Granular cell ameloblastoma: A rare and unique variant

Ameloblastoma is a slow-growing and locally invasive epithelial odontogenic tumor of the jaw that runs a benign course in most cases. Granular cell ameloblastoma is a rare subtype of ameloblastoma, showing the granular transformation of its cytoplasm. It is considered as an aggressive variant of ameloblastoma. Herein, we report the case of a 34-year-old male patient who presented with a swelling in the left cheek for a 1-year duration with a recent rapid increase in size. Examination showed a 4 � 3 cm growth involving the left buccal mucosa and retromolar area. Imaging studies showed expansile lytic lesion mandible. Biopsy revealed neoplasm with odontogenic epithelial islands showing peripheral palisading of tall columnar cells with reversal of polarity and the center of the islands showing stellate reticulum-like cells which were markedly replaced by granular cells. Granular cells can appear in various odontogenic and non-odontogenic tumors. When there is extensive granular cell change in ameloblastoma, it should be differentiated from other oral lesions with granular cells including granular cell odontogenic tumor, granular cell tumor, and congenital epulis.

Flow cytometric analysis of Mixed phenotype acute leukemia: Experience from a tertiary oncology center.

Introduction: Mixed phenotype acute leukemia (MPAL) is a rare subset of acute leukemia where the blasts exhibit lineage specifi c antigens of more than one lineage. Flow cytometric immunophenotyping is essential for the diagnosis of MPAL and the accurate diagnosis highly depends on the panel of markers used. The precise incidence of MPAL is uncertain as various institutions use different combinations of antibodies to assign the blasts to a particular lineage. Aim: The aim was to study the immunoprofi le of acute leukemia including aberrant antigen expressions and to study the incidence, clinical features, laboratory fi ndings, and immunophenotype of MPAL in our institution. Materials and Methods: All cases of acute leukemias in which fl ow cytometric analysis during 1-year period from July 2012 to July 2013 were included in this study. Results: During the study period, fl ow cytometric analysis of 506 cases was performed. B lymphoblastic leukemia was the most common subtype of acute leukemia. CD13 was the most common aberrant antigen expression in acute lymphoblastic leukemia and CD7 was the most common aberrant antigen expression in acute myeloid leukemia. A diagnosis of MPAL was made in 15 cases, which accounted for 2.96% of all leukemias. 9 cases were diagnosed as T/myeloid, 5 cases as B/myeloid and 1 case as B/T. Conclusion: Mixed phenotype acute leukemia is a rare subset of acute leukemia. Flow cytometry is critical in establishing a diagnosis of MPAL. The panel of antibodies used is important in the identifi cation of the “mixed” phenotype. Cytoplasmic markers (cytoplasmic MPO, cytoplasmic 79a, cytoplasmic 22 and cytoplasmic CD3) should be included in the primary flow cytometric panel.

Renal cell carcinoma metastasizing to adenocarcinoma of esophagogastric junction: A rare case of tumor-to-tumor metastasis.

The simultaneous occurrence of two primary tumors in one patient is not uncommon, but one tumor metastasizing to another malignancy is a rare phenomenon. Tumor-to-tumor metastasis was first described by Berent in 1902. Since then fewer than 200 cases have been reported in the literature. In most of these cases renal cell carcinoma acted as a recipient tumor. In tumor-to-tumor metastasis renal cell carcinoma acting as a donor is exceedingly rare and there are no reported cases of adenocarcinoma of the esophagogastric junction acting as a recipient. We present a case of renal cell carcinoma metastasizing to an adenocarcinoma of esophagogastric junction. To our knowledge, this is the first reported case of such a combination.