Gastrointestinal stromal tumours (GIST) are rare in paediatric patients and have a discrete clini... more Gastrointestinal stromal tumours (GIST) are rare in paediatric patients and have a discrete clinicopathological and molecular divergence from that observed in adults. In the present report we present a case of a 2-month-old female in whom colonic gastrointestinal stromal tumour acted as a lead point of colocolic intussusception. Laparoscopically assisted reduction of the intussusception and resection of tumour was done.
Neurohypophysis granular cell tumor (NGCT) is a rare entity and is classified under thyroid trans... more Neurohypophysis granular cell tumor (NGCT) is a rare entity and is classified under thyroid transcription factor 1 (TTF‐1) expressing tumors of pituitary. It is considered as an uncommon differential during sellar and suprasellar mass evaluation. Its intraoperative squash cytology is distinct and has rarely been reported in literature. A 65‐year‐old female presented with reduced vision of right eye and history of seizures. Radiological findings revealed a sellar/suprasellar mass with mass effect on optic chiasma. Intraoperative squash neurocytology examination showed a spindle cell lesion with abundant granular cytoplasm in tumor cells. Subsequent histopathology and immunohistochemistry confirmed the diagnosis of granular cell tumor. Granular cell tumor remains one of the sellar/suprasellar surprises. Its intraoperative neurocytology is unique and should be considered while evaluating a sellar/suprasellar mass. A case of sellar granular cell tumor with its intraoperative squash cytology, histopathology along with a review of literature is being presented with special emphasis on cytological differential diagnosis in pituitary region.
The Indian journal of chest diseases & allied sciences, 2009
Extreme degree of cystic, haemorrhagic and necrotic changes in a thymoma is rare. A 22-year-old m... more Extreme degree of cystic, haemorrhagic and necrotic changes in a thymoma is rare. A 22-year-old male presented with cough, grade 2 dyspnoea, and occasional chest pain for the past six months. Radiological investigations revealed a large cystic lesion in the anterior mediastinum. A benign cystic tumour was suspected. Surgical resection of the tumour was done. Grossly, the almost entirely cystic and haemorrhagic dumb-bell shaped encapsulated tumour showed a subcapsular residual nodule. Histopathological examination was suggestive diagnosis of benign thymoma (World Health Organization [WHO] Type A, medullary type) associated with the rare features of cells with dendritic processes containing melanin pigment seen singly scattered throughout the tumour.
findings of high WBC in the previous cases including ours. This feature is unusual for Sweet’s sy... more findings of high WBC in the previous cases including ours. This feature is unusual for Sweet’s syndrome but would be characteristic in these unique cases. In some cases, after the diagnosis of MCTD, the other disease-specific autoantibodies appear and transition to overlap syndrome. Sweet’s syndrome preceded by MCTD is seemingly rare, but MCTD might possibly predict the onset of Sweet’s syndrome or SLND with SLE in an overlap syndrome by monitoring the serological tests of SLE during the MCTD course. Maki Okamoto, MD Shujiro Hayashi*, MD, PhD Tetsuharu Ikegami, MD Tomoko Kaminaga, MD Yoichiro Hamasaki, MD, PhD Ken Igawa, MD, PhD Department of Dermatology, Dokkyo Medical University School of Medicine, Mibu, Japan *E-mail: [email protected] Conflict of interest: None. Funding source: None. doi: 10.1111/ijd.15241 References 1 Sharp GC, Irvin WS, Tan EM, et al. Mixed connective tissue disease–an apparently distinct rheumatic disease syndrome associated with a specific antibody to...
Indian Journal of Otolaryngology and Head & Neck Surgery, 2021
Salivary gland tumours constitute an uncommon and diverse group of neoplasms that vary considerab... more Salivary gland tumours constitute an uncommon and diverse group of neoplasms that vary considerably in their histology and biologic behaviour. As per Globocon 2018, salivary gland malignancy account for 0.3% of all cancer cases and 0.2% of all cancer deaths worldwide, reflecting the rarity of these neoplasms. Mucoepidermoid carcinoma (MEC) is a common malignant tumour of major and minor salivary gland, which comprises about 10% of all salivary gland neoplasms and approximately 35% of malignant salivary gland neoplasms. While three fourth of cases of MEC arise in the parotid, they account for a large proportion of salivary gland neoplasms occurring in minor salivary glands. Appending to the uncommonness, unusual presentations like MEC arising in heterotopic rests of salivary gland tissue in intraparotid or extraparotid lymph nodes, and MEC arising in lingual tonsils have been reported. Such diversity of clinical presentation may present a diagnostic challenge. In this continuum, we r...
Materials and Methods: The present study analyzed 7 patients younger than 40 years among 87 patie... more Materials and Methods: The present study analyzed 7 patients younger than 40 years among 87 patients of MM who presentedto our hospital from 2005 to 2008. Complete diagnostic workup was carried out for all the patients. Results: The youngest of the 7 ...
Ventriculoperitoneal shunt (VPS) for hydrocephalus is associated with various complications. Tort... more Ventriculoperitoneal shunt (VPS) for hydrocephalus is associated with various complications. Torticollis due to shunt tract fibrosis is a rare complication of VPS that occurs years later after the initial operation. However, shunt track fibrosis that progressed to large neck mass, mimicking sternocleidomastoid tumour and causing torticollis is a previously unreported complication. This led to the restriction of neck movement and hemifacial hypoplasia. Complete excision of the mass restored neck movement.
Colloid cyst of third ventricle is a rare, benign, congenital lesion that usually presents with h... more Colloid cyst of third ventricle is a rare, benign, congenital lesion that usually presents with headache, and associated with altered cognition, nausea, vomiting, gait ataxia, and blurred vision. A large cyst/growing cyst can cause obstructive hydrocephalus leading to acute rapid neurological deterioration and sudden death. Here we report a classic clinical presentation and histopathological features of colloid cyst of third ventricle with specific emphasis on the importance of rapid diagnosis and management to avoid potentially fatal complications of this otherwise benign lesion. Newer modalities like neuroendoscopy or stereotactic aspiration of cyst are now the preferred choices of management. Awareness of this entity for early diagnosis and management with minimally invasive procedures such as neuroendoscopy or stereotactic aspiration of cyst is crucial for better prognosis and patient care.
Introduction: Gelatinous marrow transformation (GMT) is a rare condition characterized by fat cel... more Introduction: Gelatinous marrow transformation (GMT) is a rare condition characterized by fat cell atrophy, focal hypoplasia of haematopoietic cells and an accumulation of extracellular gelatinous substances. The purpose of this study was to study the spectrum of underlying disorders associated with GMT in our setup. Methods: This study reviews 109 cases of GMT with bone marrow aspirate, biopsies, haematological and clinical profile of all patients diagnosed with GMT over a period of 10 years. GMT was diagnosed in BM biopsy based on characteristic morphological appearance and was confirmed by alcian blue positive staining pattern at pH levels of 2.5. Results: The age of the patients with GMT ranged from 7 months to 68 years. Twenty four (24) out of one hundred and nine (109) cases were in paediatric age group (less than 15 years). Mean age was 27.05 years. Most common association was seen with nutritional deficiency followed by post-chemotherapy and HIV cases. Conclusions: GMT is a ...
Adult-onset Still's disease (AOSD) is a rare systemic inflammatory condition classically cons... more Adult-onset Still's disease (AOSD) is a rare systemic inflammatory condition classically consists of high spikes of fever, morbilliform evanescent skin rash, arthritis, neutrophilic leukocytosis, and multiple organ involvement. However, atypical form of skin rashes has been described with few specific clinical and histopathological patterns that can help in making the diagnosis. A 25-year-old female presented with high spikes of fever, severe debilitating arthritis of peripheral joints, and dusky erythematous flagellate rashes over trunk and proximal limbs. Skin punch biopsy from the cutaneous lesion revealed dyskeratotic keratinocytes in upper epidermis and stratum corneum along with acute inflammatory infiltrate in the dermis: a finding that recently has been found to be constantly associated with this specific pattern of rash of AOSD. The presence of necrotic keratinocytes in upper epidermis and a dermal infiltrate of neutrophils along with characteristic clinical scenario may facilitate earlier diagnosis of AOSD.
Objectives Etiology of thrombocytopenia is multifactorial and its pathogenesis should be distingu... more Objectives Etiology of thrombocytopenia is multifactorial and its pathogenesis should be distinguished for appropriate management. Newly formed immature platelets are called reticulated platelets (RPs) and can be estimated in peripheral blood using automated hematology analyzers, which express them as immature platelet fraction (IPF). In the present study we intend to assess and establish the clinical utility of IPF in differentiating the two major causes of thrombocytopenia—decreased production and increased destruction of platelets—along with determining its significance in monitoring patients with thrombocytopenia. Materials and Methods Sixty-one cases of thrombocytopenia and 101 healthy controls with normal platelet count were included in the study. IPF and all the other usual blood cell parameters were measured using a fully automated hematology analyzer. Based on the pathogenesis of thrombocytopenia, the cases were divided into groups and the difference in IPF value between th...
Fine‐needle aspiration cytology (FNAC) being a fast technique is used as a primary investigation ... more Fine‐needle aspiration cytology (FNAC) being a fast technique is used as a primary investigation to diagnose wide spectrum of hand, wrist, and foot lesions. These sites are prone to trauma, reparative, and infectious process, which forms mass lesions mimicking neoplasia. Our study highlighted the importance of FNAC with the chance of reduction in biopsy or excision.
Fine needle aspiration cytology is an important diagnostic tool in salivary gland cytopathology. ... more Fine needle aspiration cytology is an important diagnostic tool in salivary gland cytopathology. However, cytology of salivary gland neoplasms shows diversity with morphological overlap, heterogeneity and subjective variability, posing diagnostic challenge. Nuclear cytomorphometric image analysis turns the subjective criteria into quantitative parameters, which may aid not only in differentiating between benign and malignant tumours but also can aid in categorising challenging cases with morphological overlap.
Detection of urinary parasites is relatively rare and incidental finding in routine urine examina... more Detection of urinary parasites is relatively rare and incidental finding in routine urine examination. Common urinary parasitic infections as described in literature include Trichomonas, Schistosoma hematobium and Microfilaria. Trichomonas vaginalis is known to cause vaginitis and urethritis, and may be found in urine sediments. In this study, the spectrum of urinary parasitic infections that had been reported in the last one and a half year was evaluated, and point prevalence in this zone was estimated. Microbiologist opinion had been taken in the difficult cases. Out of the total centrifuged urine sediments examined, urinary parasitic infection was found in 33 cases. The calculated point prevalence is 0.39%. Most common parasitic infection reported was flagellates (27 cases: 25 T. vaginalis, 2 commensal flagellate closest to Chylomastix), followed by three cases showing eggs of Enterobius vermicularis, one case showing larvae of Strongyloides stercoralis and two cases of ciliate protozoa. One of the ciliate protozoa was Balantidium coli and the other one was Balantidium like ciliate morphologically closest to Chilodonella spp. Pyuria was found in 22 out of the 33 cases and hematuria in 17 out of 33 cases. A fairly wide morphological spectrum of parasites may be diagnosed through microscopic examination of centrifuged urine sediment. They may cause pyuria and haematuria, and morphological awareness helps in prompt and effective management in most cases.
A 1½-year-old female child presented with swelling in thoracolumbar region and delayed developmen... more A 1½-year-old female child presented with swelling in thoracolumbar region and delayed developmental milestones. The routine hemogram analysis on Sysmex XN 1000 showed flags of white blood cell (WBC) abnormal scattergram and lymphocytosis. The peripheral smear examination showed Alder–Reilly (AR) granules leading to a suspicion of underlying Mucopolysaccharidosis (MPS). Further clinical workup, radiographic studies, chemical test lead to the confirmatory diagnosis of MPS. A flag of abnormal WBC scattergram and AR anomaly are the hematological findings that can be seen in a case of MPS.
Leprosy is a chronic infectious disease caused by . The manifestations of this disease varies acr... more Leprosy is a chronic infectious disease caused by . The manifestations of this disease varies across the spectrum of tuberculoid (TT) to lepromatous (LL) leprosy. The course of this indolent disease is interrupted by acute exacerbations in the form of leprare actions. Erythema nodosum leprosum (ENL), a type 2 lepra reaction, occurs in lepromatous or borderline lepromatous cases, usually in response to multidrug therapy. Early detection and timely management of these patients is important to reduce the associated morbidity. We report two clinically unusual cases of ENL on fine-needle aspiration cytology. In one case, antileprosy treatment was completed 10 years back, whereas in the other case, ENL was the presenting feature of the disease. Cytological examination of swelling in both the cases showed neutrophils, lymphoid cells, clusters of foamy macrophages, histiocytes, and giant cells. Fite stain was positive, which confirmed the cytological diagnosis of ENL.
Tzanck smear is an old but useful test for diagnosis of cutaneous dermatoses. The aim of this stu... more Tzanck smear is an old but useful test for diagnosis of cutaneous dermatoses. The aim of this study was to highlight the potential usefulness and diagnostic pitfalls of Tzanck smear for diagnosis of cutaneous dermatoses and infections. This hospital based cross-sectional study was carried out on all Tzanck smears received for a period of twenty months (January 2014-August 2015). The smears were assessed to establish the utility of Tzanck smears in corroborating or excluding a diagnosis of immunobullous lesion or herpetic infection. Cases with discrepant diagnosis on histopathology were reviewed to identify additional cytomorphological features. A total of 57 Tzanck smears were performed during the study period. Out of the 18 clinically suspected cases of immunobullous disorders, Tzanck smear findings corroborated the clinical diagnosis in 7/18 cases, one case was diagnosed as cutaneous candidiasis, and diagnosis of immunobullous lesions could be excluded in 5/18 cases. Out of the 19...
Gastrointestinal stromal tumours (GIST) are rare in paediatric patients and have a discrete clini... more Gastrointestinal stromal tumours (GIST) are rare in paediatric patients and have a discrete clinicopathological and molecular divergence from that observed in adults. In the present report we present a case of a 2-month-old female in whom colonic gastrointestinal stromal tumour acted as a lead point of colocolic intussusception. Laparoscopically assisted reduction of the intussusception and resection of tumour was done.
Neurohypophysis granular cell tumor (NGCT) is a rare entity and is classified under thyroid trans... more Neurohypophysis granular cell tumor (NGCT) is a rare entity and is classified under thyroid transcription factor 1 (TTF‐1) expressing tumors of pituitary. It is considered as an uncommon differential during sellar and suprasellar mass evaluation. Its intraoperative squash cytology is distinct and has rarely been reported in literature. A 65‐year‐old female presented with reduced vision of right eye and history of seizures. Radiological findings revealed a sellar/suprasellar mass with mass effect on optic chiasma. Intraoperative squash neurocytology examination showed a spindle cell lesion with abundant granular cytoplasm in tumor cells. Subsequent histopathology and immunohistochemistry confirmed the diagnosis of granular cell tumor. Granular cell tumor remains one of the sellar/suprasellar surprises. Its intraoperative neurocytology is unique and should be considered while evaluating a sellar/suprasellar mass. A case of sellar granular cell tumor with its intraoperative squash cytology, histopathology along with a review of literature is being presented with special emphasis on cytological differential diagnosis in pituitary region.
The Indian journal of chest diseases & allied sciences, 2009
Extreme degree of cystic, haemorrhagic and necrotic changes in a thymoma is rare. A 22-year-old m... more Extreme degree of cystic, haemorrhagic and necrotic changes in a thymoma is rare. A 22-year-old male presented with cough, grade 2 dyspnoea, and occasional chest pain for the past six months. Radiological investigations revealed a large cystic lesion in the anterior mediastinum. A benign cystic tumour was suspected. Surgical resection of the tumour was done. Grossly, the almost entirely cystic and haemorrhagic dumb-bell shaped encapsulated tumour showed a subcapsular residual nodule. Histopathological examination was suggestive diagnosis of benign thymoma (World Health Organization [WHO] Type A, medullary type) associated with the rare features of cells with dendritic processes containing melanin pigment seen singly scattered throughout the tumour.
findings of high WBC in the previous cases including ours. This feature is unusual for Sweet’s sy... more findings of high WBC in the previous cases including ours. This feature is unusual for Sweet’s syndrome but would be characteristic in these unique cases. In some cases, after the diagnosis of MCTD, the other disease-specific autoantibodies appear and transition to overlap syndrome. Sweet’s syndrome preceded by MCTD is seemingly rare, but MCTD might possibly predict the onset of Sweet’s syndrome or SLND with SLE in an overlap syndrome by monitoring the serological tests of SLE during the MCTD course. Maki Okamoto, MD Shujiro Hayashi*, MD, PhD Tetsuharu Ikegami, MD Tomoko Kaminaga, MD Yoichiro Hamasaki, MD, PhD Ken Igawa, MD, PhD Department of Dermatology, Dokkyo Medical University School of Medicine, Mibu, Japan *E-mail: [email protected] Conflict of interest: None. Funding source: None. doi: 10.1111/ijd.15241 References 1 Sharp GC, Irvin WS, Tan EM, et al. Mixed connective tissue disease–an apparently distinct rheumatic disease syndrome associated with a specific antibody to...
Indian Journal of Otolaryngology and Head & Neck Surgery, 2021
Salivary gland tumours constitute an uncommon and diverse group of neoplasms that vary considerab... more Salivary gland tumours constitute an uncommon and diverse group of neoplasms that vary considerably in their histology and biologic behaviour. As per Globocon 2018, salivary gland malignancy account for 0.3% of all cancer cases and 0.2% of all cancer deaths worldwide, reflecting the rarity of these neoplasms. Mucoepidermoid carcinoma (MEC) is a common malignant tumour of major and minor salivary gland, which comprises about 10% of all salivary gland neoplasms and approximately 35% of malignant salivary gland neoplasms. While three fourth of cases of MEC arise in the parotid, they account for a large proportion of salivary gland neoplasms occurring in minor salivary glands. Appending to the uncommonness, unusual presentations like MEC arising in heterotopic rests of salivary gland tissue in intraparotid or extraparotid lymph nodes, and MEC arising in lingual tonsils have been reported. Such diversity of clinical presentation may present a diagnostic challenge. In this continuum, we r...
Materials and Methods: The present study analyzed 7 patients younger than 40 years among 87 patie... more Materials and Methods: The present study analyzed 7 patients younger than 40 years among 87 patients of MM who presentedto our hospital from 2005 to 2008. Complete diagnostic workup was carried out for all the patients. Results: The youngest of the 7 ...
Ventriculoperitoneal shunt (VPS) for hydrocephalus is associated with various complications. Tort... more Ventriculoperitoneal shunt (VPS) for hydrocephalus is associated with various complications. Torticollis due to shunt tract fibrosis is a rare complication of VPS that occurs years later after the initial operation. However, shunt track fibrosis that progressed to large neck mass, mimicking sternocleidomastoid tumour and causing torticollis is a previously unreported complication. This led to the restriction of neck movement and hemifacial hypoplasia. Complete excision of the mass restored neck movement.
Colloid cyst of third ventricle is a rare, benign, congenital lesion that usually presents with h... more Colloid cyst of third ventricle is a rare, benign, congenital lesion that usually presents with headache, and associated with altered cognition, nausea, vomiting, gait ataxia, and blurred vision. A large cyst/growing cyst can cause obstructive hydrocephalus leading to acute rapid neurological deterioration and sudden death. Here we report a classic clinical presentation and histopathological features of colloid cyst of third ventricle with specific emphasis on the importance of rapid diagnosis and management to avoid potentially fatal complications of this otherwise benign lesion. Newer modalities like neuroendoscopy or stereotactic aspiration of cyst are now the preferred choices of management. Awareness of this entity for early diagnosis and management with minimally invasive procedures such as neuroendoscopy or stereotactic aspiration of cyst is crucial for better prognosis and patient care.
Introduction: Gelatinous marrow transformation (GMT) is a rare condition characterized by fat cel... more Introduction: Gelatinous marrow transformation (GMT) is a rare condition characterized by fat cell atrophy, focal hypoplasia of haematopoietic cells and an accumulation of extracellular gelatinous substances. The purpose of this study was to study the spectrum of underlying disorders associated with GMT in our setup. Methods: This study reviews 109 cases of GMT with bone marrow aspirate, biopsies, haematological and clinical profile of all patients diagnosed with GMT over a period of 10 years. GMT was diagnosed in BM biopsy based on characteristic morphological appearance and was confirmed by alcian blue positive staining pattern at pH levels of 2.5. Results: The age of the patients with GMT ranged from 7 months to 68 years. Twenty four (24) out of one hundred and nine (109) cases were in paediatric age group (less than 15 years). Mean age was 27.05 years. Most common association was seen with nutritional deficiency followed by post-chemotherapy and HIV cases. Conclusions: GMT is a ...
Adult-onset Still's disease (AOSD) is a rare systemic inflammatory condition classically cons... more Adult-onset Still's disease (AOSD) is a rare systemic inflammatory condition classically consists of high spikes of fever, morbilliform evanescent skin rash, arthritis, neutrophilic leukocytosis, and multiple organ involvement. However, atypical form of skin rashes has been described with few specific clinical and histopathological patterns that can help in making the diagnosis. A 25-year-old female presented with high spikes of fever, severe debilitating arthritis of peripheral joints, and dusky erythematous flagellate rashes over trunk and proximal limbs. Skin punch biopsy from the cutaneous lesion revealed dyskeratotic keratinocytes in upper epidermis and stratum corneum along with acute inflammatory infiltrate in the dermis: a finding that recently has been found to be constantly associated with this specific pattern of rash of AOSD. The presence of necrotic keratinocytes in upper epidermis and a dermal infiltrate of neutrophils along with characteristic clinical scenario may facilitate earlier diagnosis of AOSD.
Objectives Etiology of thrombocytopenia is multifactorial and its pathogenesis should be distingu... more Objectives Etiology of thrombocytopenia is multifactorial and its pathogenesis should be distinguished for appropriate management. Newly formed immature platelets are called reticulated platelets (RPs) and can be estimated in peripheral blood using automated hematology analyzers, which express them as immature platelet fraction (IPF). In the present study we intend to assess and establish the clinical utility of IPF in differentiating the two major causes of thrombocytopenia—decreased production and increased destruction of platelets—along with determining its significance in monitoring patients with thrombocytopenia. Materials and Methods Sixty-one cases of thrombocytopenia and 101 healthy controls with normal platelet count were included in the study. IPF and all the other usual blood cell parameters were measured using a fully automated hematology analyzer. Based on the pathogenesis of thrombocytopenia, the cases were divided into groups and the difference in IPF value between th...
Fine‐needle aspiration cytology (FNAC) being a fast technique is used as a primary investigation ... more Fine‐needle aspiration cytology (FNAC) being a fast technique is used as a primary investigation to diagnose wide spectrum of hand, wrist, and foot lesions. These sites are prone to trauma, reparative, and infectious process, which forms mass lesions mimicking neoplasia. Our study highlighted the importance of FNAC with the chance of reduction in biopsy or excision.
Fine needle aspiration cytology is an important diagnostic tool in salivary gland cytopathology. ... more Fine needle aspiration cytology is an important diagnostic tool in salivary gland cytopathology. However, cytology of salivary gland neoplasms shows diversity with morphological overlap, heterogeneity and subjective variability, posing diagnostic challenge. Nuclear cytomorphometric image analysis turns the subjective criteria into quantitative parameters, which may aid not only in differentiating between benign and malignant tumours but also can aid in categorising challenging cases with morphological overlap.
Detection of urinary parasites is relatively rare and incidental finding in routine urine examina... more Detection of urinary parasites is relatively rare and incidental finding in routine urine examination. Common urinary parasitic infections as described in literature include Trichomonas, Schistosoma hematobium and Microfilaria. Trichomonas vaginalis is known to cause vaginitis and urethritis, and may be found in urine sediments. In this study, the spectrum of urinary parasitic infections that had been reported in the last one and a half year was evaluated, and point prevalence in this zone was estimated. Microbiologist opinion had been taken in the difficult cases. Out of the total centrifuged urine sediments examined, urinary parasitic infection was found in 33 cases. The calculated point prevalence is 0.39%. Most common parasitic infection reported was flagellates (27 cases: 25 T. vaginalis, 2 commensal flagellate closest to Chylomastix), followed by three cases showing eggs of Enterobius vermicularis, one case showing larvae of Strongyloides stercoralis and two cases of ciliate protozoa. One of the ciliate protozoa was Balantidium coli and the other one was Balantidium like ciliate morphologically closest to Chilodonella spp. Pyuria was found in 22 out of the 33 cases and hematuria in 17 out of 33 cases. A fairly wide morphological spectrum of parasites may be diagnosed through microscopic examination of centrifuged urine sediment. They may cause pyuria and haematuria, and morphological awareness helps in prompt and effective management in most cases.
A 1½-year-old female child presented with swelling in thoracolumbar region and delayed developmen... more A 1½-year-old female child presented with swelling in thoracolumbar region and delayed developmental milestones. The routine hemogram analysis on Sysmex XN 1000 showed flags of white blood cell (WBC) abnormal scattergram and lymphocytosis. The peripheral smear examination showed Alder–Reilly (AR) granules leading to a suspicion of underlying Mucopolysaccharidosis (MPS). Further clinical workup, radiographic studies, chemical test lead to the confirmatory diagnosis of MPS. A flag of abnormal WBC scattergram and AR anomaly are the hematological findings that can be seen in a case of MPS.
Leprosy is a chronic infectious disease caused by . The manifestations of this disease varies acr... more Leprosy is a chronic infectious disease caused by . The manifestations of this disease varies across the spectrum of tuberculoid (TT) to lepromatous (LL) leprosy. The course of this indolent disease is interrupted by acute exacerbations in the form of leprare actions. Erythema nodosum leprosum (ENL), a type 2 lepra reaction, occurs in lepromatous or borderline lepromatous cases, usually in response to multidrug therapy. Early detection and timely management of these patients is important to reduce the associated morbidity. We report two clinically unusual cases of ENL on fine-needle aspiration cytology. In one case, antileprosy treatment was completed 10 years back, whereas in the other case, ENL was the presenting feature of the disease. Cytological examination of swelling in both the cases showed neutrophils, lymphoid cells, clusters of foamy macrophages, histiocytes, and giant cells. Fite stain was positive, which confirmed the cytological diagnosis of ENL.
Tzanck smear is an old but useful test for diagnosis of cutaneous dermatoses. The aim of this stu... more Tzanck smear is an old but useful test for diagnosis of cutaneous dermatoses. The aim of this study was to highlight the potential usefulness and diagnostic pitfalls of Tzanck smear for diagnosis of cutaneous dermatoses and infections. This hospital based cross-sectional study was carried out on all Tzanck smears received for a period of twenty months (January 2014-August 2015). The smears were assessed to establish the utility of Tzanck smears in corroborating or excluding a diagnosis of immunobullous lesion or herpetic infection. Cases with discrepant diagnosis on histopathology were reviewed to identify additional cytomorphological features. A total of 57 Tzanck smears were performed during the study period. Out of the 18 clinically suspected cases of immunobullous disorders, Tzanck smear findings corroborated the clinical diagnosis in 7/18 cases, one case was diagnosed as cutaneous candidiasis, and diagnosis of immunobullous lesions could be excluded in 5/18 cases. Out of the 19...
Uploads
Papers by Garima Goel