Child with hepatic hydatid cyst: A diagnostic uncertainty

Many parts of India are endemic for hydatid cyst, and hence, the most common diagnosis of a hepatic cyst in such regions is hydatid cyst. Undifferentiated embryonal sarcoma of the liver (UESL) is a rare differential diagnosis for hepatic hydatid cyst as the clinical and radiological features of hydatid cysts and UESL overlap. Here, we report a 4-year-old boy with hepatic cyst, who was initially diagnosed as hepatic hydatid cyst, which was later confirmed as UESL. The child was successfully treated with chemotherapy. This case report highlights the need to spread awareness about UESL, as prompt diagnosis and treatment improves prognosis of the same

A case of successful treatment of mucor pyelonephritis in a child with acute lymphoblastic leukemia

Invasive fungal infection (IFI) is a known complication in children with malignancy. Mucormycosis is a rare cause of IFI in children receiving chemotherapy. Isolated renal involvement of mucormycosis is extremely rare and carries a grave prognosis. A high index of suspicion and early management with antifungals and surgery is essential in the treatment of mucormycosis. Here, we describe a child with mucor pyelonephritis treated successfully with antifungals and surgery with the review of literature

Fluorescent In-Situ Hybridization is the Hand Mirror of Cytogenetics: A Rare Case of Near Tetraploidy in Pediatric Acute Lymphoblastic Leukemia

Identification of specific chromosomal changes has important prognostic and biological implications in childhood Acute Lymphoblastic Leukemia (ALL). ALL cases with 90 chromosomes are rare. Here, we report a case of near-tetraploidy in a 4 year old boy diagnosed with B-cell ALL, where the ploidy was identified by Fluorescent In- Situ Hybridization (FISH) and confirmed by Conventional Cytogenetics. Our aim was to enumerate multiple signals observed by FISH, and to confirm the same by cytogenetics. FISH on cytogenetically fixed air-dried slides was performed by using BCR/ABL and MLL probe .Two hundred cells were scored. BMA was cultured and G-banded metaphases were analyzed in accordance with ISCN 2013. The results of the FISH test showed more than two signals and cytogenetics revealed clones of near-tetraploidy with mn 90, karyotype: 90-92, 4nXXY,-Y,-10,-10,-13, +14, +17, along with normal clones. The tetraploidy condition compared to hyperdiploid ALL has a poorer prognosis and the rarity of these cases makes accounting on treatment decisions a supposition. Presently, the patient is on standard treatment for ALL (UK ALL regime A). The numerical abnormality detected by FISH was confirmed by cytogenetics, which facilitated in reporting the results of this case earlier than the defined turnaround time. Therefore author opines that FISH reports should also contain observed additional information along with positive or negative status of the requested test