A young woman on long term corticosteroid therapy presented with a discrete hyperpigmented nodular cystic swelling on her upper thigh to the buttock region. There was history of discharging sinuses however at presentation the lesion was painless nondischarging. The lesion was subjected to fine‐needle aspiration. The cytological smears on routine and special stains showed branching, septate fungal hyphae present extracellularly and intracellularly. The background showed dense mixed inflammation and granulomatous inflammation. The aspirated material was further subjected to culture. A nonsporulating melanized fungus was obtained and a culture isolate was sent for molecular characterization. Medicopsis romeroi, a rare melanized fungus belonging to the order Pleosporales was isolated on Internal transcribed spacer sequencing.
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Lipomatous uterine neoplasms are extremely uncommon lesions with a reported incidence of 0.01% to 0.2%. These lesions frequently pose a diagnostic challenge not only for the clinician but also for radiologists and pathologists alike. Diagnosis requires a multidisciplinary as well as multimodality approach. A 42-year-old peri-menopausal lady presented with abdominal distension, pain and irregular menstrual bleeding. On radiology, an intra-abdodominal hetergenous mass was seen suggestive of neoplastic etiology, possibly intraperitoneal liposarcoma. Microscopy revealed numerous adipocyte clusters intersecting the smooth muscle bundles, diagnostic of lipoleiomyoma. The present case is unusual as the patient had both intramural and broad ligament lipoleiomyoma. Through the present case we revisit clinical and morphological findings of lipoleiomyomas along with review of cases published in literature till date.
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