Thymic amyloidoma mimicking sclerosing thymoma in a triple vessel disease patient: An incidental finding.

A 65 year old man who underwent coronary artery bypass graft (CABG) for triple vessel disease was found to have enlarged thymus. Biopsy of the thymic mass revealed localised amyloid deposits demonstrating strong apple green birefringence on polarised microscopy. Localized thymic amyloidosis is an extremely rare finding with present case as the seventh in the world and the first in India. Review of literature of thymic amyloidoma and its close differential sclerosing thymoma is hereby described.

A rare case of benign fibrous histiocytoma of the cornea.

Fibrous histiocytoma (FH) commonly occurs in the superficial layers of the skin. Orbit and limbus are documented ophthalmic sites of involvement but isolated corneal FH has never been reported in literature. We present the first case of FH exclusively involving the cornea where a 10-year-old male child presented with a 3-month history of a painless growth on the superior cornea of the right eye with deterioration of vision. Tumor excision with therapeutic penetrating keratoplasty was done and the histopathological examination confirmed the diagnosis. There was no recurrence and the corneal graft was clear at 1 year.

Tumor Budding and Worse Pattern of Invasion Can Predict Nodal Metastasis in Oral Cancers and Associated With Poor Survival in Early-Stage Tumors.

The management and prognosis of oral squamous cell carcinoma (OSCC) depend on tumor stage and lymph node (LN) metastasis status. Early-stage (T1/T2 N0M0) OSCC comprises a heterogeneous group. We evaluated the role of histological parameters including worst pattern of invasion (WPOI) and tumor budding to determine the risk of LN metastasis in cases of OSCC and to determine the risk of recurrence and death in early-stage OSCC in north Indian patients. All cases of buccal mucosa and tongue SCC which underwent excision over 4 and half years were reviewed for histological parameters including histologic grade, WPOI, tumor budding, lymphovascular emboli (LVE), perineural invasion (PNI), depth of invasion (DOI), host lymphocyte response, and stromal response and compared to LN metastasis. Clinical follow-up of early-stage tumor was obtained and compared. A total of 126 cases of OSCC were included, of which 48 showed LN metastasis. Histological grade, WPOI, tumor budding (≥3/×40 field), LVE, and PNI were significantly associated with risk of LN metastasis. On multivariate analysis, WPOI and tumor budding were 2 most significant factors. Among the early-stage tumors with available follow up (n = 48), DOI, WPOI, tumor budding, and LVE were associated with a shorter overall survival, although it was not statistically significant. To conclude, WPOI and tumor budding are important risk factors for predicting LN metastasis in all stages of OSCC and associated with a poorer outcome in early-stage tumors. These are easy and reliable prognostic factors and should be included in the histopathological reporting guidelines.

Parotid gland chondroma masquerading as pleomorphic adenoma in fine needle aspiration cytology: A diagnostic challenge.

Chondroid neoplasm of parotid gland is extremely rare. Only a few cases of extraskeletal chondroma and one case of chondrosarcoma of parotid gland have been reported in the literature. The cytological features of parotid gland chondroma are not well documented. A 61-year female patient presented with a slow growing left preauricular mass for past 6 years. Computer tomography scan showed a well circumscribed mass in the superficial lobe of left parotid gland. Fine needle aspiration cytology (FNAC) showed uniform chondrocytes embedded in a chondroid matrix, and was diagnosed as pleomorphic adenoma. Histological examination of the excised specimen showed a benign cartilaginous tumor, consistent with chondroma. There was no epithelial or myoepithelial component on extensive search. Chondroma is an extremely rare tumor of parotid gland and can be misdiagnosed as pleomorphic adenoma on cytology examination. However, absence of epithelial and myoepithelial component can give a clue toward a pure chondroid neoplasm. This report highlights the diagnostic features of chondroma of parotid gland and its diagnostic pitfalls in FNAC.