Twin reversed arterial perfusion in twin pregnancy

An interesting case of twin reversed arterial perfusion “TRAP” from a larger apparently normal pump twin with VACTERL abnormality; to smaller structurally abnormal twin in a monoamniotic monochorionic twin pregnancy resulting in fetal demise with subsequent termination of pregnancy. Defect in early embryogenesis leads to such rare multiple presentations.

Histopathological Profile of Skin Adnexal Tumours - A Three Year Experience at a Tertiary Care Centre in Manipur.

Skin adnexal tumours are a large group of benign and malignant tumours that arise from pluripotent stem cells and differentiate toward one or more adnexal structures. So, quite often they may exhibit more than one line of differentiation (hybrid tumours). Moreover, they are uncommon, clinically nonspecific, and remain a diagnostic challenge to surgeons and pathologists alike. The present study is aimed at analysing the histopathological profile of skin adnexal tumours in a hospital based population in Manipur.METHODSThe present study is a retrospective analysis conducted over a period of 3 years from January 2017 to December 2019 in the Department of Pathology, Jawaharlal Institute of Medical Sciences, Manipur, India. Specimens were fixed in formalin, paraffin embedded and stained with haematoxylin and eosin for histopathologic analysis.RESULTSA total of 34 cases of skin adnexal tumours were reported in the Department of Pathology, JNIMS, Imphal, over a period of 3 years out of which 94% (32/34) of the total cases were benign tumours and 5.88% (2/34) were malignant tumours. Tumours with hair follicle differentiation comprised the largest group (44.1%). Pilomatrixoma was the most common tumour followed by Nevus Sebaceous. Both malignant adnexal tumours were sebaceous carcinomas.CONCLUSIONSSkin adnexal tumours are uncommon tumours with most of them being benign tumours and there is a low incidence of malignant tumours. Malignant tumours although rare, need to be diagnosed accurately since they can be aggressive with distant and nodal metastasis. Histopathologic examination remains the gold standard in diagnosing these rare lesions.

Primary neurological manifestations of lung cancer--a retrospective analysis of 8 patients.

Neurological manifestations are reported in 5 to 10% of cases of lung cancer. We present a series of 216 consecutive patients of lung cancer of which 8 patients presented first with neurological manifestations without overt respiratory symptoms. The present study aimed to identify the number of patients of lung cancer presenting with primary neurological symptoms, the nature of the presentations, and the outcome of these patients among 216 patients who presented over a 2 year period in the Institute of Postgraduate Medical Education and Research, Kolkata. Out of 8 patients, 3 patients presented with seizures, 3 patients with hemiparesis and 2 patients with paraparesis. Thus, 3.7% (8/216) of patients in our series presented with a neurological manifestation. We concluded that primary neurological manifestations are rare in lung cancer. The lungs should be the first site of evaluation in a case of a cerebral metastasis with an unknown primary.

Histopathological spectrum in cutaneous leishmaniasis: a study in Oman.

Cutaneous leishmaniasis presents a spectrum of manifestations both clinically and histologically. Several previous studies have established the value of histological examination in the diagnosis of cutaneous leishmaniasis. Different reaction patterns have been reported. Forty cases of cutaneous leishmaniasis were studied in the Sultanate of Oman, with particular reference to the different histological features. Clinical features were correlated with the histological patterns. Four histological patterns were identified-1) diffuse macrophage infiltration without necrosis, 2) macrophage infiltration with necrosis. 3) early reactive granuloma and 4) established epitheloid granuloma. LD bodies were identified in 65% of cases. Epidermal features were nonspecific. Though the patterns could be correlated with the duration and the clinical type of lesion in a few cases, the correlation was not consistent.

Clinical features & HIV progression as observed longitudinally in a cohort of injecting drug users in Manipur.

Study on a cohort of injecting drug users (n = 76) was initiated in June, 1994 with the objective of documenting the clinical presentation of HIV and its progression with time. The participation in the study was voluntary. An informed consent was taken from the subjects before they were enrolled in the study. The subjects were followed up every 45 days for clinical and laboratory examination and analysis made after 27 months of the study. The study had a follow-up rate of 65 per cent. The commonest feature observed in stage I (n = 47) was persistent generalized lymphadenopathy (83%), in stage II (n = 40) was body weight loss < 10 per cent (37.5%), in stage III (n = 32) was pulmonary tuberculosis (56.3%) and in stage IV (n = 9) was cryptosporidial diarrhoea > 1 month (3 cases). Kaposi's sarcoma was detected in one subject. The median time taken for conversion from the date of seroconversion to stage III of HIV infection was observed to be 3.15 yr (95% CI = 2.98-3.58 yr). The rate of HIV progression seems to be significantly faster than that observed in industrialized countries. Age is a cofactor in the rate of progression of HIV. Tuberculosis is the commonest opportunistic infection.

Pre leukemic granulocytic sarcoma of vagina. A case report with review of literature.

Granulocytic sarcoma is an extramedullary tumor of malignant granulocytic progenitor cells, that may precede the onset of acute myeloid leukemia or appear during the leukemic manifestation or blastic crisis of chronic myeloproliferative disorders. We describe a case of granulocytic sarcoma of vagina in a 27 year old woman treated with local radiotherapy. After seven months of follow up she developed acute myeloid leukemia. The case has been presented in view of its rarity and discussed in light of the available literature.