Epignathus Leading to Fatal Airway Obstruction in a Neonate.

Teratomas are benign tumours containing cells from ectodermal, mesodermal and endodermal layers with an incidence of about 1 in every 4,000 births. Their commonest site is sacro-coccygeal region, followed by anterior mediastinum. The incidence of teratomas localised to the head and neck region is around 2-9% of all cases. Epignathus is a rare congenital oropharyngeal teratoma originating from the base of the skull. Here we present a rare case of oropharyngeal teratoma in a neonate who was referred to our institute with an ill-defined oral mass protruding through a cleft in the hard palate. Computed tomography scan showed a contrast-enhanced solid mass with areas of calcification and fat extending to oropharynx and nasal cavity with hard palate defect suggestive of a teratoma. Unfortunately, the patient succumbed due to respiratory compromise before the biopsy could be done. Postmortem histopathological examination confirmed diagnosis of benign teratoma consisting of mature tissue.

Pancardiac tuberculosis - a case report.

Tuberculous involvement of the heart though not common has been reported in literature. Pericardium is commonly involved followed by the myocardium. Endocardial involvement is rare. We would like to report a case of a 14-year-old female with florid and extensive involvement of all the layers of the heart by tuberculosis.

Sudden Death in a Case of Isolated Left Ventricular Noncompaction: An Autopsy Case Report.

We report a case of isolated left ventricular noncompaction in a 15-year-old girl, who presented with sudden death. There were no associated anomalies or history of cardiac disease.

Primary adenocarcinoma of lung: a pictorial review of recent updates.

Primary adenocarcinoma of lung has replaced squamous cell carcinoma as the commonest histological subtype of lung cancer and the incidence of primary lung adenocarcinoma appears to be rising. Although the main factors behind this 'epidemic-like' situation are largely undiscovered, filter cigarettes appear to significantly contribute to this shift in the histopathological spectrum. The new multidisciplinary classification of adenocarcinoma of lung was introduced to address advances in clinical, pathological, radiological and molecular sciences. The purpose of this essay is to discuss various classes of lung adenocarcinoma in the new classification with their classical imaging features on computed tomography and summarise the recent advances in the field of radiology and review radiology recommendations.

Fine needle aspiration cytology of epididymal nodules.

BACKGROUND: The incidence of non neoplastic lesions are much more common in epididymis. Clinically, epididymal nodules are easily accessible to fine needle aspiration cytology (FNAC) procedure. There are very few literature reports documenting the role of cytology in evaluation of epididymal nodules. Thus, we studied patients presenting with palpable epididymis nodules in the out patient department (OPD) from a tertiary care general hospital. AIM: This study is aimed to put forth the diagnostic utility of FNAC in palpable lesions of epididymis. MATERIALS AND METHODS: A total of 40 palpable epididymal nodules were aspirated as a routine OPD procedure as part of this study. Smears were fixed in isopropyl alcohol and air dried. In all the cases, wet fixed papanicoloau stained and air dried giemsa stained smears were studied. Zeihl Neelsen stain was performed in cases which yielded caseous aspirate. RESULTS: Except for two cases of adenomatoid tumor of epididymis all other lesions were nonneoplastic and included 14 cases (35%) of tuberculous granulomatous inflammation, 10 (25%) cystic nodules (9 spermatoceles and 1 encysted hydrocele), 5 (12.5%) of nonspecific inflammations, 3 (7.5%) filarial infection, 3 (7.5%) sperm granulomas and 3 (7.5%) adenomatous hyperplasia of rete testes. Except for the two tumors, one adenomatous hyperplasia and one tuberculous lesion, no other lesion was excised. Follow up and response to therapy was available in 78% patients and resolution indicated appropriateness of the diagnosis CONCLUSIONS: Thus, as most of the lesions in epididymis are non neoplastic responding to medical line of treatment and FNAC served to aid diagnosis of non specific inflammation and avoid surgical excision in most cases.

MRI appearance of perianal carcinoma in Crohn's disease.

Detection of carcinoma in perianal Crohn's disease can be difficult. The purpose of this study was to describe the MRI appearance of anorectal cancer in patients with perianal Crohn's disease. A total of six patients with anorectal carcinoma (four mucinous adenocarcinoma, two squamous) in Crohn's disease were retrospectively reviewed. Axial T2 and dynamic postcontrast fat-suppressed T1-weighted gradient echo sequences were performed, and findings were compared with 18 noncancer patients with perianal fistulae in Crohn's disease. MRI characteristics of carcinoma were irregular inner wall contours and delayed mild enhancement of internal tissue. The combined features of an irregular internal wall and delayed enhancing tissue were seen exclusively in cancer patients. The four cases of mucinous adenocarcinoma all displayed a pattern of lobulated fluid-filled cavities with delayed internal tissue enhancement. This pattern was not seen in any of the control cases. The presence of a double-layered enhancement pattern was seen in both cases of squamous carcinoma and in only one of four cases of mucinous adenocarcinoma and one of 18 noncancer cases. The pattern of contrast enhancement is valuable in the MRI diagnosis of carcinoma in perianal Crohn's disease.

Computed tomographic histogram analysis in the diagnosis of lipid-poor adenomas: comparison to adrenal washout computed tomography.

OBJECTIVE: To evaluate the ability of computed tomographic histogram analysis to diagnose lipid poor adenoma in comparison with adrenal washout computed tomography (CT). MATERIALS AND METHODS: Adrenal CT washout examinations performed during a period from January 2000 to July 2005 were reviewed. Computed tomographic histogram analysis was performed on the unenhanced component of the study, and sensitivity was assessed at thresholds of more than 5% and 10% negative pixels. Liver and spleen were used to represent the control/nonadenoma group. Computed tomographic noise was measured recording standard deviation (SD) of mean CT attenuation in adrenal, liver, and spleen. RESULTS: Twenty-four lipid-poor adenomas included exhibited more than 60% absolute enhancement washout (range, 60%-79%, mean, 69%) and remained stable for a period greater than 6 months. At threshold of more than 5% or 10% negative pixels CT histogram analysis yielded sensitivities of 91.6% and 70.8%, respectively, with 100% specificity. The mean SDs of adrenal, liver, and spleen were 18.2, 16.4 and 15, respectively. These differences in the mean SD were much smaller compared with the differences in the percentage of negative pixels in adrenal, liver, and spleen of 12.75%, 0.75%, and 0.25%, respectively. CONCLUSIONS: Computed tomographic histogram analysis has good potential in the diagnosis of lipid-poor adenoma and can reduce the need to perform adrenal washout CT.