Adenoid cystic carcinoma of the trachea.

Primary salivary gland ‑ type tumors of the lung and airways being unusual, they pose a diagnostic challenge on small biopsies and are usually consigned as non‑small cell lung carcinomas. Since the clinical behavior of these tumors is different from the conventional lung tumors, it is important to accurately diagnose them. Among this category of tumors, adenoid cystic carcinoma (ACC) of the lungs and airways is exceedingly rare. Few large studies and maximum case reports have been reported in literature on ACC of the lungs and trachea so far. We herein report a rare case of primary ACC of the trachea diagnosed on bronchoscopic biopsy.

Idiopathic mitral valve prolapse with tricuspid, aortic and pulmonary valve involvement: An autopsy case report.

Mitral valve prolapse (MVP) is usually asymptomatic, but can be associated with complications such as infective endocarditis, mitral regurgitation, thromboembolism and sudden cardiac death. It has been very rarely reported to occur in association with other valvular involvement. A 55-year-old male patient was brought dead and at autopsy the mitral valve orifi ce was stenotic and the leafl ets were enlarged, myxoid and bulging suggestive of MVP and chordae tendinae were thickened, stretched and elongated. Similar changes were seen in the tricuspid valve. The pulmonary and aortic valves also showed myxomatous degeneration of their cusps. Myxomatous degeneration is the most common cause of MVP and it can be associated with involvement of the other valves. Concomitant involvement of the aortic valve has been reported, however it is very rare and simultaneous involvement of the pulmonary valve has not been reported in the literature so far. We report a case of MVP associated with myxomatous degeneration of the tricuspid, pulmonary and aortic valves.

Contained cardiac rupture: An autopsy case.

Rupture of the myocardium due to myocardial infarction is often fatal but when such patients survive, they present with a pseudoaneurysm where the defect is sealed by the pericardium preventing the complete rupture. This is described as a ‘contained myocardial rupture’. We describe here a case of left ventricular contained myocardial rupture following an acute myocardial infarction.

Eosinophillic myocarditis and coronary arteritis in a fatal case of asthma.

Mortality is very unusual in the case of asthma. We recently came across a fatal case of asthma which showed a rare combination of unusual complications like eosinophilic myocarditis, coronary arteritis, biventricular cardiac hypertrophy, eosinophilic pneumonitis and pulmonary hypertension.

Papillary fibroelastoma of the heart.

Primary intra-cardiac tumors are rare. Most of them are benign. Of the benign tumors, myxomas are the most common. Others are lipoma, rhabdomyoma, hemangioma, and papillary fibroelastoma (PFE). PFE is a relatively rare benign tumor of the heart. It occurs commonly on cardiac valves and is often an incidental finding. They are most commonly discovered during autopsy, but may present with thromboembolism, which is a dreaded complication. It is important to be aware of this entity because even though it is benign it may present with life-threatening complications, which are well documented in literature. Surgery is the treatment of choice for these tumors. We present the case of a 30-year-old male in whom PFE was an incidental finding.

Mucinous adenocarcinoma of the renal pelvis with pseudomyxoma peritonei.

Mucinous adenocarcinoma of the renal pelvis is an extremely rare tumor with very few case reports in literature. Pseudomyxoma peritonei is an uncommon condition characterized by the presence of mucinous gelatinous material in the peritoneal cavity. It occurs secondary to primary mucinous neoplasms of particularly the appendix and the ovary. We present a case of a 35-year-old female who had a history of dull aching pain in the right flank since one and a half years. Upon ultrasonography (USG) and computerized tomography (CT) scan, there was a large cystic mass measuring 15x15x12 cm, extending into the right lumbar region. Grossly, the entire kidney was converted into a cystic mass measuring 15x15x12 cm containing gelatinous mucinous material weighing 1 kg. Histologically, the tumor was composed of simple and complex glandular acini together with a superficial resemblance to colonic mucosa with abundant extracellular mucin. Thus, a diagnosis of mucinous adenocarcinoma of the renal pelvis leading to pseudomyxoma peritonei was made.

Bilateral axillary apocrine nevi--a case report.

Apocrine glands are tubular glands, which function as scent glands. These are found at only a few sites like the axillae and anogenital region. They are present as modified glands in the external ear canal (ceruminous glands), in the eyelid (Moll's glands) and in the breast (mammary glands). Occasionally, apocrine glands are found on the face, in the scalp and on the abdomen where they are usually small and non-functional. Apocrine glands develop their secretory portion and become functional only at puberty. Tumours of these glands involving only apocrine tissue are very rare. We present an uncommon case of benign apocrine nevi of the axilla, which occurred bilaterally. These nevi are uncommon and only occasional reports are available in literature.

Rheumatic heart disease in the past decade: an autopsy analysis.

BACKGROUND: Rheumatic heart disease continues to be an important cardiac problem, afflicting the young population of India. Though prophylaxis and various treatment modalities are available for the valvar pathology, mortality and morbidity continue to be high. Autopsy data are scarce. METHODS AND RESULTS: This is an autopsy analysis of rheumatic heart disease as seen at a large teaching hospital over a period of 5 years in the past decade. Four hundred thirty-four cases were autopsied in a five-year period from 1993 to 1997. The majority of cases were between 16 and 40 years of age. Fifty cases showed the presence of Aschoff bodies indicating a recent attack of rheumatic carditis. One hundred seventy-eight valves were examined in detail--in 174, the mitral valve was involved. In 4 cases, only the aortic valve was affected. The mitral valve showed significant disease with a severe degree of subvalvar pathology. One hundred thirty-eight patients had already undergone some form of previous surgery and presented with valve dysfunction. Most of these patients were in the third and fourth decades of life. The most frequent cause of death in operated and unoperated cases was congestive cardiac failure. CONCLUSIONS: There is no decrease in the incidence or severity of rheumatic heart disease over a period of 25 years as seen at our institute. The pattern of the disease has changed, with patients who had a previous surgery now returning with valve dysfunction or related problems.