Morphological Spectrum Of Malignant Renal Tumours In Different Age Groups - Case Series And Review Of Literature

Renal tumours have acquired a new face in the recent times due to the expanding list of new entities. Renal cell carcinoma are classified based on their architectural features (eg: papillary RCC ), cytoplasmic features (eg: clear cell and chromophobe renal cell carcinomas RCCs), anatomic location of tumours (eg: collecting duct and renal medullary carcinomas), and background in which they arise (eg: acquired cystic disease associated RCCs) , based on molecular changes (eg: MiTfamily translocation carcinomas and succinate dehydrogenase [SDH]–deficient renal carcinomas) or familial predisposition syndromes (eg: hereditary leiomyomatosis and RCC [HLRCC] syndrome–associated RCC). This article provides an insight into the various new entities and difficulties encountered in the diagnosis.

Correlation of Rheumatoid Factor Serotypes and Computed Tomography Findings in Rheumatoid Arthritis Related Interstitial Lung Disease

@#The most common extra-articular manifestation of rheumatoid arthritis (RA) is interstitial lung disease (ILD). RA related ILD (RA-ILD) is associated with significant morbidity and mortality. The main objective of this study was to determine the correlation between the rheumatoid factor (RF) serotypes and the severity of RA-ILD based on computed tomography (CT) findings. We recruited a total of 100 RA patients who were tested for IgA RF, IgG RF and IgM RF and had high resolution CT chest performed. Seventy-two patients had ILD changes on HRCT of the chest and were included in this study. We found that the the CT scores for ground glass showed significant positive correlation with disease duration and IgA RF levels whereas the fibrosis scores had significant relationship with multiple clinical covariates i.e age, disease duration, IgA RF levels, IgG RF levels and anti-CCP levels. On multivariate analysis, only IgA levels remained significantly (p<0.05, standardized beta coefficient = 0.604) associated with the ground glass scores. Regarding the fibrosis scores, IgA RF levels and age were independent predictors based on multivariate analysis after adjusting for confounders, with p scores of <0.05 and 0.02, respectively. In conclusion, the IgA RF was the only serotype which was independently associated with the severity of RA-ILD.

Dilemma in the Management of Ovarian Cyst in Pregnancy: A Series of Three Different Cases.

The incidence of ovarian cyst in pregnancy is increased due to ovulation induction and dating ultrasound. Mostly they are benign and managed by observation. Surgery is indicated if there are complications or any suspicion of malignancy. Here, we have presented three different cases of ovarian cyst in pregnancy, which was managed by surgery. The first case is a 27-year-old second gravida with para1 live1 with complaints of pain in right iliac fossa at 15 weeks of gestation that was diagnosed as a dermoid cyst of right ovary. She underwent laparoscopic cystectomy. Rest of the antenatal period was uneventful, and she delivered vaginally at term. The second case is 31 year old third gravida with para2 live2 came with complaints of lower abdominal pain around 14 weeks of gestation which was diagnosed as fibroma of ovary for which laparotomy and right salphingo-oophorectomy was done. Rest of the antenatal period was normal, she delivered by caesarean section at term. The third case was 30-year-old second gravid with para1 live1 with left ovarian mass presented at term for which cesarean section along with left salphingo-oophorectomy done.

Ruptured Uterus in Pregnancy: A Case Report.

Spontaneous uterine rupture in pregnancy is a rare phenomenon especially in the second trimester. When it occurs one has to suspect placenta percreta. Here we had such a case in a 32-year-old lady who had previous caesarean section for fetal distress 7 years ago. Now she got admitted with a history of 4 months of amenorrhea with severe pallor and hypotension. She did not have any uterine contraction before admission, and there is no history suggestive of any interference with the present pregnancy. On opening the abdomen, there was hemoperitoneum and an intact gestational sac was found protruding through the rent at right side of the fundus. Total abdominal hysterectomy was done, and the placenta was found to be placenta percreta, that was confi rmed by histopathological examination.

Lower Uterine Segment Fibroid Complicating Pregnancy: A Case Report.

Th e uterine fi broids are very common in the reproductive age group. During pregnancy, it may undergo rapid growth and red degeneration. It may get infected during puerperium. Most of the fi broids are asymptomatic. Women with fi broids may have infertility, a tendency for miscarriage, pre-term labor, placental abruption, placenta previa, fetal growth restrictions, fetal anomalies, postpartum hemorrhage, uterine dystocia, malpresentations and increased risk of caesarean. Here, we present 26-year-old primigravida who was admitted with 9 months of amenorrhea and anterior lower uterine segment intramural fi broid of size 7.2 cm × 7.1 cm on the right side. She conceived immediately after marriage. All Investigations were normal. She was delivered by a cesarean section. An alive female baby of 2.5 kg with good Apgar score. Th e indication was lower uterine segment fi broid. Th e liquor was meconium stained. Th ere was no sign of intrauterine growth restriction of the baby. Th e Doppler study, cardio-topography was normal before section. Th e post-operative period was uneventful. Th e patient was discharged and came for follow-up after a month and was found to be alright.

Post-evacuation cardiopulmonary distress in a case of molar pregnancy

Molar pregnancy is a gestational trophoblastic disease wherein the swollen chorionic villi grow in a way that resembles a cluster of grapes. Patients with molar pregnancies very often need anesthesia for suction evacuation. Though molar pregnancy is usually uncomplicated, few cases may be associated with perioperative complications. Various anesthetic techniques have been used for molar evacuation. We present here a case of molar pregnancy with hyperthyroidism, in which general anesthesia [GA] was administered to the patient with laryngeal mask airway. Six hours after evacuation, she went into acute cardiopulmonary distress. She was fortunate enough to be picked up early and was managed successfully

Awake rigid bronchoscopy for post intubation tracheal stenosis

Prolonged tracheal intubation is a common cause of tracheal stenosis. These patients may present with respiratory insufficiency and stridor of insidious onset and progressive nature. Immediate management includes securing the airway which requires anesthesia. We present successful management of a case of post intubation tracheal stenosis using rigid bronchoscopy under a combination of regional and general anesthesia

Inhibitory effect of cinnamoyl compounds against human malignant cell line.

In the present study, anti-proliferative effects of dietary polyphenolic compounds have been observed and demonstrated the strong anticancer efficacy of curcumin (CMN), an active constituent of dietary spice (turmeric) using human leukemia cancer cell line. CMN inhibited the proliferation of K562 leukemic cells by induction of apoptosis. The current study demonstrated synergy with combination of drug therapy, and suggested that combination of ferulic acid and cisplatin synergistically inhibited cellular proliferation. Cytotoxic synergy was observed independent of the sequence of addition of two drugs to cultured cells. The synergized growth inhibitory effect with cisplatin was probably associated with G2-M arrest in cell cycle progression. These findings suggested that among the cinnamoyl compounds, CMN was most potent and FER appeared to be a better modulating agent on human malignant cell line.

Neurodevelopmental outcome of 'at risk' nursery graduates.

A cohort study at a tertiary care neonatal service was undertaken to determine the neurodevelopmental outcome of neonates who required intensive care. One hundred and nineteen nursery graduates were enrolled for follow up if they fulfilled any of the following risk factors: birth weight less than 1500 g, Apgar score less than 4 at 5 minutes, seizure(s), and required assisted ventilation for more than 24 hours. They were subjected to periodic clinical evaluation and administered the Bayley Scales of Infant Development in early childhood. Of the total infants enrolled, 101 completed the required follow up. They included 55 infants with birth weight < 1500 g, 45 with low Apgar scores, 12 with seizure(s) and 28 who received assisted ventilation. An overwhelming majority of subjects (85%) had normal neurodevelopmental outcome. The adverse outcome in the remaining 15 included mental retardation in all, subnormal motor development in 14, microcephaly in 1, hearing loss in 2 and visual impairment in 4. Among the neonatal risk factors, seizures, sepsis and hypoxic ischemic encephalopathy had a significant association with adverse outcome. Despite serious neonatal morbidity, the early neurodevelopmental outcome of nursery graduates was reasonably good. The association of neonatal sepsis with neurodevelopmental sequelae merits a prospective evaluation.

Endodermal sinus tumour of cervix--case report.

Endodermal sinus tumor of Cervix is an extremely rare cause of vaginal bleeding. Because of its rarity and interesting features, it is reported with a brief review of literature.

Fine needle aspiration biopsy of pancreas.

Percutaneous fine needle aspiration biopsy (FNAB) were performed in 22 cases of pancreatic lesions. FNAB was done with the help of ultrasonographic guidance in 14 cases and intraoperatively in 2 cases. In rest of the cases it was done without any radiological guidance. Diagnosis was confirmed either by histopathology or exploratory laparotomy by follow-up data in rest of the cases. There was no false positive or negative diagnosis. Nuclear crowding, nuclear enlargement and prominent nucleoli were the important cytological criteria for pancreatic adenocarcinoma. Cytology smears of the islet cell tumour show round to oval monomorphic cells with central to eccentric nuclei and fine reddish granulations in cytoplasm. There was no complication following aspiration. Thus FNAB of pancreas is a relatively safe, reliable and quick technique which can be performed under ultrasound guidance.

Primary squamous cell carcinoma-in-situ of the endometrium--a case report.

A case of primary squamous cell carcinoma in situ of the endometrium is reported here. The in-situ nature of the tumor, with involvement of the surface mucosa and extension into superficial endometrial glands and its incidental association with prolapse uterus are notable features.

Identification of Helicobacter pylori by endoscopic crush cytology.

BACKGROUND: Gastric crush cytology is employed in a variety of situations including diagnosis of malignant disease and the detection of Helicobacter pylori infection. OBJECTIVE: To evaluate the usefulness of gastric crush cytology in the detection of H pylori infection. METHODS: Gastric biopsy specimens from 50 patients of gastric or duodenal peptic ulceration were studied by gastric crush cytology, histopathology, bacteriologic culture and rapid urease test and results of various methods compared. RESULTS: Thirty seven patients had H pylori demonstrable in crush smears and 28 in histopathological sections. In 15 patients, the organism was detected by cytology alone and in 6 samples by histopathology alone. There was concordance of 76% between these two morphological techniques. The organism could be cultured from 22 biopsy specimens and urease test was positive in 37 specimens. CONCLUSION: Gastric crush cytology is a useful method for detection of H pylori infection.

Malignant rhabdoid tumour of kidney. A case report.

A case of malignant rhabdoid tumour of kidney is reported. Interesting features are bony metastasis at presentation and FNAB diagnosis of metastasis.