Outbreak of Mucormycosis in Coronavirus Disease Patients, Pune, India.

We provide an overview of the epidemiology and clinical course of mucormycosis in the coronavirus disease (COVID-19) pandemic era. We conducted a retrospective chart review of 178 patients with clinical or diagnostic, endoscopically or histopathologically confirmed rhino-sino-orbital or cerebral mucormycosis after COVID-19 treatment during the second wave of COVID-19 in Pune, India. Median time to symptom onset from COVID-19 detection was 28 days. Moderate or severe COVID-19 was seen in 73% of patients and diabetes in 74.2%. A total of 52.8% received steroids. Eschar over or inside the nose was seen in 75%, but baseline clinical and laboratory parameters were mostly unremarkable. Bone penetration was present in ≈90% of cases, 30% had soft-tissue swelling of the pterygopalatine fossa and 7% had cavernous sinus thrombosis, and 60% had multifocal mucormycosis. Of the 178 study cases, 151 (85%) underwent surgical debridement. Twenty-six (15%) died, and 16 (62%) of those had multifocal mucormycosis.

Utility of squash smear cytology in intraoperative diagnosis of central nervous system tumors.

BACKGROUND: Central nervous system (CNS) squash cytology (CSC) has established itself as a technically simple, rapid, inexpensive, fairly accurate, and dependable intraoperative diagnostic tool. It helps neurosurgeons immensely when management is dependent on it. AIMS: This study aimed at finding out the utility of CSC as an intraoperative diagnostic tool from a neurosurgeon's perspective. MATERIALS AND METHODS: Fifty prospectively registered patients with clinical diagnosis of CNS tumors were enrolled in the study. All the patients were subjected to magnetic resonance imaging (MRI). Intraoperative CSC was performed and smears were stained with Leishman and rapid Hematoxylin and Eosin (H and E) stain. The diagnosis of CSC was compared with MRI diagnosis and histopathological diagnosis. The CNS tumors were categorized based on clinical and therapeutic implications. Diagnostic accuracy, sensitivity, specificity, and positive and negative predictive value of MRI and CSC were calculated by using appropriate formulae. RESULTS AND CONCLUSIONS: The age range of the CNS tumors included in the study was 2 to 68 years. There was a slight female preponderance. Sensitivity, specificity, positive predictive value, and negative predictive value of preoperative MRI were 90.47%, 82.76%, 79.17%, and 92.31% respectively. These values of utility parameters for CSC were 100% for each of the clinical and therapeutic implications. It helped neurosurgeons in optimizing surgical procedure in 12 cases of meningioma. It influenced surgical management in 1 case of infratentorial pilocytic astrocytoma, and helped in the diagnosis and management of 9 unexpected tumors missed on MRI.

Primary dural non-hodgkin's lymphoma mimicking meningioma: A case report and review of literature.

A 42-year-old immunocompetent female presented with headache, vomiting and diminished unilateral vision. Computed tomography and magnetic resonance imaging were suggestive of high-grade meningioma. Neurological examination and routine hematological parameters were within normal limits. Craniotomy was performed; the tumor was arising from the dura mater, which was completely resected. Hematoxylin and eosin showed lesion comprising a tumor mass with monomorphic population of tumor cells arranged in sheets and small follicles. The tumor cells were immunoreactive for leukocyte common antigen and CD20 and immunonegative for glial fibrillary acid protein, epithelial membrane antigen, cytokeratin, CD3 and CD30. Rest of the body scan was normal. A diagnosis of primary dural non-Hodgkin's lymphoma was made. We report this exceedingly rare case of primary dural non-Hodgkin's lymphoma, which mimicked clinically and radiologically as meningioma.

Primary malignant melanoma of cervix: a case report.

Primary malignant melanoma of cervix is a rare entity. A case of primary malignant melanoma of cervix presented with vaginal discharge and black colored growth over cervix. Histology showed malignant pleomorphic cells with melanin pigment in the cytoplasm.

Fibrosarcoma of penis--a case report.

Malignant mesenchymal tumours of penis are rare. A rare case of fibrosarcoma of penis in 60 year male is presented herewith.

Toxoplasmosis Presenting as Hyper Viscosity Syndrome due to Polyclonal Gammopathy.

We are presenting a rare case of toxoplasma lymphadenopathy with hyper viscosity syndrome due to polyclonal gammopathy. A 30 year old female presented with generalized lymphadenopathy. Lymph node biopsy findings suggestive of toxoplasmosis were confirmed on serology. Bone marrow aspiration showed 50 % plasma cells. On serum electrophoresis broad, diffuse band noted, indicative of polyclonal gammopathy. M band was absent. The patient was immunocompetent and presented with hyper viscosity syndrome masking the symptoms of underlying toxoplasmosis.