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Background/aim: Xanthogranulomatous cholecystitis (XGC) is a rare destructive inflammatory disease of the gallbladder. It is frequently misdiagnosed as gallbladder carcinoma (GBC) as it mimics latter with regard to clinical manifestations, imaging and intraoperative findings, often leading to extended surgical resection in these patients. The aim of this study was to evaluate the diagnostic dilemma of XGC cases clinico-radiologically diagnosed with GBC.Materials and Methods: From January 2017 to June 2019, a total of eight cases histopathologically diagnosed as XGC, were misdiagnosed with GBC based on preoperative and intra-operative findings. The clinical characteristics, imaging, intra-operative findings, and surgical data of these patients were collected and analyzed.Results: A total of 2154 cholecystectomy specimens were received in the histopathology section during the study period. Sixty-nine cases (3.2%) were histologically diagnosed as XGC, of which 8 cases (11.6%) were preoperatively diagnosed with GBC. These cases were predominantly seen in males in the age range of 24-62 years. The most common clinical presentation was chronic cholecystitis. Gallstones were present in all the 8 cases. Six cases presented with heterogeneous enhancement within thickened gallbladder walls on imaging. Intraoperatively, adhesions to adjacent organs were observed in seven cases. All these eight cases misdiagnosed with GBC underwent aggressive surgical treatment following which histopathology ultimately revealed XGC.Conclusion: Neither clinical manifestations nor laboratory tests/radiological methods can provide an effective means of differentiating between XGC and GBC. Preoperative diagnosis is difficult, and histopathology remains the gold standard to differentiate the two entities. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) and malignancy are among the most important current global health problems. Many authors suggest that their coexistence is a chance association owing to their high prevalence. There is, however, enough evidence that one condition may predispose the other. In our retrospective report of two cases, TB in draining lymph nodes was discovered incidentally on histopathology, following surgical resection for malignancy. The possibility of coexistent lesions, especially in regions endemic for TB, mandate a detailed histopathological examination to prevent the chances of diagnostic failure and thus therapeutic error. [ABSTRACT FROM AUTHOR]

Uterine smooth muscle tumors and endometrial stromal tumors (ESTs) are the two major types of mesenchymal tumors of the uterus, the latter being fairly uncommon. Among these, endometrial stromal sarcoma (ESS) accounts for 0.2-1.5% of all uterine malignancies. Although routine histopathological examination is sufficient to distinguish between ESS and smooth muscle tumors in most of the cases, the distinction between ESTs and highly cellular leiomyomas (CMs), on several occasions becomes a great diagnostic challenge for the pathologist. The differentiation between EST and CM is necessary on account of the variable clinical course and slight variation in the therapy. However, this is difficult due to the tendency of endometrial stromal cells to differentiate into well-developed smooth muscle cells as well as overlapping immunohistochemical profile in some cases. We hereby report a series of cases which posed a diagnostic challenge to us as to whether they are CMs or ESTs. We therefore discuss the histological features which helped us resolve this dilemma as well as the utility of immunohistochemistry (IHC) as a diagnostic aid in arriving at a final diagnosis in such problematic cases. [ABSTRACT FROM AUTHOR]

The most common site of primary malignant melanoma is the skin, however, virtually any organ system may be involved. Metastatic melanoma of unknown primary origin accounts for approximately 2-6% of all melanoma cases. The mediastinum as the site for malignant melanoma is extremely rare, both as a primary or metastatic lesion. Primary malignant melanoma of mediastinum is very rare with only a handful of reports in the literature. We hereby report a rare case of malignant melanoma of mediastinum in a 31 year old male who was initially misdiagnosed on fine needle aspiration cytology as adenocarcinoma for which he received chemotherapy with clinical deterioration. Even on extensive meticulous search, no primary was discovered. [ABSTRACT FROM AUTHOR]

Aim: The primary goal of our study was to evaluate the value and accuracy of fine needle aspiration cytology (FNAC) in the diagnosis of various intraoral lesions and to correlate the cytological diagnosis with final histopathological findings. Materials and Methods: Fine needle aspiration was performed in 229 patients presented with different lesions of the oral cavity at our institution. Cytological findings were then compared with final histopathological diagnosis. Results: With a male to female ratio of 1.79:1, 229 patients presented with different lesions of the oral cavity were aspirated. Histopathological correlation was available in 86.9% of cases while inadequate material was obtained in 13.1% cases. The diagnostic accuracy of fine needle aspiration in diagnosing benign, pre-malignant and malignant lesions were 95.8%, 84.6% and 97% respectively. Overall the diagnostic accuracy of FNAC in diagnosing intraoral lesions was 94.9% with sensitivity and specificity of 93.2% and 96.8% respectively. Conclusion: FNAC of intraoral lesion is recommended as a valuable procedure for the initial evaluation of all intraoral lesions as it is simple, inexpensive, convenient and comfortable to the patient. Moreover, it can offer a rapid and accurate diagnosis for further management of the patient. [ABSTRACT FROM AUTHOR]

Ewing's sarcoma (ES) is a highly malignant neoplasm of childhood and adolescence seen commonly in both axial and appendicular skeleton but uncommonly in acral region. Ewing's tumor in the hand is extraordinarily rare. Radiological features are variable and can mimic other common lesions. We present a case of 13 year old female, with complaints of pain and swelling in right hand, which on X-ray showed periosteal reaction, giving a sun burst appearance and provisional diagnosis of osteosarcoma was made. The patient was operated and histopathological diagnosis of ES was confirmed. Histopathological examination remains the mainstay of diagnosis, supported by immunochemistry and cytogenetic studies. Surgical extirpation with chemotherapy is the therapeutic regimen of choice. We intend to report this case, because it is very rare location and the radiological features can mimic other lesions which commonly occur in this location like chronic osteomyelitis so it can be easily missed especially at preliminary evaluations. [ABSTRACT FROM AUTHOR]

Acinic cell carcinoma (ACC) is an uncommon low-grade tumor of the salivary glands that constitutes 2.5-4% of parotid gland tumors. Papillary cystic variant (PCV) of ACC is even rarer and can be diagnosed on histopathological examination only. It is important to diagnose this variant as it carries a poor prognosis when compared with other variants of ACC and is known to be universally fatal in 10 years. The present case describes ACC-PCV in a 20-year-old male, which presented as a slow growing parotid tail tumor and was misdiagnosed as a benign lesion both cytologically and radiologically. This case emphasizes the importance of histopathological examination in parotid masses as well as the need to consider malignant lesion in the differential diagnosis of a parotid tail tumor. [ABSTRACT FROM AUTHOR]

Pleomorphic adenoma forms the majority of salivary gland neoplasms. Cystic change in pleomorphic adenomas is a diagnostic dilemma and can mimic mucoepidermoid carcinoma, mucocele or carcinoma ex pleomorphic adenoma and squamous cell carcinoma. Hereby we report this interesting and rare case of cystic pleomorphic adenoma in a 32-year-old male. [ABSTRACT FROM AUTHOR]

Filariasis is a disabling parasitic disease and it constitutes as a major health problem in most of the tropical and sub-tropical countries. One hundred and twenty million people in at least 80 tropical and sub-tropical countries are infected with lymphatic filarial parasite, with one billion people being at risk of the disease. The laboratory diagnosis of filariasis is conventionally made by demonstrating microfilaria in peripheral blood smear. However, microfilaria have been incidentally detected by doing fine needle aspiration of various lesions in clinically unsuspected cases of filariasis. In 1982, detected microfilariae in the sediment smears of cystoscopically catheterized urine samples, but reports on detection of microfilaria in normally voided urine samples are extremely rare. Here, we are reporting, such a case of microfilariae of Wuchereria bancrofti in an 18-year-old boy who presented with chylous haematuria. [ABSTRACT FROM AUTHOR]

Objective: Image guided fine needle aspiration cytology (FNAC) is a safe, simple, rapid, cost effective and accurate modality in evaluation of deep seated lumps (abdominal, pelvic and intrathoracic masses) which are unapproachable by blind FNAC. In this study, a critical analysis of the utility of image guided FNAC in deep seated and otherwise inacessible mass lesions was carried out., Material and Method: Fifty-four ultrasound (USG) or computed tomography (CT) guided FNACs from lumps at any location in the body, that is, thoracic, abdominal, pelvic etc over a period of 3 years (January 2012- December 2014) were included in the study. The most common site aspirated, the indications for a guided aspiration and the accuracy of aspiration cytology in comparison to the histological diagnosis were evaluated, wherever possible., Results: Fifty-four image guided FNACs were performed (46 USG guided and 8 CT guided). Inconclusive, inflammatory, benign tumors, suspicious and malignant lesion rates were 5.6%, 29.6%, 11.1%, 5.6%, and 48.1%, respectively. The most common site was the liver (25.5%), followed by the thyroid (18.5%), lung (14.8%), gallbladder (11.1%), and lymph nodes (7.4%). Cytohistological correlation could be performed in 32 cases with a diagnostic accuracy of 100%., Conclusion: FNAC coupled with a diagnostic imaging technique such as USG or CT can improve the diagnostic yield and a definite diagnosis can be reached in most of the cases.