Idiopathic Granulomatous Mastitis-A Case Report.

Idiopathic granulomatous mastitis (IGM) is an uncommon and curious condition of unknown etiology. However, its association with the use of oral contraceptive pills, autoimmune disorders, hyperprolactinaemia and Corynebacterium species has been proposed. It occurs in young parous women and presents as a firm tender lump that may be mistaken for carcinoma. Histopathologically proven IGM initially show breast masses which were suspected of having breast carcinoma. So, detailed histopathological examination of the cases which are suspected as carcinoma is mandatory. We present a case of painless breast lump with radiological suspicion of malignancy and diagnosed as Idiopathic Granulomatous mastitis without any underlying cause. Correct diagnosis requires the exclusion of infectious etiologies, other causes of granulomatous mastitis and malignancy combined with definitive histopathological confirmation.

Role of automated urine analyser in the diagnosis of urinary tract infection.

Aim: Although urine culture is used as the reference standard to determine presence or absence of urinary tract infection (UTI), culture is an expensive and time-consuming method. The objectives of the study were to compare automated dipstick urinalysis with microscopic urinalysis and form an algorithm to reduce time and labour of the pathologist and faster initiation of treatment to the patient. Method: 500 morning urine samples were analysed by using automated dipstick analyser( Cobas u 411) and those samples showing abnormal results were subjected to microscopy. Leucocyte esterase and nitrite positivity were taken into consideration as predictive indicators of UTI. Result: 34% of the samples showed abnormal results on automated urine analyser. Total 28% samples showed positive results for leucocytes, nitrite, protein and RBC’s were sent for urine culture. 5% samples grossly turbid were sent for culture. Conclusion: Automated urinalysis method can be used for the rapid diagnosis of UTI. The algorithm presented in this study will guide the pathologist to decide when culture should be advised after urinalysis. Urine culture is an expensive test for routine use and should not be applied unless the result of nitrite, leukocyte or RBC’s are positive on automated dipstick/ microscopic examination.

Sarcomatous transformation in a conventional Giant cell tumour of femur.

Although giant cell tumour (GCT) is seen quite frequently, malignant giant cell tumour (MGCT) is a rare entity occurring in less than 1% of patients with GCT. It can develop as a primary (de novo) or a secondary form. Secondary malignant giant cell tumour occurs as a result of previous attempts at local control of a benign GCT i.e. post-surgical or post-irradiation. Malignant transformation has been very rarely reported in patients with GCT who have not received radiation treatment. We report a rare case of sarcomatous transformation in a benign giant cell tumour occurring six years after the primary surgery for GCT and without radiotherapy. This report of malignant spindle cell transformation of a conventional GCT of bone strengths the theory that there is a mesenchymal cell line in GCT which can spontaneously transform into sarcoma. The prognosis of such patients is poor because the malignancies are usually high grade sarcomas. Key Messages: Although giant cell tumour (GCT) is seen quite frequently, malignant giant cell tumour (MGCT) is a rare entity occurring in less than 1% of patients with GCT. It can develop as a primary (de novo) or a secondary form. The prognosis of such patients is poor because the malignancies are usually high grade sarcomas.