Synchronous phyllodes tumor and invasive breast carcinoma in contralateral breasts- a rare case report

Phyllodes tumours are rare breast tumours, accounting for 0.3-1% of all breast cancers and 2.5% of fibroepithelial tumours. They occur in younger age women in Asian countries. These can be classified into benign, borderline and malignant based on stromal hypercellularity, mitotic figures, cellular pleomorphism, stromal overgrowth and nature of the tumour borders. Synchronous coexistence of phyllodes tumour and invasive breast carcinoma in the contralateral breast is very rare, and probably the second one reported in the literature. Hereby, we report a case of a middle-aged woman presenting with a lump in the bilateral breast, diagnosed to have benign phyllodes of one breast and Invasive carcinoma of the contralateral breast

Myositis ossificans of thigh: Unusual mimicker

Metastatic tumors of the intestinal tract from extra-abdominal sites are rare. In cervical cancer, the liver, lung, and the bones are the most common distant sites of metastases. Metastasis to the small intestine is very rare. We report a rare case of metastasis of cervical squamous cell carcinoma to jejunum after a few months of chemoradiotherapy

Item analysis of multiple choice questions: Assessing an assessment tool in medical students

Aim: Assessment is a very important component of the medical course curriculum. Item analysis is the process of collecting, summarizing, and using information from student's responses to assess the quality of multiple-choice questions (MCQs). Difficulty index (P) and discrimination index (D) are the parameters used to evaluate the standard of MCQs. The aim of the study was to assess quality of MCQs. Materials and Methods: The study was conducted in the Department of Pathology. One hundred and twenty, 2nd year MBBS students took the MCQs test comprising 40 questions. There was no negative marking and evaluation was done out of 40 marks, and 50% score was the passing mark. Postvalidation of the paper was done by item analysis. Each item was analyzed for difficulty index, discrimination index, and distractor effectiveness. The relationship between them for each item was determined by Pearson correlation analysis using SPSS 20.0. Results: Difficulty index of 34 (85%) items was in the acceptable range (P = 30–70%), 2 (5%) item was too easy (P >70%), and 4 (10%) items were too difficult (P 0.4), 4 (10%) items were good (D =0.3–0.39), 6 (15%) items were acceptable (D =0.2–0.29), and 6 (15%) items were poor (D < 0–0.19). A total 40 items had 120 distractors. Amongst these, 6 (5%) were nonfunctional distracters, 114 (95%) were functional distracters. The discrimination index exhibited positive correlation with difficulty index (r = 0.563, P = 0.010, significant at 0.01 level [two-tailed]). The maximum discrimination (D = 0.5–0.6) was observed in acceptable range (P = 30–70%). Conclusion: In this study, the majority of items fulfilled the criteria of acceptable difficulty and good discrimination. Moderately easy/difficult had the maximal discriminative ability. Very difficult item displayed poor discrimination, but the very easy item had high discrimination index, indicating a faulty item, or incorrect keys. The results of this study would initiate a change in the way MCQ test items are selected for any examination, and there should be proper assessment strategy as part of the curriculum development

Uncommon manifestations of Endocervical Malignant Mixed Mullerian Tumor with Incidental Bilateral Fallopian Tube Carcinoma

A 43-year-old perimenopausal lady presented with bleeding per vagina and lower abdominal pain. On evaluation, she had cervical polyp, which expelled spontaneously during the per speculum examination. Histopathology revealed malignant mixed Mullerian tumor. Extended hysterectomy with salphingo oophorectomy was carried out, which showed bilateral fallopian tube carcinoma and leiomyoma uterus. The patient was treated with carboplatin regime and found to be disease-free for 1 year. This case presented because of a rare combination of the lesions

Fibrocartilagenous dysplasia: A rare variant of fibrous dysplasia

Fibrous dysplasia (FD) is a benign disorder affecting one or more bones seen in all age groups and shows no geographical, racial and sex predilection. Fibrocartilaginous dysplasia (FCD) is a type of fibrous dysplasia where there is extensive cartilaginous differentiation. Our patient was a young girl with a 2 year history of pain in the right forearm and hip. Imaging studies showed multiple lucent lesions in the femur, humerus and radius. Microscopic examination of the curetted fragments from the lesion showed predominant cartilaginous components with focal fibro-osseous areas and areas of enchondral ossification. We present this case due to its rarity and the importance of distinguishing FCD from other benign and malignant cartilaginous tumors as it mimics these in clinical and histological features

Filariasis in body fluids: Report of three cases

Filariasis is disabling parasitic disease which is prevalent worldwide and caused by various species of filarial organism. Wuchereria bancrofti (W. Bancrofti) is responsible for 90% of cases of filariasis and is found throughout the tropics and in some sub-tropical areas. Cytology has an important role in the diagnosis of subclinical filariasis. Microfilaria is frequently detected in association with neoplasm, although the role in tumorogenesis is controversial. The early detection of the disease could thus mean the difference between a productive healthy life and a lifetime of chronic disability. The identification of microfilaria in body fluids is a rare scenario. We are presenting here with three cases of microfilaria, which was detected in the pleural fluid, bronchoalveolar lavage, pericardial fluid, and in semen with different clinical scenarios. The purpose of this paper was to illustrate these examples and to review the appropriate literature in order to make physicians aware of this uncommon entity

Urachal cyst with xanthogranulomatous cystitis: A rare case report

An urachal cyst is a sinus remaining from the allantois during embryogenesis which is rarely manifested in adults. The urachus is an embryologic remnant which degenerates after the birth. Defective obliteration of the urachus leads to urachal abnormalities. Urachal cyst is a rare pathology in adult women, and this pathology should be considered in the differential diagnosis of acute abdomen. Xanthogranulomatous cystitis (XC) is a benign disease of unknown etiology. The clinical manifestations of these are nonspecific such as lower abdominal pain, umbilical discharge with occasional hematuria. Urachal lesions present with persistent umbilical drainage in infants and newborn. However, in 35% cases, enclosed urachal cyst or infected urachal cyst (abscess) manifests without having umbilical discharge. Computed tomography scan and magnetic resonance imaging are of little help to the identification of these preoperatively. Here, we present a rare case of urachal cyst with XC in 30-year-old female which has produced diagnostic dilemma