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.
Background: Tumourlike lesions or reactive lesions of the oral cavity are group of fibroconnective tissue lesions that commonly occur in the oral mucosa as a result of injury. Aim: The purpose of this study is to determine the relative prevalence of different histopathological aspects of oral soft tissue tumourlike lesions which were received at Pathology department, Government medical college, Miraj, Maharashtra Methods: A total number of 95 cases of tumourlike lesions were included in the study. Specimens were received at department of pathology, Government medical college, Miraj, Maharashtra over a period of 5 years from August 2008 to July 2013. It was one year retrospective and four years prospective, cross sectional study Result: A total number of 642 oral biopsies and excised specimens were studied, out of which 95cases (14.8%) belonged to tumourlike lesions. Among tumorlike lesions, pyogenic granuloma (47.38%) was the commonest lesion, followed by Mucocele (26.32%). Majority of tumorlike lesions were located on gingiva (38.94%) followed by lower lip (28.42%). Males (57.89%) were more commonly affected than females and the commonest symptom was swelling (100%). Conclusion:The most common tumourlike lesion in our study was pyogenic granuloma. Few very rare and interesting cases like plasma cell granuloma and Nasolabial cyst were also seen. Tumorlike lesions presented mainly as nodule or swelling, which should be differentiated from other benign and sometimes malignant lesions, as the tumourlike lesions have good prognosis when compared to malignant lesions. Hence histopathology remains the mainstay for correct diagnosis and treatment.
Malignant tumors rarely metastasize to the oral cavity and account for about 1% of all oral tumors. Metastasis to soft-tissue of the oral cavity is much rarer than jaw bones. Because of the rarity, metastatic tumors in the oral region are challenging for diagnosis. Primary tumors which metastasize to mouth are the most commonly lung, breast, and kidney. Oral cavity metastases represent distant spread and are associated with poor prognosis with short survival. We present a case of the gastroesophageal junction adenocarcinoma with metastasis to the oral soft-tissue.
Chondroid syringoma (CS) also known as mixed tumor of the skin, is a rare benign adnexal tumor accounting for < 0.098%. Epithelial cells arranged in cords and tubules set in myxoid or chondroid stroma. Differentiation such as osteoid, sebaceous or mature adipocytes can be seen rarely. Hyaline cell rich is a rare variant of CS composed of cells with eosinophilic hyaline cytoplasm and plasmacytoid features. CS can have benign, atypical and malignant variants. The term atypical mixed tumor is recommended for those tumors which have histological features of malignancy such as infiltrative margin, satellite tumor nodules and tumor necrosis but without proven metastasis. Very few case reports of hyaline cellrich benign CS have been reported in the past, but to the best of our knowledge, possibly it is the first case of atypical hyaline cellrich CS of the little finger in a 65 year-old female showing divergent differentiation.
A 44-year-old female with history of Type II diabetes mellitus and severe anaemia presented to emergency department with vomiting, nausea and abdominal pain. General examination revealed severe pallor and systemic examination revealed hepatosplenomegaly. There was no lymphadenopathy. Laboratory data showed haemoglobin 6.5 gm%, WBC count was 20x103/µl, peripheral smear examination showed rouleaux formation with microcytes hypochromia and anisopoikilocytosis with 40% plasma cells and 27% plasmablasts [ Liver and renal function tests showed hypoalbuminaemia, hyperuricaemia and hyperphosphataemia, blood urea 106 mg/dl, serum creatinine 4.8 mg/dl, serum calcium 12 mg/dl, Lactate Dehydrogenase (LDH) 450U/l, ESR 36 mm/hr, and B2 microglobulin>20,000 ng/ml. Serum protein electrophoresis showed a monoclonal band in the gamma region. X-ray of skull and spine showed only osteoporosis and did not show any osteolytic lesions. Bone marrow aspiration and biopsy were performed. Aspirate revealed diluted sinusoidal blood. Bone marrow biopsy showed mostly cortical bone with small groups of plasma cells amidst few erythroid series cells [ AbSTRACTPrimary Plasma Cell Leukaemia (pPCL) is a very rare and aggressive subtype of plasma cell dyscrasias with a very poor outcome and characterized by presence of >2x10 9 /l circulating plasma cells. Overall incidence being 1%-2% of all malignant plasma cell diseases and 0.9% of all acute leukaemias. Patients with primary and secondary PCL have similar clinical features but differences do exist. Here we report a rare and interesting case diagnosed as primary PCL in a 44-year-old female with unusual clinical presentation and complex karyotyping. Her serum electrophoresis showed a monoclonal IgG component and immunohistochemistry of bone marrow plasma cells showed CD 38 positive and CD 20 negative. The patient initially responded partially for combination chemotherapy, but succumbed after 20 days of diagnosis. We are presenting this case to highlight the importance of early diagnosis of such haematological malignancies in settings where treatment options like stem cell transplantation are limited. abnormality i.e., hyperploidy with monosomy X(51,XO). The following abnormalities were noted: 51,X,-Xadd(4)(p16),+5,del(6)(q21),+7,+8,add(8)(q24)x2,+del(9) (p11),+12,dict(1;12)(p11;q24),+19,-22,+mar [Table /Fig-4].Our patient was diagnosed to have primary PCL based on the findings of peripheral smear, bone marrow biopsy, serum electrophoresis and cytogenetic analysis. After first cycle of chemotherapy, plasma cell count reduced to 25% and plasmablasts to 12%. Later, her conditions deteriorated and succumbed within 20 days of diagnosis due to uraemic encephalopathy. Consent was not given for clinical autopsy by patient's relatives. DISCUSSIONPCL is defined as a clonal proliferation of plasma cells first diagnosed in the leukaemic phase [1]. The first cases of PCL were first described in a 63-year-old woman at autopsy, who had widespread infiltration of plasma cells in multiple organs and a 47-year-old...
Background: To describe the histopathological types and frequency of the most common benign tumours of oral cavity reporting to the government referral hospital at Miraj in Maharashtra state. Materials and Methods: A retrospective analysis was made of the five year records of reports of oral biop-sy samples of patients maintained by the department of pathology. The data obtained was compiled for age, gender, site of the lesion and the histopathology features of the lesions. Results: Seventy of the 642 biopsy samples of the oral lesions reported in this five year period were categorised as benign oral tumours. Fibro-ma (48.6%) followed by squamous papilloma (28.6%) were found to be the commonest benign tumours. The buccal mucosa was the most commonest site of these benign tumours (44.3%). Conclusions: Fibroma is the commonest benign tumour of the oral cavity reporting to the referral government hospital at Miraj in Maharastra state. Keywords: Benign oral tumour, fibroma, oral cavity, soft tissue lesion, histopathology
Background: Breast carcinoma is now one of the most common cause of death in females worldwide, hence should be early diagnosis and treatment is necessary. This study aims at establishing Fine needle aspiration cytology (FNAC) as an individual parameter in diagnosing and grading breast carcinoma followed by correlation with histological grading. Methods: Cytological smears of 51 cases of breast carcinomas were graded by using Robinson's method and corresponding histology sections were graded according to Elston and Ellis Nottingham modification of Bloom Richardson's method and correlation was done. Result: On cytology, there were 10,26 and 15 cases of grade I, grade II and grade III tumours respectively while on histology there were 12, 31 and 8 cases of grade I, grade II and grade III tumours. The concordance rates between cytology and histology grades were 90%, 76.92% and 26.67% respectively with an absolute concordance rate of 64.71%. Conclusion: FNAC is simple, non invasive and a very good tool which provides information about the aggressiveness of the tumour and helps to select appropriate treatment.
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