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Filariasis is a major concern, particularly in endemic regions. The majority of patients harbouring the parasite may remain asymptomatic for years. Here, we present six patients who were sent for routine cytological examination to rule out neoplastic pathology, in whom cytology identified filarial infestation. The main purposes of our paper are to highlight the importance of fine needle aspiration cytology (FNAC), a cheap and quick investigation to detect the microfilaria from tissue swelling and body fluids, and to point out that clinicians practising in endemic regions should always consider filarial infestation in patients presenting with longstanding swelling.

Diffuse serous cystic neoplasm (SCN) associated with pancreatic neuroendocrine tumor (PNET) is a rare finding reported previously in only three patients to the best of our knowledge. We herein present one such interesting report of a diffuse serous cystic adenoma (SCA) and co-existent PNET in a 25-year old lady who presented with abdominal pain for past 6 months. A triple-phase pancreatic protocol computed tomography (CT) scan revealed multiple cysts involving the entire pancreas. The cysts were thin walled, ranging from 2 to 8 cm in width, with no calcification or central scar that was confirmed at laparotomy. A frozen section revealed a neuroendocrine tumor and she underwent total pancreatectomy. Diffuse SCA with co-existent PNET infiltrating nerve bundles of the pancreatic parenchyma was made upon histopathology further verified by chromogranin-A immunostaining. The patient is insulin dependent and doing well at 2 years of follow-up. The origin of endocrine tumors from multipotent ductular stem cells has been suggested.

Epithelial-myoepithelial carcinoma (EMC) is a biphasic low-grade malignant tumor that shows ductal structures lined by the ductal cells with surrounding myoepithelial cells. EMC is most commonly reported in the parotid gland followed by other major and minor salivary glands. EMC of the tongue is an extremely uncommon tumor, with only five previously published case reports. We herein report the sixth case of EMC of the tongue. A 40-year-old female who had throat pain, dysphagia, and right earache for 3 years showed a 4 cm × 4 cm nodular tumor at the base of her tongue. Histopathological and immunohistochemical features were diagnostic of EMC with cervical lymph node metastasis. The metastatic behavior of EMC of the tongue in the absence of myoepithelial anaplasia or high-grade histological features is unusual and reported in this case report for the first time.

Male breast cancers constitute less than 1% of all the breast cancers. Papillary carcinoma is a very rare tumour of the male breast. Due to rarity, Fine Needle Aspiration Biopsy (FNAB) findings of papillary carcinoma in male breast are seldom reported. A 55-year-old male presented with a lump in the left breast of two years’ duration. FNAB was reported as fibroadenoma. Histopathological examination of the excised breast lump revealed invasive papillary carcinoma. Immunohistochemistry showed expression of pancytokeratin, oestrogen receptor, and progesterone receptor. Negative immunostaining was seen for HER2, p53, 34βE12, and CD34. Ki-67 proliferative index was 5%. We have discussed cytological findings of invasive papillary carcinoma and its differential diagnoses. Cytopathologists must be aware of cytologic findings of invasive papillary carcinoma of the male breast.

Introduction After the recent approval of Trastuzumab (anti-HER2 antibody) for the treatment of HER2 overexpressed Gastric Adenocarcinoma (GA), importance of HER2 testing is increasingly recognized. However, there is paucity of studies for HER2 overexpression in the Indian patients of GA. Similarly, study of p53 expression in the Indian patients of GA is infrequent. Aim To study immunohistochemical expression of HER2 and p53 in GA biopsy samples. Materials and methods This was a cross-sectional observational study. The expression of HER2 and p53 by immunohistochemistry were analyzed in 50 cases of GA. The HER2 expression was scored as negative (0 and 1+), equivocal (2+), and overexpression (3+). The p53 expression was quantified as negative (0-9% tumour cells) and positive (≥10% tumour cells). The intensity of p53 expression was assessed as strong and weak. Results Mean age of the patients was 56.8±14.8 years. Male:female ratio was 2:1. Histological types of adenocarcinoma were intestinal (68%), diffuse (28%), and indeterminate (4%). HER2 overexpression and equivocal results were present in 10% cases, each. Overall, a positive expression of p53 was seen in 72% (strong and weak intensities: 66.7% and 33.3% cases, respectively). Conclusion As compared to HER2 overexpression, a higher incidence of p53 expression was seen (10% vs.72%) in GA.

Neoplastic lesions of the fallopian tube are rarely seen by surgical pathologists. Haemangioma of the fallopian tube is an extremely rare benign neoplasm. A 30-year-old lady with polymenorrhea and dysmenorrhea underwent hysterectomy and bilateral salpingo-oophorectomy. Her left fallopian tube showed a 2mm sized solid nodule in the wall. Histopathological examination revealed a well-defined vascular lesion in the left fallopian tube, consistent with capillary haemangioma. The vascular endothelium was highlighted by CD34 immunostaining. Our literature review has identified 10 cases of cavernous haemangioma of the fallopian tube. To the best of our knowledge, we report the first ever case of capillary haemangioma of the fallopian tube. This is also the smallest detected haemangioma in the fallopian tube.

Paraganglioma of the urinary bladder is a rare tumour derived from chromaffin tissue of the sympathetic nervous system. Paraganglioma of the urinary bladder especially the non-functional type is often misdiagnosed as urothelial cancer. Two female patients aged 32 years and 45 years presented with painless haematuria without any symptoms of catecholamine excess. Radiological investigations revealed urinary bladder tumour. The tumour was removed by transurethral resection in both the patients. Histopathological diagnosis was paraganglioma, which was confirmed by immunohistochemistry. Complete resection of tumour by transurethral approach is curative in paraganglioma of the urinary bladder. We hereby, also discuss the salient features of nonfunctional paraganglioma of the urinary bladder.

A 3-year-old girl presented with multiple episodes of vomiting, fever, and hematemesis for the past 2 months. Except for hemoglobin, her rests of the laboratory tests were unremarkable. Her barium X-ray showed absence of the duodenal bulb and the C-loop. Her endoscopy showed deformed stomach with multiple ulcers and diverticuli. The gastric outlet was not visualized. Distal gastrectomy with gastro-duodenal anastomosis was performed. Histopathological findings revealed transmural dense infiltrates of eosinophils, consistent with eosinophilic gastritis.

A 72-year-old male presented with urinary symptoms. His serum prostate specific antigen level was 65.2 ng/ml. His radical prostatectomy specimen showed clear cell lesion reminiscent of the clear cell renal cell carcinoma along with acinar type of prostatic adenocarcinoma, Gleason score 4 + 4. The lesional clear cells were positive for pancytokeratin, epithelial membrane antigen, CD10, vimentin, and AMACR while negative for 34βE12, CK7, prostate specific antigen, and PAX8. The final diagnosis was renal-type clear cell carcinoma of the prostate. A follow-up of 20 months did not show metastasis. We herein report fifth case of renal-type clear cell carcinoma of the prostate.

Thrombocytosis is defined as a platelet count greater than 400×10(9)/L. Electric shock may lead to tissue injury and marked thrombocytosis. We herein report a case of 45-year-old woman, who was hospitalized with progressively increasing weakness, tingling sensation, and numbness of the bilateral lower limbs. She had a history of receiving electric shock during household work, 15 days prior to her admission. Her laboratory investigations revealed a markedly increased platelet count (1,570×10(9)/L) along with increased level of serum uric acid (12 mg/dL), and mild increase in serum potassium (6.7 mmol/L), and serum alanine transaminase (50 U/L). She was treated with intravenous fluids, calcium, and multivitamins. Following hospitalization and treatment, condition of the patient improved, her symptoms resolved, and her platelet counts declined. We report this case because of rare presentation of marked thrombocytosis secondary to electric shock with a brief discussion on pathophysiology of this condition. Language: en

A 37-year-old man from eastern Uttar Pradesh, India, presented with 20 days of a painless swelling of the left testis. There was no history of trauma, fever, infertility, lymphadenitis, lymphangitis, or previous history of testicular tumor. On examination, the left testis measured 5×4 cm, and was found to be slightly enlarged, firm, and nontender on palpation (Figure 1 ). Palpation of the right testis and bilateral spermatic cords were unremarkable. There was no inguinal lymphadenopathy. His complete blood counts were within the normal limits; differential count showed 9% eosinophils (absolute eosinophil count = 870/μL). The patient was amicrofilaremic on peripheral blood smears examined at 10 am. Results for serum alpha-fetoprotein, β-human chorionic gonadotropin, and carcinoembryonic antigen were within normal limits. Ultrasonography of the left testis showed increased vascularity and presence of hypoechoic areas containing mottled hyperechogenicity (Figure 2 ). The right testis, bilateral epididymis, and bilateral spermatic cords were of normal size, shape, and echotexture. Considering clinical presentation, age, and radiological findings of the patient, a provisional diagnosis of the left testicular neoplasm (teratoma) was made, and he was advised to undergo orchiectomy. However, owing to the patient's refusal of the orchiectomy, trans-scrotal fine-needle aspiration cytology (FNAC) was done as a second line of investigation. Papanicolaou- and Giemsa-stained smears revealed a dense inflammatory infiltrate comprised of neutrophils, histiocytes, and occasional multinucleate giant cells along with many sheathed microfilarial larvae without nuclei at the tail tip (Figure 3 ). FNAC findings confirmed the diagnosis of filariasis due to Wuchereria bancrofti. There was no evidence of malignant cells or fungal elements in the smears examined. The final diagnosis was bancroftian filarial orchitis. The patient was prescribed a 14-day course of diethylcarbamazine.

Objectives To assess incidence and volume of fetomaternal hemorrhage (FMH) after chorionic villus sampling (CVS) by Kleihauer Betke test (KBT) and rise in maternal protein (MSAFP). Methods A prospective study was conducted on 61 cases requiring CVS. FMH due to CVS was assessed by KBT and MSAFP. Results Out of 61 cases, 60 (98.36%) cases showed FMH by MSAFP while all showed FMH by KBT. Median volume of FMH detected by MSAFP was 0.06 mL (25 to 75th interquartile (IQR) 0.01 to 0.12 mL) and by KBT was 0.45 mL (25 to 75th IQR 0.09 to 0.90). Mean volume of FMH detected by MSAFP was 0.1 + 0.1424 mL and by KBT was 0.58 + 0.637 mL. Significant FMH up to 0.1 mL was found in 20 (32.8%) and 45 (60.6%) by MSAFP and KBT respectively. Conclusion MSAFP and KBT are sensitive to detect FMH. KBT estimates more FMH than MSAFP. Fifty micrograms of anti-D is sufficient to cover FMH during CVS. Copyright © 2006 John Wiley & Sons, Ltd.

Langerhans cell histiocytosis (LCH) is a rare clonal disorder of unknown etiology and characterized by the proliferation of dendritic cells. LCH most commonly involves the bone followed by the skin and the lymph nodes. Recently, only a few cases of LCH with predominant lymph node involvement have been diagnosed by fine-needle aspiration cytology (FNAC). A 2-year-old boy presented with generalized lymphadenopathy, fever, and cough. The patient had hepatosplenomegaly, anemia, and lytic lesions in the skull. FNAC from the largest submandibular lymph node showed features of LCH. The large cells of LCH showed positive immunostaining for S-100 protein on FNAC smears. Later, lymph node biopsy and immunohistochemistry against S-100 protein and CD1a confirmed the diagnosis of LCH. The patient was treated with chemotherapy and he is under regular follow-up. This case report highlights the importance of FNAC as a rapid and accurate investigation in the diagnosis of lymph node predominant LCH.