A 52-year-old female presented with chief complaints of distension of abdomen, lower abdominal back pain and generalized weakness from last three months. She was Gravida 4 & para 4 and she had attained menopause 8 years back. On examination, she appeared pale. On abdominal examination, a fixed, firm mass was palpable in the left hypochondrium. On speculum examination, cervix was high up and not visualized. On vaginal examination, the mass was felt in anterior and lateral fornices. There was no mass palpable in the pouch of Douglas. A clinical diagnosis of ovarian tumour was made. Haematological and biochemical profile was unremarkable, except mild anaemia. Chest X-ray showed no abnormality. Abdominal ultrasonography revealed large heterogeneous, mainly solid 15x10cm mass in left adnexal region [Table/ Fig-1]. CT-scan of abdomen showed a large enhancing mass lesion with hypodense areas in left tubo-ovarian region [Table/ Fig-2]. No lymphoadenopathy or organomegaly was present. Patient's consent was taken. Patient underwent for exploratory laparotomy and the specimen was submitted for histopathological examination. Gross finding consist of a single, firm, lobulated ovarian mass measuring 16 X 10 X 5 cm in size. External surface was smooth with occasional areas of haemorrhage [Table/ Fig-3]. On cut section, it was a multilobular mass with a soft to firm consistency and colour varying from grey to tan. Focal areas of haemorrhage and necrosis were seen [Table /Fig-4]. A portion of attached fallopian tube was identified. On microscopic examination, Haematoxylin and Eosin stained section showed uniform population of monomorphic tumour cells intersected by fibro-vascular septa. Individual tumour cells were round to oval with prominent nucleoli at places. High N/C ratio and focal areas of haemorrhage and necrosis was noted [Table/ Fig-5,6].The diagnosis of non-Hodgkin's lymphoma diffuse, large celltype was made on light microscopy which was later confirmed by
Background:Fine-needle aspiration (FNA) of the thyroid gland has proven to be an important and widely accepted, cost-effective, simple, safe, and accurate method triaging patients with thyroid nodules. Awareness and understanding of wide spectrum thyroid disorders are of great value because most lesions are treatable by medical or surgical management.Aim:The aim of this study is to determine the accuracy of FNA cytology (FNAC) in the diagnosis of thyroid lesion using the Bethesda system for reporting thyroid cytopathology nomenclature (BSRTC) and to correlate these with histopathological findings.Materials and Methods:FNA was performed in 238 patients from January 2014 to October 2015 at a Tertiary Teaching Hospital in Bihar presenting with the thyroid swelling and its histopathological correlation was done in 105 patients.Results and Observations:Out of 238 patients with thyroid swelling, majority were females (196) and in younger age group (n = 104 [43.6%], 21–40 years). In 224 cases, adequate smears for cytological interpretation were obtained. Among them, colloid goiter was the most common lesion. Of these, 105 cases were surgically treated, and tissue was submitted for histopathological examination, which showed 97 nonneoplastic lesions and eight neoplastic lesions.Conclusion:FNAC is rapid, simple, safe, and cost-effective diagnostic modality in the investigation of thyroid disease with high sensitivity, specificity, and accuracy. It can be used as an excellent first-line method for investigating the nature of lesion. Bethesda system is very useful as it is simplified, systematic, standardized system for reporting thyroid cytopathology, which provides better communication between cytopathologist and clinicians, leading to more consistent management approach.
Macrodystrophia lipomatosa is a rare congenital nonhereditary developmental anomaly. It is characterized by hamartomatous proliferation of the soft tissue leading to disproportionate enlargement of the limbs and digits. Since it leads to diagnostic dilemma, it has to be differentiated from various other conditions as they differ in course, prognosis, complications, and treatment. Herein, we present two cases with localized gigantism and discuss the various differential diagnoses and need for clinico-patho-radilogical correlation for diagnosis of this rare entity.
Malignant Melanoma of nasal cavity is an extremely rare tumour and is more aggressive than its cutaneous counterpart. Primary malignant melanoma of nasal cavity arise from melanocytes located in the mucous membrane. Only 0.5% of malignant melanoma arises in nasal cavity. We report a case of malignant melanoma of the nasal cavity in a 51-year-old male who presented with swelling of nose, nasal block and epistaxis. By brush cytology and CT scan imaging, the pre operative diagnosis of malignant melanoma was made which was later confirmed by histopathology examination along with immunohistochemistry by using S100 and HMB 45. Malignant melanoma of nose is rare tumour, with aggressive behavior and poor prognosis. Rarity of this lesion warrants its mention and emphasizes the importance of considering malignant melanoma among the differential diagnosis of tumours of nose and paranasal sinuses.
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