Unusual clinical presentation and complications following preoperative embolization of a large adrenal tumor

Authors present a case of a young female presenting with secondary amenorrhea which on further investigation revealed a large intra-abdominal mass, likely arising from the left adrenal gland. As the tumor was highly vascular with large feeders, she was referred for pre-operative embolization to reduce the blood loss during surgery. Post embolization, the patient suffered from an unusual complication of tumor rupture along with excessive secretion of catecholamines resulting in myocarditis and myocardial infarction. Patient ultimately died of the myocardial infarction. Preoperative embolization of a large, hypervascular adrenal mass lesion is not devoid of unusual complications like tumor rupture and subsequent cardiovascular complications even if the tumor is hormonally inactive. This complication is extremely rare and has never been reported in adrenal tumors after embolization.

An Unusual Anomaly Of Deep Venous System In The Lower Limb: Complete Unilateral Agenesis Of Iliofemoral Veins In The Absence Of Persistent Sciatic Vein

Venous anomalies are the most common congenital vascular anomalies. The rarest of these is complete deep venous agenesis. Here, we report a case of a 15-year-old male patient evaluated on color Doppler and computed tomographic venogram with complete right iliofemoral deep venous agenesis with the inferior vena cava continuing as the left common iliac vein and the right popliteal vein draining into superficial anomalous veins of the thigh. These superficial veins were seen to drain through a superficial suprapubic arcuate connector vein into the dilated left common femoral vein. Uniquely in our case, there was no persistent embryonic sciatic vein and no demonstrable reflux into the superficial connector vein, suggesting an uncommon embryological mechanism underlying its pathogenesis. Surgical resection of the dilated superficial veins is absolutely contraindicated in cases of deep venous agenesis and hence accurate diagnosis by the radiologist is absolutely essential in such cases

Histopathological Findings in Spleen on Autopsy—A Study of 100 Cases

Background: Autopsies are carried out to establish the identity, cause of death, time of death, and antemortem orpostmortem nature of death. These help in establishing the cause of death and ascertain the disease process which led to death. It provides the opportunity to discover new diseases, to evaluate toxic effects of drugs and therapies. The spleen is the site of direct and indirect toxicity, a target for some carcinogens, and also a site for metastatic neoplasia. Many systemic or generalized diseases have splenic involvement. Methods: The present study was conducted on 100 specimens of spleen on routine autopsies received in the department of pathology, Government Medical College, Patiala, Punjab to find out the frequency of various lesions in spleen on autopsy. All the histological sections were stained in H & E stain, mounted ,examined microscopically & findings were recorded and tabulated. Results: 80 of the 100 autopsies were males, while 20 were females. In 81 (81%) cases, the microscopic findings were congestion, hemorrhage in 8 cases(8%) ,7 cases (7%) had autolytic changes,1 case(1%) had necrosis, granulomatous pathology were seen in 2 cases (2%) and 1 case (1%) had leukemic infiltration. Conclusion: Despite recent advances in diagnostic technology, there is large number of cases of preventable diseases for which the autopsy has remained an important complementary tool for identifying.

Study of Adverse Donor Reaction of Plateletpheresis in a Tertiary Care Centre of North India

Background: Plateletpheresis is a lifesaving procedure in preventing and treating serious complications from bleeding and haemorrhage in patients having disorders manifesting as thrombocytopenia like in dengue patients, ITP, aplastic anemia and chemotherapy for leukaemia. Methods: In this study 100 healthy voluntary donors were enrolled after taking the informed written consent and adverse donor reactions of plateletpheresis were noted. Results: It was observed that out of 100 donors, only two donors had adverse effects during plateletphersis. Citrate toxicity was seen in one donor (1%) and one donor (1%) had bruising on the arm at venipuncture site during phlebotomy. Conclusion: Plateletphersis is one of the safest procedure in which adverse effects were managed conservatively and rarely donor need hospitalisation.

A Study of Comprasion of Conventional Cytology with Liquid Based Cytology of Thyroid FNAC – A Study of 100 Cases

Background: Fine Needle Aspiration (FNA) cytology of the thyroid has been increasingly utilized for the investigation of thyroid lesions. FNA of the thyroid gland is considered to be most cost effective and accurate primary diagnostic procedure for thyroid nodules. In the recent years many approaches has been devised to improve the quality of thyroid FNA cytology because the conventional smear (CS) is subject to error in sample collection and slide preparation. The liquid based cytology (LBC) originally developed for the application of gynaecologic cervical smears, has progressively gained for application of both non gynaecologic and fine needle aspiration cytological material. According to the Wilcoxon signed ranked test for thyroid lesions LBC was not useful in goitre and infectious lesions. It gave better results in anaplastic and medullary carcinoma. So conventional smear is more sensitive, specific and accurate than LBC. Methods: in this prospective study, we had 100 cases of thyroid. In each case, two passes were performed. The first pass was for CS and the second pass yielded material for LBC. Both CS and LBC smears were compared for cellularity, background blood and necrotic cell debris, cell architecture, informative background, presence of a monolayer of cells and nuclear and cytoplasmic details and test on an for statistical analysis. Results: Diagnostic accuracy was better in CS compared withLBC smears as CS was most sensitive (93.18%) and accurate (91.75%) method for analysis of thyroid while LBC method is sensitive (89.04%) and accuracy (86.59%).Conclusion: Conventional smear is more sensitive, specific and accurate than LBC because LBC introduce more cytological artifacts to thyroid aspirates.

Squamous Cell carcinoma (Moderately Differentiated) of Conjunctiva – A Rare Case in a Five Year Retrospective Study.

Worldwide squamous cell carcinoma (SCC) of the conjunctiva is a rare malignancy; however, it is reported to be the most common malignant tumour of the ocular surface. Its incidence varies between 0.02 and 3.5/100.000. We report a case of squamous cell carcinoma of conjunctiva presented with triangular pedunculated mass of left eye of 75 years old female. It is diagnosed on FNAC and confirmed on histopathological examination after excision. On analyzing the data of FNA done (19150) and biopsies received (23158) in 5 years in the department of pathology, we found only five cases of eye region came for FNA while 25 biopsies of eye region received and diagnosed rightly. Out of all these cases, this is the only case of squamous cell carcinoma of conjunctiva in this study. Incidence of SCC of conjunctiva in our retrospective study of data of total pathological biopsies received found to be 4.3/100000.