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Adenoid Cystic Carcinoma (ACC) is an uncommon form of malignant neoplasm of the salivary gland. ACC is a rare epithelial, slowgrowing yet aggressive neoplasm with a remarkable capacity for recurrence. It most commonly develops in the salivary glands or other regions of the head and neck. Hereby, authors present a case of a 72-year-old female who presented with a rapidly enlarging swelling in the right submandibular region, which had recurred three times. Histopathological examination reported it as ACC grade II. ACC is known for its ability to invade perineurally, its high frequency of local and distant recurrence and its poor long-term prognosis. In the present case, the treatment provided was complete surgical resection. The patient underwent wide surgical excision of the lesion with appropriate margins, as well as a completion neck dissection of level IA. The histopathological diagnosis is based on tissue examination findings that exhibit typical histologic features. The presence and percentage of solid architecture reflect clinical outcomes and should be reported in the pathology report. Current diagnostics mainly rely on histomorphology, along with immunohistochemistry and cytogenetics. Poor prognostic factors include large tumour size, solid growth pattern, positive surgical margins, nodal status, nuclear atypia, high mitotic activity, high-grade transformation, lymphovascular invasion and tumour necrosis. The patient was kept on regular follow-up and there was no recurrence or metastasis noted over two years. ACC remains extremely difficult to treat due to its high recurrence and metastasis rates. The authors are presenting a case of right submandibular gland ACC for its rarity, multiple recurrences, aggressive clinical behaviour and associated radiological and histopathological findings. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes Mellitus is a prothrombotic state characterised by enhanced platelet activity, which may lead to microvascular and macrovascular complications. Platelet indices, such as Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW), are routinely available in laboratories and can serve as a prognostic markers for patients. Aim: To evaluate platelet indices in patients with Type 2 Diabetes Mellitus (T2DM) and associated complications. Materials and Methods: A cross-sectional study was conducted at the Department of Pathology in Krishna Vishva Vidyapeeth's Krishna Hospital and Medical Research Centre, Karad, Maharashtra, India, from July 2020 to May 2022. A total of 120 patients with type 2 diabetes, both with and without complications, were investigated. Haematological parameters (platelet count and platelet indices such as MPV and PDW) and biochemical parameters {fasting blood sugar and Haemoglobin A1c (HbA1c)} were compared between the two groups. Platelet indices were measured using an automated haematology analyser. Statistical analysis was performed using the t-test, Analysis of Variance (ANOVA), and Statistical Package for Social Sciences (SPSS) version 16.0. Results: The study included 60 cases each of DM with complications and without. Among those with complications, 17 (28.33%) were aged 51-60 years, 14 (23.33%) were 61- 70 years old, and 12 (20%) were over 70 years. The mean MPV was 12.74±3.076 fL for patients with complications and 8.65±1.58 fL for those without. The mean PDW was 15.54 15.54±3.31 fL for patients with complications and 13.94±2.66 for those without. The mean HbA1c levels were 8.33 mmol/ mol for patients with complications and 6.75 mmol/mol for those without. The mean platelet count was 3.12 lakh/mm³ for patients with complications and 2.45 lakh/mm³ for those without. The mean fasting blood sugar levels were 219.65 mmol/L for patients with complications and 109.96 mmol/L for those without. Conclusion: Diabetes contributes to endothelial dysfunction and platelet hyperactivity. The present study reveals that diabetic patients with uncontrolled glycaemic indices and elevated fasting blood sugar levels have higher platelet indices compared to patients without complications, where the platelet count, platelet indices, and glycaemic indices were within normal limits. These indices may also serve as useful prognostic tools. [ABSTRACT FROM AUTHOR]

Bladder cancer ranks as the 9th most common malignancy worldwide within the urinary system. Urothelial carcinoma stands as the predominant histologic type in the United States and Western Europe, constituting approximately 90% of bladder cancer cases. While common sites of metastasis for urothelial carcinoma typically involve regional and distinct lymph nodes, the liver, lungs, and bones, instances of metastasis to the pericardium are rare. Roughly 10% of urothelial carcinoma cases exhibit cardiac metastasis, often remaining clinically asymptomatic. Hereby, the authors present a rare case of symptomatic pericardial infiltration originating from urothelial carcinoma in a 32-year-old male. The patient initially presented with a two-week history of progressive dyspnoea on exertion and had been previously diagnosed with high-grade transitional cell carcinoma with squamous differentiation upon histopathological examination and urothelial carcinoma on a Positron Emission Tomography (PET) scan 12 months earlier. Following neoadjuvant chemotherapy and radiotherapy, the patient exhibited a partial response to the treatment. However, despite the effectiveness of the therapies, he developed dyspnoea and pericardial effusion. Although pericardial involvement in advanced malignancies is not uncommon, symptomatic cardiac metastasis from urothelial carcinoma remains rare. Radiographic studies revealed right-sided pleural effusion, while a Computed Tomography (CT) scan of the thorax and upper abdomen (plain and contrast) displayed severe bilateral pleural effusion, pericardial effusion, and metastatic deposits in the mediastinal lymph nodes. Electrocardiography indicated sinus tachycardia, inverted T-waves in leads V1 to V5, and flattening of the T-wave in V6. The patient underwent pericardial tapping, yielding approximately 50 cc of pericardial fluid. A 10 cc of the pericardial fluid was subsequently sent for examination in the Pathology Department, with fluid cytology results indicating the presence of malignant cells. [ABSTRACT FROM AUTHOR]