A Friend or a Foe? Bariatric Surgery in Chronic Kidney Disease: A Case Report.

There has been a parallel rise in the need for bariatric surgery as the prevalence of obesity has increased by leaps and bounds over the last 2 decades. Certain procedures like Roux-en-Y gastric bypass are associated with nephrolithiasis, hyperoxaluria, and, rarely, oxalate nephropathy. We report an interesting case of a patient who had relentless progression of his kidney disease post-bariatric surgery.

Rare crystalline nephropathy leading to acute graft dysfunction: a case report.

BACKGROUND: Adenine phosphoribosyl transferase (APRT) deficiency is a rare genetic form of kidney stones and/or kidney failure characterized by intratubular precipitation of 2,8 dihydroxyadenine crystals. Early diagnosis and prompt management can completely reverse the kidney injury. CASE PRESENTATION: 44 year old Indian male, renal transplant recipient got admitted with acute graft dysfunction. Graft biopsy showed light brown refractile intratubular crystals with surrounding giant cell reaction, consistent with APRT deficiency. Patient improved after receiving allopurinol and hydration. CONCLUSION: APRT forms a reversible cause of crystalline nephropathy. High index of suspicion is required for the correct diagnosis as timely diagnosis has therapeutic implications.

Parasitic Leiomyoma on PET-CT in A Suspected Case of Uterine Sarcoma - Report on Diagnosis and Management.

This case is a very good example of how a multimodality approach was taken in diagnosis and management of patient with suspected uterine sarcoma, which turned out to be uterine leiomyoma with parasitic leiomyoma mimicking the pararenal deposit. There has been an increased use of fluorodeoxyglucose avid positron emission tomography-computed tomography in pelvic malignancies, especially in the cases where there is suspected extrapelvic spread. It was an interesting finding of parasitic leiomyoma, which can be easily thought to be as deposit/mass in a patient with pelvic malignancy.

Laparoscopic management of a case of accessory gall bladder with review of literature.

Gall bladder duplication is a rare congenital anomaly. True duplication is still rarer. Pre-operative detection helps in avoiding complications or missing the gall bladder during surgery. Ultrasonography (USG) and magnetic resonance cholangiography are investigation of choice. Laparoscopic cholecystectomy is the preferred modality for management of double gall bladder. We present a case diagnosed as cholelithiasis on USG. While doing laparoscopic surgery 2 gall bladders were found. She had a normal gall bladder that was lying in the supraduodenal area. It had cystic duct that joined the common bile duct. There was an accessory gall bladder attached to the anterior free margin of the liver. This gallbladder was occluded with a big solitary calculus occupying the whole of gall bladder cavity and had a small feeding vessel; whereas its duct had fibrosed.

Primary dural follicular lymphoma masquerading as meningioma: a case report.

Patient presented with a dural-based mass lesion and was diagnosed as having meningioma on imaging. Post-resection histological examination revealed a low grade follicular lymphoma. The patient received cranial radiotherapy and is recurrence-free at 6-month follow-up. Primary dural follicular lymphoma is an exceedingly rare entity with only as few as six reported cases. Herein, the clinico-radio-pathological appearances and treatment protocol of this entity are discussed.

Cervical ectopic thymic cyst: a rare preoperative diagnosis.

We present a case of a 5-year-old child with a painless swelling on the neck. Imaging revealed a multilocular cystic lesion lying in close proximity to carotid vessels. Based on imaging a possibility of ectopic thymic cyst was considered, which was confirmed on histopathology. Ectopic cervical cyst is an infrequent cause of neck cyst in a child which is rarely diagnosed preoperatively.

Juvenile psammomatoid ossifying fibroma: a rare cause of unilateral proptosis.

This is case of a young girl who presented with unilateral proptosis. Imaging (CT & MRI) revealed an expansile lytic bony tumour involving the left frontal bone and orbital roof. The globe was displaced but uninvolved. Complete surgical resection was done and histopathology revealed psammomatoid bodies diagnostic of juvenile psammomatoid ossifying fibroma (JPOF). JPOF is a rare bone tumour characterised by a predilection for the sino-nasal tract and orbit, a tendency to affect younger patients, a potential for aggressive growth and a high recurrence rate of 30-50%. It warrants a complete surgical resection to avoid recurrence.

Lichen planus of uterine cervix - the first report of a novel site of occurrence: a case report.

INTRODUCTION: Lichen planus is an immune mediated inflammatory lesion involving skin and mucosal sites including oral mucosa, vulva and rarely vagina. Lichen planus occurring at mucosal sites has been shown to be associated with squamous cell carcinoma in a proportion of cases. To the best of our knowledge, no case of lichen planus of uterine cervix has been reported in the available literature. CASE PRESENTATION: A 45-year-old female underwent vaginal hysterectomy for uterine prolapse. The resected specimen showed a bluish-colored area in the non-dependent part of the ectocervix. Microscopic sections from this area showed dense lymphocytic infiltrate at the junction of mucosa and submucosa causing disruption of the basal cell layer. On immunohistochemical examination there was predominance of CD8+ T lymphocytes at the junction with scattered CD4+ T lymphocytes, characteristic of lichen planus. Based on the history and negative serum antibody titers, other differential diagnoses including lupus erythematosus and drug reaction were excluded. The patient did not have any cutaneous or oral lesions of lichen planus. CONCLUSION: Lichen planus of uterine cervix is a hitherto unreported entity, and is worth studying considering the premalignant potential of lichen planus at other mucosal sites.