IntroductionForeign body ingestion is a common problem encountered in the pediatric age group. Impaction of lithium batteries of greater than 20-mm diameter in the esophagus is associated with severe complications. This study aimed at analyzing the evolving trends of button battery ingestion in pediatric age groups at our tertiary care center in terms of clinical presentation, intraoperative findings, and the correlation of various clinical variables.MethodsA retrospective observational study was done. All children younger than 18 years with impaction of a button battery of size greater than 20 mm in the esophagus between January 2015 and December 2018 were included in the study. All children underwent removal of the battery using direct laryngoscopy/rigid esophagoscopy under general anesthesia.ResultsThere were 100 children included in the study with a mean age of 29.92 months having 93 children (93%) younger than 6 years. The mean duration of impaction was 34.7 hours. Increased duration of impaction was associated with an increased risk of complications and an increased difficulty in removal. There was a significant correlation between the site of impaction and the age of the patient. Complications were seen in 10% of cases with severe complications in 6 cases. No fatalities were reported in this study.ConclusionsButton batteries impacted in the esophagus can lead to severe complications including death. There has been an increasing trend in the ingestion of button batteries over the last 4 years. A prompt diagnosis and emergent removal of the battery are crucial to minimize the rate of complications. Symptoms of stridor and dysphagia must be given more attention, and these children are prioritized because they are more prone to have complications. Furthermore, primary prevention and caregiver education should be emphasized, and the need for a legislation to change the policies for securing the batteries in their products must be endorsed.

Background Histoplasmosis is an endemic granulomatous fungal infection which rarely infects the larynx; less than 100 cases have been reported in medical literature till date. Case presentation A 6-year-old female child, a diagnosed case of B cell acute lymphoblastic leukemia since past 2 years and on chemotherapy, presented with hoarseness and dysphagia since past 2 months. Direct laryngoscopy revealed granular appearance of posterior pharyngeal wall and the supra-glottic larynx. Histopathological examination and bone marrow aspiration confirmed the diagnosis of disseminated histoplasmosis. Conclusions Pharyngo-laryngeal histoplasmosis should be considered in the differential diagnosis of an immunocompromised patient presenting with persistent hoarseness.

<p class="abstract">Plasmablastic lymphoma (PbL) is a rare and aggressive neoplasm with heterogeneous clinical, histological and genetic features. It has been reported in both immuno-compromised and immuno-competent patients and commonly presents in the extra-nodal regions, but it is more heterogeneous in immuno-competent patients. Its clinical course is aggressive with early dissemination and poor response to therapy. A 61 year old male presented with left sided nasal bleeding and nasal obstruction for last 6 months, snoring and disturbed sleep for last 2 months. On examination, there was fullness over left side of nose and obliteration of left naso-facial groove. A mass lesion was seen in the left nasal cavity on endoscopy. There was bulge in the soft palate and the mass extended into the oropharynx. CECT showed a locally aggressive sino-nasal mass. Histopathology and immuno-histo-chemistry (IHC) of the biopsy were suggestive of plasmablastic lymphoma. A debulking surgery was done to relieve his obstructive symptoms. The patient received 3 cycles of EPOCH chemotherapy and radiotherapy to local site. At 9 months of follow up he presented with recurrence of the mass. Plasmablastic lymphoma presents in patients other than those with HIV. Awareness about its unique characteristics is crucial for establishing a correct diagnosis. Currently available treatments are ineffective in achieving long term remission and prognosis remains unfavourable with high incidence of recurrence</p>