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Caprine hemal nodes were studied by light microscopy after glutaraldehyde fixation and epoxy resin embedding. Anode consisted of a capsule, subcapsular and other sinuses, cortex, medulla and hilus. Elements of circulating blood filled the interstices of the reticular meshwork and associated macrophages which traversed the lumina of subcapsular and medullary sinuses. The latter were rare in 1-month-old goats, progressively increased in number and size in 2- to 4-month-old goats and coalesced with each other and the subcapsular sinus in adult animals. The cortical tissue appeared as lymphoid nodules. Circumferential lymphatic vessels abutted on outer margins of the nodules and gave origin to several radial lymphatics which branched and anastomosed between the medullary blood sinuses. Medullary cords were organized around the radial lymphatics. A single efferent lymphatic was formed at the hilum by confluence of the radial lymphatics. Our study, in contrast to earlier reports, shows that caprine hemal nodes possess efferent lymphatics. The present data suggest that the hemal nodes are involved, in addition to classical functions, in blood storage by hemoconcentration.

A 45 year old male patient presented with the complaint of a purplish nodular painful swelling on the flexor aspect of the left forearm of five years duration. A radiological examination of the lesion was not done prior to its excision. A biopsy was done and it was sent for a histopathological examination. The biopsied tissue was single, irregular, firm and globular, it measured 0.5 x 0.5cm in size and it was processed in two halves Its microscopic examination showed a well circumscribed area which comprised of sheets and nodules of monomorphic round cells with slightly vesicular, round nuclei and an acidophilic cytoplasm, amongst which were interspersed numerous blood vessels, many of which were dilated and congested, along with numerous lymphatic channels which were filled with lymph. Immunohistochemistry for SMA, CEA and CD 34 was advised, out of which only SMA turned out to be strongly positive and a final diagnosis of a Glomus tumour was made.

Spinal cord compression (SCC) is an unusual sequale of extra-medullary hematopoiesis (EMH). We report a patient diagnosed with β-thalassemia intermedia at the age of 7 years presenting as a 24-year-old with symptoms suggestive of paraparesis. MR imaging revealed long masses of EMH opposite T5-T11 and L5-S2 vertebrae with cord compression at T6 vertebrae. Patient was treated with external beam radiotherapy (EBRT) to a low dose of 20 Gy in 10 fractions over 2 weeks. The patient had symptomatic relief of paraparesis by the 5th fraction and nearly regained full power in bilateral lower limbs by EBRT conclusion. Patient was begun on hydroxyurea post EBRT and was symptom free at 2-month follow up. With a follow-up of 18 months so far, he remains asymptomatic and free of recurrence. MRI correlation of pre-EBRT, post-EBRT and at first follow-up showed a significant reduction in the size of EMH, increase in diameter of spinal canal post EBRT but a persistent edema which had no clinical manifestation. Though there was a 58% drop in leukocyte count by the end of EBRT, there was no leukocytopenia. We suggest that EBRT should be treatment of choice for SCC due to EMH as it produces as rapid and durable response with minimal acute hematological side-effects.

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Introduction: Type 1 diabetes mellitus (T1DM) is associated with various autoimmune disorders like celiac disease, thyroid disorder, adrenal failure, etc. However, how common is this association in Indian children is not clearly known. Objective: To assess the prevalence of other coexisting autoimmune disorders in children with T1DM. Materials and Methods: In this cross-sectional study, patients requiring insulin and ketosis-prone diabetic and with history of diabetic ketoacidosis/undetectable fasting C-peptide levels were included. Beside demographic and clinical data, detailed biochemistry evaluations were performed. Celiac disease was diagnosed as per the ESPGHAN diagnostic criteria. ACTH stimulation test was done to confirm the adrenal insufficiency in patients with basal serum cortisol <5 μg/dL. Thyroid function test (TSH) and anti-TPO antibody were assessed in all patients. Screening for other autoimmune disorders was done only when clinically indicated or symptoms or family history was suggestive of presence of such disorder. Results: Among 150 patients enrolled, 64.66% were males and mean age was 13.48 ± 3.29 years (range 3–18 years). Mean age at diagnosis of T1DM was 10.0 ± 3.63 years and duration of diabetes was 3.46 ± 3.18 years. The prevalence of antibodies positive against autoimmune diseases was anti-tTG IgA (20.7%), anti-TPO (33.7%), anti-CCP ab (1.3%), and ANA (0.7%). Significantly higher proportion of females had raised anti-TPO antibodies than males (47.2% vs. 25.8%, P = 0.006). Celiac disease was most common association (24.8%) followed by hypothyroidism (14.1%) and Grave's disease (3.3%). Significantly higher proportion of females had hypothyroidism than males (25.0% vs. 8.2%, respectively, P = 0.005). Prevalence of raised anti-tTG and anti-TPO did not differ significantly by the age ( P = 0.841 and P = 0.067) or duration of T1DM ( P = 0.493 and P = 0.399). Conclusion: In this part of country, celiac disease, hypothyroidism, and Graves's disease are common associations in children with T1DM.

A 40-year-old male presented with a right lower lid painless, gradually progressive swelling for the past 2 years. There was no preceding history of trauma, cutaneous lesion, infection or any drug intake. No physical or systemic abnormality was noted. Patient had normal haemogram, coagulation profile and immune status. Lesion was excised and submitted for histopathological examination.Biopsy specimen received was a single, irregular, firm, reddish brown piece of tissue measuring 0.5x0.5cm in size and was processed as such. ABSTRACTTufted Angiomas also known as angioblastomas /Angioblastoma of Nagakawa are rare vascular neoplasms localised to the skin and subcutaneous tissues with the upper trunk and neck being most common sites. They are mainly seen in children but a few cases in juveniles and adults have been reported. We hereby report this case, a 40-year-old male who presented with a right lower lid, painless, slowly progressive, firm swelling diagnosed as Tufted Angioma on histopathology and immunohistochemistry.

Background:The nasal cavity and paranasal sinuses - including the maxillary, ethmoid, sphenoid, and frontal sinuses are collectively referred to as the sinonasal tract. Fine needle aspiration (FNA) of paranasal sinus lesions for early diagnosis of neoplastic lesions is difficult due to closed architecture, and only one study has been documented in the literature.Aims:To find the efficacy of intra-operative cytology and frozen section for frequently encountered tumor and tumor-like lesions of the nose and paranasal sinuses.Materials and Methods:Thirty cases were included in this study. The material for cytologic examination and frozen sections were taken per-operatively. Cytological smears were prepared by imprint/squash methods from the representative tissue pieces and stained with Leishman-Giemsa and Papanicolaou. Frozen section and paraffin-embedded section were stained with hematoxylin and eosin stain. A rapid opinion regarding the benign or malignant nature of the lesion and the type of tumor was given.Results:The sensitivity, specificity, and positive predictive value of imprint cytology, squash cytology, and frozen section were 100%, 100%, and 100%; 100%, 96.15%, and 80.0%; and 100%, 96.15%, and 80.0%, respectively. Overall diagnostic accuracy of imprint smears, squash smears, and frozen section was100%, 96.7%, and 96.7%, respectively. Imprint smears had better specificity as cells morphology could be more accurately appreciated.Conclusions:Intra-operative cytology and frozen section examinations of lesions of nose and paranasal sinuses are useful, quick, and reliable diagnostic technique for rapid diagnosis in the operation theatre and can be used as an adjunct to histopathology for better management of patients.