Choriocarcinoma is a highly malignant trophoblastic neoplasia, arising following any type of pregnancy. Even though choriocarcinoma has an early haematogenous metastasis to multiple organs, spinal metastasis is extremely rare. A 28-year-old woman presented with a two-week history of progressive numbness and weakness of the lower limbs and difficulty in walking. In magnetic resonance imaging of the spine, soft tissue components were noted adjacent to the spinal cord. She underwent laminectomy to remove the extramedullary located tumour mass, which was compressing the spinal cord. Although there was a significant improvement in tactile stimulation in the lower limb following six courses of multi-agent chemotherapy, she continued to have leg weakness. Despite improvements in treatment modality and the use of combined modality treatment with chemotherapy, surgery, and radiation, the prognosis for this choriocarcinoma with spinal metastasis is unfavourable. Earlier diagnosis and multimodality treatment is crucial for a significant reduction in mortality and morbidity.
Primary Cardiac Lymphoma (PCL) is a very rare condition accounts for 2% of all primary cardiac tumours. This is a case report of a 76 year old male patient with shortness of breath, cough and pyrexia of unknown origin for 2 months. In the initial diagnostic workup, echocardiography revealed aortic and mitral regurgitation with no pericardial effusion. With the development of right sided pleural effusion about one month after the initial presentation, ultrasound scan guided pleural fluid aspiration performed. Pleural fluid culture revealed no bacterial growth. Second echocardiography showed no flow in the Superior Vena Cava (SVC) and suspected of a thrombus. Contrast enhanced Computed Tomography scan of the chest demonstrated a mass lesion in the right heart and distal inferior vena cava (IVC). The lesion was compressing the SVC without complete obstruction. The pericardium was intact with no pericardial effusion. No mediastinal lymphadenopathy identified. Initial differential diagnosis was leiomyosarcoma of the distal IVC extending in to the right heart. As there was no pericardial involvement, possibility of lymphoma was made as a remote cause. Subsequently digital subtraction angiography guided biopsy performed from the mass in the distal IVC and right atrium. Diffuse lymphoma was confirmed on histology. As there were no Hodgkin cells in the sample, probable diagnosis of Non-Hodgkin's lymphoma was made. Subsequently patient died due to cardiovascular compromise before starting specific therapy.
Background: According to the National Cancer Registry of 2019, lymphoma was the eighth commonest malignancy in males and the tenth commonest malignancy in females in Sri Lanka. There is only one previously published study on the distribution of lymphoma subtypes in the Sri Lankan population. Objectives: The objectives of this study were to describe the morphological spectrum and the pattern distribution of subtypes of lymphomas in a cohort of Sri Lankan patients according to the latest World Health Organization (WHO) classification 2016, and to identify the limitations encountered in the process of laboratory diagnosis. Method: This was a descriptive, cross-sectional study carried out in Departments of Histopathology of the
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