Wandering Spleen Presenting As Gastric Mass: A Rare Case

Wandering or ectopic spleen is a rare condition in which spleen is located outside its normal location. Wandering spleen is an incidental finding with a reported incidence of <0.2%, fewer than 500 cases reported worldwide in literature. It presents as a diagnostic challenge as it can easily mimic a neoplastic mass, an abscess, or an organized hematoma. Ultrasonography and contrast tomography are useful radiological methods in the diagnosis of wandering spleen. We report here autopsy case of a 51-year-old male with wandering spleen in gastric wall diagnosed on histopathology but presented as gastric mass mimicking malignancy. This case highlights the importance of radiology and histopathology in the diagnosis of an ectopic spleen. In the absence of spleen on radiology at a normal site and with a presence of intra-abdominal mass, the clinician should keep in mind ectopic spleen as a differential diagnosis

Pathologic lesions in children with acquired immunodeficiency syndrome an autopsy study of 11 cases from Mumbai, India.

Background: Human immunodeficiency virus (HIV) infection in India has now been prevalent over three decades, and an increasing number of children are being affected with HIV. The spectrum of pathologic lesions in children with acquired immunodeficiency syndrome (AIDS) in India has not been well described. Materials and Methods: A review of systematically conducted autopsies of 11 (10 boys and 1 girl) children with AIDS is presented. Results: The mode of HIV transmission in 6 children was vertical; in one it was blood transfusion and in 4 children route was presumably vertical as these were children of orphanage. The clinical manifestations were failure to thrive; 9 children, persistent gastroenteritis; 8, recurrent fever; 5, bacterial infections; 5, hepatosplenomegaly; 5, candidiasis; 1, scabies; 1, skin rash; 2, tuberculous (TB) meningitis; 1 and paraplegia; in 1 child. The spectrum of pathologic lesions observed were precocious involution in thymus in 3 and dysinvolution in 2 cases. Infectious diseases comprised of TB; 4 cases, cytomegalovirus infection (CMV) 4; bacterial pneumonia and meningitis; 7, and esophageal candidiasis in 2 cases. Dual or multiple infections were observed in 9 (82%) cases; these comprised of two lesions in 2, three lesions in 2, four lesions in 4, and five lesions in 1 case. TB, bacterial pneumonia, meningitis, and CMV infection are the most frequent causes of death in children with AIDS. Vascular lesions showing features of arteriopathy were observed in 5 cases and brain in one case showed non‑Hodgkin’s lymphoma. Conclusions: This study provides a better insight into the spectrum of pathologic lesions in children with AIDS in India. TB and CMV infection has been found to be the most prevalent infection in our children.

Cutaneous myxoma: An important clue to Carney complex.

A 22-year-old male became unconscious and was found to have left-sided weakness and facial asymmetry. Previously, he had up to 35 excisions for subcutaneous swellings all over the body, commencing at age 6 years. Examination revealed small nodular skin lesions on the neck, the eyelid and hard palate. Two-dimensional echocardiography showed two left atrial masses. Histopathological examination of the subcutaneous lesions showed cutaneous myxomas with a prominent epithelial component. The left atrial masses were also myxomas. The case attempts to highlight the importance of histopathological examination of subcutaneous swellings. Cutaneous and subcutaneous manifestations, including cutaneous myxomas, are among the earliest presentations in Carney’s complex and may herald potentially fatal cardiac myxoma. The prominent epithelial component in cutaneous myxomas may be confusing and cause diagnostic difficulties.