Gittwa Vatsaraj Kottangal

Abstract

Malignant deciduoid mesothelioma (MDM), a rare variant of epithelioid mesothelioma, accounts for less than 5% of mesotheliomas. The term deciduoid mesothelioma was introduced by Nascimento et al. in 1994 to describe a rare variant of epithelioid mesothelioma that bears a morphological resemblance to decidua or decidual-type changes. It has an unknown etiology, and the relation with asbestos exposure remains debatable. The presence of decidual-type cells often makes the diagnosis difficult in the small biopsy specimen, especially in the peritoneal biopsy of young female patients, as they can be misdiagnosed as normal decidualized tissue. The prognosis of deciduoid mesothelioma was considered poor, but now reports suggest that the prognosis depends on the grade of the tumor. Mesothelioma is more commonly seen in older men, but deciduoid mesothelioma most often occurs in young women and is initially thought to occur only in the peritoneum of young women. Later case reports of this rare variant occurring in the pleura, the pericardium, and the tunica vaginalis of older adults are also seen. Herein we report a case of a 60-year-old male patient diagnosed with high-grade malignant deciduoid pleural mesothelioma on small biopsy, treated with four cycles of neoadjuvant chemotherapy (Pemetrexed + Carboplatin + Bevacizumab), with partial favorable response to chemotherapy underwent pleurectomy. Following this, the patient was on maintenance chemotherapy; unfortunately, he had progressive disease with adrenal and lymph node metastasis.   Keywords: Malignant, Deciduoid mesothelioma, Epithelioid, Peritoneum, Pleural

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Abstract

Spindle cell oncocytoma (SCO) of the pituitary is a rare tumor of the adenohypophysis occurring in the sellar/suprasellar region. This tumor has been recognized as a distinct entity by the  WHO Classification of CNS tumor in 2007. Spindle cell oncocytoma of the pituitary gland accounts for 0.1–0.4% of all sellar region tumors and is predominantly seen in the older adult population. This rare entity simulates clinical and radiological features of pituitary adenoma and is often misdiagnosed. Though WHO grade 1, the tumor can recur and have invasive properties. Herein, we report a 61-year-old woman with panhypopituitarism and temporal field cut, clinically and radiologically diagnosed as pituitary macroadenoma, while the histomorphological and immunohistochemistry features helped in arriving at a diagnosis of Spindle Cell Oncocytoma. The clinicopathological, histomorphological, immunohistochemical, and molecular properties of the tumor are further discussed.   Keywords: Spindle cell oncocytoma, Adenohypophysis, Pituitary, Macroadenoma, Panhypopituitarism.

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Abstract

Hairy cell leukemia (HCL), a rare, chronic B-cell leukemia, first described as a distinct entity in 1958, was recognized as an entity by the World Health Organization in 2008. The disease accounts for 2% of all leukemias and is more frequent in middle-aged to older men. The diagnosis is based on the hairy lymphoid cells in the peripheral smear and the bone marrow aspiration cytology and the bone marrow biopsy showing a monotonous interstitial infiltrate with a fried egg appearance. The classic immunophenotypic profile in the flow cytometry and the BRAF V600E mutation confirm the diagnosis. Herein we report a 52- year-old male patient presented with pancytopenia, high-grade fever, and weight loss. The characteristic histomorphological and the flow cytometry features of this leukemia will be used to discuss further the recent updates on the distinct clinicopathologic features, differential diagnosis, treatment, and prognosis of the entity. Keywords: Hairy cell leukemia, Monotonous, Fried egg, Flow cytometry, Pancytopenia.

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