Tarali Pathak

Abstract

Xanthogranulomatous cholecystitis (XGC)- a rare pathological entity of gall bladder, is characterized by marked inflammatory infiltrates of macrophages and foam cells with proliferative fibrosis of the gall bladder wall. Although it is a benign condition, its radiological picture and intra operative findings mimic gall bladder carcinoma- leading to misdiagnosis in most cases. We report a case of XGC in a middle-aged lady who presented with a lump in right hypochondrium. Computed Tomography (CT) scans of the abdomen was inconclusive for her. A CT-guided Fine Needle Aspiration Cytology (FNAC) was obtained, where findings were suggestive of XGC which was finally confirmed on histopathological examination of the cholecystectomy specimen. The characteristic cytologic features of XGC on FNAC in this case helped differentiate it from malignancy, thereby sparing the patient a morbid radical surgery. Preoperative FNAC and intraoperative frozen section are valuable tools for differential diagnosis of XGC and help guide the surgeon towards a correct surgical approach.   Keywords: Xanthogranulomatous cholecystitis, Carcinoma gall bladder, Foamy macrophages

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Abstract

Purpose/Background:  Sinonasal malignancies (SNM) constitute nearly 3% of Head & Neck cancers. Though rare, they still are one of the most challenging conditions to manage. Immunohistochemical (IHC) evaluation using relevant antibodies has become an indispensable ancillary technique for differentiating these tumours. An early and definitive diagnosis is important for optimally managing these aggressive tumours. Materials and Methods: This study was done in the department of Head & Neck Surgery in association with department of Oncopathology of a tertiary Cancer Hospital in Northeast-India. Hospital records of all patients who received treatment for a sinonasal malignancy between the years 2013 to 2017 were retrospectively reviewed. Patients reported having a ‘Small round cell tumour’ in their initial histopathological examination (HPE) of biopsied tissue were included in the study. Results: The study included 31 patients of Sinonasal SRCT, nearly 38% of the total 81 patients diagnosed with a sinonasal malignancy during the study period of 5 years. The median age of these patients was 43 +/- 8 years (range 8-82 years). With a gender ratio of 1.6: 1 (M: F), SRCTs was found slightly commoner in males. Epistaxis and nose block (unilateral or bilateral) were the commonest symptoms. Mean symptom duration was approximately 3 months. Conclusion: Establishing a precise diagnosis of Sinonasal SRCT is important not only in determining how aggressive the tumor might be, but is especially critical in deciding treatment modalities and their sequences. Immunohistochemistry plays an important role in proper histopathological diagnosis and further treatment planning.   Keywords: Sinonasal small round cell tumour, Sino nasal undifferentiated carcinoma, Lymphoma, Olfactory neuroblastoma, Immunohistochemistry

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