Cerebrospinal fluid cytology of choroid plexus tumor: A report of two cases.

Choroid plexus tumors (CPTs) are relatively uncommon tumors of the central nervous system, constituting approximately 5% of all pediatric brain tumors. Although squash cytology of CPT has been described in literature, shedding of tumor cells into cerebrospinal fluid (CSF) has rarely been described. We report two such cases of atypical choroid plexus papilloma in a 5-month-old male child and a 12-year-old female child, where characteristic cytomorphology of CPT was noted in the CSF.

Role of immunohistochemistry in diagnosis of a rare bladder tumor.

Neuroendocrine tumors (NETs) are commonly located in the respiratory and gastrointestinal tract; however, these tumors can rarely be found in the urinary bladder. NETs comprise <1% of all bladder tumors; usually intermixed with urothelial carcinoma and its variants. We report a case of primary neuroendocrine carcinoma of urinary bladder in an adult female with a history of smoking and hematuria. The present case highlights the importance of immunohistochemistry in arriving at an accurate diagnosis and thereby differentiating this tumor from other clinical mimics.

Cytodiagnosis of extramedullary hematopoiesis in thyroid gland unravelling an asymptomatic hematological malignancy.

Extramedullary hematopoeisis (EMH), also known as myeloid metaplasia can be seen in association with various hematological disorders. The common sites of EMH are liver, spleen and lymph nodes; but it can occur in almost any organ and in numerous locations. Involvement of the thyroid gland with EMH has rarely been reported. We present a case of EMH in the thyroid gland in an adult female diagnosed on fine-needle aspiration cytology (FNAC) which further helped in revealing an underlying myeloproliferative neoplasm; chronic myeloid leukemia (CML).

Malignant melanoma of conjunctiva: Diagnosis on fine-needle aspiration cytology.

Malignant melanoma of conjunctiva is an uncommon malignancy. The diagnosis is suspected clinically and confirmed on pathological examination. We present a case of a 63-year-old female with previous history of pigmented lesion in the right eye and subsequently diagnosed as malignant melanoma of right conjunctiva and cornea on fine-needle aspiration cytology and histopathology.

Cytodiagnosis of Rosai-Dorfman disease masquerading as lymphoma: A case report with brief review of literature.

Rosai-Dorfman disease (RDD) or sinus histiocytosis with massive lymphadenopathy (SHML) is a self-limiting, benign histiocytic disorder. We report a case of RDD mimicking lymphoma clinically and cytologically in a 3-year-old male child. The present case highlights the importance of cytology in the diagnosis of RDD along with cytological features of other differential diagnoses.

Cytodiagnosis of extramedullary hematopoiesis in serous effusion: A rare presentation unfolding the underlying etiology.

Extramedullary hematopoiesis (EMH) usually involves reticuloendothelial system. However, it rarely may be present in the serous body effusions. In our case, the fluid cytology of both peritoneal and pleural fluid was diagnostic of the EMH in a patient with an undiagnosed underlying etiology.

Primitive neuroectodermal tumor of the kidney: A rare case report.

Renal primitive neuroectodermal tumor (PNET) is a rare primary renal neoplasm. Morphologically, it may mimic small blue round-cell tumor. Hence, histopathology in conjunction with immunohistochemistry plays a significant role in correctly diagnosing this malignancy. We report a case of PNET of kidney in a 30-year-old female with an extension to inferior vena cava, who succumbed following an aggressive course of illness.

Unusual presentation of renal cell carcinoma: A rare case report.

Cutaneous and intraoral metastasis from any malignancy is not common. Cutaneous spread is usually noted in 5%-10% of high-grade malignancies, as in carcinoma breast, lung, colon, ovary, and malignant melanoma. Only 4.6% cases of cutaneous spread are from renal cell carcinoma (RCC). Intraoral spread from RCC is much rarer with an incidence of approximately 1% of all malignant oral tumors, noted sometimes in tongue, palate, buccal mucosa, gingiva, and lips. RCC is a highly aggressive tumor which requires early diagnosis for increasing the chance of cure. In our case, a 54-year-old male presented with swelling over upper lip, scalp, and retromolar area, which on histopathology and immunohistochemistry revealed clear cell carcinoma compatible with metastatic RCC.

Cytopathological examination of bronchoalveolar lavage fluid in diagnosis of pulmonary alveolar proteinosis.

Pulmonary alveolar proteinosis (PAP) is a rare disease characterized by the deposition of extracellular lipoproteinaceous material within the air spaces. Although the diagnosis is mainly based on histopathological findings, sometimes, the diagnostic yield of transbronchial and even open lung biopsy can be unsatisfactory. The advantage with bronchoalveolar lavage (BAL) cytology is that apart from being safer for the patient, it can sample a much wider area and help in giving an early diagnosis and treatment to the patient. Herein, we present a case of PAP diagnosed on BAL fluid cytology in an elderly female.

Epithelioid hemangioma of penis mimicking malignancy: A rare case.

Penile epithelioid hemangioma (EH) is a rare vascular neoplasm with no definite etiology. Herein, we report a case of EH of the penis in a 64-year-old man presenting with painless, bleeding mass on the glans penis. The patient underwent local excision, and on histopathological examination, a diagnosis of EH was made. Immunohistochemistry revealed positivity for CD31, smooth muscle antigen, and negative expression of cytokeratin. The present case highlights the importance of histopathology in conjunction with immunohistochemistry to reach a definitive diagnosis of this rare benign entity and differentiating it from the close malignant mimics, thereby avoiding aggressive management of the patients.

Cutaneous Meningioma: A Cytomorphological Diagnosis.

Cutaneous meningiomas are rare tumors. These are ectopic meningothelial cells located in the dermis and subcutis, and are usually seen on the scalp. Here, we report the case of a 40-year-old woman who presented with a slowly growing asymptomatic mass over the scalp in the right parieto-occipital region. The lesion was firm, adherent to underlying structures, and covered by normal appearing skin. The cytomorphological features along with histological and immunohistochemical studies showing positivity for epithelial membrane antigen, Vimentin, and S100 helped in making a definitive diagnosis of cutaneous meningioma. No evidence of intracranial meningioma was noted in contrast-enhanced computed tomography of the brain.

Unusual Presentation of Acute Leukaemia: A Tripod of Cases.

Acute Leukemia is one of the common haematological malignancies encountered with varied clinical and haematological presentation. In acute leukaemia, complications like bleeding and infection cause significant morbidity and mortality, thus overshadowing the thromboembolic events. Among the various malignant haematological disorders, the association of thromboembolic events is often noted with acute promyelocytic leukemia, though the overall frequency of such events remains very low. Acute Lymphoblastic Leukemia (ALL) is, however, more common than Acute non-lymphoblastic Leukaemia. Usually patients present with symptoms because of cytopenias, organomegaly, lymphadenopathy and bone pain, including other skeletal abnormalities. Granular Acute lymphoblastic Leukaemia (G-ALL) may be misdiagnosed as Acute Myeloid Leukemia (AML) because of the presence of cytoplasmic granules in the lymphoblasts. This variant of ALL is usually noted in children, but may be seen in adults too. It is also important to note that asymptomatic skeletal involvement can be seen in 40-60% of patients with ALL, but pathological fractures and osteolytic lesions along with hypercalcemia at the time of presentation are very rare. Herein, we present a series of three cases of acute Leukemia presenting with unusual clinical and other rare haematological findings.