Congenital cystic adenomatoid malformations (CCAM) are rare developmental anomalies of the lung characterized by cysts of varying sizes and/or adenomatoid proliferation. Type I CCAM, the most frequent subtype, is associated with an increased incidence of malignant transformation, principally bronchioloalveolar carcinoma, with a reported incidence of around 1%. We report the first case of mucoepidermoid carcinoma arising in a type 1 CCAM.
PTCL, NOS constituted about 30.68% of all PTCLs in our institution during a 5-year period and was the second most common type of PTCL. Immunophenotyping using a wide panel of T-cell antibodies is necessary to distinguish PTCL, NOS from other lymphomas which they mimic, as they are known to carry a worse prognosis.
A 75-year-old male presented with history of abdominal pain and generalised weakness for about three months. Clinically he was anaemic and per abdomen examination was unremarkable. Oesophagogastroduodenoscopy revealed an ulceroproliferative polypoidal growth involving the gastric antrum [Table/ Fig-1] and few scattered small sessile nodules in the body and antrum of stomach. Colonoscopy revealed a polyp in the rectum. The gastric antral lesion was biopsied and rectal polyp was excised and sent for histopathological examination. The patient also had an enlarged left supraclavicular lymph node which was also biopsied. Gastric antral lesion was reported as a moderately differentiated adenocarcinoma with papillary pattern and the rectal polyp was reported as ganglioneuroma [Table/ Fig-2]. The supraclavicular lymphnode showed a necrotising granulomatous inflammation, however the special stains such as Zeihl-Neelsen and Periodic Acid Schiff (PAS) for tuberculosis and fungi were negative.A radical subtotal gastrectomy with D2 lymphadenectomy and Billroth I anastomosis with feeding jejunostomy was done. Specimen was fixed in 10% neutral buffered formalin and representative sections were taken. Grossly, there was a raised ulcerated lesion involving the gastric antrum along the greater curvature measuring 5.0 x 3.0
AbSTRACTAlpha Fetoprotein (AFP) producing gastric carcinomas are very rare and have unique clinicopathological features and an extremely poor prognosis. Here, we report a case of AFP producing gastric carcinoma with three distinct histomorphologic patterns such as yolk sac like, hepatoid, tubular and papillary adenocarcinoma components. The uniqueness of this case is absence of metastases and associated findings such as fundic gland polyposis with varying degrees of dysplasia, gastric and duodenal well differentiated neuroendocrine tumour and rectal ganglioneuroma. The patient is symptom free as of two and half year's postoperative period.
Sertoli-Leydig Cell Tumors (SLCT) are very rare neoplasms of the ovary (0.2%) and they belong to the group of sex cord-stromal tumors. Of these, 20% of the cases show heterologous elements. We report a case of a 22-year-old woman who presented with complaints of lower abdominal pain and secondary amenorrhea for 10 months. Physical examination revealed right lower abdominal tenderness and fullness. Imaging showed a right ovarian mass. She underwent right salpingo-oophorectomy with bilateral pelvic lymphadenectomy and omentectomy. Microscopic examination revealed a neoplasm with varied histomorphological patterns. The predominant pattern was an atypical proliferative mucinous tumor with foci of microinvasion. The other component was that of moderately differentiated Sertoli-Leydig Cell Tumor. Focal areas resembling carcinoid were also noted. Immunohistochemistry was performed and the Sertoli-Leydig Cells were positive for CD56, calretinin, inhibin, vimentin, and ER. The glandular component was positive for CK20, EMA, CEA, and CDX2. Synaptophysin and chromogranin were positive within nests resembling carcinoid. With the given histomorphological features and immunohistochemistry findings, a diagnosis of moderately differentiated Sertoli-Leydig Cell Tumor of the ovary with associated mucinous carcinoma and carcinoid was rendered. The presence of heterologous elements in SLCTs has been reported to be associated with poor prognosis.
Ovarian endometrioid malignancies with sex cord like elements are extremely rare. These neoplasms often get misdiagnosed as sex cord stromal tumors. Although Sertoliform variant of endometrioid adenocarcinoma has been well documented, an endometrioid adenofibroma with sertoliform tubules has not been reported so far in the literature. We report a case of postmenopausal woman with endometrial growth which has been reported as Malignant Mixed Mullerian tumor. She also had an incidental ovarian mass which showed features of an endometrioid adenofibroma with areas resembling sertoli like tubules. This case report is to emphasize the potential of misdiagnosing these entities as sex cord stromal tumors.
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