Tuberculosis of Gallbladder A Case Report

Gall bladder is considered a rare site for occurrence of tuberculosis and is usually found in association with gallstones or cystic duct obstruction. The diagnosis is very difficult prior to surgery unless there is strong suspicion of tuberculosis, with the confirmation being possible only after histopathological examination of gall bladder. Here we present a case of gall bladder tuberculosis in a 40-year-old female, who came with symptoms of chronic cholecystitis due to gallstones. Ultrasound of abdomen revealed a single gall stone located in the fundal region. The patient underwent laparoscopic cholecystectomy and was treated with anti-tubercular drugs. .

A lesion on lip – Hemangioma with Chronic Granuloma.

Infections as well as tumours and tumour-like conditions are common in the oral cavity. While hemangiomas are benign vascular tumours which may be encountered in any part of the body, granulomatous infections are unusual in the mouth. We discuss below the rare occurrence of a hemangioma on the lip which was associated with a chronic granuloma.

Diagnostic Approach to Thyroid Nodules.

Derangement of thyroid function is a common clinical problem, with variable clinical presentations ranging from subtle, incidentally discovered disorders to overt disease, with frank disturbances of hormone levels and visible thyroid enlargement. In addition, there are the autoimmune thyroid disorders, and the neoplastic enlargements which result in palpable nodules. A large amount of new information has become available in recent times. They provide a comprehensive approach to diagnosis of thyroid nodules, ranging from initial evaluation, clinical and ultrasound criteria for fine-needle aspiration biopsy, interpretation of fine-needle aspiration biopsy results, and their management. Recommendations regarding the initial management of thyroid cancer include those relating to optimal surgical management, radioiodine remnant ablation, and suppression therapy using levothyroxine. Recommendations related to long-term management of differentiated thyroid cancer include those related to surveillance for recurrent disease using ultrasound and serum thyroglobulin as well as those related to management of recurrent and metastatic disease. We went through the published literature available electronically and assessed the various studies and their results. The results were reviewed carefully and interpreted in order to analyse the approach to diagnosis of thyroid swellings, especially in the Indian context. Although a detailed review is outside the scope of this paper, we will attempt to discuss some of these guidelines, especially in light of the scenario in our region.

Effects of Methotrexate on Ovary: An Experimental Study on Albino Rat.

Background: Methotrexate is an anti-cancer drug but carries toxic effects on genital system and the study was conducted to find out the exact mechanism involved and to search for remedy. Methods: Twelve female albino rats 6 experimental and 6 control received methotrexate. [in former] and normal saline. [in latter], 1 mg/kg, intraperitoneally for 6 weeks. Results: H/E stained sections from ovary of experimental rat showed poorly developed Graafian follicles with loss of ova. There were follicular spaces in these rats with albuminous fluid and inflammatory cells. Granulosa lutein cells also showed degeneration due to inflammation. Cells were found to be smaller, shrunken, and irregular with vacuolated lighter colour cytoplasm. Conclusion: The drug is safer to be used in those patients who have completed their family.

Effects of Methotrexate on Testis: An Experimental Study on Albino Rats.

Background: Methotrexate was often used for prolonged period for satisfactory therapeutic results enhancing the chance of toxicity. Methotrexate was known for its toxic effects involving most of the organs of body including testis. Attempts were made earlier to find out changes in testicular structure of methotrexate toxicity, but details of histopathological reports were not available in literature. The aim of the present study was to see the histopathological changes on testis after giving methotrexate. Materials and methods: Twelve male albino rats were divided into experimental and control groups of equal animals. Former received methotrexate, 1mg per Kg, intraperitoneally, weekly for 6 weeks. Testicular tissue after perfusion fixation, were processed for wax embedding technique and the sections thus obtained were stained with H/E stains. Result: Marked histopathological alterations in seminiferous tubules, cells in its wall undergoing spermatogenesis and Leydig cells were observed. Conclusion: In younger patients the risk of infertility should be kept in mind while using it for prolonged period.

Myopericytoma of lip: A rare lesion in an unusual location.

Myopericytoma is a rare benign tumor with perivascular myoid differentiation. It shares histomorpholoic features with the so-called hemangiopericytoma, myofi broma and glomus tumor. We hereby report the case of a 14-year-old boy who presented with a slowly growing, painless, fi rm mass on upper lip, diagnosed as myopericytoma on the basis of histopathology and immunohistochemistry. To the best of our knowledge, this is only the second such reported case.

Spindle cell lipoma breast.

Spindle cell lipoma, which usually arises in the soft tissues, is rare in breast and is difficult to differentiate from primary mammary spindle cell tumor. Here, we present the case of a 48-year-old woman with a 3-cm, solitary, well-circumscribed and nontethered mass lying deep within the tissue of left breast, incidentally detected on routine mammography. The spindle cells proved to be immunoreactive to CD 34, but nonreactive to desmin and smooth muscle actin.

Significance of AgNOR score in benign and malignant soft tissue tumours.

AgNOR staining was employed on FNAC and histopathological sections obtained from patients with soft tissue tumours. The study comprised of 20 normal appearing soft tissues, 74 benign and 36 malignant soft tissue tumours. The slides were stained with AgNOR in order to differentiate between benign and malignant soft tissue tumours. The mean AgNOR count in normal appearing soft tissues, benign lesions and malignant lesions was 1.04+/-0.10 (0.94-1.14), 1.51+/-0.21 (1.1-2.1) and 4.96+/-1.33 (2.57-7.21) respectively. The mean AgNOR count was found to be higher in benign soft tissue tumours as compared to normal appearing soft tissues and the difference was found to be statistically significant. The mean AgNOR count in soft tissue sarcomas was found to be higher as compared to both normal appearing soft tissues and benign soft tissue tumours and the results were found to be statistically significant. The increased AgNOR score in both benign and malignant soft tissue tumours as compared to normal appearing soft tissues indicates high proliferative activity. Thus AgNOR staining is a simple and useful method for estimating tumour cell proliferation thereby differentiating normal appearing soft tissues from benign and malignant soft tissue tumours.

Role of FNAC and antithyroid antibodies in the diagnosis of thyroid disorders.

Multiple parameters are needed to diagnose thyroid disorders. 100 cases of thyroid swellings were studied by clinical assessment, hormonal assay, fine needle aspiration cytology (FNAC), antithyroglobulin (Tg) and antimicrosomal (Tm) antibodies and histopathology. The cases were divided into four groups. Cases of thyroiditis on FNAC showed predominance of lymphocytes (76%), hurthle cells (77%), epithelioid cells and giant cells (31%) and high titres of Tg (66%) and Tm (92%). Non toxic goitre was characterized by colloid and foam cells (100%) and low positivity for Tg and Tm (25%). Toxic goitre showed colloid (30%). Hurthle cells, anisonucleosis of acinar cells (38%), fire flare (62%) and high positivity for Tg and Tm (73%). Neoplasia was diagnosed mainly by cell morphology on FNAC and a low positivity for Tg and Tm (30%). FNAC in correlation with thyroid antibodies is useful in diagnosing autoimmune thyroiditis, goitre, Grave's disease and malignancy of thyroid. Antibodies have a specific role in the diagnosis of early stage of thyroiditis.