ingh S

Ectopic decidual reaction mimicking peritoneal tubercles: a report of three cases.

Ectopic decidual reaction is commonly seen in the ovary and cervix; however, peritoneal localization is rare. Peritoneal deciduosis is usually an incidental histological finding. It may present a diagnostic dilemma by mimicking grossly peritoneal carcinomatosis or tubercles and deciduoid mesothelioma, microscopically. We report three cases of ectopic decidual reaction discovered incidentally during caesarian sections, as whitish yellow nodules resembling tubercles. Histology revealed extensive decidualisation. To the best of our knowledge, this is the first report of ectopic decidua mimicking peritoneal tubercles.

Paediatric cutaneous blastomycosis: a rare case diagnosed on FNAC.

Blastomycosis, usually presenting as pneumonia, is more common in adults than in children. Moreover, cutaneous blastomycosis is quite uncommon in children. We describe a case of cutaneous blastomycosis in an 8‐year‐old boy who presented with multiple hyperkeratotic verrucous plaques where diagnosis was made on fine‐needle aspiration cytology, and the infection responded well to oral itraconazole therapy with reduction in number of spores and size of lesions. Diagn. Cytopathol. 2009.

Multiple disseminated abdominal hydatidosis presenting with gross hydatiduria: a rare case report.

Cystic hydatid disease may develop in almost any part of the body. Approximately 70% of the hydatid cysts are located in the liver followed by the lung (25%). The kidneys, spleen, mesentry, peritoneum, soft tissues and brain are uncommon locations for hydatid cysts. Renal involvement in echinococcosis is extremely rare. Hydatiduria accompanies only 10-20% of all cases of renal hydatidosis and is usually microscopic. Gross hydatiduria is an exceptional presentation of hydatidosis. We report an exceptionally rare case of multiple hydatidosis with cysts in the liver, spleen, kidney and peritoneal cavity, presenting with gross hydatiduria.

Acid-fast bacilli positive isolated tubercular splenic abscess in a HIV-negative patient

Isolated splenic tubercular abscess in a HIV-negative patient is an exceedingly rare clinical condition. It is even more rare to demonstrate acid-fast bacilli positivity on Ziehl-Neelson stains in such cases. We hereby present one such case.

Microfilaria in malignant pleural effusion: an unusual association.

Lymphatic filariasis is common in tropical countries and is endemic in India. Filariasis presenting with pleural effusion is an unusual presentation. Malignancy in association of filarial pleural effusion is extremely rare. We report a case of a 60-year-old female who presented with chest pain, loss of weight and breathlessness for a few months. Pleural fluid examination revealed malignant cells, along with microfilaria of Wuchereria bancrofti.

Multicentric malignant gastrointestinal stromal tumor.

Malignant gastrointestinal stromal tumor (GIST) is a rare type of sarcoma that is found in the digestive system, most often in the wall of the stomach. Multiple GISTs are extremely rare and usually associated with type 1 neurofibromatosis and familial GIST. We report here a case of a 70-year-old woman who reported pain in the abdomen, loss of appetite, and weight loss for six months. Ultrasound examination showed a small bowel mass along with multiple peritoneal deposits and a mass within the liver. Barium studies were suggestive of a neoplastic pathology of the distal ileum. A differential diagnosis of adenocarcinoma/lymphoma with metastases was entertained. Perioperative findings showed two large growths arising from the jejunum and the distal ileum, along with multiple smaller nodules on the serosal surface and adjoining mesentery of the involved bowel segments. Segmental resection of the involved portions of the intestine was performed. Histopathological features were consistent with those of multicentric malignant GIST-not otherwise specified (GIST-NOS). Follow-up examination three months after surgery showed no evidence of recurrence.

Oxyphilic clear cell carcinoma ovary.

1 O xyphilic clear cell carcinoma of the ovary is a rare variant of clear cell carcinoma with abundant eosinophilic cytoplasm. The importance of recognizing this entity lies in distinguishing it from diverse other primary and metastatic oxyphil cell tumors of the ovary. A 60-year-old postmenopausal female presented with complaints of heaviness in the abdomen associated with loss of weight and appetite. There were no urinary complaints or bleeding per vaginum. A vague mass was palpable in the lower abdomen measuring about 8x5 cm. Multiple bilateral inguinal lymph nodes were palpable. On per vaginal examination, a firm solid mass measuring 8x4 cm was felt through the right and posterior fornix, extending into the left fornix. CA-125 was markedly elevated at 18,250 U/ml. Pap smear revealed benign reactive changes of inflammation. Ultrasonography revealed a cystic lesion in the right iliac fossa measuring 9.4x3 cm with multiple hypoechoic solid areas measuring 4x4 cm in the right adnexal region. Contrast enhanced computerized tomography Pelvis revealed a complex right abdominopelvic mass predominantly in the right iliac fossa showing cystic component with multiple enhancing mural excrescences and an ill-defined solid component. There was extensive small bowel and omental involvement with anterior rectal wall infiltration, ascites and paraortic lymphadenopathy. An impression of pelvic malignancy, most likely, ovarian was made. Barium meal follow-through did not reveal any significant abnormality. A staging laparotomy with ovarian biopsy was performed. On peroperative examination, abdominal surfaces were studded with metastatic deposits. The tumor was unresectable, with sigmoid colon, uterus and both ovaries forming a single jammed up mass. Paraaortic lymph nodes were enlarged and firm. Friable tissue bits from the tumor were sent for histopathology. Histopathological findings: Microscopic examination revealed tumor cells arranged in nests, sheets [Figure 1], tubules and acini. Occasional papillary structures [Figure 2] were also noticed. The individual cells were large, round to polygonal with abundant eosinophilic cytoplasm, vesicular pleomorphic nuclei with coarsely clumped chromatin and one to two prominent eosinophilic nucleoli. Occasional giant cells were also seen. The tumor cells were separated by thin fibrovascular septa infiltrated by neutrophils, with focal areas of hemorrhage. Mitotic activity was 5-10/10 HPF. Also seen were foci of conventional clear cell carcinoma [Figure 3] and the characteristic hobnail cells. Tumor cells showed focal PAS positivity. Immunohistochemically, the tumor cells were cytokeratin (CK) and epithelial membrane antigen (EMA) positive and alfa fetoprotein (AFP) negative. The diagnosis of oxyphilic variant of clear cell …