Peripheral blood smear - An expeditious test in the preliminary diagnosis of bone marrow embolism in a case of multiple fractures: A case report.

ABSTRACT: Bone marrow embolism is known to occur after fractures of long bones such as the femur and pelvis. We report a case of multiple fractures in a 32-year-old female patient, demonstrating bone marrow elements in the peripheral blood as early as 2 hours after trauma. This is the first case being reported with an ante-mortem demonstration of circulating marrow emboli in the peripheral blood, while the previously reported cases have demonstrated the emboli in post-mortem examination. A careful correlation of the clinical history of trauma, hematology auto-analyzer results, and the presence of bone marrow particles and fat globules in peripheral blood helped in arriving at the diagnosis of fat embolism in our case irrefutably.

Fine needle aspiration cytology of solitary fibrous tumor of the orbit.

Solitary fibrous tumor (SFT) is a distinct and a rare spindle cell neoplasm, commonly known to occur in the pleura and other serosal sites. With the advent of immunohistochemistry, varied extraserosal sites are being recognized as common locations for this rare tumor. We report a case of SFT in a 50-year-old male patient who presented with multiple swellings in the eyelid, with emphasis on the cytological features.

Evaluation of Nuclear Morphometry and Ki-67 Index in Clear Cell Renal Cell Carcinomas: a Five-Year Study.

BACKGROUND AND OBJECTIVE: Clear Cell Renal Cell Carcinoma (CCRCC) is the most common adult renal neoplasm. Staging and grading of RCC are important predictors of survival. Fuhrman nuclear grading is widely used for CCRCC, the subjective nature of which has prompted more objective methods to evaluate nuclear features. Furthermore, Ki-67, a reliable marker of cellular proliferation may provide another variable for assessment of the biological behavior of RCC. The aim of this research was to study nuclear morphometry and Fuhrman nuclear grading of clear cell RCC, and to assess their relationship with the Ki-67 index. METHODS: Hematoxylin and eosin slides of forty cases of CCRCC were retrieved and studied for pathologic variables, including Fuhrman nuclear grade, pathological tumor and node stage. Nuclear morphometric analysis was performed using computer-assisted image analysis. The relationship between Fuhrman nuclear grading, pathologic stage, tumor size, nuclear morphometry and proliferative index were analyzed. RESULTS: According to Fuhrman grading, four (10%) cases were grade I, 23 (57.5%) were grade II, 12 (30%) were grade III, and one (2.5%) was grade IV. Moderate to high correlation was seen between Fuhrman nuclear grade and mean nuclear area, perimeter, diameter, length, nuclear roundness factor and Ki -67, with a P value of < 0.05. CONCLUSION: The CCRCC is an extremely heterogenous disease and clinical outcome is unpredictable despite several validated prognostic factors. The widely used Fuhrman nuclear grading is subjective, while nuclear morphometry, using computer assisted image analysis, can ensure more objective assessment. The Ki-67 index could provide reliable information and compliment the other prognostic parameters.

Neonatal Intramural Calcification in Jejunal Atresia: Case Report of a Rare Phenomenon.

Intramural calcification in intestinal atresia is a rare type of intra-abdominal calcification. The exact etiology of intramural calcification remains obscure. A 1-day-old newborn male baby presented with signs of intestinal obstruction and was diagnosed to have jejunal atresia. The newborn underwent laparotomy with resection of atretic and dilated part of the small bowel. Histology of atretic part of jejunum and adjacent area revealed intramural calcification with extensive foreign-body giant cell reaction. This appears to be the first time that intramural calcification has been documented in association with extensive foreign-body giant cell reaction in a case of jejunal atresia. It can be hypothesized that vascular insult is the initiating event. The further consequences could be multifactorial. This could be the reason for the variation in the site of calcific deposits. Intramural calcification with extensive foreign-body giant cell reaction is a rare phenomenon and calls for focused studies aiming at elucidating the exact etiopathogenesis of intramural calcification.

Hemolytic Disease of the Newborn Due to Anti-c Isoimmunization: A Case Report.

The Rhesus (Rh) blood group is one of the most complex blood groups known in humans. It has remained of primary importance in obstetrics, being the main cause of hemolytic disease of the newborn (HDN). Anti-D causes the most severe form of HDN. Other Rh allo antibodies that are capable of causing severe HDN include anti-c, which clinically is the most important Rh antigen after the D antigen. We report a case of hemolytic disease of the newborn due to Rh anti-c in an infant of an Rh positive mother.

Disseminated cryptococcosis in an immunocompetent patient: a case report.

Cryptococcus neoformans is ubiquitous encapsulated yeast found throughout the world. It predominantly causes significant infections in immunocompromised individuals, of which 80-90% occur in people with human immunodeficiency virus (HIV) infection. Disseminated cryptococcal infection is uncommon and almost always occurs in HIV-infected patients. Disseminated disease, especially noncutaneous cryptococcal abscess in immunocompetent hosts, is exceedingly rare. We report a case of disseminated cryptococcosis with soft tissue, pulmonary, and cerebral involvement in an otherwise healthy immunocompetent patient initially diagnosed by fine needle aspiration cytology (FNAC).

Fine needle aspiration cytology of cysticercosis-a case report.

Cysticercosis, caused by cysticercus cellulosae, the larval form of Taenia solium, is potentially a dangerous systemic disease with variable clinical manifestations. The disease most commonly involves subcutaneous and muscle tissues, followed by the eye and brain. Cysticercosis can be diagnosed by various radiologic means or by serology, both of which, however, are not definitive. Biopsy and histologic examination containing the cysticerci is the most definitive method of diagnosis. We report a case of cysticercosis in a 27-year-old male patient, who presented with a subcutaneous swelling in the back which was diagnosed on fine needle aspiration cytology (FNAC).

Bcg induced mycobacterial spindle cell pseudotumor in an infant.

Mycobacterial Spindle cell Pseudotumor (MSP) is a rare complication of mycobacterial infection, especially the atypical variety. It is characterized by an exuberant spindle cell proliferation. This has been reported in the lymph nodes, skin, spleen, lungs, brain, etc. The incidence is higher in immuno-compromised patients, especially those with acquired immunodeficiency syndrome. It is rare to encounter this lesion in infants. We report a case of MSP in the axillary lymph node of a 7-month-old infant, following Bacillus Calmette Guerin (BCG) vaccination due to Mycobacterium tuberculosis complex, which was proved by PCR.

Sporotrichosis in Mysore: a case report to emphasize the role of histopathology.

Lymphocutaneous sporotrichosis is unusual in southern India. The diagnosis was made by histopathological examination which is purported to have poor sensitivity. The culture of the specimen confirmed the diagnosis. The pre-eminent role of a careful study of serial sections is emphasized.