Prakash R Malur

Necrotizing lymphadenitis in systemic lupus erythematosus: is it Kikuchi-Fujimoto disease?

Kikuchi-Fujimoto disease (KFD; also called Kikuchi disease) is a rare disorder clinically characterized by lymphadenopathy along with constitutional symptoms and several systemic features which may closely mimic infections, malignancies, and autoimmune diseases. Systemic lupus erythematosus (SLE) is an autoimmune disorder which may have several clinical manifestations similar to KFD. Association of KFD with SLE is only rarely described, and whether this is a chance incidence or Kikuchi disease is a localized manifestation of SLE per se remains a matter of debate. We report here coexistence of these two diseases in 1 patient.

Primary intracranial malignant melanoma: A rare casewith review of literature.

We present a rare case of the primary intracranial melanoma in the right parafalcine frontal region in a 65-year-old male. Computed tomography and magnetic resonance imaging showed a Space occupying lesion in the right parafalcine frontal region with necrosis, vasogenic edema and mass effect. A rather well-defined, dark brown-black tumor was totally removed and histologically diagnosed as malignant melanoma. The patient improved after surgery. In our case, no systemic melanomas were found in close clinical examinations, there was a single nodular tumor attached to the leptomeninges and a favorable outcome was obtained by surgical treatment alone. Primary central nervous system melanomas have rarely been reported, and this case is reported for its rarity.

Orbital Rosai-Dorfman disease: report of a case with fine needle aspiration cytology and histopathology.

BACKGROUND Rosai-Dorfman disease, or sinus histiocytosis with massive lymphadenopathy (SHML), is a rare, nonhereditary, benign histiocytic proliferative disorder, affecting mainly the lymph nodes. Orbital involvement in the absence of lymphadenopathy is relatively uncommon. CASE A 50-year-old woman presented to our hospital with gradual proptosis of the left eye for 5 years. Physical examination revealed no abnormalities, including lymphadenopathy. Ultrasonography and magnetic resonance imaging showed a soft tissue mass in the intraconal retroorbital region of the left eye. Fine needle aspiration cytology of the mass yielded a good number of mature lymphocytes, a few neutrophils, plasma cells and many histiocytes exhibiting emperipolesis. A provisional diagnosis of SHML was suggested and later confirmed by histology of the excised mass. CONCLUSION Though the orbit is a rare site of extranodal SHML, the disease should be entertained in the differential diagnosis of orbital swellings. To the best of our knowledge, this is the fourth case of SHML involving the orbit exclusively, with no nodal involvement.

Tubercular orchitis in a patient with AIDS : Report of a case with fine needle aspiration diagnosis

BACKGROUND Although tuberculosis is one of the most common opportunistic infections in AIDS, the testis is rarely involved. Clinically, tubercular orchitis mimics malignancy. Fine needle aspiration (FNA) can be used to distinguish these 2 lesions. CASE A 34-year-old, heterosexual male presented with right scrotal swelling, loss of weight and fever. Clinically, malignancy was suspected. FNA showed a few lymphocytes and neutrophils in a necrotic background. Ziehl-Neelsen staining showed high acid-fast bacillus positivity. Serologic testing for HIV showed seropositivity for HIV I and II antibodies. CONCLUSION FNA is a useful modality in differentiating tuberculosis from malignancy. In developing countries, tuberculosis should be considered in cases of unilateral testicular enlargement. To the best of our knowledge, this is the third reported case of AIDS presenting as testicular tuberculosis.

Primitive neuro-ectodermal tumor of the lung in an adult

A rare case of a thoracic primitive neuro-ectodermal tumor in an adult is presented here. In this case, wide excision surgical excision followed by chemotherapy and radiotherapy were delivered. But due to the rapid aggressive progression of the tumor, which is the characteristic of disease, the patient died within four months after the diagnosis.

Cardiac sarcoidosis causing sudden death

Sarcoidosis is a systemic disease of young adults. Cardiac involvement is rarely diagnosed clinically. In most cases it presents with arrhythmias and conduction disorders. We report a case of sudden death of a young female, wherein sarcoidosis with prominent cardiac involvement was diagnosed at autopsy. The other organs involved were lung and liver. Cardiac sarcoidosis should be considered in young patients with unexplained conduction disorders.

Primary neuroendocrine carcinoma of the thymus

Primary neuroendocrine tumors of the thymus, previously known as carcinoid tumors of the thymus, are unusual and rare tumors, and prognosis for these patients has been difficult to predict. We hereby report a case of primary neuroendocrine tumor of the thymus that had an aggressive and fatal course in spite of surgical resection and adjuvant chemotherapy. These tumors must be regarded as a malignant neoplasm that is prone to metastasize to distant sites, even after total excision.

Primary endobronchial Hodgkin's disease.

We report a case of primary pulmonary Hodgkins disease presenting as an endobronchial mass. Tissue diagnosis was made by microscopic examination following open thoracotomy and excision biopsy of the mass. The patient responded well to the chemotherapy regimen.

Premitive neuro-ectodermal tumour of the lung

Primitive neuro-ectodermal tumour of the lung is an extremely rare occurrence and we hereby report a case of a neuro-ectodermal tumour of the lung which was proved by immuno-histochemical examination of the resected specimen, and he had a very aggressive pattern of behavior.

Serous microcystic adenoma of the pancreas

Serous microcystic adenoma (SMA) is a rare benign neoplasm. It accounts for 1-2% of all exocrine pancreatic tumors. It is thought to arise from the ductal epithelial cells. It is usually located in the body and the tail of the pancreas. It is important to identify SMAs and distinguish them from mucinous cystic neoplasm, which can be premalignant or malignant, and pseudocyst, which is a non neoplastic condition. We present one such rare case of SMA occurring in the head of the pancreas, an infrequent location requiring a Whippels resection.