Leiomyoma of kidney: An Indian experience with literature review.

INTRODUCTION: Leiomyoma of kidney is an exceptional finding in the urinary tract. Though most of these tumors are detected on autopsy, still it remains a diagnostic challenge. PRESENTATION OF CASE: We report three adult cases of renal leiomyoma in our institute who presented with abdominal mass and haematuria in last 8 years. DISCUSSION: Leiomyoma has been reported in other organs but renal leiomyoma is rare tumour, though in autopsy series they are second in order of frequency among the renal mesenchymal neoplasms, and few cases have been described in the literature. Still no Indian experience is evaluated on this rare site of occurrence. CONCLUSION: Considering the difficulty of clinical diagnosis of this tumour, strong suspicion is indicated when a patient presents with voluminous, well circumscribed renal lesions.

Primary squamous cell carcinoma of breast with ipsilateral axillary lymph node metastasis: An unusual case.

INTRODUCTION: Pure squamous cell carcinoma of the breast [SCCB] is rare. PRESENTATION OF CASE: We report a case of primary squamous cell carcinoma of breast with ipsilateral axillary lymph node metastasis in a 58year old woman. DISCUSSION: It is a breast carcinoma entirely composed of metaplastic squamous cells that may be keratinized, non-keratinized or spindled. The pure squamous cell carcinoma usually present with central cystic cavity, which we found in our case, also supported by immunohistochemical evidence. CONCLUSION: Although a rare breast cancer subtype, SCCB is of considerable interest due to its pathological heterogeneity and differences in clinical behavior and less reported occurrence of nodal metastasis.

Morphometric analysis in potentially malignant head and neck lesions: oral submucous fibrosis.

OBJECTIVE: The objective of this study is to analyze cases of oral submucous fibrosis (OSMF) Grade I, II, III and IV morphometrically with regard to epithelium, vasculature and fibrosis and determine any correlation with histological grading after Pindborg and Sirsat. MATERIALS AND METHODS: Eighty three oral submucous fibrosis cases were analyzed morpometrically using an interactive image analysis system in the Department of Pathology, M.L.N Medical College, Allahabad, U.P, India. Paraffin embedded sections of 3-4 microm thickness were stained with hematoxylin/eosin, Van Gieson's picric acid and acid fuchsin stain and Masson's trichrome stains. Image analysis was performed with specific software (Image Pro Plus 6.0) and data obtained were finally transported to Excel sheets for calculation of average values for each parameter. RESULTS: With the grading criteria applied, 9 cases of OSMF were grade I, 32 grade II, 39 grade III and 3 grade IV. Clinical trismus was most frequent in Grade IV followed by Grade III, II and I respectively. OSMF Grade I cases did not show any measurable amount of collagenization, whereas it showed a significant increase with OSMF I and II grades [Pearson's chi2 test= 85.72; p= 0.051] and OSMF-III and IV [Pearson's chi2 test=188.74; p<0.001]. Numbers of endothelial cells per low power field consistently decreased with the increasing grade. CONCLUSIONS: We concluded that mean blood vessel area and the mean vessel diameter showed a marked increase in grade II and a marker decrease in grade IV and the grade III, collagen thickness (mum) increases according to increasing grade while density of endothelial cells decreases.

Correlation of addictive factors, human papilloma virus infection and histopathology of oral submucous fibrosis.

BACKGROUND: Oral submucous fibrosis (OSMF) is a widely prevalent, potentially malignant disorder of the oral cavity in the Indian subcontinent. Areca nut has been incriminated as the main causative factor. However, other factors, including viruses may also play a role in the initiation/development of these lesions. This study was designed to assess the correlation of addictive factors, human papilloma virus infection and histopathology of OSMF. METHODS: One hundred and thirteen cases of OSMF were studied. Demographic information of each patient, including the patient's age, sex, addiction habits and histopathological grading was obtained. Presence of high-risk human papilloma virus (HR-HPV) DNA was detected using the Hybrid Capture II assay. RESULTS: Of 105 cases finally included in the study, 33 (31.4%) patients were found to be positive for HR-HPV, while 72 (68.6%) were negative. A total of 52/105 (49.5%) patients chewed areca nut, of whom 18 (34.6%) patients were found to be positive and 34 (63.5%) were negative (P = 0.08). A total of 18/105 (17.1%) patients were addicted to smoking, of whom five (27.7%) were positive (0.69). Only one (11.1%) patient, who was only habituated to alcohol, was positive (1.08). Of the 105 patients 26 (24.7%) chewed as well as smoked tobacco, of whom, nine (34.6%) were positive and 17(65.3%) were negative (P = 0.67). Thus, there was no significant association between the various addiction habits and the presence of HR-HPV. On correlating the various histopathological grades of the disease with HR-HPV positivity a Pearson correlation of 0.053 was obtained (P = 0.588). Thus, again no significant correlation was observed between the different histopathological grades and HR-HPV positivity. CONCLUSION: In conclusion, it was found that there is neither significant correlation between HR-HPV infection and the various addiction habits nor with the different histopathological grades of the disease. To the best of our knowledge, a study of these different factors has never been attempted before in patients with OSMF.

Tramadol versus clonidine in management of heroin withdrawl.

UNLABELLED: Opiod dependence is one of the leading psychiatric morbidities in India. The deaddiction centres are meager in number; stigma attached to admission in deaddiction centre is high and most addicts want outpatient treatment so that they do not miss daily wages. Several recent reports stated effectiveness of tramadol in treating opioid withdrawal. This study attempts to compare effectiveness of tramadol with clonidine in opioid withdrawal. METHODOLOGY: A total of 60 patients having heroin dependence were selected and out of them 30 got clonidine treatment and the other 30 got tramadol treatment. The clinical opioid withdrawal scale was used. STATISTICAL ANALYSIS: "t"-Test was used using SPSS (version-16) for comparison. RESULT: Tramadol was more effective in preventing sweating, restlessness, aches, runny nose, GI upset, yawning, anxiety and goose skin. i.e., Tramadol can be used effectively in opioid withdrawal in outpatient based treatment programme.

Significance of Charcot Leyden crystals in hepatic aspirates.

Charcot Leyden crystals are hexagonal bipyramidal structures localised in the primary granules of the cytoplasm of eosinophils and basophils. Their presence, along with eosinophilic infiltrate, is an indirect evidence of parasitic infestation particularly with Toxocara, Capilliriasis, Ascariasis, or Fasciola. We report here two cases where Charcot Leyden crystals with eosinophilic infiltrate were found in the smears prepared from hepatic abscess.