Tonsillar Actinomycosis with presence of Epidermal inclusion cyst: Report of a rare entity

Epidermal inclusion cysts (EIC) are benign lesions that can be encountered throughout the body, but with a low incidence in the head and neck region. (1.6 to 7%) The various locations in this region where the cyst can arise are sublingual, submental, submandibular and buccal mucosa. EIC present in the tonsils are extremely rare and reported less than 0.01% in published English literature. We report a rare and incidental finding of epidermal inclusion cyst with actinomycetes in tonsil in a 57 year old male who presented with sore throat and difficulty in swallowing.

Nodular Fasciitis of the breast – An uncommon benign reactive proliferative lesion

Nodular fasciitis is rarely reported in breast. It is benign reactive proliferative lesion of fibroblast. A 65 year old female presented to surgical department for left breast mass since 2 months duration, rapidly enlarging without any regional lymphadenopathy. Mammography showed hyperdensity masses with irregular margin. On FNAC reported as benign spindle cell lesion. Left sided two breast masses measuring 4 x 3.3 x 2.5cm and 2.0 x 1.6 x 0.5cm were excised and on histopathology reported as Nodular Fasciitis of left breast. We are presenting this extremely rare case of nodular fasciitis of breast for its clinical, radiological and histopathological findings.

Xanthomatous meningioma, a rare histological variant: Case report

Xanthomatous meningioma is a WHO grade I metaplastic meningioma where neoplastic cells contain lipid-filled vacuolated cytoplasm. The origin of xanthomatous meningiomas is believed to be from meningothelial cells but diagnosis remains difficult because of their close resemblance with the histiocytes. Peculiar radiographic features may aid in diagnosis, however, definitive diagnosis requires immunohistochemical staining. We report a case of 43-year-old male with sphenoid wing meningioma revealing xanthomatous changes and received treatment as grade 1 meningioma. Though the exact pathophysiology remains unknown, we believe focal or gross metaplastic changes lead to transformation of tumor cells into the xanthomatous subtype. Authors discuss this interesting a rare histologic variant with discussion of the relevant literature.

Cyclin D1 expression in Peripheral T-Cell Lymphoma: A report of 2 cases

: Peripheral T-cell lymphomas (PTCLs) represent a heterogeneous group of non-Hodgkin's lymphomas (NHL), characterized by poor outcome, accounting approximately for 10%-15% of all non-Hodgkin lymphomas in the western countries, and with a higher prevalence in Asia. Cyclin D1 immunoreactivity is characteristically seen in mantle cell lymphoma. It is also observed in hairy cell leukemia, plasma cell myeloma and a proportion of diffuse large B-cell lymphomas, however its expression in peripheral T-cell lymphoma is rarely recorded. : We report two cases of peripheral T-cell lymphoma not otherwise specified with heterogeneous nuclear Cyclin D1 immunohistochemical overexpression, due to gene copy gain, a phenomenon similar to that observed in Mantle Cell Lymphoma.: Cyclin D1 expression can be seen in PTCLs, besides mantle cell lymphoma, hairy cell leukemia and plasma cell myeloma and underline the importance of molecular biology integration tests as a diagnostic tool to escape the pitfall.

Cutaneous ciliated cyst: A case report

Cutaneous ciliated cyst are relatively rare benign lesions, found in the dermis or subcutis of the lower extremities of young females in their second and third decades. The cysts are typically lined by ciliated cuboidal to columnar epithelium, showing pseudostratified areas and focal squamous metaplasia is occasionally present. Immunohistochemical studies have demonstrated that the cysts can be PR and ER positive, similar to the epithelia of the fallopian tubes. The pathogenesis of the cyst is yet being studied, some hypotheses have been proposed including the Mullerian heterotopias, ciliated metaplasia of eccrine sweat glands, and embryonic remnants of the cloacal membrane. We report a cutaneous ciliated cyst over the right gluteus area in a 29 year old female. On histologic examination, the cyst was lined by ciliated columnar epithelium, showing occasional papillary projections.

Evaluation of renal biopsies in various kidney diseases with reference to staining

Renal diseases of different origin and nature may produce essentially similar disturbances of renal functions and may have clinical similarities and hence there was a need to classify renal diseases more scientifically. The basic approach was to correlate clinical signs and symptoms with histological changes in the tissue, using both simple and special staining techniques so as to reach to a definitive diagnosis.The present study was conducted on renal biopsy referred to pathology department. Criteria for successful biopsy were as follows-Adequate biopsy sample size, correct processing of specimen, informed interpretation and issue of an accurate report. A total of 29 renal biopsies were examined. In minimal change disease, only in 4 patients the glomerulus was sclerosed. Membranous glomerulonephritis comprised of the maximum number of cases (9/30). Total of 3 cases of renal biopsies revealed amyloidosis. Focal amyloid deposits with deposits either near the hilum or perivascular areas were found in 33.3% of cases, while extensive amyloid deposits were found in 33.3% of the cases.It is necessary to determine both the type of renal disease and the cause of the primary disorder in order to make the diagnosis and various staining techniques play a very helpful role. The likelihood that the biopsy specimen accurately reflects the type and severity of the underlying disease is directly related to both the diffuseness of the disease process and the amount of tissue examined.

Synovial chondromatosis of the foot: A case report with brief review

Synovial chondromatosis is a rare, benign disorder which commonly involves the large joints and is characterised by the proliferation of cartilaginous nodules beneath the synovial membrane. We report a case of an elderly male who presented with pain and swelling of the right foot since five years. Proper clinico- radiological and histological evaluation of this case led to the diagnosis of synovial chondromatosis which was managed surgically and patient’s symptoms were relieved. The rare occurrence of this entity in the small joints of hands and feet and the presence of several close differentials, warrants a thorough clinico-radiological and histological work-up to prevent unnecessary surgical exploration.

Clinicopathological study of non-granulomatous necrotizing lymphadenopathies

Non-granulomatous necrotizing lymphadenopathy (NGNL) is not a specific entity. It is seen in various conditions like Kikuchi-Fujimoto disease (KFD), Systemic Lupus Erythematosus (SLE), tuberculosis, lymphoma/metastasis and lymph node infarction. These conditions mimic each other histologically but it is necessary to identify the correct pathology as the treatment differs significantly. To highlight the subtle morphological features which lead to the etiological diagnosis in NGNL. The lymphnode biopsies (N=198), reported in our institute as NGNL, over 4½ year study period, were retrieved. Of these, the benign cases were 64 in total, with 40 cases of KFD and 8 cases of SLE. H&E, special stains and immunohistochemistry slides were reviewed by two pathologists. Histomorphological features like amount of necrosis, apoptotic debris, vasculitis, presence of neutrophils, eosinophils, histiocytes, plasma cells, hematoxylin bodies, Azzopardi phenomenon and thrombus formation were studied. Logistic regression analysis was performed to identify the most significant histopathological parameter with each disease. Kendall’s Tau matrix plot analysis was used to measure the correlation between the disease and the histopathologic variables. Features like vasculitis, hematoxylin bodies and Azzopardi phenomenon showed strong correlation with SLE and inverse correlation with KFD. Apoptotic debris, paucity of neutrophils and eosinophils had a strong positive association with KFD. The histological features help in differentiating the various entities associated with NGNL. It is necessary to correlate with clinical details and various laboratory parameters to reach a conclusive diagnosis because these conditions have varied treatment modalities.

Importance of fine needle aspiration cytology in revealing the spectrum of axillary swelling: An experience with 30 cases

FNAC plays an important role in the early diagnosis of the axillary swelling. This study was conducted to document the spectrum of lesions on the patients that came for FNAC with the complain of axillary swelling. Present study was carried out at the Department of Pathology. A total of 30 cases of axillary swelling which were referred for FNAC in the department of Pathology, over the period of 3 months were retrospectively evaluated. All the stained slides of the cases were also reviewed.: From 30 cases there were 13 males and 17 females. On examining the stained slides maximum number of cases presented with chronic granulomatous lymphadenitis followed by Reactive lymphadenitis , Lipoma, Ductal carcinoma metastasis of breast in axillary lymphnode, chronic non-specific lymphadenitis, One unusual case of Hydatid cyst who presenting with axillary swelling was also diagnosed. : FNAC is an important tool in differentiating benign and malignant lesions thus, helps in the proper management of the disease.