Histopathological spectrum of disorders of sexual development: a case series of seven cases

Disorders of sexual development (DSD) refer to cases in which there is a discordance among at least two of the following; genetic sex, gonadal sex, genital tract sex and phenotypic sex. DSDs are quite rare with reported incidence varying from 1 in 4,500 to 1 in 5,500. Ovotesticular disorder is amongst the rarest variety of DSD comprising only to 3-10% of all cases of DSD with only 500 cases reported till now worldwide. Frequency of MRKH syndrome is 1 in 4,500 cases and is the cause of amenorrhoea in 15% of cases of primary amenorrhoea. Authors present a case series of seven cases of DSDs with three cases diagnosed as androgen insensitivity syndrome, two cases of true ovotesticular DSD (true hermaphrodite), one case each of mixed gonadal dysgenesis and Mayer-Rokitansky-Kuster Hauser (MRKH) syndrome. Authors received the histopathology specimen of these cases in this department which was extensively sampled to study the gonads and the other derivatives of Mullerian and Wolffian duct and to rule out presence of any malignancy.

Coexisting Pathology Of Ectopic Pregnancy And Dermoid Cyst: An Uncommon Occurrence

Mature cystic teratomas (dermoid cysts) are common benign ovarian neoplasms. About 10% of dermoid cysts are detected during pregnancy. Multiple gynecologic pathologies occurring together are uncommon, and both an ectopic pregnancy and dermoid cyst are seen concurrently being unknown and poorly documented. Here, we report a case of ectopic pregnancy and dermoid cyst occurring simultaneously in a 30-year-old woman

Pathology of thyroid in acquired immunodeficiency syndrome.

Background: The course of human immunodeficiency virus infection and the acquired immunodeficiency syndrome can be complicated by a variety of endocrine abnormalities, including abnormalities of thyroid gland. Materials and Methods: This study was designed to understand the spectrum of pathology of thyroid in Indian patients with AIDS. The present study describes the findings of retrospective autopsy findings of 158 patients with AIDS which revealed infectious diseases from a time period before the use of highly active antiretroviral regimen. Results: A wide range of bacterial, fungal, and viral infections were observed. Tuberculosis was recorded in 14 (09%) patients, Cryptococcus neoformans in 11 (7%) patients and cytomegalovirus in 3 (2%) patients. Hashimoto’s thyroiditis and lymphocytic thyroiditis were seen in 02 (01%) patients each. One patient had dual infection comprising of tuberculosis and cytomegalovirus infection. The other microscopic findings observed were goiter (2 patients), interstitial fibrosis in thyroid (7 patients), and calcification in thyroid (8 patients). Conclusions: Abnormalities of thyroid are uncommon findings in patients with HIV infection however several case reports of thyroid involvement by infectious agents and neoplasm are described in these patients; hence patients with HIV infection should be closely followed up for development of goiter or abnormalities of thyroid functions.

Ectopic Pregnancy Complicating Tuberculous Salpingitis.

Genital tuberculosis contributes to infertility in a significant proportion of females in developing countries. Although tuberculous salpingitis is not infrequent, it is rarely associated with pregnancy. We present here a case of special interest and rarity of a 27 year old female presenting with ruptured tubal ectopic pregnancy complicating tuberculous salpingitis.

Fine-needle aspiration cytology of pleomorphic adenoma: cytologic variations and diagnostic pitfalls: a report of two cases.

Introduction: Fine-needle aspiration cytology (FNAC) of the salivary gland is a sensitive and specific technique used in the diagnosis of lesions of the salivary gland. On FNA, adequately cellular aspirates make distinction easy in most cases. However, sparse cellularity makes diagnosis difficult partly due to lack of observer familiarity with the different patterns. The diagnosis of pleomorphic adenoma (PA) can be made accurately but this common salivary gland neoplasm can be diagnostically challenging, causing pitfalls in cytodiagnosis. Material And Methods: A 26-year-old male presented with a firm, painless, mobile slowly-growing mass in the right preauricular region of three years duration. Fine needle aspiration (FNA) was done. A diagnosis of pleomorphic adenoma suspicious of malignancy was given due to the presence of isolated squamous cells, occasional cluster of basaloid cells, occasional giant cells and hyaline globules. Histology confirmed a pleomorphic adenoma with marked squamous metaplasia and keratin cyst formation without evidence of malignancy. A 52-year-old male presented with a firm, painless, mass in the right preauricular region of five months duration. FNAC smears were cellular and showed a hemorrhagic background. Numerous single anucleate and nucleate squamous cells, myoepithelial cell clusters and epithelial cell aggregates were seen. Few foamy cells, giant cells and hyaline globules were noted. Characteristic metachromatic fibrillary chondromyxoid stroma which is usually seen in pleomorphic adenoma was absent. A diagnosis of pleomorphic adenoma suspicious of malignancy was given. The patient was lost to follow up and hence details regarding the histopathological status of his preauricular swelling were not known. Results: Here we illustrate that PA with squamous metaplasia, basaloid cells and hyaline globules can be misinterpreted as carcinoma on cytology and discuss the various pitfalls of cytology. Conclusion: FNAC is a good pre-operative procedure for the diagnosis of PA. One should be aware of the cytological variations to avoid diagnostic errors. When one is uncertain about classification of a salivary gland tumour the cytopathologist should leave the diagnosis open with a few suggested differential diagnoses rather than issuing a misleading report.

Right atrial appendage thrombus with atrial infarct in a case of thyrotoxicosis: An autopsy report.

Cardiac function has long been known to be altered in patients with thyrotoxicosis and atrial fibrillation occurs in patients with hyperthyroidism. In addition to its disabling symptoms, atrial fibrillation is a strong risk factor for systemic embolism, especially with regard to cerebral circulation. A right atrial appendage thrombus formation in atrial fibrillation is a rare phenomenon. In this report, we describe a case of a 30-year-old female, who suffered from hyperthyroidism and subsequently developed atrial fibrillation and a right atrial appendage thrombus with infarction of right atrial appendage.

Primary malignant melanoma of the mediastinum.

Primary malignant melanoma of mediastinum is extremely rare. Skin is the most common site for primary melanoma. However, it can occur at other sites like eye, oronasal mucosa and anorectal junction where melanin cells reside. Literature reveals primary melanomas in the oral cavity, oesophagus, gall bladder, uterus, genitourinary tract, meninges and thorax. We present a case report of a 32 years woman who presented with an anterior mediastinal melanoma.

Anaplastic thyroid carcinoma with osteoclast-like giant cells.

A case of anaplastic thyroid carcinoma with osteoclast-like giant cells is reported. This is an unusual malignant thyroid neoplasm with morphologic resemblance to giant cell tumor of bone. Light microscopy disclosed an undifferentiated carcinoma. Pleomorphic cells and tumour giant cells were accompanied by numerous osteoclast-like multinucleated giant cells.