Shashikant Singh

Mature cystic teratoma (MCT), also known as the dermoid cyst, is the most common ovarian germ cell tumor. It commonly arises in women age less than 40 years. With a reported incidence of 1% to 3%, malignant transformation in a mature cystic teratoma (MCT) is a rare occurrence. We report a case of malignant transformation within a mature cystic teratoma with invasion into the large intestine.

Skin appendageal tumours (SATs) are uncommon tumours that differentiate towards one or more appendageal structures. Benign SATs are relatively common, while malignant tumours are rare. These are locally aggressive tumours, with malignant cases having a poor clinical outcome. Histopathology remains the gold standard in the diagnosis of SATs. Correct diagnosis of SATs is important for the appropriate management of patients. In the present study, we analyzed the epidemiological profile and histopathological features of benign and malignant SATs. A total of 30,200 biopsies from skin lesions were received from January 2011 to September 2021 in the department of pathology. Out of all the biopsies, 293 cases were diagnosed as SATs. The age ranged from 3 to 82 years, with a male-to-female ratio of 1.29:1. Tumours of sweat gland differentiation, i.e., both apocrine and eccrine, constituted the largest group with 43% (126/293) cases, followed by tumours showing follicular differentiation with 28.32% (83/293) cases, and tumours with sebaceous differentiation in 27.30% (80/293) cases. To conclude, skin appendageal tumours are an uncommon group of tumours. Since, these tumours have morphological overlap and are rare, the diagnosis is often a challenge for the pathologist.

Background: The cytological analysis of body fluids is the preliminary investigation performed for the diagnostic evaluation of body fluids, helping the physician make the diagnosis and plan proper treatment. The International System for Reporting Serous Fluid Cytology (ISFRSFC) was created using best international practises, current literature and expert consensus to make a uniform reporting system for serous fluids. Aims: The present study was conducted with the aim of recategorising the effusion fluids as per the guidelines prescribed by ISRFRC, knowing the distribution of cases into various categories and assessing their feasibility in day-to-day reporting. Patients and Methods: This study was performed on serous fluids (ascitic, pleural, peritoneal and pericardial) received over a period of 5 years, from January 2017 to April 2022, in the cytology unit of the Department of Pathology, ABVIMS, Dr. Ram Manohar Lohia Hospital, New Delhi. Wherever possible, clinicoradiological and histopathological data were obtained and correlated with cytological findings. Serous fluids were categorised into reporting formats as prescribed by ISRFRC and its feasibility was assessed in day-to-day reporting. Results: A total of 1115 cases of serous effusion fluid were examined. The male-to-female ratio was 1:1.12. Pleural fluid constituted the majority of the sample (436, 39.10%). Overall, 56 (5.02%) cases were non-diagnostic (ND), 1013 (90.85%) cases were negative for malignancy, 8 (0.72%) were atypia of undetermined significance, 11 (0.99%) were suspicious of malignancy and 27 (2.42%) were malignant (MAL). Conclusion: The current study emphasises the significance of cytological analysis of serous fluid as a comprehensive diagnostic investigation that also aids in determining the cause and monitoring the disease process. With the introduction of ISFRSFC, serous fluid reporting is now uniform and more comprehensive, both for cytopathologists and clinicians.

Left ventricular noncompaction cardiomyopathy (LVNC) is a type of primary genetic cardiomyopathy, which occurs during embryogenesis by the arrest in the ventricular myocardium compaction. LVNC is characterized by prominent wall trabeculations and intertrabecular recesses that communicate with the ventricular cavity. There are 2 types of cardiomyopathy: the first one is associated with other primary cardiac structural abnormalities like malfunctional cardiac valves as mentioned in the case report below and the second type is in which there are no other associated cardiac structural abnormalities also called isolated LV noncompaction cardiomyopathy. We report an association of severe rheumatic mitral valve disease and LV noncompaction with significantly reduced ejection fraction which is rare.

Paragangliomas or extra adrenal pheochromocytoma of the genitourinary tract are infrequent and arise from chromaffin cells of the autonomic nervous system. They have been described in the kidney, bladder, prostate, urethra and spermatic cord. However, the occurrence of paragangliomas in the ureter is very unusual. We present one such case in a patient who presented with signs and symptoms of pelvi-ureteric junction obstruction, wherein the initial clinical and imaging findings were deceptive. The patient underwent right-sided open end-to-end uretero-ureterostomy with excision of the strictured segment. Histopathological examination of excised tissue revealed a tumour with clear cell morphology, and in conjunction with immunohistochemistry a final diagnosis of paraganglioma of the ureter was rendered. The case is discussed here with differential diagnosis in the context of its location.