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R Gondal

Publications and source records attributed to R Gondal.

At least 19 recordsLinked to original sources

Smear morphology of cryptococcosis presenting as a subcutaneous swelling in healthy adults: a report of three cases.

OBJECTIVE: To highlight the various morphological smear pattern in cases of subcutaneous Cryptococcus infection in healthy adults. METHOD: Cryptococcus is an opportunist fungus and primary infection is acquired through respiratory tract. Dissemination by blood stream results in systemic infection. Ten to 15% of systemic infection present as cutaneous lesions. Between December 2002 and April 2004 three healthy adults presented to us consecutively with subcutaneous swelling. RESULTS: We diagnosed these cases on FNAC as Cryptococcus. In all the three patients there was no history of local penetrating injury and any signs or symptoms of systemic disease. They were two male and one female, immuno competent and were negative for HIV 1 & 2 tested by ELISA. The sites were right abdominal flank, occipital and left anterior upper thigh. Aspirated materials were oily fibro fatty tissue and necrotic purulent materials. Cryptococcus numbers varied in all the smears so also their size and capsule thickness. Background smear morphology and tissue reaction were also different. It could be gelatinous, granulomatous, and cellulitic response or mixed responses and this can be picked up on cytological smears. Cultures were confirmatory in all the three cases. These lesions were resolved with antifungal treatment. CONCLUSION: Our brief article highlights the morphological spectrum on FNAC smears and diagnostic problems faced in these uncommon circumstances where the aspirates were purulent and the yeasts were small, few and thin walled. In the acute inflammatory smear with occasional giant cells and/or granulomas special stains like PAS or Mucicarmine are necessary to look for budding yeast of Cryptococcus with thin neck.

Adult↗

Benign signet ring cell change with multilayering in the gallbladder mucosa--a case report.

We describe a case of benign signet ring cell change in the gallbladder mucosa. On histopathological examination of H&E-stained sections, the gallbladder epithelium showed multilayering. The epithelial cells were large, columnar to polygonal with a small round basal or eccentric nucleus and vacuolated cytoplasm, giving them a signet ring appearance. There was no nuclear atypia, hyperchromatism or mitotic activity. The cells showed uniform positivity with mucicarmine, PAS and Alcian blue stains. The cytoplasmic vacuolations were negative for fat stains (Oil red O and Sudan IV). On immunohistochemistry, the cells showed positivity with antibodies for pancytokeratin (PCK) and epithelial membrane antigen (EMA). A diagnosis of benign signet ring cell change with multilayering in the gall bladder mucosa was made. Thoroughly reviewing the literature, we found only one case of benign signet ring cell aggregates in the gallbladder mucosa documented earlier. The lesion is hereby reported because of the unique histomorphology and the diagnostic dilemma which can occur as a malignant change in situ has to be excluded.

Adult↗

Periampullary gangliocytic paraganglioma.

A33-year-old man presented with features of obstructive jaundice. Enterohepatic retrograde cholangiopancreatography examination revealed a periampullary growth. After pancreatoduodenectomy, histologic examination of the growth revealed three elements: a spindle cell element, large ganglion cells, and smaller paraganglioma-like cells arranged in small nests and groups. A diagnosis of gangliocytic paraganglioma was given. Gangliocytic paraganglioma is a rare benign duodenal tumor, with uncertain histogenesis. It is possible to identify the three components that are essential for its diagnosis on routine hematoxylin and eosin sections without the use of immunohistochemical markers. Because this lesion may present clinically as a periampullary carcinoma, it is important to recognize and diagnose this rare, but benign, entity.

Adult↗

Ectopic meningioma of the paranasal sinuses.

An 11-year-old boy presented with epistaxis and proptosis. Plain X-ray revealed a bony mass in the nasal cavity. Computed tomography showed a high-density mass which at surgery turned out to be a meningioma.

Child↗

Solitary rectal ulcer syndrome.

Solitary rectal ulcer syndrome (SRUS) clinically presents with rectal bleed. Twenty three cases of SRUS are described highlighting that it is a distinct clinicopathological entity which can be diagnosed in the presence of typical clinical features, sigmoidoscopic findings and histopathological appearance of mucosal biopsy.

Adolescent↗

An unusual case of plasma cell granuloma involving lung and brain.

A young male aged 20 years had resection of the upper lobe of right lung for plasma cell granuloma. Five years later he developed three lesions in the brain, one of which was resected. Brain lesion showed similar histopathological picture. A unique case of plasma cell granuloma involving more than one organ is reported.

Adult↗

Tuberculous abscess of the brain stem.

Three cases of tuberculous abscess of the brain stem were treated with excision of the abscess supplemented with antitubercular therapy for 12 to 18 months. The lesions were frankly purulent and tubercle bacilli were demonstrated in the pus. A computed tomography scan demonstrated the site and extent of the lesion. Two of three patients developed the abscess during the course of antitubercular therapy for associated tubercular lesions. In spite of modern antitubercular treatment the abscess did not resolve and surgical excision had to be employed as a curative treatment.

Abscess↗

An autopsy study of rheumatic heart disease. Part II. Associated findings.

Histo-morphological changes of the coronary vessels in cases of rheumatic heart disease (RHD) have been studied in 60 cases. Involvement of intramyocardial branches of coronary vessels in the form of active rheumatic vasculitis or inactive lesions characterized by medial hypertrophy and replacement fibrosis was seen in 15 of 60 cases. These lesions may affect myocardial function. Atherosclerosis of the pulmonary trunk and its branches was frequently seen in these hearts, indicating that this may be an important index of pulmonary hypertension. An unusual association of bicuspid aortic stenosis and RHD was seen in one case. Another case showed acute myocardial infarction due to coronary embolism from bacterial vegetation of bacterial endocarditis.

Adolescent↗

Mycopathology of cerebral mycosis.

Seven cases of cerebral mycosis have been studied with respect to the pattern of distribution of the various cerebral fungi and the spectrum of histopathological changes. It has been found that aspergillosis is the most prevalent pathogen in our region unlike in the western world where candidosis dominates the picture. The relevant literature is discussed.

Adult↗