The granulocytic “shift to left” reflects marrow response to bacterial infection, and this may be quantified as band count or immature granulocyte count (IGC). The former value, used widely in neonatal sepsis, has been notoriously difficult to measure accurately and precisely. A reproducible, precise, and accurate counting of immature granulocyte counts may be possible with automation. This study of 200 febrile patients aimed at analysing the performance characteristics of automated immature granulocytes (AIGs) in predicting blood culture and their clinical utility. The absolute (IGC) and relative IG count (IG%) had area under curve (AUC) of 0.69 and 0.66. Moreover, the means of IGC and IG% between culture positive and negative groups were statistically significant suggesting that they are potential markers for bacteremia. IGC of 0.03 × 103 cu·mm and IG% of 0.5% offered sensitivity of 86.3% and 92.2%, respectively, and may be used for screening for bacteremia. Higher values, IGC > 0.3, and IG% > 3 had specificity greater than 90%, although the values were infrequent. It may not be long before that these automated hemograms are put into regular diagnostic use.

Anastomosing hemangioma (AH) is a rare vascular tumor, which has a predilection for the genitourinary system. Ovarian AH is rare, only few cases have been reported in literature so far. Here, we report a case of 50-year-old woman with right ovarian mass clinically diagnosed as ovarian epithelial malignancy. We received a specimen of hysterectomy with bilateral salpingo-oophorectomy. Grossly, the right ovary showed a well-demarcated solid and spongy lesion with congested areas which was continuous with a cystic lesion, the wall of which showed luteinization. Microscopy revealed a vaguely lobulated lesion composed of anastomosing capillaries with sinusoidal pattern lined by cytologically bland endothelial cells with hobnail appearance in an edematous and hyalinized stroma. Focal areas showed fibrin thrombi within the capillaries. Immunohistochemically, the endothelial cells were strongly positive for CD31 and CD34. The surrounding ovarian parenchyma showed stromal luteinization.

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Meningiomas are the most common primary intracranial tumors in adults. Although Grade I meningiomas are considered benign, Grade II/III (atypical and anaplastic) meningiomas are known to be locally aggressive, recurrent, and rarely present with distant metastases. We report a 40-year-old female with recurrent atypical meningioma (WHO Grade II) who presented with features suggestive of a massive right-sided pleural effusion. Imaging showed bilateral large pleural-based lesions, and histopathological examination and immunohistochemistry of the mass were consistent with metastatic atypical meningioma. A high index of suspicion is warranted to detect extracranial metastases, especially in patients with recurrent meningiomas and higher WHO grade of tumor.

Aim:We report an uncommon case of uterine inflammatory myofibroblastic tumor (IMT), a unique mesenchymal tumor often misdiagnosed as "fibroid uterus" on radiology. Background: Inflammatory myofibroblastic tumor is a mesenchymal tumor reported in the lungs, mesentery, omentum, and retroperitoneum. Its occurrence in the uterus is rare and is often misidentified as a smooth muscle or endometrial stromal tumor. Herein, we report a case of IMT of the uterus. Case description: A 33-year-old lady presented to the OP with menorrhagia. USG abdomen was reported as bulky uterus with an intra-mural (8.7 × 7 cm) fibroid arising from the anterior myometrium. No lymph nodes or free fluid noted. "Myomectomy" was done under spinal anesthesia, and the specimen was sent for HPE. Grossly, it was a circumscribed gray-white soft-tissue mass mimicking a leiomyoma. However, microscopy of the mass was rather unusual to call it a leiomyoma. It had a "tissue-culture-like" or "nodular fasciitis-like" appearance. There were spindle cells in fascicles and prominent myxoid change with lymphoplasmacytic infiltrate. No nuclear atypia, necrosis, or infiltrative margins were noted. So, a morphological diagnosis of IMT was made. Conclusion:The case is reported for its diagnostic challenge and rarity. Clinical significance: Inflammatory myofibroblastic tumors are uncommon mesenchymal tumors of low malignant potential with a tendency to recur and rare metastases. Surgical excision is the treatment of choice. Recurrent IMTs can be treated with ALK-based targeted therapy.