Annals of Pathology and Laboratory Medicine

Spectrum of Patterns in Lymph Node Histopathology at A Tertiary Healthcare Centre in Hadoti Region

Vandana Pathak — 2024-05-07

Background

Lymph nodes are an integral part of immune system and, being the most widely distributed and easily accessible lymphoid tissue so they are frequently examined for diagnostic purposes. It is necessary to document the spectrum in a particular region to understand the trend and diseases occurring frequently in that region. The aim of this study is to evaluate spectrum of histopathological diagnosis among multiple etiologies of lymphadenopathy.

Methods

This is a retrospective descriptive study undertaken in the Department of Pathology, Government Medical College, Kota of all the lymph node biopsies received in our department over a period of one year from January 2023 to December 2023.

Result

A total of 102 patients were included, out of which females are 60 (59%) cases and males constituted 42 (41%) cases. Most common affected age group was 21-40 years and site was cervical with 42 (41.17%) cases. 54 cases (52.94%) showed changes of reactive lymphadenitis. Hodgkin and non-Hodgkin lymphoma ratio in male to female was 3:1, while that of tubercular lymphadenitis was 3:10. Metastatic squamous cell carcinoma and infiltrating ductal carcinoma was seen contributing to 10 (40%) cases each.

Conclusion

It is evident that most common pattern in lymph node pathology is reactive lymphadenitis, affecting age group 21-40 years, majorly affecting females. Females are mostly involved in cases of tuberculosis with ratio being 3:10. In developing country such as India, this points to frequent population exposure to infections. This could indicate a need to strengthen primary and secondary levels of preventive measures.

Epidermoid Cyst Localized in Bilateral Palatine Tonsils – A Rare Case Report

Krishna Vijaykumar Mistry — 2024-05-07

Epidermoid cysts (ECs) are benign lesions that can occur throughout the body, but they have a low incidence in the head and neck region (1.6 to 7%). In the oral cavity, the most commonly affected site is the floor of the mouth, while tonsillar location remains extremely rare (less than 0.01%). Here, we present a case of bilateral epidermoid cysts of the palatine tonsils, which were incidentally detected in a patient.

Xanthogranulomatous Pyelonephritis: An Uncommon Case Report Mimicking Sarcomatoid Renal Cell Carcinoma

Ruchi Agrawal — 2024-05-07

Introduction:

Xanthogranulomatous pyelonephritis (XGP) is an atypical form of chronic pyelonephritis characterized by the destruction of renal parenchyma and its replacement with a chronic inflammatory infiltrate of xanthoma cells.

Case Report:

A 46-year-old male presented in the surgery outpatient department with abdominal pain and recurrent fever. Contrast-enhancing computed tomography (CECT) revealed a lobulated, irregularly shaped, heterogeneously enhancing lesion in the left kidney arising from the upper pole with mitotic activity. Left total nephrectomy was performed, and the specimen was sent for histopathology. The specimen measured 12x8.5x5.3cm. Grossly, a globular mass lesion measuring 9x7x2.4 cm was observed at the upper pole of the kidney. On cutting, an unencapsulated grey-white solid mass with ill-defined margins was identified in the upper pole of the kidney. Microscopically, sheets and bundles of oval to spindle-shaped cells amidst chronic inflammatory infiltrate and giant cells were seen. These cells exhibited moderate pleomorphism with large vesicular nuclei, irregular nuclear margins, clumped chromatin, and pale to eosinophilic ample cytoplasm. Immunohistochemistry (IHC) revealed strong positivity for both vimentin and CD68 and negativity for cytokeratin, CD10, and desmin. The final diagnosis of XGP was made.

Conclusion:

XGP has earned the title of the "great imitator" due to its overlapping gross and microscopic features with renal cell carcinoma (RCC). This overlap often leads to a delay in reaching a specific diagnosis. However, immunohistochemistry (IHC) helps to avoid such misdiagnoses in the majority of cases.