Shobha Mohindroo

Isolated tubercular hypoglossal nerve paralysis

Hypoglossal nerve palsy is not an uncommon neurological finding but primary nasopharyngeal tuberculosis (TB) presenting as hypoglossal nerve palsy is very rare. A 31-year-old woman presented with headache and progressive tongue deviation towards the right side. Diagnostic nasal endoscopy revealed soft tissue mass lesion on the posterior wall of nasopharynx while MRI revealed isointense tumour in nasopharynx with normal hypoglossal nerve and brain. Histopathological examination found TB. We discuss the clinical challenges and possible pathogenesis of this rare clinical entity.

Collagenous spherulosis: An interesting cytological finding in breast lesion

Collagenous spherulosis (CS) is a rare and interesting entity associated with benign breast lesions. CS is an incidental finding picked up only on 0.2% of cytology specimen. Typically cytologically of CS of breast consists of central spherical hyaline spherule surrounded by myoepithelial cells. The central hyaline spherule has been found to be basement membrane material histochemically and immunohistochemically. The importance of recognizing CS of breast lies in the fact that similar hyaline globules can occur in adenoid cystic carcinoma of the breast (ACCB). The two lesions need to be differentiated on cytology failing which inappropriate treatment can be given for either of the two lesions. We present here a case of CS associated with benign breast lesion and a case of ACCB to describe their cytological features and key points to differentiate them cytologically.

Type-3 Gaucher disease with bilateral necrosis of the neck of femur: a case report

IntroductionThough Gauchers disease (G.D.), a lipid storage disease is most commonly encountered by the hematologist but we present a case of G.D. type-3 which is rare in Indian subcontinent.Case presentationA 36-year-old Hindu, Indian male patient presented with bony pain, kyphosis, dragging sensation in the abdomen, dementia and ptosis of the left eyelid for one year. Clinical examination and history pointed to be a lipid storage disease. Radiological examination showed bilateral necrosis of the neck of femur. A final diagnosis of G.D. type-3 with bilateral necrosis of the femur neck was reported after examining the bone marrow smears. Unfortunately, we were unable to do the enzyme study as the patient was lost in the follow-up.ConclusionG.D. type-3 with bilateral necrosis of femur neck is rare in our sub-continent. We are adding a new case to stress the importance of early recognition by clinical manifestation and finding of G.C. which is hallmark in the diagnosis of G.D.

Two rare variants of cervical cancer with review of literature

Cervical cancer is the most common malignancy in females in the developing world. Squamous cell carcinoma and adenocarcinoma are the most common histological types. Papillary squamous cell carcinoma is a rare variant of squamous cell carcinoma associated with recurrence and more aggressive behavior. Adenoid cystic carcinoma is a rare variant of adenocarcinoma which is associated with early lymph node and vascular metastasis.

Bilateral ovarian fibromas in a young patient: A rare occurrence

Ovarian fibroma accounts for 4% of all ovarian tumors. The mean age of presentation is 48 years. Nearly 10% cases are seen in age less than 30 years. Bilateral fibromas occur in association with nevoid basal cell carcinoma syndrome (gorlin syndrome). We report a case of bilateral fibromas in a 22-year-old female patient with ascites without any evidence of nevoid basal cell carcinoma syndrome.