Bidyut Krishna Goswami

Primary hydatid cyst of the neck diagnosed by aspiration cytology

Primary hydatid cyst of the neck is of extremely rare occurrence even in endemic regions. Clinically mimicking a cold abscess, we report such a case which was diagnosed by fine needle aspiration cytology. The lesion was removed surgically and at 6-month follow-up visit, the patient was a symptom-free.

Disfiguring molluscum contagiosum in a HIV-positive patient responding to antiretroviral therapy

Molluscum contagiosum (MC) is caused by a double stranded DNA virus belonging to the pox virus family. MC lesions are usually pearly, dome shaped, small, discrete lesions with central umbilication. In HIV-positive patients atypical varieties are found. They may be large or nonumbilicated. Individual papules may join to form the agminate variety. This form is rare. Lesions of MC in healthy immunocompetent patients may occur at any part of the body including face, trunk, and limbs. Sexually active adults have lesions usually on the genitalia, pubis, and inner thigh, rarely on the face and scalp. We present a case of agminate MC occurring in a patient with acquired immunodeficiency disease responding to highly active antiretroviral therapy.

Spectrum of hemoglobin variants in the population of northern region of west bengal: an ethnogenetic proposition.

Context: The birth of transfusion-dependent states of hemoglobinopathies including thalassemias is preventable by population screening and genetic counseling. Magnitude is not addressed in the Northern Region of West Bengal where many ethnic variants inhabit. Aims and Objectives: The aim of the following study is to find out the burden of different entities of hemoglobinopathies, their correlation with ethnicity and the “at risk” groups. Subjects and Methods: A descriptive study was conducted from the Hematology Unit of North Bengal Medical College over 1 year on the subjects underwent screening for hemoglobinopathies for detection of abnormal hemoglobin (Hb) variants by “cation-exchange high-performance liquid chromatography” principle along with other relevant tests. Statistical Analysis: Data was analyzed by frequency distribution and Chi-square test assuming P value as 95% of the level of significance using the SPSS version 16 (SPSS Inc., Chicago, Illinois, U.S.A). Result: Abnormal Hb variant was 47.5% among 1872. Hb E trait (34.4%) was most common followed by Hb E disease (25.3%) and others. Hb E disorders (92.7%) were observed mostly among Rajbangsi population while E-β-thalassemias (40%) in the Muslims and a heterogeneous pattern noted among tribal and mongoloid. Conclusion: Hb E hemoglobinopathies was high among Rajbangsi and Muslims with identification of some other hemoglobinopathies involving tribal and mongoloid.

A community based pilot study on prevalence of hemoglobinopathies among the antenatal women in a rural area of Darjeeling district, West Bengal.

Background: Hemoglobinopathies comprising of thalassemias and various hemoglobin (Hb) variants continue to plague the health system of India. Aims: To find out the prevalence of various hemoglobinopathies in the study population and to identify any association with the various ethnic groups residing in rural community of Darjeeling district, West Bengal. Materials and Methods: A community-based cross-sectional study was conducted in Naxalbari block of Darjeeling district, West Bengal from June 2011 to August 2011, involving hemoglobin variant screening by high-performance liquid chromatography (HPLC) method of 188 antenatal women, selected through multistage random sampling technique. Results: 26.6% of mothers had abnormal hemoglobin, the commonest being the Hemoglobin E (Hb E) trait (15.42%). The prevalence of homozygous HbE, HbE βthalassemia, β-thalassemia trait and hemoglobin S-trait in the studied population was 6.91%, 0.53%, 2.12% and 1.06% respectively. There was a single case of the rare hemoglobin J Meerut. Among those having abnormal hemoglobin, 66% belonged to one ethnic group, Rajbanshis. A statistically significant association was noted between Hb E syndrome (comprising of HbE trait, homozygous HbE, HbE-betathalassemia) and Rajbanshis ( P Conclusion: Findings suggest a high prevalence of hemoglobinopathies particularly Hb E in the studied population, especially Rajbanshis and warrant the need of wider community-based initiative for carrier detection and awareness generation.

Cytopathological dilemma of anaplastic sacral chordoma with radiological and histological corroboration.

Chordoma is a relatively rare locally invasive and potentially malignant tumor of fetal notochord origin, affecting the axial skeleton. Cytopathological diagnosis of chordoma is favored by the presence of characteristic physaliphorous cells, bearing abundant foamy cytoplasm dispersed in a myxoid matrix. Anaplastic chordoma or dedifferentiated chordoma, an even rarer variant, can cause a diagnostic confusion with chondrosarcoma from the cytopathological point of view, with similar chondromyxoid matrix and atypical cells. Hence, chordoma bearing anaplastic features needs to be identified and should be distinguished from chondrosarcoma on aspiration cytopathology. We present a case of anaplastic sacral chordoma in a man 59 years of age, causing extensive destruction of sacrum and invading the paravertebral tissues as evidenced by radiology. Fine needle aspiration cytopathology revealed few large pleomorphic hyperchromatic cells, admixed with characteristic physaliphorous cells and myxoid matrix. The cytopathological diagnosis has been confirmed by histopathology and immunohistochemistry. Since anaplastic chordoma bears an unfavorable prognosis, it should be suspected on preoperative aspiration cytopathology. Clinicoradiological correlation along with histopathological and immunohistochemical confirmation is necessary subsequently.

Cytohistopathological Diagnosis of Solitary Plasmacytoma ofClavicle: A Rare Site for a Rare Tumor

Plasmacytoma refers to a malignant tumor composed of abnormal plasma cells which grows within soft tissue or within the axial skeleton. There are three distinct groups of plasmacytoma, solitary plasmacytoma of the bone (SPB), extramedullary plasmacytoma (EMP) and systemic myelomaof which the solitary plasmacytomas of bone (SPB) account for less than 5% of patients with plasma cell myeloma [1]. The SPB more commonly involves the axial skeleton eg: vertebra, ribs, skull, pelvis, femur, clavicle and scapula [2]. Klein et al. [3] found that only 0.45% of more than 1300 primary bone tumours involved the clavicle. The World Health Organization define solitary plasmacytoma of bone (SPB) as a localized bone tumor consisting of plasma cell identical to those seen in plasma cell myeloma ,which appears as a solitary lytic lesion on radiological examination [2]. Case Report

Clinico-pathologic profile of Hodgkin's lymphoma in a rural medical college.

Purpose of studyA prospective study was done at North Bengal Medical College and Hospital (NBMCH), Darjeeling, West Bengal, which caters predominantly to the rural and hilly population. All patients diagnosed as Hodgkin’s lymphoma (HL) were analyzed for clinical presentation, histological classified and staging.ResultsTotal of 48 cases reported for HL were studied (n=48). A lower median age of onset (28.1year) and higher male to female ratio (3.8:1) as compared to western countries were observed. We found neck swelling was the commonest presenting symptom (58.28%) and peripheral lymphadenopathy was the commonest sign (83.33%). “B symptoms” was noted in 79.17% cases. Cervical lymph nodes were commonly involved (79.17%), followed by inguinal (45.83%) and axillary (29.17%). Thoracic lymph nodes and abdominal lymph nodes were enlarged in 29.17% of the cases and 25% of the cases respectively. Eosinophilia was noted in 29.17% of cases. Marrow involvement by neoplastic process was observed in 8.33% of cases and reactive changes in the marrow were observed in 12.5% of cases. We found mixed cellularity subtypes was the commonest (45.83%) followed by nodular sclerosis subtypes (33.33%). At presentation 54.17% of cases were of advanced stage of disease (stage III and IV).ConclusionWe noticed a distinct geographical pattern of HL in respect of age, sex, presentation, histological typing and staging of the disease, which is comparable to some other Indian studies but is noticeably different from patterns noted in Western countries.