Primary endometrial squamous cell carcinoma with extensive squamous metaplasia and dysplasia.

Primary squamous cell carcinoma of endometrium is a rare entity. Only 64 cases have been documented in the literature. We report a case of 60-year-old postmenopausal woman who presented with abdominal distention and blood-stained vaginal discharge for 6-7 months. Clinically, chronic pyometra was considered. Total abdominal hysterectomy was performed and histopathologically, it was diagnosed as a case of primary squamous cell carcinoma of endometrium with extensive squamous metaplasia and dysplasia.

Premalignant lesions of prostate and their association with nodular hyperplasia and carcinoma prostate.

BACKGROUND: A relatively new development in the arena of prostatic histopathological study is the premalignant proliferative changes in the glandular epithelium, possibly relating to carcinoma. Two major categories have come up, namely prostatic intraepithelial neoplasia (PIN) and atypical adenomatous hyperplasia (AAH). AIMS: The aims of present study were to identify foci of the two putative premalignant conditions viz. PIN and AAH in ducto-acinar lining epithelia of 200 prostatectomy specimens and their association with nodular hyperplasia and adenocarcinoma prostate. MATERIAL AND METHODS: Micro sections from 200 prostatectomy specimens, received in the Department of Pathology, PGIMS, Rohtak, were extensively studied for the presence and association of premalignant conditions. Significant values were obtained by employing Chi-square (chi2) test, with P value < 0.05 as significant. RESULTS: Out of 177 cases of nodular hyperplasia, 53 (29.9%) showed PIN and 38 (20.3%) showed presence of AAH. All 6 cases (100%) of pure carcinoma revealed foci of PIN. Out of the remaining 23 cases of carcinoma with nodular hyperplasia, foci of PIN were observed in 16 cases (94.1%) and AAH in 2 cases (11.7%). High-grade PIN was observed in 20 cases (86.9%) of the total 23 cases of carcinoma, with/without nodular hyperplasia and 20 cases (11.2%) of nodular hyperplasia. Low-grade PIN was observed in 33 cases (18.6%) of nodular hyperplasia and in only 1 case (5.8%) of carcinoma prostate with nodular hyperplasia. CONCLUSION: PIN, especially high-grade type was the most commonly observed premalignant lesion, in cases of adenocarcinoma, thereby suggesting it to be the likely precursor of carcinoma prostate. AAH showed a weaker association with carcinoma.

Solitary amyloid tumour of breast--a case report.

45 years old woman with solitary amyloid tumor of breast is described. Clinically, the breast mass was hard and was suspicious of carcinoma. Microscopically there was no neoplasia. Instead there was extensive fibrosis with amyloid deposition in perivascular periductal areas and also in intervening stroma. The presence of amyloid was confirmed by Special stains and by Polarised microscope. Investigations revealed no evidence of systemic amyloidosis or amyloid related illness.

Mesenchymal hamartoma of the liver--a case report.

Mesenchymal hamartoma of the liver is a rare benign tumor of infancy and childhood. A case of mesenchymal hamartoma of liver seen in a 37 day old child is reported and the available literature on the subject is briefly reviewed.

Isolated conjunctival amyloidosis--a case report.

Isolated conjunctival amyloidosis is extremely rare and usually diagnosed histologically instead of clinically. This has been variously reported as an unusual cause of ptosis, complication of trachoma, painless nodular aggregates and recurrent subconjunctival hemorrhages. Once diagnosed, evaluation for systemic disease is advised though results of examination are almost always negative and frustrating.

Acute intestinal obstruction due to small gut hemangioma.

A 20-year-old man presented with acute intestinal obstruction due to multiple hemangiomas of small intestine extending into the adjoining mesentery. The diagnosis was made at laparotomy and subsequently confirmed on histology. Occurrence of hemangioma in the small intestine and its presentation as acute intestinal obstruction are rare.

Non-gestational choriocarcinoma in small intestine.

Choriocarcinoma most commonly arises from intrauterine gestational trophoblastic tissue; non gestational choriocarcinoma is rare. We report a 22-year-old married woman with non-gestational choriocarcinoma in the small intestine. Partial resection of the jejunum and ileum was done, followed by chemotherapy. She was well one year later.

Basaloid carcinoma of descending colon.

A 24-year old woman presented with abdominal pain and diarrhea. Examination showed distension and tenderness of the abdomen. At laparotomy, she had a circumferential obstructing growth in the descending colon, with hemorrhagic ascites and metastases in the liver and lymph nodes. Microscopy showed features of basaloid variety of cloacogenic tumors.

Secretory carcinoma of breast in an elderly female.

Secretory carcinoma is the currently preferred designation for a unique neoplasm earlier thought to be exclusive to the adolescent/pre-menarchal breast. The neoplasm has a predilection for juveniles and young adults (< 30 years of age), becoming progressive less common with advancing age. This report is of one such instance in a 52 year old female, rare occurrence in the elderly (> 50 years of age), with only five earlier cases on record in the English literature.

Synovial hemangioma--a case report.

True synovial based hemangiomas are rare lesions and should be differentiated from mass lesions especially pigmented villonodular synovitis. A case of 4 years old male child, presenting with recurrent painful swelling, is described in the present article. The differential diagnosis is also discussed.

Evaluation of leprosy lesions by skin smear cytology in comparison to histopathology.

Cytological evaluation of leprosy skin lesion was done to evaluate cytohistological correlation. Twenty five clinically suspected patients of leprosy were evaluated by performing fine needle aspiration (FNA) in nodular lesions and slit skin smear technique in flat lesions to classify across R-J scale. May-Grunwald-Giemsa (MGG) and Ziehl-Neelsen stain were employed on slit skin smears and fine needle aspiration material. Histopathological assessment of slides from same lesion was done. The overall diagnostic accuracy of fine needle aspiration was 76.1% and that of slit skin smear 50%. However, on adequate material diagnostic accuracy of slit skin smear was high, 100% as compared to 81.8% of fine needle aspiration smears. In cases of polar leprosy cytological findings paralleled histopathological diagnosis. Within the constraints of cytological interpretation the cases in borderline unstable spectrum of leprosy can be classified broadly.

Pseudomyxoma peritonei of hernial sac--a case report.

A rare presentation of Pseudomyxoma Peritonei of hernial sac is described. The patient was admitted for repair of an inguinal hernia. During herniorraphy large amount of mucinous material was found in hernial sac. Microscopy revealed epithelial glandular cells with bland appearance within mucinous pools. A search for primary remained fruitless.

Serum lactate dehydrogenase in diagnosis of megaloblastic anaemia.

The present study was carried out in 75 patients of macrocytic anaemia categorised on bone marrow examination (into megaloblastic and non-megaloblastic anaemia) to evaluate the efficacy of total serum LDH levels and LDH isoenzyme pattern in the diagnosis of megaloblastic anaemia. 25 healthy adults were taken as controls. From this study it can be concluded that total serum LDH levels more than 3000 IU/L are diagnostic of megaloblastic anaemia. Reversed LDH isoenzyme pattern (LDH1 > LDH2) by chloroform inhibition test is an adjuvant in the diagnosis where total serum LDH levels are between 451-3000 IU/L and it will also differentiate megaloblastic anaemia from haemolytic anaemia.

Adenoid cystic carcinoma of trachea.

Adenoid cystic carcinoma of trachea is a rare but distinct salivary gland-type malignant neoplasm. This paper described such a case in a young female in whom the mass that progressed to cause almost complete obstruction before it was diagnosed.

Secretory carcinoma of breast in an elderly female.

Secretory carcinoma is the currently preferred designation for a unique neoplasm earlier thought to be exclusive to the adolescent/pre-menarchal breast. The neoplasm has a predilection for juveniles and young adults (< 30 years of age), becoming progressively less common with advancing age. This report is of one such instance in a 52 year old female, a rare occurrence in the elderly (> 50 years of age), with only five earlier cases on record in the English literature.

Evaluation of efficacy of methylprednisolone, prednisolone and chlorambucil in idiopathic glomerulonephritis.

Thirty adults with steroid resistant idiopathic glomerulonephritis were randomly assigned to symptomatic treatment only or to a 6-month course of methylprednisolone and prednisolone alternated with chlorambucil every other month. Patients were followed up for a period of 6 months. At the end of follow-up, 11 out of 15 treated patients were in complete or partial remission as compared with only 3 of 15 control patients. Three of the treated patients were in complete remission, as compared with none of the controls. In the treated group there was a significant improvement of renal functions during follow-up, whereas in the control group renal functions did not show any significant change. None of the patients was dropped from the study because of side-effects. Therefore, it is concluded that pulse steroid and chlorambucil treatment for 6 months favours remission of idiopathic glomerulonephritis in adults and it leads to improvement of renal function.