The calcifying epithelial odontogenic tumor (CEOT), also known as the Pindborg tumor, is a benign locally invasive neoplasm. Common variants of CEOT include noncalcifying, Langerhans cell, bone and cementum forming and clear cell, which have a prognostic significance. Pigmented variants are known to occur in other odontogenic tumors. However, a definitive pigmented variant of CEOT has not been reported in literature so far. Here, we report the first case of pigmented Pindborg tumor arising from the maxilla in a young female. The pigment was demonstrated as melanin by staining and confirmed by immunohistochemistry. The pigmented variant of CEOT did not recur within 18 months postsurgery. Our report indicates that it is essential to recognize the pigmented variant. We discuss the common variants of CEOT and potential histogenesis of the pigmented variant. Further studies are required to reveal the histogenesis of melanocytes and their pathological significance in the odontogenic tumors.
Mixed- phenotype acute leukaemia (MPAL) is very rare and accounts for less than 4% of acute leukaemia. Most cases of MPAL described in literature, are of T/myeloid or B/myeloid phenotype. MPAL T/B cell lineage is exceptional and occasional cases reported so far, are leukaemia with bone marrow involvement. Our case, on immunophenotyping, exhibited evidence of T and B- Lymphoid lineage. It could be diagnosed neither as MPAL, because the bone marrow was not involved, nor as lymphoblastic lymphoma because of the bi phenotypic expression of both T and B cell antigens. Hence, we reported it as Mixed phenotypic (T cell/B cell) Lymphoblastic Lymphoma. This is the first case, extra medullary as well as extra lymphoid in location, presenting as right elbow synovial lesion. We also discuss the potential diagnostic pitfalls and emphasise the importance of Immunohistochemistry in diagnosis of lymphoblastic lymphomas.
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