Dumb-bell shaped poorly differentiated pelvic synovial sarcoma with molecular confirmation: A rare presentation of an uncommon disease entity.

Pelvic localization of synovial sarcoma is a rare phenomenon and to the best of our knowledge its presentation as a large "dumb-bell"-shaped abdomino-pelvic mass showing extension to the thigh has never been reported in the literature. We report a case of a young adult presenting with retention of urine and was found to have a large abdomino-pelvic mass causing bony destruction and compression of pelvic viscera. A biopsy revealed a cellular tumor composed of spindle to oval cells arranged in a hemangiopericytomatous pattern. Histopathology was suggestive of poorly differentiated synovial sarcoma. Immunohistochemistry (IHC) was positive for vimentin, CD 99, Bcl2, Mic2 and focally for EMA and negative for CD 34, CK, desmin, synaptophysin, and WT1. Due to equivocal IHC findings molecular analysis was done which confirmed the diagnosis as synovial sarcoma.

Deep penetrating nevus: A distinct variant of melanocytic nevus.

Deep penetrating nevus (DPN) is a variant of melanocytic nevus which goes unrecognized due to its relative rarity and may be misinterpreted as malignant melanoma. It commonly presents in young adults as a dark pigmented lesion on the face, neck, or shoulder. A 60-year-old lady presented with a mole over the left arm of 8 years duration. A biopsy of the lesion was performed under the clinical impression of a compound nevus with suspicion of malignancy. Based on the histologic features, a diagnosis of DPN was put forward.

Zosteriform cutaneous metastases: A case report and brief review of literature.

A 56-year-old woman presented with painful erythematous, papulo-nodular lesions on the left side of the trunk in a dermatomal distribution of two-weeks duration. She had earlier undergone surgery for breast carcinoma and was receiving palliative chemo-radiotherapy, when seen by us. A diagnosis of zosteriform cutaneous metastases was made and biopsy was done from the representative lesion which showed chords and sheets of malignant cells. Majority of these cases in the past have been misdiagnosed as herpes zoster and were treated with antiviral drugs. Metastatic diseases should be considered in the differential diagnosis of zosteriform rash in elderly.

Nasal NK/T cell lymphoma mimicking a squamous cell carcinoma: a case report.

A 48 year old female presented with extensive ulceration of the nasal septum of 8 months duration. Investigations confirmed the local nature of the disease. A biopsy revealed large zones of ischemic necrosis and abnormal lymphoid cells invading vessel walls and glandular structures. Florid squamous metaplasia, and pseudoepitheliomatous hyperplasia of mucosal epithelium mimicked squamous cell carcinoma and necrotising sialometaplasia. Immunohistochemistry and insitu hybridization confirmed the diagnosis of an EBV positive, Nasal NK/T cell lymphoma. A Pubmed/Medline search suggests that this is the first documented case from India.

Rosette formation in non Hodgkin's lymphoma in the bone marrow--a case report.

This is a case report of rosette formation in non-Hodgkin's lymphoma in the bone marrow. A 66 year old female on treatment for metastatic papillary carcinoma thyroid and non-Hodgkin's lymphoma of the nodular small cleaved cell type was found to have bone marrow infiltration by a low grade B cell lymphoma. Bone marrow aspirate, imprint and trephine biopsy showed rosettes of the abnormal lymphoid cells. The associations of papillary carcinoma thyroid, hyperglobulinemia and retroperitoneal fibrosis in this case which explain the histogenesis of rosette formation are discussed.

Multiple myeloma with amyloidosis presenting with recurrent gastrointestinal bleeding.

We report a 45-year-old woman who presented with hematemesis. Endoscopy showed nodular lesions and ulcers in the gastric antrum; histology of the lesions showed amyloidosis. The patient had received melphalan and prednisolone for multiple myeloma 5 years earlier.

Giant cystic lymphangioma of the middle mediastinum.

A middle-aged male presenting with complaint of progressively increasing dysphagia was found to have a large cystic mass lesion in the middle mediastinum on evaluation. A diagnosis of an endo-duplication cyst was considered after exploration, in view of infiltration of the muscular layer of the lower thoracic esophagus, presence of multiple hyperemic nodular lesions on its inner surface and its location in the middle mediastinum. However, the histopathology revealed the lesion to be a cystic lymphangioma.