Synchronous occurrence of adenocarcinoma and mucosa associated lymphoid tissue (MALT) lymphoma of colon is rare, and its presence with coexisting tuberculosis is still rarer. To our knowledge, this may be the first case report. In the present report, we describe a 43-year-old female who presented with a history of abdominal pain, fever, loss of weight and loss of appetite. Colonoscopy showed a large ulceroproliferative mass arising from the caecum, biopsy of which showed it to be adenocarcinoma of the colon. A right hemicolectomy was performed and microscopic study of the colon revealed tuberculosis and synchronous adenocarcinoma with lymphoma. Eight of sixteen lymph nodes showed tuberculosis and three of sixteenpericoloniclymphnodes showed metastatic deposits. Immunostains further confirmed the tumour to be adenocarcinoma with MALT lymphoma. We would like to highlight the diagnostic challenges arising from the multi-faceted presentations of these three conditions.

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CONTEXTFNAC is the initial first line of investigation in evaluating breast lesions because of its reliability, rapidity and cost effectiveness, even in the present era of open biopsy. AIMTo evaluate the role of FNAC in diagnosing malignancy in breast lesions and to compare it with the Gold standard Histopathology. MATERIALS AND METHODSPatients with breast lesions, evaluated by FNAC and had subsequent histopathological examination were studied to correlate the diagnoses. Statistical analysis was done to find sensitivity, specificity and positive predictive value and negative predictive value of FNAC test in diagnosing malignant breast lesions. RESULTSAmong 158 total FNAC cases, 105 had subsequent histopathological followup. Out of 74 cytologically benign cases, 69 were confirmed as benign, 5 turned malignant. Out of 4 cytologically atypical cases, one turned benign and 3 malignant. Out of 27 cytologically malignant cases, 26 were malignant and one turned benign. FNAC had a sensitivity of 85.29%, specificity of 97.18%, positive predictive value of 93.55% and negative predictive value of 93.24%. CONCLUSIONThough FNAC has its own flaw, it still remains as a diagnostic tool in the preoperative evaluation of breast lesions in picking up malignant breast lesions as comparable to histopathology.