Renal Replacement Lipomatosis Associated with Renal Calculus-Incidentally Detected at Autopsy: A Case Report of Two Cases.

Renal replacement lipomatosis (RRL) is a rare benign condition of the kidney in which there is proliferation of fat within renal sinus, hilum and peri-renalspace, thus replacing the renal parenchyma. The pathogenesis of RRL is unknown, although it is generally associated with aging, renal atrophy, long-standing chronic urinary infections. We report two cases of RRL, one of right kidney and other left, both of them associated with kidney stones. The patients were 45 and 65 years old respectively andwere admitted with fever and pain in abdomen. Autopsy performed showed right RRL associated with staghorn calculus and pulmonary tuberculosis in the first patient and left RRL with renal calculus in the pelvis and left pyelonephritis with perinephric abscess and right sided pyelonephritis in the second patient.

Creutzfeldt-Jacob disease: An autopsy case report in tertiary care hospital.

Sporadic Creutzfeldt-Jakob disease (CJD) is the most common prion disease. It is a rare, fatal neurodegenerative disease caused by an infectious protein called prion. The diagnosis can be confirmed only by histological examination of brain tissue. Because of the transmissible nature of the disease, autopsy or brain biopsy cannot be performed at many institutions. Histology shows spongiform changes, neuronal loss, reactive astrocytic proliferation, accumulation of pathologic protein occurring in three general forms: Sporadic, familial, and acquired form, including a variant form of CJD. It clinically presents as predominantly progressive dementia with a rapid onset, myoclonus, cerebellar, pyramidal, extra pyramidal and visual signs. Occurrence of periodical spikes in electro-encephalogram, observation of cortical signal alterations in magnetic resonance imaging (MRI) studies, and detection of protein 14-3-3 in cerebrospinal fluid substantiate diagnosis. Autopsy case is presented of a 50 year old woman with progressive dementia, typical neurological symptoms, MRI findings and confirmation of CJD on histology and immunostaining.

Therapy related myelodysplastic syndrome: A case report and review of literature.

Therapy related myeloid neoplasm is directly related to previous cytotoxic chemotherapy or radiation therapy. We present a 47-year-old lady who developed therapy related myelodysplastic syndrome (MDS) 2.5 years after she received four cycles of chemotherapy and local radiation therapy for carcinoma breast. She presented with bicytopenia with trilineage dyspoiesis in the peripheral blood, bone marrow aspirate and biopsy. Fluorescent in-situ hybridization studies did not reveal any of the common abnormalities associated with MDS. A diagnosis of therapy related MDS was rendered. Different studies have shown that patients treated with alkylating agents and ionizing radiation present as MDS with a latent period of 3-10 years. Our patient developed MDS within 2.5 years of starting chemotherapy and radiotherapy and did not reveal any of the conventional cytogenetic abnormalities. It highlights the importance of simple tests like a complete blood count and peripheral blood smear examination in follow-up of the patients treated with chemotherapy.

Leiomyosarcoma of the renal pelvis.

Leiomyosarcomas are rare malignant tumors of the kidney. They may arise from the renal capsule, renal vein, renal pelvic musculature or renal parenchyma. Renal pelvis is an uncommon site of occurrence, with around 10 cases reported in the literature so far. Here we present a 60-year-old male who presented with increased urinary frequency, lower limb weakness, anorexia and weight loss. Imaging showed a right renal mass. A renal cell carcinoma was suspected clinically. A right nephrectomy was performed, which showed a large circumscribed mass in the hilar region. Histology revealed a tumor mass arising from the renal pelvis. The tumor was composed of spindle cells arranged in fascicles. Immunohistochemistry showed tumor cells to be positive for smooth muscle actin (SMA) and desmin (Des) and negative for cytokeratin (CK), HMB 45, CD117 (C-kit), and CD34. That confirmed the diagnosis of leiomyosarcoma.

Breast hamartoma associated with pregnancy--a case report.

Hamartoma of the breast is an uncommon tumor like condition constituting only 3.9 to 4.8 % of benign breast tumors. We wish to report clinical, cytological, cytological histological findings of breast hamartoma with pregnancy