Primary Spindle Cell Malignant Melanoma of Esophagus: An Unusual Finding.

Malignant melanoma of esophagus is usually a metastatic tumour rather than a primary tumour. Primary malignant melanoma accounts for less than 0.2% of all esophageal neoplasm. We report a case of primary spindle cell malignant melanoma of esophagus in a 69-year-old male who presented with history of dysphagia since 1 month. Radiological examinations revealed polypoidal growth at lateral aspect of esophagus. Biopsy was reported as grade III squamous cell carcinoma. Video assisted thoracoscopic esophagectomy was performed. Histopathological examination along with immunohistochemistry gave confirmed diagnosis of primary spindle cell malignant melanoma of esophagus. Though a rare entity, due to its aggressive nature and poor prognosis primary malignant melanoma should be one of the differential diagnoses in a patient with polypoidal esophageal mass lesion. Despite radical surgical treatment prognosis is extremely poor.

Helicobacter pylori Associated Gastritis in Northern Maharashtra, India: A Histopathological Study of Gastric Mucosal Biopsies.

INTRODUCTION: Helicobacter pylori (H.pylori) are of major concern today because of its causal relationships with gastrointestinal diseases. It represents one of the most common and medically important infections worldwide. H.pylori plays a key role in the aetiology of chronic gastritis, duodenal ulcer, gastric carcinoma and MALT lymphoma. There is paucity of literature regarding the morphological changes in H.pylori associated gastritis. AIM: We undertake this study to find out the association and prevalence of H.pylori associated gastritis by histopathological methods in North Maharashtra, India. MATERIALS AND METHODS: A total 310 patients with various upper gastrointestinal disorders were included in this study over the period of 19 months from July 2013 to January 2015. The detailed clinical history was taken and patients were subjected to video gastroscopy. Each biopsy was studied with Haematoxylin and Eosin/Giemsa method. RESULTS: The prevalence of H.pylori was high in third to fourth decades. Out of 310 patients of gastrocopy, 144 were H.pylori positive by Haematoxylin and Eosin/Giemsa method. Morphological changes specific for H.pylori was noted as atrophy and irregular gastric mucosa, lymphoid aggregates and reactive atypia. Male patient were outnumbered by female patients. CONCLUSION: Histopathological evaluation is the gold standard for diagnosing H.pylori infection. Prevalence of H.pylori in the present study was 46.5% in patients undergoing videogastroscopic biopsies for gastritis and vague upper gastrointestinal symptoms. Furthermore and large scale studies are required to establish the diagnostic modalities for H.pylori associated gastritis to prevent morbidity and mortality.

Cytodiagnosis of isolated primary hydatid cyst of breast masquerading as a breast neoplasm: A rare case report.

Hydatid cyst in the breast is very rare and unusual for its location. Reported incidence of hydatid cyst in the breast is 0.27% in the literature. Herein, we report a case of hydatid cyst of breast in a 65-year-old female who presented with painless, slowly growing lump in the breast mimicking breast neoplasm clinically. Radiological investigations such as ultrasonography and mammography may be helpful but not conclusive. Preoperative fine-needle aspiration cytology (FNAC) diagnosis was consistent with hydatid cyst of breast and was without any complications. Histopathological examination of lumpectomy specimen confirmed the diagnosis of hydatid cyst of breast. High suspicion of this entity should be there in the differential diagnosis in the evaluation of breast lump in endemic as well as in migrant population in nonendemic areas.

Gastrointestinal stromal tumour of small intestine presenting as a mesenteric mass.

Gastrointestinal stromal tumors (GISTs) are uncommon tumors; accounts for 0.1% to 3% of all gastrointestinal neoplasm. Most common site of involvement is stomach (60-70 %), small intestine (20-30 %) and rarely at extra-gastrointestinal sites like omentum and mesentery called as extra-gastrointestinal stromal tumor (EGIST). Diagnosis is based on characteristic histological findings and expression of transmembrane receptor tyrosine kinase protein (CD 117) derived from activated c-kit gene. Herein, we report a case of GIST of small intestine presented as mesenteric mass in a 35- year-old female and discuss review of literature.

Primary intratesticular pleomorphic leiomyosarcoma: a rare case report.

Intratesticular leiomyosarcoma is an extremely rare tumor of the genitourinary system. We report a case of intratesticular pleomorphic leiomyosarcoma in a 68-year-old male who presented with gradual painless enlargement of the right scrotal mass over a period of 1-2 years. Radiological examination revealed a right testicular tumor.Right radical orchiectomy was performed with high ligation of the spermatic cord. Histopathological examination along with immunohistochemistry confirmed the diagnosis of a pleomorphic leiomyosarcoma of the testis. This is, to the best of our knowledge, the 13 th case of primary intratesticular leiomyosarcoma and the third case of high-grade (pleomorphic) intratesticular leiomyosarcoma in an elderly male reported in the literature.

Clinicopathological Spectrum of Endometrial Changes in Peri-menopausal and Post-menopausal Abnormal Uterine Bleeding: A 2 Years Study.

BACKGROUND: Abnormal uterine bleeding is the Common presenting complaint in Gynaecology Outpatient Department in all age groups. It is due to the anovulatory cycles which are commonly seen in adolescent and peri-menopausal women. Abnormal uterine bleeding is caused by wide variety of organic or non-organic causes. Histopathological examination of endometrial sample remains the gold standard for diagnosis of endometrial pathology. AIM: To study the clinicopathological spectrum of endometrium in abnormal uterine bleeding in peri-menopausal and post-menopausal age groups. MATERIAL AND METHODS: The study included prospective analysis of 119 cases of endometrial samples in patients of abnormal uterine bleeding above 40 years of age. The specimens were routinely processed and H&E stained slides were studied. Patients were categorized into peri-menopausal (40-49 years) and post-menopausal (> 50 years) age group. RESULTS: A total of 119 specimens of endometrium were analyzed. Maximum number (73.94%) of cases were from peri-menopausal age group. The most common presenting complaint was menorrhagia (48.86%) followed by post-menopausal bleeding (26.05%). In peri-menopausal age group proliferative endometrium (35.22%) was the predominant histopathological pattern followed by endometrial hyperplasia (23.86%). Atrophic endometrium (25.80%) was the most frequent finding followed by endometrial hyperplasia (19.35%) in post-menopausal age group. Three cases of endometrial carcinoma were reported in post-menopausal age group only. CONCLUSION: A thorough histopathological work up and clinical correlation is mandatory in cases of abnormal uterine bleeding above the age of 40 years to find out organic lesions. Careful screening can detect early cancer of endometrium which has excellent prognosis and it will help in further management.