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Yolk sac tumour is the most common germ cell tumour in infants and children, with a majority of them arising in the gonads. Rare cases of extra - gonadal germ cell tumours have been described in the literature. We are presenting here, a case of a yolk sac tumour of the cryptorchid testis in a 2 year old child, who initially presented with a mass in the left lobe of the liver, with huge ascites and which posed diagnostic difficulties. The mass was diagnosed as hepatoblastoma on Computed Tomography (CT). Subsequently, CT guided Fine Needle Aspiration Cytology (FNAC) of the liver mass showed the features of a yolk sac tumour. The raised serum Alfa Foetoprotein (AFP) levels corroborated with the cytological diagnosis.

BACKGROUND Alcoholic Liver Disease (ALD) is the cause of about 14 million premature deaths per year worldwide. 1 Alcohol induced liver injury is the most prevalent cause of liver disease and affects 10-20% of the populations worldwide. 2 Chronic alcohol consumption gives rise to various health hazards including liver disease, pancreatitis, central nervous system disorders, peripheral neuropathies and certain forms of cancer. Various haematological and biochemical changes are also seen in a chronic alcoholic patients that further worsen the clinical condition of the patient. The objective of the present study to evaluate clinical and haematological changes that occur in alcoholic liver disease patients and early identification of abnormalities in haematological indices. METHODS This observational, non-interventional hospital-based study was done at North Bengal Medical College and Hospital in the department of General Medicine for a duration of one year from March 2018 to February 2019. Total 200 cases diagnosed alcoholic liver disease patients were included in the study. Clinical history, examination, biochemical and haematological parameters, and USG of abdomen were studied. RESULTS Patients' age ranged from 30 to 60 years and male to female ratio was 2:1. Majority of the patients were in the age group of 41 to 50 years (42%). Anorexia, abdominal pain, jaundice, ascites and splenomegaly were predominant symptoms and signs. Common haematological abnormalities were anaemia, thrombocytopenia and raised PT. Common types of anaemia were normocytic normochromic (58%) and macrocytic (58%). CONCLUSIONS Long duration excessive alcohol ingestion not only leads to acute and chronic liver disorder but also affect haematological indices. Pancytopenia, megaloblastic anaemia, increased PT, INR are some characteristic haematological abnormality in ALD.

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