Primary pulmonary Hodgkin's disease: a distinct entity.

A 30-year-old lady presented with fever, dry cough and weight loss for the preceding five months. Radiological investigations revealed a solitary nodular lesion in the lingula of the left lung. Guided fine needle aspiration cytology failed to yield any diagnostic material. Bronchoscopic cytology was also not contributory. As a last resort open lung biopsy was done and a diagnosis of Hodgkin's disease was made. Hilar and pre aortic lymph node biopsies showed only reactive change. The final diagnosis was primary pulmonary Hodgkin's disease.

Holoacardius acephalus-myelecephalus.

Holoacardius acephalus is a rare anomaly occurring in twin pregnancy. This case was an amorphic monstrous mass with only lower limb buds showing five digits and no definite human form unlike those reported in the Indian literature which either showed the presence of other body parts like thorax, abdomen and head and neck structures or were totally undifferentiated. The other twin had intra uterine growth retardation. This case came to the hospital in labour. As this condition can be recognised in the antenatal period, diagnosis of this anomaly is important for better perinatal outcome.

Ovarian strumal carcinoid--report of a case that matastasized.

Ovarian teratomas are known for their ability to form a wide variety of tissues. One unusual example of this potential is the strumal carcinoid in which the thyroid tissue is found in intimate association with carcinoid tumor. Although considered as a malignant transformation of struma ovarii, it is almost always benign. We report a rare case of strumal carcionid in a 44 year old lady who had metastasis in the contralateral ovary, myometrium and lungs.

Primary papillary carcinoma in a thyroglossal duct cyst.

A rare case of primary thyroid papillary carcinoma arising in a thyroglossal duct cyst occuring in a 46 year old man is reported. The diagnosis was not suspected preoperatively. On gross examination of the excised specimen the presence of a papillary tumour in the cystic mass suggested the diagnosis which was proved histopathologically. The thyroid gland was normal on physical examination and scintigram thus ruling out the possibility of metastasis from a primary tumour in the thyroid gland.

Mast cell profile in prostatic lesions.

Mast cell profile in common prostatic lesions was analysed in this study. 17B consecutive prostatic biopsy specimens specimens were categorised broadly into nodular hyperplasia without prostatitis (101), nodular heperplasia with prostatitis (50, prostatic intraepithelial neoplasia (2) and adenocarcinoma (25). Toluidine blue stain (0.1%) was used to demonstrate the mast cells and their count was expressed per square millimeter. Mast cell count was significantly higher in the fibromuscular stroma when compared to the glandular areas in nodular hyperplasia (p < .05). The mast cell counts were very significantly lower in inflammatory lesions (p < 0.0001) probably due to degranulation. Absence or a low count was the most significant finding in adenocarcinoma irrespective of the grade of the tumour with concentration of mast cells around the tumour. This study shows the variations in mast cell distribution in commonly encountered prostatic lesions. There is paucity of such studies in the literature and the possible utility of mast cell count to differentiate malignant from benign and atypical conditions needs further evaluation.

Parathyroid cyst--a rare case report.

A rare case of parathyroid cyst in a forty six-year-old lady diagnosed clinically as solitary thyroid nodule is reported. An intra-operative diagnosis of parathyroid cyst was made which was confirmed histopathologically. The clinicopathologic aspects, diagnostic methods and treatment modalities of this unusual condition are briefly discussed.

Primary carcinoma of the fallopian tube. A clinicopathologic study.

Five cases of primary fallopian tube carcinoma were located in 30 years retrospective study (1965-1994) from the Department of Pathology, Kasturba Medical College, Mangalore, Karnataka. Abnormal vaginal bleeding was the presenting symptom in all the cases. Pelvic mass was palpable in four cases. The diagnosis was not suspected preoperatively in any case. All patients underwent surgical treatment. Laparotomy revealed the presence of a macroscopic growth in the fallopian tube which was confirmed to be adenocarcinoma histopathologically in all the cases. In three cases follow-up is available. Only one patient received postoperative radiotherapy and chemotherapy.

Unilocular cystic sebaceous lymphadenoma of the parotid gland.

Unilocular Cystic Sebaceous Lymphadenoma of the parotid gland also described as benign lymphoepithelial parotid cyst with sebaceous differentiation is an unusual tumour which histogenetically resembles Warthin's tumour. We present two such cases reported in the department of Pathology, Kasturba Medical College with review of the literature on histogenesis.

Three years assessment of multidrug therapy in multibacillary leprosy cases.

Analysis of Bacteriological Index (BI) of 584 multibacillary leprosy patients who had completed multidrug therapy (MDT) as per the recommendations of World Health Organization (WHO) and Indian Association of Leprologists (IAL) showed smear conversion rates of 56% at 24 doses and 66% at 36 doses. Taking BI as a parameter of judgement, the results indicate distinct improvement over the performance achieved through dapsone monotherapy during earlier period. IAL regimen consisting of daily initial administration of rifampicin for 21 days did not show any distinct advantage over WHO regimen. Bacteriological decline was uniformally noticeable in all patients though in cases with high initial BI, smear conversion rate was much less. All the six patients with BI more than 5, and 59 patients (70%) with BI 1 to 4.9 and 87 patients (64%) with BI 3 to 3.9 have not been rendered negative even after three years of treatment. On the contrary seventeen patients whose skin smears were still positive after receiving 24 supervised doses became bacteriologically negative subsequently, and remained so though chemotherapy was stopped. Such studies on large number of patients for a longer period is essential to establish whether chemotherapy should necessarily be continued up to the point of negativity.