A ccording to the World Health Organization, the annual tuberculosis (TB) burden in India was 2.2 million in 2012; this figure constitutes one quarter of global TB cases per year.1 Genitourinary TB is a common form of extrapulmonary TB, accounting for 27% (range: 14-41%) of all cases of extrapulmonary TB in developed countries.2 Usually, genitourinary TB is a complication in 3-4% of pulmonary TB cases.3 Active genitourinary TB generally occurs between five and 15 years after a primary pulmonary infection with Mycobacterium tuberculosis. 4 Despite its status as the most common form of genitourinary TB, renal TB is very rare in the paediatric population. 5Genitourinary TB mostly presents with irritative voiding symptoms, haematuria and flank pain. Presentation as a mass lesion is extremely rare and few cases have been published in the literature to date. [7][8][9][10] This report describes a two-year-old child who presented with a renal mass and was diagnosed with renal TB via a post-nephroureterectomy histopathological examination. Case ReportA two-year-old girl presented to a private health clinic in Kolkata, India, with non-specific abdominal pain of three months' duration. As she did not improve with symptomatic management and anthelmintic therapy, she was referred to the Nil Ratan Sircar Medical College, Kolkata, India, in June 2014 for further evaluation. There was no history of fever, vomiting, altered bowel habits, abdominal distension or changes in urinary frequency or colour over the preceding three months. In addition, no appetite or weight loss had been observed by the parents. The child Genitourinary tuberculosis usually occurs in young adults and the middle-aged and is very uncommon in the paediatric population. It generally presents with haematuria, pyuria, irritative voiding symptoms and flank pain; presentation as a renal mass is highly unusual. We report a two-year-old girl who was referred to the Nil Ratan Sircar Medical College, Kolkata, India, in June 2014 with abdominal pain. Subsequent radiological investigations revealed a left renal hypoechoic mass lesion. A left nephroureterectomy was performed on suspicion of a Wilms' tumour. Histopathology indicated an epithelioid granuloma with lymphocytic infiltration, suggestive of a tubercular aetiology. A Mantoux tuberculin skin test was positive; however, there was no evidence of tuberculosis detected elsewhere in the body and the source of the infection could not be identified. A diagnosis of renal tuberculosis was made and the child was treated with antitubercular drugs. The patient was asymptomatic at a six-month follow-up.

Choriocarcinoma include a spectrum of chorionic neoplasms that may be gestational or non-gestational. By virtue of their high vascularity and affinity of trophoblast for blood vessels, metastases often occur early, and the most common site of such metastases is the lung. Metastatic pleural effusions from choriocarcinoma are infrequent. Pleural seeding usually results from extension of a sub-pleural peripheral nodule. We describe a case of gestational choriocarcinoma whose clinical presentation was medical like hemothorax as in our case rather than gynecologic.

Context:Currently treatment decisions in asthma are governed by clinical assessment and spirometry. Sputum eosinophil, being a marker of airway inflammation, can serve as a tool for assessing severity and response to treatment in asthma patients.Aims:To establish correlation between change in sputum eosinophil count and forced expiratory volume in one second (FEV1)% predicted value of asthma patients in response to treatment. In this study, we also predicted prognosis and treatment outcome of asthma patients from baseline sputum eosinophil count.Settings and Design:A longitudinal study was conducted to determine the treatment outcome among newly diagnosed asthma patients who were classified into A (n = 80) and B (n = 80) groups on the basis of initial sputum eosinophil count (A ≥ 3% and B < 3%).Materials and Methods:After starting treatment according to Global Initiative for Asthma Guideline, both A and B groups were evaluated every 15 days interval for the 1st month and monthly thereafter for a total duration of 12 months. In each follow-up visit detailed history, induced sputum eosinophil count and spirometry were done to evaluate severity and treatment outcome.Results:FEV1% predicted of group A asthma patients gradually increased and sputum eosinophil count gradually decreased on treatment. Longer time was required to achieve satisfactory improvement (FEV1% predicted) in asthma patients with sputum eosinophil count ≥3%. There was statistically significant negative correlation between FEV1% predicted and sputum eosinophil count (%) in of group A patients in each follow-up visit, with most significant negative correlation found in 8th visit (r = −0.9237 and P = < 0.001). Change in mean FEV1% (predicted) from baseline showed strong positive correlation (r = 0.976) with change in reduction of mean sputum eosinophil count at each follow-up visits in group A patients.Conclusions:Sputum eosinophil count, being an excellent biomarker of airway inflammation, can serve as a useful marker to assess disease severity, treatment outcome, and prognosis in asthma patients.