Primary testicular lymphoma (PTL) is an uncommon disease, and accounts for about 1% to 2% of non-Hodgkin's lymphomas and less than 5% of all testicular malignancies. Of all testicular malignances, primary testicular diffuse large B-cell lymphoma is the most common type, whose incidence is estimated at 0.26/100 000 per year. At presentation or relapse, PTL tends to spread to several extranodal sites, such as the contralateral testis, the central nervous system, skin, lung, pleura, Waldeyer's ring, and soft tissues. Orchiectomy and chemotherapy are the preferred treatment. We report a case of a 40-year-old male presenting with a nodule on the anterior abdominal wall and with right scrotal swelling on physical examination. Histopathologic examination led to the diagnosis of cutaneous metastasis of testicular lymphoma.
Fine needle aspiration cytology (FNAC) is often the first investigation in the work up of salivary gland lesions. However, its diagnostic accuracy is limited by the high rates of false positives and false negatives. Usually, acinic cell carcinoma is prone to be underdiagnosed because of the cytological similarity of the tumor cells to normal acinar cells, however rarely, a predominant papillary architecture on cytology may cause confusion with adenocarcinomas. We present a case of a 45-year-old male with a painful swelling of the right parotid region. FNA smears revealed a predominant papillary architecture and focal acinar pattern. A provisional diagnosis of acinic cell carcinoma was given, which was confirmed on histopathology. Familiarity with the cytomorphologic features of acinic cell carcinoma is cardinal for an accurate diagnosis and appropriate management.
Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy, accounting for 70%–80% of all thyroid malignancies. It is biologically indolent and has an excellent prognosis. Variations in histopathologic patterns are known to influence prognosis and often result in a diagnostic dilemma. We report an unusual case of a 35-year-old female with papillary carcinoma of a thyroid isthmus showing anastomosing channels on histopathology, a distinctive pattern that has not been described in PTC. Similar to tumor cells, the lining cells of these channels were also positive for thyroid transcription factor 1, thyroglobulin, and cytokeratin-19 and negative for CD34 and CD31. The diagnosis of PTC should rely on nuclear morphology rather than architecture. Pathologists should be aware of different variants because some of these variants show aggressive behavior and poor outcome. The present report highlights the distinctive pattern of PTC, recognition of which is important to avoid any diagnostic pitfall.
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