Ranjan Agrawal

Context: Granulomatous skin lesions frequently present as a diagnostic challenge to the pathologist because of various modes of presentation. Both infectious and non infectious causes lead to cutaneous granulomas. Histopathological diagnosis is required to confirm the clinical diagnosis and to classify the cutaneous granulomatous lesions. Aim: To study the spectrum, prevlance and frequency of various types of granulomatous skin diseases according to the age and sex of the patient. Materials and Methods: A cross-sectional type of observational study was carried out in the department of pathology, Rohilkhand medical college and hospital, Bareilly, Uttar Pradesh for the duration of 12 months (November 2018-October 2019). Punch biopsies received were fixed, grossed and processed, with the standard methods and were stained with hematoxylin and Eosin stain. All these biopsies were examined under the microscope and the slides in which granulomatous skin lesions were seen were selected for the study. Special stains were used wherever required. Statistical analysis: The data was analysed using SPSS version 22.0. Results: Out of total 138 cases maximum number of patients belong to the age group of 21-40 years, with male preponderance. Infectious causes were the most common pathology leading to granulomatous skin lesions, with leprosy as the most common etiology. Conclusion: Leprosy is the leading cause of granulomatous skin lesions in this study. Skin biopsies are an integral part of evaluating cutaneous granulomas. Histopathology along with special stains are the gold standard in reaching exact etiology for a final diagnosis. Keywords: Histopathology, Skin, Granulomatous, Leprosy, Tuberculosis.

Occurrence of distant metastasis from a primary in head and neck squamous cell carcinoma is relatively rare when compared to malignancies from other sites. Carcinoma arising from the hypopharynx, oropharynx and oral cavity are associated with the highest incidence of distant metastases. Knowledge of the metastatic potential and also the presentation helps in an early surgical intervention for improving the life expectancy as well as in the quality of life. We report a rare case of oropharyngeal carcinoma with no neck nodes, where the initial presenting complaint was a pathological fracture in the right femur. The case is being presented due to its rarity. Keywords: Femur, Pathological fracture, Squamous cell carcinoma, Tongue.

Enterobius vermicularis is one of the most prevalent human nematode worldwide. Besides intestine extra intestinal sites especially the female gential tract may be involved. We present herein a case of infestation of the ovary by Enterobius in a lady aged 40 years. Keywords: Ovary, Enterobiusvermicularis.

Introduction: Gall bladder diseases are a cause of great concern. Cholelithiasis has troubled humanity since long and has been a common disease worldwide. They are among the most common gastrointestinal conditions presenting with acute pain in abdomen. Gall stone disease is usually common among middle aged females who are fertile and fatty. Materials and Methods: The present study was conducted in in the Department of Pathology of a tertiary care teaching Institute of Western Uttar Pradesh. The study period was one year (October 2015–September 2016) with a sample size of 500 cases. Gross examination of gall bladder was done in the department and sections from representative areas were taken for microscopic examination. Special stains were used as and when required. Statistical analysis was carried out to assess the significance of various risk factors and mucosal changes in different age groups and genders. Results: of the total 500 cases, 441(88.2%) were females and 59(11.80%) were males. Maximum cases of gall bladder disease were in the age group of 31-40 years in both the sexes. Amongst all lesions, 394 (78.8%) patients had gallstones and 106 (21.2%) were acalculous. Majority of the gall stones were of mixed type in 310 (78.69%) cases. The commonest pathological mucosal changes observed included chronic cholecystitis with cholelithiasis in 250 (62.5%) cases. 50 cases each in the pre-malignant and malignant category were observed. Conclusion: Gall bladder diseases are most commonly seen in females. Majority of cases were of chronic cholecystitis with cholelithiasis. Gall stones mainly injure the mucosal columnar epithelium leading to changes such as metaplasia, dysplasia or neoplasia. Knowledge of non-neoplastic as well as pre-neoplastic conditions is important especially since they cause significant morbidity or even mortality. Keywords: Gallbladder, Cholecystectomy, Stones, Carcinoma.

Lipomas may occur anywhere within the body. However, their occurrence in the digits is very rare. We report 2 cases of lipoma in the digits. The first case is of a 70 years lady who had a soft painless swelling in the left thumb while the second case was of a 40 years lady who presented with a swelling over the medial aspect of right foot. Excision biopsy in both the cases proved them to be lipoma. The cases are presented due to the rarity of their sites as only 14 cases of lipoma in the digits have been reported earlier. Keywords: Lipoma, Digits.

We report a case of sacrococcygeal teratoma with squamous cell carcinomatous transformation in a 40-year-old lady. This is an infrequent location for teratoma in adults and malignant transformation has rarely been described. The uniqueness of the present case was the presence of congenital sacrococcygeal teratoma presenting in adulthood with malignant transformation. Keywords: Malignant transformation, Sacrococcygeal, Squamous cell carcinoma, Teratoma.