Bipolar transurethral resection of bladder tumor was not superior to monopolar resection with respect to obturator jerk, bladder perforation and hemostasis. There was a significantly lower incidence of severe cautery artifact after bipolar resection.

A 58-year-old gentleman presented with history of fever and left loin pain for three months. On physical examination, he was found to have a renal mass. On laboratory evaluation he was found to be anaemic (PCV 23.8) with thrombocytosis (7,25,000/mm 3 ) and had an elevated ESR (77). His CT abdomen revealed an 11 x 13 cm heterogenously enhancing mass arising from the upper pole of left kidney [Table/ Fig-1]. There was no involvement of the contiguous structures but superiorly, it was adherent to the spleen. aBstRaCtMalignant Fibrous Histiocytoma (MFH) usually arises from the extremities with the retroperitoneum being the second most common site. We present the case report of a 58-year-old man presenting with fever and was detected to have a renal mass on evaluation. He underwent a radical nephrectomy with a preoperative diagnosis of renal cell carcinoma. But the final histopathological report was MFH. Primary renal MFH is extremely rare and is usually diagnosed on histopathology with the aid of immunohistochemistry.keywords: CD 68, Kidney, Radical nephrectomy microscopy: The renal parenchyma was infiltrated by a fairly circumscribed tumour [Table /Fig-2]; with clustered and scattered polygonal cells to spindle cells with markedly pleomorphic, vesicular nuclei and moderate amount of eosinophilic, cytoplasm. There were multinucleate giant cells, foamy macrophages and bizarre tumor cells. The intervening stroma showed many thick collagen bundle and dense infiltrates of lymphocytes, plasma cells, histiocytes, many neutrophils and eosinophils [Table/ Fig-3]. There was focal hyalinization. There was no lymphovascular invasion or nodal involvement. The tumour cells were negative for desmin and myogenin but showed positive staining with CD68 [Table/ Fig-4] on immunohistochemistry. These features were consistent with the diagnosis of inflammatory subtype of malignant fibrous histiocytoma. The tumour infiltrated the sinus fat with rest of the parenchyma being normal. Spleen showed features of congestive splenomegaly but was otherwise free of tumour [Table/ Fig-5].

Introduction Radical nephrectomy (RN), a recommended treatment option for patients with Renal cell carcinoma (RCC) leads to an inevitable decline in global renal function. Pathological changes in the non-tumour parenchyma of the kidney may help predict the function of the remaining kidney.Materials and Methods Aim of this prospective, observational study was to find histopathological factors in the non-tumor renal parenchyma that could predict the decline in global renal function postoperatively and its association with co-morbidities like diabetes (DM). Data of consecutive patients undergoing RN from December-2013 to January-2015 was collected. Non-tumor parenchyma of the specimen was reported by a dedicated histopathologist. eGFR was calculated using Cockcroft-Gault formula before the surgery and at last follow up of at least 12 months.Results 73 RN specimens were analyzed. Mean follow up was 12.3 months. The mean decrease in eGFR was 22% (p=.0001). Percent decrease in eGFR did not show association with any of the histopathological parameters studied. DM was significantly associated with decrease in percent eGFR (p<0.05) and increase in arteriolar hyalinosis (p=0.004), Glomerulosclerosis (p=0.03) and Interstitial fibrosis/ Tubular atrophy (p=.0001). Maximum size of the tumor showed a negative correlation with percentage change in eGFR (p=.028).Conclusion Histological parameters in the non-tumour portion of the RN specimen may not be able to predict renal function outcome over a short follow up. However, presence of DM was associated with adverse pathological changes and significant decrease in renal function postoperatively.

Incision site metastasis is a rare yet well-recognized complication of oncologic operations. We describe the case of a 60-year-old man with a large mass at the site of abdominal incision for a nephrectomy. The operation was performed for infection in an obstructed kidney, which in retrospect harbored malignancy. Percutaneous core biopsy of the mass revealed metastatic conventional renal cell carcinoma (RCC). Surgical resection was obviated by the presence of nodal disease on imaging. Palliative targeted therapy with tyrosine kinase inhibitor was initiated. RCC can not only mimic an inflammatory renal mass radiologically but also coexist with infective renal conditions. Diligent histopathological examination as a routine following nephrectomy for complicated diagnoses is imperative.

Very few cases of placental site trophoblastic tumor (PSTT) primarily involving extrauterine sites have been reported to date. We report a case of a 29-year-old female who presented with a vaginal nodule 9 months after delivery at an outside hospital which was initially diagnosed as a poorly differentiated squamous cell carcinoma. Subsequently she was referred to our institute, and on the basis of histology, mildly elevated serum β-HCG level, and immunohistochemistry, PSTT was diagnosed. After the completion of chemotherapy, the vaginal nodule completely regressed and serum β-hCG returned to baseline. Her follow-up has been unremarkable. This case highlights the importance of the fact that PSTT can be easily misdiagnosed at extrauterine sites in the absence of proper clinical, histologic, and immunohistochemical correlation.

Background: Malignancies form one of the important causes of pediatric morbidity as well as mortality. These malignancies are increasingly becoming more important causes of pediatric mortality as deaths from other causes such as infections, malnutrition, and heart diseases are decreasing due to advances in field of pediatric medicine. Urogenital tumors form one of the important causes of pediatric urology consultations. This study was done to describe the spectrum and clinicopathologic features of childhood tumors of the urogenital tract in our institution. Aims and Objectives: The aims of this study were as follows: (1) To study the histopathology of childhood tumors of the urogenital system. (2) To describe the clinical, gross, and microscopic features of these tumors. Materials and Methods: This was a retrospective study conducted in the Department of Pathology of Christian Medical College, Vellore, in which children below 18 years of age, in whom biopsies or resections of tumors of the urogenital system was done, were included on the basis of a predefined inclusion and exclusion criteria. Slides of all such specimens were retrieved from the archives of General Pathology. The clinical features were recorded from cases papers. Microscopic and immunohistochemistry findings were studied. Data analysis was done using SPSS 16.0. Descriptive data were reported and compared. Categorical variables were reported using frequency and percentage. Continuous variables were reported using mean ± standard deviation or median (interquartile range) as appropriate. Results: In our study of 100 pediatric patients with urogenital tumors, there were 55 boys (55%) and 45 girls (45%) amongst the studied cases with a M: F ratio of 1:0.81. The most common type of urogenital neoplasm in pediatric age group was found to be Wilms tumor which was seen in 55 (55%) patients. The other common histopathological findings were mature cystic teratoma (13%), mixed germ cell tumor (7%), yolk sac tumor (6%), and rhabdomyosarcoma (6%). Sertoli cell tumor, Sertoli-Leydig cell tumor, and clear cell renal carcinoma were less common and were seen in one patient (1%) each. Conclusion: Urogenital tumors in pediatric age groups form one of the important causes for pediatric urology consultation. In our study Wilms tumor was most common urogenital tumors followed by mature cystic teratoma, mixed germ cell tumor, yolk sac tumor, rhabdomyosarcoma, and immature teratoma.

Objective Primary cervical lymphoma is a rare clinical condition among the Non-Hodgkin's lymphomas. Here, we describe our experience with primary lymphoma of the cervix. Methods Chart review of patients with lymphoma of the cervix at tertiary care center in Southern India, during the period 2010-2012. Results Three cases of primary lymphoma of the cervix were identified from our records. The ages of these women were 54, 36, and 49. All three presented with vaginal bleeding and a cervical mass. The first patient had a large, infiltrative, smooth cervical mass, the biopsy of which was reported as a cervical lymphoma. The second patient had a cervical mass, diagnosed as cervical fibroid, and underwent a difficult hysterectomy. The final biopsy report was reported as cervical lymphoma. The last patient underwent hysterectomy elsewhere for cervical fibroid and presented to us 3 months later with a pelvic mass. Biopsy of this mass as well as the cervix (slide review) of the original specimen showed lymphoma. All the three patients underwent chemotherapy with R-CHOP.One patient died after her 12th cycle of chemotherapy, one patient is well at 16 months follow-up. The last patient decided to continue her chemotherapy in her home town. Conclusion Primary cervical lymphoma is a rare diagnosis often made after hysterectomy or large excision biopsy. The mainstay of treatment is chemotherapy and surgery is usually reserved for a persistent cervical mass.

Urothelial cancers of the upper tract are aggressive malignancies with a propensity for distant metastases. Transitional cell carcinoma can also develop de novo in the ovaries and differentiation between these lesions requires immunohistochemistry. We report a case of right lower ureteric urothelial carcinoma with metastases to both ovaries. To our knowledge, this is the first reported case of bilateral ovarian metastases from an upper tract primary, diagnosed with immunohistochemistry.