Browsing by Author "Aryal, Gopi"
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Publication Asymptomatic Pulmonary Cryptococcosis And Tuberculosis Co-infection in an immunocompetent Host: A case report(Nepalese Respiratory Society, 2023) Giri, Rashmi; Khetaan, Khusboo; Aryal, Gopi; Karthik, Ashish; Shrestha, Ashish; Gurung, Naresh; Shrestha, Sanjeet K.Abstract: Pulmonary Cryptococcosis is a rare fungal infection that mostly occurs in immunocompromised host. However, with advancement in diagnostic approach like tissue biopsy, cryptococcal infections are now increasingly being recognised.In immunocompetent host, cryptococcal infection is often asymptomatic and rarely becomes disseminated. Symptom development in immunocompetent host largely depends on burden and virulence of pathogen. Due to similarities in clinical, radiological and pathological findings in Cryptococcosis, Tuberculosis and other fungal infections like Blastomycocosis, it is important to have a tissue biospy to confirm the diagnosis. The aim of this case report is to highlight the investigation necessary to diagnose both fungal infection and Tuberculosis due to similar clinical, radiological features in both. We report a case of Gene Xpert positive Tuberculosis and histopathology proven Pulmonary Cryptococcos in same patient.Publication Primary Intracranial Adenoid Cystic Carcinoma: A Case Report(Nepal Medical Association, 2025) Maharjan, Pralisha; Aryal, Gopi; Rana, ReenaAbstract Adenoid cystic carcinoma (ACC) is a rare slow-growing but aggressive malignant tumor arising from the epithelial cells of mucous-secreting glands. Primary intracranial ACC is one of the rarest entity. We report a case of a 61 years old male presenting with difficulty in swallowing, slurring of speech, generalized body weakness. Patient had residual right cerebellopontine angle (CPA) mass causing midline shift and fourth ventricular obstruction on MRI. Patient underwent right retrosigmoid craniotomy with excision of CPA mass. Histopathological examination confirmed the case as primary intracranial ACC.Publication Primary Intracranial Adenoid Cystic Carcinoma: A Case Report(Nepal Medical Association, 2025) Maharjan, Pralisha; Aryal, Gopi; Rana, ReenaAbstract Adenoid cystic carcinoma (ACC) is a rare slow-growing but aggressive malignant tumor arising from the epithelial cells of mucous-secreting glands. Primary intracranial ACC is one of the rarest entity. We report a case of a 61 years old male presenting with difficulty in swallowing, slurring of speech, generalized body weakness. Patient had residual right cerebellopontine angle (CPA) mass causing midline shift and fourth ventricular obstruction on MRI. Patient underwent right retrosigmoid craniotomy with excision of CPA mass. Histopathological examination confirmed the case as primary intracranial ACC.Publication Radical Cystectomy for Intradiverticular Bladder Carcinoma: A Case Report(Nepal Medical Association, 2021) Sah, Anil Kumar; Maharjan, Bipin; Adhikari, Mahesh Bahadur; Rana, Reena; Basnet, Sunila; Panta, Rajesh; Aryal, GopiAbstract: Herniation of bladder mucosa through the bladder wall muscle layer is known as bladder diverticulum. The incidence of bladder diverticulum is 1.7. About 0.8 to 10% of the urinary bladder diverticulum develops carcinoma. Transitional cell carcinoma is the most common. Painless hematuria is the most common clinical presentation. Different imaging modalities along with cystoscopy are the key to accurate diagnosis and staging. High grade multifocal urothelial carcinoma in the bladder diverticulum is better managed by radical cystectomy and standard pelvic lymph node dissection with an ileal conduit. Here we report a case of a 66-year old gentleman of high grade multifocal urothelial carcinoma in bladder diverticulum managed with radical cystectomy and standard pelvic lymph node dissection with an ileal conduit. Such cases have been addressed adequately in the literature, but we did not find such cases from our country.Publication Rapid Progression of Red Itchy Rash, Diagnostic Dilemma(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2023) Keyal, Uma; Aryal, Gopi; Shrestha, Sanju Babu; Bhatta, Anil KumarAbstract: Cutaneous T-cell lymphoma (CTCL) is an uncommon type of cancer that begins in white blood cells called T lymphocytes (T cells). Normally, T cells help body's immune system to fight off infection but, in CTCL, these cells develop abnormalities that make them attack the skin. It comprises heterogeneous group of skin neoplasms, the most common being mycosis fungoides (MF). Skin lesions are classified into patches, plaques, and tumor stage. Extra skin manifestations like enlarged lymph nodes are usually seen in plaques or tumor stage, when there are thick lesions on skin. It is usually a slow growing cancer that develops over many years. Herein, we present an 83-year female patient who suddenly developed extremely itchy patches on abdomen, which had spread to involve the entire trunk and all four limbs in about 10 days’ time. She already had lymphadenopathy and splenomegaly at the time of presentation. Skin biopsy and immunohistochemistry revealed CD4+ T cells CTCL. Moreover, bone marrow was hypercellular for age with 12% atypical lymphocytes. It is very unusual for CTCL to involve bone marrow at patch stage with no any plaques or nodules on the skin. Also, the sudden onset of skin lesions and its rapid progression with probably, the involvement of lymph nodes and spleen warrant further studies to guide diagnostic approaches and treatment recommendations for CTCL