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Langerhans cell histiocytosis (LCH) encompasses a group of disorders characterized by neoplastic proliferation of Langerhans cells causing destruction of tissue, morbidity and mortality. The authors bring forth the case of a 2-year-old child presenting with chronic diarrhea and features of chronic malabsorption that revealed lesions over the ileocolonic mucosa. Histopathological examination with immunohistochemical expression for CD1a confirmed the diagnosis of LCH. Gastrointestinal LCH is quite uncommon, and review of the published English literature revealed about 50 reported cases. The importance of diagnosing this disease is echoed by the grim survival rate of 18 months from the time of diagnosis that is seen in around 60% of cases. Owing to its rarity and unfamiliarity of practicing physicians and pathologists of this disease at this site, the authors wish to discuss the potential pitfalls and differential diagnoses.

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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.

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Context: Giant placental chorioangiomas (GPC) are exceedingly rare and harbour potential to cause feto-maternal complications with resultant morbidity. Aims & Materials and Methods: A retrospective study using details from Department of Obstetrics & Gynaecology and Pathology is done to study the various clinical and pathological features of placental chorioangiomas with a special emphasis on the rare GPCs and associated complications. Results: Over a period of 16 years, 20 cases were diagnosed as chorioangioma in our institution. 60% of these occurred in primigravida (n=12) and 71% cases carried a female foetus. Only 25% cases were > 30 years. Maternal and foetal complications occurred in 85% and 50% cases. Pre-term labour was the common maternal complication and foetal death/stillbirth was the most common foetal complication. There were 15 cases of GPC, 73% occurred in primigravida (n=11) and 75% of cases carried a female foetus. There were no cases of maternal death or recurrence. Primigravidity was associated with maternal complication in contrast to multigravidity (P = 0.049). Mean age of mothers with maternal complications and those without maternal complications reached statistical significance (P = 0.001). Though histologically all the cases were similar, calcification and infarction were seen exclusively in GPC cases. Conclusion: GPCs are rare and our data adds evidence to use 4cm as an optimum cut-off in the definition. GPCs were associated with a high percentage of primigravidity, female foetus, and poorer outcome of pregnancy. Routine examination of placenta in unexplained foetal/perinatal demise must be stressed to detect microscopic evidence of chorioangioma.

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