Xanthogranulomatous inflammatory lesions: a 10-year clinicopathological study in a teaching hospital.

Objective: To review the demographic, clinical and histomorphological aspects of xanthogranulomatous inflammation (XGI) in different organs. Material and methods: All the cases diagnosed as XGI by histopathology from the specimens received in the department of Pathology, Regional Institute of Medical Sciences, Imphal, Manipur, India over the period of 10 years from January 2001 to December 2010 were included in the study. All the available data including age, sex, organ of involvement, association with stone etc. were collected and analyzed retrospectively. All the slides were reviewed. The results were recorded and ana-lyzed. Results: A total of 98 cases of XGI were diagnosed out of a total of 9755 specimens received, constituted by 5382 of gall bladder, 4298 of appendix, 41 of kidney and 24 of tube and tubo-ovarian mass making an overall incidence of 1%. The incidence of XGI in kidney was 12.19%, followed by 4.16% in tube and tubo-ovarian mass, 1.5% in gall bladder and 0.25% in appendix. Maximum number of cases were in the age group of 41-50 years with 33.67%. The female to male sex ratio was 2.5: 1. 90.2% cases in kidney and 86.6 % in gall bladder were associated with calculi. One case was associated with adenocarcinoma of gall bladder. Conclusion: Xanthogranulomatous inflammation which often mimics malignancy clinically and morphologically, is increasingly recognized in different anatomic locations. An accurate diagnosis will relieve the psychological panic of suspected malignancy and prevent the patient from aggressive treatment.

Lipoid pneumonia: An uncommon entity.

Lipoid pneumonia is a rare form of pneumonia caused by inhalation or aspiration of fat-containing substances like petroleum jelly, mineral oils, certain laxatives, etc. It usually presents as an insidious onset, chronic respiratory illness simulating interstitial lung diseases. Rarely, it may present as an acute respiratory illness, especially when the exposure to fatty substance(s) is massive. Radiological findings are diverse and can mimic many other diseases including carcinoma, acute or chronic pneumonia, ARDS, or a localized granuloma. Pathologically it is a chronic foreign body reaction characterized by lipid-laden macrophages. Diagnosis of this disease is often missed as it is usually not considered in the differential diagnoses of community-acquired pneumonia; it requires a high degree of suspicion. In suspected cases, diagnosis may be confirmed by demonstrating the presence of lipid-laden macrophages in sputum, bronchoalveolar lavage fluid, or fine needle aspiration cytology/biopsy from the lung lesion. Treatment of this illness is poorly defined and constitutes supportive therapy, repeated bronchoalveolar lavage, and corticosteroids.