Isolated giant ileal neurofibroma sans neurofibromatosis

Neurofibromas are benign neoplasms that are usually seen in hereditary disorders such as von Recklinghausen's disease [neurofibromatosis type 1 (NF1)]. The occurrence of isolated ileal neurofibroma in patients without the classic manifestations of NF1 or multiple endocrine neoplasia (MEN) syndromes is an extremely rare entity . We report one such case of isolated ileal neurofibroma in a 60 year old woman without any other stigmata of NF. It may be the initial manifestation of NF1 or MEN 2b or malignant transformation, all of which necessitate further follow-up of these patients.

Death Due to Low Voltage Electric Shock Induced Myocarditis

Low voltage electric shock resulting in myocarditis induced delayed death is a rarity and has not been reported so far, to the best of our knowledge. The definitive diagnosis is autopsy based as it has variable clinical presentations. We report such a case where in the histopathologic findings of myocarditis came as a surprise during microscopic evaluation of the autopsy sections in a case with an apparently normal heart on gross examination. The present case mandates a careful microscopic examination of autopsy sections in cases of electrocution.

Relative value of immunohistochemistry in detection of mycobacterial antigen in suspected cases of tuberculosis in tissue sections.

Background: The diagnosis of tuberculosis (TB) depends on identifi cation of the infecting organism. The diagnosis presents as a challenge due to its diverse clinical presentation and low yield of acid-fast bacilli (AFB) in tissue sections. Aim: The aim of the present study is immunohistochemical localization of tubercle bacilli or their components that persist in the granulomas, but have lost the property of staining with acid-fast stain, assess the advantage of immunostaining over conventional Ziehl–Neelsen (ZN) staining and further to study the staining pattern on immunohistochemistry (IHC). Materials and Methods: The study population comprised 100 suspected cases of TB. Tissue sections from these were subjected to hematoxylin and eosin, ZN and IHC staining using polyclonal antibody to Mycobacterium tuberculosis followed by a comparative analysis of the results. Cases of lepromatous leprosy were used as a positive control. Results: Acid-fast bacilli were identifi ed by ZN stain in 23% of cases. IHC identifi ed 72% cases. In the present study, IHC had higher sensitivity (95.56%) and negative predictive value (96.43%), but lower specifi city (35.06%) and positive predictive value (30.56%) than ZN stain which had the sensitivity, specifi city, positive predictive value and negative predictive values of 30.56%, 96.43%, 95.65% and 41.56% respectively. Conclusion: Immunohistochemistry is a simple and sensitive technique for localization of tubercle bacilli and their components on tissue sections. It can be easily incorporated in routine histopathology laboratory and serve as an effi cient diagnostic adjunct to conventional ZN staining. This will help reduce the practice of prescribing empirical antitubercular treatment based on clinical suspicion alone.

Right Atrial Myxoma Complicated by Pulmonary Thromboembolism: A Case Report and Review of Literature.

Primary cardiac tumors are rare with myxoma being the most common benign cardiac tumor. They are usually sporadic, affecting left atrium and frequently occur in women. They are known to cause valvular obstruction, thromboembolism and arrhythmias. We present a case of right atrial myxoma complicated by pulmonary embolism. The atrial myxoma was diagnosed on autopsy.

Clinicopathological study of dermolipoma--a report of four cases.

Dermolipomas are congenital solid choristomas usually located in the superotemporal fornix, near the lacrimal gland and lateral rectus muscle. Retrospective analysis of four consecutive cases of dermolipoma reported between Jan 1994 and July 2005 was done. Three cases were males and one was female and in all the cases swelling was first noted in the early childhood. Histologically they show squamous epithelium lined tissue containing mature adipose tissue in addition to bundles of dense collagen and adnexal structures which were present in all our cases. Surgical excision of dermolipoma is conservative and confined to the irritating dermal surface or the visible portion of the lesion.

Langerhans cell histiocytosis of skin: a clinicopathologic analysis of five cases.

BACKGROUND AND AIMS: Langerhans cell histiocytosis (LCH) is a rare proliferative disorder of histiocytes characterized by a proliferation of abnormal and clonal Langerhans cells. We retrospectively studied clinicopathologic features of this disorder in five cases. METHODS: Clinical and histopathological findings of five cases of cutaneous LCH were reviewed based on the hospital records. RESULTS: The age of patients ranged from 28 days to 5 years and M: F ratio was 1:1.5. Clinically, the diagnoses suggested were histiocytosis, varicella, transient neonatal pustular melanosis, keloid, sarcoidosis, seborrheic keratosis and LCH. The most common type of skin lesion was a generalized papular lesion. Histologically, all cases showed aggregates of large mononuclear histiocytes (Langerhans cells) with reniform, irregular, cleaved nuclei and abundant eosinophilic cytoplasm. There was multi-systemic involvement in two patients and single-system involvement in three patients. CONCLUSION: Cutaneous lesions may be the sole presenting feature of LCH. Diagnosis is based on demonstration of S-100 positive histiocytes.

FNAC in a case of NHL presenting initially as nodal infarction.

Lymph node infarction is rare and can occur in either nonneoplastic or neoplastic conditions. Fine needle aspiration cytology (FNAC) of infarction preceding lymphoma has not been described earlier. A 26-year-old male, was referred to the cytology laboratory for FNAC of bilateral axillary lymph nodes. FNA smears showed uniform looking ghost cells. There were no viable cells. A biopsy was advised which also showed extensive coagulative necrosis. Five weeks later, right cervical lymph nodes also appeared and FNA smears showed discrete monomorphic population of immature lymphoid cells. A cytologic diagnosis of infarction in a case of non-Hodgkin's lymphoma (NHL) was made and subsequently confirmed by histopathologic examination. Our case indicates that such cases should be followed up closely and repeated aspirations should be done to prevent a delayed diagnosis of lymphoma.

Subcutaneous angiolipomas: a clinicopathological study of 12 cases.

A total of 12 cases of angiolipomas were received over a period of 2 years and comprised 13% of all lipomatous tumors. There were eleven males and one female. Pain/tenderness was the presenting feature in 11 of the cases and in all the cases, the tumors were located on upper extremities or trunk. Grossly, the tumors were encapsulated and histologic examination revealed fibrin thrombi in many capillaries, in all cases. None of these tumors were infiltrating into the surrounding skeletal muscle or soft tissue.

Gastrointestinal stromal tumour of the colon presenting with intestinal obstruction.

Gastrointestinal Stromal Tumours are the commonest mesenchymal tumors of the gastrointestinal tract, the stomach and small intestine being the favored sites. They rarely occur in the colon and rectum and esophagus. The diagnosis is difficult, especially in the rarer sites, since there are no pathognomic features to suggest GIST on preoperative clinical examination and investigations, and only a detailed histopathological analysis of the specimen reveals their true nature. The case of a young female patient who presented with intestinal obstruction due a GIST of the transverse colon is reported. The relevant literature is briefly reviewed.

Recurrent diffuse lipomatosis of the neck--a case report.

Diffuse lipomatosis is a rare disorder of adipose tissue occurring in young people . It has a predilection for trunk and proximal extremities where it presents as poorly circumscribed overgrowth of fatty tissue. Definite diagnosis is established by histological examination of tumor. Though it attains extensive size and has a high tendency to recur, the clinical course is benign.

Peripheral nerve sheath tumours--a short series with some uncommon variants.

Peripheral nerve sheath tumours are rarely malignant (0.001%), such malignant peripheral nerve sheath tumours (MPNST) are more common in upper extremities than in head and neck. Chondroid differentiation in benign peripheral nerve sheath tumours and melanotic schwannoma are very uncommon. In a retrospective analysis of 25 peripheral nerve sheath tumours over a period of two years, we reported two MPNST one of which was in a parapharyngeal location while the other MPNST showed melanotic differentiation. Similar melanotic differentiation was also seen in another benign melanotic schwannoma. Chondroid differentiation in a schwannoma was also observed which is usually documented in MPNST.

Xanthogranulomatous oophoritis and salpingitis: late sequelae of inadequately treated staphylococcal PID.

We describe the case of a 42-year-old woman who was a follow-up case of incompletely treated pelvic inflammatory disease, and presented with menorrhagia and bilateral ovarian masses. Subtotal hysterectomy with bilateral salpingo-oophorectomy was performed. Purulent material was obtained from the cystic masses, which grew Staphylococcus aureus. Histological examination of right-sided cystic mass revealed a simple cyst of the ovary. Left sided tuboovarian mass revealed the presence of lipid filled macrophages with lymphocytes, plasma cells and neutrophils; this established the diagnosis of xanthogranulomatous salpingitis and oophoritis. The case is of interest in view of the rarity of this condition; five cases of xanthogranulomatous salpingitis and oophoritis have been reported in the world literature till date.