Indian Journal of Pathology: Research and Practice

Spleen is an uncommon site of tumor metastases, usually as a part of multivisceral metastatic disease. Breast, lung, ovarian, colorectal, and gastric carcinomas and skin melanoma are the most common primary sources. Isolated metastasis to the spleen is extremely rare especially from lung with only 8 cases reported to date in literature. Splenic metastasis is often asymptomatic and radiologically mistaken for primary splenic lesions. Hence clinical suspicion and pathological confirmation is essential with careful and extended follow up for prompt therapeutic intervention. Here we report a rare case that presented with abdominal symptoms and massive splenomegaly and revealed isolated splenic metastasis from moderately differentiated adenocarcinoma in left lung. 

Keywords: Splenic metastasis; Adenocarcinoma of lung. 

Granular cell tumours are uncommon tumors of putative neural origin, now incontroveribly proven to be derived from Schwann cells. They can occur in almost any part of the body. The lesions presenting over the skin are located deep in the subcutis yet are not aspirated very often and so the reports of their cytological diagnosis at these sites are sparse in literature. We report a case of 39 year old male presenting with a nodule over nape of neck which presented as a subcutaneous nodule mimicking as an adnexal tumor. Cytolgically, it showed clusters of large oval to polygonal cells with abundant amount of granular cytoplasm. The tumour was diagnosed as granular cell tumour with differential diagnosis of benign adnexal tumour. Histopathology and PAS stained sections from the excised lesion confirmed the FNA diagnosis. The aim of presenting this case is to highlight the importance of cytology in diagnosing the granular cell tumour, cytologically mimicking an adnexal tumour in subcutaneous site along with a review of literature. 

Keywords: FNAC; Granular cell tumour; Subcutaneous.  

Background: Gastrointestinal tract (GIT) cancers have a varied presentation and different prognosis for similarly staged disease. In addition to breast carcinoma, overexpression of components of the HER signalling pathway have been associated with poor outcomes and a more aggressive disease even in primary GIT cancers. To evaluate the utility of EGFR and HER-2/Neu immunoexpression pattern in various primary GIT malignancies as surrogate genetic prognostic markers in comparison to convention histological parameters. Methods: A retrospective analysis of formalin fixed, paraffin embedded (FFPE) sections of tumour tissue from 30 GIT resection specimen were done. EGFR and HER2/Neu immunoexpression were evaluated against the histological grade and stage of the tumour. Result: In the study population the mean age was 58.4 years. Adenocarcinoma constituted 80% cases, with 73.33% being moderately differentiated. T3 tumours (60% cases) were the most frequently encountered malignancy. Lymphovascular invasion was seen in 13.33% while nodal positivity was noted in 64.29% cases. HER2 overexpression was seen in three cases (10%) of oesophageal squamous cell carcinoma while EGFR overexpression was found in four cases (13.33%). Overall, cases showing EGFR and HER-2 overexpression were mostly of the elderly age group, oesophageal squamous carcinomas, were T2/T3 in size and with nodal involvement. Conclusion: EGFR and HER2 have a valuable role as ancillary prognostic markers in GIT malignancies. However standardization of EGFR and HER2 testing procedures along with careful interpretation are essential steps to ensure accurate, reproducible and optimal results.

Keywords: EGFR; Genetic prognostic factors; GIT malignancies; HER-2.