Annular elastolytic giant cell granuloma is a condition characterized histologically by damaged elastic fibers associated with preponderance of giant cells along with absence of necrobiosis, lipid, mucin, and pallisading granuloma. It usually occurs on sun-damaged skin and hence the previous name actinic granuloma. A similar process occurs on the conjunctiva. Over the past three decades only four cases of conjunctival actinic granuloma have been documented. All the previous patients were females with lesions in nasal or temporal bulbar conjunctiva varying 2-3 mm in size. We report a male patient aged 70 years presenting with a 14 mm × 7 mm fleshy mass on right lower bulbar conjunctiva. Clinical differential diagnoses were lymphoma, squamous cell carcinoma in situ and amyloidosis. Surgical excision followed by histopathology confirmed it to be a case of actinic granuloma. This is the first case of isolated conjunctival actinic granuloma of such a large size reported from India.

Background: Leprosy (Hansen’s disease) is one of the major health problems of the world especially in developing countries. In India, it was first described in “Sushruta Samhita” & treated by Chaulmoogra oil and caused by Mycobacterium Leprae. Early diagnosis of leprosy, an absolute necessity for control as well as effective therapy. For this, clinical diagnosis, skin smear examination is adequate coupled with histo-pathological examination of skin and nerve lesions with modified Fite Faraco stain for demonstration of acid-fast bacilli. Moreover, bacillary index is required for adequate combined chemotherapy regimen. Detection of anti PGL-1 antibodies in serum gives an added advantage for detection and monitoring treatment. Materials & Methods : A total of 85 cases of leprosy who attended outpatient department of Skin & VD, Shri Sayaji General Hospital Baroda chosen for study during ‘07-08’ period with 75 cases from leprosy hospital, Baroda which included 50 detected patients and 25 child contacts with 25 healthy voluntary blood donors from blood bank, SSGH selected. Clinical, past and family history taken with slit skin smears stained with Z-N stain, graded and histopathological evaluation done. Serological study done from serum of leprosy patients and healthy blood donors; tested by Serodia Kitsand interpretation made. Results: Most cases were in 2nd to 4th decade and males dominated. Clinically most cases were of indeterminate and tuberculoid type and histologically indeterminate and border-line tuberculoid. Clinico-histopathological correlation was found most in indeterminate followed by histoid type. Voluntary blood donors were seronegative. 21 out of 48 multibacillary cases and 6 out of 28 pauci-bacillary showed seropositivity for anti PGL-1 anti-bodies (p<0.001) Conclusion: All suspected leprosy cases clinically should be subjected to slit skin smear examination with histopathological evaluation; bacillary study which helps in diagnosis and adequate treatment of patients. Detection of antibodies to PGL-1 in patients indicate presence of leprosy bacilli and useful in preclinical diagnosis and determining progress of therapy. DOI: http://dx.doi.org/10.3329/bjms.v13i3.9153 Bangladesh Journal of Medical Science Vol.13(3) 2014 p.316-322

Context:Extra-nasal rhinosporidiosis is not uncommon in endemic region like India. Clinical presentations of extra-nasal rhinosporidiosis lesion often lead to diagnostic dilemma. Cytology can help in the preoperative diagnosis of such lesions.Aims:The aims of our study were to find the clinico-pathological presentation of extra-nasal rhinosporidiosis and to evaluate the role of cytology in diagnosing these lesions preoperatively.Settings and Design:Fine-needle aspiration cytology is often used for preoperative diagnosis of sub-cutaneous lesions of the head and neck region. This retrospective study was designed to include the cytologically diagnosed cases of rhinosporidiosis and to compare with final histopathology of the lesions.Materials and Methods:A total of 21 cases of extra-nasal rhinosporidiosis were diagnosed in our study period of 18 months. Cytology was approached in 17 cases and 16 cases were diagnosed as rhinosporidiosis, which were included in the study group. Twelve cases were sampled by fine-needle aspiration and four cases by scrap technique. Histopathological confirmation was possible in all cytologically diagnosed cases.Results:Head and neck region were involved in 15 cases and only one case was on the skin of right upper arm. Orbital region was the most common extra-nasal site of involvement. Most of the cases (13 cases, 81.25%) belonged to the age group of 11-30 years. All cytologicaly diagnosed cases of rhinosporidiosis were concordant with histopathology. Only one false-negative case was cytologically diagnosed as suppurative inflammatory lesion. Sensitivity and specificity of cytology in diagnosis of extra-nasal rhinosporidiosis were 94.11% and 100% respectively.Conclusions:Extra-nasal rhinosporidiosis is an important differential diagnosis of nodular, polypoid mass of head-neck-face region. Cytology can be used as an important tool in preoperative diagnosis of extra-nasal rhinosporidiosis.

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