Evaluation of skin biopsies for fungal infections: role of routine fungal staining.

BACKGROUND: The diagnosis of cutaneous fungal infection is usually made on clinical examination of the lesion and direct microscopic examination of skin scrapings with potassium hydroxide. Histopathological examination is rarely required to confirm dermatophytic infections. There is often a discord between the clinical and histopathological findings and many times clinical appearance can have a poor histopathological correlation. METHODS: This retrospective study was carried out on all skin biopsies received in a period of 1 year. The clinical details of all cases were retrieved and slides were reviewed. Routine fungal staining periodic acid-Schiff (PAS) stain was performed in all cases. RESULTS: Of 403 skin biopsies received in 1 year, material for further staining was available in 338. On re-examining the slides stained with PAS stain, fungi were identified in 34 cases (10%), of which fungal infection had been suspected clinically in five cases. CONCLUSIONS: Use of routine stains like PAS can help to reach a correct diagnosis and initiate appropriate treatment. Fungal staining should be done in skin biopsies with non-specific clinical details and microscopic findings for best patient management.

Multiple cysticerci as an unusual cause of mesenteric lymph node enlargement: a case report.

INTRODUCTION: Cysticercosis is a disease caused by infestation with the larval stage of the intestinal cestode Taenia solium. The parasite usually localizes to subcutaneous tissues and muscles causing palpable or visible nodules, to the brain leading to epileptic attacks, and to the eyes with visible nodules leading to blindness and atrophy. CASE PRESENTATION: Here we present the case of a 15-year-old girl who was incidentally detected as having mesenteric lymph node enlargement caused by multiple cysticerci. This is the second case report of lymph node enlargement due to cysticercus infestation. CONCLUSION: This rare mode of presentation of cysticercus infestation highlights the importance of parasites as a cause of treatable lymph node enlargement.

Endometrial stromal lesions: a morphological and immunohistochemical study of short series.

BACKGROUND: Endometrial stromal tumours are rare and constitute less than 5% of uterine tumours. This study presents our experience of endometrial stromal tumours and their immunohistochemical profile. METHODS: All cases reported as endometrial stromal tumors from January 2001 to December 2004 were extracted from the files of pathology department. Hematoxylin and eosin stained slides were reviewed and immunohistochemical staining for vimentin, desmin and cytokeratin was done in all cases. RESULTS: In all five cases of endometrial stromal tumors were retrieved from the records and constituted 0.3% of endometrial neoplasms. One case was diagnosed as endometrial stromal nodule and four cases were diagnosed as low-grade endometrial stromal sarcoma. Four out of five cases were confined to the uterine corpus. Only one case showed spread to the cervix and the fallopian tube. All tumors were negative for desmin and cytokeratin and showed only focal vimentin positivity. CONCLUSIONS: The diagnosis rests on morphological features mainly while immunohistochemical profile of these tumours is rather inconsistent.

A comparative study of serum lipid profile and gallstone disease.

The diseased gallbladder is one of the commonest specimens submitted to the surgical pathology laboratory in North India. Obesity is associated with a linear increase in gallstone formation. It has been observed that the plasma lipoprotein profile of patients with gallstones differs markedly from that of healthy subjects. Serum lipid profile was done by enzyme kit method. All the gallstones received were categorized morphologically and examined biochemically. The age range of 200 cases was 13 to 77 years with a mean of43.75 +/- 13.39 years. There were 171 females (85.5%) and 29 males (14.5%) with male to female ratio of 1: 5.8. The stones containing both cholesterol and bile pigments were the most common (129 cases, 84.87%); while pure cholesterol stones were seen in 23 cases (11.50%) and pigment stones were infrequent (1 case, 0.65%). On lipidogram of patients in the study group, mean serum total cholesterol was 155.50 +/- 43.03 mg/dL, mean serum triglycerides was 100.49 +/- 45.23 mg/dL, mean HDL cholesterol was 46.71 +/- 15.20 mg/dL, mean LDL cholesterol was 87.94 +/- 36.85 mg/dL and mean VLDL cholesterol was 20.84 +/- 11.97 mg/dL. Serum total cholesterol values were significantly higher in patients older than 39 years as compared to patients < or =39 years (161.44 +/- 42.32 mg/dL vs. 145.79 +/- 32.96 mg/dL, p < 0.05). But the observed mean values in both of these subgroups were within the normal range i.e. <200 mg/dL. No significant difference was observed in the mean serum triglyceride values between male and female patients. The findings of this study did not indicate any role of serum lipid profile in the formation of gallstones. However the higher mean values of serum total cholesterol and serum triglycerides in patients older than 39 years of age may be explained by increasing age.

Mucinous adenocarcinoma of the renal pelvis presenting as pyonephrosis: a case report.

Tumours of the renal pelvis are rare. We present a case of primary mucinous adenocarcinoma of the renal pelvis masquerading as pyonephrosis clinically and diagnosed on histopathologic examination. Patient presented with pyonephrosis of the left kidney due to a large staghorn calculus and was treated with tube nephrostomy followed by nephrectomy.