For the foreseeable future, vaccines are the cornerstone in the global campaign against the Coronavirus Disease-19 (COVID-19) pandemic. As the number and fatalities due to COVID-19 decline and the lockdown anywise rescinded, we recognize an increase in the incidence of autoimmune disease post-COVID-19 vaccination. However, the causality of the most vaccine-induced side effects is debatable and, at best, limited to a temporal correlation. We herein report a case of a 51-year-old gentleman who developed Anti-Neutrophil Cytoplasmic Antibody (ANCA)-associated vasculitis (AAV) 2 week post-COVID-19 vaccination. The patient responded favorably to oral steroids and rituximab. Additionally, we conducted a case-based review of vaccine-associated AAV describing their clinical manifestations and treatment response of this emerging entity. Supplementary Information The online version contains supplementary material available at 10.1007/s00296-021-05069-x.
Cytoblocks prepared from residual tissue fluids and fine-needle aspirations can be useful adjuncts to smears for establishing a more definitive cytopathologic diagnosis. These paraffin embedded cytoblocks have been popular since these can be handled like any other histologic specimen. Rapid on-site evaluation (ROSE) can help in attaining adequate material in the cytoblock, which is a major concern to the cytopathologists. Ancillary studies can be done using cytoblocks including IHC and various molecular techniques. The opportunities for cytopathologists to influence therapy, and uncover strategies in the complex field of lung cancer are exciting and limitless especially in the presence of an adequate cytoblock
Background: Cholecystitis is one of the most common indications for abdominal surgery. Routine examination of gallbladder grossly and microscopically shows lot of interesting findings. This study aims to quantify the various outcomes of routine gallbladder examination following cholecystectomy procedure.Methods: All clinical details and data from case sheet and patient history are collected and analysed for all the patients who underwent cholecystectomy surgery in the Department of General Surgery, Govt. Omandurar Medical College, Chennai, from August 2017 to August 2018. The Study period of this study was from August 2017 to August 2018. Three sections each from neck, body and fundus taken. Tissues were processed in automated tissue processor and paraffin blocks made. Statistical analysis of the data was done.Results: Total number of specimens received were 36. And among the cases the number of females were 33 and the number of males were 3. The number of cases of calculous cholecystitis were 31 and the number of cases with pigment stones were 26, number of cases with cholesterol stone were 2 and the number of cases with mixed stones were 3. The number of cases of acalculous cholecystitis were 5. The number of cases of cholecystectomy by laproscopy were 30 whereas the number of cases of cholecystectomy by open procedure were 6. Chronic cholecystitis was seen in 34 cases and chronic cholecystitis with stones was seen in 29 cases and chronic cholecystitis without stones was seen in 5 cases and Acute on chronic cholecystitis with pigment stone was seen in 1 case and xanthogranulomatous cholecystitis with pigment stone was seen in 1 case.Conclusions: The risk factors for developing chronic cholecystitis was seen in female gender. The predominant histomorphological pattern seen in this study group is chronic calculous cholecystitis. And the predominant type of stone found in this study is pigment stone compared to mixed and cholesterol stone.
Stratified mucin-producing intraepithelial lesion (SMILE) is an intraepithelial lesion with overlapping features of the high-grade squamous intraepithelial lesion (HSIL) and adenocarcinoma in situ (AIS). Currently, it is well described in the cervix. We present a case showing similar SMILE-like lesions in the polypectomy specimen from the anal canal along with invasive adenocarcinoma components. This lesion showed an immuno-profile characteristic of a SMILE lesion described in the cervix, such as p63 negativity, high ki67 index, and nuclear positivity for p16. It might be arising from the Human papillomavirus prone transitional region of the anal canal as described in the cervix. However, we could not assure this association and etiological link due to insufficient material in the formalin-fixed paraffin-embedded block. Notwithstanding, we strongly suggest that the HPV is the main driver for this SMILE-like lesion similar to what is described in the cervix. To our knowledge, this is the first case report of a SMILE lesion in the anal canal. Further studies will be required to elucidate the underlying pathogenetic mechanism of SMILE-like lesions described in the anal canal.
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