Tubercular sialadenitis of parotid gland - An extremely rare case series.

Tuberculosis is a potentially fatal infectious disease caused by Mycobacterium Tuberculosis. It most commonly involves the lungs (Pulmonary Tuberculosis), although it can involve any organ system in the body. However even in a country like India which has high burden of this disease, the tubercular invasion of parotid gland is extremely rare. Here we describe two such cases. Both patients were immune competent and presented with fever and swelling in the parotid region. They were diagnosed as tuberculosis of parotid gland by ultrasound guided fine needle aspiration and confirmed bacteriologically.

Perineurioma of scalp in an infant: A case report with short review of literature.

Perineuriomas are rare benign peripheral nerve sheath tumor composed exclusively of perineurial cells. They have been classified into two main types according to their location - intraneural and extraneural (soft-tissue). Extraneural perineurioma are uncommon, found mostly in the soft tissue of the extremities and trunk, rare at other site. They mainly affect adults and have been sometimes described in children but are extremely rare in infants. We present a case of extraneural (soft-tissue) perineurioma of scalp in a 3-month-old infant, highlighting clinical, pathologic, and immunohistochemical features along with a discussion of the main differential diagnosis of this tumor. This is also the youngest case ever reported in the literature.

Isolated angiomyolipoma of vulva: A case report of an uncommon tumor at an uncommon site.

Extra renal angiomyolipoma is an exceedingly rare entity. This is usually not associated with tuberous sclerosis as it has no human melanoma black 45 immune reactive cells although it shares the terminology with renal angiomyolipoma. The histological features are characterized by admixture of blood vessels, smooth muscles, and mature adipose tissues in variable proportion. Surgical excision is considered curative. We report a case of isolated vulval angiomyolipoma in a 45-year-old female which clinically and radiologically presented as lipoma like lesion. Our case of isolated vulval angiomyolipoma is the first reported case in the literature.

Evaluation profile of thyroid nodule by fnac in the rural population of khanpur kalan, sonepat, haryana.

BACKGROUND: Thyroid disease is most common endocrine disorder and is different from other endocrine diseases because of its visible swelling and ease of diagnosis. If left untreated, thyroid disease makes a person more prone for heart disease, infertility and osteoporosis. In India, significant burden of thyroid diseases exist with an estimation of around 42 million cases. The thyroid status and autoimmune status of adult Indian population in the post iodinization phase is largely unknown. AIM: The main objective of this study was to generate valuable epidemiological data regarding the prevalence of thyroid disorders in rural population of Khanpur Kalan, Sonepat in the post-iodinisation era in India. To assess whether thyroid autoimmunity or goitrogens along with environmental factors play role in the development of thyroid.This paper is being presented in view that no such study has been carried out in the rural population of this region in Haryana. MATERIALS AND METHODS: The present study was conducted in Department of Pathology, Bhagat Phool Singh Medical College for Women, Khanpur Kalan, Sonepat between August 2011 to July 2013. It included retrospective analysis of cytomorphology of fine needle aspiration cytology material of 206 patients presenting with thyroid nodule in the Department of Pathology. RESULTS: The commonest age group affected was 31-40 yrs. The female patients (93.4%) outnumbered the male patients (6.6%).The cytomorphological analysis of 206 patients revealed 190 cases (92.2%) of neoplastic lesions, 10 cases (4.8%) were neoplastic and 6 cases (2.9%) had indeterminate cytomorphology. Maximum number (65.5%) of patients was suffering with goiter followed by lymphocytic thyroiditis (26.2%). Amongst the malignant cases three cases were of papillary carcinoma and one case of medullary carcinoma. Two out of the six cases of follicular neoplasm proved to be follicular adenoma on histopathology. Four patients with high T3 levels were under treatment with neomercazole. They showed change in cytomorphology from hyperplasia to colloid goiter. Only one case of acute suppurative thyroiditis was reported which shows rarity of its type. CONCLUSION: The increased prevalence of goiter in this post iodinisation era can be attributed to goitrogens, autoimmune thyroid disease and micronutrient deficiency of iron and selenium. Higher prevalence of autoimmune thyroiditis in females is linked with both genetic and environmental factors such as infection, stress.

Progressive muscular dystrophy of heart: diagnosis easily missed by clinicians.

Muscular dystrophy connotes a heterogeneous group of inherited disorders characterized by progressive wasting and weakness of the skeletal muscles. In several forms of muscular dystrophy, cardiac dysfunction occurs, and cardiac disease may even be the predominant manifestation of the underlying genetic myopathy. We present a case of progressive muscular dystrophy of the heart in which the initial and only manifestation was sudden death in a young man.

Leukaemic pleural effusion as a manifestation of acute myeloid leukaemia: a case report and review of literature.

Haematologic malignancies such as acute and chronic leukaemias rarely present with or develop pleural effusion during their clinical course. We present a case of a young female who presented with unilateral pleural effusion and was diagnosed with haematologic malignancy on pleural fluid cytology. On further workup, a diagnosis of acute myeloid leukaemia was established. The patient was put on chemotherapy thereafter. This case clearly highlights the importance of cytopathology aids in making a diagnosis of rare and unusual presentation in haematologic malignancies.

A rare case of Endometriosis in vaginal hysterectomy scar.

Presented hereunder is probably the first reported case of endometriosis at the vaginal apex following vaginal hysterectomy. No other similar case could be traced in the review of the literature.

An unusual presentation of pelvic leiomyomatosis misdiagnosed as disseminated malignancy.

Leiomyomatosis peritonealis disseminata (LPD) is an exceedingly rare, usually benign condition that clinically simulates a disseminated malignancy, occurring predominantly in women of childbearing age. We present a case of LPD in a postmenopausal woman who had undergone hysterectomy 8 years back for fibroids along with simultaneous presence of pelvic metastasis from breast carcinoma.

Correlation of gallstone characteristics with mucosal changes in gall bladder.

BACKGROUND AND AIM: Gallstones are known to produce diverse histopathological changes in the gall bladder. Our aim was to correlate various gallstone characteristics (number, size, weight, volume and morphological type) with the type of mucosal response in gall bladder (inflammation, hyperplasia, metaplasia and carcinoma). METHODS: The study was conducted on 330 open cholecystectomy specimens with complete gallstones. The stones were assessed for various parameters i.e. number, size, weight, volume and morphological type. For microscopy, sections were obtained from the fundus, body and neck of the gallbladder. Additional sections were taken from abnormal looking areas. RESULTS: Out of the 330 cases, 194 (59%) had mixed stones, 84 (25%) combined, 30 (9%) pigment and 22 (7%) had cholesterol stones. Number of stones varied from a single calculus in 131 (39.6%) cases, double in 29 (8.8%) and multiple in the remaining 170 (51.6%) cases. Cholecystitis, hyperplasia, metaplasia and carcinoma were more commonly seen with mixed and multiple stones. The average weight of calculi in cholecystitis was 2.551 gm, in hyperplasia 3.619 gm, metaplasia4.549 gm and 17.96 gm in cases with carcinoma. Similarly, average volume of the stone(s) was 2.664 ml in cholecystitis, 3.742 ml in hyperplasia, 4.532 ml in metaplasia and 19.178 ml in carcinoma. The average calculus size (2.147 cm) was found to be maximum in cases with carcinoma, followed by hyperplasia (1.187 cm), metaplasia (1.145 cm) and cholecystitis (1.136 cm). CONCLUSION: As the weight, volume and size of the stone increases the changes in the gall bladder mucosa changes from cholecystitis, hyperplasia, metaplasia, dysplasia, to carcinoma.

Oral cysticercosis-a rare presentation.

Cysticercosis is a condition that occurs when man is infected with larvae of Taenia solium. Oral cysticercosis is a rare event, and it represents difficulty in clinical diagnosis. A case of oral cysticercosis in 11 year old girl is presented which complained of painless swelling for 6 months. A FNAC was performed which revealed bluish pink fibrillary material and interspersed nuclei and fragments of wall of larvae. Patient was treated with antihelminthic.

Isolated tuberculous splenic abscess in an immunocompetent individual.

Tuberculosis (TB) of the spleen is an extremely rare clinical entity particularly among immunocompetent persons. We report a case of isolated tuberculous abscess of spleen in a 13- years- old boy. No primary focus of infection was detected in lungs or any other organ. The patient was treated by splenectomy after a therapeutic failure with standard antituberculous medication.

Spinal meningeal melanocytoma.

Primary melanotic meningeal neoplasms are extremely rare lesions and benign forms are even rarer though with better prognosis than the malignant ones. We describe a 40-year-old male with a history of gradually progressive weakness of both lower limbs with normal bowel, bladder control, and an intradural mass measuring 1.5×1.0 cm on radiologic investigations. The lesion was surgically excised. Histopathologic examination revealed heavily melanin-pigmented cells, nuclei with reticulogranular chromatin and small nucleoli, moderate amount of eosinophillic cytoplasm with indistinct cell boundaries, and symplasmic appearance. A probable diagnosis of meningeal melanocytoma was made. The diagnosis was confirmed on immunohistochemical analysis which revealed strongly positive expression of HMB-45 in the tumor cells. Vimentin and S-100 were also diffusely positive while neuron specific enolase showed focal and patchy positivity; however, epithelial membrane antigen was distinctly negative.

Tuberculosis of uterine cervix: a report of two cases with variable clinical presentation.

Tuberculosis (TB) of the cervix is a rare disease. We describe two cases of tuberculous cervicitis with variable clinical presentation. In one case, a young woman presented with primary infertility and secondary amenorrhoea. The other is a perimenopausal woman with irregular vaginal bleeding and postcoital blood-stained discharge. The diagnosis was confirmed on histopathological examination of the endocervical curettings and a cervical biopsy. The patients were given six months of anti-tuberculous therapy and responded well.