Skin Manifestations in COVID-19: Prevalence and Relationship with Disease Severity

Background: Data on the clinical patterns and histopathology of SARS-CoV-2 related skin lesions, as well as on their relationship with the severity of COVID-19 are limited. Methods and Materials: Retrospective analysis of a prospectively collected cohort of patients with SARS-CoV-2 infection in a teaching hospital in Barcelona, Spain, from 1 April to 1 May 2020. Clinical, microbiological and therapeutic characteristics, clinicopathological patterns of skin lesions, and direct immunofluorescence and immunohistochemical findings in skin biopsies were analyzed. Results: Fifty-eight out of the 2761 patients (2.1%) either consulting to the emergency room or admitted to the hospital for COVID-19 suspicion during the study period presented COVID-19 related skin lesions. Cutaneous lesions could be categorized into six patterns represented by the acronym “GROUCH”: Generalized maculo-papular (20.7%), Grover’s disease and other papulo-vesicular eruptions (13.8%), livedo Reticularis (6.9%), Other eruptions (22.4%), Urticarial (6.9%), and CHilblain-like (29.3%). Skin biopsies were performed in 72.4%, including direct immunofluorescence in 71.4% and immunohistochemistry in 28.6%. Patients with chilblain-like lesions exhibited a characteristic histology and were significantly younger and presented lower rates of systemic symptoms, radiological lung infiltrates and analytical abnormalities, and hospital and ICU admission compared to the rest of patients. Conclusion: Cutaneous lesions in patients with COVID-19 appear to be relatively rare and varied. Patients with chilblain-like lesions have a characteristic clinicopathological pattern and a less severe presentation of COVID-19.

Xanthogranulomatous salpingo-oophoritis mimicking an ovarian malignancy: a clinical dilemma

Background: Xanthogranulomatoussalpingo-oophoritis is an uncommon form of chronic inflammation in the genitourinary tract. Its symptoms and radiological findings mimic ovarian malignancy. Aim of this study was to evaluate the clinicopathological pattern of xanthogranulomatous salphingo oophoritis.Methods: This study was conducted in the department of pathology, Government Medical College, Srinagar. It was a retrospective study done over a period of 5 years, November 2014 to November 2019.Results: The study was done to evaluate the clinicopathological pattern of 6 cases of rare entity xantogranulomatous salphingo oophoritis diagnosed at a tertiary care hospital. All patients, presented with pain abdomen. All patients were operated due to radiological suspicion of ovarian malignancy. Histopathological examination proved the lesion as xanthogranulomatous salphingo oophoritis.Conclusions: Xanthogranulomatoussalpingo-oophoritis is a rare condition that is often mistaken for ovarian malignancy clinically and radiologically. Oophorectomy is the recommended treatment but most women are “over treated” with staging laparotomies and hysterectomies that render them infertile.

Clinicopathological profile of colorectal cancer managed at a university teaching hospital, Nepal

Introductions: Colorectal carcinoma is the third most common cancer worldwide. The incidence is increasing in developing countries including Nepal. The aim of this study is to find out the clinicopathological pattern of colorectal carcinoma locally. Methods: Data were recorded retrospectively by reviewing the charts of the patients who were diagnosed and treated for in patients having colorectal cancer managed during three years period of 2016-9 at Patan Hospital, the university teaching hospital of Patan Academy of health sciences, Nepal. Clinicopathological profile, age, gender, surgery, histopathological findings were descriptively analised. Results: There were 36 colorectal cancer patients, male 20 (56%) and females 16 (44%), mean age 56.9 years (range 24 to 89). Curative surgery was possible in 17 (47.2%) and adenocarcinoma of moderate differentiation was found in 25 (70%) of the resected specimen. Conclusions: Colorectal carcinoma was found in old age, slightly more in male than female, adenocarcinoma being most common histology type.

COLORECTAL CANCER

Objectives: To determine the changing clinicopathological pattern anddistribution of colorectal cancer in our setup, highlighting future planning and designing forits prevention. Study Design: A retrospective study. Place and Duration: Department ofSurgery, Chandka Medical College and LINAR, Larkana from January 2012 to December 2016.Methodology: All the diagnosed cases of colorectal cancer were included in our study. Therecords analyzed for age, gender, clinical presentation, socioeconomic status, risk factors,histopathological variable types, site of distribution, tumor grading & staging based on TNM.The method of treatment & surgical procedures performed, were also recorded. Statistics datawas entered and analyzed by SPSS version 17. Results: 363 diagnosed cases of colorectalcancer were registered from January, 2012 to December, 2016. 211 (58. %) were male and 147(40.9%) female, with ratio of 1.3:1. Age ranged between 17 to 88 years with mean age of 56 +12. 217 patients were > 50 years, while 146 < 50 years. The predominant subsite distributionwas found in rectum & recto sigmoid junction in 205 cases (56.49%). Majority of cases belong tolow socioeconomic class with Duke’s B and C stages (45.73%. and 39.11%). The mortality ratewas observed in 12.9%, however 30% of patients were not returned for follow-up. Conclusion:Colorectal cancer is shown rising higher up and vated cancer was found increasing in incidenceamong young population < 50 years. There is a need of early detection, to reduce the numberof CRC in future.

Primary renal leiomyosarcoma: a rare entity

Background: Primary leiomyosarcoma of the kidney is an exceptionally rare tumor with an aggressive behavior. However, reported literature is very limited. Since the prognosis for a renal sarcoma is extremely poor, differentiation from sarcomatoid renal cell carcinoma (RCC) is necessary. Histopathology and immunohistochemistry are the only modes of diagnosing these sarcomas as they have no specific diagnostic features clinically and radiologically. Objectives was to evaluate the clinicopathological pattern of leiomyosarcomas arising from kidney.Methods: This study was conducted in the Department of Pathology, Government Medical College, Srinagar. It was a retrospective study done over a period of 3 years, July 2014 to June 2017. A total of 4 patients, who underwent surgery and were diagnosed with primary LMS of the kidney, were included in the present study.Results: The study was done to evaluate the clinicopathological pattern of 4 cases of primary renal LMS diagnosed at a tertiary care hospital. Age of the patients ranged from 35-64 years with a mean age of 53.5 years. Sex ratio of 1:1 was observed. Major presenting symptom was flank pain (75%) followed by mass abdomen (50%). Also, one of the patients presented with spontaneous rupture of kidney. Radical nephrectomy was done in all patients. On gross examination tumor had originated from renal pelvis (50%) in 2 patients, renal vein (25%) in one patient whereas, renal capsule (25%) appeared to be the site of origin in other patient. Histopathological examination and immunohistochemistry proved the lesion as primary leiomyosarcoma of kidney.Conclusions: Being a rare tumour, renal leiomyosarcoma needs to be considered in the differential diagnosis of renal masses even in patients younger than 40 years.