Plexiform fibrohistiocytic tumor in the submandibular region: A rare diagnosis.

Plexiform fibrohistiocytic tumor (PFHT) is a rare mesenchymal neoplasm of intermediate malignancy, first reported by Enzinger and Zhang in 1988 [1]. It mainly affects children and young adults and preferentially involves the upper extremity [1, 2].We report a rare case in the submandibular region which was diagnosed on histopathology.

Assessment of possible tuberculous lymphadenopathy by PCR compared to non-molecular methods.

Tuberculosis is a major public health problem in India and other developing countries and has formed a lethal partnership with AIDS. It often presents a diagnostic challenge especially when clinical presentation is suggestive but bacteriological proof is lacking. The objective of this study was to compare the various diagnostic techniques in clinically suspected cases of tubercular lymph nodes and to find a suitable, cost-effective but sensitive and specific method for diagnosis. A total of 100 cases were recruited for the study. Fine needle aspiration cytology was done in all cases and the smears prepared were processed for Giemsa, Ziehl-Neelsen's, Kinyoun and Papanicolaou stains. Parts of the aspirated materials were assessed by fluorescent staining, culture and PCR. Seventy-four percent of aspirates were positive by fluorescent stain while only 22% were positive by culture. PCR could be performed in 55 cases, out of which 22 (40%) were positive. When compared to culture, the sensitivity and specificity of PCR were found to be 89.5% and 86.1%, respectively. Fluorescent stain was found to be the most sensitive (81.8%) of the conventional methods but showed poor specificity (28.2%). Interestingly, PCR detected 80% of smear-negative but culture-positive cases.

Hemophagocytic syndrome in malaria and kala-azar.

Hemophagocytic syndrome is a clinicopathological entity characterized by systemic proliferation of cells of the monocyte-macrophage-histiocytic lineage associated with fever, cytopenias, hepatosplenomegaly, lymphadenopathy and coagulopathy. Two forms of the syndrome have been described-familial hemophagocytic lymphohistiocytosis (FHL) of infants and reactive hemophagocytosis syndrome (RHS) encountered at any age. The underlying diseases are heterogenous which include, systemic lupus erythematosus and infections- bacterial, viral, fungal and parasitic. Mechanisms of RHS remain unclear, but cytokines may play a role. Risk factors associated with death are worsening anemia, thrombocytopenia during treatment, presence of DIC, and increase in serum ferritin and â-2 microglobulin and jaundice. We discuss the peripheral blood and bone marrow findings in 14 cases RHS with associated Kala-Azar (9 cases) and malaria (plasmodium vivax-2, plasmodium falciparum-3 cases). Three patients of Kala-azar expired- two due to hemorrhagic shock and one as a result of antimony related myocarditis.

Acute fulminant visceral leishmaniasis in children--a report of two cases.

Kala-azar usually presents in older children and young adults with insidious onset of fever, splenomegaly and pancytopenia. Characteristic L.D. bodies in bone marrow or splenic aspirates are diagnostic of kala-azar. We report two cases of visceral leishmaniasis in children-1 1/2 and 10 year old with unusual presentation and fulminant course. In case 1 a female presented with fever, jaundice and bleeding manifestations. Peripheral smear revealed L.D. bodies in neutrophils as well as monocytes. The liver function tests were deranged. The child died within three days due to respiratory arrest. Case 2 was a boy who presented with fever and altered sensorium with deranged liver function tests. The patient expired within three days due to hepatic encephalopathy. Thus, it is important to consider the diagnosis of Kala-azar even when the presenting complaints are atypical and institute diagnostic and therapeutic measures early to prevent mortality.

Angiomyoma of the palate--a case report.

Leiomyomas are rare tumors of the palate amongst which angiomyomas are the commonest sub-type. Recurrence is rare and prognosis is excellent. Only a few case reports are available in literature. We report a case of angiomyoma of the palate presenting as an encapsulated swelling in the roof of the mouth.

Neurilemmoma of tongue.

Neurilemmoma is usually soimry, benign tumour derived from schwan cells of the Sheaths of peripheral cranial or autonomie nerves. In thehead and neck region it occurs most commonly in association with acoustic nerve within the skuil and is rely fottnd in the oral cavity (1,2). We report here two cases of the iongue diagnosed on histopathohgy.