Hepatic Angiomyolipoma With Predominant Lipomatous Component: A Rare Entity.

Hepatic angiomyolipoma (HAML) is a rare benign mesenchymal tumor with varying amounts of mature adipose tissue, smooth muscle cells, and thick-walled blood vessels. We present a rare case of hepatic angiomyolipoma (AML) with predominant lipomatous components. A 42-year-old female presented to the hospital with pain in the right lumbar region. On imaging, there was a large fat-predominant mass attached to the surface of the liver extending down to the lumbar region. On small biopsy, it was reported as a well-differentiated adipocytic neoplasm, and fluorescence in situ hybridization (FISH) studies performed for MDM2 were negative. On excision, histopathological examination showed predominantly fat components, but there were few epithelioid cells between adipocytes and thick-walled blood vessels. These cells were positive for Melan-A, HMB45, and smooth muscle actin (SMA) and negative for hepatocyte paraffin-1 (Hep Par1). Angiomyolipoma is a benign tumor and has a good prognosis with surgical excision. Few cases are associated with tuberous sclerosis.

Superficial CD34-Positive Fibroblastic Tumor: A Case Series and a Review of Literature.

Superficial CD34-positive fibroblastic tumor (SCD34PFBT) is a recently recognized neoplasm of mesenchymal origin. Only a few cases have been reported in the literature so far. Microscopically, it consists of a dermal spindle cell neoplasm, with low mitotic activity, arranged in a fascicular pattern. The individual neoplastic cells show marked nuclear atypia, nuclear pseudo-inclusions, and dense eosinophilic cytoplasm. The tumor cells characteristically show positivity for CD34 immunohistochemical stain. This tumor behaves as a low-grade malignancy with potential to recur locally, with rare cases showing lymph node metastasis. Wide local excision and regular follow-up are the currently followed steps for management. This tumor serves as a diagnostic challenge due to its overt atypia, and it can be misdiagnosed as a sarcoma. Recognition of this entity among pathologists is important due to this reason. We hereby report four cases of this newly recognized entity.

Removal of hazardous textile dye from simulated wastewater by municipal organic solid waste charcoal using machine learning approaches: Kinetics, isotherm, and thermodynamics.

This study focuses on the probable use of municipal organic solid waste charcoal (MOSWC) as an adsorbent for Methyl orange (MO) adsorption. The prepared MOSWC is characterized by FE-SEM and FT-IR. Batch adsorption experiments were conducted with the influencing of different operational conditions namely time of contact (1-180 min), adsorbate concentration (60-140 mg/L), adsorbent dose (1-5 g/L), pH (3-11), and temperature (25-60 °C). The high coefficient value (R2 = 0.96) of the process optimization model suggests that this model was significant, where pH and adsorbent dose expressively stimulus adsorption efficiency including 40.11 mg/g at pH (3), MO concentration (100 mg/L), and MOSWC dose (1 g/L). Furthermore, the machine learning approaches (ANN and BB-RSM) revealed a good association between the tested and projected values. The highest monolayer adsorption capacity of MO was 90.909 mg/g. Pseudo-second-order was the well-suited kinetics, where Langmuir isotherm could explain better for equilibrium adsorption data. Thermodynamic study shows MO adsorption is favourable, exothermic, and spontaneous. Finally, this study indicates that MOSWC could be a potential candidate for the adsorption of MO from wastewater.

Black carbon derived PET plastic bottle waste and rice straw for sorption of Acid Red 27 dye: Machine learning approaches, kinetics, isotherm and thermodynamic studies.

This study focuses on the probable use of PET waste black carbon (PETWBC) and rice straw black carbon (RSBC) as an adsorbent for Acid Red 27 (AR 27) adsorption. The prepared adsorbent is characterized by FE-SEM and FT-IR. Batch adsorption experiments were conducted with the influencing of different operational conditions namely time of contact (1-180 min), AR 27 concentration (5-70 mg/L), adsorbent dose (0.5-20 g/L), pH (2-10), and temperature (25-60°C). High coefficient value [PETWBC (R2 = 0.94), and RSBC (R2 = 0.97)] of process optimization model suggesting that this model was significant, where pH and adsorbent dose expressively stimulus removal efficiency including 99.88, and 99.89% for PETWBC, and RSBC at pH (2). Furthermore, the machine learning approaches (ANN and BB-RSM) revealed a good association between the tested and projected value. Pseudo-second-order was the well-suited kinetics, where Freundlich isotherm could explain better equilibrium adsorption data. Thermodynamic study shows AR 27 adsorption is favourable, endothermic, and spontaneous. Environmental friendliness properties are confirmed by desorption studies and satisfactory results also attain from real wastewater experiments. Finally, this study indicates that PETWBC and RSBC could be potential candidates for the adsorption of AR 27 from wastewater.

Receptor model-based sources and risks appraisal of potentially toxic elements in the urban soils of Bangladesh.

Rapid urbanization and industrial development have prompted potentially toxic elements (PTEs) in urban soil in Bangladesh, which is a great concern for ecological and public health matters. The present study explored the receptor-based sources, probable human health and ecological risks of PTEs (As, Cd, Pb, Cr, Ni, and Cu) in the urban soil of the Jashore district, Bangladesh. The USEPA modified method 3050B and atomic absorption spectrophotometers were used to digest and evaluate the PTEs concentration in 71 soil samples collected from eleven different land use areas, respectively. The concentration ranges of As, Cd, Pb, Cr, Ni, and Cu in the studied soils were 1.8-18.09, 0.1-3.58, 0.4-113.26, 0.9-72.09, 2.1-68.23, and 3.82-212.57 mg/kg, respectively. The contamination factor (CF), pollution load index (PLI), and enrichment factor (EF) were applied to evaluate the ecological risk posed by PTEs in soils. Soil quality evaluation indices showed that Cd was a great contributor to soil pollution. The PLI values range was 0.48-2.82, indicating base levels to continuous soil degradation. The positive matrix factorization (PMF) model showed that As (50.3 %), Cd (38.8 %), Cu (64.7 %), Pb (81.8 %) and Ni (47.2 %) were derived from industrial sources and mixed anthropogenic sources, while Cr (78.1 %) from natural sources. The highest contamination was found in the metal workshop, followed by the industrial area, and brick filed site. Soil from all land use types revealed moderate to high ecological risk after evaluating probable ecological risks, and the descending order of single metal potential ecological risk was Cd > As > Pb > Cu > Ni > Cr. Ingestion was the primary route of exposure to potentially toxic elements for both adults and children from the study area soil. The overall non-cancer risk to human health is caused by PTEs for children (HI=0.65 ± 0.1) and adults (HI=0.09 ± 0.03) under USEPA safe limit (HI>1), while the cancer risks from exclusively ingesting As through soil were 2.10E-03 and 2.74E-04 for children and adults, respectively, exceeding the USEPA acceptable standard (>1E-04).

Granular Cell Astrocytoma.

Granular cell astrocytoma (GCA) is a rare glial neoplasm composed of abundant granular cytoplasm gives immunoreactivity for GFAP and S100 stains. We report a case of GCA in a 64 years old male presented with history of fits, right sided weakness and loss of consciousness. The microscopy showed sheets of large cells with abundant eosinophilic granular cytoplasm. No high-grade features were seen. Its differential diagnosis includes most of the benign histiocytic conditions. Granular cell astrocytoma has an aggressive clinical course and its survival rate is less than 1 year. That's why early correct diagnosis is very essential.

Human health risk ​and receptor model-oriented sources of heavy metal pollution in commonly consume vegetable and fish species of high Ganges river floodplain agro-ecological area, Bangladesh.

This study was intended to assess heavy metal contents and sources in commonly consumed vegetables and fish collected from the Jashore district of Bangladesh and to evaluate the probable human health risks via the ingesting of those vegetables and fish species. A total of 130 vegetable and fish samples were analyzed for As, Mn, Cu, Cr, Ni, and Pb concentration by an atomic absorption spectrophotometer. Metals and metalloids like As, Pb, and Cr in vegetable species were greater than the maximum allowable concentration (MAC), while Pb and cu in fish species exceeded the MAC. Pollution evaluation index values were ranges from 0.40-10.35 and 1.53-2.78 for vegetable and fish species, respectively, indicating light to serious pollution. Lactuca sativa followed by Cucurbita moschata, Amaranthus gangeticus for vegetables and Channa punctate, Oreochromis mossambicus, followed by Dendrobranchiata for fish are the most contaminated food items. The positive matrix factorization model showed that As (81.9%), Ni (48%), Cr (49.6%), Mn (46%), Pb (44.3%), and Cu (44.4%) for vegetable species and As (86.9%), Ni (90.5%), Mn (67.6%), Pb (65.3%), Cr (57%) and Cu (46.2%) for fish species were resulting from agrochemical, atmospheric emission, irrigation, contaminated feed, and mixed sources. The self-organizing map and principle component analysis indicates three spatial patterns e.g., As-Mn-Cu, Pb-Cr, and Ni in vegetables and As-Mn-Cr, Cu-Ni, and Pb in fish samples. The THQ values for single elements were less than 1 (except As for vegetables and Pb for fish species) for all food items but the HI values for all of the vegetables (2.18E+00 to 2.04E+01) and fish (1.07E+00 to 9.39E+00) samples were exceeded the USEPA acceptable risk level (HI > 1E+00). While the cancer risks only induced by As for all vegetables and fish species, which exceeded the USEPA safe level (TCR>1E-04). Sensitivity analysis indicates that metal concentration was the most responsible factor for carcinogenic risk.

High-grade desmoplastic infantile astrocytoma in a 1-year-old child with Down's syndrome: a case report.

BACKGROUND: Down's syndrome is the most common chromosomal abnormality in humans. It has been associated with central nervous system tumors such as primary acute lymphoblastic leukemia and germinomas, but desmoplastic infantile astrocytoma has not yet been reported with Down's syndrome. Desmoplastic infantile astrocytoma is a rare intracranial tumor that mostly occurs in the first 2 years of life. It usually presents as a large, aggressive tumor with both solid and cystic components. Genetically, it has been linked to the BRAF V600E mutation. Despite the rapid growth pattern, it usually has a favorable prognosis after neurosurgical excision. The presence of this extremely rare, genetically linked tumor, and its combination with Down's syndrome, the most common human genetic defect, makes this a very novel clinical presentation. It also raises a very research-worthy question of an undiscovered link between these two genetic disorders. CASE PRESENTATION: In this case, we report a 1-year-old Pakistani origin male child with Down's syndrome, who presented with progressive macrocephaly and developmental regression over the last 2 months. He was unable to sit by himself, and had lost his handgrip bilaterally. Down's Syndrome was diagnosed soon after birth, based on typical facial features and presence of palmar crease, and later confirmed karyotypically for Trisomy 21. Upon presentation, initial blood tests did not show any abnormality. Magnetic resonance imaging of the brain was done, and showed a mixed intensity cystic mass with solid dural component posteriorly in the right parieto temporo occipital region. Craniotomy was performed, and about 85% of the tumor mass was excised. Histological examination and immunochemistry confirmed the suspected radiological diagnosis of desmoplastic infantile astrocytoma. After surgical excision, our patient gradually reacquired his previously regressed developmental milestones. Unfortunately, the remaining mass, which could not be excised due to its attachment to the highly vascular dura mater, showed regrowth on repeat brain magnetic resonance imaging. As his parents did not consent to further surgery, chemotherapy was offered as the next treatment option to prevent tumor regrowth. CONCLUSIONS: This case report highlights the need for more case data and research to understand desmoplastic infantile astrocytoma, and their genetic correlation with Down's syndrome. From a clinical standpoint, since desmoplastic infantile astrocytoma has a good postresection prognosis in a majority of early-diagnosed clinical cases, pediatricians, radiologists, and pathologists should consider desmoplastic infantile astrocytoma in their initial differential diagnosis in Down's syndrome patients with macrocephaly and developmental regression during the first 2 years of life.

Arsenic, iron, and manganese in groundwater and its associated human health risk assessment in the rural area of Jashore, Bangladesh.

This study investigated groundwater pollution and potential human health risks from arsenic, iron, and manganese in the rural area of Jashore, Bangladesh. Study results show that the mean value of groundwater pH is 7.25 ± 0.31, with a mean conductivity of 633.94 ± 327.41 µs/cm, while about 73, 97, and 91% of groundwater samples exceeded the Bangladesh drinking water standard limits for As, Fe, and Mn, respectively. Groundwater pollution evaluation indices, including the heavy metal pollution index, the heavy metal evaluation index, the degree of contamination, and the Nemerow pollution index, show that approximately 97, 82, 100, and 100% of samples are in the high degree of pollution category, respectively. Spatial distribution exhibited that the study area is highly exposed to As (73%), Fe (82%), and Mn (46%). In the case of non-carcinogenic health risk via oral exposure, about 94% of samples suggest a high category of risk for infants, and 97% of samples are found to be at high risk for children and adults. The carcinogenic risk of arsenic via an oral exposure pathway suggests that approximately 97% of the samples are found to be at high risk for infants, and all of the samples are at high risk for both adults and children.

Human health risk assessment of elevated and variable iron and manganese intake with arsenic-safe groundwater in Jashore, Bangladesh.

Groundwater through hand-operated tubewell (a type of water well) tapping is the main source of drinking water in Bangladesh. This study investigated iron and manganese concentration in groundwater across Jashore district-one of the worst arsenic contaminated area in Bangladesh. One working tubewell that had been tested previously for arsenic and marked safe (green) was selected from each unions of the district. Results revealed that approximately 73% and 87% of groundwater samples exceeded the limits for iron and manganese in Bangladesh drinking water, respectively. Additionally, spatial distribution of iron and manganese indicate that only 5% of the total surface area of groundwater is covered by safe level of iron and manganese. Human health risk due to ingestion of iron and manganese through drinking water was evaluated using hazard quotients (HQ) for adults and children. The result of the health risk assessment revealed that the non-carcinogenic health risks due to ingestion of iron (HQ up to 1.446 for adults and 0.590 for children) and manganese (HQ up to 2.459 for adults and 1.004 for children) contaminated groundwater are much higher among adults than children. On the basis of occurrences, spatial distribution and health risk assessment results, the area can be categorized as a high-risk zone for iron and manganese-related problems and needs special attention in order to protect public health of local residents.

High Grade B- Cell Non- Hodgkin's Lymphoma Arising in a Mature Cystic Teratoma of The Ovary: A Case Report.

Mature cystic teratoma (MCT) is the most common type of ovarian germ cell tumor occurring in females of reproductive age. It is typically benign, but rare malignant transformations have been reported in 1-2% of the cases. Among a wide variety of malignancies arising in MCTs, high grade lymphomas are the least common. We present a case of a 45- years -old female with a unilateral adnexal mass. Gross examination revealed a unilocular cyst with a smooth and intact capsule. The cyst lumen was filled with sebaceous material and hair. Except for a 5.0 cm Rokitansky nodule, no other nodule or papillary structures were identified. Microscopic examination revealed an array of mature tissues arising from different germ cell layers, and foci of diffuse sheets of large atypical lymphoid cells. These were positive for CD-20 marker, confirming their B lymphoid series cell origin. A final diagnosis of a high grade B cell non Hodgkin's lymphoma arising in an ovarian MCT was made. Such cases have been known to be associated with a very poor prognosis, and there are no established criteria for their pre-operative diagnosis. Risk factors for malignant transformation in an MCT including tumor size, post menopausal status and serum tumor markers are thus analyzed routinely to make a presumptive diagnosis. These coupled with extensive gross sampling of the tumor specimens, and a diligent histopathological examination may aid in an accurate diagnosis of a malignant neoplasm arising in MCTs.

Primary renal Ewing's sarcoma: a rare entity.

Ewing's sarcoma, a primitive neuroectodermal tumour is a rare entity belonging to a family of neoplasms of neuroectodermal origin. These highly aggressive neoplasms primarily affect older children and young adults. They primarily involve the bones or soft tissues. A quarter of Ewing's sarcomas occur principally in the soft tissues with primary involvement of the kidney being exceptionally rare. We hereby, present a case of 6 years old girl child with primary Ewing's sarcoma of the kidney who presented with abdominal mass and posed much diagnostic challenge. The patient underwent complete surgical excision of tumour, and is being treated with aggressive adjuvant chemotherapy.

Salivary gland tumours: a review of 91 cases.

BACKGROUND: Salivary gland tumours constitute heterogeneous group of tumours with different biological behaviour and account for 3% of all head and neck tumours. This study was conducted to study the clinico-pathological spectrum of salivary gland tumours. METHODS: The study is a review of 91 cases of salivary gland tumours reported at Chugtai's Lahore Laboratory from 2009-2011. The clinical data of the patients was obtained from their respective files. RESULTS: Age range of the patients was from 8-92 years. These tumours were slightly more common in females with female to male ratio of 1.1:1. Parotid gland (51.6%) was the commonest site for the occurrence followed by minor salivary glands (27.4%). Majority (58.2%) of them were benign. Of all the benign and malignant tumours pleomorphic adenoma (47.2%) was commonest tumour followed by adenoid cystic (17.5%) and mucoepidermoid tumours (16.4%). CONCLUSION: These tumours are more common in females with wide range of age distribution. Parotid gland is the most common site of involvement with pleomorphic adenoma being the commonest tumour type.

Hepatic tumours in childhood: an experience at the Children Hospital and Institute of Child Health, Lahore.

OBJECTIVES: In this report, we share our experience about the common types of childhood hepatic tumours during 10 years (2001-2010) and compare them with other studies. METHODS: During 10 years (2001-2010), all the hepatic tumours of childhood received at Pathology Department of the Children Hospital and Institute of Child Health, Lahore Pakistan are recorded. This includes both resected specimens and biopsies. All the slides were reviewed and the pathologic diagnosis was confirmed. RESULTS: We diagnosed 48 liver tumour cases in children (below 18 years of age). Among these tumours, 39 (81.25%) were malignant. Male to female ratio was 2:1. Hepatoblastoma was the most common liver tumour in this age group accounting for 69.23% of all malignant tumours (27 cases). The second most common primary tumour was hepatocellular carcinoma diagnosed in six patients (15.38%). Other malignant tumours were undifferentiated embryonal sarcoma and biliary rhabdomyosarcoma. Benign tumours included mesenchymal hamartoma, infantile haemangioendotheloima, hemangioma and benign cyst. There were also three metastatic tumours during these 10 years. In one case there was tumour necrosis only and as such no definitive diagnosis was rendered. CONCLUSION: The spectrum of hepatic tumours in children is different from that found in the older age group and most of them are malignant.

Lymph nodal infarction simulating acute appendicitis.

A number of diseases can present as acute right iliac region pain. Lymph node infarction, located adjacent to the cecum, mimicking acute appendicitis in a 13-year-old boy is presented here.

A retrospective study of ovarian tumours and tumour-like lesions.

BACKGROUND: Ovaries are common site of non-neoplastic and neoplastic lesions. They can present from the neonatal period to post menopause. Most are functional in nature and resolve with minimal treatment. Objective of the study was to determine the nature of various ovarian lesions and to ascertain the frequency and distribution of the various non-neoplastic and neoplastic lesions. METHODS: The study was a retrospective review of all cases of ovarian cancer, benign ovarian neoplasm and functional ovarian cysts received during Jan-Dec 2008 at Chughtai's Lahore Laboratory. The clinical data of the patients was obtained from their respective files. RESULTS: A total of 498 different non-neoplastic and neoplastic lesions were seen during one calendar year 2008. Non-neoplastic cysts were more common (343, 68.87%) than neoplastic tumours (155, 31.12%). The commonest non-neoplastic cyst was luteal cyst followed by follicular cyst. Among the neoplastic tumours 78.70% were benign and 21.29% were malignant. Benign serous cysts were the commonest benign tumour followed by mature cystic teratoma and mucinous cyst. Serous cystadenocarcinoma was the commonest malignant tumour followed closely by endometrioid carcinoma and granulosa cell tumour. Krukenberg tumour, tumour metastatic to ovaries and non-Hodgkins lymphoma was also diagnosed during this period. Malignant germ cell tumours were seen in much younger age group followed by sex cord stromal tumours. Epithelial tumours were seen in much older age group. CONCLUSION: The morphologic diversity of ovarian masses poses many challenges. A specific diagnosis can usually be made by evaluating routinely stained slides but sometimes immunohistochemistry is required in difficult cases. Gross features also provide useful diagnostic clues.