Chronic intractable ulcerative lesions, with or without lymphedema, are occasional sequelae of various sexually transmitted diseases that lead to gross morbidity. This study of 15 such cases, including seven of granuloma inguinale, four of lymphogranuloma venereum, three of confined lesions (granuloma inguinale and lymphogranuloma venereum), and one of sexually transmitted amebic ulcer of the penis, employed surgical procedures aimed at sound healing after a single-stage procedure. The surgical techniques included full skin cover by direct flaps, myocutaneous flaps, sliding flaps (floating island), and excision of the involved rectum (two cases). Nine lesions healed by primary intention, one by spontaneous contraction of the wound, and two needed limited secondary procedures. In view of the paucity of literature on the subject, an argument is made for identifying such cases and saving them from prolonged morbidity by a suitable single-stage surgical procedure.

Adolescent↗

PubMedDate not supplied

Marginal vacuoles in thyroid aspirates.

OBJECTIVES: To report on two cases of metastatic follicular carcinoma with marginal vacuoles (MVs) and review smear results in 441 solitary nodular goiters (SNGs) for this cytologic feature. STUDY DESIGN: The first case was a 55-year-old male who presented with a huge mass in the left hip region; the second case was a 50-year-old male with a thyroid nodule and a large mass on the scalp. The age of the 441 ultrasonographically diagnosed SNG cases ranged from 11 to 75 years. The May-Grünwald-Giemsa-stained fine needle aspiration (FNA) smears of these cases were reviewed by one of the authors (D.K.D.) for various cytomorphologic features, including MVs. RESULTS: FNA smears from the mass in the hip in the first case showed follicular cells with acinar formation and MVs, indicating metastatic follicular thyroid carcinoma (FTC). These features were of help in detecting the thyroid primary, which had previously gone undetected. Aspiration smears from the thyroid nodule and the mass on the scalp in the second case showed tumor cells of FTC with MVs and microfilariae. Review of 441 SNG cases revealed MVs in 42.6% of hyperplastic nodules; that rate was significantly higher (P < .001) than that of colloid goiter (5.2%) and neoplastic goiter (13.3%) but lower (P < .05) than that of thyrotoxic goiter (100%). MVs were limited to neoplasms with a follicular component; that included 15% of follicular neoplasms and 50% of follicular variant of papillary carcinoma (FVPC). The difference between FVPC and the rest of the neoplastic goiters (6%) was statistically significant (P = .002).

Adenocarcinoma, Follicular↗

PubMedDate not supplied

Littre's hernia in association with exstrophy of the urinary bladder in an adult.

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Adult↗

PubMedDate not supplied

Role of guided fine needle aspiration cytology in diagnosis and classification of liver malignancies.

Ultrasound or CT-guided fine needle aspiration was performed on 212 patients with space occupying lesions of the liver during a period of 5 years (1986-1990) to study the utility of fine needle aspiration (FNAC) in the diagnosis of hepatic malignancies. The initial FNAC diagnosis was malignancy in 91 cases. However, following review of the smears by one of the investigators (DKD) 93 (43.9%) cases were found to be malignant. Age of the patients with malignancy ranged from 20 days to 85 years. Male to female ratio was 57:36. The clinical diagnosis was malignancy in 58% which improved to 72% following imaging whereas nonspecific diagnosis was reduced from 34% to 20%. The primary malignancies consisted of 21 cases of hepatocellular carcinoma (HCC) and 7 hepatoblastomas. There were 61 metastatic lesions which included 43 adenocarcinomas, 6 small cell anaplastic carcinomas, 3 leiomyosarcomas, 2 cases each of malignant melanoma, paraganglioma and germ cell tumour, and one case each of squamous cell carcinoma, neuroendocrine tumour and undifferentiated carcinoma/soft tissue sarcoma. In two cases decision between HCC and secondaries was not possible. There were also two cases of non-Hodgkin's lymphoma. Thirty six percent of primary malignancies and 58% of secondaries were correctly diagnosed or suggested as one of the possibilities by combined clinical examination and imaging prior to FNAC. Thus, US/ CT guided FNAC played an important role in diagnosis and classification of malignancies of liver.

Adolescent↗