Context: Abnormal uterine bleeding (AUB) is a common crippling gynaecological condition with vast financial implications. A structured approach for establishing the cause using the FIGO defined PALM-COEIN (Polyp, Adenomyosis, Leiomyoma, Malignancy (and hyperplasia), Coagulopathy, Ovulatory disorders, Endometrial, Iatrogenic and Not otherwise classified) classification system will facilitate accurate diagnosis and inform treatment options. Aims and objectives: 1. Clinico-pathological evaluation of patients presenting with chronic AUB. 2. Etiological stratification of patients with chronic AUB in accordance to PALM-COEIN Classification. 3. To determine frequency of various uterine histopathological findings and their associated etiologies in the population of Nalgonda district.

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Kikuchi-Fujimoto disease is a rare benign, condition of necrotizing histiocytic lymphadenitis. A case of a 21 year old gentleman is described here. He presented with fever, weight loss and non-tender cervical lymph nodes. Kikuchi-Fujimoto disease was diagnosed after cervical lymph node biopsy. Symptomatic treatment was provided and an uneventful full recovery was made. BACKGROUND: The presenting complaint of neck masses in association with non-specific systemic signs and symptoms prompt investigation towards the more common diagnoses. However, rarer conditions like Kikuchi-Fujimoto disease must be included in the differential diagnosis of necrotizing lymphadenopathies such as tuberculosis, lupus erythematosus and lymphoma as its course and treatment are entirely different. (1) Here in we discuss a case of male patient who presented with a neck mass that was not attributable to the more common causes. KEYWORDS: Cervical lymphadenopathy kikuchi-fujimoto disease. CASE PRESENTATION:A 21 year old male patient presented with a two week history of fever, anorexia and weight loss. There were no other complaints. He had been previously fit and well and was on no medication. On examination, he was lethargic, but otherwise looked well. He was afebrile and hemodynamically stable. Significant findings were generalized lymphadenopathy, palpable in the cervical and axillary regions.There was no evidence of hepatosplenomegaly. Blood tests revealed neutropenia, hyponatraemia, raised alkaline phosphate and C-reactive protein. Electrocardiogram and chest radiographs were normal. His initial management consisted of fluid restriction and regular paracetamol, whilst results of further tests were awaited. These included blood and sputum cultures, autoimmune and viral screens.Subsequently there was a reduction in size and tenderness of the cervical lymph nodes. There were persistent intermittent temperature spikes and a two day episode of self-resolved diarrhea.Blood, urine and stool cultures were negative. Sputum cultures grew respiratory tract flora and were negative for acid-fast bacilli. The autoimmune screen was negative, as was toxoplasma and cytomegalovirus screens.Computerized tomography demonstrated cervical and axillary lymphadenopathy The abdominal viscera were normal.Excisional biopsy of a cervical lymph node confirmed a diagnosis of Kikuchi-Fujimoto disease (KFD). Histological analysis showed histiocytic granulomatous infiltration with widespread paracortical necrosis of the lymph node, extensive karyorrhectic debris and scattered fibrin deposits and sheets of foam cells. Special stains for acid fast bacilli (Ziehl-Neelsen) and fungi (Gomori's methanamine silver and periodic acid Schiff with diastase) did not reveal any micro-organisms.

Back ground: Spinal SOLs are quite fascinating group of lesions, comprising a minority of central nervous system lesions often resulting in significant morbidity. There is paucity of comprehensive population-based data of these SOLs in Indian subcontinent.    Material and methods: The present study was a retrospective descriptive study conducted at the department of pathology, Kamineni Institute of Medical Sciences for 3 years starting from January 2017 to December 2019.   Results: We analyzed eighty-nine spinal SOLs during the study period. Spinal neoplasms encompassed the largest number accounting for 70.7% of total spinal SOLs. Majority were reported in the 20-40 years’ age group with predominant male preponderance except for universal phenomenon of female predominance in meningioma. Back pain was the most common clinical presentation. Among spinal neoplasms, NSTs comprising of schwannoma and neurofibroma, was the most common finding and spinal tuberculosis was the most common non-neoplastic SOL. Majority of benign spinal tumors were distributed in the intradural extra medullary location and involved thoracic vertebrae. Malignant tumors predominantly involved extradural location and were clustered along thoracic and lumbar vertebrae. Measure of agreement between radiological and histopathological diagnosis using kappa statistics revealed almost perfect agreement for extradural spinal SOLs and moderate agreement for intradural intramedullary and intradural extra medullary SOLs.   Conclusion: Comprehensive evaluation of spinal SOLs warrants multidisciplinary approach. Rapid advancements in radiology optimised diagnostic evaluation of non-neoplastic SOLs, however we conclude that histopathological evaluation is still the gold standard for diagnosis of primary spinal cord tumours and for planning the treatment and predicting prognosis.

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