Oncocytic adrenal cortical neoplasm of uncertain malignant potential – A rare case report

Adrenal oncocytic tumors are rarely encountered. Most of the oncocytic tumors are benign and rarely malignant. Here we report a case of a 10-year-old male child presented with abdominal mass whose Contrast-Enhanced Computed Tomography (CECT) shows well-circumscribed tumor. Right adrenalectomy was carried out. Histopathologically, it was diagnosed as adrenal cortical oncocytic neoplasm of uncertain malignant potential (AONUMP). This case highlights that although adrenal oncoytic tumors are rare, we should consider this as a differential diagnosis while evaluating the patient for adrenal masses. The case is presented in view of its rarity, and distinguishing gross and microscopy appearance, the diagnosis of which was further confirmed with immunohistochemistry markers.

Spontaneous perforation of the extrahepatic biliary tract.

Spontaneous perforation of the extra-hepatic biliary tract presenting with pseudocyst is rare. We report the case of a two-month old infant who presented to us with increasing jaundice and progressive loss of weight. Ultrasonography, magnetic resonance cholangiopancreatography and hepatobiliary iminodiacetic acid scan revealed features of obstructed choledochal cyst. Laparotomy revealed a small, walled-offcollection of bile near the confluence of the cystic and common bile ducts. Distal obstruction was excluded and biliary tract drainage was successful in treating the infant.

Vascular transformation of sinuses in lymph nodes associated with myelodysplastic syndrome--a case report.

We describe a case of plexiform variant of vascular transformation of lymph nodes sinuses in association with myelodysplastic syndrome. The patient had repeated bacterial infections and terminal fungal infection and dies after a protracted illness of seven years.

Fatal complications of systemic lupus erythematosus--an autopsy study from north India.

Systemic lupus erythematosus (SLE) is a multisystem, autoimmune disease with varied clinical manifestations and outcome. It may prove fatal due to disease activity or intercurrent infections. In recent years, earlier diagnosis and better treatment modalities have resulted in a change in the pattern of organ involvement and mode of death in the west. This aspect of the disease is unknown in India. Hence, in this autopsy series of SLE, the organ involvement and cause of death have been studied. Twenty five cases of clinically diagnosed SLE have been analysed retrospectively. Renal involvement was invariably present (96%) with class IV being the commonest lesion in 60% cases. Disease activity was noted in 60% cases. Pleuro pulmonary lesions were seen in 92% cases with infection being the commonest. Pulmonary infections included bacterial pneumonias (13), disseminated tuberculosis (3), pulmonary mucormycosis (1) and aspergillosis (1). Massive pulmonary haemorrhage in 5 cases and acute lupus pneumonitis in one, contributed to the demise of the patient. Vasculitis was evident in single organ in 9 cases, in two or more organs in 3 cases with systemic vasculitis significantly attributing to morbidity in 1 case. Active disease was the cause of death in 60% cases and infection in 40%.