Verruciform xanthoma is a very uncommon papillary growth seen chiefly in the oral mucosa. The presence of foam cells in the connective tissue papillae between the epithelial rete ridges forms the hallmark in its diagnosis. There has been wide speculation and various hypotheses put forth in explaining the etiopathogenesis of verruciform xanthoma and the origin of foam cells. This article aims to update the different hypotheses in understanding the pathogenesis of the lesion.

Introduction: Computed tomography guided fine needle aspiration cytology is a safe and well established technique for the diagnosis of lung and mediastinal lesions. This study was carried out in the department of pathology in the tertiary health care and teaching institute where radiology department is well established. The aim was to study the cytomorphology of the spectrum of the lung and mediastinal lesions and to correlate the cytological diagnosis with the radiological diagnosis. Material and methods: Computed tomography guided fine needle aspiration cytology was done in 90 pateints after taking written consent of the patient. Patients were explained the benefits and risks of the procedure. The results were analysed. Results: A total of 90 patients were included in the study. There were 81 patients of lung lesions and nine patients of mediastinal lesions. There were 63(70%) males and 27(30%) females. Adequate aspirate was obtained in 77 patients giving the adequacy rate of 85.55%. Adenocarcinoma was the most common type of lung malignancy and Non Hodgkins Lymphoma was the most common malignancy in the mediastinum. Inflammatory lesions were seen in 13 cases. Granulomatous lesions were found in six patients. One interesting case of hydatid with aspergillosis was diagnosed on cytology smears, which on radiology was diagnosed as neoplastic. Pneumothorax was seen in three patients. No patient required chest tube insertion. Conclusion: Computed tomography guided fine needle aspiration cytology is a safe and reliable method for the diagnosis of lung and mediastinal lesions. It can help in early diagnosis and initiation of the treatment avoiding major surgical procedures.

Four cases of NPA with extra-nasopharyngeal extensions have been presented, two of which had an intracranial extension. On of the cases with intracranial extension underwent a transtemporal craniotomy removal and four temporal fossa. The other three cases were managed by the sublabial and transantral routes. Methods of pre-operative diagnosis of such extensions have been discussed and the importance of pre-operative recognition of extension in every NPA has been emphasized. Various approaches to the lateral and intracranial extensions have been reviewed. We feel that, for lateral extensions, sublabial and/or transantral or transzygomatic approaches are adequate, while the radical approach of Karnik is to be preferred only in large lateral extensions and in cases of intracranial extensions without symptoms of a space-occupying intracranial lesion. However, for patients with intracranial symptoms, a staged procedure is indicated and is safe for the patient.

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Introduction: Maternal death (MD) is defined as death of a woman occurring while pregnant or within 42 days of termination of pregnancy irrespective of the duration or its management. Accidental or incidental causes are not included. Maternal mortality rate (MMR) of the region indicates the quality of maternal health care, availability of health care facilities and overall socio-economical status of the population in general. It is essential to know the exact cause responsible for maternal death which is possible by detailed autopsy and careful pathological study under expert guidance. Material and Methods: Autopsy study was performed in 100 consecutive cases of maternal deaths, over a period of 22 months. Detailed gross and microscopic examination of the visceral organs that included uterus, placenta was carried out in all cases of maternal deaths. Analysis of pathological findings was done in the light of available clinical data. Results: Out of the 100 cases of maternal deaths 87% belonged to age group of 21 to 30 years. There were 52% deaths in antenatal period. Direct causes were responsible for maternal deaths in 52% cases, indirect causes in 43% cases and in 5% cases the causes were coincidental. Conclusion: Direct causes of MD were more frequent than indirect causes in the present study. Haemorrhage being the most common direct cause of MD. Lesser accessibility to health care facilities at peripheral health centres for the prospective mothers is highlighted by the present study.