ABSTRACT Extranodal NK/T- cell lymphoma (ENKTCL) is an aggressive lymphoma driven by Epstein-Barr virus (EBV) infection in genetically susceptible individuals. It was historically called a lethal midline granuloma. Due to the angio-destructive nature of ENKTCL, lymphoma cells are often accompanied and masked by necrosis and dense inflammation in the biopsy. Further, the biopsy may show vasculitis, which can mimic granulomatosis with polyangiitis. Due to these masquerades, ENKTCL is often misdiagnosed in the biopsy. Several biopsies may be required to establish the diagnosis. We describe the clinical course and autopsy findings of a young female who presented with a hard-palate ulcer. Antemortem biopsies failed to establish the diagnosis. The autopsy revealed an advanced nasal subtype of Extranodal NK/T-cell lymphoma with dissemination to the kidneys, adrenals, liver, spleen, and small intestine. NK/T NKT NK T (ENKTCL EpsteinBarr Epstein Barr EBV (EBV individuals granuloma angiodestructive angio destructive Further vasculitis polyangiitis masquerades diagnosis hardpalate hard palate ulcer NK/Tcell NKTcell kidneys adrenals liver spleen intestine Tcell

ABSTRACT Anaplastic lymphoma kinase (ALK) positive, anaplastic large cell lymphoma involving the non-mammary implant is an extremely rare presentation. Irrespective of the type or site, the implant-associated primary ALCL is morphologically and immunophenotypically similar to ALK-negative ALCLs. Herein, we present the case of a 42-year-old male who developed a lytic lesion after an implant for a right femur fracture. The lytic lesion biopsy revealed anaplastic large cell lymphoma with ALK protein expression. Imaging findings showed the widespread dissemination of disease all over the body, entrapping the implant too. ALCL involving the bone implant is a very unusual and rare presentation that needs to be documented.

Objectives: To investigate and compare the effects of strength training (Shoulder girdle and respiratory muscles) and drug (Jatamansi) on reducing hand tremor in archers. Design: Randomized experimental, different subject design. Setting: Institutional study done at Manipur Archery Association. Interventions: Thera-band (Hygienic Corporation) and Nardostachys jatamansi (GMP Certified) were used as interventions. Pre & Post Hand Steadiness Score (Arm-Hand-Steadiness Tester on 4 mm hole) and Performance Test Scores (AAPHER Archery Test) was evaluated. 45 National Level Archers within age 16-28yrs were assigned into three groups: Group I (Medicine), Group II (Strength Training) and Group III (Control). Medicine was consumed for 4 weeks continuously 3 gm TDS and Thera-band strength training was given for 3 times weekly for 4 weeks. Main Outcome Measures: It was hypothesized that strength training is more effective in reducing hand tremors than medicinal or control groups. Results: Arm-Hand-Steadiness: Numbers of Contact (NOC): On inter Group Comparison of the three Groups using One Way ANOVA, left and right arm showed significant differences (F = 5.64, p<0.05; F = 8.97, p<0.001) respectively and on Post Hoc Scheffe’s analysis, Group II showed maximum improvement. Total Contact Time (TCT): On inter Group comparison of the three Groups using One Way ANOVA, left and right arm showed significant differences (F = 12.50, p<0.001; F = 9.23, p<0.001) respectively and On Post Hoc Scheffe’s analysis, Group II showed maximum improvement. Archery Performance: On inter Group comparison of the three Groups using One Way ANOVA showed significant difference (F = 6.53, p<0.005) and on Post Hoc Scheffe’s analysis, Group II showed maximum improvement. Conclusion: Intervention of strength training and jatamansi may be effective for an archer however, Strength training with Thera-band and Respiratory Muscles Conditioning intervention in combination increases steadiness and archery performance.