Aspiration cytology of glomus tumor: a case report

BACKGROUND

Glomus tumor is a relatively uncommon soft tissue tumor that can occur at any age and anatomic site, with a predilection for the subungual region.

CASE

A 24-year-old female presented with a gradually enlarging, painful swelling in the subungual region of the right index finger. Fine needle aspiration was performed under a ring block and yielded hemorrhagic material. The smears revealed clusters of uniform, round to oval cells admixed with wisps of magenta intercellular myxoid material and a few spindle-shaped cells crossing clusters of tumor cells. A diagnosis of benign vascular tumor consistent with glomus tumor was given. Subsequent histopathologic examination confirmed the diagnosis and showed alpha-SMA positivity on immunohistochemistry.

CONCLUSION

This case report is the second on the cytologic features of glomus tumor in the English-language literature. Although the cytomorphologic features of glomus tumor are quite distinctive, an appropriate clinical history and immunohistochemical stains (e.g., alpha-SMA and vimentin positivity) can further help to ascertain the diagnosis.

Osteosarcoma of the bladder--a case report

A 25-year old man with hematuria had a polypoid tumor of the urinary bladder which was diagnosed as transitional cell carcinoma (TCC) on transurethral resection with partial cystectomy. One year following post-operative radiotherapy, he had to undergo surgery for intestinal perforation. On laparotomy the recurrent tumor had involved pelvic organs and sigmoid colon. It now showed predominantly osteogenic sarcoma on histopathologic examination. The case is reported in view of rarity of primary osteogenic sarcoma in the urinary bladder.

Kikuchi disease with facial rash and erythema multiforme

Kikuchi disease, or histiocytic necrotizing lymphadenitis, is a benign illness characterized by fever and cervical lymphadenopathy predominantly in young women. It has a self-limiting course. Skin changes occur in about one-third of patients and are of a nonspecific nature. A case of Kikuchi disease with cutaneous involvement in the guise of erythema multiforme and a facial rash is reported. The differential diagnosis with systemic lupus erythematosus and Rowell syndrome is discussed.

Cytodiagnosis of hydatid disease presenting with Horner's syndrome: a case report

BACKGROUND

The diagnosis of echinococcosis is based on clinical, radiologic and serologic findings. Fine needle aspiration (FNA) is useful in evaluating the lesion when the presentation is atypical. We report a case of hydatid cyst at the lung apex in which the diagnosis was made on FNA, with no adverse reaction to the aspiration.

CASE

A 30-year-old male, a chronic smoker, presented with pain radiating to the medial two fingers of the right hand for two years. He also had miosis and ptosis of the right eye and anhidrosis of the right side of theface. There was wasting of small muscles in the right hand. Magnetic resonance imaging revealed a hyperintense mass at the apex of the right lung, thoracic inlet and adjacent vertebral bodies. A clinical diagnosis of Horner's syndrome due to pancoast tumor was rendered. Ultrasound-guided FNA showed protoscolices, scattered hooklets and bits of acellular laminated membrane, characteristic of echinococcosis. Surgical excision of the cyst was done. Gross and histopathologic examination of the excised cyst confirmed the diagnosis.

CONCLUSION

FNA, though traditionally contraindicated, is a highly desirable, rapid, noninvasive diagnostic mode for echinococcosis. In view of its pathognomonic cytomorphologic features and numerous reports on cytodiagnosis in the literature, it is time to evaluate the diagnostic benefits and weigh the risks against the advantages of the technique.

Pilomatricoma--a reprospective analysis of 18 cases

Pilomatricoma (calcifying epithelioma of Malherebe) is an uncommon skin tumour that occurs predominantly in young people. No studies are available from the Indian subcontinent on pilomatricoma. We analyzed records of 18 cases of pilomatricoma seen during 5 years period (1995-99). There were 16 females and 2 males and their age ranged from 5 to 60 years. All patients had solitary lesions in 10 out of 18 cases (55.5%), the tumour was located in head and neck region including 5 cases (27%) where it involved orbital margin and eye-brow. In only 2 out of 18 cases, a clinical diagnosis of pilomatricoma was suggested. In addition to the secondary changes described in previous studies, we observed additional changes like myxoid change, oedema fluid and necrosis with karyorrhectic debris in few of these tumours. Making a clinical diagnosis of pilomatricoma can be difficult. The final confirmation is by histopathological examination only.

Scrofuloderma with multiple organ involvement in a 5-year-old child

Cutaneous tuberculosis is a rare form of extrapulmonary tuberculosis seen in children in developing countries. We report a 5-year-old child with cutaneous tuberculosis with involvement of lymph nodes, lungs, and the musculoskeletal and central nervous systems, which was not clinically obvious. Antituberculous treatment led to marked clinical improvement. The importance of a thorough search for internal organ involvement in patients presenting with cutaneous tuberculosis is emphasized.

Epithelioid haemangioendothelioma of the rib--a case report

Epithelioid haemangioendothelioma is a rare primary malignant tumour of the bone that accounts for less than 1% of all primary bone malignancies. The case discussed here is of a 35 years old male who presented with gradually increasing left infrascapular mass attached to 10th rib. X-ray showed an expansile lytic lesion in 10th rib. On FNA the diagnOsis of fibrous dysplasia or fibrous-histiocytic lesions was suggested. The lesion was excised along with adjacent rib. Histopathological examination showed features of epithelioid haemangioendothelioma. Immunohistochemistry revealed focal factor VIII related antigen positivity.

The efficacy of electrosurgery and excision in treating patients with multiple apocrine hidrocystomas

BACKGROUND

Apocrine hidrocystomas are adenomatous cystic proliferations of the apocrine glands. They typically occur as solitary lesions, though rarely may occur as multiple lesions. Management of multiple hidrocystomas can be difficult, particularly if they are large. Surgical modalities may be required for effective therapy.

OBJECTIVE

To compare the results of electrosurgery and excision in treating multiple apocrine hidrocystomas.

METHODS

A 50-year-old man presented with multiple apocrine hidrocystomas ranging in size from 1 to 12 mm. The lesions were located over the periorbital skin, cheeks, and pinnae. Excision and electrodessication were utilized for therapy. At a 1-year follow-up, the patient was evaluated for recurrences and cosmetic result.

RESULTS

There were no recurrences until 1 year after surgery. In the areas treated with electrodessication, no visible scars were identified. In the areas treated with excision, localized scars were observed.

CONCLUSIONS

Both electrodessiation and excision are effective therapies for multiple apocrine hidrocystomas. We suggest that tumors less than 1 cm be treated with electrodessication and lesions greater than 1 cm with excision.

Tuberculous parotitis: a series of five cases diagnosed on fine needle aspiration cytology

Parotid gland tuberculosis is still a rare entity and has mostly been diagnosed after parotidectomy. We present five cases which were diagnosed on fine needle aspiration cytology (FNAC) and managed medically avoiding surgical intervention.

Urticaria pigmentosa

A 2-year- old child with multiple brownish papules over trunk and limbs for one year having history of occasional blister formation is described. Histopathology revealed perivascular mast cell infiltration. Symptomatic treatment with topical corticosteroids and oral antihistaminics was effective.

Suprasellar malignant mixed germ cell tumour presenting as craniopharyngioma

A 15 year old boy presented with diminution in vision of both eyes, diabetes insipidus and hypopituitarism. MRI was suggestive of a large suprasellar and retrosellar craniopharyngioma with stretching of the optic chiasma. Histopathological findings on the first surgical specimen were interpreted as a craniopharyngioma. He was reoperated on account of clinical deterioration and increase in tumour size. Histological examination this time revealed derivatives of all three germ cell lineages along with areas of embryonal carcinoma, and yolk sac tumour besides squamous cysts, establishing the diagnosis of malignant mixed germ cell tumour. Serum and CSF were strongly positive for alpha foetoproteins.

Reactive oxygen species mediated membrane damage induced by fullerene derivatives and its possible biological implications

Fullerenes have attracted considerable attention in recent years due to their unique chemical structure and potential applications. Hence it is of interest to study their biological effects. Using rat liver microsomes as model systems we have examined the ability of the most commonly used fullerene, C60 and its water-soluble derivative, C60(OH)18 to induce membrane damage on photosensitization. For photoexcitation, UV or tungsten lamps were used. Damage was assessed as lipid peroxidation products like conjugated dienes, lipid hydroperoxides and thiobarbituric acid reactive substances (TBARS). protein oxidation in the form of protein carbonyls, besides loss of membrane bound enzymes. Both fullerene derivatives induced significant oxidative damage. The alterations induced were both time- and concentration-dependent. Role of different reactive oxygen species (ROS) in the damage induced was examined by various scavengers of ROS and by deuteration of the buffer. The changes induced by C60 were predominantly due to 1O2 while that by C60(OH)18 was mainly due to radical species. Biological antioxidants such as glutathione, ascorbic acid and alpha-tocopherol were capable of inhibiting membrane damage induced by both the fullerenes. However, the damage induced by C60(OH)18 was more for both lipids and proteins than that showed by C60. C60 also showed enhancement in the formation of lipid peroxidation in sarcoma 180 ascites microsomes. In conclusion, our studies indicate that fullerene/its derivative can generate ROS on photoexcitation and can induce significant lipid peroxidation/protein oxidation in membranes and these phenomena can be prevented by endogenous/natural antioxidants.

Oxidative degradation of triazine derivatives in aqueous medium: a radiation and photochemical study

Pulse and steady state radiolysis techniques have been used to determine the bimolecular rate constants and to investigate the spectral nature of the intermediates and the degradation induced by hydroxyl radicals ((*)OH) with 1,3,5-triazine (T), 2,4, 6-trimethoxy-1,3,5-triazine (TMT), and 2,4-dioxohexahydro-1,3, 5-triazine (DHT) in aqueous medium. A competitive kinetic method with KSCN as the (*)OH scavenger was used to determine the rate constants for the reaction of (*)OH with T, TMT, and DHT. The bimolecular rate constants are 3.4 x 10(9), 2.06 x 10(8), and 1.61 x 10(9) dm(3) mol(-)(1) s(-)(1) respectively, for T, TMT, and DHT at pH approximately 6. The transient absorption spectra obtained from the reaction of (*)OH with T, TMT, and DHT have single absorption maxima at 320, 300, and 300 nm, respectively, and were found to undergo a second-order decay. The formation of TOH(*) [C(6)OH-N(5)-yl radical], TMTOH(*) [N(5)OH-C(6)-yl radical], and DHT(*) [C(6)-yl radical] is proposed from the initial attack of (*)OH with T, TMT, and DHT, respectively. A complete degradation of TMT (10(-3) mol dm(-3)) was obtained after absorbed doses of 5 kGy in N(2)O-saturated solutions and 16 kGy in aerated solutions. A similar degradation pattern was obtained with DHT in N(2)O-saturated solutions. Complete degradation was observed with an absorbed dose of 7 kGy. On the basis of the results from both pulse and steady state radiolysis, a possible reaction mechanism involving (*)OH-mediated oxidative degradation is proposed. A complete photodecomposition of DHT was also observed in the presence of ferric perchlorate using ultraviolet light at low pH. Photoinduced electron transfer between Fe(III) and DHT in the Fe(III)-DHT complex and subsequent formation of DHT(*) are proposed to be the major processes that lead to the complete degradation of DHT at pH 3.

Pancytopenia due to hemophagocytic syndrome as the presenting manifestation of tuberculosis

We report here an unusual hematologic manifestation of tuberculosis. A 40 year old male presented with pancytopenia due to hemophagocytic syndrome. Further investigations revealed he had tuberculosis.

Use of intravenous immunoglobulins as an adjunct in the conservative management of chylothorax

Two children who developed chylothorax after surgery for congenital heart disease are presented. The conservative management of chylothorax is reviewed and the use of immunoglobulins in the treatment of sepsis is discussed. One patient survived.

Dermatofibrosarcoma protuberans metastasizing to lymph nodes: a case report and review of literature

Dermatofibrosarcoma Protuberans (DFSP) is an uncommon cutaneous soft tissue tumor. It is locally invasive and is known to recur. Metastases are rare and occur most commonly to the lungs. Metastasis to lymph nodes is extremely rare with only a few case reports in literature. The management strategy for such lymph node metastases remains controversial because of rarity of the condition. We report a case of DFSP of the lower limb with definite inguinal node secondaries managed by loco-regional surgery. We recommend that block dissection of lymph nodes should be performed in all cases with secondaries. J. Surg. Oncol. 1999;72;178-180.

Fine needle aspiration of angiomatoid malignant fibrous histiocytoma. A case report

BACKGROUND

During recent years, reliable cytodiagnostic criteria have been proposed for a number of soft tissue lesions, both benign and malignant. However, cytomorphologic descriptions of angiomatoid malignant fibrous histiocytoma (AMFH) are lacking. We report the cytomorphologic features of this uncommon lesion.

CASE

A 10-year-old female presented with a swelling in the thigh that, on fine needle aspiration (FNA), was reported as a soft tissue tumor (vasoformative) of intermediate malignancy. Subsequent excision with histopathologic examination confirmed the diagnosis.

CONCLUSION

The differential diagnosis of AMFH based on FNA findings can be difficult and should be made in conjunction with clinical findings.

Parathyroid cyst: a rare cause of an anterior neck mass

Parathyroid cysts are rare. Most of them present in the anterior neck as cystic neck swellings. A case of cervical parathyroid cyst is presented, along with a brief review of the literature regarding the aetiology, clinical features, diagnosis and management of this condition.

Spitz nevus

A case of Spitz nevus is presented in view of the difficulties of differentiating it from malignant melanoma. Spitz nevus with predominantly epithelioid cell is uncommon.

Tuberculosis of the pyriform fossa--a rare entity

Tuberculosis of the pharynx is less common than tuberculosis of the larynx. We present a rare case of tuberculosis of the pyriform fossa which clinically masqueraded as a malignancy. Our patient showed a prompt improvement in symptoms after commencing antitubercular treatment.

Oxidative damage induced by the fullerene C60 on photosensitization in rat liver microsomes

We have examined the ability of a commonly used fullerene, C60, to induce oxidative damage on photosensitization using rat liver microsomes as model membranes. When C60 was incorporated into rat liver microsomes in the form of its cyclodextrin complex and exposed to UV or visible light, it induced significant oxidative damage in terms of (1) lipid peroxidation as assayed by thiobarbituric acid reactive substances (TBARS), lipid hydroperoxides and conjugated dienes, and (2) damage to proteins as assessed by protein carbonyls and loss of the membrane-bound enzymes. The oxidative damage induced was both time- and concentration-dependent. C60 plus light-induced lipid peroxidation was significantly inhibited by the quenchers of singlet oxygen ((1)O2), beta-carotene and sodium azide, and deuteration of the buffer-enhanced peroxidation. These observations indicate that C60 is an efficient inducer of peroxidation and is predominantly due to (1)O2. Biological antioxidants such as glutathione, ascorbic acid and alpha-tocopherol significantly differ in their ability to inhibit peroxidation induced by C60. Our studies, hence, indicate that C60, on photosensitization, can induce significant lipid peroxidation and other forms of oxidative damage in biological membranes and that this phenomenon can be greatly modulated by endogenous antioxidants and scavengers of reactive oxygen species.

Inter-relationship of zinc levels in serum and semen in oligospermic infertile patients and fertile males

Infertility is a problem affecting 10-12% of couples. Zinc is necessary for growth, sexual maturation and reproduction. Semen analysis is helpful in ascertaining the evidence of spermatogenesis, sperm transport, sperm quantity and quality and also provides clue to the functioning of the accessory glands i.e. seminal vesicles and prostate. The present study was conducted in 50 oligospermic infertile males and control group consisting of 25 normospermic known fertile males. Semen and Serum samples were obtained from each case in study as well as control group. Semen and serum were processed by wet ash method. The seminal and serum zinc levels of each case in study and control group were estimated. Statistically, serum zinc and semen zinc levels were significantly lower in infertile patients than fertile males. A significant correlation was observed between serum and semen zinc levels in study group.