MICROFILARIA IN A ROUTINE PAP SMEAR.

Filariasis is endemic in India and accounts for about 40% of the total global disease burden - in 2000 over 120 million people were infected by lariasis and about 40 million were disgured and incapacitated due [1] to lymphatic obstruction and lymphedema. In India, Uttar Pradesh, Bihar, Orissa, Jharkhand, Gujarat, Andhra Pradesh, Tamil Nadu, and [2] Kerala are mainly affected

Lymphangioma of the Mesentery: Case Report and Review of the Literature

Background: Lymphangioma of the mesentery is a rare benign condition. Lymphangioma usually occurs in children during first few years of life most likely because of congenital abnormality of the lymphatic system. It may also be caused by trauma, lymphatic obstruction, surgery, inflammatory process, or radiotherapy. Lymphangioma of the mesentery represents less than 1% of all lymphangiomas and about 70% of abdominal lymphangiomas.Case presentation: We report the case of the 42-year-old woman who was diagnosed with the lymphangioma. Laparotomy was performed. A cystic lymph-filled tumor of about 12 cm in diameter was removed from the ileum mesentery. Conclusions: Lymphangioma of the mesentery is a rare condition. Despite its benign nature, it can cause serious complications if not treated. Ultrasound and CT are used for detection of lymphangioma. It is important to surgically remove the lymphangiomas even in the absence of symptoms.

A rare entity of non-filarial lymphedema

Patient is a 77 year old female who presented to the outpatient dermatology clinic due to progressive massive leg swelling. Physical exam demonstrated bilateral lower extremity chronic lymphedema with stasis dermatitis changes with the left more significant than the right. The patient was diagnosed with elephantiasis nostras verrucosa (ENV) and was treated with leg elevation and arranged for follow-up with a chronic lymphedema clinic. ENV is a rare complication of non-filarial chronic lymphedema. Its pathogenesis is characterized by long-standing lymphatic obstruction, which may occur due to a variety of obstructive diseases. This can lead to accumulation of proteinaceous fluid in the dermis and subcutaneous tissues causing further lymphatic obstruction and edema followed by hyperkeratosis, fibrosis, and formation of papillated, verrucous papules. Differential diagnoses to consider include venous stasis dermatitis, cellulitis, lipodermatosclerosis, pretibial myxedema, and lymphatic filariasis. Mainstays of treatment of ENV include elevation of the affected body part, compressive hosiery, and antibiotic prophylaxis for superimposed infection [1].

Determination of Cervical Metastases by Lymphoscintigraphy in Patients with Oral Cancer: A Single Institute Experience

Background: Oral cancer is the sixth most common cancer in the world. Cervical metastasis is an important adverse prognostic factor and about 40% of the patients with oral cancer develop lymphatic metastasis. Lymphoscintigraphy is the minimally invasive method for the detection of cervical nodal metastasis. The aim of the study was to detect the lymphatic involvement with the aid of lymphoscnitigraphy in patient with oral cancer undergoing surgical procedure and to find out the accuracy of the findings with the post operative histopathological diagnosis. Patients and methods: A total of 30 patients with histologically proven oral cancer underwent lymphoscintigraphic evaluation to detect the lymphatic spread of the tumor. The findings and results of lymphoscintigraphy were compared with the postoperative histopathological diagnosis. Results: Among the 30 patients, lymphatic obstruction was observed in 19 patients of whom 15 patients had perfusion defect and 4 patients had gap defect. No lymphatic obstruction was evident in the rest 11 patients by lymphoscintigraphy. The calculated sensitivity of lymphoscintigraphy in diagnosis of cervical lymph node metastasis was 100%, specificity 78.6%, accuracy 90% and positive predictive value was 84.2% and negative predictive value was 100%. Conclusion: Lymphoscintigraphy was found to be an effective method in detecting lymph node involvement and can be used as an alternative to identify regional lymph nodes metastases pre-operatively in oral cancer patients. Thereby, it will help the surgeon to plan the extent of dissection before surgery which may decrease postoperative complications related to unnecessary extensive lymph node dissection and morbidity. Bangladesh J. Nuclear Med. 21(1): 12-15, January 2018

Role of the paraventricular nucleus in the reflex diuresis to pulmonary lymphatic obstruction in rabbits

The changes in urine flow and renal sympathetic nerve activity (RSNA) due to pulmonary lymphatic obstruction (PLO) were examined in anesthetized, artificially ventilated New Zealand white rabbits. PLO was produced by pressurizing an isolated pouch created in the right external jugular vein at the points of entry of the right lymphatic ducts. During this maneuver, urine flow increased from 8.5 ± 0.3 mL/10 min to 12 ± 0.5 mL/10 min (P < 0.0001) and RSNA increased from 24.0 ± 4 to 40.0 ± 5 μV·s (P < 0.0001). Bilateral lesioning of the paraventricular nucleus (PVN) of the hypothalamus or cervical vagotomy abolished these responses. PLO increased c-fos gene expression in the PVN. The increase in urine flow due to PLO was attenuated by muscimol and abolished by kynurenic acid microinjections into the PVN. The results show that (i) neurons in the PVN are an important relay site in the reflex arc, which is activated by PLO; and (ii) this activation is regulated by glutamatergic and partly by GABAergic input to the PVN.