Rare Finding Research Articles

Accessory tympanic plate ossicle: a new osteological entity.

The auricular cartilage, which is typically soft and flexible, can calcify or ossify because of diseases such as diabetes mellitus, trauma, radiation therapy for cancer, and more commonly from frostbite. Calcified, ossified, or hardened auricular cartilage is a rare finding in the clinical literature and appears to be absent in the physical and forensic anthropological literature. This study examines the ossified auricular cartilage and tests whether the hypothesis can be identified in postmortem skeletonized tissue and be part of the external auditory meatus. A total of 290 crania were examined for accessory ossicles. A descriptive and interpretative analysis was performed grossly, histologically, and morphometrically to document the morphology and location of the ossicles, investigate their structure, and perform hypothesis testing. Results revealed that seven females and one male crania from a total of 290 crania (2.76%) exhibit semi-ossified auricular cartilage attached to the tympanic plate of the temporal bone. The morphology and location of the ossicles at the junction of the auricle and external auditory meatus indicate they are hardened auricular cartilage that was verified with histological observations. Regression analysis indicates that addition of the ossicle to the depth of the auditory tube significantly changes coefficient of determination (R2) with respect to cranial breadth. In conclusion, results indicate that small cartilaginous structures of the external ear may ossify forming accessory tympanic plate ossicles that potentially could be identified in skeletal remains as a new osteological entity. This report highlights the types of information that can be gained using an approach that integrates forensic anthropology, gross anatomy, and histology.

Clinical significance of true umbilical cord knot: a propensity score matching study

ObjectiveTrue umbilical cord knot (TUCK) is a rare finding that often leads to intensified surveillance and patient anxiety. This study sought to evaluate the incidence, risk factors, and obstetric and neonatal outcomes of TUCK.MethodsA retrospective cohort study was conducted at a tertiary university medical center in 2007–2019. Patients with singleton pregnancies diagnosed postnatally with TUCK were identified and compared to women without TUCK for obstetric and neonatal outcomes using propensity score matching (PSM).ResultsTUCK was diagnosed in 780 of the 96,766 deliveries (0.8%). Women with TUCK were older than those without TUCK (32.57 vs. 31.06 years, P < 0.001) and had higher gravidity (3 vs. 2, P < 001) and a higher rate of prior stillbirth (1.76% vs. 0.43%, P < 0.01). Following covariate adjustment, 732 women with TUCK were compared to 7320 matched controls. TUCK was associated with emergency cesarean delivery due to non-reassuring fetal heart rate (2.54% vs. 4.35%, P = 0.008, OR 1.71, 95%CI 1.14–2.56) and intrapartum meconium-stained amniotic fluid (19.26% vs. 15.41%, P = 0.022, OR 1.31, 95%CI 1.04–1.65). Neonatal outcomes were comparable except for higher rates of 1-min Apgar score < 7 and neonatal seizures in the TUCK group. The stillbirth rate was higher in the TUCK group, but the difference was not statistically significant (1.23% vs 0.62%, P = 0.06, OR 1.96, 95%CI 0.96–4.03).ConclusionsTUCK has several identifiable risk factors. Pregnant women with TUCK may cautiously be informed of the relatively low risks of major obstetric or perinatal complications. The lower occurrence of stillbirth in the TUCK group warrants further study.

Annular remodelling predicts outcome in isolated severe tricuspid regurgitation: a registry-based echocardiographic analysis.

Depending on volume status, secondary tricuspid regurgitation (sTR) has a strong dynamic component. In contrast, associated structural dilatation of the tricuspid annulus and the right heart chambers may be less volume dependent. This study aimed to assess the prognostic value of right heart remodelling in isolated severe sTR (isoTR). A total of 36 000 patients from the longitudinal echocardiographic database of our tertiary centre were screened for severe isoTR [vena contracta (VC) ≥ 7 mm] in the absence of atrial fibrillation (AF), other valve disease, and/or reduced systolic left ventricular function. Echocardiographic examinations were re-read, focusing on right ventricular (RV) parameters and on quantitative and qualitative parameters of isoTR. All-cause mortality was defined as the primary endpoint. Two hundred and sixteen patients fulfilled the inclusion criteria. Severe TR was predominant; only few were classified in the new grades massive [n = 23 (10%)] and torrential TR [n = 4 (2%)]. During a median follow-up of 35 months (20-53), all-cause mortality was 31% (n = 67). Multivariate Cox regression analysis revealed no association of VC, effective regurgitant orifice area, or regurgitant volume with all-cause mortality. However, indexed RV end-diastolic diameter (P < 0.001), indexed right atrial dimensions (P = 0.019), and particularly tricuspid valve (TV) annulus diameter diastole index (P = 0.002) and TV annulus diameter systole index (P = 0.001) were significantly associated with outcome. Severe isolated TR in the absence of AF is a rare finding with a grim prognosis. Tricuspid annular diameter dimensions rather than quantitative measures of TR proved to be of significant prognostic value indicating a continuous remodelling leading to a 'point of no return' with a dismal outcome.

Multiple Myeloma Patient with Secondary Liver and Tongue Involvement, Complicated by COVID-19-Induced ARDS: An Autopsy Case Report and Literature Review

Background. Liver involvement secondary to multiple myeloma is a rare and uncommon radiologic finding. Such extraosseous secondary lesions as well as tongue involvement require pathohistological confirmation to prevent misdiagnosis. Clinical and laboratory diagnostics are challenging in patients with COVID-19 and underlying multiple myeloma and its secondary lesions, leading to difficulties in treatment and outcomes.&#x0D; Case Report. A 64-year-old male patient, not vaccinated against COVID-19, with a history of multiple myeloma presented with symptoms of headache, fatigue, dyspnea, cough, and fever. The patient’s medical history was intricate, involving cholecystectomy and a diagnosis of multiple myeloma, which was subsequently treated with chemotherapy and radiation therapy. Additionally, uncommon liver and tongue involvement secondary to multiple myeloma was found. Upon admission, the patient’s peripheral oxygen saturation was 90%, accompanied by increasing shortness of breath and a respiratory rate of 26 breaths per minute. A positive COVID-19 test was recorded. A lung computed tomography revealed bilateral multifocal areas of ground-glass opacity and consolidation, encompassing the entire pulmonary regions, corresponding to CO-RADS 6. The patient was admitted to the intensive care unit. Despite initiating oxygen support and symptomatic therapy, the patient’s death occurred. Autopsy confirmed the development of severe acute respiratory distress syndrome and bilateral hemorrhagic pneumonia, with multiple myeloma as a contributing factor.&#x0D; Conclusions. This case report highlighted the rare occurrence of secondary liver involvement in multiple myeloma, characterized by nodules with distinct imaging features. It underscored the importance of identifying coexisting lesions, such as tongue involvement, and the diagnostic challenges they pose. Additionally, the case emphasized the need for comprehensive clinical assessment in patients with concurrent COVID-19 and underlying multiple myeloma, as it may lead to the development of acute respiratory distress syndrome.

Symptomatic pericardial cysts and dilemmas in their diagnosis.

Pericardial cysts (PCs) or pleuropericardial cysts are rare congenital mediastinal lesions with an approximate incidence of one in 100 000 persons. Usually, they are asymptomatic, being incidentally discovered during a routine chest imaging examination or an autopsy exam. The study involved a retrospective evaluation of clinicopathological findings in a 6-year series of PCs, treated in the Clinic of Pulmonary Diseases, Iaşi, Romania. A group of five cases of PCs, four females and one male, were evaluated. All patients displayed different symptoms, such as dyspnea, chest pain, chronic cough, fatigue, palpitation, and epigastric pain. The cystic lesions were located in the right and left cardiophrenic angle, in four cases, and in the central mediastinum in a single case. The lesions had a fluid content and a maximum diameter that ranged between 35 and 95 mm. The microscopic examination of the surgical resection tissues revealed a thin connective tissue wall without any associated smooth muscle cells. The loose connective tissue band was lined by a layer of mesothelial cells with no cellular atypia, which displayed discrete papillary projections, in one case. Although PCs are rare incidental findings, they should be considered in differential diagnoses of mediastinal cysts, especially as they are associated with non-specific symptoms. Furthermore, considering the possibility of development of severe complications, PCs should be thoroughly explored for suitable patients' management.

P19 Spontaneous regression of aleukaemic cutis leukaemia in a male infant

Abstract Introduction Congenital leukaemia is a rare haematologic disease presenting in the first 4-6 weeks of life. Affected children may present with systemic symptoms of fever, hepatosplenomegaly and skin infiltration in the form of leukaemia cutis. Prognosis is generally poor but some cases of spontaneous regression have been described. We report a case of a 5-week-old who had biopsy confirmed cutis leukaemia which went on to resolve spontaneously. Case A male infant developed widespread erythematous/violaceous patches and nodules in the first week of life. He remained systemically well. A skin biopsy at 5 weeks of age showed features of a malignant haematological infiltrate, favouring a myeloid/monocytic leukaemic process. Baseline bloods were normal including a blood film which did not show any evidence of blasts. Interestingly, following his biopsy, skin lesions began to improve with complete resolution of all skin lesions by six weeks of age. RNA fusion panel analysis of affected skin detected a PICALM::MLLT10 t(10;11) (p12;q14) fusion which is a rare but recurrent finding in acute lymphoblastic leukaemia . He continues monthly haematology surveillance and has remained disease free at 8 months. Conclusion Spontaneous regression of aleukaemic leukaemia cutis is a rare phenomenon. Patients require close ongoing surveillance as some may relapse with systemic disease after several years. Key to management of this case was prompt suspicion of leukaemia cutis and biopsy which enabled an accurate diagnosis despite the brief window of skin lesions and has subsequently enabled accurate genotyping and future rigorous surveillance in this child.

A rare occurrence of superior retinochoroidal coloboma: A case report

Purpose: To brief a rare case of superior retinochoroidal coloboma and to analyze the possible embryogenic aspects involved in its provenance. Method: A case report. Result: This case report highlights an 11-year-old myopic girl who presented with diminution of vision in both eyes for the past 1 year. She had no other specific ocular complaints. The best corrected visual acuity was 6/18p and N24 in the left eye (OS) and 6/6 and N6 in the right eye (OD) at 30 cm. On detailed examination, all ocular structures were found to be normal except the fundus, which showed superior choroidal coloboma with foveal involvement in OS, with OD being normal. This is a rare phenomenon as most often, ocular coloboma is located in the inferior nasal quadrant with the involvement of the iris and/or crystalline lens. Conclusion: The rare finding in this case is the location of coloboma at the superior quadrant. Moreover, this coloboma case spares the iris and crystalline lens, making it even rarer in the category, considering the uncommonness of such cases.

Bilateral Psoas Minor: A Case Report with Clinical, Embryological, and Evolutionary Insights

A 57-year-old female cadaver donated for research contained an accidental bilateral presence of the psoas minor (PMn) muscle. Bilateral PMn is a rare finding but it may be associated with other anatomical variations or abnormalities in the abdomen or pelvis. In some cases, the muscle may be involved in the development of certain medical conditions or may compress nearby structures, leading to symptoms such as pain or discomfort. Overall, bilateral PMn is a relatively uncommon anatomical variation that may be of interest to anatomists or medical professionals. A thorough understanding of this muscle is essential, particularly when making a clinical diagnosis and carrying out procedures in the iliac area. In this case report, we tried to discuss the clinical, embryological, and evolutionary significance of PMn muscle.

Paralabral Cysts with Associated Infraspinatus and Teres Minor Denervation: A Case Report

Introduction: The shoulder is one of the most intricate articulation complexes in the human body. Any insult to its equilibrium can cause joint instability, pain, and dysfunction. The complex bony projections of the scapula, lengthy nature of the nerves, and extensive mobility of the joint places nerves at risk for impingement; this can, especially, be seen when examining the axillary and suprascapular nerves. Another rare cause of nerve impingement is a paralabral cyst secondary to labral tearing. If a paralabral cyst expands into the limited space occupied by the nerves, this can result in neuropraxia, muscle wasting, and loss of function. This phenomenon presents an interesting anatomic and clinical correlation. Case Report: A 41-year-old male with no past medical history presented with left shoulder pain for 3 months. Physical examination showed a great range of motion but diffusely decreased strength. Magnetic resonance imaging of the left shoulder demonstrated posterosuperior labral tearing with an associated paralabral cyst extending into the spinoglenoid notch. An additional anteroinferior labral tear with an associated paralabral cyst was also found. Extensive infraspinatus and teres minor muscle atrophy suggesting active denervation was present. The patient failed conservative management and underwent arthroscopic labral repair with posterosuperior and anteroinferior paralabral cysts excision. The patient had an unremarkable recovery and by 1 year had full motion and 5/5 strength in all planes. Conclusion: While paralabral cysts are well documented, there have been limited reports of cysts causing neural impingement of the axillary or the distal suprascapular nerve, let alone both occurring within the same individual. This case provides an interesting clinical scenario which very clearly depicts the neural innervation of the shoulder and pathologies that can impact function. This cystic impingement is a very interesting and rare finding that provides tremendous insight into both shoulder pathology and anatomy. This case is also useful to predict patient recovery after long-term nerve impingement and muscle denervation. This patient presented with significant loss of strength, motion, and shoulder dysfunction, but after surgical intervention, he regained complete motion and strength. This information can be used to help educate and guide patients in practice. Keywords: Arthroscopy, paralabral cyst, superior labral anterior to posterior tear, bankart tear, sports medicine, denervation, atrophy, orthopedics.

Prevalence of Azygos Lobe of the Lung in Southern Indian Cadaveric Population: A Retrospective Observational Study

Introduction: The azygos lobe is a developmental anomaly found in the upper lobe of the right lung. It has a prevalence of 0.4% in clinical scenarios and 1% during routine anatomical dissections. Clinically, the azygos lobe mimics various conditions. It is a rare incidental finding during chest radiography or Computed Tomography (CT). Aim: To determine the prevalence of the azygos lobe during anatomical dissection. Materials and Methods: A retrospective observational study was conducted over a 13-year period from June 2010 to August 2023 in various medical colleges in Mangaluru, Karnataka, India. A total of 102 adult cadavers were studied. The dissected right and left lungs of each cadaver were examined for the presence or absence of an azygos lobe and recorded. The morphology of the azygos lobe was studied, including its size, the presence of the azygos fissure, the depth of the azygos fissure, and the course of the azygos vein. The presence of mesoazygos was also checked, and its attachments were noted. Descriptive statistics were used in terms of frequency and percentage. Results: Out of the 102 cadavers, only one right lung had an azygos lobe. None of the cadavers had bilateral azygos lobes. The maximum height of the lobe was 5.8 cm, and the width was 4.5 cm. An azygos fissure was found, through which the mesoazygos was present. The mesoazygos was located from the lung to the thoracic wall. Conclusion: Despite being an incidental finding, the azygos lobe is clinically important. Physicians should be aware of this anomaly, and thoracic surgeons should exercise caution during surgeries involving the thoracic region, such as Video-Assisted Thoracic Sympathectomy (VATS).

Lower motor neuron disease with MRI «snake eyes» pattern

Motor neuron disease with isolated or predominant lesion of the lower motor neuron at one level of the pyramidal tract is a rare diagnostic finding. In the article, we analyze the case of a patient with asymmetric lesion of the inferior motor neuron at the cervical level: clinical manifestations, results of additional studies and dynamic observation of the patient. Special attention is paid to the MRI picture of changes in the pyramidal tracts in the cervical region, which have been called the «snake eyes» in the literature, and the impact of this finding on the diagnosis and prognosis of the disease.

Benign Hyalinizing Chronic Cholecystitis Associated with Choledocholithiasis a Rare Pathological Finding in Laparoscopic Cholecystectomy – Case Report

Benign Hyalinizing Chronic Cholecystitis Associated with Choledocholithiasis a Rare Pathological Finding in Laparoscopic Cholecystectomy – Case Report

Unraveling the Unusual Pathological Findings of Appendiceal Lesions: A Cross-sectional Study from Tertiary Care Centre in Chengalpattu, Tamil Nadu, India

Introduction: The appendix, once considered a vestigial structure, is now recognised as a site of diverse pathologies beyond simple appendicitis through a systematic analysis of published literature and case studies. The diagnosis of appendiceal lesions is still a clinical phenomenon and a constant struggle. The gold standard for diagnosing appendiceal lesions, however, is meticulous histopathological examination. Aim: To determine the histopathological distribution of all the appendiceal lesions and to identify the rare and unusual histopathological findings in appendectomy specimens received at a tertiary care Centre. Materials and Methods: A cross-sectional study was conducted in the Department of Pathology at Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Chengalpattu, Tamil Nadu, India for a duration of 10 years, from August 2013 to August 2023. From the histopathological records of 832 appendectomies, 40 specimens with unusual histopathological findings were identified and analysed in this study. Relevant recorded data from all the appendiceal specimens reported during the study period, with special reference to age, sex, and histopathological findings, were retrieved and evaluated retrospectively. Corresponding slides and specimens were reviewed. The data were presented in the form of frequency tables and percentages. The analysis was done using Statistical Package for Social Sciences (SPSS) software version 20.0. Results: Out of 832 appendectomy specimens, there were 485 (58.29%) cases of acute appendicitis, 244 (29.33%) cases of chronic appendicitis, 59 (7.09%) cases of subacute appendicitis, and 4 (0.48%) cases of gangrenous appendicitis. Unusual histopathology findings were noted in 40 cases (4.81%). These include 17 cases of appendiceal neuroma, eight cases of Xanthogranulomatous appendicitis, seven cases of Enterobius vermicularis, three cases of Low-grade Appendiceal Mucinous Neoplasm (LAMN), one case of appendiceal Neuroendocrine Tumour (NET), one case of Goblet Cell Adenocarcinoma (GCA), one case of metastatic squamous cell carcinomatous deposit in the appendix, one case of urothelial rests in the appendix, and one case of appendiceal lipoma. Conclusion: In this study, 4.81% of patients had atypical appendiceal lesions. A complete histopathological examination of appendectomy specimens increases the chances of discovering unusual lesions of the appendix. Ultimately, this comprehensive analysis will contribute to future improvements in clinical management and prognostication, fostering better patient outcomes.

Avian trematodes of central European corvids are heterogeneous regarding preferences for host species and age.

Corvids are highly adaptive birds that respond well to anthropogenic changes in their environment. Trematode communities of corvids were studied mainly in the 1950s through 1970s in regularly flooded parts of the Volga River delta in Russia; more recent studies and data from other regions where the corvids are in less contact with postflooding habitats are limited. Data for Corvus corax were lacking. Using our samples obtained from 1963 to 2023, we performed a large-scale analysis of trematode species composition and community structure in Corvus frugilegus, Corvus cornix, C. corax, Coloeus monedula, Pica pica, and Garrulus glandarius; all originated from the Czech Republic. We identified corvids as hosts of mutually overlapping component communities of only a few species of trematodes (Brachylecithum lobatum, Lyperosomum petiolatum, Lyperosomum longicauda, Tamerlania zarudnyi, Urogonimus macrostomus), with the presence of many rare and incidental findings of other trematode species. Only a few species used corvids as their core hosts (L. longicauda and B. lobatum). Trematode component communities in first-year birds included Prosthogonimus cuneatus, Prosthogonimus ovatus, Plagiorchis asperus, and Morishitium dollfusi due to an increased share of insects (intermediate hosts of Prosthogonimus and Plagiorchis) and snails (intermediate hosts of Morishitium) in the diet of juveniles. The trematode component communities of corvid species overlapped but were heterogeneous at the level of host individuals, likely reflecting differences in food sources related to the respective host ages and nesting sites.

Prostate-Specific Membrane Antigen (PSMA) Uptake in the Scrotum and Epididymis on PET-CT: When is it Pathological?

Prostate cancer is the most common solid organ tumor in men and has been reported to metastasize to unusual sites such as the epididymis. The clinical standard for detecting recurrent disease is through positive emission tomography/computed tomography with the radiotracer 18F-DCFPyL binding prostate-specific membrane antigen (PSMA) expressed by cancerous cells. Although PSMA can also be expressed physiologically, metastases are more likely to be intensely PSMA expressing and in a typical distribution depending on the extent of disease burden in the individual patient. A MEDLINE search revealed only three other case reports of isolated epididymal metastases from prostate cancer diagnosed with prostate-specific membrane antigen positron emission tomography-computed tomography. This case series comprising both metastatic and physiological PSMA expression in the epididymis provides a useful framework for the interpreting physician when the possibility of this rare but important finding is encountered in prostate cancer imaging.

Bilateral Upper Limb Congenital Anomalies in a Neonate: A Case Report

Congenital anomalies are diverse in nature and can affect multiple organ systems, posing significant diagnostic and management challenges. Among these, nubbins, characterised by the absence or underdevelopment of distal terminal phalanges, present a rare clinical finding. The present case report discusses a neonate born via normal vaginal delivery who demonstrated immediate cries upon birth. The patient’s clinical presentation led to a series of diagnostic investigations. The absence of distal terminal phalanges in both hands was concerning; however, radiographs of the forearms showed normal structural findings. The detection of mild Developmental Dysplasia of the Hip (DDH) on hip Ultrasonography (USG) necessitated regular monitoring with USG and radiographs of both hips to ensure proper hip joint development. The USG of the spine revealed no anomalies, which was reassuring. The most significant finding came from the Echocardiogram (ECHO), which identified a small ostium secundum Atrial Septal Defect (ASD) with mild tricuspid regurgitation and pulmonary hypertension. The present case underscores the importance of ongoing research and collaboration in advancing our understanding and management of rare congenital anomalies.

Primary cutaneous balloon cell melanoma, a rare pathologic finding of melanoma

Primary cutaneous balloon cell melanoma, a rare pathologic finding of melanoma

The voice of the Adriatic? The Keszthely triton conch trumpet

A trumpet made from the shell of a triton conch (Charonia sp.), from the time of the Late Copper Age Protoboleráz horizon, was found at the Keszthely–Fenékpuszta I site in western Hungary. Triton’s trumpet conches are widely spread in tropical, subtropical, and Mediterranean marine habitats, including the Mediterranean and Adriatic Seas. In Hungary, extremely rare finds of this species may have originated from the Adriatic Sea, the closest distribution area within the reach of long-distance trade. By removing the tip of the shell of the conch, a horn was made which could be used to emit high-pitched sounds, as a ceremonial horn and/or played in harmony with other instruments.

Ovarian Low-Grade Papillary Serous Cystadenocarcinoma with Osseous Metaplasia- Case Report and Review of Literature

Introduction: The stromal osseous metaplasia is extremely rare finding in serous cystadenocarcinoma of the ovary. Case report: A 45-year old female presented with pain in lower abdomen of about 2 months, breathlessness of 10days. On physical examination per abdomen, a large pelvic mass identified. She had pleural and pericardial effusion. Pericardiocentesis was done. Abdomen and pelvis ultrasound revealed a large heterogeneous right adnexal ovarian mass measuring 13.5 × 13.1 × 10.8cm, volume about 916 ml. It was well defined, oval, cystic, partially solid mass, the impression of ovarian neoplasm was given. There was no significant lymphadenopathy. The left ovary, uterus, cervix, fallopian tubes and rest of abdominal organs were normal. Serum CA 125 was 75.5 U/ml. She underwent total abdominal hysterectomy. On histopathological findings reported as right ovarian low-grade papillary serous cystadenocarcinoma with osseous metaplasia. Conclusion: The osseous metaplasia in ovarian serous cystadenocarcinoma is extremely rare.

A Retrospective Cross-sectional Analysis of Renal Complications in Association with Cancer: Insights from 120 Autopsies

Introduction: Kidney diseases frequently complicate cancer and its treatment, contributing to both morbidity and mortality. Malignancies can give rise to various kidney issues, such as glomerulonephritis and Chronic Kidney Disease (CKD). This association operates bidirectionally, with patients experiencing the development of renal diseases due to cancer, and CKD predisposing to cancer. Furthermore, nephrotoxicity induced by chemotherapy can result in Acute Tubular Injury (ATI) and necrosis, imposing limitations on its application. Aim: To evaluate the spectrum of renal pathology in autopsies of malignancies. Materials and Methods: This was a retrospective crosssectional study of complete autopsies of all cases of malignancies performed in the Department of Pathology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India. The study was carried out over a 5-year period from January 2015 to December 2019. Analysis of cases with respect to demographics, type of primary malignancy, gross and microscopic features, and the final cause of death was conducted. These findings were meticulously tabulated, with frequencies and percentages calculated for each category. Results: A total of 4392 autopsies were conducted throughout the study period, with 120 of them revealing the presence of malignancies. A total of 38 (31.6%) malignancies were diagnosed for the first time at autopsy. The commonest renal findings on gross were scars (superficial and deep) seen in 40 (33.33%), followed by cortical cysts in 25 (20.83%), granular contracted kidney in 15 (12.50%), mass lesions in 7 (5.83%), abscesses in 7 (5.83%), and swollen, oedematous kidneys in 6 (5%) autopsies. The most frequent renal pathology on microscopy were infective lesions seen in 43 (35.83%), Acute Tubular Necrosis (ATN) in 32 (26.66%), ATI in 30 (25%), followed by malignancies- primary and secondary in 11 (9.16%), tubular casts in 6 (5%), etc. Rare findings included membranous glomerulonephritis and Tumour Lysis Syndrome (TLS) (Acute urate nephropathy) in 1 (0.83%) each. The TLS case had classic histomorphological features of TLS, apart from laboratory parameters. Extensive deposits of uric acid crystals were seen obstructing the tubules as well as some of the glomeruli on microscopy. Conclusion: In one-third of the cases, the malignancy was exclusively discovered during the autopsy. The study revealed a diverse array of lesions, encompassing pyelonephritis, ATN, primary and metastatic renal tumours, cast nephropathy, membranous glomerulonephritis, and TLS. One-fifth of the cases had end-stage renal disease (advanced renal disease). A significant number of the cases exhibited tumour masses within the kidneys. One-fifth of the cases had renal pathology contributing to the final cause of death, further highlighting the association between malignancies and renal pathology