Adult ; Antipsychotic Agents ; therapeutic use ; Diagnosis, Differential ; Humans ; Insulin-Like Growth Factor I ; biosynthesis ; Magnetic Resonance Imaging ; methods ; Male ; Mental Status Schedule ; Pituitary Neoplasms ; complications ; diagnosis ; Prolactinoma ; complications ; diagnosis ; Psychotic Disorders ; complications ; diagnosis

Follicular carcinoma of the thyroid rarely manifests itself as a distant metastatic lesion, and, when present, is usually found in flat bones. A soft tissue metastasis is extremely rare, and synchronous metastases to the bone and soft tissue is not reported in the literature so far. We report such a case of a 42-yr-old male, who presented with a goiter, scalp and forearm soft tissue swellings, and, fine needle aspiration cytology of all these swellings revealed a follicular neoplasm. A wide excision of the forearm swelling was carried out and the histopathology was consistent with features of metastatic follicular carcinoma of the thyroid. The main stay of treatment is surgical resection of the primary tumor. The various modalities of treatment of metastasis is discussed with a review of literature.
Adenocarcinoma, Follicular/*pathology/surgery ; Adult ; Bone Neoplasms/pathology/*secondary/surgery ; Human ; Male ; Soft Tissue Neoplasms/pathology/*secondary/surgery ; Thyroid Neoplasms/*pathology/surgery ; Treatment Outcome

Low parasitemic condition in malaria remains a diagnostic challenge; as the available diagnostic methods failed to detect. Currently, hemozoin (Hz) pigment is gaining attention in the diagnosis of malaria. The major drawback is ease of detection of Hz in routine practice. A pilot study was conducted to evaluate the role of Hz pigment and to compare the performance of quantitative buffy coat assay (QBC) and PCR in such conditions. Clinically suspected cases of malaria were examined by both Giemsa stain and immunochromatographic test (ICT). Samples positive by ICT and negative by Giemsa stain were further examined by nested PCR targeting 18S rRNA and QBC for the presence of malaria parasites and pigments. Thirty blood samples fulfilled the inclusion criteria out of which 23 were Plasmodium vivax (Pv), 4 Plasmodium falciparum (Pf), and 3 mixed (Pv and Pf) by immunochromatographic test. Twenty-one out of 30 (70%) were positive by nested PCR in comparison to 25/30 (83%) by QBC. Samples containing both malaria parasites and Hz pigment by QBC completely showed concordance with the PCR result. However, 61% of total samples containing only Hz pigment were observed positive by PCR. Hz pigment remains an important tool for malaria diagnosis. Identification of leukocytes containing pigments by QBC not only indicates recent malarial infections but also puts light on severity of the disease. QBC assay is a rapid, highly sensitive, and cost-effective method to detect malaria parasites and Hz pigment especially in low parasitemic conditions.
Azure Stains ; Diagnosis* ; Leukocytes ; Malaria ; Methods ; Parasites ; Pilot Projects ; Plasmodium falciparum ; Plasmodium vivax ; Polymerase Chain Reaction