No abstract

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm in which the granulocytes are the major proliferative component and is characterised by the chromosomal translocation t(9;22)(q34.1;q11.2) leading to the formation of Philadelphia chromosome (Ph) containing the BCR-ABL1 fusion gene. This entity is quite rare in paediatric age group and even unusual is a child presenting for the first time in an accelerated or blast crisis. Here we unfold an noteworthy case of a 9 year old school going child presenting with complains of vague abdominal distension who on further evaluation was found to be living through leukaemia.

Background: The new IASLC/ATS/ERS classification provides standardized terminology for lung cancer diagnosis in small biopsies and cytology specimens. Objectives: The aim was to study the feasibility of the guidelines using one marker for adenocarcinoma (ADC) and one for squamous cell carcinoma (SQCC) in non-small cell lung carcinomas (NSCLCs). Subject and Methods: In this study, we reviewed all the formalin-fixed paraffin-embedded tissue blocks diagnosed as lung carcinoma between July 2016 and December 2017. Cases were labeled as SCLC, ADC, SQCC, NSCLC favor ADC, NSCLC favor SQCC, NSCLC-not otherwise specified (NOS), and NSCLC-NOS possible adeno-SQCC (ADSQCC) as per IASLC/ATS/ERS 2011 guidelines. A three-step approach incorporating morphology, immunohistochemistry (IHC), and molecular analysis was used. Results: One hundred and nine cases were included. Six of the 109 cases were SCLC and 1 case was of large-cell neuroendocrine type. Of the remaining 102, 51 were diagnosed based on their classical histomorphology into SQCC (8) and ADC (43). Remaining 51 cases required IHC/special stains for categorization. The panel comprised anti-CK7, anti-thyroid transcription factor-1 (TTF-1), and anti-p63. Twenty-nine were positive for anti-TTF-1 and thus labeled as NSCLC favor ADC. Fifteen were labeled as NSCLC favor SQCC as they were highlighted by anti-p63. Four cases showed reaction to both the antibodies in different sets of tumor cells and thus were classified as NSCLC-NOS, possible ADSQCC. Remaining 3 cases did not show reaction to any of the antibodies and hence were labeled NSCLC-NOS. Conclusion: The need for every laboratory to use minimal tissue for ancillary tests to diagnose lung carcinoma on small biopsies is reemphasized. Tissue from small biopsies needs to be preserved not only for the diagnosis but also for molecular testing and evaluation of markers of resistance to therapy, in this era of personalized medicine.

Intravascular papillary endothelial hyperplasia (Masson's Tumour) is an infrequently occurring reactive vascular lesion which is typified by papillary intravascular proliferation of endothelial cells. It was first described by Masson in his publication in the year 1923. It usually arises in the extra-cranial location ordinarily in the skin and subcutaneous soft tissue. They are extremely uncommon in the intra-cranial sites with only a handful of cases reported in the literature amongst more than 300 cases of the same lesion reported in the sites arising outside the cranium. The authors here would like to report a rare case of Masson's tumour arising from the superior sagittal sinus eroding the skull bone and ultimately leading to an oval defect in the skull. The one-off nature of this location is what is intriguing in this case.