Primary central nervous system lymphoma (PCNSL) is uncommon with scarce cases having involvement of the spinal cord. Cauda equina is unique in its location and shows very rare involvement by diseases pathologies. When the same occur, they pose a lot of diagnostic difficulties as the location is difficult to access with overlapping radiologic abnormalities. It is an unusual location for lymphomas to occur with only few cases reported in literature. The cauda equina lymphomas may mimic other entities which occur at that site. Histopathology is the gold standard for the same. Here, we report an unusual case of cauda equina lymphoma mimicking a myxopapillary ependymoma in a 50-year-old male.
<p>Sinonasal region, with its anatomical complexity, is commonly associated with a number of tumors. Salivary gland tumors are frequent but adenocarcinomas are uncommon.Here presented an uncommon case of high-grade adenocarcinoma non-salivary non-intestinal type.</p>
Background and Aim:Non-specific terminal ileum abnormalities (INSTIA) are frequently observed on ileo-colonoscopic examinations, but their clinical significance is unclear. Moreover, there is no recommended protocol for the management of these abnormalities. Presuming infectious origin, a randomized controlled trial of empirical protocolized management with three commonly used antimicrobial agents was carried out with an aim to study its impact on patients with INSTIA. Methodology:Patients with INSTIA were randomized into two groups such as both symptomatic and empirical protocolized treatment with three commonly used antimicrobial agents [rifaximin, albendazole and tinidazole (group A)] and symptomatic treatment alone (group B). Clinical, endoscopic, and histological findings of these subjects were noted at baseline and after follow-up of 3 months. The primary outcome measure was mucosal healing on follow-up ileo-colonoscopy after 3 months.Results: A total of 60 patients with INSTIA were enrolled. The most prevalent symptoms were abdominal discomfort (61.6%), diarrhoea (41.6%), and constipation (40%). The incidence of ulcers, nodularity and erosions were 62.1%, 27.6%, 10.34% in group A and 58%, 29%, 13% in group B respectively. After a mean follow-up duration of 3.36 ± 0.27 months, both groups showed comparable resolution in clinical symptoms (92.4% vs 88.8%, p=0.954), ileo-colonoscopic findings (88.5%vs 81.5%, p=0.765), and histological characteristics (76.5%vs 70.4%, p=0.806).Conclusion: The clinical, endoscopic, and histopathological remission occurs in most patients with INSTIA. The use of empirical protocolized management with antimicrobials did not have any impact on the rate of mucosal healing in these patients.
<p class="abstract">Though the parapharyngeal space is sites of primary involvement by neoplastic process, they can rarely house masses descending from a base of skull tumour. Chordoma is an uncommon tumour of the skull base and sacrococcyx. Originating from the notochordal remnants, they are locally aggressive causing lytic destruction of the adjacent bony structures, particularly in the base of the skull. The use of surgery and adjuvant high-dose proton RT is documented to produce best results. Here we report a diagnostic challenge posed by a chordoma occurring as a parapharyngeal mass in a 68 year old male.</p>
Endometriosis is a disease seen among women in reproductive age group. It is characterised by deposition of endometrial tissue outside the uterus. It commonly involves the pelvic organs like ovary, fallopian tube and pelvic ligaments. Involvement of gastrointestinal tract by endometriosis is uncommon and the incidence varies widely among different studies. Colonic endometriosis can be confused as malignancy both clinically and radiologically. In these instances, histopathology is essential for a correct diagnosis. Here, the authors report a case of colonic endometriosis presenting with features of large bowel obstruction in a 49-year-old female with previous history of laparoscopic hysterectomy. Radiological scanning of abdomen and colonoscopic examination were suspicious of sigmoid malignancy. Although colonic biopsy was inconclusive and tumour markers were normal, she underwent sigmoidectomy with lymphnode clearance as per oncological principles with primary anastomosis. Her final histopathological examination revealed features of colonic endometriosis without any evidence of malignancy. Detailed evaluation of the patient didn’t reveal endometriosis at any other site. Patient was discharged after full surgical recovery and was doing well till the last follow-up.
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