No abstract

Desmoplastic small round cell tumor (DSRCT) is a rare abdominal malignancy usually diagnosed in young adult males. Most patients have widespread disease at presentation, with an organ of origin difficult to ascertain. A 33-year-old female presented to her gynecologist with complaints of suprapubic pressure, abdominal pain, and increased abdominal girth. She had a large intraabdominal tumor on ultrasound, thought to be ovarian cancer. She underwent surgical exploration, which confirmed a malignancy, but the exact etiology was uncertain. Final pathology was consistent with DSRCT. DSRCT is a rare malignancy that can mimic other more commonly seen tumors such as lymphoma and ovarian cancer. When encountering an extensive intraabdominal malignancy of uncertain etiology, DSRCT should be in the differential diagnosis.

The lungs are discovered to have been involved by metastasis from extrathoracic tumors in about 30% to 41% of patients at autopsy.1,2 Pulmonary metastasis may mimic primary lung cancer appearing as a single parenchymal lesion and the clinical picture may be indistinguishable from a centrally located bronchogenic carcinoma if the metastasis involves a major bronchus. Such involvement of bronchi by metastatic deposits has been documented by various authors in necropsy series 3,4 or follow-up studies. 5 To highlight the danger of misdiagnosis and consequent inappropriate therapy in such patients, especially if the primary tumor is not evident, we discuss" a rare presentation of renal cell carcinoma (RCC) presenting with pulmonary symptoms more than one year prior to the detection of the primary lesion. Case ReportA 50-year-old male, first seen elsewhere, presented with a history of cough with expectoration and hemoptysis associated with intermittent fever of six months' duration. He was reported to have chest signs and a radiological picture suggestive of pulmonary tuberculosis. Although he did not have AFB-positive sputum, antitubercular treatment was started empirically (isoniazid, rifampicin and ethambutol). After six months of treatment, in the absence of any response, the treatment was stopped. He was referred to us two months later with a diagnosis of bronchogenic carcinoma, complaining of progressive shortness of breath in addition to the previously recorded symptoms.On admission, he was afebrile, with a pulse rate of 85/min and regular and his BP was 160/90 mmHg. There was no lymphadenopathy or clubbing. Examination of his chest revealed a wheeze which was more prominent on the left side and features of consolidation in the mid-lung field on the left side. The rest of the examination was unremarkable. Blood tests, urine examination and EKG were within normal limits. Sputum examination did not reveal any AFB or malignant cells. Chest x-ray showed a large, irregular, homogenous, hilar opacity extending into the left upper and middle zones and a left paratracheal gland (Figure 1).

Systemic lupus erythematosus (SLE) is one of the most common autoimmune disorders in women during their child bearing age and is being recognized increasingly throughout the world. The female to male ratio is 9:1 when the female is in child bearing age. The fundamental defect in SLE is failure of regulatory mechanisms to sustain self tolerance. SLE can involve any organ and the most common visceral organ involved is the kidney. Renal disease occurs approximately in half the patients with SLE as immune mediated nephritis is a common complication. A kidney biopsy is thus essential in renal assessment of patients with SLE. Almost all patients of SLE have abnormalities of renal biopsy especially if histopathology is supplemented by immunofluorescence and electron microscopy. Renal biopsy using WHO classification provides valuable information concerning the risk of renal failure even 10 years after initial 1,2 biopsy and plays a major role in management of lupus. MethodsThis study was conducted on 35 percutaneous renal biopsies of SLE patients received in our department over a period of two and a half years (BACKGROUND: Renal involvement in Systemic lupus erythematosus (SLE) can display diverse morphological patterns. OBJECTIVES: To study the histopathological changes along with activity and chronicity of lesions in kidney biopsies of patients with SLE.METHODS: Thirty-five renal biopsies of SLE patients were received during two and a half years period. The biopsies were classified according to the WHO classification. Immunofluorescence pattern was also studied and correlated with histological features.RESULTS: There were 32(91.4%) females and 3(8.6%) males. Age of the subjects ranged from 15 to 60 years with a mean age of 33.48 years. The most common class of lupus nephritis was class IV which was observed in 54.29% of biopsies. Immunofluorescence was performed in 30 biopsies and all these were positive for various antisera with anti-IgG positivity in 27(90%). Mesangial deposits were seen in 13(43.3%) cases followed by granular deposits in 9(30%) cases. CONCLUSION: Majority of SLE cases at SKIMS present during the severe course of the disease. JMS 2012;15(2):162-65