Role of immunohistochemistry in diagnosis of a rare bladder tumor

Neuroendocrine tumors (NETs) are commonly located in the respiratory and gastrointestinal tract; however, these tumors can rarely be found in the urinary bladder. NETs comprise <1% of all bladder tumors; usually intermixed with urothelial carcinoma and its variants. We report a case of primary neuroendocrine carcinoma of urinary bladder in an adult female with a history of smoking and hematuria. The present case highlights the importance of immunohistochemistry in arriving at an accurate diagnosis and thereby differentiating this tumor from other clinical mimics

Syringocystadenoma papilliferum on the thigh: An unusual location

A 28-year-old man presented with a partially eroded growth on the back of his right thigh for the last 15 years. Tuberculosis verrucosa cutis and pyogenic granuloma were suspected on clinical examination. Histopathological examination revealed syringocystadenoma papilliferum (SCAP). SCAP is rare on the thigh and a review of the English literature revealed eight cases. Non-descript clinical presentation in an unusual location and the rare linear and segmental variants lead to misdiagnosis. Onset at puberty should alert one to the possibility of the unusual location of SCAP

Leiomyoma cutis: A clinicopathological series of 37 cases

<b>Background:</b> Cutaneous leiomyomas are benign smooth muscle tumors that comprise three distinct types such as piloleimyoma, angioleiomyoma, and genital leiomyoma. <b>Aim:</b> The objective of this study was to report a series of cases seen in last 8 years in a tertiary care hospital in north India and to discuss their clinicopathologic findings. <b>Material and Methods:</b> Paraffin-embedded blocks of cases reported as cutaneous leiomyoma from 1999 to 2007 were retrieved from the Institute of Pathology, New Delhi, and their clinical parameters were noted. Their histopathological features were reviewed on hematoxylin-eosin stained slides. Immunohistochemistry was performed where necessary. <b>Results:</b> Twenty-seven cases of piloleiomyoma, three cases of angioleiomyoma, five breast leiomyomas, and two scrotal leiomyomas were seen in patients ranging from 21 to 65 years of age, with an average of 38.2 years at presentation. There was a male predominance with 26 males and 11 females (M:F = 2.2:1). Solitary lesions (<i>n</i> = 21) were more common than multiple ( <i>n</i> = 16). The trunk and upper limbs were involved most commonly, comprising 23 of 37 (62.2&#x0025;) cases. This was followed by lower limb, face, breast, and scrotum. <b>Conclusion:</b> Cutaneous leiomyomas are rare lesions and form an important clinical differential diagnosis of painful papulonodules. These must be biopsied in order to differentiate them from other spindle cell lesions

Multiple asymptomatic juxta-articular nodules mimicking tuberous-xanthoma–a unusual presentation of tophaceous gout

Asymptomatic, juxta-articular nodules are an uncommon morphology, which is usually diagnosed as xanthomas, calcinosis cutis or rheumatoid nodules. This study was represented as a case of gout, which is a disorder of purine metabolism resulting in elevation of serum uric acid and deposition of monosodium urate crystals within and around joints and manifests clinically as inflammatory arthritis. Urate crystal deposits have also been found in tendons, ligaments, viscera, and the skin, with the term “tophi” being used for the non-articular deposits. In the chronic stage, the lesion can be asymptomatic lesions and is often misdiagnosed

Pheniramine maleate: an apparently safe drug causing bullous fixed drug eruption

Fixed drug eruption is a delayed type hypersensitivity reaction to a drug seen most frequently with antibiotics such as tetracyclines, sulfonamides, and NSAIDs such as naproxen and ibuprofen. Although H1-antihistamines rarely elicit cutaneous adverse effects, there have been a few reports in the literature implicating them in causing fixed drug eruption, particularly the piperazine derivatives (hydroxyzine, cetirizine, levocetirizine), and loratadine. However, cutaneous drug reactions with the alkylamine derivatives like pheniramine maleate are extremely uncommon and fixed drug eruptions have not been reported with any of the alkylamine antihistamines to date. We herein report a case of multifocal bullous fixed drug eruption following ingestion of pheniramine maleate