A Rare Case of True Pancreatic Cyst.

Pancreatic cysts can be true or pseudocysts. True pancreatic cysts in children are rare clinical entities. We present a 23-month-old boy with a cystic lesion in the distal body and tail of the pancreas which on histopathology was found to be a rare true congenital simple cyst of the pancreas.

Risk Prediction Scoring System to Predict the Postsurgical Outcomes of Biliary Atresia.

Aim: To find out association between liver function, liver histopathology and outcomes of biliary atresia (BA) following Kasai Portoenterostomy (KPE).

Materials And Methods: This is a retrospective study of children who underwent KPE at a single institute by single surgeon. The patient records analyzed and data of complete blood counts, liver function tests, coagulation profile and histopathology reports collected.

Intrapancreatic accessory spleen: an enigmatic entity.

Solitary hypervascular lesion in the distal body/tail of pancreas in a patient with non-specific abdominal symptoms is a diagnostic challenge. Neuroendocrine neoplasm (NEN) and metastasis from renal cell carcinoma are the most common differentials and intrapancreatic accessory spleen (IPAS) is the rarest of its differential diagnosis. We present, here, a case of a 56-year-old man with a space-occupying lesion in body/tail of pancreas that was preoperatively diagnosed as a NEN based on elevated chromogranin levels and hyperenhancing lesion on contrast-enhanced CT scan.

Autoimmune Pancreatitis Type II: First Report from India.

Autoimmune Pancreatitis (AIP) presents in two forms - Type I or lymphoplasmacytic sclerosing pancreatitis and Type II or idiopathic ducto-centric pancreatitis (IDCP). AIP II is rare in south Asia and, especially so, in India. Most patients have either Idiopathic Chronic Pancreatitis (ICP) or alcohol related chronic pancreatitis.

Spindle cell oncocytoma of adenohypophysis: Review of literature and report of another recurrent case.

Spindle cell oncocytoma (SCO) of adenohypophysis was first described in 2002 by Roncaroli et al. as a new entity in the tumors originating from adenohypophysis. It was subsequently recognized as a distinct entity in the 2007 WHO classification of CNS tumors and retained in the current updated classification.

Reporting the margin in pancreaticoduodenectomies: R0 versus R1.

Aim: This study was conducted to analyze the changes in margin positivity in pancreaticoduodenectomies, on using a standardized protocol, which bread loafs the pancreas and duodenum in the axial plane for adenocarcinomas arising in the pancreatic head, ampulla, terminal common bile duct (CBD), and duodenum, and then to assess whether these tumor subsets involve the margins in different ways.

Methods: The analysis was performed on 70 consecutive specimens, the pre-protocol specimens serving as the control group.

Results And Conclusions: Tumors originating from the pancreatic head, ampulla, terminal CBD, and duodenum showed a consistent increase in their R1 incidence, post-protocol.

Ileal duplication cyst in the elderly complicated by appendicitis: A rare case report and review of literature.

Introduction: Gastrointestinal duplication cysts are rare, generally found in infants and young adults. Adult presentation is rare.

Presentation Of The Case: We present an elderly lady who presented with right iliac fossa pain.

Common Hepatic Duct Mixed Adenoneuroendocrine Carcinoma Masquerading as Cholangiocarcinoma.

Bile duct mixed adenoneuroendocrine carcinoma (MANEC) is a rare entity. It is defined as having mixed elements of both neuroendocrine tumors (NET) and an adenocarcinoma element, the lesser component forming at least 30% of the tumor. It is a subtype of neuroendocrine carcinoma (NEC) showing both gland-forming epithelial tumor cells and neuroendocrine cells.

Intraoperative parathyroid hormone assay-cutting the Gordian knot.

Background: Hyperparathyroidism is treated by surgical excision of the hyperfunctioning parathyroid gland. In case of adenoma the single abnormal gland is removed, while in hyperplasias, a subtotal excision, that is, three-and-a-half of the four glands are removed. This therapeutic decision is made intraoperatively through frozen section evaluation and is sometimes problematic, due to a histological overlap between hyperplasia and the adenoma.

An unusual case of invasive Aspergillus ulcerative tracheobronchitis without involvement of lung parenchyma in a post-renal transplant patient.

We present the case of a 54-year-old male, who presented with respiratory complaints four months after he underwent renal transplantation. Bronchoscopy showed ulcerated mucosa of the left main bronchus and computed tomography (CT) of the thorax showed foci of air within the bronchial wall. A biopsy from the lesion showed septate fungal hyphae, dichotomously branching at acute angles.

Pathology for the HPB Surgeon.

Optimal care of a patient implies a good professional understanding between all the medical personnel involved in that patient's care. Similarly a basic understanding of the areas where surgery and pathology interact would go a long way, in clarifying the disease process in the patient. This review aims to cover a few topics in liver lesions, FNAC Vs core biopsy, IHC, Margin examination, and frozen sections, in order to improve the communication between these two specialities.

In search of the rainbow: colored inks in surgical pathology.

Introduction: Although surgical pathologists are aware of the multiple advantages that coloured inks contribute to surgical pathology practice, these coloured inks are not available in India and importing them is not a viable proposition. A systematic search for locally available coloring agents was done, and resulted in identifying specific shades within a popular set of children's hobby colors of a particular brand. They retain their bright distinct colors on paraffin blocks and sections.

Kearns Sayre Syndrome--case report with review of literature.

Kearns-Sayre Syndrome is form of rare mitochondrial cytopathy, first described by Thomas P. Kearns and George Pomeroy Sayre in 1958 and is characterized by progressive external opthalmoplegia, cardiac conduction block, pigmentary retinal degeneration, variable number of red ragged fibers on muscle biopsy. It presents before the child reaches the age of twenty.

Squamous cell carcinoma of tongue in a renal transplant recipient.

The overall incidence of malignancies in post renal transplant recipients is reported to be approximately 5 to 6%. Malignancies are significant complications after transplantation. Common malignancies include malignancies of the skin and post-transplant lymphoproliferative disorder (PTLD).

Retrorectal cyst hamartoma (tailgut cyst) with malignant transformation.

Background: Tailgut cyst [retrorectal hamartomas] is an unusual cystic lesion, located in the retrorectal space. It develops from post anal foetal gut remnants, present anterior to the sacrum and posterior to the rectum. A high index of clinical suspicion is required to diagnose this rare tumour.

Microcystic serous cystadenoma of the pancreas: a report of two cases with one of diffuse presentation.

Microcystic adenoma or serous cystadenoma is an uncommon tumor and accounts for 1-2% of the exocrine neoplasms of the pancreas. Usually unifocal, they present as single, large, well-demarcated multiloculated cystic tumors, ranging in size from 1 to 25 cm. Multifocal variants or diffuse serous cystadenomas are extremely rare.

HPV-associated carcinoma of esophagus in the young: a case report and review of literature.

Esophageal carcinoma (EC) is rare in the younger age group, with only 15 cases reported in world literature. It is even rarer for an etiological agent to be implicated.A case of a 15-yr-old boy with squamous cell carcinoma of the esophagus is reported.

Calcitonin-secreting tumor of the pancreas.

Pancreatic endocrine tumors (PETs) are unusual tumors arising from cells belonging generically to the amine precursor uptake and decarboxylation systems. We present a case of a calcitonin-secreting PET in a 56-year-old female who presented with watery diarrhea, dehydration and hypokalemia. Investigation revealed hypercalcemia, hyperphosphatemia, hypercalcitonemia and a well-defined mass in the head of the pancreas on CT scan.