Epitheloid Variant of Angiomyolipoma in a Patient with Tuberous Sclerosis.

Epitheloid angiomyolipoma of kidney is a type of Perivascular endothelial cell derived tumor with an aggressive behaviour with specific pathological, immunohistochemistrical and genetic characteristics. They can occur in a pure form or in assosciation with classical angiomyolipoma. It can be assosciated with tuberous sclerosis in 50% of cases. Our case is a possible case of tuberous sclerosis with epitheloid angiomyolipoma, hepatic angiomyolipoma and lymphangioleiomyomatosis with normal MRI brain and no cutaneous features. Radical nephrectomy with biopsy of hepatic lesion was performed. Histopathological examination revealed epitheloid variant with features of angiomyolipoma. It is six months post surgery and patient is doing well with no evidence of recurrence. Epitheloid angiomyolipoma is a rare malignancy with only 120 cases reported in literature

Images in Pathology - Pseudomyxoma Peritonei Masquerading as Abdominal Hydatidosis

A 50-year-old male presented with gradually increasing abdominal distension and right inguinoscrotal swelling of two years' duration. On clinical examination, the distended abdomen was soft, nontender, with presence of shifting dullness. A 10 x 8 cm nodular mass was felt in the right paraumbilical region with minimal intrinsic mobility. The right inguinoscrotal swelling measuring 12 x 6 cm was firm to hard and was irreducible. The right testis and cord could not be palpated separately. Abdominoscrotal ultrasonogram showed multiple echogeneic areas occupying the abdominal cavity as well as lesions in the liver and spleen suggestive of intraperitoneal hydatid disease with extension to the right scrotum (Figure 1). This was further ratified by the computerised tomographic (CT) scan of the abdomen and the pelvis

Adaptive Isogeometric Analysis Based on a Combined r-h Strategy

In the present work, an r-h adaptive isogeometric analysis is proposed for plane elasticity problems. For performing the r-adaption, the control net is considered to be a network of springs with the individual spring stiffness values being proportional to the error estimated at the control points. While preserving the boundary control points, relocation of only the interior control points is made by adopting a successive relaxation approach to achieve the equilibrium of spring system. To suit the non-interpolatory nature of the isogeometric approximation, a new point-wise error estimate for the h-refinement is proposed. To evaluate the point-wise error, hierarchical B-spline functions in Sobolev spaces are considered. The proposed adaptive h-refinement strategy is based on using De-Casteljau’s algorithm for obtaining the new control points. The subsequent control meshes are thus obtained by using a recursive subdivision of reference control mesh. Such a strategy ensures that the control points lie in the physical domain in subsequent refinements, thus making the physical mesh to exactly interpolate the control mesh and thereby allowing the exact imposition of essential boundary conditions in the classical isogeometric analysis. The combined r-h adaptive refinement strategy results in better convergence characteristics with reduced errors than r- or h-refinement. Several numerical examples are presented to illustrate the efficiency of the proposed approach

Pseudomyxoma peritonei masquerading as abdominal hydatidosis

A 50-year-old male presented with gradually increasing abdominal distension and right inguinoscrotal swelling of two years' duration. On clinical examination, the distended abdomen was soft, nontender, with presence of shifting dullness. A 10 x 8 cm nodular mass was felt in the right paraumbilical region with minimal intrinsic mobility. The right inguinoscrotal swelling measuring 12 x 6 cm was firm to hard and was irreducible. The right testis and cord could not be palpated separately. Abdominoscrotal ultrasonogram showed multiple echogeneic areas occupying the abdominal cavity as well as lesions in the liver and spleen suggestive of intraperitoneal hydatid disease with extension to the right scrotum (Figure 1). This was further ratified by the computerised tomographic (CT) scan of the abdomen and the pelvis