Biomedical subjects
Publications and source records attributed to M C Sharma.
Malignant melanoma presenting initially with disseminated disease is common. However, bilateral breast masses as the initial symptom of malignant melanoma are rare. One such case is detailed here, together with a review of literature.
Localized extramedullary collection of leukemic cells is termed as granulocytic sarcoma. Incidences of 2-8% in acute myeloid leukemia have been reported in various autopsy studies. In female it usually involves ovary. Since most of such tumors are asymptomatic, they are detected only at autopsy. We report here a case who manifested as abnormal vaginal bleeding, large cervical mass, renal failure, and aspergillous fungaemia. The patient died before she could be treated. From the present report it would appear that granulocytic sarcoma at times may precede other manifestations of leukemia.
Seven cases of adrenal myelolipoma comprising 5.8% of total adrenal tumors are described with a male-to-female ratio of 1.3:1. Five were symptomatic, of which 4 had a palpable abdominal mass, 2 cases detected incidentally were associated with carcinoma of the uterine cervix and renal cell carcinoma, respectively. The average age and duration of symptoms at presentation were 56 years (range 38-70 years) and 3.16 months (range 1-9 months). A CT scan was done in all cases, of which 5 showed a nonenhancing mass lesion with fat density diagnosed as adrenal myelolipoma. However, in 1 case radiological diagnosis of liposarcoma was maintained because of the huge size of the lesion whereas in another case the lesion was missed because of associated renal cell carcinoma. Interestingly the right adrenal was involved in all cases and the weight varied from 7 to 2,000 g. No recurrence was noted in the follow-up period (ranging from 3 months to 10 years).
OBJECTIVE: The purpose of our study was to examine imaging findings in patients with pachymeningeal tuberculosis. Imaging studies of seven patients with pachymeningeal tuberculosis were retrospectively reviewed. The diagnosis had been established on the basis of histopathology in three patients and response to antitubercular treatment in four patients. CONCLUSION: Tuberculosis can lead to localized or diffuse involvement of the pachymeninges. Most of the focal lesions were seen as en plaque, homogeneous, uniformly enhancing, dural-based masses. The lesions appeared hyperdense on plain CT scans, isointense to brain parenchyma on T1-weighted MR images, and isointense to hypointense on T2-weighted MR images. One patient had diffuse sheet-like thickening of the pachymeninges in the right hemicranium, involving both the supratentorial and infratentorial compartments.
During a period of four years three cases of solid and cystic (papillary) tumour of the pancreas were encountered. The patients presented predominantly with chief complaints of lump abdomen associated with dull aching pain in right hypochondrium. Radiologically diagnosis was suspected in two cases. Excessive bleeding during surgery was observed in two cases. In two survivors no recurrence or distant metastasis was noted after surgical excision (follow up 6 months to 3.5 years), third patient died after eight hours of operation.
In the present series, the clinical and pathological features of 29 patients of gliosarcoma diagnosed over a 12 yr period (1984-1995) are reviewed. Gliosarcomas constituted 0.48 per cent of all intracranial tumours and 4.9 per cent of all cases of glioblastoma multiforme. Most patients (68.6%) with these tumours were above 40 yr of age. However, an interesting observation in the present series was that 10.3 per cent of patients (3/29) were below 14 yr of age, the youngest being 9 months. A male preponderance was noted and the temporal lobe was involved in 55 per cent patients. Histologically, in 25 of the 29 tumours, the sarcomatous component had the appearance of fibrosarcoma. Tumours from 4 patients were unique in that one showed rhabdomyoblastic differentiation in the mesenchymal areas as confirmed by immunohistochemical stains and electron microscopy (gliomyosarcoma). In three others, the neoplastic spindle cell component was closely associated with discrete areas of osteogenic sarcoma. Follow up in 12 patients (including the 4 patients with unique variants) revealed poor outcome similar to glioblastomas. All of them died within 1 month to 1.5 yr following surgery and postoperative radiotherapy. This study possibly represents the most comprehensive and largest series of gliosarcomas being reported from India.
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Hepatic microsomal androstenedione 15 alpha-hydroxylase (i.e.cytochrome P450(15)alpha AD was purified from female CD-1 mice. Protein purification was monitored in eluates from Fractogel, DEAE-Sephacel, and hydroxylapatite columns at heme absorbing 417 nm, by cytochrome P450 content, reactivity to monoclonal antibody against female-specific rat cytochrome P450 2C12, and androstenedione 15 alpha-hydroxylase activity. The catalytic activity for androgens of the purified cytochrome P450(15)alpha AD, exhibiting a high degree of regioselectivity and stereospecificity, was restricted to the 7 alpha- and 15 alpha-hydroxylation of androstenedione, representing, respectively, > 5% and > 93% of the total metabolites. Polyclonal antibodies against cytochrome P450(15)alpha AD exhibited a concentration-dependent and very selective inhibition of hepatic microsomal androstenedione 7 alpha- and 15 alpha-hydroxylation and a 60% inhibition of benzphetamine demethylation, the latter drug appearing to be a much more effective substrate than androgens. Cytochrome P450(15)alpha AD accounted for about 3% of the total P450 in female mouse liver microsomes. The apparent subunit molecular weight of P450(15)alpha AD was 53,000, and the protein appeared as a single band or sodium dodecyl sulfate-polyacrylamide gels. The isoform was intensely expressed in both liver and lung of CD-1 female mice and was female-predominant in the livers of five or eight strains examined; it was sex-independent in the remaining three strains. Amino-terminal sequence analysis indicates that cytochrome P450(15)alpha AD is a member of the murine cytochrome P450 2c subfamily.
We describe a rare case of extramedullary plasmacytoma of the orbit in an 11-year-old boy. Immunoperoxidase staining of the tissue was positive for IgG, kappa chain and negative for lambda chain. Serum and urine electrophoresis showed no M spike. Systemic examination and bone marrow aspirate failed to show generalised involvement. The tumour was completely excised and radiotherapy given postoperatively.
In Churug-Strauss Syndrome (CSS), gastrointestinal tract (GIT) is an uncommon site of involvement. In addition to review of recent literature, we herein report a case of CSS with unusual involvement of GIT. The patient was being treated for idiopathic hypereosinophilic syndrome for 2 years; he later developed acute peritonitis and an emergency laparotomy revealed 3-cm-diameter perforation in the small intestine. In order to establish a correlation between the clinical features and the histopathological findings, we highlight the importance of adequate sampling and examination of mesenteric vessels in the attached mesentry in the resected specimen.
Intraparenchymal schwannomas of the CNS are extremely rare. Between 1979 and 1993 400 cases of intracranial schwannomas were operated on and among them were eight patients with intraparenchymal schwannomas comprising 2% of intracranial benign nerve sheath tumours. Four of them were located in the cerebral hemispheres and two each in the brain stem and in the cerebellum. In two cases, there was associated neurofibromatosis (NF-1 and NF-2, one case each). The age ranged from 6 months to 45 years with a male/female ratio of 3:1 and, surprisingly, six of them were in the left cerebral or cerebellar hemisphere.
A 38-year-old female with urachal carcinoma showed extensive bone metastases 1 year after wide excision of the urachal tumor, including partial cystectomy. A combination of radiotherapy and systemic chemotherapy was offered. Local radiotherapy of 8 Gy as a single fraction or 10 Gy in two fractions was delivered to the painful regions of the skeletal system. Multiagent chemotherapy consisting of methotrexate, vinblastine, Adriamycin, and cisplatin was given for three cycles. The patient died 28 months after the initial presentation with progression of the disease to pelvis and skeletal sites. The problem of metastatic spread after initial resection should be considered in urachal carcinoma, and adjuvant chemoradiotherapy should improve the outcome in this rare neoplasm.
Metastatic carcinoma to testis is an extremely rare but interesting phenomenon. Over a period of nineteen years 300 testicular tumors were diagnosed in our department, and of which 10 were metastatic carcinoma from other sites. Four of these patients (40%) presented as testicular lump of which two were already diagnosed cases of squamous cell carcinoma larynx and adenocarcinoma of lung, and two had occult primary in the kidney and colon. However six (60%) were detected incidentally in the orchiectomy done as a part of hormonal therapy for carcinoma prostate.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Kala-azar, or visceral leishmaniasis, in India is generally assumed to be a result of infection with Leishmania donovani. 15 parasite isolates collected over the past 10 years from patients with classical disease were typed by monoclonal antibodies, isoenzymes, and kDNA analysis. 4 were shown to be L tropica, a species historically associated with cutaneous disease and more recently a mild "visceralising" disease from the Desert Storm experience. The results confirm that L tropica is a co-endemic agent of visceral leishmaniasis in India, and may shed light on the rising frequency of therapeutic unresponsiveness to sodium antimony gluconate, which complicates treatment of this lethal disease.