Divya Aggarwal

All India Institute of Medical Sciences Jodhpur · Department of Pathology

A 65-year-old male presented with recurrent episodes of asymptomatic erythematous papular and nodular lesions over the trunk and extremities for 6 years. Over the last month, he developed painful oral ulcers associated with lip edema and sudden onset hoarseness of voice.

Paraneoplastic neurological syndrome (PNS) represents a rare group of central nervous system disorders that are unrelated to direct tumor invasion or metastasis but may be triggered by an immune system reaction to a neoplasm or malignant tumor. In many patients, PNS is diagnosed before identifying the primary cancer. In such instances, positron emi...

Introduction Gynecological cancers pose a significant health challenge globally, especially in India, where their prevalence is high. However, Rajasthan, the largest state in India, lacks a structured fellowship program in gynecological oncology, exacerbating the difficulties in managing these diseases effectively Methods A scoping review of liter...

Paraneoplastic neurologic syndromes are a rare, heterogeneous group of complications associated with malignancy, unrelated to direct tumor invasion or metastasis. They are the remote effects of a malignancy owing to immune-mediated reaction toward the antigens that are common to both the malignant and normal cells. Few paraneoplastic syndromes are...

A woman presented with a painless swelling in front of her right auricle, which, on examination, seemed to be a hard, immobile mass arising from the right parotid gland. CT scan showed a heterogeneously enhancing mass lesion in the superficial lobe of the parotid gland with partial extension into the deep lobe. Fine needle aspiration cytology sugge...

Fine needle aspiration cytology (FNAC) is an established diagnostic modality today, but its utilization in skin tumors is limited by the fact that most of these lesions are small and easily accessible for clinicians to perform an excision biopsy. As a result, our knowledge of the cytological features of some of the uncommonly encountered skin tumor...

Context Bone marrow examination (BME) is an invaluable tool for cases with pyrexia of unknown origin and pancytopenia. However, it is under-utilized for diagnosing infectious etiology and there is a paucity of literature regarding its role in infective pathology. Aims This study aims to bring to light the role of BME in diagnosing infectious patho...

Background: Esophageal carcinosarcoma is an uncommon histologic variant of esophageal malignancy, occurring in approximately 0.5% to 2.8% of patients. Esophageal carcinosarcoma usually involves the middle and lower esophagus and consists of both epithelial and mesenchymal components. Case Report: A 54-year-old male presented with painless progressi...

Most soft tissue sarcomas afflict the extremities; however, the retro peritoneum can also be affected rarely. Retroperitoneal sarcomas are relatively asymptomatic. Although tumor-induced hypoglycemia is rare in tumors other than insulinomas, extrapancreatic tumors are a subset that displays this phenomenon. The occurrence of hypo-insulinemic hypogl...

Dear Editor, Cutaneous actinomycosis commonly manifests as an abscess with sinuses and characteristic sulfur granules caused by Actinomyces spp.,¹ filamentous bacteria that are commensal on certain body sites and cause tissue infection rarely in predisposed individuals.¹ Here we describe a case of scalp actinomycosis associated with brain and ocula...

A 67-year-old male was incidentally found to have a large left perinephric mass with a poorly functioning left kidney. A differential diagnosis of renal cell carcinoma, lymphoma, retroperitoneal fibrosis (RPF), and IgG4 renal disease was suggested on imaging studies and biopsy of the mass. A left radical nephrectomy was performed as malignancy coul...

Giant cell tumour of bone accounts for 5% of all primary bone tumours. Multicentric giant cell tumour is an infrequent variety be it either synchronous or metachronous accounting for less than 1% of all giant cell tumours. Synchronous multicentric giant cell tumour of foot and ankle with epiphysiometaphyseal origin is unheard of. We delineate a cas...

Figure 1. A-Macroscopic view of the stomach with multiple targetoid lesions of varying size, round to oval in shape with elevated margins and necrotic base (scale bar= 5 cm); B-Section from stomach depicting the transition zone between viable and necrotic tissue, left side of the image shows viable gastric tissue with patent submucosal blood vessel...

Introduction Diabetes is a potent risk factor for the activation of latent tuberculosis and worsens the tuberculosis (TB) treatment outcome. The major reason for mortality and morbidity in diabetic patients is due to their increased susceptibility to TB. Thus, the study was conducted to understand the crosstalk between M. tuberculosis and its host...

Introduction: The estimated global prevalence of late onset Pompe's disease is 1/57000 live birth(1). We present the case of two patients diagnosed to have Pompe's disease with a rare association of cardiomyopathy. Materials: Two siblings born out of non consanguineous marriage presented with proximal myopathy of 5 years duration. Patient 1 - 19...

Cervical cancer is the most common malignancy in Indian women. After primary treatment, distant recurrence is rare and occurs at liver, lung or bone. Distant metastases to other abdominal sites are very rare. We present a case of pancreatic metastasis from cervical cancer, which has not been reported in literature. A 53-year-old woman presented wit...

Background: Akin to cervical squamous intra-epithelial neoplasia (CIN), anal squamous intra-epithelial lesion (a-SIL) is attributed to persistent infection with high-risk human papilloma virus infection. Amplification of human telomerase reverse transcriptase (hTERT) gene and aneuploidy are known to correlate with CIN evolution. It is plausible th...

The evidence of an association between diabetes and latent tuberculosis infection (LTBI) remains limited and inconsistent. Thus, the study aims to delineate the role of diabetes in activation of latent tuberculosis infection. Murine model of latent tuberculosis and diabetes was developed, bacillary load and gene expression of resuscitation promotin...

Background Syringocystadenoma papilliferum is a benign adnexal neoplasm. Contiguous squamous proliferation has been rarely described in syringocystadenoma papilliferum. Aims This study aimed to evaluate the spectrum and pathogenesis of contiguous squamous proliferation in syringocystadenoma papilliferum. Materials and Methods All cases of syringo...

A 51-year-old man presented with a 1-month history of multiple eruptive seborrheic keratoses on his back and a single painless nodule on his chest. He reported occasional dry cough and loss of appetite over the past 3 months, but he did not seek medical care for them. He had no history of fever, weight loss, night sweats, or gastrointestinal compla...

Congenital myopathies are an expanding spectrum of neuromuscular disorders with early infantile or childhood onset hypotonia and slowly or nonprogressive skeletal muscle weakness. RYR1-related myopathies are the most common and frequently diagnosed class of congenital myopathies. Malignant hyperthermia susceptibility and central core disease are au...

Sarcoidosis is an idiopathic multisystem granulomatous disorder that most commonly affects the lungs. Cutaneous involvement is seen in 30% cases and is rightly termed as the ‘great imitator’ due to varied morphological presentations. Identification of non‑caseating granulomas and exclusion of other causes of granulomatous dermatoses is diagnostic....

Candidal peritonitis is a rare entity usually occurring in patients undergoing repeated peritoneal dialysis. The condition is associated with high morbidity and mortality despite aggressive anti‐fungal treatment; hence, establishing a prompt diagnosis is essential for better patient outcome. A case is described in a young female which was diagnosed...

In India, prevalence of cutaneous reactions secondary to tattoo pigment are increasing now a days. Among these granulomatous tattoo reactions warrants thorough investigation to rule out systemic sarcoidosis. Clinicians should consider LASER or oral and topical steroids in the management of granulomatous hypersensitivity reactions after ruling out m...

Gestational trophoblastic diseases (GTDs) are a group of disorders that include molar diseases like partial and complete hydatidiform moles (HMs) as well as neoplastic conditions like invasive mole, placental site trophoblastic tumor, epithelioid trophoblastic tumor, and choriocarcinoma. These lesions arise as a result of uncontrolled proliferation...

Palmoplantar involvement has been infrequently reported in leprosy and is an easily misdiagnosed entity. The institutional database of leprosy clinic from 2015 to 2018 was accessed. Details pertaining to demography, clinical presentation, comorbidities (if any), treatment received, and outcome were analyzed in leprosy patients with palmoplantar inv...

Background Epithelioid glioblastoma (eGB) is a recently recognized and a rare variant of glioblastoma. This study aimed to describe the clinical, histological and immunohistochemical spectrum and outcome of eGB from a tertiary care hospital in north India. Materials and methods Twenty four cases of eGB diagnosed over past 10 years were reviewed wi...

COVID-19 is a relatively new disease whose complete pathogenesis and complications have not been elucidated. Apart from the morbidity and mortality caused by the virus itself, it is noted that patients affected with this virus have a higher susceptibility to bacterial and fungal co-infections. Mucormycosis is a rare and life-threatening fungal infe...

Background: Duplication cysts (DC) are uncommon congenital malformations which predominantly present in infants and young children. Owing to their variable clinical presentation, radiology and/or histopathology are often required to clinch the diagnosis. We present a case series of 66 patients, which is the largest series reported so far.Methods: A...

Background Small cell carcinoma of ovary, hypercalcemia type (SCCOHT), also known as the malignant rhabdoid tumor of the ovary, is a rare and highly aggressive malignancy affecting younger women. The pathogenesis involves mutations in SMARCA4/BRG1 and/or SMARCA2/BRM. Case A 10-year-old girl presented with lower abdominal pain and a mass for the pa...

Introduction: Acquired dermal hyperpigmentation (ADMH) presenting on periorbital region has been described as individual case reports. We tried to characterize the features of periorbital ADMH. Materials and methods: This was a retrospective case-control study among our patients who attended the pigmentary clinic during January 2016-December 201...

Dowling–Degos disease (DDD) is a late-onset genodermatosis characterized by hyperpigmented macules on the flexures along with scattered comedo-like lesions and pitted acneiform scars. Follicular Dowling–Degos is a rare type of DDD, with only two reports so far. It presents with follicular papules and comedo-like lesions predominantly on the face an...

Background: Defect in internal elastic lamina, defect in tunica media, and the amount of collagen and elastin play a role in vessel wall weakening leading to aneurysm formation. A similar picture may be found in connective tissue disorders, such as Marfan syndrome, Ehlers-Danlos syndrome (EDS), neurofibromatosis type 1, and Loeys-Dietz syndrome (L...

A man in his 20s with a history of unprotected sex with a commercial sex worker three months before presented with a solitary slowly-growing, well-defined, non-tender, oval, verrucous lesion on the mucosal aspect of his prepuce. Dermoscopy revealed a polylobular, pinkish-white, amorphous structure in the centre with a surrounding crown of vessels t...

Immunoglobulin G4-related disease is a fibroinflammatory condition that has the tendency to involve almost every organ of the body. We report the case of a young asymptomatic man with right suprahilar opacity on chest radiograph detected during routine annual health check-up. Mediastinoscopic sampling of the lesion was inconclusive. F-FDG PET/CT do...

Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease due to a lytic infection of oligodendrocytes caused by polyoma virus (JC virus) infection. PML usually occurs in a setting of severe immunosuppression and is most commonly associated with human immunodeficiency virus (HIV) infection. Idiopathic CD4+ lymphocytopenia is...

Background: Lichen planus pigmentosus (LPP) is an acquired disorder of hyperpigmentation affecting certain racial and ethnic groups. Objective: To retrospectively analyze the demographic and clinical characteristics of LPP. Methods: Clinical and demographic records of all LPP patients attending our pigmentary clinic from January 2011 to June 2...

Dear Editor, A 1‐year‐old boy with unremarkable birth history sought treatment for multiple yellowish lesions all over his body for the past 6 months. The lesions were insidious in onset, slightly pruritic, painless and rapidly progressive. The child's past medical and family history were unremarkable, and there was no history of consanguinity in...

Background Fine needle aspiration cytology (FNAC) plays a pivotal role in evaluating salivary gland (SG) tumors. Several studies have shown diagnostic utility of MILAN system for reporting salivary gland cytopathology (MSRSGC) by examining risk of malignancy but only an occasional study has focused on interobserver variability. Hence, the present s...

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Background: Lipomatous uterine tumors are encountered infrequently, and pure uterine lipomas are extremely rare. A diagnosis of pure uterine lipoma should be made only if the tumor itself does not show the presence of smooth-muscle bundles or does show muscle bundles confined only to the periphery of the tumor. Case: A postmenopausal 70-year-old fe...

A 55-year-old female patient with a history of metastatic renal cell carcinoma presented to us with erythematous, painful, mildly itchy lesions on both hands, arms and feet with impaired function. The patient was taking sorafenib 400 mg twice daily. Four weeks after starting the drug, she developed a painful palmoplantar erythema with numbness and...

A 55-year-old female patient with a history of metastatic renal cell carcinoma presented to us with erythematous, painful, mildly itchy lesions on both hands, arms and feet with impaired function. The patient was taking sorafenib 400 mg twice daily. Four weeks after starting the drug, she developed a painful palmoplantar erythema with numbness and...

Genital lichen sclerosus et atrophicus (LSA) is an uncommon genital dermatosis. Its resemblance to vitiligo, especially during the earlier stages, leads to delay in its diagnosis. Apart from the common complications such as meatal stenosis, balanoposthitis, phimosis, and painful erections, squamous cell carcinoma is a rare but ominous complication...

Hydatid disease is an infrequent parasitic infestation caused by cestode, most commonly, Echinococcus granulosus. Bone involvement is distinctly uncommon. We would like to share our experience of a rare case of hydatid disease of femur in a 24-year-old male who presented with nonunion of subtrochanteric fracture. Histopathology showed typical lamel...

Management of delayed presenting esophageal perforations has long been a topic of debate. Most authors consider definitive surgery being the management of choice. Management, however, differs in pediatric patients in consideration with better healing of younger tissues. We extensively review the role of aggressive non-operative management in pediat...