Sheetal G. Gole

Successful treatment of buschke-löwenstein tumour by surgical excision alone

A 48-year-old man presented with multiple warts in groin for 1 year, which progressively increased in size. Local examination showed large vegetative growth in perianal area. Full thickness excision of involved skin and lesions was undertaken by electrocautery. Entire wound was left open to heal by secondary intention. Histopathological examination suggested Buschke-Löwenstein tumour. Postoperative follow-up for more than 2 years showed the absence of any recurrence.

Aggressive Digital Papillary Adenocarcinoma in a Young Female-a Rare Presentation.

A 20 year old female presented with a recurrent soft tissue swelling over the medial aspect of proximal phalanx of left little finger. It had recurred one year after excision. There was no lymphadenopathy or bony involvement. Previous histopathology reports were not available. After excision histopathological diagnosis was aggressive digital papillary adenocarcinoma. Later Ray’s amputation of little finger was planned. Aggressive digital papillary adenocarcinomas are rare sweat gland tumors which occur on hands, fingers, and toes. They have high local recurrence rate and may metastasize to lungs and lymph nodes.

Plexiform neurofibroma: A rare tumor of submandibular salivary gland

A 15-year-old boy presented with swelling in the submandibular region. X-ray of the swollen part showed faint radio opaque shadow. A provisional diagnosis of sialadenitis with sialolithiasis was made. Excised mass was reported histopathologically as plexiform neurofibroma of submandibular salivary gland. Plexiform neurofibroma of the salivary gland is a rare benign tumor often present in the parotid gland. It is very rare in submandibular salivary gland. It is a slow growing, locally infiltrating tumor.

Gallbladder Carcinoma and Its Mimics

Background: Symptomatic gallstone disease is most common indication for routine cholecystectomy. Gallstones cause various histological changes in gallbladder ranging from metaplasia to dysplasia and gallbladder carcinoma. Aims: Study was conducted to evaluate histopathological lesions in gallbladder diseases, correlate clinical and histopathological diagnoses in cholecystectomies and to know prevalence of incidental gallbladder carcinoma in our region. Method: All cholecystectomy specimens received in histopathology laboratory during study period of one year were included. Detailed gross and microscopic examination was done in each case. Slides were stained by Hematoxylin and Eosin stain. Results: Total 290 cholecystectomy specimens were studied over a period of one year. Clinically suspicion of gallbladder carcinoma was raised in five cases due to preoperative and intraoperative findings of thickened gallbladder wall with adherence to surrounding structures and presence of gallstones. On microscopy, three cases of these were reported as xanthogranulomatous cholecystitis, one as nonspecific chronic cholecystitis and one was rare case of eumycetoma of gallbladder. On histopathological examination suspicion of gallbladder carcinoma was raised in three cases of dysplasia and final diagnosis was biliary intraepithelial neoplasia-3 in two cases and biliary intraepithelial neoplasia-1 in one case. Histopathologically two cases (0.69%) were reported as gallbladder carcinoma and clinically there was no suspicion of gallbladder carcinoma in both cases. However in one case suspicion of gallbladder carcinoma was raised intraoperatively while one case was of incidental gallbladder carcinoma (0.34%). Conclusion: Gallstones disease can mimic gallbladder carcinoma clinically while incidental gallbladder carcinoma can occur in grossly normal looking gallbladder.

Comparison of conventional Ziehl–Neelsen method of acid fast bacilli with modified bleach method in tuberculous lymphadenitis

Introduction: Tuberculosis caused by Mycobacterium tuberculosis is a chronic infectious disease and a major health problem in developing countries, with lymphadenopathy being the most common presentation. Tuberculous lymphadenitis can be diagnosed on fine needle aspiration cytology of lymph node. Conventional Ziehl–Neelsen method for acid fast bacilli plays a key role in the diagnosis and monitoring of treatment for tuberculosis, however, with low sensitivity. Present study emphasizes the role of bleach concentration method in fine needle aspiration cytology of lymph nodes over conventional direct smear microscopy. Materials and Methods: The study included 75 patients with clinically suspected tuberculous lymphadenopathy who were referred to the Department of Pathology in a tertiary care hospital, Faridabad. Data regarding age, sex, duration and site of swelling, nature of aspirate, and cytomorphological diagnosis were documented for each patient. Results: Of the total 75 cases, 15 were positive both in conventional Ziehl–Neelsen method and bleach concentration method. By bleach concentration method, additional 34 cases showed positivity that were not revealed by conventional Ziehl–Neelsen method. Thus, a total 49 cases were positive for acid fast bacilli. Conclusion: There are problems in arriving at an absolute diagnosis in certain cases of tuberculous lymphadenitis when the aspirate shows polymorphous picture with occasional epithelioid cells and absence of typical Langhans giant cell or caseous necrosis. In the present study, acid fast bacilli positivity was established in 65.33% of the cases with the bleach method. Bleach method for detection of tubercle bacilli has a high case detection rate than that of the conventional Ziehl–Neelsen method.