Adenocarcinoma of urinary bladder in a 55-year-old female: An unusual case report

Adenocarcinoma of the bladder is an uncommon malignant neoplasm and accounts for fewer than 2% of all the malignant urinarybladder tumors. It may arise primarily in the bladder or secondarily from a number of other organs. Adenocarcinoma of urinarybladder can be diagnosed mainly on histopathology and with the aid of immunohistochemistry. We present clinical, imaging,histopathology, and immunohistochemical findings in a case of primary bladder adenocarcinoma (PBA) in a 55-year-old female.Complete clinical details along with a panel of antibodies comprising of β-catenin, cytokeratin 20 (CK20), CK7, and CDX2 can behelpful in distinguishing PBA from metastatic colonic adenocarcinoma.Adenocarcinoma, Bladder, Neoplas

Parathyroid adenoma in a young female presenting with craniofacial brown tumor and acute pancreatitis – A case report

Solitary Parathyroid adenomas have a diverse clinical presentation. They may be asymptomatic or may sometimes lead to extensive bony resorption and replacement of bone by fibrous tissue, also known as a brown tumor. Brown tumor is a relatively rare presentation of primary hyperparathyroidism and is even rarer in a younger age group. Here, we report the case of a 20-year-old female presenting with craniofacial brown tumor and during the course of hospital stay; she also developed an attack of acute pancreatitis due to hyperparathyroidism. This case report emphasizes the importance of a complete investigative work up in patients presenting with maxillofacial bony lesions for early diagnosis and planning of definitive management

Primary renal squamous cell carcinoma in a non-functioning kidney with nephrolithiasis: A case report

Primary squamous cell carcinoma (SCC) of renal pelvis is a rare neoplasm. A 50-year-old female presented with a history of chronic dull aching pain in left flank region and burning micturition for 8 months. Workup showed multiple calculi in non-functioning, hydronephrotic left kidney. Histopathological examination of nephrectomy specimen revealed SCC of renal pelvis; although, there was no obvious growth. The case report highlights the fact that SCC should be suspected in a patient with renal mass in a non-functioning kidney following long-standing nephrolithiasis

Abnormal semen parameters among males in infertile couples: a cross sectional study from a tertiary care centre

Background: In India, the prevalence of primary infertility ranges from 3.9% to 16.8%. Male factor contributes 40-50% of this. Male factor infertility is indicated by decreased sperm concentration, reduced motility, vitality or abnormal sperm morphology. Semen analysis is the single most important investigation to detect male factor infertility. The aim of this study was to analyse the prevalence of abnormal semen parameters among males in infertile couples and their association with contributing factors.Methods: This cross-sectional hospital-based study was carried out in the Department of Pathology at Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital. A total of 400 cases were analyzed during a period of 6 months. Detailed history of the couple was taken. Semen analysis was done using automated semen analyzer (SQA-vision) after 3 days of abstinence according to the WHO 5th edition 2010 guidelines. The results were analysed using excel sheet and SPSS software.Results: In the present study, 122 cases (30.5%) out of 400 cases had abnormal semen parameters. Most common abnormality detected was asthenozoospermia (14.3%) followed by oligozoospermia (13.8%), azoospermia (10.5%) and teratozoospermia (10.5%). There was significant association of alcohol intake, obesity and trauma with abnormal semen parameters.Conclusions: Asthenozoospermia was the most common abnormality noted in this study. Lifestyle modifications along with timely medical attention in male partners of infertile couples can improve the semen quality

Comparison of diagnostic performance of simple international ovarian tumor analysis rules versus subjective pattern recognition for triage of adnexal masses

Background: Accurate and early diagnosis of adnexal masses is essential for optimal clinical decision-making. The aim of the study was to compare the diagnostic performance of simple international ovarian tumor analysis (IOTA) rules vs subjective pattern recognition, to discriminate between benign and malignant adnexal mass, and to establish the diagnostic utility of IOTA rules as a standardized examination tool in early diagnosis of ovarian malignancy. Methods: A prospective cohort study was conducted at a tertiary care hospital between November 2017 and March 2019 on 100 women with adnexal masses. All adnexal masses detected on ultrasound were classified according to IOTA rules by the trainee, followed by subjective pattern recognition by experts. These observations were further correlated with histopathology/intraoperative findings/ follow-up examination. Diagnostic efficacy was assessed by comparing sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy. Results: Among the 100 patients, 81 had benign, and 19 had malignant masses on final diagnosis. The sensitivity, specificity, PPV, NPV, and accuracy for the detection of malignancy using IOTA rules by trainee were 100%, 95.59%, 81.82%, 100%, and 95.65%, and by subjective evaluation by experts were 100%, 97.5%%, 90.5%, 100%, and 98% respectively. No statistically significant difference was found between the diagnostic accuracy of the two methods. Conclusions: Simple IOTA rules are as accurate as subjective evaluation by experts in the characterization of adnexal masses. Their inherent simplicity and reproducibility make them ideal for use by less experienced sonographers

Congenital Presentation of a Solitary Superficial Angiomyxoma in the Parotid Region Masquerading as Parotid Tumor

Superficial angiomyxoma is a rare cutaneous and benign lesion. We present a case of congenital presentation of a superficial angiomyxoma in the parotid region in a 9-year- old female that was misdiagnosed as a parotid tumor. Appropriate diagnosis is important since such lesions have a good prognosis and rarely affect deeper structures. Possibility of superficial angiomyxoma should be kept in mind in the differential diagnosis of lesions of the parotid region

Sweet′s Syndrome in Acute Lymphoblastic Leukemia with t (9:22)

Sweet′s syndrome (SS) is a rare disease diagnosed in children and is characterized by fever, erythematous skin lesions, and dense infiltration of neutrophils in the upper dermis without evidence of leukocytoclastic vasculitis on histopathology. It may occur secondary to infection, malignancy or drug intake. A case of a 9-year-old boy diagnosed as acute precursor B-cell lymphoblastic leukemia with BCR-ABL1 mutation and treated with induction chemotherapy and imatinib mesylate (IM) therapy is presented. After 8 weeks of consolidation chemotherapy, the patient developed painful and erythematous nodules where a biopsy showed dense neutrophilic infiltrate and edema in the papillary dermis consistent with SS. Whether SS is caused clinically by acute lymphoblastic leukemia, the presence of BCR-ABL1 mutation or due to IM therapy is discussed

Multiple disseminated abdominal hydatidosis presenting with gross hydatiduria: A rare case report

Cystic hydatid disease may develop in almost any part of the body. Approximately 70% of the hydatid cysts are located in the liver followed by the lung (25%). The kidneys, spleen, mesentry, peritoneum, soft tissues and brain are uncommon locations for hydatid cysts. Renal involvement in echinococcosis is extremely rare. Hydatiduria accompanies only 10-20% of all cases of renal hydatidosis and is usually microscopic. Gross hydatiduria is an exceptional presentation of hydatidosis. We report an exceptionally rare case of multiple hydatidosis with cysts in the liver, spleen, kidney and peritoneal cavity, presenting with gross hydatiduria

Extramammary Paget’s Disease of Vulva in a Postmenopausal Woman: a Case Report

Paget’s disease of the vulva is a rare disease. It can present as a primary lesion or as a secondary lesion. When present as a secondary lesion, it is associated with adenocarcinoma originating from local organs such as urethra, or rectum. Patients generally tend to be of postmenopausal age group. We report a case of a 49-year-old postmenopausal woman who presented with the complaints of a slow growing lesion in the vulval region associated with itching. Biopsy from vulval lesion showed presence of pagetoid cells in the epidermis. The subclassification of vulvar Paget’s disease is essential for correct clinical management and treatment. Immunohistochemistry may help in the diagnosis and assessing tumour progression and invasion

p53 and bcl2 expression in malignant and premalignant lesions of uterine cervix and their correlation with human papilloma virus 16 and 18

Background and Objective: Persistent high risk human papilloma virus (HPV) infection is probably the best predictor of increased risk of cervical cancer, but expression of certain markers of cell proliferation and apoptosis have been studied. The present study was conducted to evaluate the expression of p53 and bcl2 in premalignant and malignant lesions of cervix and its correlation with HPV type 16 and 18. Materials and Methods: The study comprised of 35 cases (including 24 prospective cases and 11 retrospective cases) of premalignant and malignant lesions of the cervix. Slides were stained with Hematoxylin and Eosin and p53, bcl2 (immunohistochemistry), HPV 16 and HPV 18 (in situ hybridization). Results: p53 positivity was seen in 8/19 (42.1%) cases of cervical intraepithelial neoplasia (CIN) and 8/16 (50%) cases of carcinoma cervix, the difference not significant statistically. The difference in bcl2 expression in CIN versus carcinoma cervix (84.21% vs. 43.75%) was statistically significant (P = 0.030). There was no significant difference between p53 and bcl2 expression and the stage and grade of the tumors. Seven out of 19 cases of CIN (36.84%) were positive for HPV 16/18 infection and 8/16 cases (50%) of carcinoma cervix were HPV positive (P = 0.628). Conclusions : No significant association was found between HPV 16/18 infection and p53 and bcl2 expression in premalignant and malignant lesions of uterine cervix. Although, bcl2 staining showed a significant difference between CIN and carcinoma cervix, a larger case series is required to assess the association between HPV infection and overexpression of p53 and bcl2 proteins in these lesions