Proteinaceous Lymphadenopathy Masquerading as Malignancy: a Rare Case Presenting a Diagnostic Dilemma.

Proteinaceous lymphadenopathy (PLD) is a rare poorly defined, underrecognized entity of uncertain etiology, characterized by massive deposition of amorphous, acellular, eosinophilic, PAS-positive material within an enlarged lymph node. We report an unusual case of a 46-year-old female with a large abdominal lump in the left lumbar region with inguinal lymphadenopathy. Contrast-enhanced computed tomography (CECT) showed multiple variable-sized lobulated non-enhancing soft tissue attenuated masses showing multiple peripheral and central calcific foci in the right para-aortic, bilateral iliac region, pelvis on the left side and left inguinal region. No evidence of any abnormal hypermetabolic focus was found in the neck, chest, abdomen, and pelvis on fluorodeoxyglucose positron emission tomography. A large, well-defined, non-FDG avid mass lesion with significant central and peripheral calcification in the left iliac fossa, abutting the descending colon, was seen. A biopsy of left-sided inguinal lymph nodes revealed large masses of an amorphous, acellular, eosinophilic material with areas of mature lymphoid cell aggregates interspersed between the pink amorphous materials. A final impression of proteinaceous lymphadenopathy was given. Proteinaceous lymphadenopathy is a benign condition with often a large mass masquerading as malignancy. It is a major therapeutic challenge for pathologists and clinicians. Histopathologists need to be vigilant in such cases and be aware of the morphological appearances in such cases.

Liesegang Rings in a Patient With Pulmonary Tuberculosis: The First Report.

Liesegang rings are eosinophilic, concentric, lamellated structures that can assume a variety of shapes and sizes ranging from a few microns to hundreds of microns. To date, Liesegang rings have been reported in around 30 examples in the English literature, in the kidney, breast, female genital tract, and skin, and only a single report in the lung associated with allergic bronchopulmonary aspergillosis. Liesegang rings are usually incidental discoveries and have been associated with benign cystic lesions, inflammatory diseases, fibrosis, and tissue necrosis. Their typical appearance helps differentiate them from their mimics including parasites, foreign materials, corpora amylacae, and psammoma bodies. We report Liesegang rings in a 62-year-old male patient with pulmonary tuberculosis to create awareness about this rare entity among pathologists to avoid its misdiagnosis as a parasitic infection.

Evaluation of a mixture of zinc oxide-10% sodium fluoride as novel root canal filling material: A pilot study!!

BACKGROUND: To establish mixture of zinc oxide and 10% sodium fluoride as a novel root canal obturating material for primary teeth. AIM: This study aims to evaluate clinical and radiographic success of a mixture of zinc oxide and 10% sodium fluoride as root canal obturating material. SETTINGS AND DESIGN: This pilot study was conducted among 30 primary molars indicated for pulpectomy. METHODS: Thirty grossly decayed primary molars of children aged 4-9 years were selected with signs or symptoms of irreversibly inflamed or degenerative pulp tissue. Single sitting pulpectomy was carried out in all the teeth with a mixture of zinc oxide powder with 10% sodium fluoride, and they were subsequently restored with preformed crown. Teeth were assessed clinically and radiographically at 3-, 6-, 9-, and 12-month intervals. STATISTICAL ANALYSIS: Data were analyzed using SPSS Software Version 20.0 (IBM SPSS Statistics, Chicago, IL, USA) and statistical significance was determined by Chi-square test; level of significance was set at P < 0.05. RESULTS: Overall clinical and radiographic success rate of combination of zinc oxide and sodium fluoride was 92.9% and 85.7%, respectively, at the end of 12 months. Furthermore, resorption rate of material matched resorption of tooth root. Excess filling material was also observed to resorb at the end of 3 months. CONCLUSION: These results suggest that combination of zinc oxide and sodium fluoride can be considered as suitable alternative root canal obturating materials for primary teeth with low cost to achieve acceptable therapeutic results.

Effect of Low-level LASER Therapy on P6 Acupoint to Control Gag Reflex in Children: A Clinical Trial.

OBJECTIVE: To investigate the effect of low level laser therapy (LLLT) on PC6 acupuncture point in suppressing gag reflex, regulating pulse rates and oxygen saturation, thereby reducing the anxiety levels. MATERIALS AND METHOD: A total of 40 patients who demonstrated hyperactive gag reflex in the age group of 4-14 years were included in the study. In Group A (20 patients), maxillary impression was recorded. In the second step, PC6 acupuncture point was stimulated with LLLT followed by recording of second maxillary impression. In group B (20 patients), steps were reversed. Gag reflex, anxiety levels, pulse rate and oxygen saturation levels were assessed. RESULTS: Values of pulse rate and oxygen saturation were regulated to normal, signifying lowered anxiety levels. Gag reflex was also significantly decreased after stimulating PC6 acupuncture point with LLLT. CONCLUSION: LLLT on PC6 point was found to be effective in lowering anxiety levels as observed by faces modified anxiety rating scale. Further, it was authenticated as the pulse rates were significantly reduced and oxygen saturation levels were significantly increased. Also, gag reflex was significantly controlled when LASER stimulation was done at PC6.