Macrodystrophia lipomatosa: a case report.

Macrodystrophia lipomatosa is a rare congenital form of localized gigantism, characterized by an increase in all mesenchymal elements, particularly fibroadipose tissue. The areas of predilection are segments supplied by the median or plantar nerves. We report such a rare case in a thirty four year old male patient, who presented with a swelling of the right upper limb and a marked increase in the size of the right thumb, index finger and radial half of the right hand, present since birth, with progressive increase to the present size. Amputation of the right thumb and debulking of the palm was done. The specimen measured 26 x 18 x 12 cms. and the thumb alone measured 13 x 7 x 7 cm. histology revealed hypertrophy of adipose tissue in the subcutaneous compartment and infiltration into the nerve sheaths and muscles.

Pathology of placenta in HIV infection.

The spectrum of HIV pathological lesions encountered in the placenta has not been well documented in the literature. To address this issue, we examined 51 placentae of HIV positive mothers, prospectively over a one year period and compared the pathology of the cases treated with zidovudine (AZT) or nevirapine (NVP) with untreated cases. We also correlated the placental pathology with the HIV status of the neonates. The maternal to child transmission rate was 4.44%. A lower fetal / placental weight ratio was seen in normal birth weight neonates compared to low birth weight neonates. No significant gross lesions were encountered and the placental disc did not show any significant decrease in dimensions. The commonest inflammatory lesion seen was chorio-amnionitis 31.37% and the commonest non-inflammatory lesion was cytotrophoblastic hyperplasia 76.47%. There was no significant decrease in the incidence of the lesions following anti-retroviral therapy in our study, and we did not find any correlation between the incidence of placental lesions and the HIV status of the newborn.

Self inflicted, bilateral oleogranuloma of the breast: report of a bizarre case.

A 30-year-old male was admitted with bilateral painful breast enlargement of 6 months duration. There was a past history of surgery for similar bilateral swellings, which was then diagnosed as fibrocystic disease. On examination both breasts were firm to hard, tender & adherent to deeper structures. A single axillary lymph node was palpable on each side. The clinical diagnosis was sarcoma of the breast. After initial denial, the patient confessed to having injected gear oil into both the breasts,for the purpose of augmentation. He was a homosexual.