Vidya Monappa

• MD, DNB (Path)
• Additional Professor at Manipal Academy of Higher Education

Mucinous tubular and spindle cell carcinomas are rare kidney tumors with generally indolent behavior. As the name suggests, classic histomorphology reveals bland spindle cells, tubules, and mucinous stroma. Uncommon histologic features include mucin-poor stroma, high nuclear grade, cellular pleomorphism, and presence of necrosis. Rare cases can sho...

Colorectal carcinoma with sarcomatoid components (which includes so-called carcinosarcomas and sarcomatoid car-cinomas) is a rare subtype with 50 reported cases in the literature and overlapping criteria with undifferentiated carcinoma. We collected and described 15 cases from 10 men and 5 women, with a mean age of 66 years. Symptoms included abdom...

Background Blastoid mantle cell lymphoma (B-MCL) is a rare aggressive lymphoma. It is characterized by blastoid morphology with high proliferation and inconsistent immunohistochemistry (IHC), making it a diagnostic challenge for the pathologist. Methods This is a retrospective analytical cohort study. We reviewed biopsy confirmed cases of B-MCL di...

Background Hematolymphoid neoplasms (HLNs) presenting as body cavity effusions are not a common finding. They may be the first manifestation of the disease. A diagnosis on effusion cytology may provide an early breakthrough for effective clinical management. Aims Study the cytomorphology of HLNs in effusion cytology, determine common types, sites...

Background: Myeloid sarcoma (MS) is a rare tumor composed of proliferation of myeloid precursors at extramedullary sites. They can arise de-novo or in association with hematological malignancies, most commonly acute myeloid leukemia. Clinically, it can masquerade as an abscess, cutaneous ulcer, or mass lesion. Morphologically, MS can mimic a varie...

Introduction: Colorectal Cancer (CRC) is one of the leading causes of mortality worldwide. Adequate and appropriate treatment depends on accurate histopathological staging. The current College of American Pathologists (CAP) guidelines emphasise sampling 12 Lymph Nodes (LNs) for adequate staging; however, there are situations where this ‘magic numbe...

Background Muscle-invasive bladder carcinomas (MIBCs) exhibit significant heterogeneity, with diverse histopathological features associated with varied prognosis and therapeutic response. Although genomic profiling studies have identified several molecular subtypes of MIBC, two basic molecular subtypes are identified - luminal and basal, differing...

Ganglioneuromas are rare benign tumors with favorable prognosis. Pancreatic ganglioneuromas are particularly uncommon, with only a few cases reported in the literature. Preoperative diagnosis can be challenging due to nonspecific radiological findings, difficult Fine needle aspiration (FNA) access, or inadequate sampling caused by the fibrous natur...

Background Blastoid mantle cell lymphoma (B-MCL) is a rare aggressive lymphoma. It is characterized by blastoid morphology with high proliferation and inconsistent immunohistochemistry (IHC), making it a diagnostic challenge for the pathologist. Methods This is a retrospective analytical cohort study. We reviewed biopsy confirmed cases of B-MCL di...

Introduction Sarcomas presenting as malignant effusion are rare and the diagnosing them on fluid cytology requires expertise and clinicoradiological correlation as cells undergo morphological changes, mimicking carcinoma, or mesothelioma. Case presentation We present a case of 70-year old man with abdominal distention and pain, initially suggestive...

Background:Iron is an element now synonymous with inflammatory diseases, but in recent years it has shown potential in the pathophysiology of Diabetes. This review aims to cohesively analyze the association of serum iron in Diabetes and evaluate its clinical theranostic potential. Method:Literature was obtained from PubMed, Embase, and Clinical Key...

Central nervous system involvement is a rare complication of Waldenstrom macroglobulinemia (WM) accounting for 1–2% cases. This syndrome is called Bing–Neel syndrome (BNS) after the people who first described it in 1936. Although WM has a good prognosis, with the onset of this syndrome, most patients fare poorly with a high mortality rate. A 77/mal...

Purpose Desmoid fibromatosis in head and neck is infrequent and poses a significant challenge to the clinicians due to its non-specific characteristics. Methods This case report focuses on a 69-year-old male who presented to a tertiary healthcare center in Karnataka, India with a swelling in the oral cavity. Results Despite initial suspicions of...

Background & Objective Primary extranodal lymphoma (pENL) is a malignant lymphoid neoplasm that presents with the main bulk of disease at an extranodal site. The incidence of primary pENL has risen sharply in recent years due to the advent of better diagnostic modalities. Diagnosing pENL can be challenging due to its morphological overlap with othe...

Introduction: Diabetes is a disease that is studied in several fields of clinical practice. In this paper, we present studies of diabetes in relevance to the field of blood transfusion, specifically about donation from insulin-dependent diabetics. The objective of this paper is to interpret relevant information and data pertaining to guiding nation...

Pseudomyogenic hemangioendothelioma (PHE) is an uncommon mesenchymal neoplasm of intermediate malignant potential showing endothelial differentiation. Around 20 cases of primary osseous PHE have been reported to date. A 16-year-old boy presented with complaints of pain in his right leg. Imaging revealed multifocal intramedullary and cortical-based...

Background: Ulcerative colitis (UC) is an inflammatory bowel disorder affecting the colonic mucosa, characterized by intense inflammation and mucosal damage. The present study aimed to evaluate the protective effect of the Trigonellafoenum-graecum L. (TFG) seeds in acetic acid-induced UC in rats. Materials and Methods: Male rats (n=30) were distrib...

There exists a wide spectrum of non-neoplastic conditions which can mimic a brain tumor, both clinically and radiologically. Central nervous system (CNS) infections are the commonest conditions in this group. CNS infections presenting as space-occupying lesions (SOLs) are not uncommon, especially in developing countries with large populations in th...

CDX2, Barretts esophagus

Introduction: Primary Gastrointestinal Lymphoma (PGIL) is a heterogeneous disease in terms of patient characteristics, site, histologic types and treatment modalities. Although rare disease, it is the most common site for extranodal lymphomas accounting for 10-15% of all non-Hodgkin lymphoma and 30-40% of all extranodal lymphoma. Aim: To study the...

Desmoid tumour of the anterior abdominal wall (rectus sheath) commonly occurs in women post abdominal surgery. Metastasis from colorectal cancer to the anterior abdominal wall, on the other hand, is rare and produces a complex management dilemma. This Case study presents a 57-year-old woman who received a curative laparoscopic low anterior resectio...

Leishmaniasis, an endemic disease in several parts of India, is a parasitic disease caused by protozoa and transmitted by the sandfly. Although cutaneous and visceral varieties are common, isolated lymph nodal involvement is extremely rare, and the diagnosis is often delayed owing to its uncommon presentation and lack of awareness of this possibili...

Ulcerative colitis is an inflammatory disorder affecting colonic mucosa, characterized by intense inflammation and mucosal damage. The currently available medical treatment is not completely safe and effective in alleviating the disease manifestations and its complications. The present study aimed to evaluate the protective effect of herbal product...

Abdominal actinomycosis is a chronic suppurative infection caused by Actinomyces species. The ileo-cecal region is most commonly affected, while the left side of the colon is more rarely involved. The infection has a tendency to infiltrate adjacent tissues and is, therefore, rarely confined to a single organ. Presentation may vary from non-specific...

Background & Objective: Meningiomas are the most frequently encountered primary non-glial tumors of the central nervous system (CNS). The Ki67 labelling index (Ki67LI) is a proliferation marker that may prove useful in determining the histological grade. This study aims at: 1) Studying the frequency, grade and histomorphological spectrum of meningi...

Introduction: Epithelioid sarcoma is a malignant mesenchymal neoplasm with evidence of epithelial differentiation. All the cases reported in the solid organs are of “proximal type” occurring in adults. We report a primary epithelioid sarcoma arising in the adrenal gland of a young male. Case report: An 11-year-old male patient presented with right...

Background Anxiety disorders are highly prevalent that affect millions of people worldwide. Homeopathic system is gaining popularity due to its efficacy in chronic diseases. Ultra-diluted Aconitum napellus is a homeopathic medicine used by clinicians for treatment of acute anxiety. Aim Objective of this study is to test the efficacy of Aconite on e...

Introduction: Eosinophilic variant of clear cell renal cell carcinoma is an important entity to diagnose since it is aggressive and is associated with poor prognosis. Case Report: A 75-year-old patient presented with pain abdomen. The magnetic resonance imaging showed a mass in the kidney. The differential diagnosis given was renal cell carcinoma a...

Medullary thyroid carcinoma (MTC) is a rare tumor arising from parafollicular C-cells. The oncocytic variant of MTC is an extremely rare diagnosis, with less than 20 cases reported. Here we present the case of a 36-year-old male patient with complaints of neck swelling and dysphagia. On fine needle aspiration cytology (FNAC), a Hürthle cell neoplas...

We report a rare case of a 64-year-old patient with recurrent syncope and a history of tonsillar carcinoma under treatment for the past three months. ECG showed complete heart block and echocardiography revealed cardiac metastases at atrioventricular junction. This case report highlights the fact that sometimes unusual causes can be responsible for...

Background Cyclophosphamide (CPA) is an anti-cancer drug, used in chemotherapy. This is a toxic drug which targets the cancer cells and also the normal cells of the body. The original compound is inactive in vitro and exercises its biologic action through metabolites, chiefly phosphoramide mustard. The objective is to study the harmful effects of t...

Gestational Gigantomastia (GG) is a rare condition that presents with excessive enlargement of breast which becomes uncomfortable and embarrassing. Here is a case report of a primigravida who presented to us with GG at term. Post-delivery she had abscess formation and difficulties in breastfeeding. She was conservatively treated by abscess drainage...

Primary fallopian tube carcinomas (PFTC) are rare tumors with non-specific clinical presentations. The current case was unique since the tumor was first detected on endometrial curettage and clinicoradiologically was misdiagnosed as endometrial carcinoma. A 48-year-old, post-menopausal female presented with one episode of vaginal bleeding. Endometr...

Introduction Bladder paragangliomas (BP) are rare tumors, with clinical manifestations ranging from hypertension to hematuria to being asymptomatic. Histologically, they can mimic urothelial carcinomas. Around 200 cases of paragangliomas arising in the urinary bladder have been described in the world literature. Observation We report 2 new cases o...

Introduction: This study provides a description of development of various components of the human ureter at different gestational ages. Methods: Measurements of the length of the ureter from pelvi-ureteric junction to vesico-ureteric junction, length of its intravesicular portion and angle made by the ureter at the entry into the bladder with respe...

Introduction Cytologic features of papillary thyroid carcinoma (PTC) have been extensively documented in literature. However, PTC variants can prove to be diagnostically challenging on fine needle aspiration cytology (FNAC). Aims To study the FNAC features of PTC and its variants and explore the causes for misdiagnosis. Materials and Methods This...

Since its first description, the diagnosis and terminology of hemangiopericytoma have been in controversy. We report perhaps the first case of multiple lipomatous hemangiopericytoma occurring in the foot and ankle region.

Cutaneous leiomyomas (CL) often present as painful tumors in the skin. Herein we report an adult man who presented with multiple, erythematous papulonodules in both segmental and non-segmental distribution.

A 60-year-old postmenopausal woman, presented with a left ovarian cystic mass with mildly elevated CA125 levels. An intraoperative frozen section showed oedematous ovarian stroma with interspersed large aggregates of spindle shaped stromal cells. Subsequently, the excised specimen was reported as Sertoli-Leydig Cell Tumour (SLCT) of intermediate di...

Amongst the varied, diverse causes of intraabdominal masses in infancy and early childhood, gastric teratomas (GTs) account for a very small proportion. A worldwide literature search reveals only around one hundred cases of GT and also supports the fact that its preoperative diagnosis remains elusive. Here we report the case of a two-month-old male...

Tumours of the testicular adnexa include a heterogeous group of mesothelial, mesenchymal and germ cell tumours. Adenomatoid tumour, pseudosarcomatous myofibroblastic proliferations and rhabdomyosarcoma are the more frequently encountered neoplasms. Lymphoma/leukemic infiltration secondary to testicular involvement or primary tumour elsewhere is not...

Juvenile Granulosa Cell Tumour (JGCT) of ovary represents a small fraction of all primary ovarian malignancies. It is a subtype of granulosa cell tumour that is almost always found during the first three decades of life. Histologically, it differs from the typical adult type of granulosa cell tumour. It accounts for 5-15% of all granulosa cell tumo...

Malignant mixed Müllerian tumors (MMMTs) of the uterus are rare, aggressive tumors that present at an advanced stage and are associated with poor prognosis. They arise as a result of divergent carcinomatous and mesenchymal differentiation of tumor stem cells. Rarely one of the components may predominate contributing to diagnostic confusion. We pres...

INTRODUCTION : Hamartoma of the breast is a rare entity , frequently underdiagnosed by pathologists . It is a benign tumour - like nodule with overgrowth of mature cells that normally occur in the affected part . Patients present at an average of 45 y r s . with a unilateral , well defined , painless mass or enlargement ; incidence being 0 . 1% to...

Primary fallopian tube carcinoma [PFTC] is an uncommon, aggressive neoplasm. Diagnosis is based on ultrasonographic findings combined with a thorough histopathological examination. It must be considered as a differential diagnosis in patients presenting wi th vaginal bleed or discharge, with bilateral adnexal masses and those who fail to respond to...

Soft tissue chondroma (STC), also known as extraskeletal chondroma or chondroma of soft parts is a benign cartilaginous tumor which arise de novo from soft tissue. Also, it is an extremely rare entity predominantly involving extremities, especially fingers. A 26 year old male presented with 3 year history of swelling in left index finger. On local...

We report a case of a 27-year-old man who presented with a slowly growing left testicular swelling associated with mild pain over a period of 3 months. He was evaluated by his family physician with scrotal ultrasound and testicular tumour markers. He was diagnosed and treated as epididymo-orchitis and managed with antibiotics. When he later present...

We present the first case of a nonmetastasizing renal cell carcinoma (RCC) masquerading as an adrenal mass, in the presence of normal bilateral native kidneys, in a young adult. The possibility of this mass developing in a supernumerary kidney was ruled out, since no identifiable renal tissue, pelvis or ureters was seen within the mass, nor was any...

Cutaneous Tuberculosis is an uncommon form of extrapulmonary tuberculosis and is infrequently seen in dermatology practice. Primary inoculation tuberculosis occurs following direct inoculation of mycobacte-rium in the skin of a person through a breach in the continuity of skin from an abrasion of the skin, allowing the entry of tubercle bacilli.The...

A 53-year-old man with a significant smoking history presented with chronic cough, exertional breathlessness, intermittent fever, weight loss and anorexia. A review of his past medical records revealed he was diagnosed to have sputum smear-positive pulmonary tuberculosis 5 years earlier, for which he had received multiple courses of incomplete anti...

Malignant Germ Cell Tumours (GCTs) are rare, accounting for 3% of intracranial tumours and just like their extracranial counterparts represent a wide array of disease. Combination of Germinoma with Teratoma is very rare. Here in, we describe a case of Mixed Malignant Germ cell tumor of third ventricle with recurrence with emphasis on histopathologi...

Congenital self-healing reticulohistiocytosis (CSHRH) is a benign type of Langerhans cell histiocytosis (LCH) also known as Hashimoto-Pritzker disease. Clinically it presents with skin lesions at birth or in neonatal period, usually without any systemic involvement. Lesions often heal spontaneously in period of weeks to months. We report a case of...

Desmoplastic Small Round Cell Tumour (DSRCT) is a rare, highly aggressive, mesenchymal tumour that arises from the peritoneal cavity. It is commonly seen in adolescent and young adult males and its occurrence in females is uncommon. We are reporting here a rare case of DSRCT in a young woman, which clinically masqueraded as an ovarian malignancy, w...

A rare case of large adrenal mass which was non-functioning is presented. It is difficult to make preoperative diagnosis in these cases as the imaging findings are non-specific. Radical excision is mandatory as preoperative malignancy cannot be ruled out.

We report a 66-year-old male who presented with a blackish discolored ulcerated nodule over the right flank of 2 months duration. Biopsy of the lesion revealed ulcerated epidermis with fungal hyphae of Aspergillus overlying dense, angiocentric atypical lymphoid infiltrate involving the dermis, and extending into sub cutis with geographic areas of n...

Context: p53 tumor suppressor gene is a frequent target for mutations in a variety of tumors. The mutated gene is more stable than the normal gene and can be detected by immunohistochemical methods. Aims: 1) To determine the expression of p53 immunohistochemically in a spectrum of benign, premalignant lesions and in various histological grades of o...

Adamantinoid trichoblastoma is a rare adnexal tumor which clinically masquerades as various benign and malignant lesions. Less than 50 cases have been documented so far. In this report we discuss the clinicopathological features of this rare and fascinating tumor with a brief review of literature.

Pancreatic endocrine tumours (PETs) are uncommon tumours with typical morphology characterised by relatively uniform cuboidal cells arranged in nests and festoons, with distinctive nuclear salt-and-pepper chromatin. A lipid-rich variant poses diagnostic difficulties in the midst of other pancreatic tumours and metastatic goblet cell carcinoid. A 22...

Extraosseous Ewing's sarcoma/primitive neuroectodermal tumor (ES/PNET) is an uncommon, aggressive, and malignant tumor with a poor patient outcome. Its occurrence in the lesser sac is a rare event and to the best of our knowledge, has not been previously described. The present case was clinically and radiologically misdiagnosed as a pancreatic tumo...

Neural fibrolipoma is an uncommon tumor-like lesion that involves the upper extremity and usually arises in the median nerve. It is associated with macrodactyly in one-third of the cases. A 3-year-old girl presented with increasing size of fingers of both the hands since birth. Clinical examination revealed macrodactyly of two fingers of the right...

Myocardial infarction is the most common cause of sudden death. However the identification of myocardial infarcts at necropsy is difficult. Various methods are being used to detect it. It has been shown that the use of dyes such as nitroblue tetrazolium and 2,3,5 triphenyl tetrazolium chloride (TTC) that identify the dehydrogenase deficient infract...

Posterior reversible encephalopathy syndrome (PRES) is a rare complication of nephrotic syndrome and corticosteroid therapy. Here, we discuss an 18 year old man with type 1 membranoproliferative glomerulonephritis (MPGN) secondary to hepatitis B infection who developed posterior leukoencephalopathy while on therapy with lamivudine and prednisone. H...

Myocardial infarction is the most common cause of sudden death. However the identification of myocardial infarcts at necropsy is difficult. Various methods are being used to detect it. It has been shown that the use of dyes such as nitroblue tetrazolium and 2,3,5 triphenyl tetrazolium chloride (TTC) that identify the dehydrogenase deficient infract...

Adenomatoid tumor is one of the most common primary neoplasms of the paratesticular area. The epididymis is the most common site of involvement; however, it can also arise from the tunica albuginea, spermatic cord, tunica vaginalis and testis. Fine needle aspiration cytology (FNAC) is being increasingly used for lesions in the paratesticular area....

In this case report we describe a rare tumor--Oncocytic variant of Mucoepidermoid carcinoma of the submandibular salivary gland with a review of the literature. Oncocytic metaplasia in salivary glands is a benign change that is associated with increasing age and also seen in a few salivary gland neoplasms', which include oncocytoma, Warthin's tumor...

We describe a 63-year old male who presented with diarrhea, weight loss, epigastric pain and was found to have cutaneous hyperpigmentation, onychodystrophy and gastric and colonic polyposis on endoscopy. Histology of a polyp from the stomach showed hyperplastic features with cystic dilatation, stromal edema and inflammatory cell infiltrates with H....