Background: Breast cancer is the most common malignancy in women worldwide and the second most common cancer in females in India. Receptor status may be important for survival. Objective: To analyse and correlate the clinical and morphological parameters with receptor status in breast carcinoma patients in a tertiary care institution in Southern India. Materials and Methods: This retrospective study involved 320 patients of breast cancer diagnosed in an oncology hospital over a period of 3½ years. Data was analysed using SPSS Version 21. Results: Some 60.6% patients with breast carcinomas belonged to the age group of 40 to 60 years. The most common histological type was infiltrating ductal carcinoma, not otherwise specified, accounting for 84.4% of patients. On immunohistochemistry, estrogen receptor (ER) and progesterone receptor (PR) were expressed in 56.3% and 53.1% of cases, respectively. Conclusions: Breast cancers in India, a developing country, occur in younger women and tend to be more aggressive with lower rates of ER and PR expression and higher histological tumor grades. Both ER and PR status of the tumors had significant associations with the patient age, pathological TNM stage and histological tumor grade.

Lichen planus is a benign disorder characterized by an itchy, noninfectious skin rash. Though lichen planus is a common papulosquamous disorder affecting about 1-2% of the population, neoplastic transformation of cutaneous lichen planus lesions occurs very rarely and should be borne in mind while treating nonhealing longstanding lesions of lichen planus. Studies suggest an estimated 0.3–3% risk of malignancy in patients with oral lichen planus, however, cutaneous lichen planus does not carry an increased risk of malignant degeneration. We present a case of a 36-year-old male with a 10-year-long history of hypertrophic lichen planus who presented with a nonhealing ulcer in the left popliteal fossa. The patient underwent wide local excision with superficial skin grafting. Postoperative histopathological examination revealed verrucous squamous cell carcinoma complicating lichen planus. In view of underlying structure involvement, adjuvant radiation therapy was given. This case is being reported to emphasize the infrequent possibility of development of malignancy in cutaneous lichen planus, especially if it presents as a longstanding, nonhealing, itchy lesion with patchy areas of depigmentation in the lower limbs.

Dual malignancy was first reported by Billroth in 1889. Incidence of second malignancy in cancer patients is as high as 10%, but synchronous anaplastic thyroid cancer along with breast tumor is a rare entity. We present a case of a 61-year-old female with a synchronous anaplastic carcinoma thyroid with ductal carcinoma breast. The plausible association of breast cancers with thyroid carcinomas should thus be evaluated in larger cohort studies. More importantly, this report is to highlight the unusual synchronous occurrence of anaplastic thyroid cancer with ductal breast cancer and the therapeutic challenges involved in such cases.

BACKGROUNDMediastinal lesions are uncommon and infrequent, encountered as mediastinal masses with wide histopathological spectrum which cause diagnostic difficulty to the clinicians and radiologists because of the variations of presenting symptoms, locati on and accessibility. Mediastinal lesions also pose difficulty in obtaining samples directly by Fine Needle Aspiration or Needle Core Biopsy technique, Ultra Sound/ Computed Tomography guided techniques aid in getting adequate material and to arrive at a definitive diagnosis in cases where resection of the lesion is not possible, and accessibility is poor. We wanted to present the spectrum of histopathological diagnosis of various mediastinal lesions both benign and malignant, encountered in this institution, a tertiary care center in India. METHODSThis is a retrospective study conducted from June 2015-December 2018 on Fine Needle Aspirations (FNA), Needle Core Biopsies (FNB) and surgically resected specimens of all mediastinal lesions sent to the Department of Pathology for histopathological examination. RESULTSA total of 43 cases of mediastinal lesions was taken into consideration. Out of these 43 cases, 17 (39.53%) were CT guided FNA, 5 (11.63%) CT guided FNBs and 21 (48.84%) were excised specimens. In 3 (6.97%) of these cases of FNA diagnosis was inconclusive and in 2 (4.65%) cases no opinion could be given as material was necrotic and inadequate. Of the total 43 cases 27 (62.8 %) cases were males and about 16 (37.2%) were female patients. M:F ratio was 1.7:1. Age distribution was between 04 -70 yrs. 4 (9.30%) of the cases were in paediatric age group (<16 yrs.) and 39 (90.60 %) were in adult age group (>1 6 yrs.). Mean age in adults was (47.7 yrs.). CONCLUSIONSThe present study emphasizes on the importance of awareness of various lesions that can occur in mediastinum, spectrum of histopathological variants and a definitive diagnosis in guiding the treating clinician to initiate the appropriate treatment at the earliest especially in cases of malignancies and non resectable lesions. Wherever necessary IHC should be done. In the present study, thymic lesions and lymphomas are the most common lesions encountered in adults (8 and 7 of the total 43 lesions). In paediatric age group, we encountered two thymic cysts and two lymphomas of which one was Hodgkin's and the other was Non-Hodgkin's lymphoma. HOW TO CITE THIS ARTICLE: Parasa GD, Remala KR, Turlapati SPV. Histopathological spectrum of mediastinal lesions in a tertiary care centre, Andhra Pradesh, India. BACKGROUND Mediastinal lesions are uncommon lesions which occur in the central portion of the thoracic cavity, limited by pleural cavities laterally, thoracic inlet superiorly, the diaphragm inferiorly and vertebral column posteriorly. Diagnosis of these lesions is a difficult task for clinicians, radiologists and pathologists because of its variable presentation clinically, inaccessibility and also due to histomorphological variations. Mediastinal masses present as space occupying masses situated in differ...