Xanthomatous pleuritis.

This case presentation relates to a 21 year young male, cachectic in appearance, who presented with progressive shortness of breath, and dull pain on the lower part of the chest ongoing over three months. The patient received antitubercular drugs by local physician for suspected tuberculosis with no significant improvement. He was referred to our Respiratory Department for further evaluation of his chest pain and breathlessness. His X-ray showed moderate pleural effusion on the left side which confirmed by USG chest screening which showed multiple septation with thick parietal pleura and USG abdomen was normal. Moreover, the pleural effusion aspiration was performed and pleural fluid examination revealed exudative in character and thoracoscopic view of pleura was reddish with exudatives. Pleural biopsy histological examination showed mixed cell infiltrate with predominantly foamy macrophage along with plasma cells, lymphocytes and eosinophils with capillary proliferation. This is the first care report of xanthomatous pleuritis in the literature.

Disseminated solitary fibrous tumour of the lung and pleura.

Solitary fibrous tumours (SFTs) are a heterogeneous group of rare spindle-cell tumours. Classically they presented as a solitary pleural-based mass. Pulmonary parenchymal SFT is rare and multiple bilateral lesions are extremely rare. We present the clinical, imaging and histological features of SFT which are presented as multiple nodular lesions of the lung and pleura with probable distant metastasis.

Primary pituitary abscess with coexisting pyogenic meningitis: an unexpected diagnosis.

Primary pituitary abscess is a very rare disease most likely associated with pyogenic infection. A 27-year-old woman was initially diagnosed and treated as a case of acute pyogenic meningitis. In view of persistent headache, impaired visual fields, galactorrhea and menstrual irregularities, she underwent evaluation of pituitary mass lesion. Magnetic resonance imaging of the pituitary reported the mass as pituitary macroadenoma. However, transsphenoidal surgery revealed copious collection of purulent materials confirmed as pyogenic pituitary abscess. A follow-up magnetic resonance imaging of the pituitary 2 years later confirmed secondary empty sella. She has developed panhypopituitarism; she remains on appropriate anterior pituitary hormone replacement.

Diagnostic value of fine needle aspiration cytology in gouty tophi: a report of 7 cases.

UNLABELLED: BACKGROUND The diagnosis of gout can be problematic when the presentation is atypical and serum uric acid is borderline elevated. Demonstration of monosodium urate (MSU) crystals in fine needle aspiration (FNA) smears from nodular masses clinically suspected to be tophi establishes the diagnosis unequivocally. CASES: Of the 7 cases in this study, 4 were suspected clinically to have gouty tophi. Giant cell tumor of tendon sheath, giant cell tumor of bone and metastatic tumor with multicentric involvement of bone were the clinical diagnoses in 1 case each. Serum uric acid levels high enough to be in the diagnostic range for gout were reported in 3 cases, within normal limits in 3 cases and low in 1 chronic alcoholic patient. Bright field microscopy of FNA smears revealed singly scattered or stacks of MSU crystals with variable number of inflammatory cells, with or without foreign body giant cells in 6 cases. In 1 patient, FNA showed stacks of MSU crystals only. Characteristic birefringence of MSU crystals was observed on polarizing microscopy. CONCLUSION: FNA demonstration of MSU crystals on polarizing microscopy can easily establish the nature of the nodules in and around the joints and in soft tissue as gouty tophi and is thus an investigation differentiating this lesion from other masses clinically simulating it.