Prostate-specific Membrane Antigen-expressing Hepatic Lesion: Metastatic or Hepatocellular Carcinoma.

Prostate-specific membrane antigen (PSMA) is a glycosylated type-II transmembrane protein highly expressed in certain tumor cells. It has emerged as a novel radiotracer for evaluation of prostate cancer. Increased PSMA expression in isolated liver lesion is a diagnostic challenge. Solitary liver metastasis from prostate cancer is rare. On the other hand, PSMA avid primary hepatocellular carcinoma (HCC) has been reported in literature. We report a case of PSMA expressing atypical HCC with normal alphafeto protein (AFP) and raised prostate specific antigen (PSA).

Lymphoepithelial Sialadenitis Involving HIV-Infected and Sjogren Syndrome Patients: A Cytologic Study.

Lymphoepithelial salivary gland cysts are rarely seen in autoimmune diseases particularly Sjogren syndrome as well as in HIV for which medical management is advocated. To study the morphology of these cysts, correlate with the disease process and assess the final outcome. Case series. Fine needle aspiration clinic. HIV-infected and autoimmune disease patients with lymphoepithelial cysts. Antiretroviral therapy for HIV-patients and anti-inflammatory drugs for Sjogren syndrome. Three HIV-infected patients (two children and one adult) and three middle aged female patients presented with parotid and submandibular cysts, two of which were bilateral along with submandibular (one each in the HIV and the autoimmune group). In the adult HIV-patient, the cyst was found at the inception of the disease while the other pediatric HIV-patients just crossed a decade. Of the other three cases of Sjogren syndrome, two were primary and one, secondary to rheumatoid arthritis. All the cysts regressed completely with treatment of the respective diseases which was confirmed by ultrasonograms. Lymphoepithelial cysts are produced by release of serous secretion by the acinar and ductal cells within the epithelial islands in the process of their destruction. Possibly, antibody mediated increased secretion in the initial stages also plays a role. Lymphoepithelial cysts of HIV patients may occur in the course of treatment, not necessarily in the beginning, though it resolves spontaneously. Lymphoepithelial cysts of primary or secondary Sjogren syndrome may be repressed sufficiently by anti-inflammatory/immunosuppressant treatment.

Discovered on gastrointestinal stromal tumor 1, a keystone in the diagnosis of extraintestinal gastrointestinal stromal tumors.

INTRODUCTION: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract (GIT) but have a low incidence. Arising from the interstitial cells of Cajal, GISTs occur at different sites in the GIT with stomach being the most common. They can rarely be seen at sites outside the GIT such as omentum, retroperitoneum and are called as extraintestinal GISTs (EGIST). They have a spindle or epithelioid cell morphology and show positivity by immunohistochemistry (IHC) for CD117. Our aim was to study the clinicopathological and immunohistochemical profile of our cases of EGISTs. MATERIALS AND METHODS: A cross-sectional study of EGISTs received from 2010 to 2015 was done. IHC with CD117 and discovered on GIST1 (DOG1) was performed and tumors were scored based on the percentage of cells that stained positive. Thirteen abdominal non-GIST spindle cell tumors were included in the study as controls. RESULTS: Seven cases of EGIST were included (four-omental, three-retroperitoneal). All cases stained positive for CD117 and DOG1. One case of epithelioid EGIST scored 4 + with DOG1 and 2 + with CD117. Another case with mixed morphology scored 2 + with DOG1 and 4 + with CD117. All controls were negative for both markers. CONCLUSION: EGISTs are one of the rare differentials for spindle cell lesions outside the GIT. Although both markers stain positive, DOG1 showed higher score with epithelioid GISTs.

Mixed epithelial and stromal tumor - A solid-cystic renal neoplasm undergoing malignant transformation: A rare case report.

We present a case of 53-year-old female who came with the complaints of mass on the right side of the abdomen noticed 3 weeks back. There was no history of localized swelling or rise of temperature, no history of weight loss, or evening rise of temperature. On examination, there was a flank mass which was bimanually palpable and tender. Routine laboratory investigations were within normal limits, except for the presence of hematuria in routine urinalysis. Computed tomography scan abdomen revealed a large multiloculated solid-cystic mass lesion with septation in the right-sided kidney. Cystic renal cell carcinoma was suspected and conventional open right radical nephrectomy was done. Grossly, the tumor was solid-cystic containing blood-tinged fluid. Microscopy revealed a complex tumor with both epithelial and stromal proliferation and with the aid of immunohistochemistry a diagnosis of mixed epithelial and stromal tumor undergoing malignant transformation was concluded.