Histopathological Evidence of Thyroid Dermopathy and its Correlation with Thyroid-Associated Orbitopathy in Patients with Graves' Disease having Normally Appearing Pretibial Skin: A Case-Control Study.

Objective: Thyroid dermopathy (TD), reportedly encountered in less than 5% of patients with Graves' disease (GD), is supposed to coexist only with thyroid-associated orbitopathy (TAO). However, clinically inapparent TD, detected non-invasively by thermal imaging or ultrasonography, seems to be present in a larger proportion of GD. Histopathological examination (HPE), though considered as gold standard for detecting TD, has not been performed widely to identify subclinical TD in GD. Materials and Methods: In this single-centre, cross-sectional, case-control study, 50 patients with GD (cases) and normal appearing pretibial skin were compared with 45 age- and sex-matched individuals (39 healthy volunteers, 3 with toxic multinodular goitre and 3 with solitary toxic nodule) (control). All patients were evaluated clinically for presence of TAO. Punch biopsy specimens were obtained from the pretibial skin in all 95 participants. Tissue sections were examined under light microscopy for mucin deposition, splitting of collagen fibrils and perivascular lymphocytic infiltration. Results: Sixty per cent of patients with GD demonstrated at least one of the above three histological features, while 52% had any combination of two features and 46% harboured all the three features. Mucin deposition, splitting of collagen fibrils and lymphocytic infiltration were found overall in 52%, 54% and 52% of GD, respectively; 4.4-11.1% of controls also had some evidence of TD on HPE. Subclinical TD was not related to age, duration of disease and TAO in our study. Conclusions: TD, particularly in its subclinical form, Seems to be widely prevalent in GD (46-60%) and exists even in absence of TAO. HPE, though more sensitive than the various non-invasive tests, is not specific (ranges from 89% to 95%) for TD. However, HPE can accurately diagnose TD in appropriate clinical background.

Adenomyoepithelial Adenosis of Breast: A Rare Case Report.

Myoepithelial cells of the breast and their hyperplasia is found in many benign conditions resulting in a spectrum of lesions of myoepitheliosis to myoepithelial carcinoma. We present a rare case of adenomyoepithelial adenosis in a 17-year-old female who presented with a palpable right breast lump. Although considered benign, adenomyoepithelial lesions have a high chance of recurrence due to inadequate excision. Recurrence and even metastasis are therefore important issues in the follow-up of adenomyoepithelial lesions.

Goblet cell carcinoid of appendix: A rare case with literature review.

INTRODUCTION: The goblet cell carcinoid, a rare tumor of the appendix, is a separate entity from adenocarcinoma and carcinoid tumors. PRESENTATION OF CASE: We report a case of goblet cell carcinoid in our institute who presented with acute abdominal symptoms simulating acute appendicitis. DISCUSSION: Goblet cell carcinoid is a rare neoplasm with distinct histological and clinical features. The diagnosis is essentially made on histological grounds. Still the exact biological behavior of this tumor is uncertain. CONCLUSION: Considering the difficulty of clinical suspicion of this tumor, presenting as appendicitis and incidentally found during appendectomies, we review the goblet cell carcinoid of the appendix using an illustrative case report.

Leiomyoma of kidney: An Indian experience with literature review.

INTRODUCTION: Leiomyoma of kidney is an exceptional finding in the urinary tract. Though most of these tumors are detected on autopsy, still it remains a diagnostic challenge. PRESENTATION OF CASE: We report three adult cases of renal leiomyoma in our institute who presented with abdominal mass and haematuria in last 8 years. DISCUSSION: Leiomyoma has been reported in other organs but renal leiomyoma is rare tumour, though in autopsy series they are second in order of frequency among the renal mesenchymal neoplasms, and few cases have been described in the literature. Still no Indian experience is evaluated on this rare site of occurrence. CONCLUSION: Considering the difficulty of clinical diagnosis of this tumour, strong suspicion is indicated when a patient presents with voluminous, well circumscribed renal lesions.

Primary squamous cell carcinoma of breast with ipsilateral axillary lymph node metastasis: An unusual case.

INTRODUCTION: Pure squamous cell carcinoma of the breast [SCCB] is rare. PRESENTATION OF CASE: We report a case of primary squamous cell carcinoma of breast with ipsilateral axillary lymph node metastasis in a 58year old woman. DISCUSSION: It is a breast carcinoma entirely composed of metaplastic squamous cells that may be keratinized, non-keratinized or spindled. The pure squamous cell carcinoma usually present with central cystic cavity, which we found in our case, also supported by immunohistochemical evidence. CONCLUSION: Although a rare breast cancer subtype, SCCB is of considerable interest due to its pathological heterogeneity and differences in clinical behavior and less reported occurrence of nodal metastasis.