Malignant proliferating trichilemmal tumor.

Proliferating trichilemmal tumor (PTT) is a benign tumor originating from the outer root sheath of a hair follicle. Malignant transformation in case of PTT is very rare and unusual finding. It is usually confused with squamous cell carcinoma both sharing many common features. So the identification of malignant PTT is very essential. Only 39 well-documented cases of malignant proliferating trichilemmal cyst have been published to date in the English language literature. We hereby present a case of a 75-year-old female patient with a rapidly growing swelling on the scalp.

Screening for thalassemia and other hemoglobinopathies in a tertiary care hospital of West Bengal: implications for population screening.

Hemoglobinopathies are common genetic disorders of hemoglobin, which can be prevented by population screening and offering genetic counseling. In absence of population-based screening for hemoglobinopathies, the hospital-based diagnosis register provide idea about the extent of problem in the community. The present study was undertaken to find out the burden of hemoglobinopathies and spectrum of this disorders among the population who were screened in the hospital-based screening program. A record-basedanalysis of subjects who underwent screening for hemoglobinopathies in Burdwan Medical College and Hospital over a period of 3 years and 4 months revealed that overall 29.3% of subjects were positive for hemoglobinopathies. Beta thalassemia heterozygous was the most commonhemoglobinopathy in this region closely followed by hemoglobin E heterozygous. In view of high prevalence of hemoglobinopathies in this region, a routine premarital screening program is needed for identification and prevention of high-risk marriages.

Fine needle aspiration cytology of metastatic alveolar rhabdomyosarcoma.

Rhabdomyosarcoma (RMS) is an aggressive malignant soft tissue tumor that arises from primitive striated muscle cells called rhabdomyoblasts. RMS is a rare tumor in adults, and involvement of the sinonasal area is extremely rare, comprising only 1.5% of all reported head and neck RMSs. Alveolar RMS, mainly seen in adults, has the worst prognosis. Incidence of lymph node metastases is more common in this type compared with the other forms. Fine needle aspiration cytology (FNAC) has been used extensively in the diagnosis of metastatic malignancies. However, metastatic soft tissue sarcomas are often overlooked, primarily due to the low frequency with which they occur. Here, we report a rare case of metastatic alveolar RMS in the cervical lymph nodes of an 18-year-old girl that was detected by FNAC. After 6 months, the patient came with a huge mass involving the nasal vestibule and the upper lip. Histology of both the main mass and the lymph nodes revealed alveolar RMS.

Lewandowsky and lutz dysplasia: report of two cases in a family.

Lewandowsky and Lutz dysplasia, also known as epidermodysplasia verruciformis (EV), is an inherited disorder in which there is widespread and persistent infection with human papilloma virus, defect in cell-mediated immunity and propensity for malignant transformation. Differential clinical and histopathologic evolutions of lesions in two cases of familial EV are compared and discussed in detail. Cases were followed up for 7 years. Detailed history, clinical features and investigations, including skin biopsy from different sites at different times, were examined. Generalized pityriasis versicolor like hypopigmented lesions in both the cases, together with variable pigmented nodular actinic keratosis like lesions on sun-exposed areas, were present. Multiple skin biopsies done from various sites on different occasions revealed features typical of EV along with lesions, i.e., actinic keratosis, Bowen's disease, basal and squamous cell carcinoma, in the elder sibling. However, skin biopsy of the other sibling showed features of EV and seborrheic keratosis only till date. This study reveals that the disease progression is variable among two individuals of the same family. Malignant lesions were seen only on sun-exposed areas and may be associated with other skin lesions or infections such as angiokeratoma of Fordyce and tinea cruris, as seen in this report.

Prognostic value of AgNOR in benign and malignant lesions of larynx in a rural medical college hospital, Burdwan, West Bengal.

AgNOR counting is a useful proliferative marker in different malignant lesions and it also acts as a good prognostic indicator in rural hospital. Fifty-three cases of benign and malignant lesions of larynx were examine using AgNOR distribution in routinely processed paraffin embedded histological tissue sections. Significant differences were found between benign lesion, dysplasia (p > 0.10) and carcinoma (p > 0.10). Mean AgNOR count was 2.41% in dysplasia and 3.71% in malignant lesion. This value was high in poorly differentiated squamous cell carcinoma (4.17%) and also in supraglottic type of laryngeal squamous cell carcinoma which associated with lymph node metastasis. Thus proliferative marker AgNOR may be a prognostic factor and might be of clinical value as predictor of lymph node metastasis in supraglottic type of laryngeal squamous cell carcinoma.

Neurocognitive impairment in early HIV-positive individuals.

The study was carried out to find out the cognitive impairment if any, in early stages of human immunodeficiency virus-positive patients and if there is any cognitive impairment, then its association with duration of illness detection. Fifty patients with early stages of HIV and 50 matched controls were compared in various neuropsychological tests along with demographic profiles. Seropositive patients had poorly performed in digit symbol substitution test, trail making test and controlled word association test. This impairment had no association with duration of detection of illness. It is not known whether mild neurocognitive disorder predisposes patients to the development of frank dementia. Cognitive impairment should be identified early in order to maximise functional status, enhance quality of life and survival time.

Extragonadal teratomas presenting at birth and originating from 3 different sites--a report of 3 cases.

Three cases of extragonadal teratomas presented at birth and all the cases arisen from three separate sites are reported in the present study. A huge sacrococcygeal teratoma is being reported and the other two retroperitoneal and nasopharyngeal teratomas, are reported for the rarity of their location in neonatal period. Teratomas of all three babies were mature benign on histopathology and surgical removal sufficed as mode of treatment. No recurrence was noted on follow-up.

Primary adenocarcinoma of bladder--A case report.

A 24 years old male presented with haematuria. Ultrasonography depicted an echogenic mass on bladder wall, where prostate showed normal echo characters. Cystoscopy revealed a large papillary growth involving lateral wall, neck of the urinary bladder and prostatic urethra. Punched biopsy showed features of adenocarcinoma. Radical cystectomy was performed and it was reported as a case of primary adenocarcinoma of the urinary bladder.

Endometrioid carcinoma of uterus and ovary.

A thirty-two-year-old married woman presented with pain abdomen and polymenorrhoea. Her uterus was bulky and one of the fornices was full. USG of abdomen revealed unilateral ovarian tumour associated with a mass in the uterus. Histopathological report revealed synchronous endometrioid carcinoma of the uterus and the ovary with morphological evidences in favour of independent primary carcinomas. With these perspectives the present case is reported where endometrioid carcinomas of uterus and ovary are two separate primary tumours.