Episiotomy Scar Endometriosis a Rare Case Report

Endometriosis is defined as the presence of ectopic endometrial tissue outside the uterine cavity. It is a benign condition commonly observed in women of the reproductive age group. It can occur in both pelvic and extra-pelvic sites. Moreover, pelvic endometriosis is relatively common, as compared to extra-pelvic endometriosis. The most frequent site for pelvic endometriosis is ovary. It can also affect rectum, uterosacral ligaments, rectovaginal septum, urinary bladder. Extra-pelvic endometriosis is rare and when it occurs, does so more frequently in surgical scar sites, especially in caesarean section scar. Endometriosis in an episiotomy scar is extremely rare but can lead to significant morbidity in patients due to local infiltration. This condition can be diagnosed by the presence of the classical clinical triad of history of episiotomy, tender nodule at the scar site and cyclical pain. Surgical excision is very useful to assess the deeper extension of the lesion. Herein, we report one such case of episiotomy scar endometriosis

A Rare Case of Cat Scratch Disease Presenting with Splenic Abscess-A Case Report

Cat scratch disease is a zoonotic infection presenting with usual symptoms such as fever, fatigue, rigor, myalgia, rashes followed by regional tender and painful lympadenopathy. Other rare presentations include abscess formation in major organs. The main agent is Bartonella henselae. In this study, we describe a patient presenting with abdominal pain and tenderness with prodromal symptoms and microscopically it showed necrotizing granuloma in stellate pattern with palisading histiocytes. The prompt history of having pets, classical microscopy and by ruling out other causes of necrotizing granuloma, the diagnosis of cat scratch disease is obtained

A Rare Case of High-Grade Urothelial Carcinoma of Renal Pelvis and Proximal Ureter with Divergent Differentiation

Urothelial carcinoma with divergent differentiation is a variant of urothelial carcinoma and it is being increasingly recognized with the increase in awareness and advancement of immunohistochemistry. It is important to quantify the degrees of each differentiation for the prognosis and treatment of the patient. Here, we present a unique case of urothelial carcinoma of Renal pelvis with divergent differentiation showing urothelial, squamous, papillary, glandular, Rhabdoid and Plasmacytoid differentiation

Renal Tuberculosis Masquerading as Renal Cystic Disease A Case Report

Genitourinary tuberculosis is third most common type of extrapulmonary tuberculosis. We report a 31- year-old women with severe kidney function loss, radiologically left renal cystic disease with <10% perfusion was suspected but turned out that the renal failure was secondary to renal tuberculosis in histopathological examination. This article is to emphasize high level of clinical suspicion of renal tuberculosis

Mature Cystic Teratoma with Squamous Cell Carcinoma-Rare Case Presentation

Introduction: Mature cystic teratomas are part of a subclass of ovarian germ-cell tumour believed to arise from the primordial germ cells. Ovarian germ-cell tumours account for around 20–25% of ovarian neoplasms and 5% of ovarian cancers. A secondary malignant transformation of the various tissue components of mature cystic teratoma can occur, typically in postmenopausal women.  More than 80% of malignant transformations are squamous-cell carcinomas arising from the ectoderm; the rest are carcinoid tumours or adenocarcinomas. Methods and Methodology, Case Report: A 40-year-old postmenopausal patient came with lower abdominal pain past 2 months.  The patient was submitted to a gynecological examination and to transvaginal ultrasound, which confirmed the presence of right adnexal mass measuring 11×8x 2 cm; the mass proved to have cystic features in association with intracystic fat, raising the suspicion of an ovarian teratoma. In addition, areas of acoustic shadowing were discovered, raising the suspicion of a Rokitansky nodule exhibiting solid components such as hair and teeth. Pelvic CT scan demonstrated right adnexal dermoid cyst causing mild hydroureteronephrosis. A total hysterectomy with bilateral adnexectomy was performed, and the specimen was submitted for histopathological examination. Histopathological examination revealed Mature Cystic Teratoma with Squamous Cell Carcinoma. Discussion: Ovarian teratoma develops from germ cells and might present different cellular types originating from one or more of the germ layers, represented by endoderm, ectoderm and mesoderm.  Of this malignant transformation is about 1- 2 %. Malignant transformation of ovarian teratoma can arise from any type of germ cell that is present at the level of these tumors; therefore, adenocarcinomas, squamous cell carcinomas, sarcomas, melanomas, adenosquamous carcinomas or even carcinoid tumors might occur. Of this squamous cell carcinoma is common. Conclusion: Although ovarian teratomas are frequently encountered, a small proportion of them will develop further complications, such as infection or malignancy. In cases in which malignant transformation occurs, squamous cell carcinoma is the most commonly encountered type of malignancy.  Novelty: Malignant transformation of mature cystic ovarian teratoma is a scarce eventuality, only rare cases being reported so far. Furthermore, the development of this transformation in the setting of an abscessed tumor is even scarce

Castleman Disease with Endocrine Dysfunction

Castleman disease is a rare, non-clonal lymphoproliferative disorder predominantly affecting lymphoid tissues. This report presents the case of a 23-year-old male with a chronic left-sided neck swelling and gynecomastia. Surgical excision and Webster technique for gynecomastia were performed, and histopathological examination revealed features consistent with Castleman disease. The lymph node specimen displayed enlarged and reactive atretic germinal centers with an onion skin arrangement of lymphocytes and occasional atypical follicular dendritic cells. Additionally, the breast tissue showed proliferating ducts indicative of gynecomastia. Immunohistochemical analysis confirmed the diagnosis, revealing CD20-positive mantle zones, diffuse CD45 positivity, CD3 positivity in the paracortex and interfollicular area, and Ki-67 positivity in the germinal center. Castleman disease presents clinically as unicentric or multicentric forms and histologically as hyaline vascular, plasma cell, mixed cellular, or plasmablastic variants. Elevated levels of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) underscore the disease's inflammatory background. The disease's heterogeneity presents challenges in diagnosis, particularly the plasma cell variant, which can mimic Hodgkin lymphoma. Laboratory abnormalities, such as elevated ESR, LDH, CRP, and anemia, are seen in the multicentric variant. Associations with POEMS syndrome, Kaposi's sarcoma, and co-existing malignant lymphomas complicate the disease's clinical course. Recognition of this condition is crucial for timely intervention, as surgical excision is curative in unicentric cases, while multicentric forms often exhibit a rebound effect. Understanding the disease's diverse presentations and associated lymphomas is essential for accurate diagnosis and appropriate management

A Captivating Case of Amoebiasis Cutis with Nodular Fasciitis

Primary cutaneous amoebic infections as well as cutaneous lesions from disseminated amebiasis are exceedingly rare and are more commonly seen in immunocompromised patients. Review of Literature has shown several species that cause cutaneous disease include Entamoeba histolytica, Acanthamoeba, Naegleria fowleri, and Balamuthia mandrillaris. Although cutaneous amoebic infections are rare, they are usually underrecognized and frequently misdiagnosed. Hence, it is important for pathologists to be aware of this histomorphologic appearance and diagnostic pitfalls when evaluating a skin lesion. Primary cutaneous amoebic abscess in association with nodular fasciitis in an immunocompetent patient

Amoebic Splenic Abscess A Rare Case Report

Primary splenic amoebic infections are rare and more commonly seen in immunocompromised patients. Though amoebic infection is common in tropical regions or areas having poor hygienic practices. It’s the 3rd most common cause of parasitic death and has 15% prevalence in India. Review of literature has shown several species that cause splenic amoebiasis followed by Amoebiasis colitis due to feco-oral transmission. In this case, The entry of amoeba into the spleen may be explained by trauma due to the increased movement of fluid into the injured area. Once in splenic parenchyma, amoeba causes proteolytic destruction and abscess formation. Hence, it is important for pathologists to be aware of this histomorphologic appearance and diagnostic pitfalls when evaluating as its easily curable with the use of metronidazole. Peculiarity: Primary amoebic splenic abscess with colourless thickened pus showing E.coli positivit

Angiomyxolipoma A Rare Variant of Lipoma A Case Report

Angiomyxolipoma is a rare subtype of lipoma, is a tumor of mesenchymal origin, and several subtypes have been described that vary according to their location. It is an admixture of fatty tissue admixed with myxoid stroma and blood vessels. Here we report a case of a 43-year-old man presented with complaints of painless swelling in the left scapular region. Patient underwent for local excision which on histopathologic examination revealed poorly encapsulated lesion with an admixture of lobules of adipocytes, clumps of blood vessels of varying sizes and loose fibrous tissue with myxoid change which was consistent with angiomyxolipoma

Do elephants need to sweat?

An adequate rate of evaporative water loss is considered essential for the maintenance of thermal balance in the elephant in warm climatic conditions. Histological studies have failed to reveal the existence of sweat glands in elephant skin. Transepidermal water-loss rate has been measured and shown to be sufficiently high for possible thermal needs. The structure of elephant skin and the behaviour of elephants are seen to contribute towards maintaining skin permeability and the necessary level of transepidermal water loss