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| Year : 2022 | Volume
: 65
| Issue : 3 | Page : 746-747 |
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| Pathology conundrums |
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KV Bharathi
Department of Pathology, IGMC, Puducherry, India
Click here for correspondence address and email
| Date of Submission | 25-Aug-2021 |
| Date of Decision | 20-Oct-2021 |
| Date of Acceptance | 25-Oct-2021 |
| Date of Web Publication | 21-Jul-2022 |
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How to cite this article:
Bharathi K V. Pathology conundrums. Indian J Pathol Microbiol 2022;65:746-7 |
1.
I am a syndrome, inherited not acquired
With heart failure, I present that is typically right-sided
Palmo-plantar skin is tough and thickened
The beat of the heart is wildly quickened
Its right ventricular wall is filled with fat
Rhythm disturbances make the ECG go flat
What Syndrome am I?
 Answer to Riddle 1 | |  |
Naxos Syndrome
Features:
- Arrhythmogenic right ventricular dysplasia (Loss of myocytes and extensive fatty infiltration of the right ventricular wall)
- Palmo-plantar Hyperkeratosis
2.
I am an incompetent tricuspid valve
Damaged endocardium I do have
Abounding with Collagen and mucopolysaccharide
Hurting the cardiac chambers on the right side
The person who has me is often seen blushing
Suffering tummy cramps and episodic wheezing
A lesion in the lung precedes my appearance
The plasma level of an amine is the test of relevance
What has hurt me?
| Answer to Riddle 2 | | |
Carcinoid heart disease
Lung lesion: Bronchial carcinoid Tumor
3.
I present in an infant as a bleeding abnormality
My lesions are mainly in the skin, liver, or mesentry
The tissue in these lesions is tufted and convoluted
Once I appear, neither surgery nor transfusion is recommended
A triad of tumor, cytopenia, and bleeding define me
Steroids and Vincristine are the first line of therapy
What phenomenon am I?
What lesions am I most often associated with?
| Answer to Riddle 3 | | |
Kasabach–Merritt phenomenon/Syndrome:
Often associated with Kaposiform hemangioendothelioma or Tufted Angioma
4.
Transmitted by inoculation, arising from a change in conformation
I stack up in nerve cells, defying protease digestion
I make the brain “spongy,” I cause degeneration
I can even come to exist by a sporadic mutation
I can drive you crazy, I can make you forget
Progressive dementia follows the clinical onset
What am I?
What do I cause?
| Answer to Riddle 4 | | |
Prion Protein causing Transmissible spongiform encephalopathy (Prion diseases)
Riddle 5
We are a family 20 members strong
Some things we just get right and some things so wrong
Our functions are many, our activators three
For our presence in your plasma, we charge no fee
Orderly are we, we work in a cascade
Phagocytosis or cell lysis, its part of our trade
What are we?
| Answer to Riddle 5: | | |
Complement System
Riddle 6:
I am a bacterium, one-of-a kind
My property is unique, I'm happy to find
Inflammation and atrophy are part of my daily grind
A “pathogenicity island” in me is a tumor entwined
What am I?
| Answer to Riddle 6: | | |
Helicobacter pylori
Riddle 7:
I'm a syndrome that makes you wheezy
I tickle your nose and make you sneezy
Your lung X-ray shows infiltrates
Your myocardium, the eosinophil penetrates
Small blood vessels show necrosis
A study about me reveals vasculitis
What syndrome am I?
| Answer to Riddle 7: | | |
Churg Strauss Syndrome
Riddle 8:
I am an organ buried in obscurity
Yet I have a starring role in cell-mediated immunity
With 22q deletion I am hypoplastic
With myasthenia gravis, I am hyperplastic
A tumor of my origin leads to red cell aplasia
Impinging on other structures, it could lead to dysphagia
What organ am I?
| Answer to Riddle 8: | | |
Thymus
Riddle 9:
Multiplicity and multifocality are our defining features
To be hyperplastic or neoplastic we have a “consensus”
Our origin may be synchronous or metachronous too
The organs we affect are often more than two
PTH levels often give a diagnostic clue
What are we?
| Answer to Riddle 9: | | |
Multiple Endocrine Neoplasia (MEN) Syndromes
Riddle 10:
I come from far away
On another organ, I hold my sway
To a “new growth” I owe my loyalty
Sometimes a hormone, sometimes a mineral
I present to you with variety
What am I?
| Answer to Riddle 10: | | |
Paraneoplastic Syndrome
Riddle 11:
The liver is my mother, she's one busy bee
A long-standing illness made her give birth to me
My children are all stacked up, in a pattern so perfect
But in the tissue in which they're found, there's always a defect
Fibrillar and abnormal is what I'll always be
Sometimes a minor component accompanies me
What am I?
| Answer to Riddle 11: | | |
Amyloidosis (Serum Amyloid Associated protein, SAA)
Riddle 12:
Many are the modes of my transmission
Transplacental, transplantation, or transfusion
The cell I infect is easy to detect
Its size is gigantic, more than you expect
”Does its nucleus have an inclusion?”
Is what you'll suspect
What am I?
| Answer to Riddle 12: | | |
Cytomegalovirus (CMV)
Correspondence Address:
K V Bharathi
Plot. No. 17, Door. No. 3, 4th Cross, Ponnagar, Puducherry - 605 010
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijpm.ijpm_861_21
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