Extranodal follicular dendritic cell sarcoma involving tonsil.

Follicular dendritic cell sarcoma (FDCS) is a rare neoplasm arising from lymph nodes as well as extranodal sites. Despite the characteristic histopathological features and distinctive immunophenotype, extranodal FDCS are often misdiagnosed initially as undifferentiated carcinoma, inflammatory pseudotumour, meningioma, metastatic malignant melanoma, ectopic thymoma, etc., because of its rarity and lack of awareness. Correct diagnosis of this tumour is imperative given its potential for recurrence and metastasis. We report a case of tonsillar FDCS in a 30-year-old lady who presented with slowly progressing throat pain and dysphagia for a duration of one year. Local examination showed an enlarged left tonsil with an ulceroproliferative growth. The right tonsil was normal. There was no regional lymphadenopathy. Histopathological examination of the tonsillectomy specimen showed a 2.2x1.5 cm infiltrative tumour composed of ovoid to spindle cells arranged in characteristic storiform, interlacing fascicular and diffuse patterns. The tumour cells were immunopositive for CD21, CD23, CD35, and S-100 protein and negative for cytokeratin. The Ki-67 antigen-labelling index (Ki-67 LI) was 6%. The EBV status was negative. It was classified as a low risk FDCS. The patient was lost to follow-up after 6 months.

Diagnostic pitfall in a case of ductal carcinoma-in situ with microinvasion.

We report a case of microinvasive carcinoma of the breast cytologically diagnosed as ductal carcinoma - in situ in an 80-year-old lady with a breast lump. Extensive sampling of mastectomy specimen showed ductal carcinoma in situ (DCIS). Many ducts showed stromal reaction - periductal sclerosis and lymphocytic infiltration-features suggestive of microinvasion. However, no definite invasion was noted histologically. Immunohistochemical study highlighted the microinvasive foci.

Malignant proliferating trichilemmal tumor: a case report and review of literature.

Proliferating trichilemmal tumor (PTT) is an uncommon appendageal skin tumor that affects mainly elderly women. It arises from the external root sheath of the hair follicle and is most commonly observed on the scalp. Although most cases pursue a favorable clinical course and surgical excision is curative, malignant transformation has rarely been reported in these lesions. Because of limited number of cases reported in the literature, management of malignant PTT is controversial and mainly entails wide local excision. Many other adjuvant modalities have been tried. In this report, we present a case of malignant PTT in a 65-year-old male patient who presented with ulceroproliferative growth over occipital region since 4 months.

Gastroesophageal junction adenocarcinoma metastasizing to gingiva.

Malignant tumors rarely metastasize to the oral cavity and account for about 1% of all oral tumors. Metastasis to soft-tissue of the oral cavity is much rarer than jaw bones. Because of the rarity, metastatic tumors in the oral region are challenging for diagnosis. Primary tumors which metastasize to mouth are the most commonly lung, breast, and kidney. Oral cavity metastases represent distant spread and are associated with poor prognosis with short survival. We present a case of the gastroesophageal junction adenocarcinoma with metastasis to the oral soft-tissue.

Cytodiagnosis of coexistent cryptococcal and mycobacterial lymphadenitis in a case of AIDS.

Multiple infections are a common feature of acquired immunodeficiency syndrome (AIDS), but coexistent infections at the same site are rare. In this report, we describe a 35-year-old human immunodeficiency virus infected male with coexistent cryptococcal and mycobacterial lymphadenitis. He presented with generalised lymphadenopathy. Fine needle aspiration cytology of enlarged cervical lymph node, aided by special stains, revealed coexistent cryptococcal and mycobacterial infection. Coexistent infections pose diagnostic problems in AIDS patients and are likely to be missed. Special stains are valuable for accurate diagnosis of coexistent infections.

Intracystic papillary carcinoma of the breast: report of two cases.

Intracystic papillary carcinoma (IPC) of the breast has traditionally been considered to be a variant of ductal carcinoma in-situ (DCIS). It is an uncommon tumor accounting for less than 3% of all breast cancers and predominantly affects elderly women. IPC is extremely rare in men and only few cases have been reported in the literature. The tumor has excellent prognosis regardless of whether it is in-situ or invasive. Hence an accurate diagnosis plays a crucial role in the management of patients with IPC. We report two cases of IPC, one in a 68-year-old woman and the other one in a 70-year-old man. The diagnosis was suspected on fine needle aspiration cytology (FNAC) and was confirmed by histopathology.

Hepatic angiosarcoma arising in an adult mesenchymal hamartoma.

Embryonal (undifferentiated) sarcomas arising in mesenchymal hamartoma are on record but cases of hepatic angiosarcoma (AS) arising in mesenchymal hamartoma (MH) of the liver are extremely rare. We report one such case in a 20-year-old male patient. He presented with a lump in the right hypochondriac region and pain of two years duration with rapid increase in size since two months. Ultrasonography (USG) revealed a well circumscribed mass on the undersurface of the right lobe of liver suggestive of hemangioma. The patient underwent resection of the mass. Histopathology revealed AS with areas of MH.