Search

Carcinoma breast is common tumor which tends to metastasize to different organs but diagnostic difficulty may arise if known case of carcinoma eventually presents with another secondary malignancy with clinical features which closely mimics with metastatic carcinoma. This overlapping of symptoms may lead to delayed diagnosis of secondary malignancy with worsening of the condition of patient due to lack of specific treatment.The present case is being reported where a known case of primary breast carcinoma presented with scapular erosions suggesting metastasis. However, despite treatment her worsening condition necessitated further work up revealing multiple myeloma. The case signifies the pitfall due to overlapping of symptoms and draws attention to the fact that every known case of primary carcinoma suggestive of metastasis should also be investigated in light of another secondary malignancy. Early diagnosis of secondary malignancy followed by specific treatment would be helpful in improved prognosis of the patient.

Familial clustering of Hepatocellular Carcinoma (HCC) is commonly observed in various parts of the world including China and Eastern Asia where HBV is endemic while in western world, genetic factors and metabolic disorders may play an important role. In India, HCC is considered to be a rare tumour and till date no case of familial HCC has been reported here. Therefore the present case demonstrates rare occurrence of familial HCC which is being reported for the first time from India on cytology. The case also highlights an unusual feature that it was not associated with any risk factor including HBV, HCV infection, alcoholism, obesity, diabetes or smoking suggesting its independent association with genetic factors. Cytology is uncomplicated diagnostic tool for HCC and may be useful for its early diagnosis. This case also highlights the importance of early surveillance and follow up of blood relatives for every case of HCC so that early diagnosis and management of familial HCC is possible.

Summary Introduction: Megaloblastic anaemia may present with pancytopenia and clinically mimic other causes of pancytopenia including myelodysplastic syndrome or aplastic anaemia. Bone marrow examination may be required for precise differentiation. The study was conducted to evaluate the role of mean platelet volume (MPV) to discriminate between pancytopenia due to megaloblastic anaemia or non-megaloblastic causes. Methods: A total of 268 cases of pancytopenia were divided into megaloblastic and non- megaloblastic group depending on clinical, laboratory and bone marrow examination. Mean MPV was statistically analyzed in both the groups along with comparison with healthy controls. Results: The mean MPV in 88 cases of megaloblastic group (7.97 fl) was although statistically significantly higher than mean MPV in 180 cases of non-megaloblastic group (7.04 fl) with P value