Chromophobe renal cell carcinoma with rare distant metastasis.

Metastasis accounts for the most common tumor of the central nervous system (CNS) in adults. Renal cell carcinoma (RCC) is one of the common carcinoma showing brain metastasis, with a predilection for clear cell variant. Chromophobe RCC (ChRCC) in contrast to clear cell RCC shows far less common distant metastasis. When they metastasize, commonly involve the liver, lungs, and lymph nodes. ChRCC metastasizing to the brain is extremely rare. Isolated brain metastasis from RCCs is also uncommon. We report an unusual case of a 54-year-old woman with ChRCC with isolated metastasis to the brain, 2 years after radical nephrectomy for renal mass.

Microfilaria and Strongyloides larva diagnosed in cerebrospinal fluid and ascitic fluid, respectively: Approach to their morphology on cytology.

Filariasis and Strongyloidiasis are two endemic parasitic infections seen in any tropical country. Filariasis, commonly caused by Wuchereria bancrofti, Brugia malayi, and Brugia timori is seen often in peripheral blood and lymphoid tissue. But it can be isolated from wide variety of soft tissue sites in the body like soft tissue lumps, breast, thyroid, body fluids. Strongyloides stercoralis, a helminthic infection, usually affects the respiratory and gastrointestinal (GI) tract, and frequently picked up in GI biopsies. However, in cases of hyper infection and patients with altered immunity, it can be isolated from other rare sites like body fluid samples. Accurate morphological Identification and confirmation are important for specific management. We report a case of microfilaria isolated from cerebrospinal fluid and a case of Strongyloides larva isolated from ascitic fluid in clinically unsuspected cases of these two parasitic infestations. We have also added a brief discussion on morphological differences between the two larval forms.

Liquid-based cytology of pigmented phaeohyphomycotic lesion of the palm masquerading as a metastatic tumor.

Phaeohyphomycosis is a chronic subcutaneous fungal infection caused by dematiaceous fungi, commonly involving the extremities, which present as single or multiple lesions mimicking a benign tumor. Fine-needle aspiration cytology (FNAC) is an easy method for the diagnosis of the lesion. Morphology of the fungus is characteristic with no difficulty for cytopathologist for identification; with a close differential diagnosis of Candida and Aspergillosis. The special stains like periodic acid schiff (PAS) highlights the fungus and the Masson Fontana confirm the melanin pigment and dematiaceous nature of the fungi. Liquid-based cytology (LBC) preparation of the aspirated material was attempted, which is not usually performed on day to day basis. However, in our case the conventional smears were better for appreciating the fungal morphology.

Cutaneous granular cell tumor clinically mimicking ectopic breast diagnosed on fine needle aspiration cytology.

Granular cell tumor (GCT) is a rare benign neoplasm of Schwannian origin which accounts of 0.5% of soft tissue tumors. Although the most common site for GCT is tongue, it can occur at any site. GCT presenting as cutaneous nodule is rare, however cases have been reported in literature. We hereby document a case of 30 year female with a hyper-pigmented cutaneous nodule of anterior chest wall on the milk-line mimicking as an ectopic breast, diagnosed as GCT on fine needle aspiration cytology. We also add a note on the differential diagnoses of GCT with differentiating cytological features to emphasize on the correct diagnosis of GCT pre-operatively.