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Author(s): Riddhi Jaiswal [1]; Deval B. Dubey (corresponding author) [1]; Richa Singh [1]; Ashutosh Mishra [1] INTRODUCTION Mucinous cystic neoplasm (MCN) of the mesentery is an extremely uncommon intra-abdominal lesion [...], Inroduction: Mucinous cystic neoplasms are rare tumors. They may originate from either ovaries, pancreas, or other intra-abdominal sites, but rarely from the mesentery. Case History: A 22-year-old nulliparaous woman, who had undergone laparascopic bilateral cystectomy for recurrent ovarian mass, presented with pain in abdomen, backache, and menstrual irregularities. Provisionally diagnosed as ovarian carcinoma, she underwent bilateral salpingo-oophorectomy and sigmoid colectomy. However, the histopathological examination revealed mucinous cystic neoplasm of the mesentery. Discussion: Thus, complete resection of the cysts with meticulous gross and histopathological examination remains the gold standard to differentiate mucinous cystic neoplasm (MCN) of the mesentery from its mimics, especially malignant counterparts, enabling clinicians to adequately manage such patients. Here, we present a case of recurrent MCN of mesentery (mesocolon), mimicking as ovarian carcinoma confirmed on histopathological examination, in a young adult. Keywords: Extra-ovarian, intra-abdominal, mucinous cystic neoplasm, ovarian carcinoma, recurrent ovarian mass

Interstitial lung diseases (ILDs) are a varied group of disorders that have been clubbed together due to some common attributes. The data is abundant from the developed world. However, the developing countries have gradually amassed the knowledge of these disorders and epidemiological data is still missing. We aimed to profile the ILD patients at our center.

Even before the onslaught of COVID-19 pandemic could settle, the unprecedented rise in cases with COVID-19 associated mucormycosis pushed the medical health to the fringe. Hyperglycaemia and corticosteroids appear to be the most consistent associations leading to the commonest manifestation of mucormycosis, Rhino-Orbito-Cerebral Mucormycosis. To address challenges right from categorisation and staging of the disease to the management of relentless progression, a multi-disciplinary expert committee was formed to handle the task in an evidence-based format to enforce best practices. The report of the committee on one hand attempts to succinctly present the currently available evidence while at the other also attempts to bridge the evidence-deficient gaps with the specialty-specific virtuosity of experts.

Introduction: Gynecological malignancies are one of the leading causes of early mortality in women of all ages, whether they originate from any part of the female genital tract. Coming to demography, gynaecological malignancies account for around half of all cancers in women (45.2%). Cancer cervix accounts for 33.3% of all cancers, whereas fallopian tube cancer (0.15% of all gynaecological cancers) is the rarest of all gynaecological cancers. Gynaecological malignancies are more prevalent in rural India (76.5%). Since various tumors have variable amounts of angiogenic activity, corresponding with the development of gynaecological carcinomas, many specialists are intrigued by the possibility of blocking angiogenesis as a cancer therapy approach. Vascular endothelial growth factor (VEGF), also known as vascular permeability factor, stimulates the development of capillary channels around the tumor and works as a highly selective mitogen on endothelial cells. Intra-tumoural angiogenesis indicators include VEGF, basic fibroblast growth factor (bFGF), and microvessel density (MVD). MVD evaluation on excised tumor sections using particular antibodies that stain endothelial cells can be used to study angiogenesis. Method: Our aim was to identify and quantify angiogenesis in paraffin-embedded histopathological sections of gynaecological malignancies by using an immune histochemical marker (CD105:BIOGENEX QD 400-60KE) to predict association of MVD with premalignant and malignant lesions of cervical, ovarian, and endometrial origin. The study design was observational descriptive over a sample size of 65. Result: The mean of MVD origin in cancer cervix, ovary, and endometrium was 66.54 ± 28.76, 55.64 ± 39.76, and 54.3 ± 20.68, respectively. The mean difference was statistically insignificant (p= 0.3550). The inter-observer variability by pathologist-1 and pathologist-2 was excellent with reliable agreement (0.8717). Poorly differentiated carcinoma had a higher MVD than those more well differentiated. Consequently, angiogenesis may have a negative impact on the prognosis and survival of gynaecological cancer patients.

Tuberculosis (TB) is a common disease in underdeveloped countries. Of all tuberculosis cases worldwide, 28% were reported from India. The most prevalent site of infection is the lungs (pulmonary TB), whereas extrapulmonary tuberculosis (EPTB) is less common. The most common form of EPTB in India is Lymph Node TB, which accounts for around 35% of total EPTB cases. Splenic tuberculosis incidence is 8 % whereas tuberculosis of pancreas and gall bladder is extremely rare. Pancreatic and gallbladder tuberculosis (GT) is extremely rare and presents with non-specific features. The clinical manifestations of EPTB are variable, imitate other diseases, and are usually confused with other diseases. Thus, it is crucial to be cautious and highly suspicious of EPTB infection in endemic areas. Probability of developing EPTB in immunocompromised patients is higher than in immunocompetent patients. The burden of EPTB in HIV patients ranges from 15 to 20% of all TB cases in HIV-negative patients, while in HIV-positive people, it accounts for around 40–50% of new TB cases. Histopathological examination (HPE) and positive Acid-Fast Bacilli (AFB) smears are used to make the diagnosis. ATT is given to such patients for 6 months. Due to such a diverse presentation of TB, here, we report a case series of extrapulmonary TB occurring in the abdomen in, pancreas, gallbladder, and spleen.

Ovarian cancer is the seventh most common cancer in women and second most common female genital cancer in India. The high mortality is due to the fact that ovarian cancer is detected in later stages because of its non-specific symptoms like bloating, pain and increased size, gastrointestinal symptoms like indigestion, constipation or nausea with pelvic symptoms like bleeding. Cancer antigen 125(CA125) has been useful for detection of ovarian cancer and also for follow-up. Recently, another tumor marker for ovarian cancer has been proposed, the Human Epididymis 4 protein (HE4), frequently over-expressed in ovarian cancers, especially in serous and endometrioid histology. Descriptive study on 64 patients was done over a period of 1 year using pre- and postoperative serum samples for CA125 and HE4 and comparing them with histological diagnosis. ELISA for HE4 (Quantikine®Human HE4/WFDC2 Immunoassay) and chemiluminescence (ARCHITECT CA125 II assay) were used to assess CA125 levels and in serum. Results were compared between the two tumor markers, and statistical analysis (SPSS package Windows version 15.0) was done to compare the results. CA125 and HE4 levels were increased in malignant cases more than in benign cases. HE4 was seen as more specific than CA125, but, however, it did not prove superior in sensitivity. Hence, we conclude that CA125 along with HE4 will prove both as sensitive and as specific markers and hence prevent benign lesions being over-diagnosed and operated unnecessarily.