Kikuchi-Fujimoto's disease involving mesenteric nodes: a report and review of literature.

An adolescent boy underwent laparoscopic evaluation with persisting fever associated with colicky abdominal pain of about 3 weeks duration after a CT study of his abdomen revealed mesenteric adenopathy. Histopathological evaluation of the excised mesenteric nodes showed features of histiocytic necrotising lymphadenopathy suggestive of Kikuchi-Fujimoto lymphadenopathy which was confirmed on immunehistochemistry staining. Kikuchi-Fujimoto's disease involving the mesenteric nodes is extremely unusual and can be confounding with a mistaken diagnosis of and prolonged treatment for tuberculosis. The authors present a case of Kikuchi-Fujimoto's disease involving the mesenteric lymph nodes and discuss the various aspects of diagnosis and management of the case along with a review of published literature.

Mesothelial cyst of the spleen in an adult: a case report.

A young adult in her third decade presented with a 2-week history of catching left upper abdominal pain and was detected to have a cystic lesion occupying almost the entire spleen. Laparoscopic total splenectomy was carried out, and the cyst wall revealed a true mesothelial cyst with no squamous metaplasia. The various aspects of mesothelial cysts, including immunophenotyping and treatment modalities, are briefly discussed.

Painful digital Pacinian corpuscle hyperplasia following dog bite: a case report.

Digital Pacinian corpuscle hyperplasia is an extremely rare, painful condition that generally follows local trauma. We report a case of painful digital Pacinian corpuscle hyperplasia of the right index finger that was preceded by a dog bite at the same site over one and a half years ago. To the best of our knowledge, this is the first instance of a Pacinian corpuscle hyperplasia following dog bite. The literature is reviewed and immunohistological features are outlined.

Hospital outbreak of atypical mycobacterial infection of port sites after laparoscopic surgery.

A series of 145 laparoscopy port site infections due to Mycobacterium chelonae were found in 35 patients following laparoscopy at a single hospital over a six-week period. The contaminating source was ultimately identified as the rinsing water used for washing chemically disinfected instruments. The organism survived and grew within the biofilm at the bottom of disinfectant trays and within the outer sleeves of re-usable laparoscopic instruments. Remedial control measures included changing to ethylene oxide gas sterilization of laparoscopic equipment instead of chemical sterilization, thorough dismantling and manual precleaning of instruments, drying prior to gas sterilization, and random checks of environmental samples within the operating room complex for acid-fast bacilli. No further atypical mycobacterial infective episodes have occurred in the three years since the study. Awareness of this ubiquitous opportunistic organism that is not easily eradicated from the hospital environment, careful surveillance, detailed attention to disinfection methods of medical devices, and appropriate control measures are essential to prevent potential outbreaks.

Teratoma of palatine tonsil in a neonate.

Among many causes of respiratory distress and feeding difficulties in the neonatal period, a tumor involving oropharyngeal region is very rare. But still rarer is the unique presentation of this case of teratoma tonsil with intermittent attacks of choking with cyanosis.

Cytological diagnosis of subcutaneous fat necrosis of newborn: a case report.

Cytological findings of subcutaneous fat necrosis of the newborn, a rare and transient disorder of neonates, is described in a 20-day-old male baby, who presented with a 2-week history of firm, erythematous nodules and plaques on the back and upper arms.

Inflammatory fibroid polyp of jejunum causing jejuno-jejunal intussusception.

Intussusceptions originating in the jejunum are rare. We report a 20-year-old woman who had a chronic jejuno-jejunal intussusception due to an inflammatory fibroid polyp manifesting in the post-partum period as peritonitis. Resection-anastomosis of the intussuscepted segment was done. She is well one year later.

A large pleomorphic adenoma of soft palate causing sleep apnea syndrome--a case report.

Pleomorphic adenoma of soft palate is extremely rare. A large tumour in soft palate is reported with sleep apnea syndrome. Diagnosis was made by fine needle aspiration cytology and intraoperative consultation by imprint smears, which were confirmed by histopathological and immunohistochemical studies.

Combined primary fibrosarcoma--malignant fibrous histiocytoma of the breast: a case report.

Malignant mesenchymal tumours of the breast are relatively rare tumours that have yet to receive universal approval in terms of terminology. With classification based on histogenesis rapidly gaining acceptance, we present a case with histological features of both fibrosarcoma and malignant fibrous histiocytoma, with the former predominating. An unusual finding was the presence of large areas with haemangiopericytomatous appearance. The literature on changing concepts regarding classification of malignant mesenchymal tumours of the breast is reviewed.

Primary non-Hodgkin's lymphoma of the nose and paranasal sinuses: a case report.

Non Hodgkin's Lymphomas of the sinonasal tract are uncommon neoplasms that can be morphologically difficult to distinguish from destructive non-neoplastic process or other malignant neoplasm in this site. Non-Hodgkin's Lymphomas of the sinonasal tract are heterogeneous diseases that can be clinically aggressive. Immunophenotypic pattern of Non-Hodgkin's Lymphomas shows marked variations. We are reporting a case of B-Cell type of Non-Hodgkin's Lymphoma of the nasal cavity and paranasal sinus with complete clinicopathological and immunohistochemical study as it is rare in Indian literature and review of the literature is done.

Cutaneous leishmaniasis occurring with atopic eczema: report of three cases.

This is a report of three cases of cutaneous leishmaniasis occurring in patients with atopic eczema. The objective of the study is to highlight the possible changes in the classical lesions seen in cutaneous leishmaniasis due to the persistent pruritus associated with atopic eczema.

Skin and treponemal diseases among Asian domestic house-helpers in northern Saudi Arabia.

BACKGROUND: Asian domestic house-helpers in Saudi Arabia come from a different socioeconomic setting with a different disease pattern from that of their host country. This study reports the incidence of skin and treponemal diseases in this group seen at a referral hospital in northern Saudi Arabia. METHODS: The study was based on the analysis of the dermatologic and serologic examinations of 1520 domestic house-helpers during resident permit issue, and a retrospective study of clinical records of house-helpers with skin disorders. RESULTS: Routine examination revealed significant skin disease in 374 (24.6%) individuals, and the disease was transmissible in 126 (8.3%). Treponemal infection (5, 0.3%) and leprosy (1, 0.07%) were seen. Hand dermatitis and chicken pox were the most common causes of hospital attendance. Psychologic skin disorders included three cases of neurotic excoriations, two cases of delusion of parasitosis, and a case of dermatitis artefacta. CONCLUSIONS: The prevalence of transmissible skin diseases in Asian domestic house-helpers is low compared with that in their home countries. Excluding individuals with stigmata of atopic dermatitis from employment as house-helpers, adequate counselling will reduce the incidence of hand dermatitis and psychologic skin disorders. There is a need for continuous surveillance to prevent the introduction of skin diseases not normally seen in the native population.

Cutaneous leishmaniasis in expatriates in northern Saudi Arabia.

Cutaneous leishmaniasis is a protozoal disease transmitted by sandflies. It is endemic across the desert of the Middle East to Afghanistan and Africa. This paper reviews the findings in 148 expatriates with cutaneous leishmaniasis seen in Arar, northern Saudi Arabia, during a five year period. Cutaneous leishmaniasis was seen in all age groups. Farm workers, labourers and military personnel stationed in the region during the Gulf war were most affected. There was a seasonal variation with maximum incidence between November and January. The lesions were commonly multiple, the number of lesions per patient ranged from one to twelve. 18% of the lesions were located on the face, 34% on the upper extremity, 42% on the lower extremity and six per cent on other sites. The average duration of the lesions before diagnosis was two months. The most common complications were secondary bacterial skin infection (pyoderma and cellulitis) and residual scarring. The response to sodium stibogluconate was good. There has been a gradual reduction in the number of cases from a peak of 64 in 1991 to twelve in 1995. As compared to studies in the indigenous population, cutaneous leishmaniasis tends to be more frequent and server in expatriates from non endemic areas. There is a need for increased awareness of this disorder, especially in the home countries of these expatriates.

Risk factors for palmo-plantar pustulosis in a developing country.

Twenty patients with palmo-plantar pustulosis (10 males and 10 females) with a mean age of 41 +/- 6.4 years were compared to 20 controls (10 males and 10 females, mean age 42 +/- 7.2 years, for possible risk factors for palmo-plantar pustulosis. No statistically significant difference was found when the two groups were compared as regards history of atopy diabetes mellitus and thyroid disease. A statistically significant difference was found with regard to cigarette smoking (P < 0.001) and presence of joint symptoms (P < 0.01). This pattern, with minor variations, is similar to the findings in Western countries. There is a need for increased awareness of this association in developing countries. A larger population based study will be highly desirable.

Ethnic differences in the severity of varicella in adults in northern Saudi Arabia.

The severity of varicella infection in 124 expatriates from the Asian continent was compared to that in 120 Saudi nationals, seen in Arar Central Hospital, Arar, Saudi Arabia, between January 1992 and December 1994. Persistent fever (defined as a raised body temperature more than 37.4 degrees C lasting more than 5 days), extensive skin eruptions (defined as extensive, when more than 50% of the body surface was affected) and transient elevation of hepatic enzymes (aspartate transaminases > 37 U/L and alanine transaminases > 40 U/L) after excluding other possible causes, occurred significantly more in expatriates than in Saudis. The mean duration of the illness in expatriates was 15.9 +/- 3.41 days as compared to a mean duration of 13.1 +/- 3.52 days in Saudis. This difference was statistically significant (p < 0.01 Student's t-test). The findings in this study suggest that varicella infection runs a more severe course in expatriates from the Asian continent as compared to the Saudis. Treatment with the antiviral agent acyclovir may be indicated in this group of expatriates with varicella infection.

Recurrent cutaneous necrotizing vasculitis in a patient with Kikuchi's disease: case report.

Kikuchi's disease or histiocytic necrotizing lymphadenitis without granulocytic infilteration, is a clinico-pathologic entity well described in developed countries. We report a case of this disorder presenting with recurrent cutaneous necrotizing vasculitis, with the dual objective of highlighting this condition in developing countries and presenting an uncommon manifestation of this disorder.