54 research outputs found
Balloon cell melanoma of the anal canal: A wolf in sheep′s clothing?
Balloon cell melanoma (BCM) is a rare histologic variant of cutaneous malignant melanoma with exceptional reports of occurrences at non-cutaneous sites. Herein we present a case of primary amelanotic BCM of anal canal, a heretofore undescribed location. Histologically, the tumor was characterized by sheets of pale cells that bore striking resemblance to foamy macrophages. Presence of rare atypical mitoses confirmed the malignant nature of the cells. Neoplastic cells were immunoreactive for S100, Melan-A, and focally for HMB-45 while were negative for myogenic, gastrointestinal stromal tumor, epithelial and neuroendocrine markers. Resemblance to foamy macrophages, bland cytology and absence of pigment imparts this tumor a deceptively benign histological appearance making it prone to diagnostic pitfalls. Awareness of this rare entity and judicious employment of immunohistochemistry is imperative in segregating it from its diverse mimics
Spinal epidermoid cyst with sudden onset of paraplegia
Spinal epidermoid cysts, whether congenital or iatrogenic, are
relatively uncommon in the spinal cord. When they occur, the typical
location is in the subdural, extramedullary space of the lumbo-sacral
region. We describe an unusual presentation in a 3-year-old male child
which mimicked astrocytoma clinicoradiologically. The child developed
sudden onset of inability in walking and weakness of both lower limbs
after a fall. There was a dramatic reversal of symptoms after surgery.
Histopathology revealed an epidermoid cyst of the spine. On the first
follow-up visit at 3 months, the child was asymptomatic
Pancreatoblastoma masquerading as hepatoblastoma: A diagnostic dilemma
Clinicoradiological and histopathological differentiation of pancreatoblastoma from hepatoblastoma can often be a challenge in clinical practice owing to their peculiar resemblance. We report a case of a 4-year-old boy with a right hypochondriac region mass, which was diagnosed as hepatoblastoma on the basis of imaging, raised tumor marker, and biopsy; however, pancreatic origin of the mass was ascertained on exploration and pancreatoblastoma was confirmed on histopathology
Outcomes of pediatric rhabdomyosarcoma (RMS) from a tertiary referral cancer centre in India: Can we obviate therapy related toxicity in favorable risk groups?
Clinicopathologic features of four rare types of chordomas, confirmed by brachyury immunostaining
Background: A wide clinicopathologic spectrum of a chordoma exists. Brachyury constitutes as its most useful diagnostic immunohistochemical (IHC) marker. Methods: During a 7-year-period, 4 unusual histopathologic types of chordomas were identified. Immunohistochemistry was performed by polymer technique. Results: Clinicopathologic features of the 4 cases are as follows: Cases 1 and 2: Two tumors occurred in the sacrococcygeal and lumbosacral regions of a 42-year-old male and a 34-year-old female, respectively. Histopathologic examination showed areas of classical chordoma; juxtaposed to a high-grade, spindle cell sarcoma. By IHC, cytokeratin (CK), epithelial membrane antigen (EMA), S-100 protein, and brachyury were found to be distinctly positive in the differentiated chordomatous areas. Both these cases were diagnosed as dedifferentiated chordomas. The first patient, postresection and adjuvant radiation therapy (RT), died after 14 months of therapy. Case 3: A 58-year-old male presented with pain in his sacral region and urinary incontinence. Imaging disclosed a sacral mass. Histopathologic examination showed physaliphorous cells intimately admixed with, markedly pleomorphic cells, scattered mitotic figures, and focal tumor necrosis. By IHC, the tumor cells were positive for CK, AE1/AE3, S-100 protein, brachyury, and INI1/SMARCB1. The diagnosis of a poorly differentiated chordoma was offered. Despite surgical resection and adjuvant RT, the patient died within 18 months. Case 4: A 58-year-old male presented with a soft tissue lesion in his left leg. Histopathologic examination showed physaliphorous cells, embedded in a myxohyaline stroma. By IHC, the tumor cells were positive for EMA, S-100 protein, brachyury, and INI1. Diagnosis of an extra-axial, soft tissue chordoma was offered. Conclusions: These four unusual chordomas, confirmed by brachyury immunoexpression, constitute as one of the first such documentation from our country, revealing a wide clinicopathologic spectrum of chordomas. Dedifferentiated and poorly differentiated chordomas are associated with an aggressive clinical course. Further diagnostic implications are discussed herewith
A rare case of primary gastric plasmacytoma: An unforeseen surprise
Primary plasmacytoma of the gastrointestinal tract is a rare entity. We
report a case of a primary gastric plasmacytoma in a 57-year-old man
who presented with upper-gastrointestinal bleeding. Endoscopy showed a
nodular gastric mass with central umblication. Histological examination
of the gastrectomy specimen revealed a monoclonal lambda-chain
extramedullary plasmacytoma. Further staging was found to be negative
for multiple myeloma. As other more common pathologic processes at this
site may also be endowed with numerous plasma cells, awareness of this
entity and distinction using immunohistochemistry are extremely
crucial. Because systemic disease ultimately develops in many patients
with localized plasmacytoma, such patients should be followed closely
for the appearance of clinical, biochemical, and roentgenologic
evidence of multiple myeloma
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