Adenomatoid tumor of tunica albuginea mimicking seminoma on fine needle aspiration cytology: a case report.

BACKGROUND: Adenomatoid tumor is one of the most common primary neoplasms of the paratesticular area. The epididymis is the most common site of involvement; however, it can also arise from the tunica albuginea, spermatic cord, tunica vaginalis and testis. Fine needle aspiration cytology (FNAC) is being increasingly used for lesions in the paratesticular area. Review of the literature showed very few reports on the cytologic features of adenomatoid tumor. We report the cytologic features of a case of adenomatoid tumor arising from testicular tunica albuginea. CASE: A 40-year-old man presented with right-sided scrotal swelling of 1 years' duration. FNAC of the lesion showed highly cellular smears composed of clusters of monomorphic plump cells with oval eccentric nucleus, fine granular chromatin, small single nucleolus and abundant pale to vacuolated cytoplasm. The background showed "tigroid substance," classically described in seminoma. Histopathologic examination confirmed the diagnosis as adenomatoid tumor of tunica albuginea. CONCLUSION: FNAC of an adenomatoid tumor poses a diagnostic challenge when the tumor arises from sites other than the epididymis because they can be mistaken for intratesticular tumors. It is thus important to consider this tumor in the differential diagnosis of scrotal swellings.

Role of AgNOR count and its correlation with serum PSA levels in prostatic lesions.

OBJECTIVE: Prostatic diseases are a major cause of morbidity and mortality. The need is to detect the disease early in its natural history and manage it aggressively. Prostate-specific antigen (PSA) is not very sensitive, thus other indices are being employed. Argyrophillic nucleolar organizer region (AgNOR) count is the proliferative index marker used in our study. Our main objective was to evaluate the role of AgNOR in prostatic lesions and to find a correlation between serum PSA and AgNOR counts. PATIENTS AND METHODS: We evaluated 60 patients of prostate diseases over a year. The patients were classified as benign prostatic hyperplasia (BPH), prostatitis, or prostatic adenocarcinoma (Ca). Patients with suspicious areas or foci of prostatic intraepithelial neoplasia (PIN) on histology were subjected to a slide review. All slides were H&E and AgNOR stained. RESULTS: The difference between the mean AgNOR counts of BPH and prostatitis was significant, as between BPH and PIN (p < 0.001). The difference between low- and high-grade PIN was also significant.Ca prostate showed a significant increase in AgNOR counts from benign diseases; and also between localized and metastatic carcinoma (p < 0.001). On finding a correlation between serum PSA values and AgNOR counts, they were significant for benign and carcinoma cases (p < 0.001), though not for PIN. CONCLUSIONS: Our study depicts the usefulness of AgNOR counts in the diagnosis of various prostatic diseases including the pre malignant PIN. The relation between serum PSA and AgNOR was highly significant for BPH and Ca prostate. Hence, AgNOR is an efficient adjunct to our diagnostic armamentarium leading to improved prognostication and management.

Cytomegalovirus ureteritis: an unreported cause of hematuria in an immunocompetent individual.

A middle-aged woman presented with painless hematuria and passage of large clots. Two weeks earlier, she had pyrexia with upper respiratory tract symptoms. Imaging studies revealed no lesions of the urinary tract. Cystoscopy showed clots and oozing of blood from the left ureteric orifice. Urine cytology and mucosal biopsies were normal. Left nephroureterectomy was done as an emergency procedure; the hematuria stopped following the procedure. Histopathology revealed cytomegalovirus inclusion bodies in the mucosa of the excised ureter. This unusual presentation of hematuria has not been reported previously.

A thyroid nodule with adipose metaplasia in a nodular goitre: a case report.

Fat containing lesions of the thyroid gland are a rarity with very few cases reported in the literature. We report a case ofa thyroid nodule with adipose metaplasia in a nodular goiter in a 67-year-old female.

Adrenal schwannoma: a case report and review of literature.

Nerve sheath tumors occurring in the adrenal gland are uncommon. Although schwannomas originating in retroperitoneal and juxta-adrenal locations have been reported, those occurring in adrenal gland are rare. Till date no such case has been documented in the Indian literature.

Lupus anticoagulant and anticardiolipin antibodies in SLE with secondary Antiphospholipid Antibody Syndrome.

Thirty patients with systemic lupus erythematosus (SLE) and suspected secondary antiphospholipid antibody syndrome (APLAS) were evaluated in the study based on their clinical manifestations. The aim was to study the prevalence of various antiphospholipid antibodies, compare the tests used for their detection and to find a correlation between clinical and laboratory parameters. Coagulation tests used were activated partial thromboplastin time, dilute Russell viper venom time and kaolin clotting time and the results were analyzed statistically. In our study, arteriovenous thrombosis was more common than recurrent abortions and other clinical manifestations. Twelve percent of patients had positive lupus anticoagulant and 78% had elevated anticardiolipin antibody titers. We concluded that the prevalence of lupus anticoagulant and anticardiolipin antibodies in SLE patients with secondary APLAS was 12% and 17%, respectively. We also proved that dilute Russell viper venom time and kaolin clotting time proved to be much more specific tests and the anticardiolipin antibody a much more sensitive test.

Adrenal oncocytoma masquerading as a functional tumor.

Adrenal oncocytoma is a rare entity, with 20 cases reported in literature. A functional oncocytoma is extremely rare. We present a case of adrenal oncocytoma in a hypertensive male who had elevated catecholamine levels, which improved after adrenalectomy with decrease in daily antihypertensive requirement.