Fibroadenomas with a predominant cystic change are called cystic fibroadenomas. These are extremely rare forms of fibroadenomas and only one case has been reported so far. They are classified under the category of complex fibroadenomas. Complex fibroadenomas are a rare variant of fibroadenomas occurring in elderly females. They are characterized by presence of one of the complex features along with the usual patterns of fibroadenoma such as cysts more than 3 mm, papillary apocrine metaplasia, or sclerosing adenosis. Patients with these lesions have higher chances of developing carcinoma of breast. We present a case of 35 years old lady with a freely mobile mass in the left breast diagnosed as cystic fibroadenoma after thorough histopathological examination of the lesion.
Introduction: Hashimoto's thyroiditis (HT) is a well-known autoimmune disorder of the thyroid diagnosed on fine needle aspiration cytology (FNAC) and a common cause of hypothyroidism in women. Often serological and hematological parameters are additional investigations aiding the diagnosis of this entity. Aim: To grade HT based on cytomorphology and to correlate the cytological grades with thyroid hormone status and basic hematological parameters. Materials and Methods: During a period of 2.5 years, 1762 patients underwent FNAC of thyroid at our tertiary healthcare center. Cytological evidence of lymphocytic thyroiditis was seen in 102 cases, of which 58 cases in addition had thyroid hormone levels and hematological parameters for correlation. Results: Of the 58 cases, 55 were females. Majority of the patients had grade II thyroiditis (56.9%), followed by grade I (34.5%) and grade III (8.6%). Elevated thyroid-stimulating hormone was seen in 74.2% of cases, with 39.7% of patients presenting with subclinical hypothyroidism and 18.9% being euthyroid. Mean hemoglobin was low in all grades, more so in hypothyroid state, while other hematological parameters were normal when correlated with grade and hormonal status without any significant P value. Conclusion: Cytomorphological grading of HT can explain the pathogenesis of this autoimmune disease. Subclinical hypothyroidism was significantly observed. There was no significant statistical correlation of cytological grades with thyroid status. In this study, most of the hypothyroid cases had low hemoglobin levels while other basic hematological parameters did not show any statistically significant correlation with the thyroid hormonal status.
Primary renal echinococcosis, a rare entity in diseases involving the kidney, accounts for 2-3 % of all cases. We present a case of 37-year-old female presenting with pain in the right iliac fossa. Radiologically, both ultrasound abdomen and CECT diagnosed as hydatid cyst, mild to moderate hydronephrosis, proximal hydroureterosis, and a possibility of rupturing into the pelvicalyceal system. Renal sparing surgery is the treatment of choice in most cases (75 %) with nephrectomy being reserved for non-functioning kidney as in our case. Histopathological examination of the nephrectomy specimen confirmed the diagnosis.
A 29-year-old female patient presented with a gradually increasing painless lobulated mass at right parieto-occipital region along with headache since one year. All routine investigations along with CT brain were within normal limits. On examination, the swelling was multilobulated measuring about 6x5x3 cm, showing surface ulceration with focal loss of hair and along with loss of pigmentation. The mass was mobile, free from the underlying structures and bled on touch. No regional lymphadenopathy was noted. A presumptive diagnosis of soft tissue sarcoma was given. FNAC was attempted twice, but yielded only haemorrhage as it was very vascular, located over scalp region. Hence, the mass was excised and sent for histopathological evaluation.Grossly, the specimen showed a skin covered mass with surface ulceration together measuring 5x4x3 cm. The cut surface of the tumour showed grey white appearance with areas of haemorrhage and cystic degeneration [Table/ Fig-1].Microscopic examination revealed skin with an underlying infiltrating tumour composed of polygonal to cuboidal cells having pleomorphic vesicular nuclei with prominent one to two nucleoli and having moderate to abundant pale cytoplasm arranged in lobules, nests and cords which are separated by thick fibrous septae [Table /Fig-2]. Many mitotic figures (upto 6-7/hpf) along with duct formation [Table/ Fig-3a] and foci of tumor necrosis were noted. Ducts stained with Pas stain [Table/ Fig-3b]. At places lymphatic tumour emboli were noted. The tumour depth noted was >7mm and was seen reaching upto the deep surgical margin.Immunohistochemical studies showed that the tumour cells were positive for cytokeratin [Table/ Fig-4a] and the ductal structures were highlighted by carcinoembryogenic antigen (CEA) [Table/ Fig-4b]. Based on these findings the diagnosis of eccrine porocarcinoma was arrived at. The patient developed recurrence ABSTRACTEccrine porocarcinoma (EPC) is a potentially lethal neoplasm of the skin that arises from the intraepidermal portion of the eccrine sweat glands. It was previously known as eccrine adenocarcinoma or malignant eccrine poroma. It commonly occurs between 60 to 80 years of age, usually arising from hands and feet. However, few case reports on involvement of rare sites such as scalp, face and eyelids are present in literature. We herein report an unusual case of porocarcinoma arising on the right parieto occipital region of scalp in a 29-yearold young female patient. To the best of our knowledge, there have been fewer than 20 cases of porocarcinoma arising on scalp with fewer than 10 cases seen in younger age group reported previously in the literature.
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