Adenoid cystic carcinoma of the trachea.

Primary salivary gland ‑ type tumors of the lung and airways being unusual, they pose a diagnostic challenge on small biopsies and are usually consigned as non‑small cell lung carcinomas. Since the clinical behavior of these tumors is different from the conventional lung tumors, it is important to accurately diagnose them. Among this category of tumors, adenoid cystic carcinoma (ACC) of the lungs and airways is exceedingly rare. Few large studies and maximum case reports have been reported in literature on ACC of the lungs and trachea so far. We herein report a rare case of primary ACC of the trachea diagnosed on bronchoscopic biopsy.

Cadaveric Study of Varoations in Branching Pattern of Splenic Artery.

Introduction: Splenic artery was previously called as Lineal artery. Splenic artery is the largest branch of the celiac trunk and is the most tortuous artery in the body. Splenic artery mainly supplies spleen and gives off branches to the stomach and the pancreas. Splenic artery divides into terminal branches before entering into the hilum of the spleen which may be Magistral or Distributed type. Sometimes it may pass through the hilum without dividing and supplies the spleen. Materials and methods: The study was done on 50 embalmed cadavers during routine dissection practices for undergraduates in the dissection hall of Gandhi Medical College, Secunderabad, and from the Department of Anatomy Osmania medical college, Hyderabad, during the period of 3years.The variations in the branching pattern of the splenic artery was observed and photographed. The prime objective of the study is to compare the prevalence of variations in the branching pattern of splenic artery. Results and conclusion: The variations in the present study were almost correlated with the available literature. In some instances the left gastro epiploic artery, the posterior gastric artery and the accessory left gastric artery took origin from the interior of spleen. so care should be taken during splenectomy. Hence, the arterial blood supply of spleen is so varied that no two vascular patterns are ever the same.

Comprehensive Study of Neural Tube Defects in 1000 Foetuses with Clinical Spectrum.

Introduction: A variety of malformations are included under the description of Neural tube defects (NTDs). These are abnormalities of the embryonic neuralization process. The congenital malformations of human structure and are of great interest to anatomists, obstetricians, pediatricians and radiologists. NTDs are among the commonest and most severe disorders, affecting 0.5-2 per 1000 established pregnancies, and are second commonest group of birth defects, after congenital heart defects. A valuable contribution of this study, the neural tube defects aimed at clinical methods and refined for the prenatal diagnosis in utero. Materials and Methods: This comprehensive study was undertaken to know the incidence of detail knowledge of neural tube defects in KIMS Narketpally and KAMS & RC Hyderabad, among 1000 births during the period of two years. We found seven fetuses with neural tube defects involving brain and spinal cord. A detailed study was done emphasizing on embryology and genetic and non-genetic concepts. Results & Conclusion: The seven fetuses were stillbirths and aborted babies between 20 to 40 weeks, presented with neural tube defects (0.7%). Five fetuses were females and two fetuses were males. The spinal defects were 0.4%, cranial defects 0.2% and complete neural tube defects is 0.1%. This review article discusses the classification, clinical research and epidemiological understanding of NTDs and correlated with the available literatures.

Idiopathic mitral valve prolapse with tricuspid, aortic and pulmonary valve involvement: An autopsy case report.

Mitral valve prolapse (MVP) is usually asymptomatic, but can be associated with complications such as infective endocarditis, mitral regurgitation, thromboembolism and sudden cardiac death. It has been very rarely reported to occur in association with other valvular involvement. A 55-year-old male patient was brought dead and at autopsy the mitral valve orifi ce was stenotic and the leafl ets were enlarged, myxoid and bulging suggestive of MVP and chordae tendinae were thickened, stretched and elongated. Similar changes were seen in the tricuspid valve. The pulmonary and aortic valves also showed myxomatous degeneration of their cusps. Myxomatous degeneration is the most common cause of MVP and it can be associated with involvement of the other valves. Concomitant involvement of the aortic valve has been reported, however it is very rare and simultaneous involvement of the pulmonary valve has not been reported in the literature so far. We report a case of MVP associated with myxomatous degeneration of the tricuspid, pulmonary and aortic valves.

Contained cardiac rupture: An autopsy case.

Rupture of the myocardium due to myocardial infarction is often fatal but when such patients survive, they present with a pseudoaneurysm where the defect is sealed by the pericardium preventing the complete rupture. This is described as a ‘contained myocardial rupture’. We describe here a case of left ventricular contained myocardial rupture following an acute myocardial infarction.

Papillary fibroelastoma of the heart.

Primary intra-cardiac tumors are rare. Most of them are benign. Of the benign tumors, myxomas are the most common. Others are lipoma, rhabdomyoma, hemangioma, and papillary fibroelastoma (PFE). PFE is a relatively rare benign tumor of the heart. It occurs commonly on cardiac valves and is often an incidental finding. They are most commonly discovered during autopsy, but may present with thromboembolism, which is a dreaded complication. It is important to be aware of this entity because even though it is benign it may present with life-threatening complications, which are well documented in literature. Surgery is the treatment of choice for these tumors. We present the case of a 30-year-old male in whom PFE was an incidental finding.

Mucinous adenocarcinoma of the renal pelvis with pseudomyxoma peritonei.

Mucinous adenocarcinoma of the renal pelvis is an extremely rare tumor with very few case reports in literature. Pseudomyxoma peritonei is an uncommon condition characterized by the presence of mucinous gelatinous material in the peritoneal cavity. It occurs secondary to primary mucinous neoplasms of particularly the appendix and the ovary. We present a case of a 35-year-old female who had a history of dull aching pain in the right flank since one and a half years. Upon ultrasonography (USG) and computerized tomography (CT) scan, there was a large cystic mass measuring 15x15x12 cm, extending into the right lumbar region. Grossly, the entire kidney was converted into a cystic mass measuring 15x15x12 cm containing gelatinous mucinous material weighing 1 kg. Histologically, the tumor was composed of simple and complex glandular acini together with a superficial resemblance to colonic mucosa with abundant extracellular mucin. Thus, a diagnosis of mucinous adenocarcinoma of the renal pelvis leading to pseudomyxoma peritonei was made.

Medical autopsy: whose gain is it? An audit.

Medical audit is essential in assessing the efficacy of health care delivery system. Though autopsy services are generally looked upon indifferently and with sceptism by the clinicians, it can form an important part of the medical audit system. The aims of this study were to audit autopsies of deaths within 24 hours of hospital admission by: 1) Comparing premortem and postmortem diagnosis; 2) Comparing postmortem gross diagnosis with postmortem histopathologic diagnosis; 3) Whether deaths could be certified based on clinical judgement and autopsies avoided. The study sample was 99 autopsies. In 45% autopsies, clinical impression did not match the final cause of death. In 14.2% autopsies, final cause of death could have been given by the clinician based on his clinical judgement. In 54.5% autopsies, there was agreement between premortem and postmortem diagnosis. In 67.6% autopsies, gross findings matched with the histopathologic findings.

Bilateral axillary apocrine nevi--a case report.

Apocrine glands are tubular glands, which function as scent glands. These are found at only a few sites like the axillae and anogenital region. They are present as modified glands in the external ear canal (ceruminous glands), in the eyelid (Moll's glands) and in the breast (mammary glands). Occasionally, apocrine glands are found on the face, in the scalp and on the abdomen where they are usually small and non-functional. Apocrine glands develop their secretory portion and become functional only at puberty. Tumours of these glands involving only apocrine tissue are very rare. We present an uncommon case of benign apocrine nevi of the axilla, which occurred bilaterally. These nevi are uncommon and only occasional reports are available in literature.