Tumoral Calcinosis at Unusual Site: Diagnosis on Fine Needle Aspiration Cytology.

Tumoral calcinosis (TC) is a rare benign clinical and histological entity. It presents as tumour-like periarticular deposits of calcium in hip, shoulder and elbow regions. Idiopathic tumoral calcinosis (TC) is different from the secondary calcium deposition associated with terminal renal diseases, hypervitaminosis D and milk alkali syndrome with disturbed calcium metabolism. There are no demonstrable abnormalities of calcium metabolism in Idiopathic TC. TC predominantly affects children and young adults and is rare in old age. When TC occurs in old patients, possibility of other differential diagnoses need to be considered and ruled out with the help of morphological examination of the tumorous swelling. Two cases of TC that occurred in 65 and 75 year old females respectively were initially diagnosed on the basis of fine needle aspiration cytology (FNAC) findings of the swellings and later confirmed by histopathological examination of the excised tissue. Diagnostic biopsies were avoided in these patients. Cytological study can prove to be a rapid and reliable method of preoperative morphological diagnosis of tumoral calcinosis.

Leishmaniasis in a patient with HIV co‑infection: Diagnosis on fine needle aspiration cytology.

Leishmaniasis is a vector borne parasitic disease caused by obligate intracellular protozoa Leishmania and is transmitted by the bite of sand fly. The disease typically presents in visceral, cutaneous and mucocutaneous forms and is endemic in some states of India. Cases with atypical presentation are seen when patient has co- infection with HIV. We report a case of Leishmaniasis occurring in a HIV seropositive expectant mother diagnosed initially on fine needle aspiration cytology. The patient was resident of non endemic area and had presented with isolated cervical lymphadenopathy and fever without spleenomegaly. Characteristic morphological features of Leishmania seen in the fine needle aspiration smears from the neck nodes were identified and definitive diagnosis of Leishmaniasis could be given. Cytological features were not suggestive of any other disease. Timely diagnosis of the disease facilitated proper management in our patient.

Pneumatosis cystoides intestinalis- a morphological curio or a pitfall for surgeons: report of two cases and literature review

Pneumatosis Cystoides Intestinalis (PCI) is an uncommon but well recognised clinical entity in which gas-filled cysts appear in the intestinal wall.PCI can be an incidental finding or it may be detected during radiography or laparotomy. We came across two cases of PCI with characteristic morphological features associated with perforation peritonitis in and sigmoid volvulus respectively. In both cases PCI was not suspected pre-operatively.Both patients underwent urgent surgical exploration for the abdominal emergencies and were discharged in good general condition. It is imperative that the imaging finding of PCI is carefully correlated with the findings of physical examination, clinical history, and laboratory test results to determine which patients can be managed medically by treating the underlying disease and which will require emergency surgery. This decision can be difficult because the origin of the gas is often unclear and the patient's symptoms can be volatile, presenting a major dilemma for the surgeon.