ABSTRACT
We describe a rare case of follicular dendritic cell tumour which had arisen over the background of hyaline vascular type of Castleman's disease at the mediastinal location. Constellation of histology and immunohistochemistry using CD21 antibody and non-reactivity to CD15, CD30, cytokeratin and epithelial membrane antigen helped us diagnose this case. The literature is reviewed, specially with reference to the genesis of follicular dendritic cell neoplasm at the backdrop of Castleman's disease and its clinical relevance.
Subject(s)
Adult , Lewis X Antigen/metabolism , Ki-1 Antigen/metabolism , Dendritic Cells, Follicular/pathology , Castleman Disease/etiology , Humans , Immunoenzyme Techniques , Lymphoma, Follicular/complications , Male , Mediastinal Neoplasms/etiology , Receptors, Complement 3d/metabolismABSTRACT
Intra-arterial tumour embolism after pneumonectomy is a known but rare complication. It arises because of tumour involvement of pulmonary veins. Usual outcome of this complication is grave when embolism is to a major vessel. If embolism occurs in a peripheral circulation, timely intervention can avoid significant morbidity. We report a case where embolisation occurred in both the femoral arteries. Emergency embolectomy was done successfully avoiding major complication.
Subject(s)
Acute Disease , Adenocarcinoma/surgery , Embolism/etiology , Female , Femoral Artery , Humans , Lung Neoplasms/surgery , Middle Aged , Neoplastic Cells, Circulating/pathology , Pneumonectomy/adverse effectsABSTRACT
Clinical and pathological findings in a case of aggressive angiomyxoma, a distinctive soft tissue tumour arising in the vulva of a young female are described. The neoplasm is non malignant, but locally aggressive.
Subject(s)
Adult , Female , Humans , Myxoma/pathology , Vulvar Neoplasms/pathologyABSTRACT
Four cases of gastric cancer presenting with bone pain due to metastasis as the initial symptom are reported. Investigations revealed solitary osteolytic metastasis in the mandible in one, and left scapula in one patient. Third patient had multiple osteosclerotic metastasis with elevation of acid phosphatase and another had multiple discrete osteolytic metastasis simulating multiple myeloma. All the primary gastric cancers were poorly differentiated adenocarcinoma and three were of Borrman type III on gross appearance. One patient had sparing of the liver inspite of extensive metastasis. Chemotherapy was in effective in two patients and the prognosis was uniformly poor.
Subject(s)
Adult , Aged , Bone Neoplasms/secondary , Humans , Male , Middle Aged , Stomach Neoplasms/pathologyABSTRACT
We present here our experience of laser for the management of stenosed oropharyngeal scleroma. The diagnosis of scleroma was made 14 years ago and the patient underwent repeated procedures like dilatation, diathermy excision of adhesions and cryosurgery during this period. He attended our out-patient department with complaints of dysphagia and difficulty in breathing, progressing to stridor. On examination, severe oropharyngeal stenosis due to cicatrization extending between the base of the tongue and the post-pharyngeal wall was seen. Using CO2 laser, cicatrix was released by making radial cuts and the oropharyngeal opening was widened. No tracheostomy was needed; no blood loss occurred and the patient was discharged on the next day.
Subject(s)
Cicatrix/surgery , Humans , Laser Therapy , Male , Middle Aged , Oropharynx/surgery , Rhinoscleroma/surgeryABSTRACT
BACKGROUND. Percutaneous endoscopic gastrostomy for long term enteral nutrition is often indicated in patients with head, neck and oesophageal cancer but despite its growing popularity elsewhere, it is not widely used in India. METHODS. Between March 1990 and July 1991, we performed percutaneous endoscopic gastrostomy in 54 patients. The primary sites of tumour were the hypopharynx (11), oral cavity (7), tongue (7), cricopharynx (7), oesophagus (16) and other sites (6). The indications were difficulty in swallowing following treatment (22), preoperative nutritional support (7) and terminal care (21). In 49 patients, it was performed by the 'pull' technique in the endoscopy room under local anaesthesia and mild sedation. Indigenously prepared tubes and blenderised foods were used. Fifteen patients underwent dilatation of the tumour prior to the gastrostomy. RESULTS. The procedure was successful in 50 (93%) patients. Three failures were caused by obstructing tumours and one by a previous gastric resection. Feeding was started 18 to 24 hours after the procedure in 48 patients. No major complications occurred but minor complications were seen in 11 (22%) patients. Fourteen patients had their gastrostomy tube removed after 2 to 6 months of use while 15 patients undergoing therapy or with persistent dysphagia were on gastrostomy feeds for 1 to 6 months. Of the 21 terminally ill patients, 8 died, 6 were lost to follow up and 7 were on feeds for 1 to 6 months. CONCLUSIONS. Percutaneous endoscopic gastrostomy is a simple, safe and effective method for long term enteral feeding. Indigenous tubes and home made blenderised foods are adequate substitutes for the more expensive commercial kits and enteral formulations.
Subject(s)
Adolescent , Adult , Aged , Endoscopy, Gastrointestinal/adverse effects , Enteral Nutrition/instrumentation , Esophageal Neoplasms/therapy , Evaluation Studies as Topic , Female , Gastrostomy/adverse effects , Head and Neck Neoplasms/therapy , Humans , Male , Middle AgedABSTRACT
A young Arab male, clinically suspected to have ulcerative colitis, was operated upon for fulminant intractable diarrhea with melena. The colon showed severe necrotizing and hemorrhagic colitis which was attributed to an opportunistic infection, viz cytomegalovirus infection. The patient's immunocompromised state was a consequence of AIDS, proved by ELISA and Western Blot test. He subsequently developed multiple brain abscesses and succumbed to uncontrolled infection.