Unusual coexistence of Stewart-Treves syndrome and sickle cell anaemia: a case of dual pathology.

Chronic lymphoedema can rarely be complicated by an angiosarcoma. This combination called Stewart-Treves syndrome usually observed in upper limb in patients of post-mastectomy with axillary lymph node resection. Here, we report a male patient who had a 10-year history of right leg elephantiasis. Later on, he developed two large ulceronodular masses in the same leg with few satellite nodules in the surrounding skin. With the clinical suspicion of malignancy, a wedge biopsy was performed which revealed histological features of angiosarcoma with sickled red cells. The above knee amputation specimen received further confirmed the histological diagnosis. The investigation for haemoglobinopathy also suggested the presence of sickle cell trait. This report describes a multifocal tumour as a rare manifestation of Stewart-Treves syndrome in a post-filariasis case with sickle cell trait, which is an extremely uncommon combination.

Pulmonary hydatid cyst with co-existent aspergillosis: A rare cytology finding.

Pulmonary hydatid cyst with co-existing aspergillosis is rare. Till date, there are only two documented reports of this double pathology being diagnosed on cytology. The present case is of a young immunocompetent female who presented with respiratory complaints including intermittent hemoptysis. Chest X-ray and CT thorax revealed two well-defined lesions in the lower lobe of left lung that was suggestive of either infective or benign neoplastic etiology. But as hydatid cyst was not suspected either clinically or radiologically, FNA was performed. Based on the typical cytomorphological features a definitive diagnosis of hydatid cyst with aspergillosis was offered on cytology that was later confirmed on histopathology. To the best of our knowledge this is only the third report of pulmonary echinococcosis with aspergillus co-infection being diagnosed on cytology. The purpose of reporting this case is to draw attention to the rare possibility of co-existing aspergillus infection in pulmonary echinococcosis even in immunocompetent individuals, which can complicate the clinico-radiological picture. However, both pathologies can be effectively and accurately diagnosed on cytology, based on which proper treatment can be initiated. Diagn. Cytopathol. 2016;44:696-699. © 2016 Wiley Periodicals, Inc.