Anterior Mediastinal Mass: A Rare Presentation of Tuberculosis

We report a case of a 14-year-boy who presented to us with a low-grade fever with evening rise for 9 months. Along with this, the patient also reported a reduction in his appetite and body weight. He had a mild dry cough but no respiratory symptoms otherwise. There was no other localization for fever on history. He received antitubercular therapy, based on abnormal chest radiograph. However, there was no relief in his symptoms. General physical examination revealed mild fever. Systemic examination was unremarkable. Blood investigations done for fever were noncontributory. Computed tomographic (CT) scan of the chest revealed a mediastinal mass compressing the trachea. The possibilities of lymphoma or germ cell tumour were considered. A biopsy from the mass under CT guidance was performed. The histopathology revealed multiple epithelioid cell granulomas with necrosis, and the diagnosis of tuberculosis was made. The clinical course of this patient and the relevant literature is presented in this paper

Bilateral Parotid Involvement as the Solitary Metastatic Site from Squamous Cell Lung Cancer

The detection of metastatic disease has major therapeutic and prognostic implications on the management of cancer patients. We report an asymptomatic metastasis from the lung cancer to the intra-parotid lymph node which was detected by the FDG PET scan and subsequently confirmed by fine needle aspiration cytology. The case is unique as solitary metastatic involvement of the parotid from non-head and neck tumors are extremely rare and thus, may be missed during staging evaluation

Pulseless Right Upper Limb: An Unusual Manifestation of Invasive Pulmonary Aspergillosis in Acute Myeloid Leukemia

Abstract Aspergillus is the most common cause of fungal pneumonia in acute leukemia patients receiving chemotherapy or undergoing hematopoietic stem cell transplantation. Despite a high index of suspicion and prompt institution of specific antifungal therapy, it causes significant morbidity and mortality in patients with hematological malignancies. It has to be differentiated from mucormycosis because the treatment differs. Histological confirmation obtained by lung biopsy is ideal, but is difficult to obtain in those patients who often have thrombocytopenia. We report a case of acute megakaryoblastic leukemia with typical manifestations of invasive pulmonary aspergillosis who developed pulseless right arm due to invasion of the right subclavian artery. When total leucocyte counts recovered, patient also developed immune reconstitution inflammatory syndrome and massive pulmonary hemorrhage, which was managed by bronchial artery embolization

Vascular Cyst of Adrenal: A Report of Two Cases

Vascular cysts of the adrenal gland are rare heterogeneous group of lesions with an autopsy incidence of 0.06%. They have female preponderance with most common presentation being pain abdomen. Cysts of the adrenal glands are classified as (a) parasitic cysts (b) epithelial cyst (c) pseudocyst and (d) endothelial cysts. Out of these endothelial cysts constitute about 84% of the cases. As the clinical features and radiological findings of these lesions are nonspecific, a proper histological examination along with immunohistochemistry are necessary for a definitive diagnosis. Here, we report two cases of vascular endothelial cyst of the adrenal gland to emphasize the histomorphological and immunohistochemical features of these lesions

Cutaneous lymphomas: An update

Cutaneous lymphomas are heterogeneous and distinct entities which have been in controversy since the time of conception. WHO EORTC defined them as distinct pathological entity compared to the nodal counterpart. They are defined as lymphomas having primary cutaneous presentation without any systemic involvement. As such the diagnosis of cutaneous lymphomas is a diagnosis of exclusion. These lymphomas are distinct from the nodal lymphomas in their presentation, behaviour and prognosis. These lymphomas have been divided into B cell and T cell type based on the presence of predominance of atypical lymphocytes of B or T lineage. The most common cutaneous lymphomas are T cell immunophenotype, and Mycosis fungoides constitutes the majority of cutaneous lymphomas. Cutaneous lymphomas needs to be differentiated from pseudolymphomas which are benign proliferation of lymphoid cells mimicking lymphomas and mostly have a benign cours