Geetha Vasudevan

Gastric cryptococcal infection as an initial presentation of AIDS: a rare case report.

Cryptococcus neoformans has been recognized as a human pathogen over centuries. This has achieved new prominence in the recent years as it is an opportunistic fungi causing fatal, deep mycotic infections in immunocompromised states. Although cryptococcus is principally a pathogen of central nervous system, wide variety of other organs may also be involved. Gastrointestinal cryptococcosis is rarely reported either as an isolated finding or in a disseminated disease. However, even with the strikingly increased incidence of the disease, occurrence of obvious gastrointestinal symptoms directly attributable to cryptococcosis is outstandingly rare. We report a case of gastric cryptococcal infection with esophageal herpes as an initial presentation in an AIDS patient.

Primary Small Cell Carcinoma of The Esophagus - An Eight Year Retrospective Study

INTRODUCTION Primary small cell carcinoma of the esophagus is a rare and aggressive tumor. Patients present with metastatic disease and have a poor clinical outcome. The objective of the study was to correlate clinical and histopathological features of primary small cell carcinoma of the esophagus diagnosed and treated at our hospital. MATERIALS AND METHODS A retrospective study of 11 patients diagnosed with primary small cell carcinoma of the esophagus in Kasturba Hospital, Manipal between 2006 and 2014 was done. The histopathological and immunohistochemical features were correlated with clinical and endoscopic findings. RESULTS Eleven patients were diagnosed to have small cell carcinoma of esophagus with a male preponderance. Common presenting symptoms were dysphagia and weight loss. Majority of the patients showed mid esophageal ulceroproliferative growth. Biopsy findings were consistent with the characteristic morphology of small cell carcinoma and demonstrated immunoreactivity to neuroendocrine markers. In addition, few cases also showed adjacent squamous dysplasia/carcinoma. Most of the patients presented with metastatic disease, liver being the most common site. These patients were treated by chemotherapy and radiotherapy. CONCLUSION Esophageal small cell carcinomas are aggressive tumors with high rates of distant metastasis. Presence of squamous dysplasia /squamous cell carcinoma in the adjacent mucosa supports the hypothesis that this neoplasm arise from pleuripotent stem cells. Presence of the latter is also useful to rule out spread from lung primary.

Hepatic Epithelioid Hemangioendothelioma in an Eight Year old - A Case Report

Hepatic epithelioid haemangio-endothelioma (HEHE) is a rare vascular tumour of endothelial origin. The etiology of this tumour is unknown and has a variable clinical outcome. It usually affects adults and is extremely rare in children. Histologically, HEHE is characterized by epithelioid to dendritic tumour cells with intracytoplasmic lumina containing RBCs and a myxoid to sclerotic stroma. Being a rare entity, awareness and a high degree of suspicion is required to correctly identify this tumour. We report a case of hepatic hemangioendothelioma in an 8-year-old child.

Plasmablastic Lymphoma: A Report of 2 cases with Review of Literature

Plasmablastic lymphoma (PBL) is an aggressive subtype of Non-Hodgkin Lymphoma (NHL) initially described in extra-nodal sites in an immunocompromised and later in immune-competent patients. PBL remains a diagnostic challenge due to morphological overlap with various other entities and also due to similarities on immunohistochemistry with plasma cell myeloma. In-spite of therapeutic advances, PBL remains an aggressive disease with high fatality rate. We describe 2 cases of this uncommon neoplasm; both in immunocompromised patients.

CMV endometritis in a non- immunosuppressed patient presenting as recurrent pyometra- A case report -

Cytomegalovirus infection of the female genital tract is a rare entity. We present a case of 70 year old woman who came with recurrent pyometra, but was otherwise in good health. Hysterectomy was done and the endometrium showed occasional stromal cells with karyomegaly and intranuclear eosinophilic inclusions consistent with cytomegaloviral infection and dense lymphoplasmacytic infiltrate. This was an incidental finding in an otherwise immunocompetent nonpregnant woman, hence being reported for its rarity and uncommon presentation. Keywords: cytomegalovirus, inclusions, endometrium.

H. Pylori Associated Spruelike Duodenitis Presenting with Chronic Diarrhea,Hypoalbuminemia and Edema â A Case Report

Helicobacter pylori (H.pylori) infection is known to cause varied clinical presentations and histological changes in the gastrointestinal tract. It may be one of the several mimickers of celiac disease. We present a case of a 48 year old female who presented with intermittent episodes of diarrhea, loss of appetite and weight loss. On evaluation she had Iron deficiency, megaloblastic anemia and hypoalbuminemia causing pedal edema. Histopathological examination of gastric and duodenal mucosa revealed H.pylori associated gastritis sprue like morphological changes in the duodenal mucosa. She was put on anti H.pylori regimen leading to rapid clinical improvement within two months of initiating treatment. Hence, the possibility of H.pylori induced duodenitis should also be considered in the differential diagnosis of chronic diarrhoeal diseases.

Fibrous Pseudotumour of the Testis

Fibrous pseudotumour of the testis is a rare benign lesion involving the paratesticular region. It usually presents in nodular form and may cause diagnostic dilemma resulting in unnecessary sacrifice of the testes. We report a rare case of diffuse fibrous pseudotumour which had to be treated by orchiectomy.