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Mammary Paget disease is an uncommon malignancy of the breast that presents with ulceration or eczema of the nipple and is almost always associated with an underlying breast carcinoma. This disease is most commonly seen in the fifth and sixth decades of life and is almost always unilateral. The diagnosis of mammary Paget disease is generally based on clinical findings, confirmed by histopathologic examination. Mammographic and ultrasonographic findings may be nonspecific for malignancy, with 50% of cases showing negative findings. Magnetic resonance imaging can be used as a diagnostic tool to detect clinically occult cancer with nonspecific findings on mammogram and ultrasonogram. In this article, we are presenting a rare case of a young woman with biopsy-proven bilateral mammary Paget disease, for which bilateral modified radical mastectomy was done, followed by adjuvant chemotherapy and radiotherapy. Keywords: Bilateral mammary Paget disease, Intraductal carcinoma, Eczema, Biopsy

Calcium pyrophosphate dihydrate crystal deposition disease (CPPD) also referred to as pseudogout is an inflammatory arthritis produced by the deposition of calcium pyrophosphate crystals in the synovium and periarticular soft tissues. This report documents a case of a 41 year old female who presented with a painful swelling in the back. MRI revealed a complex swelling with lobulation of size 7.4×7.4×7 cm in the posterolateral aspect of chest wall just superficial to the ribcage. A surgical excision biopsy of the swelling was done and patient improved symptomatically. Serum uric acid levels were measured and found to be within limits.

We report the detailed gross, histopathological and immunohistochemical study of Strobilocercus fasciolaris infection, the metacestodal stage of Taenia taeniaeformis , in the liver of laboratory Wistar rats. Necropsy examination of seventeen rats revealed transparent or white or cream to clear, thick walled cysts, 1 to 97 in number, measuring about 2 mm to 12 mm on one or many of the liver lobes and containing strobilocercus of Taenia taeniaeformis . Histopathological examination revealed the presence of the cross-section of larva surrounded by a thick fibrous capsule and moderate infiltration of lymphocytes, plasma cells and a few eosinophils. Fatty degeneration of hepatocytes, gastric mucosal hyperplasia, distended gastric glands and marked increase in the mucosal epithelial cells and goblet cells in the duodenum were also observed. Contamination of feed and bedding materials seems to be the probable source in these naturally infected rats.

An epizootic causing high morbidity and high mortality in Swiss albino inbred mice over a period of two weeks caused by Klebsiella pneumoniae is reported. Diagnosis was based on clinical signs, histopathological, bacteriological evaluation of the lung, kidney and intestinal tissue and multiplex PCR. Biochemical tests were positive for citrate, nitrate, urease, lysine decarboxylase, ornithine decarboxylase and negative for phenylalanine and hydrogen sulphide production. Carbohydrates viz., glucose, lactose, adonitol, arabinose were fermented but sorbitol was not. Disc diffusion tests for antibiotic sensitivity showed susceptibility to enrofloxacin, amikacin, doxycyline and resistant to cephalexin, cefadroxil, cefuroxime, cephtriaxone and ampicillin. Amplification by multiplex PCR for sulphydryl variable (SHV) gene yielded a product size of 472bp.

Ischemic diseases of the gastrointestinal tract are some of the commonly encountered gastrointestinal diseases which are difficult to diagnose and still more difficult to treat. Presentation of colon ischemia is even more subtle, and this review article details about the various presentation patterns of ischemic colitis and their management.

A case of malignant melanoma was recorded in a four year old female Rottweiler. Grossly, four subcapsular smooth nodules of varying sizes were observed on the parietal surface and one smooth nodule on the visceral surface. On section, the nodule was soft, dirty grey-black, circumscribed and appeared as two distinct areas separated by parenchyma. Cytology revealed oval to polygonal cells containing black granular cytoplasmic pigments, obscuring the nuclear details. Anisocytosis, anisokaryosis, variable nuclear:cytoplasmic ratio, prominent nuclei were seen. Histopathologically, the neoplastic cells were round to spindle to polyhedral in shape with severe/deep and brown black pigmented cytoplasm. On special staining with Fontana, the granules of neoplastic cells stained black and nuclei stained pink. The tissue was then subjected to proliferation marker Ki-67 immunohistochemistry, where more than 75% of neoplastic cells showed strongly positive immunolabelling.

Inflammatory myofibroblastic tumour, commonly called as pseudotumor is a soft tissue tumour, commonly occurring in children and young adults and very rarely in elderly. Lungs are the most commonly affected site but sometimes it can occur in retroperitoneum and abdominal cavity. It contains spindle cells, myofibroblasts, lymphoctyes, plasma cells, and histiocytes. It is a non-encapsulated lesion. The pathogenesis of IMT remains unclear, although various allergic, immunogenic infectious mechanisms have been postulated. They are locally recurrent (15-37%) and rarely metastasize (

Background: Parotid gland is the largest of the salivary glands present in the body. Neoplastic lesions in parotid gland always causes difficulty in tissue diagnosis due to their diversified histology. Lesion in the superficial lobe of parotid is more amenable for clinical diagnosis but deep lobe lesion requires imaging to confirm the diagnosis. Managing parotid swelling seems like a mystery due to these issues.Methods: There were 30 patients who presented with complaints of swelling in the parotid region. For all these patients detailed history was taken and clinical examination was done and findings noted. Contract enhanced computed tomography (CECT) of the parotid region was done followed by fine needle aspiration cytology (FNAC) and the management was planned accordingly.Results: All the 30 patients were within the age group of 25 years to 65 years. All the patients presented with swelling in the parotid region. Among the 30 patients, 10 patients had complaints of associated pain in the parotid region. On clinical examination, all the patients had lesion in the superficial lobe of parotid and 2 patients had deep lobe involvement. 1 patient had features of facial nerve palsy. Contrast enhanced computed tomography (CECT) and Fine needle aspiration cytology (FNAC) was done. For all the patients’ surgical management was planned accordingly.Conclusions: Routinely submitting all parotid swelling patients to Fine needle aspiration cytology and computed tomography helps to solve the mystery of diversified histology and presentation.

Background: Inguinal hernia is one of the most common surgery done in any hospital. Chronic inguinal pain is one of the common problem these patients complain of. This study aims at evaluating the long-term outcomes of neuralgia and paraesthesia following routine ilioinguinal nerve division, compared to nerve preservation when performing Lichtenstein’s inguinal hernia repair.Methods: The present study is a randomized controlled trial of 60 cases of inguinal hernias admitted in General Surgery Department in our hospital. The patients were randomly chosen into Lichtenstein hernia repair with ilioinguinal neurectomy or Lichtenstein hernia repair with nerve preservation. After surgery, all patients were monitored carefully for pain and paraesthesia. Pain was assessed using visual analogue scale. Paraesthesia was assessed by the monofilament test and evaluated after comparison with the opposite side.Results: In the present study, the incidence of pain as well as the severity of pain is far higher in the nerve preservation study group as opposed to the neurectomy study group. Hypaesthesia is not a significant complication following ilioinguinal neurectomy and does not significantly add to the morbidity of the patient.Conclusions: Prophylactic neurectomy can be an appropriate solution in the prevention of chronic groin pain following Lichtenstein inguinal hernia repair and can be considered as an ideal inclusion into the standard hernia repair procedures. Hypoesthesia is not a significant complication following ilioinguinal neurectomy and does not significantly add to the morbidity of the patient.

Smooth muscle tumours of the round ligament of the uterus are rare and can mimic an inguinal hernia. Preoperative diagnosis can be established by imaging of the abdomen or an exploration of the inguinal canal. Surgical excision is the curative treatment .