Breast mass - An uncommon clinical manifestation of ovarian carcinoma: A case report and brief literature review

Metastasis from non-mammary malignant neoplasms to the breast is rare and represents 0.2%-1.3% of all breast malignancies. Fine needle aspiration cytology (FNAC) is the first line of investigation for any breast lump and cyto-morphological appearance of primary breast malignancies is well documented. Occasionally metastasis to the breast may be the initial presentation and can masquerade clinically as primary breast malignancy. The present case describes the clinical and cytological challenges in an unusual case of ovarian carcinoma with initial presentation as breast mass, mimicking as inflammatory carcinoma. In cytology the breast lesion was initially misdiagnosed as primary breast carcinoma and subsequently diagnosed as metastatic ovarian carcinoma based on core needle biopsy findings, aberrant immuno-profile and clinical findings; thus making the complex case worthy of discussion.

Theileria orientalis Buffeli pathotype in cows in a theileriosis-endemic region of India

@#Oriental theileriosis caused by Theileria orientalis is a growing health concern of lactating cows in its endemic areas. Rapid and sensitive diagnostic tests are demand areas for appropriate and effective prophylactic and therapeutic measures. Quantitative polymerase chain reaction (qPCR) is the answer for both detection and quantification of parasites. Present study deals with qPCR for detection of parasitemia level of T. orientalis in apparently healthy and clinically affected cows. Major piroplasm surface protein (MPSP) gene present in T. orientalis was cloned in pUC57 vector and transformed into E. coli Top 10 cells. Single and mixed infections of hemoprotozoa other than T. orientalis, causing anemia were differentiated through blood smear examination and PCR tests. T. orientalis was detected in 108 (63.15%) ill and 48 (26.66%) healthy cows. Piroplasms detected per 1000 red blood cells (RBCs) was 0-1 in the healthy group as compared to 3-22 in those showing clinical signs. Parasitemia in ill cows ranged between 6.9 × 102 and 4.5 × 103 parasites / µl of blood which was significantly higher (p<0.05) than healthy group (2.6 × 102 - 5.7 × 102 parasites / µl of blood). Phylogenetic study of the isolates showed similarity with Buffeli type that unfolded its pathogenic form in apparently healthy and ill cows.

A Pigmented Bullous Maxillofacial Lesion in a Diabetic Patient: A Diagnostic Dilemma.

Diabetes mellitus (DM) can be complicated by a variety of cutaneous manifestations. Cutaneous manifestations, such as neuropathic foot ulcers are universally known and have predilection for the lower extremity. However, in the maxillofacial region diabetic lesion is not yet reported in the literature. It is because of enormous blood supply to the region. We present a case of 77-year-old female with pigmented bullous lesion in maxillofacial region as a result of uncontrolled DM, which was associated with reactive lymphadenitis due to infection from carious right mandibular first molar. The patient also had normocytic normochromic anemia secondary to progressive renal failure as a result of diabetic nephropathy (DN). The patient developed lesion due to trauma following fine-needle aspiration cytology and high sugar levels. She was successfully managed by good metabolic control, extraction of the offending tooth, antibiotic prophylaxis, and occlusive dressings. To the best of our knowledge, this clinical scenario has not been previously reported in the context of the diabetic lesion and, therefore, may be considered in the classification of dermatological lesions of diabetes.