Prashant Ramteke

Report of a unique case of myoepithelial carcinoma of left parotid gland with metachronous bilateral cavernous sinus metastasis

Myoepithelial carcinoma (MC) is a rare, locally aggressive malignant neoplasm of the salivary glands. Only few evidences on its metastatic behavior are available in the literature. We herein present a unique case of MC of left parotid gland which metastasized to bilateral cavernous sinuses. The patient was successfully treated with palliative radiotherapy and chemotherapy.

Cytomorphological clues for a correct diagnosis of anaplastic lymphoma kinase-positive large B-cell lymphoma

Anaplastic Lymphoma Kinase positive Large B-cell Lymphoma (ALK+LBCL), is a rare entity, of which case reports exist in literature. It is a B-cell neoplasm with plasma-cell differentiation and displays plasmablasts/immunoblast like cells along with a peculiar immuno-histochemical profile. The cytomorphological characteristics of this entity have been described earlier, however, with the help of this case which had misleading clinical presentation, we wish to highlight certain cytological features which will act as diagnostic clues in identification of cases of ALK+LBCL in aspiration cytology. This article is protected by copyright. All rights reserved.

Aspirate from an abdominal lump in a known case of breast carcinoma

A 63-year-old woman with a history of breast carcinoma diagnosed and treated 9 years previously presented with a 2 9 2 cm swelling in her abdominal wall. There was no history of anorexia, weight loss or lymphadenopathy. Computed tomography of the chest and abdomen was performed and did not reveal any metastatic deposits. Positron emission tomography scan revealed uptake in the abdominal wall swelling.

Endobronchial ultrasound guided transbronchial needle aspirate from subcarinal lymph node: Mesothelial lesion, a diagnostic dilemma

A 16-year-old male presented with complaints of fever for 4 months and breathlessness for 2 months. There was no history of smoking or asbestos exposure. Computed tomography of the chest revealed persistent bilateral pleural effusion, axillary lymphadenopathy and thrombosis of right internal jugular, subclavian and brachiocephalic veins. No pleural-based mass lesion could be identified except for a minimal pleural thickening. Thoracentesis showed a chylous effusion with low adenosine deaminase levels. On follow-up, the patient’s general condition improved dramatically without any specific treatment (Figures 1–3).

Isolated bone marrow metastasis of testicular tumor: A rare cause of thrombocytopenia

Isolated bone marrow metastasis of testicular tumor is very rare. Here, we report this case of a 21-year-old male who was admitted to our hospital with generalized body pain, which was severe and weakness for one month. He had a history of an operative intervention for the left testicular mass about 6 months ago which was diagnosed as mixed germ cell tumor on histopathological examination. The blood investigations showed anemia, low platelets, and elevated tumor markers. Bone marrow aspiration and biopsy examination showed metastatic deposits of mixed germ cell tumor. There were no foci of disease in any other part of the body. The patient was given chemotherapy, i.e. cisplatin, etoposide, and bleomycin. After completion of chemotherapy, there was drastic improvement in pain and weakness. A repeat examination of bone marrow done after 3 month was free of tumor.

Ambiguous genitalia associated with an extremely rare syndrome: a case report of xlag syndrome and review of the literature

X-linked lissencephaly, absent corpus callosum, and epilepsy of neonatal onset with ambiguous genitalia comprises the XLAG syndrome and only 15 cases have been reported in literature. Due to its rarity, the exact clinical course and outcome are not known. Exact associations of this disease are also elusive. Hereby we are reporting this extremely rare entity and we searched the English literature extensively to get consolidated knowledge regarding this entity that would help the readers. Pre-natal radiological work-up can detect these malformations, which should be followed by medical termination, counseling and karyotyping. Till date the longest survival noted was 4 years only.

Fine needle aspiration cytology diagnosis of metastatic malignant diffuse type tenosynovial giant cell tumor

Tenosynovial giant cell tumors (TGCTs) arise from the synovium of joint, bursa, and tendon sheath, and are classified into localized and diffuse types. Diffused type often affects the large joint, and has more recurrence, metastasis, and malignant transformation potential compared to the localized type. Malignant diffused TGCT (D-TGCT) usually occurs as a large tumor (>5 cm), in older patients, and its histopathologic features include necrosis, cellular anaplasia, prominent nucleoli, high nuclear cytoplasmic ratio, brisk mitosis, discohesion of tumor cells, paucity of giant cells, and a diffuse growth pattern. At least five of these criteria are required for the histopathologic diagnosis of malignant TGCT because the benign TGCT also shares many of these morphological features. We describe the cytomorphologic features of a malignant D-TGCT from an unusual case of pulmonary metastasis in an adult patient. Fine needle aspiration cytologic features of malignant D-TGCT have not been described earlier in the English literature.

Malignant solitary fibrous tumor of thoracic spine with distant metastases: Second reported case and review of the literature

Solitary fibrous tumor (SFT) usually originates from the pleura because of abnormal proliferation of fibroblast cells. It is extremely rare for the tumor to originate from the spine. Here, we report the second case of malignant SFT of thoracic spine with distant metastases in a 35-years-old female.

Fine needle aspiration cytology from a postauricular swelling

A 21-year-old Asian male presented with swelling in the bilateral post-auricular region which slowly progressed in size for 9 months. There was no history of fever, anorexia and weight loss. On examination, the swellings were firm, non-tender and measured ~3 and 2.5 cm in maximum dimension. A chest X-ray showed no abnormality. A peripheral blood smear revealed ~21% eosinophils, and serum IgE was 1200 IU/mL.

Alteration in steroid hormone and Her-2/neu receptor status following neoadjuvant chemotherapy in locally advanced breast cancer: Experience at a tertiary care centre in India

CONTEXT Use of neoadjuvant chemotherapy (NACT) in locally advanced breast cancer (LABC) enables tumor reduction and conservative surgery. It is proposed in some studies that there may be an alteration in the hormonal receptor (HR) status and human epidermal growth factor receptor 2 (Her-2)/neu immune-expression following NACT. AIMS To study the status of estrogen receptor (ER), progesterone receptor (PR), and Her-2/neu receptor before and after NACT in LABC. MATERIALS AND METHODS HR and Her-2/neu status were evaluated by immunohistochemistry on 100 core needle biopsy of primary tumors and surgical specimens after receiving NACT (NACT group); fifty patients without NACT served as non-NACT group, and discordance was compared between the two groups. RESULTS In the NACT group, discordance of 17%, 13%, and 11% was noted in ER, PR, and Her-2/neu status, while in non-NACT group, discordance seen in ER, PR, and Her-2/neu was 8%, 8%, and 4%, respectively. CONCLUSIONS There was a significant alteration in ER and Her-2/neu status from the core biopsy to the treated resected tumor in the study group. As these changes may impact treatment, HR and Her-2/neu expression reanalysis in final surgical specimens is recommended.