Basal cell adenoma (BCA) is a rare benign epithelial tumor of the salivary gland, displaying monomorphic basaloid cells without a myxochondroid component, representing 1–3% of all salivary gland neoplasms seen predominantly in women over 50 years of age. It is uncommon in young adults. Cytodiagnosis of basaloid tumors chiefly basal cell adenoma of the salivary gland, is extremely challenging. The cytological differential diagnoses range from benign to malignant, neoplastic to non- neoplastic lesions. Histopathological examination is a must for definitive diagnosis, as these entities differ in prognosis and therapeutic aspects. We present a 22-years-old male with this uncommon diagnosis with a discussion on the role of cytological diagnosis. Fine needle aspiration cytology is a simple, minimally invasive method for the preoperative diagnosis of various types of neoplastic and non-neoplastic lesions. The knowledge of its pitfalls and limitations contributes to a more effective approach to treatment.
Fibroadenomas with a predominant cystic change are called cystic fibroadenomas. These are extremely rare forms of fibroadenomas and only one case has been reported so far. They are classified under the category of complex fibroadenomas. Complex fibroadenomas are a rare variant of fibroadenomas occurring in elderly females. They are characterized by presence of one of the complex features along with the usual patterns of fibroadenoma such as cysts more than 3 mm, papillary apocrine metaplasia, or sclerosing adenosis. Patients with these lesions have higher chances of developing carcinoma of breast. We present a case of 35 years old lady with a freely mobile mass in the left breast diagnosed as cystic fibroadenoma after thorough histopathological examination of the lesion.
Nerve sheath myxoma defined by Harkin and Reed is an uncommon benign neoplasm with nerve sheath like features. It has several cytological and histological differential diagnoses. One such lesion is neurothekeoma, which can be differentiated using immunohistochemistry. In most of the previous reports nerve sheath myxoma and neurothekeoma were considered synonymous and were often confused for one another. This case report separates the two using immunohistochemistry. Also, the cytological features of nerve sheath myxoma are not well documented in the past. This case report attempts to display the cyto-morphology of nerve sheath myxoma. We report a rare case of nerve sheath myxoma diagnosed on cytological features confirmed by histopathology and immunohistochemistry in a 32-year-old lady who presented with an asymptomatic nodule over the left cervical area and discuss its cyto-histological mimics.
A 29-year-old female patient presented with a gradually increasing painless lobulated mass at right parieto-occipital region along with headache since one year. All routine investigations along with CT brain were within normal limits. On examination, the swelling was multilobulated measuring about 6x5x3 cm, showing surface ulceration with focal loss of hair and along with loss of pigmentation. The mass was mobile, free from the underlying structures and bled on touch. No regional lymphadenopathy was noted. A presumptive diagnosis of soft tissue sarcoma was given. FNAC was attempted twice, but yielded only haemorrhage as it was very vascular, located over scalp region. Hence, the mass was excised and sent for histopathological evaluation.Grossly, the specimen showed a skin covered mass with surface ulceration together measuring 5x4x3 cm. The cut surface of the tumour showed grey white appearance with areas of haemorrhage and cystic degeneration [Table/ Fig-1].Microscopic examination revealed skin with an underlying infiltrating tumour composed of polygonal to cuboidal cells having pleomorphic vesicular nuclei with prominent one to two nucleoli and having moderate to abundant pale cytoplasm arranged in lobules, nests and cords which are separated by thick fibrous septae [Table /Fig-2]. Many mitotic figures (upto 6-7/hpf) along with duct formation [Table/ Fig-3a] and foci of tumor necrosis were noted. Ducts stained with Pas stain [Table/ Fig-3b]. At places lymphatic tumour emboli were noted. The tumour depth noted was >7mm and was seen reaching upto the deep surgical margin.Immunohistochemical studies showed that the tumour cells were positive for cytokeratin [Table/ Fig-4a] and the ductal structures were highlighted by carcinoembryogenic antigen (CEA) [Table/ Fig-4b]. Based on these findings the diagnosis of eccrine porocarcinoma was arrived at. The patient developed recurrence ABSTRACTEccrine porocarcinoma (EPC) is a potentially lethal neoplasm of the skin that arises from the intraepidermal portion of the eccrine sweat glands. It was previously known as eccrine adenocarcinoma or malignant eccrine poroma. It commonly occurs between 60 to 80 years of age, usually arising from hands and feet. However, few case reports on involvement of rare sites such as scalp, face and eyelids are present in literature. We herein report an unusual case of porocarcinoma arising on the right parieto occipital region of scalp in a 29-yearold young female patient. To the best of our knowledge, there have been fewer than 20 cases of porocarcinoma arising on scalp with fewer than 10 cases seen in younger age group reported previously in the literature.
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