Acute fulminant myocarditis at autopsy: A clinical masquerade?

Background: Myocarditis is a diagnostic challenge in cardiology. The diagnosis is frequently made post-mortem, with no clinical evidence of myocardial failure. Autopsy studies report a frequency of myocarditis ranging from 0.11-0.55% in the general population. Myocarditis is presents with varied clinical manifestations, ranging from asymptomatic to sudden cardiac death, sometimes mimicking the Myocardial Infarction (MI). Case Summary: A 55 years old male presented with sudden onset of chest pain, breathlessness at rest and flu like symptoms 5-6 days prior to admission. There was tachycardia with low Systolic blood pressure and muffled heart sounds. ECG showed ST segment & T wave changes. CK-MB was moderately raised. Though clinically diagnosed as MI and treated, patient expired the next day. On autopsy, gross examination of heart revealed no significant findings. Histological examination revealed fulminant myocarditis involving right ventricle, interventricular septum, left ventricular wall and A-V Node. Conclusion: It is not uncommon to find Myocarditis patients presenting with manifestations of MI and these cases often misdiagnosed as MI. In such cases, myocarditis should be considered as a differential diagnosis. Endomyocardial biopsies and histological examination of the myocardium is absolutely necessary for reliable diagnosis of the disease

Histopathological study of polypoidal lesions of the nasal cavity - A cross sectional study

Background & Objectives: Lesions of nasal cavity present difficulty in their diagnosis, prognosis and management because of unusual clinicopathological features. This study was done to evaluate the nasal polyps with regard to age, sex distribution and histologic types. Methods: The present study included 70 polypoidal lesions of the nasal cavity. The study period constituted from January 2003 to December 2006. All the tissues were fixed in 10% formalin, processed stained with H & E and studied for various histopathological features. Results: Simple polyps accounted for 88.57% of total cases and neoplastic polyps accounted for 11.42%. Of the simple polyps non allergic polyps accounted for 58.06% and allergic polyps for 41.93%.Seventy five percent of neoplastic polyps were benign and 25% were malignant. All the malignant polyps in the study were squamous cell carcinomas. Interpretation & Conclusion: The majority of the nasal polyps sent for histology are simple polyps. A variety of benign and malignant lesions of the nasal cavity may present as polyps, hence all polyps need histological examination

Blood and bone marrow findings in tuberculosis in adults -A cross sectional study

Background: Tuberculosis is a major public health problem in India. Hematolgical changes have been studied with variable results. Aims and objectives: The present study was undertaken to know the prevalence of blood and bone marrow changes in tuberculosis. Methods: The peripheral blood and bone marrow changes were evaluated in hundred adult patients with tuberculosis, admitted at District Hospital, Belgaum and KLES Hospital and MRC were. Results: The peripheral blood findings seen were anemia, raised ESR, leukocytosis, neutrophilia, lymphocytosis, eosinophilia, leucopenia, thrombocytosis and thrombocytope-nia. The bone marrow changes seen were hypercellularity , myeloid hyperplasia , erythroid hyperplasia with megaloblastic changes and reactive plasmacytosis. Another interesting finding in bonemarrow was presence of granulomas which were seen in 5% of cases of which 1 case showed positivity for acid fast bacilli on Zeihl –Neelsen stain. Conclusion: The varied hematological findings observed in tuberculosis should prompt us to consider tuberculosis as one of the differential diagnosis in patients with hematological findings