Adenoid cystic carcinoma (ACC) of the breast is a rare variant of breast malignancy and is associated with an excellent prognosis. ACC accounts for 0.1% of all breast carcinomas. It has favorable biological characteristics and an excellent prognosis. A 77-year-old woman presented with a lump in the right breast. Ultrasonography and mammography showed a 12-mm, well-defined, lobulated mass in the retroareolar region of the right breast. The lump was diagnosed as ACC on the basis of immunohistochemical staining results for c-kit (CD117), muscle-specific actin, p63, estrogen receptor, and progesterone receptor using a fine-needle aspiration cytology (FNAC) specimen. This diagnosis was subsequently confirmed by excision biopsy. To the best of our knowledge, this is the first case of ACC of the breast to date to be diagnosed on the basis of immunohistochemical staining of an FNAC cell block material. From our experience, we recommend the usage of cell block material for immunohistochemical studies to accurately diagnose ACC of the breast.

Thyroid paragangliomas are rare neuroendocrine tumors. They are difficult to diagnosis by fine-needle aspiration biopsy (FNAB) and can be misdiagnosed as other types of thyroid disease. Here, we present an unusual case of primary thyroid paraganglioma diagnosed by FNAB. A 66-year-old woman presented with multinodular goiter. Ultrasound (US)-guided FNAB of the 3 cm nodule in the superior portion of the right lobe of the thyroid was performed. The cytological smears showed single cells or loose clusters of round to ovoid cells with oval granular nuclei. To differentiate between thyroid paraganglioma and other thyroid neoplasms, cell block material from the FNAB specimen was immunohistochemically stained with antibodies to thyroglobulin, calcitonin (CT), AE1-AE3, carcinoembryonic antigen (CEA), synaptophysin, chromogranin A (CH-A), neuron-specific enolase (NSE), thyroid transcription factor-1 (TTF-1), parathyroid hormone (PTH), and S-100. Immunohistochemical staining was positive for synaptophysin, CH-A, NSE, and S-100, and negative for thyroglobulin, CT, AE1-AE3, PTH, CEA, and TTF-1. Congo red staining was also negative. Paraganglioma and other neuroendocrine neoplasms were considered in the differential diagnosis. A total thyroidectomy was performed, and a final diagnosis of paraganglioma was made. Paraganglioma is a rare neuroendocrine tumor of the thyroid and should be considered in the differential diagnosis based on cytology of thyroid neuroendocrine tumors. Immunohistochemistry should be performed when making a diagnosis of thyroid paraganglioma, particularly when evaluating fine-needle aspiration smears. Diagn. Cytopathol. 2016;44:643-647. © 2016 Wiley Periodicals, Inc.

Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, whereas primary thyroid lymphoma is very rare. Here, we report a case in which a right-sided nodule measuring 4.3 × 2.2 cm was examined using fine-needle aspiration biopsy. This revealed abundant monomorphic non-cohesive large lymphoid cells without thyroid follicular cells, on which basis acytodiagnosis of lymphoma coincident with lymphocytic thyroiditis was made. Subsequent histologic examination revealed CD45−, CD20+, and Bcl-6 + and cytokeratin-, CD3-, CD5-, and CD30-negative tumor cells arranged diffusely in the whole thyroid coexisting with a separate PTC nodule sized 1.3 × 1.0 cm in the right lobe. The key point exemplified by this case is that a cytodiagnosis of this extremely rare coexistence of PTC and lymphoma can be made by adequate sampling of both nodules preoperatively. In our case, only one nodule formation was sampled, and therefore the coexisting PTC was not detected with cytology preoperatively.

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Introduction: The presence of tumor deposits (TDs), number of harvested lymph nodes (LNs), LN metastasis, and LN ratio (LNR) are well-known prognostic factors in colorectal carcinoma. Materials and methods: The relationship between clinicopathologic parameters and the presence of TDs, number of harvested LNs, LN metastasis, and LNR was investigated in 278 consecutive patients who underwent surgery for colorectal adenocarcinoma. Results: Multivariate logistic regression analysis revealed that mucinous tumor histology and lymphovascular invasion (LVI) were independent risk factors for the presence of TD (p=0.016 and p=0.003, respectively). Age, tumor localization, and pT stage were statistically significant parameters affecting harvested LN number (p=0.002, p=0.007, and p=0.028, respectively). Only LVI was an independent risk factor for LN metastasis (p=0.001), whereas advanced age, mucinous tumor histology, and LVI were independent risk factors for higher LNR (p=0.033, p=0.042, and p=0.001, respectively). Conclusions: Our results revealed that mucinous tumor histology was an independent risk factor for the presence of TDs and higher LNR. In addition, LVI - which is a well-known prognostic factor- was also an independent risk factor for the presence of TD and higher LNR. Older age was found to be an independent risk factor for higher LNR. We found that the number of harvested lymph nodes was increased when the patients were younger, the tumor was located on the right colon, and the pT stage was advanced. These results have to be proven in larger cohorts with follow-up data. Keywords: colorectal cancer; mucinous tumor histology; tumor deposit; lymph node ratio; lymph node metastasis.