Placental mesenchymal dysplasia

Placental Mesenchymal Dysplasia (PMD) is a rarely encountered placental lesion often associated with high fetal mortality and morbidity. We report here a case of PMD with a favourable outcome. The salient features of diagnosis, management and literature review are discussed

A rare case of primary mesenteric gastrointestinal stromal tumor with metastasis to the cervix uteri

<p>Abstract</p> <p>Background</p> <p>Gastrointestinal stromal tumors are CD117 (C Kit) positive mesenchymal neoplasms, that may arise anywhere in the gastrointestinal tract. Their current therapy is imatinib mesylate before or after surgery.</p> <p>Case presentation</p> <p>We describe a case of 17-year-old female with metastasis to the cervix uteri of a primary mesenteric gastrointestinal tumor.</p> <p>Conclusion</p> <p>Surgery remains the mainstay of known curative treatment. The manifestations of GIST are not restricted to the typical locations within the bowel; may have very unusual metastatic sites or infiltrations per continuitatem.</p

Carcinoma Colon in a Patient with Eosinophilic Gastroenteritis

Eosinophilic gastroenteritis is an uncommon disease which can involve all layers of the gastrointestinal tract anywhere from the esophagus to colon. Clinical features depend upon the site of involvement and layer of GI tract involved. It is an inflammatory disease with remitting and relapsing course. We report a case which presented with discharging fecal fistula in lower abdomen after emergency laparotomy. Initial colonoscopy showed stricture with nodularity of the IC junction and biopsy showed features of eosinophilic gastroenteritis. Due to persistence of fistula he underwent right hemicolectomy with illeo-transverse anastomosis. Biopsy from surgical specimen showed well differentiated adenocarcinoma and eosinophilic infiltrate in muscularis. Surveillance colonoscopy done six months later showed ulcer at anastomotic site and biopsy showed features of eosinophilic colitis. The clinical course of this patient circumstantially indicates a linkage of eosinophilic colitis with carcinoma colon. This is the first reported case of association of eosinophilic colitis with carcinoma colon. We discuss in detail the clinical and pathological features of eosinophilic enteritis and possible mechanisms linking eosinophilc enteritis with carcinoma

Isolated lacrimal gland involvement in Rosai-Dorfman-Destombes disease

Rosai-Dorfman-Destombes (sinus histiocytosis with massive lymphadenopathy) disease is an uncommon disease characterized by benign proliferation of histiocytes, with painless lymph node enlargement and frequent extranodal disease. Orbital involvement occurs in 9-11% of cases. However, isolated Rosai- Dorfman-Destombes disease of the lacrimal gland without any systemic involvement is very rare with only three case reports. We describe here one such young male patient with unilateral lacrimal gland swelling. Excision biopsy revealed almost complete replacement of the lacrimal gland by lymphocytes, plasma cells and large pale histiocytes. The latter exhibited emperipolesis and stained positive for S-100 and CD68 on immunohistochemistry. Patient is well and has no other manifestation or recurrence of the disease during a follow-up of 24 months

Complete response to chemotherapy in primary hepatic lymphoma

Primary hepatic lymphoma is an uncommon lymphoid tumor with varied clinical presentations and treatment outcomes. The median age of involvement is 50 years (male preponderance) with median survival as 8-16 months. Here we report a 68-years-old female who presented with right hypochondriac pain and anorexia with hepatomegaly on physical examination. Ultrasonography (USG) with subsequent contrast enhanced computed tomography (CECT) of abdomen depicted a hypoechoic mass in the left lobe of liver. CECT of chest and neck showed no abnormality. Liver biopsy proved to be Non-Hodgkin lymphoma (NHL) diffuse large B cell type, CD20 positive. Bone marrow examination showed no infiltration by NHL. The patient was started on three weekly R-CHOP, given a total of 8 cycles. Patient attained a complete remission documented by negative computed tomography (CT) and positron emission tomography (PET) scans

Histopathological examination of the placenta in normal and SGA pregnancy and its association with neonatal outcome

Objective: To study histopathological characteristics of the placenta in SGA pregnancies and to associate it with neonatal outcomes. Material and methods: A total of 200 placentae were examined.100 from the study group (SGA pregnancies) and 100 from the low-risk control group. After delivery, they were examined for any gross lesions and weighed. They were then sent for histopathological analysis. The results were then tabulated and compared between the two groups (study and control). Results: On studying the histopathology of the placenta we found abnormalities in 73 % of placentae in the study group as compared to 34% in the control group showing a significant association of placental pathology with FGR (p< 0.05).Salient histopathological findings in the study group were villous infarcts (52%), fetal thrombotic arteriopathy (11%), chronic villitis (7%), perivillous fibrin deposit (49%), decreased vascularity (45%), diffuse calcification (35%), syncytial knots (38%). We found that 82% of neonates were delivered before 37 completed weeks in the study group which was a significant finding (p<0.01). The finding of 72% of neonates in the study group with birth weight <2 kg was expected due to FGR babies. This finding was statistically significant. Our study failed to demonstrate any significant relation between major placental lesions and depression of APGAR score except for perivillous fibrin deposition which showed significant relation (p<0.05). On comparing the placental lesions with decreased fetal weight (<1.5kg) we found decreased vascularity (p<0.05) closely related to decreased fetal weight (p<0.05).The other lesions failed to show any significant relationship between the two (chi-square two-tailed test). Conclusion: We found that though SGA foetuses are more commonly associated with histological placental abnormalities, it cannot be established whether these abnormalities certainly contribute to FGR. Malperfusion lesions of the placenta show a close association with not only FGR but decreased fetal weight and poor neonatal outcomes. We also found the association of perivillous fibrin and decreased vascularity significantly related to adverse neonatal outcomes

Gliosarcoma with prominent smooth muscle component (gliomyosarcoma): A report of 10 cases

Background and Aim: Gliosarcoma (GS) is an uncommon malignant tumor of the brain, consisting of malignant glial, usually a glioblastoma (GB), as well as sarcomatous component; the latter is usually in the form of fibrosarcoma. We report a series of 10 GSs with prominent smooth muscle component, which is a rare occurrence. Settings and Design: Out of a series of 225 cases of GB admitted in our hospital, 10 were diagnosed as GS with prominent smooth muscle component, gliomyosarcoma (GMS). Materials and Methods: This is an observational study based on the experience with 225 cases of GB, encountered between 1995 and 2008, in our hospital. The tumors showing prominent spindle cell component were stained with reticulin and 20 with strongly positive reticulin stain were diagnosed as GS. They were further studied by immunohistochemical staining for glial fibrillary acidic protein (GFAP), smooth muscle actin (SMA), desmin and factor VIII antigen. Results: Out of 225 cases of GB, 20 were diagnosed as GS. Ten of these showed prominent smooth muscle component and were diagnosed as GMS. They revealed varying degrees of SMA and factor VIII Ag positivity. In the sarcomatous component, SMA and factor VIII positive cells were seen close to the vessel walls as well as away from them. Conclusion: GMS containing prominent smooth muscle component may not be as rare as has been reported in the literature. Both GS and GMS appear to arise from the vessel wall at least in some cases, suggesting their possible vascular origin

Orbital myeloid sarcoma presenting as massive proptosis

A 10-year-old boy presented with right proptosis for 8 months. The eyeball was grossly pushed down, with diffuse corneal haze and non-reactive pupil. Systemic examination was normal. Previous investigations in another centre included a computerized tomography scan, which showed a well-defined enhancing retro-bulbar mass, a non-contributory fine needle aspiration cytology and a biopsy showing fibrocollagenous tissue with moderate lympho-monocytic infiltrate suggestive of non-specific inflammation. PET-CT scan revealed the presence of enlarged fluoro-deoxyglucose-avid cervical and mesenteric lymph nodes. Biopsy of the retro-bulbar mass was repeated in our centre. It showed fibrocollagenous and skeletal muscle tissue infiltrated by lymphoid follicles, dispersely lying lymphocytes and plasma cells, and admixed large atypical cells with vesicular nuclei, prominent nucleoli and scanty cytoplasm, strongly positive for myeloperoxidase, CD43 and CD99 immunohistochemistry. Hemogram was normal. Bone marrow aspiration/biopsy and CSF showed no evidence of acute myeloid leukemia. The child received chemotherapy in another centre and is in complete remission 6 months after completion