Necrotising myometrial granulomas leading to postpartal hemorrhage: an extremely unusual presentation

Granulomas exclusively involving the myometrium are rare pathological finding and those presenting with atonic post-partum hemorrhage have never been reported. Here we present a case of myometrial granulomas presenting with atonic postpartum hemorrhage (PPH) with no evidence of granulomatous inflammation elsewhere in the body. There was also no history of instrumentation or biopsy of the uterine cavity in the past

Angiogenesis in Non-Hodgkin's Lymphoma: An Intercategory Comparison of Microvessel Density

Background. This study was aimed at comparing angiogenesis, seen as microvessel density (MVD) in subtypes of non-Hodgkin's lymphoma (NHL). Methods. In this study, 64 cases of NHL diagnosed over a three-year period were included along with 15 lymph node biopsies of reactive hyperplasia. NHLs were classified using REAL classification, and immunohistochemistry was performed for CD34 in all cases. CD34-stained sections were evaluated for “hot spots,” where MVD was assessed and expressed as per mm2. Appropriate statistical methods were applied. Results. There were 6 cases of well-differentiated lymphocytic lymphoma (SLL), 21 diffuse large B-cell lymphoma (DLBCL), 15 follicular lymphoma, 10 lymphoblastic lymphoma, 7 MALToma, and 5 peripheral T-cell lymphoma (PTCL). Mean MVD was highest in reactive hyperplasia (191.92 ± 12.16 per mm2) compared to all NHLs. Among NHLs, PTCL demonstrated the highest MVD (183.42 ± 8.24) followed by DLBCL (149.91 ± 13.68). A significant difference was found in MVD between reactive and individual lymphoma groups. SLL had significantly lower MVD than other lymphoma subtypes. Conclusion. Angiogenesis, assessed by MVD, showed significant differences among subtypes of NHL, especially the indolent types like SLL. The higher MVD in aggressive lymphomas like PTCL and DLBCL can potentially be utilized in targeted therapy with antiangiogenic drugs

A case of syringocystadenoma papilliferum on lower leg: A rare location

An 18 years old male presented with a slowly increasing multiple papulonodular lesions on his left leg since birth. No definite diagnosis was made on clinical ground. But verrucous epidermal naevus with secondary change and appendageal tumor was suspected on clinical examination. Histopathological examination revealed syringocystadenoma papilliferm (SCAP). SCAP is very rare on lower leg. Only one case of SCAP on lower leg has been reported in literature so far, which was superimposed on an organoid nevus. The case is reported for unusual location and unusual presentation

Cytodiagnosis and pitfalls of genital tuberculosis: A report of two cases

Genital tuberculosis is fairly common in Indian women due to high prevalence of pulmonary tuberculosis in the general population. Histopathological diagnosis is invaluable but often, diagnosis can be made with reasonable accuracy by Papanicolaou (Pap) smear test if the index of suspicion is kept high. Also, genital tuberculosis is considered to be more common in patients less than 40 years of age and rare after menopause. We describe two cases of cervical tuberculosis in patients over 40 years of age, including a postmenopausal case, diagnosed by smear tests and later confirmed by histopathology and bacteriology. The differential diagnoses as well as problems encountered in the diagnosis of a tuberculous lesion in Pap smears are also discussed

Trichophyton rubrum onychomycosis in an 8-week-old infant

An 8-week-old infant presented with 7 weeks history of nail involvement and discoloration. Lesions started over the middle fingernail of right hand at 1 week of age, spreading over to other nails within 2 weeks. Only two nails of the feet were spared. On KOH examination, fungal hyphae were seen and culture showed growth of Trichophyton rubrum. The purpose is to report the earliest case of onychomycosis having multiple nail involvement of fingers and toes (18 nails)

Cytodiagnosis of papillary carcinoma of the breast: Report of a case with histological correlation

Papillary lesions of the breast pose diagnostic challenges on aspiration cytology due to overlapping features of benign and malignant entities. Accurate cytologic diagnosis of papillary breast carcinoma cannot usually be made pre-operatively. We present the case of an adult female who underwent fine-needle aspiration (FNA) of a left breast lump. FNA smears were highly cellular showing cohesive clusters, complex papillary fragments and few singly dispersed intact cells. The tumor cells had hyperchromatic nuclei, prominent nucleoli and mild nuclear pleomorphism. A cytologic impression of papillary lesion, possibly malignant (in view of high cellularity, complex papillae and single intact cells) was rendered. The lesion proved to be a papillary carcinoma with microscopic foci of stromal invasion on histologic examination. Papillary carcinoma, an uncommon subtype of breast carcinoma, should be considered while evaluating a papillary lesion with complex branching papillae containing delicate fibrovascular cores and singly lying intact atypical cells

Seroprevalence and trend of dengue cases admitted to a Government hospital, Delhi - 5-year study (2006-2010): A look into the age shift

Background: Diagnosis of dengue infection is easily and best accomplished by demonstration of specific IgM antibodies in blood. We analyzed retrospectively the dengue IgM seropositivity available for samples obtained over a period of 5 years (2006-2010) from patients with suspected dengue fever (DF)-like illness to investigate whether there was an overall increase in the dengue IgM prevalence over this period. Methods: Blood samples were collected from patients with DF-like febrile illnesses attending the Pediatric, Medicine, and Fever clinics of a Government hospital, Delhi. A total of 8138 individuals (suspected dengue cases) obtained over 5 years were tested for dengue specific IgM antibodies. Year wise, month wise, and age wise data on geographic distribution and clinical manifestations were analyzed. Results: Of the 8138 samples, 1600 (19.66%) were positive for dengue specific IgM. The year 2006 had the highest number of reported cases, 761 (46.23%). In our study, the age group most commonly affected of all 5 years was 11-20 years. Out of the total 1600 cases admitted to the hospital between 2006 and 2010, 279 (58.9%) had DF, 178 (37.6%) had dengue hemorrhagic fever, and 16 (3.38%) had dengue shock syndrome. We found a high burden of dengue in young children and late adolescents in both rural and urban communities at a magnitude greater than previously described. Interpretation and Conclusion: We observed an increase in the dengue positive cases every alternate year, thereby indicating a possible role of herd immunity in northern India. We did not find a steady increase in the number of cases over 5 years. We found an increase in the number of positive cases in children and young adolescents

DERMAL VASCULATURE IN PSORIASIS AND PSORIASIFORM DERMATITIS: A MORPHOMETRIC STUDY

Background: Vascular proliferation in the papillary dermis is considered to be an important and probably an early feature of psoriasis. Few morphometric studies have attempted to analyze the vascular changes. However, no study was found in the available literature comparing vascular changes between psoriasis and psoriasiform dermatitis. Materials and Methods : Skin biopsies from 25 cases each of psoriasis and psoriasiform lesions were immunohistochemically stained for CD34 (endothelial marker). Microvessel density (MVD), microvessel length density and ratio of microvessel area to papillary dermal area were calculated using image analysis software. Results: Skin biopsies from psoriasis showed higher staining for CD34 on light microscopy. Using morphometric techniques, microvessel length density was significantly higher in psoriasis compared to psoriasiform lesions (P value <0.05). MVD was also higher in psoriasis, though the difference was not significant. The ratio of microvessel area to dermal area was almost similar in both the groups. Conclusion : Our results indicate that vascular tortuousity and dilatation is significant only in psoriatic lesions. These results may assist in automated diagnosis of skin biopsies