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Adult granulosa cell tumors (AGCTs) are rare ovarian malignant neoplasms; their etiopathogenetic mechanisms remain largely unelucidated. Lately, defects in mismatch repair (MMR) have been implicated in the pathogenesis of AGCTs. Demonstration of MMR deficiency in these tumors can help identify patients potentially eligible for immune checkpoint inhibition therapy. The present study was done to explore the role of MMR deficiency in the etiopathogenesis of AGCTs.This was a retrospective study conducted on histopathologically confirmed AGCT cases. MMR protein expression was evaluated by immunohistochemistry (IHC) on tissue microarrays using an antibody panel of MSH2, MSH6, MLH1, and PMS2.Of a total of 40 ovarian AGCTs evaluated for MMR deficiency, none demonstrated loss of expression of any of the 4 MMR proteins.The results of our preliminary study show that there is no association between MMR deficiency with AGCT. Nevertheless, larger multicenter studies are needed to confirm or refute this observation.

Background The incidence of a bifid electrophoretic pattern in the albumin region on serum protein electrophoresis is an infrequent phenomenon. The availability of literature from India is scarce and is limited to case reports. Objective The aim of the study is to analyze the frequency of bisalbuminemia in an Indian referral facility. The study delved into their clinical associations. Material and Methods The retrospective case records of the patient from the departmental database were scrutinized. The study subjects were for an 8-year study period. Results There were about 39,900 serum electrophoresis performed in an 8-year study period. A total of 40 cases of bisalbuminemia were detected. The incidence in our cohort was 0.01%. Conclusion Bisalbuminemia, an overtly benign condition, is infrequent in Indian population although not rare. It is associated with several clinical disorders; however, the association seems to be plausibly coincidental.

Syphilis is a sexually transmitted infectious disease caused by the spirochete bacterium Treponema pallidum. A characteristic lesion of primary syphilis is chancre. It can develop over genital or extra genital sites, depending on the site of contact with the infectious agent. Cases of oral syphilis have been on the rise in the previous two decades, probably because of the involvement of the oral cavity in sexual practices. We here report an unusual case of primary syphilis who presented with a painless indurated oral ulcer over the lateral borders of the tongue.

Objectives: Immunosuppressed individuals are more prone for opportunistic infections. Pneumocystis jiroveci pneumonia (PJP), previously known as Pneumocystis carinii pneumonia (PCP), is the most common opportunistic infection affecting people living with HIV. As PJP can cause life threatening serious infection to a patient, treatment should not be delayed for these cases. To study clinico-cytomorphological spectrum of PJP. Material and Methods: We analysed the clinical and detailed cytological features of 15 patients with PJP who were diagnosed on examination of bronchoalveolar lavage (BAL) fluid. Results: The mean age of the patients was 38.4 years (range 13 – 61 years). A total of seven patients were HIV positive; five patients were post renal transplant, and one patient was a known case of acute leukaemia on immunosuppression. Presence of foamy alveolar casts (FACs) was the distinctive feature and was noted in 14 out of 15 cases. We detected 14 out of 15 cases accurately in BAL fluid cytology. Conclusion: BAL cytology is one of the important modes of investigations which can detect PJP infection. The history of fever, cough, immunosuppression, bilateral haziness in the radiography of lung and the characteristic alveolar cast indicate the possibility of PJP infection. Cytology can provide early diagnosis and can reduce the mortality of immunocompromised patients.

Triple-negative breast cancer (TNBC), a highly aggressive cancer with poor outcome and lacking specific diagnostic, prognostic, or targeted therapeutic strategies, constitutes roughly 20% of all breast cancer cases. TNBC cells lack receptors for estrogen, progesterone, and human epidermal growth factor. The effort continues to find a suitable correlate that could serve as a TNBC biomarker, or as therapeutic target, or both.A retrospective study was performed with 88 TNBC and 74 non-TNBC patients who had undergone mastectomy/lumpectomy with axillary clearance for carcinoma breast. Immunohistochemical staining was carried out for levels of proteinase-activated receptor 2 (PAR2), encoded by F2RL1 gene, and staining scores were calculated, based on intensity and percentage positivity.PAR2 levels were markedly upregulated in TNBC patients, compared with patients with other breast cancer subtypes. Amongst different non-TNBC subtypes, higher expression was noted in luminal B (88.8%) and HER2+ (100%), compared with luminal A (52.5%). PAR2 levels were significantly high in TNBC patients with age more than 40 years than corresponding patients of non-TNBC group (P=0.0017). Furthermore, there was a statistically significant increase in levels of PAR2 expression in lymph node negative (P=0.0096) and early stage (P=0.005) of TNBC versus non-TNBC patients. PAR2 staining of ductal carcinoma in situ and invasive ductal carcinoma revealed lower expression in invasive component.Our data suggest that PAR2 levels constitute a correlate of concern for TNBC, tying in with a recent report that higher levels of F2RL1 gene expression correlate with poorer disease-free, as well as overall survival in TNBCs.

Aim To explore the cytological spectrum of the gastrointestinal stromal tumour (GIST) including its metastatic sites. Material and methods A total of 42 patients (45 sites) diagnosed with GIST or its metastases on fine needle aspiration cytology were studied over a period of 5 years. May-Grunwald Giemsa- and haematoxylin and eosin-stained smears were reviewed and analysed for the cytomorphological spectrum of GIST. Results Primary GIST alone was seen in 24 cases, E-GIST in eight cases and metastasis in 11 cases (one patient showing metastasis at two distinct sites), whereas concurrent primary and metastatic lesions were noted in two cases. Amongst primary sites, the most commonly affected location was stomach (n = 22), followed by ileum (n = 2), duodenum (n = 1) and rectum (n = 1). Extra-GIST was seen in retroperitoneum and pelvis (n = 3 each), omentum and mediastinum (n = 1 each). Fine needle aspiration cytology was done from 11 metastatic sites of GIST which included liver, gall bladder fossa, chest wall, and thigh. The classic spindle cell arrangement was the predominant cytological pattern. About 8.8% cases showed predominant epithelioid cell morphology and 15.5% cases had a mixed cytomorphology comprising of both spindle cell and epithelioid cell patterns. Nuclear pseudoinclusions, perinuclear vacuoles and multinucleation were seen in four cases. Immunocytochemistry on cell-block sections for confirmation was performed in 18 cases and all these cases showed strong c-KIT positivity. Conclusion In this largest case series of cytomorphological diagnosis of GIST, we describe the cytomorphology and immunocytochemistry of primary and metastatic GIST. GISTs with predominant epithelioid cell morphology may pose a diagnostic dilemma therefore in all suspected cases of GIST, immunocytochemistry for c-KIT and/or DOG1 should be employed on cell-block preparations to confirm the diagnosis of GIST.

Invasive fungal infections are a significant cause of morbidity and mortality in patients systemic lupus erythematosus. The case illustrates the autopsy findings in a patient with systemic lupus erythematosus complicated by multiple fungal infections. Rare, uncommon manifestations of SLE such as mesenteric panniculitis and rhabdomyolysis were also present. High index of suspicion with timely intervention with aggressive antifungal was life-saving.

Objective: The aim of the study was to study the clinical and morphological spectrum of histoplasmosis diagnosed by fine needle aspiration cytology (FNAC). Study Design: A total of 17 patients diagnosed with histoplasmosis on FNAC were studied over a period of 5 years. The cytology smears were studied and analysed for the cytomorphological spectrum of histoplasmosis. Results: Among the 17 patients studied, the mean age was 51.3 years (range 6–84 years). Male-to-female ratio was 3.25:1 with 4 females and 13 males. The frequent sites of involvement were the lung (5), lymph node (4), adrenal gland (4), and skin (4). The most common cytological patterns were histiocytic collection, followed by granulomas and multinucleated giant cells. Necrosis was noted in only 4 cases. Conclusion: Fine needle aspiration is a highly accurate, rapid, and cheap technique for the diagnosis of histoplasmosis due to its distinct morphological features.

Background To differentiate pleomorphic adenoma (PA) and adenoid cystic carcinoma (ACC) on fine needle aspiration cytology (FNAC) is often challenging to cytologists. Aims In the present study, we tried to make an artificial neural network (ANN) model from the FNAC smears to differentiate PA from ACC. Methods The detailed cytomorphological features were analysed on the FNAC of histopathology proven cases of PA (n = 35) and ACC (n = 33) and enumerated semi-quantitatively by two independent observers. These data were used to make an ANN model to distinguish PA from ACC on FNAC material. We used neuro-intelligence software to build the ANN model. The network architecture was 10-2-1. The heuristic search engine was applied to have this model. We used backpropagation neural network to teach ANN. At least 500 iterations were done to train the model. The efficacy of this ANN model was assessed with the help of the confusion matrix and receiver operating characteristic curve. Result The data were separated automatically by the software as a training set (n = 48), validation set (n = 10) and test set (n = 10). The ANN model was able to differentiate every case (10/10) of PA and ACC in the final test set. The area under the receiver operating characteristic curve was 1. Conclusion The currently built ANN model is competent to identify PA and ACC cases on FNAC. Additional parameters and new cases can be incorporated into this open-ended ANN model to make it more robust.

Intraoperative crush/squash smear or frozen section consultation is routinely performed at several centers and offers rapid onsite assessment of tumor type and provides invaluable information to the neurosurgeons. The WHO classification of central nervous system neoplasms underwent a paradigm shift in 2016 with the incorporation of molecular data with the morphological features, such that several new entities came to be distinctly defined. With this paper, we present our experience at intraoperative consultation of brain tumors arising in posterior fossa and aim to apprise the pathologists with the spectrum of cytomorphologic appearances that can occur during such consultation and highlight the diagnostic dilemmas and pitfalls encountered in this setting.This is a retrospective observational study illustrating the salient morphological features of commonly encountered brain tumors arising in the posterior fossa (prototype example of each type) reported at our institute over a period of seven years. Both squash smears and rapid snap frozen section were prepared and stained with Toluidine blue and rapid hematoxylin and eosin (HE) stains.While the majority of tumors at this location comprise of pilocytic astrocytoma, ependymoma, and medulloblastoma, some rare examples may also arise; common differentials must be considered and prudently excluded to arrive at the diagnosis which is crucial in guiding the neurosurgeon. Both squash smears and rapid frozen section should be prepared and complement each other for rapid on-site evaluation.

Multicystic encephalomalacia is varying sized cystic lesions in the brain encountered in developing fetuses or infants. These cysts start at the periventricular area and may extend onto the cortex. The cause of the formation of these cystic lesions is secondary to an ischemic or hypoxic insult, which leads to liquefactive necrosis and subsequent formation of gliotic cyst walls having an admixture of microglia. We discuss four autopsy cases that had multicystic encephalomalacia to highlight the scenarios in which these lesions are encountered.

Background Small cell carcinoma of ovary (SCCO) is extremely rare. Two types of SCCO are recognized, the pulmonary type (SCCOPT) and the hypercalcemic type (SCCOHT). Establishing an accurate diagnosis is challenging, owing to its rarity and paucity of data describing the distinctive histopathologic and immunohistochemical (IHC) features. Methods This was a retrospective study conducted over a period of 4 years. All cases reported as SCCO on histopathology were retrieved. All the available clinical, histopathological, and IHC features were studied in detail. Results A total of 7 cases of SCCO were diagnosed during the study period. There were 4 cases of SCCOPT and 3 cases of SCCOHT and with mean age of 57.25 and 22 years, respectively. All the cases presented as stage IV disease. Among the SCCOPT cases, 3 showed bilateral involvement with 1 showing concurrent uterine endometrioid adenocarcinoma. Microscopy revealed small hyperchromatic cells with brisk mitosis and multifocal necrosis. On IHC, these were consistently positive for chromogranin, CD56, and synaptophysin. All the SCCOHT cases showed unilateral involvement. Microscopically, in addition to small hyperchromatic cells, larger “rhabdoid” tumor cells were also seen. On IHC, chromogranin was negative, with positivity for vimentin and epithelial membrane antigen. The expression of SMARCA4/BRG1 was lost while SMARCB1/INI1 was retained in all cases. All of these patients developed recurrence and died due to disease progression despite treatment. Conclusions SCCO is an extremely infrequent ovarian malignancy with poor prognosis. Knowledge about its characteristic features is important for accurate tissue diagnosis and appropriate management.

INTRODUCTION Any type of cutaneous metastasis indicates dismal outcome of the disease. Skin is an unusual location for metastatic deposits from any tumour and has an incidence of about 0.8%-5%. Fine needle aspiration cytology (FNAC) helps in the rapid diagnosis of metastasis with minimum pain. AIM To study the cytomorphological spectrum of cutaneous metastasis on FNAC. MATERIAL AND METHODS A total of 225 patients with diagnosis of cutaneous metastasis on cytology were analysed. May-Grunwald Giemsa and haematoxylin-eosin-stained smears were studied and examined for the cytomorphological spectrum of cutaneous metastasis. Cell block was prepared in a few cases. In a subset of cases, immunohistochemistry was done to pinpoint the primary. RESULTS Amongst the 225 patients studied, the mean age was 53.9 years. There was female preponderance with 125 females and 100 males. The commonest site was abdominal wall (n = 89) followed by chest wall (n = 60). The most common type of metastasising tumour was adenocarcinoma. CONCLUSION Clinicians and pathologists must be aware of the clinico-morphological spectrum of cutaneous metastasis for instant diagnosis followed by prompt management.

A 28-year old female presented with complaints of abdominal pain for 2 weeks and vomiting for 1 week. Abdominal ultrasonography (USG) revealed a 3x3 cm space-occupying solid lesion with necrotic areas in the pancreas. The patient was a known case of Ewing sarcoma of the pubic bone, diagnosed one year previously. USG guided fine-needle aspiration (FNA) from the pancreatic lesion was performed and smears were prepared, which were then stained with May-Grunwald-Giemsa (MGG) stain.

While adenoid cystic carcinoma is a common malignancy to arise within the salivary glands (21.9%) (Kokemueller et al. in Int J Oral Maxillofac Surg 33:25–31, 2004), it is seldom encountered as a tracheal mass and represents

Background: Adenoid cystic carcinoma (ACC) is a malignant neoplasm involving mainly the exocrine glands. The most common site of involvement is the head and neck region. However, the neoplasm can b...

Introduction Hematopoiesis usually occurs in bone marrow in adults and when it occurs at sites except for bone marrow, it is termed as extramedullary hematopoiesis (EMH). It is usually found in organs, which are vigorously involved in fetal hematopoiesis, including liver, spleen, and lymph nodes. FNAC is easy and rapid method to diagnose EMH. Aim To study the spectrum of extramedullary hematopoiesis (EMH) on fine-needle aspiration cytology (FNAC). Material and methods A total of 10 patients who were diagnosed with EMH on FNAC were studied over a period of 5.5 years. Smears were stained with May Grunwald Giemsa (MGG) and Hematoxylin and Eosin (H and E). The detailed clinical and cytomorphological spectrum of EMH were studied. Results The mean age of the patient was 42.5 years, with age ranging between 14 and 78 years. The commonest site of EMH was lymph node (n = 8, 80%) followed by paravertebral area (n = 2, 20%). Clinical diagnosis was EMH in just one case. Mean hemoglobin of the patient was 7.9 g/L. Bone marrow examination was available in 6 cases. On FNAC, we saw variable mixture of bone marrow elements including megakaryocytes (2.6%, 0-6%), myelocytes and metamyelocytes (29.2%, 18-33%), erythroid precursors (3.2%, 0-7%), polymorphs (21.7%, 10-36%), blasts (1.1%, 0-4%), eosinophils (2.5%, 0-7%), and lymphocytes (39.7%, 21-60%). Conclusion Cytopathologists must be alert of the clinical as well as cytological spectrum of extramedullary hematopoiesis for greater accuracy in diagnosis and to escape pitfalls in its diagnosis.

Introduction Hydatid disease (HD) is caused by the tapeworm of the genus Echinococcus. Fine-needle aspiration cytology (FNAC) is an expedient diagnostic technique that may be used for its rapid diagnosis. Aim To study the clinical and cytomorphological spectrum of HD diagnosed by cytology. Material and methods A total of 24 patients diagnosed with HD on FNAC and fluid were studied over a period of 5.5 years. May Grunwald Giemsa, Periodic acid Schiff, and Haematoxylin and Eosin stained smears were studied and analysed for the cytomorphological spectrum of HD. Results Amongst the 24 patients studied, the mean age was 29.8 years (range 6-64 years). There was equal sex preponderance with 12 males and 12 females. The most common organ involved was lung (54.1% of cases) followed by liver (25% of cases). Presence of laminated membranes (n-20, 83.3%) followed by presence of hooklets (n-13, 54.1%) were the common cytological features. Scolices and protoscolices representing endocyst were seen in 37.5% of cases (n-9). Conclusion Clinicians and pathologists should be aware of the clinical and morphological spectrum of HD respectively for immediate diagnosis followed by prompt management.

Introduction Adenoid cystic carcinoma (ACC) is a ubiquitous tumour which can occur in several sites of the human body. Commonly, it affects the salivary glands but also can rarely occur in various extra-salivary locations. Aim To study the clinical and cytological features of extra-salivary ACC on fine needle aspiration cytology. Methods In this paper, we included 27 patients with extra-salivary ACC on fine needle aspiration cytology over a period of 5.5 years. The complete cytomorphological spectrum of extra-salivary ACC was studied. Results The mean age of the patients was 50.2 years, with age ranging between 14 and 80 years. Male to female ratio was 1:1.7 with 17 females and 10 males. The most frequent primary site was the orbit, and the most frequent sites of metastasis were liver and lung. Conclusion Cytopathologists should be alert about the full range of location as well as the cytological spectrum of extra-salivary ACC for greater precision in diagnosis and prompt treatment.

During cell culture, trypsin, a serine protease, is applied to cells for 5-10 minutes to separate them from each other and from the underlying substratum so that they can be transferred to a different vessel, for re-plating, after growth medium containing 10 % serum has been added to the cells, in a well-known technique known as ‘passaging’. The serum in the growth medium contains alpha-1 antitrypsin, which is a potent inhibitor of trypsin, elastase and other serine proteases. Although what is used is bovine serum in which levels of proteins could be different from levels seen in humans, normal human serum contains A1AT (> 1 mg/ml; > ∼18 µmol/L) as well as trypsin itself (< 460 ng/ml, or ∼0.02 µmol/L), with the former in a ∼900-fold molar excess over the latter. Thus, it may be assumed there is also enough A1AT in the bovine serum added during passaging, to neutralize the trypsin (∼100 μM) present in the small volume of trypsin-EDTA solution used to separate cells. What are the consequences of not adding serum, when growth medium is added, or of maintaining cells for a few tens of hours in the presence of trypsin, in a serum-free growth medium? What does such sustained exposure to trypsin during cell culture do to cells? More generally, what are the responses of cells within an organism to the balance of trypsin and A1AT in the serum that bathes them constantly? We know that excesses and deficiencies in the levels of either trypsin or A1AT are associated with disease. We know that cellular metabolism can be influenced through signaling involving protease activated membrane GPCR receptors (PAR1-4). In particular, we know of a receptor called PAR2, which is specifically activated by trypsin, expressed by cells at baseline levels, and upregulated through some feedback involving trypsin-activation. We also know that cells at sites of injury or inflammation produce and secrete trypsin, and that this trypsin can act locally upon cells in a variety of ways, all of which have probably not yet been elucidated. Here, we show that sustained exposure to trypsin induces cells to de-differentiate into a stem-like state. We show that if serum is either not added at all, or added and then washed away (after confluency is attained), during cell culture, all cells exposed to exogenously-added trypsin undergo changes in morphology, transcriptome, secretome, and developmental potential, and transition into a state of stemness, in minimal essential medium (MEM). Regardless of their origins, i.e., independent of whether they are derived from primary cultures, cell lines or cancer cell lines, and regardless of the original cell type used, exposure to trypsin (∼10 µM; ∼250 µg/ml) at a concentration 10-fold lower than that used to separate cells during passaging (∼100 μM), over a period of 24-48 hours, causes cells to (1) become rounded, (2) cluster together, (3) get arrested in the G0/G1 stage of the cell cycle, (4) display increased presence of 5-hydroxymethyl cytosine in their nuclei (indicative of reprogramming), (5) display increased levels of activated PAR2 membrane receptor, (6) become capable of very efficient efflux of drug-mimicking dyes, (7) express factors and/or markers known to be associated with induction and/or attainment of stemness, with predominant expression of Sox-2 within cell nuclei; (8) display overall transcriptomic (RNASEQ) profiles characteristic of stemness; (9) secrete stemness-associated factors such as bFGF, and IL-1β, into the medium, in quantities sufficient to support autocrine function (in certain cases); and (10) display increased conversion of pro-MMPs into activated MMPs in the cell’s secretome. Notably, (11) inclusion of differentiating and/or transdifferentiating factors in the environment of such cells causes them to express markers associated with ectodermal, endodermal and mesodermal cell lineages and/or transdifferentiate into specific cell types, e.g., adipocytes or osteocytes.Most intriguingly of all, (12) the attained stemness appears to be reversible, i.e., withdrawal of trypsin from the medium prior to addition of any differentiating factors restores cells to their original morphology, also over a period of 24-48 hours. Further, (13) a known PAR2 agonist, and a known PAR2 antagonist, respectively, appear to mimic effects of trypsin addition and withdrawal/inhibition. In addition, (14) in experiments with a particular cancer characterized by high levels of stemness (TNBC; triple negative breast cancer), tissues of all TNBC patients express high levels of the PAR2 receptor, as do cells from a known TNBC-derived cell line. We propose that through their effects on PAR levels, and PAR activation status, the balance of trypsin and A1AT levels in organisms normally regulates cellular potential for differentiation, de-differentiation or transdifferentiation, in a local manner, with the default status being that A1AT inhibits trypsin and keeps cells differentiated, whereas sustained trypsin signaling at sites of injury through local production of trypsin helps to place cells into an intermediate state of stemness from which they can either return to their original differentiated state(s), or undergo factor-dependent differentiation, or transdifferentiation, into specific cell types or lineages. It is also possible that reduction in A1AT promotes regeneration. We present a core (RNASEQ-derived) signature for trypsin-induced stemness in human corneal fibroblasts (HCFs) and cells from a retinal pigment epithelial cell line (ARPE-19), noting that there are commonalities as well as differences between them, which suggests that this core signature will be amended with RNASEQ studies of more trypsin-exposed cell types. Our findings offer a possible explanation for the recent unexplained increase in the preference for serum-free protocols used for induction and maintenance of stemness involving iPSCs and mesenchymal stem cells. Also, our studies suggest a new approach to understanding and exploiting how organisms might use stemness, in adults. Trypsin-dominated serine protease induced reprogramming (SPIR) might offer a more natural, and suitably ‘softer’, method of reprogramming of cellular developmental potential for local regenerative requirements in animal tissues.

Purpose: To report a case of phacolytic glaucoma with rupture of anterior lens capsule in a case of hypermature cataract. Methods: Case report and literature review. Results: An 80-year-old woman presented with cloudiness and pain in the left eye for 1 day. The patient had visual acuity limited to perception of light with raised intraocular pressure of 70 mm Hg. Careful slit-lamp evaluation revealed corneal epithelial edema in superior quadrant and a deep and turbid anterior chamber. Ultrasound biomicroscopy confirmed the presence of a deep anterior chamber, a hypermature cataractous nucleus with lax capsular bag, and ruptured anterior lens capsule. The patient underwent extracapsular cataract extraction. Cytological examination of the lenticular fluid revealed the presence of lens protein-laden macrophages. Post-operatively, the patient had best-corrected visual acuity of 6/60 with advanced glaucomatous optic neuropathy. Conclusion: Phacolytic glaucoma can present with a cloudy cornea and a turbid anterior chamber mimicking endophthalmitis. Careful examination and ancillary investigations including ultrasound biomicroscopy was helpful in making an accurate diagnosis.

INTRODUCTION Malignant melanoma accounts for around 3% of all malignancies. Fine-needle aspiration cytology (FNAC) is a convenient diagnostic procedure for the diagnosis of melanoma and its metastases. AIM To explore the cytological spectrum of malignant melanoma including the rare metastatic sites. MATERIAL AND METHODS A total of 51 patients of malignant melanoma or its metastases on FNAC were studied over a period of 5 years. The FNAC smears of these cases were analyzed in detail by two different observers (GC and PD). RESULTS Among the 51 patients studied, the mean age was 54 years (range 19-97 years). Male-to-female ratio was 1.04:1 with 25 females and 26 males. The commonest primary site of the melanoma cases was lower extremity. The inguinal lymph node was the most common site for metastasis. Melanin pigment was the predominant feature followed by prominent nucleoli. Epithelioid pattern was the predominant shape. CONCLUSION Cytopathologists must be aware of the wide range of morphological spectrum seen in the cases of melanoma for a greater accuracy in diagnosis and to circumvent pitfalls in diagnosing melanoma.

Background: Vascular tumors of spleen represent a wide spectrum of lesions, ranging from benign to highly aggressive neoplasms. Among the benign tumors, localized hemangiomas are the most frequently encountered. Splenic hemangiomatosis is seldom seen especially in the pediatric population with anecdotal cases described in the literature. Case report: We present of 6-month-old child presenting with abdominal distention. The resected spleen was totally replaced with a hemangiomatous lesion. There were no other hemangiomatous foci outside the spleen. Conclusions: Hemangiomatosis limited to the spleen can occur in a child, and the present case demonstrates its characteristic histological features.

Phaeohyphomycosis is a rare mycotic infection caused by heterogenous groups of dematiaceous fungi involving the skin and subcutaneous tissue. Here, we report a case of cutaneous phaeohyphomycosis presenting as cauliflower-like verrucous lesion over the face in an immunocompetent individual. Histopathology showed suppurative granulomatous inflammation replete with pigmented broad fungal hyphae which is stained with periodic acid-Schiff stain, Grocott's methanamine silver stain, Schmorl's stain, and Masson-Fontana stain. Culture showed black-colored colonies identified as Exophiala spinifera.