ABSTRACT
Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal and likely underdiagnosed disease characterized by unregulated histiocyte proliferation, hypercytokinemia and hemophagocytosis, causing life-threatening tissue damage and organ failure. We report a case of a 56-day-old infant presenting with fever, acute liver failure, and neurological manifestations as presenting features that succumbed to rapidly progressive HLH. Our objective is to emphasize the importance of early diagnosis by high suspicion in varied initial presentation of HLH so that life-saving therapy may be instituted in time.
Subject(s)
Central Nervous System/pathology , Liver Failure, Acute/pathology , Lymphohistiocytosis, Hemophagocytic , Cell Proliferation , Histiocytes/pathology , Humans , Infant , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphohistiocytosis, Hemophagocytic/mortality , Lymphohistiocytosis, Hemophagocytic/pathology , Male , T-Lymphocytes, Cytotoxic/pathologyABSTRACT
Isolated bilateral inguinal tubercular lymphadenitis is a very rare presentation. A 59-year-old male, on treatment for Carcinoma rectum (T3 N1 M0) presented with bilateral inguinal lymphadenopathy. Metastasis and tuberculosis were considered for differentials. FNAC of the lesion showed Necrotizing granulomatous lymphadenitis. There was regression of the lesion on both sides after two months of Anti-tubercular Therapy. Even though Metastasis is the commonest cause of inguinal lymphadenopathy in a case of carcinoma rectum, Tuberculosis needs to be considered in the differential diagnosis in our country. FNAC/Biopsy can be considered in those patients to confirm the diagnosis.
Subject(s)
Histiocytic Necrotizing Lymphadenitis/pathology , Inguinal Canal/pathology , Lymphadenopathy/diagnosis , Tuberculosis, Lymph Node/diagnosis , Antitubercular Agents/therapeutic use , Biopsy, Fine-Needle , Diagnosis, Differential , Histiocytic Necrotizing Lymphadenitis/microbiology , Humans , Lymphadenopathy/microbiology , Lymphadenopathy/pathology , Male , Middle Aged , Staining and Labeling , Treatment Outcome , Tuberculosis, Lymph Node/drug therapy , Tuberculosis, Lymph Node/microbiology , Tuberculosis, Lymph Node/pathologyABSTRACT
Hepatocellular carcinoma (HCC) is a common malignancy for which chronic hepatitis B infection has been defined as the most common etiologic factor. The most frequent metastatic sites are the lung, bone, lymphatics, and brain. Metastases to the chest wall have been reported rarely. We report a patient with HCC who presented with an isolated metastatic mass on the right chest wall. Metastasis of HCC should be included in the differential diagnosis of rapidly growing lesions in unusual locations, particularly in patients with chronic liver disease and HBsAg-positive patients, even if a primary tumor cannot be radiologically identified.
ABSTRACT
Chromophobe renal cell carcinoma (RCC), a subtype of RCC, accounts for 4-6% of all RCC and has better prognosis then conventional RCC. Sarcomatoid dedifferentiation is thought to represent the high-grade end of all subtypes. This makes chromophobe RCC with sarcomatoid changes a rare entity associated with poor prognosis in most studies. We present a case of a 40-year old female with this rare histology, with the tumour localised to the renal capsule, managed with nephrectomy and with close follow-up thereafter. The patient is free of disease after one year of treatment.
