Epithelioid inflammatory myofibroblastic sarcoma: the youngest case reported

Epithelioid inflammatory myofibroblastic sarcoma (EIMS) is a rare variant of the inflammatory myofibroblastic tumor. It has an aggressive clinical course and a high rate of recurrence. EIMS primarily affects children and young adults. Hereby, we report this entity in a 4-month-old infant who presented with an abdominal mass. Imaging studies revealed a large hypodense mesentery-based lesion involving the right half and mid-region of the abdomen. The mass with an attached segment of the small bowel was excised in toto. Grossly, a large encapsulated tumor was identified arising from the mesentery of the small bowel. The histological examination showed a tumor consisting of epithelioid to spindle cells loosely arranged in a myxoid background with numerous blood vessels and lymphoplasmacytic inflammatory infiltrate. On immunohistochemistry, the tumor cells showed positivity for ALK1 (nuclear), desmin, SMA, CD68, and focal positivity for CD30. A final diagnosis of EIMS of the small intestine was rendered. To the best of our knowledge, this case is the youngest reported case in literature.

Giant virilising adrenal cortical carcinoma

Androgen secreting adrenocortical carcinoma (ACC) is a very rare disease with a poor prognosis. Approximately 80% of tumors are functional, most commonly secreting glucocorticoids. We herewith report a case of a huge functional ACC of the right adrenal gland in a 33-year-old female who presented with complaints of hirsutism, amenorrhea and an abdominal lump. On abdominal examination a large lump was palpable in the right hypochondrium reaching up to the umbilicus. Contrast-enhance computed tomography (CECT) revealed a mass in the right suprarenal region. The tumor measured 29 cm × 20 cm × 12 cm and weighed 7.8 kg, the largest reported case of ACC in the world to the best of our knowledge.

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)

Midline Neck Swelling Mimicking Thyroglossal Cyst: Report Of An Uncommon Presentation Of Cysticercous Infestatation

Cysticercosis in humans is caused by an infestation by larvae of Taenia solium. The neck is a rare site of the infestation. Here, we present the case of cysticercosis situated in the neck of a 12-years-old child. The midline neck swelling present in the child since 2 years mimicked thyroglossal cyst, both clinically and radiologically. There were no other systemic complaints. Fine Needle Aspiration Cytology (FNAC) of the swelling was done for reaching the final diagnosis. Hence, in all inflammatory/cystic lesions, particularly in endemic areas, the possibility of cysticercosis should be taken into consideration irrespective of age, location, and the size of the lesion.

Coexistant Extramedullary Hematopoiesisin Lymph Node And Non-Hodgkin Lymphoma With Leukemic Spill: A Rare Case Report

Extramedullary hematopoiesis (EMH) commonly occurs in the liver and spleen. Non-hepatosplenic EMH in a lymphnode is rare and with co-existing non-Hodgkin lymphoma is even rarer. Careful screening of cytological slides is a must in order not to miss such rare cases of non-hepatosplenic EMH in lymphnodes. We hereby report a rare case of a 75-year-old male with coexisting lymphnode EMH and NHL, that too with the leukemic spill, which has never been reported before.

Unusual Renal And Colonic Mass - Description Of A Rare Case

Seminoma is a germ cell tumor arising from the testis and rarely from mediastinum or other extra-gonadal locations. Seminomas account for 40% of all GCTs. Seminoma can rarely metastasize to kidney and metastasis to the GI tract is least likely with an incidence of less than 1%. It is one of the most treatable and curable cancers, with a survival rate above 95% if discovered in early stages. We are presenting a rare case of metastatic seminoma in a 40-year-old male who presented with a renal and intestinal mass two years after orchidectomy for seminoma which was PLAP negative.

Granular cell tumour of clitoris: a case report

Granular cell tumour (GCT) is tumours showing neuroectodermal differentiation. It occurs mostly in the dermis and subcutaneous tissue and occurrence in the muscle layer is rare. The most common site is the head and neck region. It has been known to occur in the vulva, with clitoris being a very rare site. Granular cell tumours are slow growing tumours, which are mostly asymptomatic. We report a case of lump in the clitoris in a 42-year-old woman which was managed with surgical excision. Histopathology confirmed the diagnosis of granular cell tumour. Very few cases of granular cell tumour of clitoris have been reported in literature till date. Although mostly benign, the differential diagnosis of granular cell tumour should be borne in mind by the clinicians in cases of clitoral lump.

A Clinicopathologic Study Of Chronic Subdural Haemorrhage With Special Emphasis On Cox–2 And Vegf Expression

Introduction: Chronic subdural haemorrhage is known for high recurrence rates. Recently, VEGF and COX2 have been implicated as causal agents for recurrences, which can be targeted to prevent repeated surgeries and reduce morbidity. Material and Methods: Retrospective study including all cases (n=40) of chronic subdural haemorrhage from 2013 to 2017. The membranes were classified into four histologic subtypes. COX 2 and VEGF antibodies were applied on all cases. Ap value of <0.05 was considered statistically significant. Results: Four subtypes were type 1: non inflammatory (22.5%), type 2: inflammatory (20%), type 3: haemorrhagic inflammatory (27.5%) and type 4: scar inflammatory (30%). Glasgow coma score less than 13 (30%), maximum mean thickness of subdural haemorrhage (6.88), highest VEGF positivity rate (100%) and highest COX 2 positivity rate (91.67%) were found in type 4 membrane [p value 0.003 and 0.0001]. Conclusion:We found that type 4 membranes had worst Glasgow coma score, maximum thickness on CT, highest positivity for VEGF and COX2. Therefore, these are likely to have maximum recurrences and hence can be targeted for anti COX 2 and VEGF therapy.

Fine‑needle aspiration cytology of isolated skull nodule: Unfolding the clinical spectrum.

Follicular thyroid carcinoma (FTC) has been classified as either minimally invasive or widely invasive carcinoma and shows a propensity for blood‑borne metastasis. Most common sites of metastasis are lung and bone followed by brain, liver, and skin. Minimally invasive FTC (MIFTC) is characterized by limited capsular and/or vascular invasion with good long‑term outcomes, some cases of which show a poor prognosis because of severe distant metastasis. Skull metastasis in adults commonly arises from the lung, breast, and prostate and uncommonly from the thyroid. In our case, fine‑needle aspiration cytology of isolated skull nodule was a reliable tool in the diagnosis of metastasis and suggesting the primary in thyroid thereby prompting early workup of a patient. The case is unique since it represents the rare disseminated metastasis from MIFTC with incomplete capsular penetration alone without angioinvasion that can behave as aggressively as a widely invasive FTC.

Comparative evaluation of immunoperoxidase versus immunofluorescent techniques in interpretation of kidney biopsies.

Background: Immunofluorescence (IF) on frozen sections has been considered to be the gold standard for evaluation of kidney biopsy specimens. Immunohistochemistry (IHC) method can also be used for this purpose with advantages of being applicable on paraffin embedded tissue, providing permanent sections, and not requiring a specialized microscope for interpretation. Our aim was to evaluate IHC as an alternative to IF in the diagnostic assessment of kidney biopsy specimens. Methods: One hundred kidney biopsy specimens were subjected to both IF and IHC staining for immunoglobulins (Ig), IgG, IgA, IgM and complement components c3 and c1q. IF staining was done on frozen sections. IHC staining was performed on paraffin‑embedded tissue following proteolytic antigen retrieval. The sections were evaluated, and the results of IHC were compared with IF. Results: Concordant observations were 98%, 87%, 89%, 83%, and 89% for IgA, IgM, IgG, C3 and C1q, respectively. The sensitivity of IHC method for Igs was found to be high (92%, 86.5%, and 95.1%, respectively for IgA, IgM, and IgG). 91% cases showed concordance of the intensity of the deposits while 100% cases showed a concordance of the pattern. Statistically, there was no significant difference in outcomes between IF and IHC for IgA, IgM, and IgG. However, statistically significant difference was found in the results for complement proteins. Conclusion: In this study, it is documented that IHC is, with few exceptions, equal to IF for the detection of Igs. Standardized immunoperoxidase method on the paraffin embedded, formalin fixed needle kidney biopsies could successfully replace the IF method in the diagnosis of glomerulonephritis.

Angiosarcoma of scalp: a case report.

Cutaneous angiosarcomas are rare and constitute less than 1% of all malignant mesenchymal tumours. Most angiosarcomas of skin arise in the following clinical settings: 1. face and scalp of elderly 2. following lymphoedema and 3. post radiation. We present a case of an elderly man presenting with scalp lesion of 18 months duration. Histological examination of the biopsy revealed features of an angiosarcoma, which showed imunohistochemical positivity for factor VIII related antigen.