Pure red cell aplasia--report of 11 cases from eastern Nepal.

There were eleven cases of pure red cell aplasia diagnosed over a period of 2 years (January 2000-December 2001). All the patients had anemia with pallor and weakness being the presenting complaints. Hematological profile depicted normocytic normochromic anemia, reticulocytopenia and marked paucity of erythroid precursors on bone marrow aspiration and biopsy studies. In the present study, one case was of congenital pure red cell aplasia, in one other case of pyrexia of unknown origin, no definitive diagnosis could be made. Other associated diseases seen with pure red cell aplasia were thymoma, septicemia, protein energy malnutrition, non-Hodgkin's lymphoma, juvenile rheumatoid arthritis, acute myeloid leukemia, tuberculosis and hepatitis C. The association of pure red cell aplasia with haematologic malignancies is rare. There are very few case reports on pure red cell aplasia with hepatitis C.

Microcystic papillary adenoma of the nose: a case report.

Microcystic papillary adenoma of nose is rarely seen in nose. This case is reported because of its rarity and to best our knowledge is a first case report from Nepal.

Incidence of pelvic and extrapelvic endometriosis in Eastern region of Nepal.

Endometriosis is described as the presence of endometrial glands or stroma in abnormal locations outside the uterus. It afflicts 10% women of childbearing age. A 5-year retrospective analysis of histopathologically proven cases of endometriosis was done. Haematoxylin and Eosin stained slides were reviewed for type of lining epithelium, endometrial glands, stroma, fresh and old hemorrhage & inflammatory cells. Clinical details were analyzed. Age of the patient ranged from 22 - 48 years. The most common site of endometriosis was ovaries (69.23%) followed by scars (11.43%), cervix (7.69%), fallopian tube (3.84%), vagina (3.84%) and appendix (3.84%) in descending order of frequency. Most common symptom was pain. On ultrasound and X-ray diagnosis could not be made in any case. Clinically endometriosis was diagnosed in 9 (34.62%) cases. On histopathological examination majority of the cases (42.3%) had endometrial glands, stroma and hemosiderin laden macrophages. 3 cases (11.43%) had endometrial lining epithelium and stroma only, which on laproscopy also were diagnosed to have endometriosis. It was concluded that high rate of surgical excision of organs were done because of misdiagnosis.

Morphometric study of lymphoid cells in mycosis fungoides and its simulators.

The distinction of early stages of mycosis fungoides from benign lymphoid disorders of skin is difficult by conventional histological techniques. We studied 10 cases of mycosis fungoides, 10 cases of large plaque parapsoriasis, 10 cases of other benign lymphoid disorders of skin and 5 cases of lymph nodes. Nuclear area, perimeter of the nucleus, nuclear contour index, cytoplasmic area, form factor and nuclear cytoplasmic ratio as well as DNA-ploidy were determined by image analysis. There were statistically significant difference (P value < 0.05) between all parameters except nuclear cytoplasmic ratio of the lymphoid cells of Mycosis Fungoides and benign lymphoid disorders of skin. Aneuploidy was found in 50% cases of Mycosis Fungoides. Histopathological parameters like epidermotropism pautrier micro-abscess and atypical lymphocytic infiltrate in both epidermis and dermis were more marked in aneuploid than diploid cases. So, the determination of nuclear contour index and DNA-ploidy is of importance to differentiate between Mycosis Fungoides and benign lymphoid disorders of skin.