Benign phyllodes tumor with tubular adenoma-like epithelial component in FNAC: A diagnostic pitfall.

Benign phyllodes tumor (BPT) is a biphasic neoplasm composed of bland stromal and epithelial elements. Cytologic diagnostic criteria of BPT, though documented in the literature, diagnostic pitfalls in fine-needle aspiration cytology (FNAC) may occur due to sampling error, high cellularity, ductal hyperplasia, paucity of stromal component, and occasional dissociation of epithelial cells. Here, we describe a case of BPT diagnosed by histology in a 19-year-old female, where FNAC features were inconclusive due to paucity of stromal component, predominance of tubular adenoma-like epithelial component, and due to the presence of other overlapping features with fibroadenoma.

A Clinicopathological Study of Benign Phyllodes Tumour of Breast with Emphasis on Unusual Features.

INTRODUCTION: Benign Phyllodes Tumours (PTs) are rare fibroepithelial neoplasms that resemble fibroadenoma. But unlike fibroadenoma, benign PT can recur and both stromal & epithelial components can progress to malignancy. Contrary to earlier belief that benign PT is a stromal neoplasm and possibly arises from fibroadenoma, more recent molecular studies have suggested that both stroma and epithelium can become neoplastic. Sometimes, benign PT can occur synchronously with fibroadenoma. Here histomorphologic analysis of eleven cases of benign PT are presented including some unusual features. MATERIALS AND METHODS: Eleven cases of benign PT diagnosed between Dec 2014 and Jan 2016 in the Department of Pathology were studied. The demographic and clinicopathological features were analysed. RESULTS: The most common age group affected was 20-30 years (range: 13-45). Clinical features included pain, lump and bleeding from nipple. The tumour size varied from 2.5-18 cm in diameter. H&E stained sections showed secondary changes (haemorrhage, myxoid, change, cystic degeneration), epithelial hyperplasia (8), squamous & columnar metaplasia (1), benign tubular adenoma like areas (1), Ductal Carcinoma In Situ (DCIS) (1), Invasive Ductal Carcinoma (IDC) (1), Pseudoangiomatous Stromal Hyperplasia (PASH) (1), histologic infarction (2), tumour necrosis (1) and synchronous fibroadenoma (1). Unusual histologic features included atypical ductal hyperplasia, DCIS, IDC, synchronous fibroadenoma and tubular adenoma like areas arising within benign PT. CONCLUSION: This study shows a spectrum of hyperplastic, metaplastic, dysplastic, benign, in-situ-malignancy and even invasive ductal malignancy occurring in benign PT. Therefore adequate and extensive sampling is recommended for accurate diagnosis.

Intraneural Hybrid Neurofibroma/Schwannoma In Scalp: A Case Report.

Benign Peripheral Nerve Sheath Tumours (BPNSTs) are traditionally classified into schwannoma, neurofibroma and perinurioma. Due to advances in molecular techniques, hybrid BPNSTs containing more than one histologic types have been documented. Recent studies have demonstrated their frequent association with inherited syndromes like schwannomatosis and neurofibromatosis. Intraneural variant of hybrid neurofibroma/schwannoma is yet to be described. Here we report such a case in a 30-year-old male, who presented with a scalp swelling and histology showed intraneural neurofibromatous tumour admixed with schwannoma-like nodules. IHC (immunohistochemistry) showed variable S100 staining in neurofibromatous areas, diffuse S100 staining in schwannoma-like areas and negative EMA staining in the tumour.

Intramuscular Hibernoma: A Rare Tumour in Buttock.

Hibernomas are benign tumours of brown fat that does not recur after complete excision. These tumours are found most often in adults and most commonly in thigh. Four morphologic variants of hibernoma are identified: typical, myxoid, spindle cell, and lipoma-like. The most common histologic type is typical variant. In this report, we present the clinical, morphological features and discuss the differential diagnosis of a typical variant of intramuscular hibernoma.

A clinico-pathological study on benign breast diseases.

BACKGROUND: To study the patterns of clinically benign breast disease in females and to co-relate them with the pathological findings. METHODS: One hundred females who attended the Surgery Outpatients Department in Indira Gandhi Medical College and Research Institute, Pondicherry, with various forms of benign breast diseases during the period from October 2011 to September 2012, were studied. Early diagnoses by doing a triple assessment like a clinical examination, FNAC or a core needle biopsy and imaging methods like ultrasonography or mammography, were made within 72 hrs from the first consultation. The clinical diagnoses were compared with the cytological or histological findings wherever possible and their accuracies were evaluated. RESULTS: Out of the 100 female patients who were studied, 87 patients who presented with breast lumps and fibroadenoma, accounted for 48% of the cases, which was the highest number of patients. Fibrocystic changes and breast abscesses came next with 18% and 12% cases respectively. We detected 3 cases of proliferative disease with atypia and one case with florid hyperplasia, which had high and low risk factors respectively, for developing invasive carcinoma. The oldest lady of the group who was clinically diagnosed to have benign disease, was detected to have invasive ductal carcinoma. They were treated in our hospital and were advised follow up. CONCLUSION: Benign breast diseases are common in female patients and fibroadenoma is the commonest of them all. Triple assessment provided a quick diagnosis and it alleviated unnecessary anxiety from the patients about breast cancer. The clinical diagnosis of a breast lump, as confirmed by cytology and histology, was accurate in 91.95 % of the cases.

PAX6 suppresses the invasiveness of glioblastoma cells and the expression of the matrix metalloproteinase-2 gene.

Glioblastoma multiforme (GBM) is the most invasive brain tumor. We have previously reported that the transcription factor PAX6 suppresses the tumorigenecity of GBM cells. By an in vitro Matrigel invasion assay on two GBM cell lines stably transfected with wild-type and/or two mutant forms of PAX6, this study displays the first evidence that PAX6 inhibits the invasiveness of GBM cells and that the DNA-binding domain of PAX6 is required for this function. Using real-time quantitative reverse transcription-PCR (RT-PCR), gelatin zymography, and immunohistochemistry assays, the expression of the gene encoding matrix metalloproteinase-2 (MMP2) in GBM cell lines grown in vitro or in intracranial xenografts in nude mice was shown to be repressed by either stable or adenoviral-mediated overexpression of PAX6. Luciferase promoter assays revealed PAX6-mediated suppression of MMP2 promoter activity. Electrophoretic mobility shift assays showed direct binding of PAX6 to the MMP2 promoter. A significant reverse correlation (P < 0.05) occurred between PAX6 and MMP2 expression quantified by real-time quantitative RT-PCR in 41 GBMs, 43 anaplastic astrocytomas, and 7 adjacent normal tissues. Interestingly, the degree and significance of the reverse correlation increased after excluding astrocytomas, whereas it became insignificant after excluding GBMs. In GBM cells stably transfected with a dominant negative mutant PAX6 showing increased MMP2 expression and invasiveness, knock-down of MMP2 revealed that MMP2 is one of the PAX6 target genes mediating its suppression of invasion. Overall data delineated a mechanism for the suppressive function of PAX6 in GBM: suppression of cell invasion by repressing the expression of proinvasive genes such as MMP2.