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Background: Non-cirrhotic portal hypertension includes primarily the cases of non-cirrhotic portal fibrosis (NCPF) and extra-hepatic portal vein obstruction, both showing no significant parenchymal disease. NCPF is a disease of uncertain etiology characterized by periportal fibrosis with small and medium sized portal vein branches involvement. Most study done in the past are clinical, hence we decided to analyse its histo-pathological features with clinical correlation. Methods: This is four and half year’s retrospective study of liver biopsies of clinically diagnosed patients of NCPF. Fifteen patients of EHPVO served as controls. Biopsies were stained with Haematoxylin and eosin, reticulin and Masson’s trichrome. Result: Total 978 benign specimens (excluding space-occupying lesions) received, of which 45 diagnosed as NCPF (4.6%). Most patients (68.88%) were between 20-40 years (M:F ratio 1:1.5), commonest symptoms long-standing splenomegaly (95%), anemia (78%) and variceal bleeds (42%) with duration varying from 3 months to 11 years. Commonest histopathological findings were portal tract fibrosis (77.78%), phlebosclerosis (68.89%), portal tract remnants (24.44%), more frequently seen in NCPF than EHPVO, septal fibrosis was seen in five. Follow up available in 91.11% cases showed no mortality or liver failure, but significant morbidity due to repeated episodes of variceal bleeds and hypersplenism. Conclusion: NCPF is still common in India. Distinctive features on histology are portal tract fibrosis, portal tract remnants, with phlebosclerosis which is being statistically significant when comparing with EHPVO. NCPF can show advanced fibrosis, can also present with features of decompensation mimicking cirrhosis, however its course remains stable with good long-term survival.

Granular cell tumours are uncommon, usually benign soft tissue tumours. They are thought to be neural, arising from Schwann cells and can occur at various sites. Their occurrence in gastrointestinal tract is rare, the commonest site being oesophagus followed by large intestine. Gastric localization is unusual. A young female presented with abdominal discomfort since 3 months. Endoscopy showed a nodule in the body of stomach. Biopsy revealed features of granular cell tumour on microscopy, which was confirmed by immunohistochemical positivity for S100 and CD68. Wide excision of the tumour was performed. At the 6-month follow-up, patient was asymptomatic. The diagnosis of gastric granular cell tumour is based on endoscopic biopsy. Unless there is histological evidence of malignancy, wide local excision is an adequate surgical treatment.

Introduction: Appendiceal carcinoids are very difficult to diagnose pre-operatively since they are uncommon and have no typical presentation. Hence, they are detected during appendectomy or other abdominal surgeries or more commonly on histopathological analysis of appendectomy specimens. In this study, we aim for retrospective analysis of the incidence and characteristics of carcinoid tumours of the appendix. Methods: The case records of all the patient's aged 18 years and above, who underwent emergency or elective, laparoscopic or open appendectomy between January 1st 2010 to December 31st 2020 at a tertiary care centre in Mumbai after obtaining institutional ethics committee approval, were included in an observational retrospective study. Demographic data like age, sex and tumour characteristics like size of the tumour, location of the tumour in the appendix (tip/body/base), grade, site of perforation (if perforated), infiltration of vessels, infiltration of mesoappendix and immunohistochemical characteristics were noted. Results: A total number of 4485 appendectomies were performed during the study period. Carcinoid tumour was found on histopathological examination in 6 specimens which accounts for 0.133 % incidence. Only one of them was male (16.66%) and the rest five were females (83.33 %). The mean age was 24.16 years with the range being 19-30 years. All patients were operated on for acute appendicitis and none was suspected to have carcinoid tumour preoperatively. Histologically, all tumours were located at the tip with the mean diameter being 0.98 cm (range 0.2-2 cm). All the tumours were grade 1 and none of them had a lymphovascular invasion. Only 2 out of 6 tumours had focal subserosal fat infiltration of the mesoappendix. Conclusion: The incidence of appendiceal carcinoid in our study was 0.133%. They do not have specific clinical features and present as acute appendicitis. Hence, they are usually diagnosed after surgery on histopathological evaluation. The size of the tumour plays an important role in treatment and prognosis.