Primary thymic mediastinal seminoma with florid granulomatous reaction.

Primary mediastinal seminomas are rare tumors. Morphologically, they can be associated with secondary changes in the form of thymic remnants, cystic change, epithelioid granulomas, abundant fibrosis, and syncytiotrophoblast like cells. Ours was an interesting case where a 17‑year‑old adolescent male presented with anterior mediastinal mass. Fine needle aspiration and trucut biopsy of the mass favored tuberculosis; however, he did not respond to antituberculosis treatment regime. He was subjected to video‑assisted thoracoscopic surgery and the histopathological examination along with supportive immunohistochemistry of the mass revealed scattered seminoma cells which were being masked by extensive granulomatous reaction. The aim of this article is to report a case of primary mediastinal thymic seminoma in a young male associated with extensive granulomatous reaction masking the neoplastic population of cells leading to erroneous diagnosis on small biopsy.

Adult‑onset Still’s disease with myocarditis and hemophagocytic lymphohistiocytosis: Rare manifestation with fatal outcome.

Adult‑onset Still’s disease (AOSD) is a rare inflammatory disorder of unknown etiology characterized by fever, evanescent pink salmon rash, arthritis, and multiorgan involvement. Here, we report an unusual manifestation of AOSD in a 40‑year‑old male who presented to our hospital with pyrexia of unknown origin and rash of 3 weeks duration. All his serological investigations and imaging studies were unremarkable. He was fulfilling clinical and laboratory criteria as per Yamaguchi for AOSD and was managed for the same. Our patient did not respond well to the treatment, had a downhill course, and succumbed to his illness. Autopsy confirmed myocarditis and florid bone marrow reactive hemophagocytosis as the cause of his death.

Frequency of impaired glucose tolerance in hypertensive patients

Objective: To determine the frequency of impaired glucose tolerance [IGT] in hypertensive patients

Design: Descriptive cross-sectional study

Place: Civil Hospital Karachi

Sample Size: Eighty patients

Duration: July 2001 to July 2002

Patients and Methods: All the hypertensive patients above 30 years of age of both sexes were included in this study. A detailed relevant history, physical examination including BP was carried out and all the base line investigations and Glucose Tolerance Test [GTT] were performed. Data of each patient were entered on a separate perfoma

Results: Eighty hypertensive patients were studied, out of these 46 [57.5%] were females and 34 [42.5%] were males. The ages of patients were between 32-80 years, mean age + SD was 55.725 + 13.364. The maximum patients were in 41-60 years of age [56.25%]. Results of this study showing that the frequency of IGT was 46.2%, prevalence of impaired fasting glucose [IFG] was 8.7% and prevalence of diabetes was 5% in these hypertensive patients

Conclusion: It is concluded hat impaired glucose tolerance is related to hypertension and other clinical and metabolic abnormalities such as obesity, smoking, hyperlipidemia and family history of DM and positive history of intake of diabetogenic antihypertensive drugs such as diuretics and beta-blockers. Hypertensive patients should be screened for glucose tolerance by OGTT on mass level for the prevention of diabetes. It is an easy and cost effective approach