Sanjay Kala

Extranodal manifestation of Rosai-Dorfman disease with bilateral ocular involvement

Rosai-Dorfman disease, that is, sinus histiocytosis with massive lymphadenopathy is a benign systemic proliferative disorder of histiocytes. The typical clinical presentation of the disease includes bilateral painless massive lymphadenopathy, fever and polyclonal hypergammaglobulinemia. Extranodal involvement is present in only a few cases and skin lesions are the most common form of extranodal disease. However, purely cutaneous Rosai-Dorfman disease is uncommon. In this study, we describe a 10-year-old child presenting with bilateral ocular involvement.

Microfilaria in cytological smears at rare sites coexisting with unusual pathology: A series of seven cases.

Filariasis is a major public health problem in India and microfilaria is sometimes seen during routine fine needle aspiration cytology (FNAC) smears, but it is very rare to find microfilaria coexistent with neoplastic lesions. Here we report a series of seven cases in which microfilaria is associated with neoplastic lesions. Out of these seven cases one is benign and six are malignant. Also we first time report the microfilaria coexistent with parotid pleomorphic adenoma, undifferentiated carcinoma thyroid and gall bladder carcinoma.

Cytological diagnosis of pediatric thyroid nodule in perspective of the Bethesda System for Reporting Thyroid Cytopathology

Background: Thyroid nodule is one of the most common endocrinopathies occurring children and adolescents. Though thyroid nodule is rare in the pediatric age group, the rate of malignancy is much higher in this age group compared to adult population. Aim: The objective is to study the application of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) in pediatric patients and compare the findings with histology. Materials and Methods: A total of 218 cases younger than 18 years were studied in a 4-year period from August 2010 to July 2014. The smears were categorized according to TBSRTC into six categories — Nondiagnostic, benign, atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), suspicious for follicular neoplasm (SFN), suspicious for malignancy (SM), and malignancy. Results: Out of 218 cases, 33 were males and 185 were females. Histological follow-up was available in 44 cases. The diagnosis according to TBSRTC included 12 (5.5%) nondiagnostic, 151 (69.26%) benign, 23 (10.5%) AUS/FLUS, 18 (8.2%) SFN, 5 (2.3%) SM, and 9 (4.1%) malignancy cases. On histological follow-up, the rate of malignancy in each category was 0%, 0%, 8.3%, 10% 100%, and 100%, respectively. Conclusion: The study demonstrates that TBSRTC in pediatric thyroid nodule is as sensitive and specific as in adults, especially with 100% accuracy in the diagnosis of benign and malignant categories.

Tuberculosis Verrucosa Cutis Developing Over A Keloid: A Rare Presentation

Cutaneous tuberculosis can present as either primary or secondary infection, or it can be associated with systemic tuberculosis. It can present with unusual clinical and histological features causing delay in diagnosis and treatment. Tuberculosis verrucosa cutis occurs as a single verrucous lesion over exposed areas of the body along with inflammatory borders and discharging sinus. Here, we are presenting a rare case of tuberculosis verrucosa cutis developing over a keloid. There is no report of such case in literature so far.

Sclerosing mucoepidermoid carcinoma with eosinophilia of the thyroid: A cytological dilemma

Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) of the thyroid is a rare primary thyroid tumor arising in a background of Hashimoto′s/lymphocytic thyroiditis and has been recently introduced in the World Health Organization (WHO) classification of thyroid tumors. It is characterized by extensive sclerosis, squamous and glandular differentiation, and inflammatory infiltrate rich in eosinophil. Here, we are discussing the cytological features of this rare case in a 35-year-old female presented with thyroid swelling and lymph-node enlargement.

Comparative study of positron emission tomography/computed tomography and computed tomography in the evaluation of post-treatment carcinoma cervix patients

Purpose of Study: To evaluate and compare imaging findings using computed tomography (CT) alone and positron emission tomography/CT (PET/CT) fusion imaging in posttreatment carcinoma cervix patients for recurrence. Subjects and Methods: From June 2014 to May 2016, 50 posttreatment carcinoma cervix patients were referred to our institution for PET/CT imaging. In all 50 of these patients referred for evaluation, a reliable reference standard was available. The reference standard was established by histopathological examination of accessible locoregional and nodal/distant metastatic involvement or follow-up of patients. CT and PET/CT were performed and analyzed for locoregional, pelvic nodal, and distant metastasis involvement in posttreatment carcinoma cervix cases. Results: In the evaluation of locoregional involvement, CT alone was found to have a sensitivity of 75% and specificity of 90% while PET/CT was found to have a sensitivity of 95% and specificity of 100%. Furthermore, in evaluation of pelvic nodal involvement, CT alone was found to have a sensitivity of 72% and specificity of 92.6% while PET/CT was found to have a sensitivity of 95.5% and specificity of 92.9%. In context to distant metastasis involvement (including para-aortic nodes), CT alone was found to have a sensitivity of 91.7% and specificity of 96.2% while PET/CT was found to have a sensitivity of 95.8% and specificity of 100%. PET/CT fusion in comparison to CT alone is better in sensitivity and specificity in the detection of locoregional involvement, pelvic node invasion, and distant metastasis in posttreatment carcinoma cervix cases.

Frozen Section versus Paraffin Section in Diagnosis of Breast Lesions: A Comparative Study

Background: Frozen section (FS) examination has a number of indications such as identification of tissue type, benign versus malignant nature of the tissue, type of malignancy, determination of surgical margins, positivity of lymph nodes, and presence of malignant implants and/or metastasis in other tissues. Contraindications to the use of FS exist such as small lesions that could be destroyed by the freezing and sectioning and leaving no tissue for a definitive diagnosis. Therefore, this prospective study was planned to compare the accuracy of FSs versus paraffin sections in diagnosis of breast lesions. Subjects and Methods: The present prospective study was conducted from December 2008 to September 2010 in the Department of Pathology, GSVM. Medical College, Kanpur. A total of 115 cases were studied including benign and malignant breast lesions. Results were compared between FS diagnosis, and gold standard paraffin section diagnosis was evaluated, following Hematoxylin and Eosin staining and analyzed for accuracy in terms of false positivity and false negativity. Results: Out of 115 cases in our study, concordance was found in 109 cases. In our study, concordance for malignant breast lesion was 100%, whereas for benign lesions, it was 95.9%. Four cases (3.5%) were deferred to paraffin section diagnosis and two cases (1.8%) were misdiagnosed on FS. Conclusions: Diagnosis by FS is accurate to 100% in case of malignancy and confirming up to 96% for benign lesions. Its use, thus during breast surgery, is advocated for better clinical management of patients.

Multiple bilateral symmetrical recurrent hyperphosphatemic tumoral calcinosis in a young adolescent girl: A rare entity

Tumoral calcinosis is an uncommon disease characterized by periarticular soft-tissue hyperplasia and calcification. Large joint such as hip, shoulder and elbow are most commonly involved. This entity usually manifest in adolescent females as slowly growing, painless, mobile soft-tissue tumor like mass around the large joint that may interfere with joint function when large. A familial predisposition has been reported. Exact cause is not known, but there is deposition of calcium phosphate with normal calcium and elevated phosphorus levels. Here, we report a case of 15-year-old female presented with symmetrical, recurrent swellings on various joints with milk like fluid extrusion and scar mark of previous excision.

Carcinoma Gall Bladder Presenting as Bilateral Inguinal Lymphnode Metastasis

The inguinal lymph nodes are common site of metastasis from various organs. However, little is known about gallbladder carcinoma presenting as inguinal lymph node metastasis. W e report a case of a primary gallbladder carcinoma with inguinal lymph node metastasis in a 65-year-old male. Clinically , our patient presented with enlarged inguinal lymph nodes without obvious signs and symptoms related to gallbladder carcinoma. Ultrasound abdomen suggested the possibility of a primary gall bladder carcinoma. Exact diagnoses could only be made after fine needle aspiration from gallbladder mass. A high index of suspicion, thorough clinical examination, cytopathological examination are essential to avoid misdiagnosis in such cases. Gallbladder carcinoma, Metastasis, Inguinal lymph node

A Correlative Study Between Transrectal Fnac And Histology Of The Prostate For The Detection Of Prostate Carcinoma.

Aim: To assess the utility of FNAC in diagnosing the prostatic carcinoma .Material and methods: The study of 121 cases was conducted from year 2006 to 2008. The data was analyzed to assess the utility of FNAC for the diagnosis of carcinoma prostate. Results: During the study overall sensitivity and specificity of FNAC were 95.23% and 98.73% respectively and positive predictive value and negative predictive value were 97.56% and 97.50% respectively. The percentage of false positive and false negative cases was 1.26% and 4.76% respectively. Conclusion: The conclusion drawn was that FNAC by trans-rectal route is easiest, accurate, quick method, with minimal discomfort to the patient and outdoor diagnostic procedure for diagnosis of prostatic carcinoma and the result are comparable to that of histopathology.