Mucinous carcinoma of breast is a rare variant of invasive breast carcinoma and usually affects older females and is associated with good prognosis. Human epidermal growth factor receptor 2 (HER2) positivity in these tumors is rare. We describe here a case of advanced stage HER2 + mucinous carcinoma with micropapillary features who underwent complete remission on treatment with radiation therapy and hormonal therapy and presented after eight years with invasive duct carcinoma in the contralateral breast.
SMARCA4-deficient thoracic tumor (SMARCA4-DTT) is a relatively new pathological entity with highly aggressive characteristics. With mass lesions developing in the thoracic region, patients tend to complain of chest symptoms, such as dyspnea or chest pain. Here, we encountered a rare case of SMARCA4-DTT presenting to the otolaryngology clinic with painful throat and diagnosed by palatal tonsil biopsy. A 47-year-old male patient with heavy smoking habit presented to a nearby clinic due to sore throat occurring a few days before presentation. Antibiotic therapy was prescribed for the treatment of acute tonsillitis. However, the pain exacerbated, and mass lesion in the submandibular region started to develop. The patient was referred to our department for detailed examination due to suspected pharyngeal malignancy. Right tonsil biopsy was performed, and the patient was diagnosed with SMARCA4-deficient tumor. Computed tomography illustrated compressive mass lesion in the mediastinum and multiple swelling of systemic lymph nodes. Although radiotherapy and chemotherapy were performed, the lesion rapidly progressed, and brain metastasis also occurred. The patient followed a poor disease course and died 91 days after the first symptom. SMARCA4-deficient tumor has been reported in other sites, such as ovary, uterus, and gastrointestinal tract. The purpose of the present article is to make literature review on clinicopathological characteristics of SMARCA4-deficient tumors in various sites while reporting the rare presentation of SMARCA4-DTT.
To date, reported cases of ectopic prostatic tissue occurring in the genitourinary tract, particularly in the anterior urethra, are exceedingly rare. We report a case of a 20-year-old man who is presented with cystic lesion on the anterior (penile) urethra. Routine investigation shows a micro-cystic submucous mass, near to the external orifice of the urethra. The performed surgical excision and histological investigation confirm that the lesion is a prostatic tissue ectopy. Histologically and immunohistochemically, the cyst wall is lined with prostatic-type benign epithelium. In addition, interspersed foci of eosinophilic metaplasia (EM) are found among the prostatic epithelium. The subsequent targeted histochemical, immunohistochemical, and ultrastructural study confirm the presence of EM in the ectopic prostatic tissue. This is the first case that presents EM occurring in ectopic prostatic tissue. The presence of EM can be used as an additional argument supporting the prostatic origin and the benign character of the lesion. The histogenesis of the ectopic prostatic tissue in the urethra is discussed. We suggest that it is most likely a hyperplastic epithelial response of embryonic prostatic nests in the urethra.
The relationship of Epstein-Barr virus (EBV) has been well characterized with a wide range of lymphoproliferative lesions and lymphomas of B-cell, T-cell, and NK-cell origin. However, the association of EBV with mantle cell lymphoma (MCL) is exceedingly rare and not well established. We report a case of classic MCL which transformed to pleomorphic MCL after a clinical course of 19 years. Particularly, EBV infection was detected in the transformed high-grade pleomorphic MCL. Molecular and genetic analyses confirmed the clonal relationship between the original and transformed lymphomas. To the best of our knowledge, there has only been one case reported in 2003 which documented an EBV-associated high-grade transformation of MCL. Therefore, our case report further expanded the spectrum of EBV in the pathogenesis of B-cell lymphoma transformation.
Cutaneous T-cell lymphoma (CTCL) presenting as mycosis fungoides is typically localized to the skin and occasional draining lymph nodes. We present a 46-year-old man with refractory CTCL status-post allogeneic stem cell transplant who was biopsied for diarrhea and abdominal pain. These gastrointestinal biopsies revealed not only graft-versus-host-disease but also a clonal atypical lymphoid infiltrate with the same morphology and immunophenotype as the patient’s known CTCL. We discuss the differential diagnosis of CTCL metastatic to the intestinal mucosa versus post-transplant lymphoproliferative disorder and present a review of the literature. This case demonstrates challenging diagnostic workups in limited tissue samples as well as critical clinical implications.
