Primary monophasic synovial sarcoma, a rare pulmonary mesenchymal neoplasm: report of a case with review of literature.

Synovial sarcoma is an uncommon malignant soft tissue tumour which occurs primarily in young adults. It most commonly occurs in the extremities near large joints, particularly the knee joint. Primary pulmonary synovial sarcoma has only occasionally been reported in the literature. We report a case of primary pulmonary monophasic synovial sarcoma in a 23 year old male patient presenting with recent onset of hemoptysis, cough and expectoration. Although an uncommon primary site, the characteristic histological and immunohistochemical features, and fluorescence in situ hybridization analysis for the characteristic (X;18) translocation, with thorough clinical and imaging correlation allowed a definitive diagnosis of primary pulmonary monophasic sarcoma. The mainstay of treatment for these unusual tumours remains complete surgical excision followed by adjuvant radiation and/or chemotherapy.

Proliferating trichilemmal tumour: a case report with review of literature.

Proliferating trichilemmal tumour is a solid-cystic neoplasm that shows trichilemmal differentiation similar to that of the isthmus of the hair follicle histologically characteristed by the presence of trichilemmal keratinization. Proliferating Trichilemmal Tumour (PTT) appears mainly in elderly women and is in general a solitary lesion on the scalp. Proliferating trichilemmal tumours generally have a benign clinical course, and a clinical differentiation from squamous cell carcinoma is often difficult. We report a case of PTT in a 30 year old man presenting as a solitary 10x8 cm ulcerated nodule on the scalp since 3 months clinically resembled a malignant tumour. The therapeutic approach is surgical removal with a wide clear margin.

Lymphocytic thyroiditis: a correlation of cytological grades with clinical, biochemical and ultrasound findings.

Background: Hashimoto’s thyroiditis sometimes referred to as goitrous thyroiditis is a synonym of chronic lymphocytic thyroiditis or autoimmune thyroiditis. Chronic lymphocytic thyroiditis (Hashimoto’s thyroiditis) is one of the most common cause of goiter and hypothyroidism, it is found most commonly in middle aged and young female, but can also occur in other age groups, including children. Chronic lymphocytic thyroiditis can be graded based on cytomorphology. In this study an attempt has been made to correlate the grades with clinical findings, biochemical levels and ultrasonography findings. Methods: This is a prospective study conducted on 309 patients in the Department of Pathology, Andhra Medical College, Visakhapatnam. The various parameters like patient’s clinical presentation, biochemical levels and thyroid ultrasound were studied. Fine needle aspiration of thyroid gland and grading of thyroiditis was done on smears. The grades were correlated with above parameters and the correlation indices were evaluated statistically. Chi-square tests were used for statistical correlation and p value of <0.05 was considered significant. Results: Most of the patients were females (297, 96.11%) who commonly presented with a diffuse goiter (263, 85.11%). Asymptomatic cases (193, 62.46%) and elevated TSH (194, 62.78%) were common. Most of the cases had grade I/II disease (299, 96.76%) by cytology. Conclusion: FNAC is a simple, safe and cost effective procedure and is a sensitive and specific diagnostic tool in diagnosing chronic lymphocytic thyroiditis. Cytological grading of chronic lymphocytic thyroiditis helps in assessing the severity of the disease and can predict the thyroid functional status. A combined approach of cytological grading of chronic lymphocytic thyroiditis along with ultrasonography and biochemical levels can detect subclinical hypothyroid states and provide a guide to therapy.