- [Show abstract] [Hide abstract] ABSTRACT: Proliferating trichilemmal cyst (PTC), a rare benign tumor, is a fascinating follicular neoplasm. It occurs on head and neck region of elderly women and its histologic hallmark is trichilemmal keratinization. A 70-year-old female presented to skin outpatient department with complaints of a slowly growing mass on scalp for the past 2 years. On examination, the lesion was firm, mobile, painless, and measured 6 × 5 × 3 cm and was not fixed to the underlying bone. Laboratory investigations were unremarkable. Excisional biopsy was done. Histopathology revealed well-demarcated tumor with variably sized lobules of squamous epithelium undergoing an abrupt change into eosinophilic amorphous keratin without granular cell layer (trichilemmal keratinization). PTC should be differentiated from trichilemmal cyst as it has potential for malignant transformation. Thus, complete excision is recommended for all benign proliferating variants owing to their potential for locally aggressive behavior and malignant transformation.
- [Show abstract] [Hide abstract] ABSTRACT: Rhabdomyosarcoma (RMS) is a highly aggressive, malignant tumor of skeletal muscle cell, associated with an early and a wide spread metastasis. Although a commonly occurring soft tissue sarcoma in the pediatric population, it is seldom encountered in adults. Outcome for adult RMS is poorly documented due to its rarity. We report a case of pleomorphic RMS (PRMS) in a 50 years male presenting with an intra-abdominal mass along with a swelling in the right inguinal region measuring 4 cm Χ 3 cm. Computed tomography revealed an ill-defined intra-abdominal mass arising from the peritoneum. Abdominal mass was resected along with the dissection of inguinal lymph node. Histopathological examination of these masses coupled with the immunohistochemistry, confirmed the diagnosis of PRMS metastasizing into inguinal lymph node. Despite of adjuvant radiotherapy and chemotherapy, the patient couldn′t survive >3 months and died of widespread lung metastasis.
- [Show abstract] [Hide abstract] ABSTRACT: Among the group of small round cell tumours, there is a distinct and rare tumour known as desmoplastic small round cell tumour (DSRCT). DSRCT presents as multiple, widespread masses in the abdomen and pelvis and may be accompanied by extensive tumour implants throughout the peritoneum as the tumour is known to spread diffusely along serosal surfaces. We discuss a case of DSRCT in a 16-year-old boy who presented with abdominal pain since 2 years, a non-tender mass was palpable on the right upper quadrant of the abdomen, ultrasonographic and CT findings suggested hydatid cyst of liver. Laparotomy revealed multiple small peritoneal deposits along with a single mass in the liver. On histopathology, the lesion was found to be neoplastic and composed of predominantly clusters of small round blue cells, in a desmoplastic stroma; tumour cells were diffusely positive for cytokeratin, vimentin and neuron-specific enolase, thus confirming the diagnosis of DSRCT.
- [Show abstract] [Hide abstract] ABSTRACT: The most common type of polydactyly in the hand is thumb polydactyly. Enchondromas are benign cartilaginous tumors and usually present in phalanx of hands. Transformation of enchondromas into chondrosarcomas is very rare, which is commonly associated with multiple enchondromatous lesions. Association of thumb polydactyly and secondary chondrosarcoma arising from a solitary enchondroma is even rarer. We present a 50-year-old female patient with right thumb polydactyly associated with secondary chondrosarcoma arising from a solitary enchondroma. To our knowledge this association has not been described previously. Key words: Chondrosarcoma, enchondroma, polydactyly
- [Show abstract] [Hide abstract] ABSTRACT: Primary bone lymphoma (PBL) is an uncommon clinical entity and a rare presentation of non-Hodgkin's lymphoma. PBL accounts for less than 5% of malignant bone tumors, 4–5% of extra nodal lymphoma and less than 1% of all non-Hodgkin's lymphoma. Diffuse large-B-cell lymphoma (DLBCL) accounts for the majority of cases of PBL. The incidence of PBL is so rare that many of its aspects remain unknown. A number of studies have been reported from western countries but only a few reports are available from Asia. Out of 20,000 bone lesions received in our department over 5 years, only 5 cases were primary bone lymphoma; all of which were DLBCL. We report our experience on PBLs with main emphasis on two unusual presentations of this rare tumor.
- [Show abstract] [Hide abstract] ABSTRACT: We present a case of a salivary gland tumour in a 25-year-old woman with lymphadenopathy and a clinical suspicion of lymphoma. The patient had a history of rapidly enlarging mass near angle of jaw which was resected and sent for histopathological examination. A final diagnosis of acinic cell tumour with dedifferentiation was made by histomorphological and immunohistochemical studies. Acinic cell tumour can mimic any salivary neoplasm phenotypically because of its varied architectural patterns of presentation with varied cell types, hence called the harlequin of salivary gland. Acinic cell tumour with dedifferentiation is a rare aggressive variant and requires adjuvant radiotherapy for better prognosis, hence the need for accurate diagnosis and communication to the surgeon.
- [Show abstract] [Hide abstract] ABSTRACT: We present a case of a 15-year-old girl with a pulsatile, rapidly enlarging mass at the root of the nose suspected to be malignant. Excisional biopsy showed worrisome histological features; however, a final diagnosis of cellular schwannoma was reached excluding the possibility of malignant peripheral nerve sheath tumour by histological and immunohistochemical attributes. Cellular schwannoma, a pseudosarcomatous entity, is a rare benign neoplasm that may cause bone erosion and may be mistaken for a malignancy, clinically and histologically. Diagnosis of cellular schwannoma is essential to prevent mismanagement as it never metastasises and responds to local excision as opposed to aggressive treatment required by a malignant neoplasm.
- [Show abstract] [Hide abstract] ABSTRACT: Scrotal ultrasound, though reliable in distinguishing between intratesticular and extratesticular lesions and characterizing them as cystic and solid, cannot distinguish benign from malignant pathology. Although fine needle aspiration cytology (FNAC) has proved to be of great diagnostic importance in testicular lesions, its scope in extratesticular lesions is largely unexplored. To evaluate extratesticular scrotal lesions cytologically and compare it with their clinical, radiological, and histological findings. Sixty five patients with extratesticular scrotal lesions were assessed clinically, radiologically, and cytologically. Histopathology was done in 45 cases where surgical exploration was undertaken. All the data were then analyzed and correlated. Extratesticular lesions accounted for 72.2% of the scrotal swellings. Of these, the epididymis is most commonly involved (61.5% cases) with the commonest type of lesion being cystic (49.3% cases). Ultrasonography preferably with color doppler is highly useful for the evaluation of the scrotum. Apart from distinguishing extratesticular from testicular and cystic from solid lesions, it has an important role in identifying individual lesions, thus reducing the list of differential diagnosis. Fine needle aspiration cytology contributed to a definitive diagnosis in 47.7% cases. It helps classify cystic masses on the basis of their contents and defines the etiology of chronic inflammatory lesions, apart from corroborating with the clinico-radiological diagnosis. Histological evaluation was possible only in cases where surgery was performed and helps further define the diagnosis. Fine needle aspiration cytology is essentially non-traumatic and easy to carry out and should be a technique of choice for the study of scrotal pathology, main advantage being avoidance of delays in diagnosis.
- [Show abstract] [Hide abstract] ABSTRACT: Actinomycosis is a rare, torpid, suppurative and chronic granulomatous infection caused by a Gram-positive organism that was initially thought to be a fungus. These organisms normally live as commensals in the human oral cavity, respiratory and digestive tracts, but become invasive when they gain access to the subcutaneous tissue through a musosal lesion, the triggering events being dental caries, dental manipulation and maxillofacial trauma. It is often misdiagnosed as it can mimic numerous infectious and non-infectious diseases. We describe an interesting case of cervical actinomycosis that was misdiagnosed as sebaceous cyst and precisely identified after histopathological examination of the tissue.
- [Show abstract] [Hide abstract] ABSTRACT: We present a case of a 60-year-old woman with multiple right axillary swellings. Patient had a history of lump with pigmentation over back for which she was operated upon. There was also a nodule over resected scar on back. A final diagnosis of malignant melanoma (recurrent and metastatic to axillary lymph nodes) was rendered with the help of fine-needle aspiration cytology (FNAC). Malignant melanomas are the most lethal of cancers of the skin and are notorious for the great variability of cytological presentation. We discuss the role of FNAC in early diagnosis and prognostication of recurrent and metastatic disease.
- [Show abstract] [Hide abstract] ABSTRACT: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. The authors take this opportunity to report two cases of GISTs of large bowel diagnosed on cytology and confirmed by histopathology and immunohistochemistry.
- [Show abstract] [Hide abstract] ABSTRACT: A case of localised cutaneous zygomycosis was diagnosed on histopathology in a one month old burn wound. The diagnosis was made by the presence of characteristic fungal hyphae on histopathological examination. The importance of the findings can be emphasised by the fact that cutaneous zygomycosis is a relatively rare but potentially fatal infection encountered in general hospital setup. The characteristic findings on histopathology confirmed the diagnosis in the absence of fungal culture. Keywords: Burn wound histopathology, Cutaneous Zygomycosis, Hematoxylin and Eosin stain, Periodic acid Schiff stain.
- [Show abstract] [Hide abstract] ABSTRACT: Burn is a type of injury caused by heat, electricity, chemicals, light, radiation or friction. Burns can be highly variable in terms of the tissue affected, the severity and resultant complications. Burns cause damage in a number of different ways, but by far the most common organ affected is the skin (Williams et al, 2008). Tissue burns involve direct coagulation and micro vascular reactions in the surrounding dermis that may result in extension of the injury. Large injuries are associated with a systemic response caused by a loss of the skin barrier, the release of vasoactive mediators from the wound and subsequent infection (Shukla and Sheridan, 2005). Infection is an inevitable complication of extensive burns (more than 30% body surface) and a major cause of morbidity and mortality (Schwarz and Dulchavsky, 2005). Infection is linked to impaired resistance from disruption of the skin’s mechanical integrity and generalized immune suppression. The skin barrier is replaced by eschar. This moist, protein rich avascular environment encourages microbial growth. Migration of immune cells is hampered, and there is a release of intermediaries that impede the immune response. Eschar also restricts distribution of systemically administered antibiotics because of its avascularity. Burn wound infection has to be differentiated between colonization of the burn wound and burn wound sepsis which is characterized by microbial invasion of viable tissue beneath the eschar. Gauging burn wound sepsis by clinical signs and symptoms is difficult (Schwarz and Dulchavsky,2005). Burn wound biopsies classified as to the depth of infections, confirm the frequent occurrence of bacterial, fungal and viral infection in burn wounds and also provide document for the importance of increasing severity of infection on successive biopsies (Pruitt, 1973). Wound swab culture /sensitivity cannot differentiate between wound colonization and wound sepsis. Burn wound biopsy can distinguish microbial colonization from invasive infection which can guide patient’s treatment (Thejaswini et al, 2007). Aims and objectives: 1.To study the clinicopathological profile of burn patients with wound sepsis.2.To carry out histopathological assessment of burn wounds and burn wound infections.3.To correlate histopathological findings with the clinical findings.
Article: Hydatid cyst in tail of pancreas[Show abstract] [Hide abstract] ABSTRACT: The authors present a case of hydatid cyst in tail of pancreas in a 35-year-male who presented with 6-month history of dull aching pain in abdomen. Radiologically, a differential diagnosis of cystic pancreatic neoplasm and pseudocyst was made which was confirmed after histopathological examination.
Article: Dermoid cyst in brain[Show abstract] [Hide abstract] ABSTRACT: The authors are presenting here a case of dermoid cyst in 50-year-male who presented with 3 months history of headache.
- [Show abstract] [Hide abstract] ABSTRACT: Synchronous occurrance of multiple neoplastic processes is not very common, and the relationship between breast cancer with lymphoproliferative diseases is unusual as well. Furthermore, breast involvement by non-Hodgkins lymphoma is a rare event and primary breast non-Hodgkins lymphoma is even rarer. The authors take this opportunity to report a case of primary B-cell non-Hodgkins lymphoma breast occurring in association with invasive ductal carcinoma in a 47-year-old female for its rare synchronous association.
Article: Steatocystoma multiplex[Show abstract] [Hide abstract] ABSTRACT: A 40-year-old man presented with multiple papules on his head and neck. The lesions had been present for about 15 years. The patient was treated for acne for 6 months, but no improvement was noted. A biopsy was performed and microscopic findings were consistent with steatocystoma multiplex.
Article: Neurofibroma of parotid[Show abstract] [Hide abstract] ABSTRACT: Tumours of neurogenic origin are rare in parotid gland. The authors are presenting here a case of neurofibroma in a 40-year-male who presented with slow growing tumour in preauricular region of 1 year duration.
Jawaharlal Nehru Medical College
Belgaum, Karnataka, India
- Department of Pathology