Ollier's disease with myelodysplastic syndrome

Ollier's disease also known as enchondromatosis is a rare skeletal disorder that is usually sporadic, non-hereditary, and characterized by abnormal bone development [skeletal dysplasia]. While this disorder may be present at birth [congenital]; it may not become apparent until early childhood with more obvious symptoms, such as deformities or improper limb growth. It carries high risk of skeletal, visceral and brain malignancy seen in approximately 25% of patients. Occurrence of Ollier's disease with myelodysplastic syndrome has never been reported in the literature. The different types of myelodysplastic syndromes are diagnosed based on certain changes in the blood cells and bone marrow characterized by one or more cytopenias despite a relatively hypercellular bone marrow. We hereby report the case of a 14 years boy who presented with painless finger swelling and hepatosplenomegaly. Radiological and bone marrow findings confirmed the diagnosis of Ollier's disease with Refractory Anemia and Excess Blasts [RAEB-1]

Patterns of pulmonary morphological lesions seen at autopsy

Chronic respiratory diseases are a group of chronic diseases affecting the airways and the other structures of the lungs. Hundreds of millions of people around the world suffer from preventable chronic respiratory diseases. Prompt investigation and diagnosis are essential to improving patient survival. The objective of this study was to observe the frequencies of different lung diseases on the basis of histopathological examination of lung tissue specimens removed at autopsy. This study was a non-interventional, cross - sectional and was conducted on 810 specimens of lungs at Pathology department of Allama Iqbal Medical College, Lahore in collaboration with the Forensic Medicine department of King Edward Medical University, Lahore. Relevant autopsy data was recorded in a proforma. The tissue specimens were fixed and processed. Paraffin sectioning was done followed by Haematoxylin and Eosin staining. The sections were then examined by a panel of consultant Histopathologists. Autopsies of 810 subjects with respiratory diseases were reviewed, and the following data were obtained: age, sex and cause of death. During a period of one year, a total of 810 lungs and hilar lymph nodes specimens from autopsy subjects were studied. Maximum numbers of cases [68.14%] were in 20 - 49 years age group. The commonest cause of death [42.96%] was tuberculosis. On microscopic examination of the sections from the lungs, there were 348 cases of tuberculosis, 324 out of 810 [40%] cases of emphysema and silicosis was present in 89 [11%] cases. Squamous metaplasia was present in 49 [6%] and Pneumonia in 4% cases. Advances in diagnostic technology have not reduced the value of autopsy and a goal directed autopsy remains a vital component for the study and evaluation of the disease process. Emphysema and tuberculosis are quite common in our population

Assisted breech delivery with transverse vaginal septum

The incidence of vaginal septum is rare. The infrequency of this anomaly makes accurate estimates of the true incidence very difficult to obtain. Diagnosis is based on careful history and examination. This is the case of a patient who presented with transverse vaginal septum in labour and breech presentation. The septum was resected and the foetus delivered normally. Careful vaginal examination should be performed in pregnant women at term before labour to detect such manageable abnormalities.

Gastric Schwannoma in a Female Patient with Pulmonary Tuberculosis — A Clinicopathological Assessment and Diagnosis

Schwannomas, or neurinomas, are generally benign, slow-growing, asymptomatic neoplasms originating from the Schwann cells of a nerve sheath. As a part of spindle cell mesenchymal tumours, schwannomas arising from the gastrointestinal tract (GIT) are unusual; however, when they occur, the most common site involved is the stomach, which represents 0.2% of all gastric tumours. We report the case of a 35-year-old female patient with a history of pulmonary tuberculosis presenting with a large palpable abdominal mass reaching up to the peritoneal cavity. The initial clinical impression was a tuberculous abdominal mass, a cyst, or a teratoma. However, intra-operative findings during a subtotal gastrectomy revealed an exophytic gastric serosal mass, which suggested a gastrointestinal stromal tumour (GIST). Post-operative histopathological findings showed a fascicular arrangement of neoplastic spindle cells with pallisading nuclei that showed intense positivity for S-100 protein, and were negative for CD117 and desmin in immunohistochemistry studies. These results confirmed the final diagnosis of a gastric schwannoma.