The anterior mediastinal cysts and masses (AMCM) can be of varied origin and presentation. Although the space in the mediastinum is limited the cysts and masses can grow to a large size before the presentation. They displace the adjacent structures and then can grow into the pleural cavities thereby acquiring a large size. We share our experience of a case of a huge anterior mediastinal cystic mass in a young female who had a characteristic presentation of sudden onset breathlessness in the supine position and immediate relief in the sitting position. The patient recovered well after surgical treatment.

Background: Bacille calmette–guerin (BCG) vaccine containing live-attenuated Mycobacterium bovis was first used in humans to prevent tuberculosis in 1921. It is a safe vaccine. However, there can be minor adverse reactions such as pain, swelling, and redness at local injection site. The lesser known severe adverse reactions such as lymphadenitis, BCG osteitis, and disseminated BCG infection can be present after BCG vaccination. Aims and Objectives: The aim of the study was to report the cases of BCG lymphadenitis diagnosed by fine needle aspiration cytology (FNAC) after BCG vaccination in infants and children. Materials and Methods: All the infants and children (1 month–2 years) who presented with regional lymphadenopathy for FNAC after BCG vaccination were included in the study. Results: Total 21 patients with BCG lymphadenitis were recruited. In all the cases, the lymphadenitis involved ipsilateral left axillary lymph nodes. In three patient sites of involvement included the left supraclavicular lymph nodes and in other three patients left cervical lymph nodes along with left axillary lymph node. Sixteen patients had suppurative granulomatous lymphadenitis (SGLA) on FNAC and positive for Ziehl–Neelsen (ZN) staining for acid fast bacilli (AFB), while rest nine had non-suppurative granulomatous lymphadenitis (NSGLA) with negative for ZN staining for AFB. Conclusion: Early diagnosis of BCG lymphadenitis can help in proper management. Furthermore, it can prevent unnecessary anti tubercular treatment in children.

Background and objectiveNasal and paranasal lesions are one of the most common otorhinolaryngological presentations encountered in clinical practice. Common presenting symptoms of these lesion range from nasal blockades, facial swellings, pain, nasal discharge, and epistaxis to orbital and ear symptoms. Diagnosis can be tricky as these symptoms are common in inflammatory conditions and tumors. The aim of our study was to observe the epidemiology and clinical pathological findings in patients with nasal and paranasal masses presenting to our institute and discuss the challenges in proper diagnosis and management due to similar presentations, and the role of histopathological examination (HPE) and immunohistochemistry (IHC) in overcoming these challenges.