Aspergillosis causes invasive pulmonary disease in patients with hematological malignancies. Children with invasive pulmonary aspergillosis (IPA) usually have non-specific radiographic findings unlike cavitary lesions commonly seen in adults. Pneumothorax due to rupture of peripheral fungal lesion may be a severe complication in patients with neutropenia. Here, we describe three children during induction chemotherapy for B-lymphoblastic leukemia with pneumothorax as a presenting feature of pulmonary aspergillosis.

Background: Anaplastic large cell lymphoma (ALCL) is an uncommon form of Non-Hodgkin Lymphoma (NHL) in younger patients, accounting for less than 15% of cases. The median age at presentation is 12 years and is exceedingly rare in infants. Various prognostic factors, risk stratification and novel treatment strategies have been studied in pediatric ALCL. There is no separate data available on the disease biology, treatment regimens and prognostic factors among infantile ALCL. Outcomes for infants with ALCL have been reported to be inferior to that of older children. The long-term Event Free Survival (EFS) in general among pediatric patients is approximately 70% regardless of the treatment approach. We report a case of an 8month old infant diagnosed with ALK positive ALCL with visceral organ involvement stratified as high risk and treated according to ALCL 99 protocol with excellent clinical response, on regular follow up and is disease free since 2years.

Background: Langerhans cell histiocytosis (LCH) is a great mimicker. It is a rare hematological disorder, incompletely characterised and understood, often affecting infants and young children. This disease has a wide spectrum of clinical presentations, ranging from an isolated disease with spontaneous resolution to life-threatening multisystem disease. Isolated oral presentation is rare and often occurs early in the disease process and usually gets overlooked. Some of the common oral presentations include gingivitis, periodontitis and tooth rotation. Case report: We report a case of a 1 year old male child who presented with a persistent white patch over the soft palate extending to the hard palate, initially treated as oral thrush and diphtheria by the primary paediatricians and subsequently was diagnosed with multisystem LCH (with liver as risk organ) at our centre . Conclusion: This disease requires a very high index of clinical suspicion, timely diagnosis and treatment for a favourable outcome.

Malignant rhabdoid tumors (MRT) are very aggressive neoplasms seen in infantile age groups. A high index of suspicion is needed for early diagnosis. They are small round cell tumors with characteristic loss of INI -1 expression. Here we present a case series of 6 rhabdoid tumors diagnosed over 2 years, of which 4 of them presented as soft tissue swelling neck and chest wall. All of them had a very short duration of presentation and despite timely diagnosis, 4 of them progressed while on treatment and resulted in mortality.

Alkuraya-Kucinskas syndrome is a neurodevelopmental disorder due to mutation in KIAA1109 gene. We report a case of optic pathway tumor in a child with novel variant of KIAA1109. A plausible mechanism of gliomagenesis is considered based on influence of KIAA1109 on regulation of phosphatidyl inositol phosphorylation.