Cytokeratin-positive interstitial reticulum cell sarcoma: Extranodal presentations mimicking carcinoma.

Cytokeratin-positive interstitial reticulum cell (CIRC) sarcoma is a rare type of dendritic cell tumor derived from a subset of fi broblastic reticular cells. Expression of cytokeratins and extranodal location of these tumors can lead to a misdiagnosis of carcinoma. We report two cases of CIRC sarcomas primarily involving the scalp and breast. Patients were referred with an initial diagnosis of carcinoma. Case 1 underwent wide local excision of the scalp tumor with left posterolateral neck dissection. Case 2 had modifi ed radical mastectomy for the tumor in left breast. Histopathological examination of both specimens showed an epithelioid to spindle cell malignant tumor that co-expressed CK 8, CK 18, vimentin, and smooth muscle actin. A diagnosis of CIRC sarcoma was made. Pathologists should be aware of this subset of dendritic cell sarcoma. Carcinomas, other sarcomas of the accessory dendritic cell family, and poorly differentiated malignant tumors have to be ruled out by combination of morphology, immunohistochemistry, and electron microscopic studies.

Multifocal histiocytic sarcoma of the gastrointestinal tract.

We report a rare case of extranodal histiocytic sarcoma with multifocal gastrointestinal tract involvement, which has not been documented in the literature so far. A diagnosis of interdigitating dendritic cell/ histiocytic sarcoma was made on the preoperative gastric biopsy. Computed tomography scan revealed multifocal, circumferential gastrointestinal wall thickening involving the stomach and jejunal loops. Patient underwent distal gastrectomy with extended D1 dissection and proximal jejunal resection with gastrojejunostomy. Immunohistochemistry profile of both the gastric and jejunal tumors was similar to the preoperative gastric biopsy. The histiocytic origin of the tumor was confirmed by positive reaction of the tumor cells for CD 163. She received four cycles of CHOP chemotherapy, and is free of disease three years, following surgery.

Malignant melanoma with osteocartilaginous differentiation.

We report a case of acral lentiginous melanoma on the plantar aspect of foot in a 50-year-old male that exhibited a prominent osteo-cartilaginous differentiation in the metastatic inguinal lymph node. The ability of melanomas to undergo multidirectional differentiation leads to a variety of histological appearances that can be misleading. Although the true nature of the tumor is most often recognized at the primary cutaneous site, metastatic tumors may closely mimic other malignant mesenchymal or neuro-ectodermal tumors. Hence awareness of this unusual phenomenon occurring in malignant melanoma is essential to avoid misdiagnosis.

Primary malignant teratoma of the thyroid in a child with nodal metastases.

Malignant teratomas of the thyroid are rare tumors. We report a case of primary malignant teratoma of the thyroid in a child with lymph node metastases. Fine needle aspiration biopsy was suggestive of malignancy. Near-total thyroidectomy with right side neck dissection revealed a malignant teratoma of the thyroid with metastases in the lymph nodes. The patient is alive and in complete remission 4 years after the initial diagnosis.

Follicular dendritic cell sarcoma of oral cavity: report of 2 cases.

We report 2 cases of Follicular Dendritic Cell Sarcomas of Oral Cavity in two elderly patients. The patients presented with oral cavity tumors. Initial tru-cut biopsies in both cases revealed spindle cell neoplasms. One of them was of low grade malignancy and showed positivity for of Vimentin. Few cells showed positivity for keratin and were negative for S-100 protein, CD 34, CD 68, EMA, SMA, HMB-45. A possible diagnosis of low grade fibrohistiocytic tumor was made. He underwent Lt total maxillectomy. Three years later he presented back with regional nodal metastasis. The regional lymph nodes showed features of follicular dendritic cell sarcoma. The second case revealed high grade spindle cell neoplasm and showed positivity for vimentin and S100 protein and was negative for EMA, keratin, CD-34, desmin, muscle actin and HMB-45. He was offered initial radio-therapy followed by hemifacial resection. The histology along with immuno histochemistry favoured a diagnosis of follicular dendritic cell sarcoma. He presented with local recurrence two months later. Both the cases are discussed in detail.

Primary fibrosarcoma of the ovary--report of two cases.

The authors describe two cases of primary fibrosarcoma of the ovary in 48 years and 66 years old women. Patients presented with abdominal masses associated with pain in the first case. USG and CT scan of the abdomen revealed ovarian tumours involving the left side in both cases . Both underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histological examination showed features of fibrosarcoma grade I and grade III respectively. A clinicopathological study and brief review of literature is presented.