar-plantar erythrodysesthesia associated with high-dose methotrexate: Case report.

BACKGROUND: Palmar-plantar erythrodysesthesia (PPE) is a common adverse event seen with many chemotherapeutic agents as well as targeted therapies which is very debilitating for the patient. To the best of our knowledge there are only a few cases of PPE reported with methotrexate infusion to date. CASE AND CONCLUSION: We report a case of Burkitt Lymphoma, who developed severe PPE with methotrexate infusion and responded very well with conservative management and dose reduction in subsequent cycles.

Mucoepidermoid Carcinoma of Salivary Gland: Limitations and Pitfalls on FNA.

Mucoepidermoid Carcinoma (MEC) is the most common malignant neoplasm of salivary gland origin. However, its morphologic heterogeneity poses difficulty in interpretation. In the present series we discuss the morphologic features of MEC, limitations and pitfalls in its diagnosis on Fine Needle Aspiration Cytology (FNAC). Fourteen cases of suspected MEC were evaluated cytologically followed by histopathological examination for confirmation. A definite cytological diagnosis was rendered in nine cases; three of the remaining five were underdiagnosed as abscess, pleomorphic adenoma and mucus cyst. Of the remaining two cases, one case each of sebaceous carcinoma and sialadenitis was mislabeled as MEC on cytology. A satisfactory aspirate composed of intermediate cells, mucin secreting cells and squamous cells in a mucinous background may not be obtained in all cases of low grade MEC. High grade MEC can be classified as squamous cell carcinoma. Hence, awareness of confounding factors with clinicopathologic correlation and judicious use of frozen section can help in minimizing errors.

Bladder Adenocarcinoma: A Persisting Diagnostic Dilemma.

Primary urinary Bladder Adenocarcinoma (PBA) is an uncommon neoplasm and can cause diagnostic difficulties due to histologic similarities with adenocarcinomas of adjacent structures like Gastrointestinal Tract (GIT) and prostate, since involvement of the bladder by metastasis or direct spread can occur. Seven cases of bladder adenocarcinomas were diagnosed during a period of four years in a tertiary care hospital. Patient's age ranged from 26-78 years with a male predilection. Three cases were signet ring type adenocarcinomas, two cases were subtyped as enteric variant, one as mucinous variant and one as adenocarcinoma Not Otherwise Specified (NOS) variant. One case showed urachal involvement. Common site of involvement was the base and posterior wall of the bladder. Three cases had prior history of GIT malignancy. No morphologic difference was identified to differentiate primary from secondary adenocarcinomas. Bladder adenocarcinoma is rare tumours. Primary and secondary adenocarcinomas cannot be distinguished from each other on morphologic grounds. Ancillary studies may have limited role in distinguishing between the two. Hence, clinical correlation has a major role in their evaluation.

Stacked Euler vector (SERVE): a gray-tone image feature based on bit-plane augmentation.

A new combinatorial feature called Stacked Euler Vector (SERVE) is introduced to characterize a gray-tone image. SERVE comprises a four-tuple, where each element is an integer representing the Euler number of the partial binary image formed by certain pixel overlap relations among the four most significant bit planes of the gray-tone image. Computation of SERVE is simple, fast, and does not involve any floating point operation. SERVE can be used to augment other features to improve the performance of image retrieval significantly. Experimental results on the COIL database are reported to demonstrate its performance.

Euler vector for search and retrieval of gray-tone images.

A new combinatorial characterization of a gray-tone image called Euler Vector is proposed. The Euler number of a binary image is a well-known topological feature, which remains invariant under translation, rotation, scaling, and rubber-sheet transformation of the image. The Euler vector comprises a 4-tuple, where each element is an integer representing the Euler number of the partial binary image formed by the gray-code representation of the four most significant bit planes of the gray-tone image. Computation of Euler vector requires only integer and Boolean operations. The Euler vector is experimentally observed to be robust against noise and compression. For efficient image indexing, storage and retrieval from an image database using this vector, a bucket searching technique based on a simple modification of Kd-tree, is employed successfully. The Euler vector can also be used to perform an efficient four-dimensional range query. The set of retrieved images are finally ranked on the basis of Mahalanobis distance measure. Experiments are performed on the COIL database and results are reported. The retrieval success can be improved significantly by augmentiong the Euler vector by a few additional simple shape features. Since Euler vector can be computed very fast, the proposed technique is likely to find many applications to content-based image retrieval.