Solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas involving the distal body and proximal tail: A case report.

INTRODUCTION AND IMPORTANCE: Solid Pseudopapillary Epithelial Neoplasm (SPEN) of the pancreas is a rare cystic exocrine tumor of the pancreas most commonly occurring in women between 30 and 40 years of age. This case report aims to demonstrate the clinicopathological findings encountered and the management of a patient diagnosed with SPEN. CASE PRESENTATION: An 18-year-old woman with gradually progressive and intermittent abdominal pain in the epigastric region presented to our outpatient department. Physical examination elicited tenderness to palpation in the epigastric area, and imaging findings suggested SPEN of the pancreas involving distal body and proximal tail region of the pancreas. The tumor was resected, and the diagnosis was confirmed on histopathology examination. CLINICAL DISCUSSION: SPEN is a slow-growing tumor with a low-grade malignant potential, found incidentally in asymptomatic patients and symptomatic patients present with abdominal pain. The average tumor size is about 4 to 6 cm in diameter. Imaging is essential for diagnosis, and distal pancreatectomy with splenectomy was the most commonly reported procedure. CONCLUSION: It is crucial to consider a diagnosis of SPEN in women with abdominal pain in the epigastric region as early surgical resection of the tumor results in resolution and excellent prognosis.

A Fortuitous Turn of Evidence in an Elderly Female - A Case of Pulmonary Fusariosis.

Pulmonary mycosis is seen infrequently in our country. It is more common in the immunocompromised. The infections caused by less known species like Fusarium have been found to be increasing in incidence in other parts of the world. We hereby report its occurrence in a 79-year-old, non-immunocompromised female who presented with pyrexia of unknown origin. Her Alanine Phosphatase (ALP) and Lactate Dehydrogenase (LHD) levels were raised. CT scan showed interstitial thickening in subpleural aspect of lungs and multiple enlarged lymph nodes in mediastinum. Liver showed multiple hypodense lesions. Metastasis was suspected for which Fine Needle Aspiration Cytology (FNAC) of liver was done which showed foci of regenerative hepatocytes with desmoplastic stromal tissue fragments and negative for tumour. Her Alpha Fetoprotein (AFP) was normal. The bronchial tree cytology showed endobronchial cells, dust-laden macrophages and chronic inflammatory cells along with fungi on Pap smear studies. This was confirmed by culture that grew Fusarium species. after one week of incubation. The acutely branching septate hyphae of Fusarium species are identical to those of Aspergillus species. In a patient who has a disseminated infection with a septate fungus, growth in culture is important to identify the specific organism and subsequently treatment with appropriate antifungals. In cases like ours, where the infection simulates malignancy, it is even more important to make the correct diagnosis to give the appropriate treatment.

O'Brien's Granuloma- A Case Report.

Actinic granuloma is a self-limiting chronic disorder with elastolytic granulomas, mainly of the sun exposed skin and unknown pathogenesis. We report a case of a middle aged woman with multiple annular erythematous lesions. Histopathology revealed degenerated elastic fibres with histiocyte aggregates surrounded by multiple giant cells suggestive of elastolytic granulomas. She also had associated dyslipidemia and hypothyroidism. Actinic granuloma is relatively rare in the Indian population and needs to be differentiated from conditions like sarcoidosis and granuloma annulare.

Morphological Spectrum of Basal Cell Carcinoma in Southern Karnataka.

INTRODUCTION: Basal Cell Carcinoma (BCC) is the most common skin cancer worldwide, which appears over sun-exposed skin as slow-growing, locally invasive lesion that rarely metastasizes. Many phenotypic presentations are possible. BCCs are more common in males and tend to occur in older people. Majority is found on the head and neck. Many histopathological subtypes have been defined including nodular, micronodular, cystic, superficial, pigmented, adenoid, infiltrating, sclerosing, keratotic, infundibulocystic, metatypical, basosquamous and fibroepitheliomatous. Mixed patterns are common. AIM: The aim was to study morphological spectrum of BCC in a tertiary care hospital in southern Karnataka. MATERIALS AND METHODS: This was a retrospective analysis of 100 cases of BCCs reported in the Department of Pathology over a 9-year period from 2006 to 2014. RESULTS: The mean age of presentation was 62 years. There was slight female preponderance (56%). The most common location was face (65%) and the most common presentation was ulceration (45%). Of the 100 BCCs, 50% were nodular, 13% infiltrating, 6% basosquamous, 4% superficial, 3% keratotic, 3% multinodular and 1% mixed. CONCLUSION: BCC, besides being the commonest cutaneous cancer, is also known for its numerous histological patterns which are shown to have prognostic implications. This study reveals the frequency of the various histological patterns of BCC in southern Karnataka, where it has been rarely studied before.

Coexistence of benign ovarian serous cystadenoma and tuberculosis in a young woman.

Genital tuberculosis involving the ovary in a non-immunocompromised individual is rare. We report a case of coexisting ovarian serous cystadenoma and tuberculosis in a 29-year-old Indian woman. Clinical examination revealed the presence of an abdominal mass suspicious for ovarian neoplasm. Histopathological evaluation revealed ovarian neoplasm and concomitant tuberculosis. To the best of our knowledge, and after an extensive search of the literature, the coexistence of benign ovarian neoplasm and tuberculosis has not been previously documented.

Sclerosing stromal tumour of the ovary--a clinicopathologic spectrum.

Majority of the Sclerosing stromal tumours of the ovary documented in the literature are single case reports. We report a series of 4 cases. Among the 4 cases encountered the mean age at presentation was 22.2 years. The clinical presentation varied from asymptomatic mass per abdomen (2 cases), menorrhagia (1 case) and amenorrhoea (1 case). The tumour was unilateral in all the cases with an average size of 10 cms. Grossly the appearances varied from a solid, partly cystic, edematous tumour (2 cases) to solid,firm tumour with yellow flecks (1 case) to unilocular cystic tumour (1 case). Microscopically, the tumour was characterized by cellular pseudolobules composed of a disorderly admixture of collagen-producing fibroblasts and lipid rich lutein cells with shrunken nuclei. In one case the lutein cells had a robust appearance with abundant cytoplasm and vesicular nuclei. The pseudolobules were very vascular and separated by hypocellular dense to oedematous fibrous tissue. Frozen section demonstrated fat in luteinized cells in 3 cases.

Cytomorphological features of combined myxoid and round cell liposarcoma--a case report.

Fine needle aspiration cytology plays an important role in the preoperative assessment of soft tissue neoplasms. In a 40-year-old man presenting with a large soft tissue mass in the posterior aspect of thigh a diagnosis of myxoid liposarcoma was suggested on FNAC. Scrape smears of the excised mass showed an additional finding of round cell component. Histopathology confirmed combined myxoid and round cell liposarcoma (grade 2), which behaves aggressively when compared to pure myxoid liposarcoma.