Hemophagocytic Lymphohistiocytosis (HLH) Associated With Scrub Typhus: Report Of 2 Cases

Hemophagocytic Lymphohistiocytosis (HLH) is a fatal hyperinflammatory syndrome characterized by histiocytic proliferation along with hemophagocytosis. HLH can be primary (inherited) or secondary, to any severe infection, malignancy or rheumatological disease. HLH, though rare, has also been noted in association with scrub typhus which is an acute febrile illness resulting from the bite of infected larval form of mite (also known as chigger). We hereby describe two cases of HLH associated with rickettsial infection (Oriental tsutsugamushi) in a 36-year-old male and in a 10-year-old male child. The former presented with high-grade fever and pruritic macular rash over abdomen. While the latter was presented with fever and decreased urinary output at the time of admission

Pilomatricoma Of Cheek Mimicking Malignancy: A Diagnostic Challenge On Fine Needle Aspiration Cytology

Pilomatricoma is a benign adnexal lesion which is often diagnosed on cytology. Sometimes cytomorphology may pose diagnostic challenge and may mimic malignant neoplasm. We present a case of a slow growing nodular swelling on the right upper cheek in a 9-year-old male child with similar diagnostic difficulty on Fine Needle Aspiration Cytology (FNAC)

Conversion Of All To Aml: A Rare Phenomenon

Among all acute leukemias, acute lymphoblastic leukemia (ALL) is five times more common than acute myeloid leukemia (AML). Lineage switch from ALL to AML is very rare. Lineage switching is a phenomenon noted in cases of leukemias where the initially diagnosed cases of leukemias of a lineage (lymphoid/myeloid) present with the opposite lineage at relapse. Here, we report the case of a 10-year-old male child who was initially diagnosed with ALL and on relapse after 4 years, presented with AML. The blast cell morphology and immunophenotype were consistent with the diagnosis of typical AML.

Low-grade Squamous Intraepithelial Lesion with Chlamydia Trachomatis Infection in Pap Smear: A Rare Association.

The role of Pap smear in detecting cervical carcinoma has been extensively acknowledged. However, it can also be very well utilized for detecting cervicovaginal infections such as fungi, bacteria, and parasites. Identifying these infections can help in providing immediate and correct treatment to the patient along with detection of any squamous intraepithelial abnormality, if present. Chlamydia trachomatis causes sexually transmitted disease along with cervical squamous dysplasia. However, as mentioned in literature, an association of chlamydial infection with squamous intraepithelial lesion is still not clear. Herein, we report a rare case of the low-grade squamous intraepithelial lesion along with chlamydial infection in the same patient.