Mucinous Carcinoma of the Skin: A Case Report

Primary mucinous carcinoma of the skin is a rare malignant neoplasm showing predilection to the periorbital region. These tumours are indolent and low-grade, with a tendency for local, sometimes multiple, recurrences. Distinguishing between these primary neoplasms and the more frequent metastatic mucinous deposits on the skin from primaries in the breast and gastrointestinal tract constitutes a diagnostic dilemma. In this case report, we have put forth the findings of a 70-year-old male who presented with a slow-growing periorbital swelling and was subsequently diagnosed with mucinous adenocarcinoma. An extensive workup in search of another primary tumour failed to show a primary malignancy elsewhere and the diagnosis of primary mucinous adenocarcinoma of the skin was rendered.

Cervical Intraepithelial Lesions in Women with Persistent Inflammatory Smear on Pap Smear: A Descriptive Cross-sectional Study

INTRODUCTION

Persistent inflammatory smear is a benign finding on pap test but is associated with premalignant lesion of the cervix. Further evaluation is therefore necessary. This study was done to determine the prevalence of cervical intraepithelial lesions in women with persistent inflammatory smear.

METHODS

This is descriptive observational study conducted in Department of Obstetrics and Gynaecology of tertiary care centre of Nepal from 15th May 2020 to 14th May 2021 after obtaining ethical clearance from Institutional Review Board (Reference no MEMG/IRC/338/GA). Women with two consecutive pap smear reports showing inflammatory findings were enrolled. Colposcopy was performed and Modified Reid's colposcopic index was used to grade the lesions. Colposcopic guided biopsy was taken and tissue sent for histopathology for abnormal colposcopic lesions. Data analysis was done using Statistical Package for Social Sciences version 21 and frequency and percentages were used to present data. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.

RESULTS

Among 115 women, 57 (49.5%) at 95% Confidence Interval (40.37-58.63) had Cervical Intraepithelial lesions. Among them 48 (41.7%) had low grade intraepithelial lesions and 9 (7.8%) had high grade lesions on colposcopy.

CONCLUSIONS

The prevalence of cervical intraepithelial lesions in women with persistent inflammatory smear on pap was higher in our study compared to other studies.

Histopathology of Sinonasal and Nasopharyngeal Neoplastic Lesions in a Tertiary Care Center of Western Nepal: A Descriptive Cross-sectional Study

Introduction:

Sinonasal and nasopharyngeal regions harbor diverse clinical conditions including many non-neoplastic and neoplastic lesions presenting with nasal obstruction, facial pain and swelling, rhinorrhea, epistaxis, and other oral, ear, and orbital symptoms. Histopathology of excised lesions is the mainstay for the definitive diagnosis and management of neoplastic lesions. The aim of this study is to find out the prevalence of neoplastic lesions among sinonasal and nasopharyngeal masses.

Methods:

This was a descriptive cross-sectional study conducted among sinonasal and nasopharyngeal masses in the department of pathology of a tertiary care center of western Nepal with primary data of 20 years from January 2001 to May 2020. Ethical approval was taken from the Institutional Review Committee. Convenience sampling method was used. Data management and statistical analysis were done using Statistical Package for Social Sciences. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage.

Results:

Out of 395 sinonasal and nasopharyngeal lesions, 134 (33.92%) (29.26-38.58 at 95% Confidence Interval) were neoplastic lesions. The malignant lesions were found to be 60 (44.77%). Inverted papilloma was the most common benign lesion comprising 28 (20.89%) of cases, and squamous cell carcinoma and nasopharyngeal carcinoma were the most common malignant lesions comprising 12 (8.95%) cases each.

Conclusions:

This study observed a variety of neoplastic lesions. The most common benign lesion was nasal polyp and squamous cell carcinoma and nasopharyngeal carcinoma were the most common malignant lesions.

COVID-19: a brief review

In December 2019, Wuhan, in China, became the center of an outbreak of pneumonia of unknown cause. In January 2020, a novel coronavirus was identified. Later the whole genomic sequence of this novel virus was established. The World Health Organization named the disease “COVID-19” and marked it as a pandemic. The origin of the virus is still conjectural. Studies suggested markedly increased levels of several pro-inflammatory cytokines and chemokines in these patients, which lead to injury to several organs. The organ which is most commonly damaged is the lungs. On histopathology, lung shows diffuse alveolar damage with hyaline membrane formation. The incubation period ranges from 1-14 days. The clinical features vary widely, from asymptomatic to multi-organ failure and shock. The common clinical features are related to the respiratory system. For diagnosis, oropharyngeal/nasopharyngeal swabs should be collected by Dacron swabs under proper precaution and the samples should be collected in viral transport media. The viral ribonuclei acid is detected by Real Time-Polymerase Chain Reaction. Till now no definite therapy or vaccination is available and the main approach to manage the pandemic is by preventive measures like social distancing, hygiene maintenance, and contact tracing.

Histopathology of important fungal infections – A summary

Fungal infections due to pathogenic or opportunistic fungi may be superficial, cutaneous, subcutaneous and systemic. With the upsurge of at risk population systemic fungal infections are increasingly common. Diagnosis of fungal infections may include several modalities including histopathology of affected tissue which reveal the morphology of fungi and tissue reaction.  Fungi can be in yeast and / or hyphae forms and tissue reactions may range from minimal to acute or chronic granulomatous inflammation. Different fungi should be differentiated from each other as well as bacteria on the basis of morphology and also clinical correlation. Special stains like GMS and PAS are helpful to identify fungi in tissue sections.

Solitary rectal ulcer syndrome in childhood

Solitary rectal ulcer syndrome is a rare disorder of childhood and usually goes unrecognised or misdiagnosed because it can mimic various other rectal entities. Here a 9-year old boy presented with bleeding per rectum and altered bowel habits. Colonoscopy revealed multiple ulcers which on histopathological examination showed features of SRUS with severe reactive changes of regeneration mimicking malignancy.