Adult Wilms' tumour: a case report with review of literature

BACKGROUND: Wilms' tumor is the commonest primary malignant renal tumor in childhood. Rarely, it may present in the adult age group. CASE PRESENTATION: We report a 48-year-old male presenting with flank pain and haematuria. Abdominal ultrasound revealed a right renal mass measuring 11 × 10 cms, and a clinical diagnosis of renal cell carcinoma was made. Nephrectomy was performed, and a final diagnosis of adult Wilms' tumor was made based on the criteria proposed by Kilton et al. CONCLUSION: The possibility of an adult Wilms' tumor should be considered when a patient presents with pain in the flank and a renal mass. Rarity of the tumor favors documentation in literature

Identification of a Severely Decomposed Body by Dental DNA STR Analysis: A Case Report

Of all human DNA sources, teeth are extremely resistant to environmental factors like cremation, drenching, trauma, mutilation and deterioration. Therefore, they constitute an astonishing sourceof DNA material. The present case study highlights the great effectiveness of dental DNA in identifying a highly decomposed and extremely fragile skeletonized drowned body with severe craniofacial fractures. Identification was achieved by paternity testing and positively establishing the car used in the crime as the murder vehicle by isolating DNA from the bloodstains present in the car.This study also emphasized the dire need to create a DNA database for Indian populations for conclusion of quick results

Primary Leiomyosarcoma of the Kidney

Primary leiomyosarcoma of the kidney is a rare tumor with an aggressive behaviour. A 55-year-old woman presented with a left sided abdominal mass in our outpatient department. Radiologic investigations revealed the mass to be renal in origin with colonic adhesions for which radical nephrectomy and hemicolectomy were done. The tumor completely appeared to replace the left kidney and had a whorled character focally on cut section. Microscopically, spindle cells having malignant features with cigar shaped nuclei were seen. The smooth muscle origin of the cells was confirmed by immunohistochemical positivity for smooth muscle actin. Sarcomatoid variant of the renal cell carcinoma was ruled out as the tumor was negative for cytokeratin. Tumors with spindle cell morphology in the kidney should not always be taken for a sarcomatoid variant of renal cell carcinoma and should be investigated thoroughly

Intracranial extramedullary hematopoiesis in a thalassemic girl: A Case report

Beta-thalassemia is a haemolytic disorder with ineffective erythropoiesis and red blood cell destruction. Extramedullary hematopoiesis is one of the complications associated with beta-thalassemia. Extramedullary hematopoiesis is the ectopic production of blood cells outside the marrow in liver, spleen, lymph nodes and many other sites. Intracranial involvement is extremely rare. We report a case of 17-year-old girl with thalassemia major and intracranial extramedullary hematopoiesis who came with the complaints of seizure, headache and generalised weakness. Imaging and blood profile leads to the final diagnosis with MRI playing a key role and patient was managed successfully. With this report, we discuss the imaging findings of intracranial extramedullary hematopoiesis in details

A novel fine-tuned deep-learning-based multi-class classifier for severity of paddy leaf diseases

IntroductionPaddy leaf diseases have a catastrophic influence on the quality and quantity of paddy grain production. The detection and identification of the intensity of various paddy infections are critical for high-quality crop production.MethodsIn this paper, infections in paddy leaves are considered for the identification of illness severity. The dataset contains both primary and secondary data. The four online repositories used for secondary data resources are Mendeley, GitHub, Kaggle and UCI. The size of the dataset is 4,068 images. The dataset is first pre-processed using ImageDataGenerator. Then, a generative adversarial network (GAN) is used to increase the dataset size exponentially. The disease severity calculation for the infected leaf is performed using a number of segmentation methods. To determine paddy infection, a deep learning-based hybrid approach is proposed that combines the capabilities of a convolutional neural network (CNN) and support vector machine (SVM). The severity levels are determined with the assistance of a domain expert. Four degrees of disease severity (mild, moderate, severe, and profound) are considered.ResultsThree infections are considered in the categorization of paddy leaf diseases: bacterial blight, blast, and leaf smut. The model predicted the paddy disease type and intensity with a 98.43% correctness rate. The loss rate is 41.25%.DiscussionThe findings show that the proposed method is reliable and effective for identifying the four levels of severity of bacterial blight, blast, and leaf smut infections in paddy crops. The proposed model performed better than the existing CNN and SVM classification models

Molecular characterization of papillary thyroid carcinoma

Papillary thyroid cancer (PTC) is the commonest endocrine malignancy, though no precursor lesion has been identified yet. Increased expression of cyclin D1 and amplification of its gene along with immunolabelling of HBME-1 in areas showing cytological features of PTC within follicular adenomatoid nodules suggest that these areas could correspond to a precursor lesion of follicular variant of PTC. Our study suggests that the progress of malignancy can be tracked by assessing expression of proliferative proteins like Ki67, pHH3 and cyclin D1, and that apoptosis inhibition by bcl-2 protein can further amplify the role of these proteins in tumour progression. Different mutations in the mitogen-activated protein kinase (MAPK) pathway play distinct roles in the growth and invasion of thyroid cancer cells. We have outlined a possible role of MAPK in the development of PTC, especially that of extracellular regulated kinases (ERK) and p38. MAPK activation may be linked to cyclin D1 expression.(MED - Sciences médicales) -- UCL, 201

Galactogram for investigation of pathological nipple discharge: A forgotten arrow in the radiologists' quiver?

Conventional X‑ray galactogram (CG) is an underutilized procedure in modern breast imaging despite offering the highest spatial resolution among all modalities available for imaging of the breast ducts. The superior diagnostic performance of CG as compared to that of both conventional mammogram and high‑resolution ultrasonography makes it a valuable imaging modality for the evaluation of pathological nipple discharge (PND). In addition, CG should always be considered in women with bloody nipple discharge but normal ultrasound and mammogram. CG also has an important role in the preoperative localization of intraductal lesions. CG may be especially useful in resource‑restricted settings where breast magnetic resonance imaging is not readily available as it can be easily performed at any mammography facility without the need for additional equipment. In this article, we describe two cases of PND, one of benign and the other of malignant etiology, to demonstrate the value of CG in these cases. We also review the current literature and compare CG with other modalities used for imaging of ductal system of the breas

C ASE REPORT Simultaneous occurrence of multiple myeloma and acute myeloid leukemia

ABSTRACT Multiple myeloma and acute leukemia may sometimes occur in the same patient, usually in patients with myeloma who receive chemotherapy and subsequently develop acute leukemia. However, simultaneous occurrence of myeloma and acute leukemia on presentation is rare, with only a handful of such cases reported in the literature

Cyclin D1 in well differentiated thyroid tumour of uncertain malignant potential.

BACKGROUND: Encapsulated follicular tumours with equivocal papillary thyroid carcinoma (PTC) type nuclear features continue to remain a challenge despite the recent attempts to classify these borderline lesions. The term 'well differentiated tumour of uncertain malignant potential (WDT-UMP)' was introduced to classify these tumours. The present study aimed to evaluate the role of a cell cycle regulator like cyclin D1 in these tumours along with assessment of other well established PTC markers like galectin-3, HBME-1, CK19. METHODS: Thirteen cases of metastatic PTC, papillary microcarcinoma and follicular variant of PTC (FVPTC) were identified from a histological review of 510 cases. In addition, 13 cases of a subset of follicular adenomatoid nodules with focal areas showing nuclear features characteristic of PTC, identified as WDT-UMP, were also analyzed. Immunohistochemical analysis of galectin-3, HBME-1, CK19 and the proliferation markers Ki67 and cyclin D1 was performed. Lesions were analyzed for cyclin D1 gene amplification by fluorescent in-situ hybridization. RESULTS: All WDT-UMP lesions showed immunolabelling of cyclin D1, Ki67; 11/ 13 cases showed immunolabelling of CK19; 10/13 cases showed immunolabelling of HBME-1 and 4/13 cases showed immunolabelling of galectin-3. Surrounding benign adenomatoid areas showed no to faint focal staining in all thirteen cases of cyclin D1, HBME-1 and galectin-3. A low rate of cyclin D1 gene amplification was identified in a significant proportion of cells in the WDT-UMP lesions as compared to surrounding benign adenomatoid areas. CONCLUSIONS: Increased expression of cyclin D1 and amplification of its gene along with immunolabelling of HBME-1 in WDT-UMP lesions showing cytological features of papillary thyroid carcinoma within follicular adenomatoid nodules suggest that these areas could correspond to a precursor lesion of follicular variant of PTC. Overexpression of cyclin D1, associated with the amplification of the gene suggests that these WDT-UMP lesions are an intermediate between the benign and malignant groups making this group of lesions a reliable precursor of FVPTC. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1851820807142117