Objective: To review the demographic, clinical and histomorphological aspects of xanthogranulomatous inflammation (XGI) in different organs. Material and methods: All the cases diagnosed as XGI by histopathology from the specimens received in the department of Pathology, Regional Institute of Medical Sciences, Imphal, Manipur, India over the period of 10 years from January 2001 to December 2010 were included in the study. All the available data including age, sex, organ of involvement, association with stone etc. were collected and analyzed retrospectively. All the slides were reviewed. The results were recorded and analyzed. Results: A total of 98 cases of XGI were diagnosed out of a total of 9755 specimens received, constituted by 5382 of gall bladder, 4298 of appendix, 41 of kidney and 24 of tube and tubo-ovarian mass making an overall incidence of 1%. The incidence of XGI in kidney was 12.19%, followed by 4.16% in tube and tubo-ovarian mass, 1.5% in gall bladder and 0.25% in appendix. Maximum number of cases were in the age group of 41-50 years with 33.67%. The female to male sex ratio was 2.5: 1. 90.2% cases in kidney and 86.6 % in gall bladder were associated with calculi. One case was associated with adenocarcinoma of gall bladder. Conclusion: Xanthogranulomatous inflammation which often mimics malignancy clinically and morphologically, is increasingly recognized in different anatomic locations. An accurate diagnosis will relieve the psychological panic of suspected malignancy and prevent the patient from aggressive treatment. DOI: http://dx.doi.org/10.3329/bjms.v13i3.16266 Bangladesh Journal of Medical Science Vol.13(3) 2014 p.302-305

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BACKGROUND Carcinoma of the gallbladder is the most common malignancy of the biliary tract. The indistinguishable clinical manifestations of cholelithiasis and cholecystitis may mask an underlying malignancy. The present study highlights the occurrence of Incidental gallbladder carcinoma (IGBC) detected during histopathological examination in cholecystectomy specimens removed for cholelithiasis. METHODS This is a tertiary hospital based cross-sectional study of 2379 cholecystectomy specimens removed during cholelithiasis over a ten-year period. Relevant hospital records, histopathology slides and reports were reviewed, re-evaluated and studied. RESULTS Eleven (11) cases of IGBC, constituting 0.46% were diagnosed. Females with IGBC were more than the males (M:F=1:4.5). Focally thickened wall (mean wall thickness of 0.57 cm) was the most common gross finding with 100% association with cholelithiasis. Moderately differentiated Adenocarcinoma was the most common histological type and more than 70% were in lower stage (3 cases in pT1 and 5 cases in pT2) while the remaining 3 cases were at a higher stage with positive margins. CONCLUSIONS Early detection of IGBC by histopathological examination would have a favourable impact on prognosis and management thereby increasing the survival outcome.

Thrombotic thrombocytopenic purpura (TTP) is a syndrome characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological abnormalities, fever and renal dysfunction. Early clinical suspicion and presumptive diagnosis of TTP helps in timely initiation of treatment modalities specic for TTP which may prove to be lifesaving and thus augment in reducing the mortality rate of TTP which is estimated to be 80 – 90 % if left untreated. We report a case of a known case of multiple myeloma who developed TTP which proved fatal despite plasmapheresis. Signicant autopsy ndings of presence of microthrombi in the microvasculature of multiple organs is also highlighted.