Sufian Zaheer

Primary neuroendocrine carcinoma of the breast

Primary neuroendocrine carcinoma of the breast is rare-only about 30 cases have been reported in literature. Immunohistochemical examination showing expression of chromogranin and/or synaptophysin confirms evidence of neuroendocrine differentiation. Usually foci of neuroendocrine differentiation can be seen in breast carcinoma and are reported to be present in about 2-5% of breast cancer cases. Here, we report a case of breast carcinoma in which most of the areas studied on the tissue section showed neuroendocrine differentiation.

Giant cell tumor along with secondary aneurysmal bone cyst of scapula: A rare presentation

Giant cell tumor (GCT) is a distinctive lesion characterized by the proliferation of multinucleate giant cells in a stroma of mononuclear cells; it is generally seen in skeletally mature individuals. GCT of bone is usually found in the long bones around the knee or in the distal radius of young adults and is unusual in the flat bones. We report a case of GCT of the acromion of the scapula, with a secondary aneurysmal bone cyst, in a 30-year-old female. Based on our review of the English language medical literature, it appears that the occurrence of a GCT along with a secondary aneurysmal bone cyst in flat bones (e.g.. the scapula) is very rare.

Xanthogranulomatous pyelonephritis: Rare presentation of a rare disease

Xanthogranulomatous pyelonephritis is a rare chronic renal infection of unknown pathogenesis characterized by replacement of renal parenchyma by lipid filled macrophages frequently associated with an enlarged, non-functioning kidney and an obstructing calculus. We report a case of a 45 year old non diabetic female who presented with gradually enlarging renal mass with extensive retroperitoneal involvement and a non-functioning kidney with no evidence of obstructing stone or fat density and simulating malignancy. She was diagnosed as stage III Xanthogranulomatous pyelonephritis and managed with radical nephrectomy with favourable outcome.

The Role of Intraoperative Cytology in the Diagnostic Evaluation of Ovarian Neoplasms

Objective: To determine the role of intraoperative cytology (IOC) in the diagnostic evaluation of ovarian neoplasms. Methods: The present study was conducted in the Department of Pathology, Jawaharlal Nehru Medical College, AMU, Aligarh, India, over a time span of 18 months. Depending on the consistency of the lesion, touch, scrape or crush techniques were used to prepare cytological smears. Smears were fixed in 95% ethyl alcohol and then stained with hematoxylin and eosin or Papanicolaou stains. Cytological results were compared with the histological diagnosis taking the latter as the gold standard. Results: Of 50 lesions studied by IOC, 25 lesions were labeled as benign, 24 lesions as malignant and 1 lesion was inconclusive. Final histological diagnoses labeled 25 lesions as benign and 25 lesions as malignant. Comparing the diagnosis of cytology smears with histology sections, 47 of 50 cases were concordant. Sensitivity, specificity and diagnostic accuracy were 95.8, 96.0 and 95.8%, respectively. Conclusions: IOC is a good complement to histopathology in the study of ovarian neoplasms, particularly in developing countries like ours, where the facility of frozen sections is often not available, since a rapid preliminary diagnosis may help in surgical management planning.

Kikuchi-Fujimoto Disease: Diagnostic Dilemma and the Role of Immunohistochemistry

Kikuchi-Fujimoto (KD) disease is the rare differential diagnoses of chronic cervical lymphadenopathy of unknown etiology. The findings of histopathology may be overlapping, in such condition immunohistochemistry has a definite role to play. Since Tubercular lymphadenopathy is the commonest cause for chronic cervical lymphadenopathy in developing and tropical country like India. Occasionally it is misdiagnosed, ignoring the other rare condition like KD if immunohistochemistry is not taken into consideration to differentiate. As a result the morbidity increases and cost of antitubercular treatment (ATT) in wrong diagnosed case is enormous. We report a similar case of misdiagnoses, non responsive to ATT, finally diagnosed as a case of Kikuchi-Fujimoto disease, did well after recommended treatment. Keywords Necrotizing lymphadenitis; Chronic cervical lymphadenitis; Immunohistochemistry

Enteric Duplication Cysts in Children: A Clinicopathological Dilemma.

AIM Enteric duplication cysts are rare and uncommon congenital malformations formed during the embryonic period of the development of human digestive system and are mainly encountered during infancy or early childhood, but seldom in adults. The clinical presentation is extremely variable depending upon its size, location and type. We present six cases of enteric duplication cysts with diverse clinico-pathological features. MATERIALS AND METHODS This study was carried out in the Department of Pathology and Department of Paediatric Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India for a period of 2 years (January 2013 - December 2014). We retrospectively analyzed six patients of enteric duplication cysts based on data obtained, which consisted of patients age, sex, clinical presentation, radiological features, operative findings and histopathology report. The data collected was analyzed by descriptive statistics. RESULTS Six children between age range of 3 days to 10 years had enteric duplication cysts. Two had ileal and one each were of pyloroduodenal, colonic and rectal duplication cyst. In one patient a presumptive diagnosis of enteric duplication cyst was made. Radiology played an important contributory role in diagnosis of these cysts in all the patients but histopathology proved to be gold standard for its confirmation. All these patients were managed by surgical excision. The postoperative and follow up period in all the cases was uneventful. CONCLUSION It is important to be aware and make a definitive diagnosis of this rare congenital anomaly as they can present in various clinical forms and can cause significant morbidity and even mortality if left untreated by causing life threatening complications.

Sister Mary Joseph's nodule: a rare cytologic presentation

Umbilical metastasis is one of the main characteristic signs of extensive neoplastic disease and is universally referred to as Sister Mary Josephs nodule. It indicates neoplasm of inner organs mostly located in the gastrointestinal tract or the pelvis. However, in approximately 15–30% the primary tumor remains occult. In most cases, Sister Mary Josephs nodule appears as an early and sometimes the only symptom of the malignancy. Here we report a rare fine needle aspiration (FNA) cytologic diagnosis of umbilical metastasis of an ovarian carcinoma.

Leiomyoma of scrotum.

Leiomyoma is a benign tumor of smooth muscles. Leiomyoma originating from the scrotum is a rare entity. We report here a case of 50-year-old male who presented with a 4-cm lump in the left side of scrotum. Clinically, it was provisionally diagnosed as sebaceous cyst and was excised. The histopathology showed findings consistent with leiomyoma. There was no cytological atypia or mitosis. The final diagnosis of solitary leiomyoma of scrotum was given. The patient was followed up regularly and is doing fine for last 4 months.

Pindborg Tumor in an Adolescent

Calcifying epithelial odontogenic tumor (Pindborg tumor), is a rare benign odontogenic neoplasm representing about 0.4-3% of all odontogenic tumors. This tumor more frequently affects adults in the age range of 20-60 years, with a peak incidence in the 5th decade of life. Calcifying epithelial odontogenic tumour has a much lower recurrence rate than ameloblastoma and malignant transformation, and metastasis is rare.

Fine-needle aspiration cytology of Kikuchi Fujimoto disease.

Kikuchi disease (KD) is an enigmatous, self-limiting, rarely fatal, disease of young females. The self-limiting disorder usually occurs in Asian women in their late 20s or early 30s. Typically it runs a benign course and appears to resolve spontaneously one to six months after definitive diagnosis. We report a 27 years old lady presenting with cervical lymphadenopathy. Fine needle aspiration cytology of the node clinched the diagnosis revealing crescentic histiocytes, plasmacytoid monocytes, extracellular (karyorrhectic) debris and necrosis. The diagnosis was subsequently confirmed by histopathology.