Amelanotic melanoma masquerading as a superficial small round cell tumor: a diagnostic challenge.

Malignant melanoma poses a remarkable capacity for morphological diversity and often presents as a diagnostic challenge due to its wide clinical presentation. We present a case of a 73-year-old lady, with a large superficial ulcerative nodular mass on the flexor aspect of the right upper arm. On fine needle aspiration poorly differentiated round cell tumor was suggested, with histopathology also supporting the same diagnosis. A final diagnosis of amelanotic melanoma was given following immunohistochemical work-up using a panel of relevant markers. We are presenting this case, not only for its rare clinical presentation, but also for the diagnostic difficulties encountered by us in cytology and histopathology to reach the final diagnosis.

Evaluation of quality indicators in a laboratory supporting tertiary cancer care facilities in India.

OBJECTIVE: To collect and tabulate errors and nonconformities in the preanalytical, analytical, and postanalytical process phases in a diagnostic clinical laboratory that supports a super-specialty cancer center in India, and identify areas of potential improvement in patient services. METHODS: We collected data from our laboratory during a period of 24 months. Departments in the study included clinical biochemistry, hematology, clinical pathology, microbiology and serology, surgical pathology, and molecular pathology. We had initiated quality assessment based on international standards in our laboratory in 2010, with the aim of obtaining accreditation by national and international governing bodies. We followed the guidelines specified by International Organization for Standardization (ISO) 15189:2007 to identify noncompliant elements of our processes. RESULTS: Among a total of 144,030 specimens that our referral laboratory received during the 2-year period of our study, we uncovered an overall error rate for all 3 process phases of 1.23%; all of our error rates closely approximated the results from our peer institutions. Errors were most common in the preanalytical phase in both years of study; preanalytical- and postanalytical-phase errors constituted more than 90% of all errors. CONCLUSION: Further improvements are warranted in laboratory services and are contingent on adequate training and interdepartmental communication and cooperation.

Isolated primary renal echinococcosis: a rare entity.

Primary renal echinococcosis, a rare entity in diseases involving the kidney, accounts for 2-3 % of all cases. We present a case of 37-year-old female presenting with pain in the right iliac fossa. Radiologically, both ultrasound abdomen and CECT diagnosed as hydatid cyst, mild to moderate hydronephrosis, proximal hydroureterosis, and a possibility of rupturing into the pelvicalyceal system. Renal sparing surgery is the treatment of choice in most cases (75 %) with nephrectomy being reserved for non-functioning kidney as in our case. Histopathological examination of the nephrectomy specimen confirmed the diagnosis.