Hydatid cyst in the breast is rare. We report a case of hydatid cyst in the breast in a 30-year-old Indian rural woman who presented with a lump in her left breast. MRI findings showed a cystic lesion in the breast. Histopathological examination showed features consistent with hydatid cyst with surrounding adherent pericystic breast tissue showing fibrocollagenisation and inflammatory response. ELISA for echinococcal antigen was also found to be positive. This case emphasises that preoperative diagnosis of hydatid cyst in the breast is difficult and often missed as the breast is a rare site of echinococcal infection and clinical and imaging findings are wide and non-specific. Cytological diagnosis by fine-needle aspiration may not always be possible. Therefore, hydatid cyst in the breast should always be considered in the differential diagnosis of a breast lump and histopathological confirmation is necessary for early and appropriate treatment.

A 45-year-old Indian woman presented in neurosurgery outpatient with seizures, headache and vomiting for the past 1 month. MRI of the brain was suggestive of a malignant central nervous system (CNS) tumour. Histological and immunohistochemical examinations of stereotactic biopsy of the tumour were diagnostic of a low-grade diffuse small lymphocytic lymphoma of the CNS. No evidence of any occult systemic lymphoma was observed, confirming its ‘primary’ origin in the CNS. The diagnosis of a low-grade primary CNS lymphoma (PCNSL) is difficult as clinical and neuroradiological features are wide and variable. The clinical course is more indolent than a high-grade PCNSL and thus, a less aggressive and localised targeted treatment could be sufficient rather than the high dose, neurotoxic methotrexate-based chemotherapeutic treatment, recommended for high-grade PCNSL. Histological and immunohistological confirmation is therefore mandatory for early, appropriate treatment and prognostic implications.

Hypoplastic coronary artery disease (HCAD) is a rare coronary artery anomaly that may be the cause of sudden death. It can involve a single or all coronary arteries. This anomaly may cause circulatory insufficiency leading to myocardial infarction. HCAD has no symptoms or may exhibit cardiovascular signs like syncope, dyspnea, chest discomfort, or dizziness. It is often diagnosed at autopsy, and early diagnosis is made with a coronary angiogram. We report HCAD as the cause of the sudden death of a 25-year-old female with a history of loss of consciousness following exertion. On autopsy, all the coronary arteries’ lumen was narrowed with thin vessel walls. Histopathological examination shows an underdeveloped and missing muscular layer of the left anterior descending and circumflex coronary arteries’ vascular wall. Many cases of HCAD diagnosed by radiographic imaging in living patients have been reported in the literature, but a structural anomaly of coronaries leading to HCAD has not been reported. We report a case of HCAD describing the histopathological examination findings of the vascular wall of coronary vessels illustrating the structural difference.

A 7-year-old Indian girl presented with symptoms of excessive development of breasts, early menarche, growth of pubic hairs, accelerated growth and abdominal distension. On clinical examination, a large right abdominopelvic mass was palpable. MRI revealed a large, heterogeneous, solid and cystic tumour in the right adnexal region, suggestive of an ovarian neoplasm. The hormonal profile showed markedly elevated oestradiol and low follicle-stimulating hormone levels. Clinical diagnosis of precocious puberty with right ovarian mass was concluded. Right-sided salpingo-oophorectomy was performed. Histopathology showed features consistent with sclerosing stromal tumour of the ovary. Postoperatively, signs and symptoms of precocity gradually regressed and her serum oestradiol level came down to normal. This is the first reported case from India.

A 32-year-old Indian woman presented with swelling in the anterior part of the neck for the last 3 years. Clinical and radiological examination and fine needle aspiration cytology suggested the diagnosis of multinodular goitre. A subtotal thyroidectomy was performed by the surgeon and the specimen was submitted for the final diagnosis. Histological examination of the specimen revealed multiple caseating tubercular granulomas coexistent with multinodular goitre and adenomatous hyperplasia. The sections demonstrated acid-fast tubercle bacteria, confirming the diagnosis of tubercular thyroiditis. This case emphasises that tubercular thyroiditis should always be considered in patients with thyroid swelling or nodule, in countries where the prevalence of tuberculosis is high.