Terminal deoxynucleotidyl transferase (TdT)-negative T-cell lymphoblastic lymphoma is a variant of T-cell lymphoblastic lymphoma/T-cell lymphoblastic leukaemia. TdT is a marker of immaturity expressed in 90%–95% cases of lymphoblastic lymphoma and useful in differentiating it from other mature lymphomas/leukaemias. It has been associated with poorer response to chemotherapy and a more aggressive outcome. Here we present a case of TdT-negative T-cell lymphoblastic lymphoma in a 28-year-old man who presented with superior vena cava syndrome. The patient was treated with hyper-cyclophosphamide,vincristine, Adriamycin, dexamethasone (CVAD), however unfortunately suffered a relapse 1 year later. A unique feature of our case was that on relapse, the patient lost expression of the T-cell lineage-specific marker CD3, which has previously not been reported in association with TdT-negative T-cell lymphoblastic lymphoma. The patient failed to respond to chemotherapy on his relapse and died.

Ultrasonographic features of six leiomyosarcomas of the inferior vena cava are described. In most cases, the presentation is typical enough to strongly suggest the histologic diagnosis. The tumor is usually greater than 10 cm long, hypoechoic, heterogeneous. Cystic components can be found. It is sharply demarcated from neighboring organs which are displaced. The mass is located at the very place of the inferior vena cava, the lumen of which is no longer seen. It is fusiform shaped, surprisingly sparing the aorta. Differential diagnosis along with other radiologic examinations, pathologic findings, and prognosis are discussed.

Verrucous carcinoma (VC) is a locally invasive, non-metastasising well differentiated variant of squamous cell carcinoma. It is very rare in the urinary bladder and mostly associated with schistosomiasis. It has a characteristic multilobular appearance with small surface projections on contrast cystogram. Owing to its bland cytology, it is a challenging diagnosis. We report a case of VC of the bladder-unrelated to schistosomiasis and involving the prostate-that recurred after transurethral resection of the tumour and prostate followed by six doses of intravesical mitomycin. To the best of our knowledge, no such case has been reported from Pakistan.

Primary cardiac sarcomas are rare malignant tumours and among them, leiomyosarcoma is extremely rare. They are especially rare in a young age group. We present a case of a 22-year-old male patient with primary leiomyosarcoma of the left atrium involving the pulmonary veins who presented with haemoptysis and shortness of breath. He underwent surgical excision of the tumour along with mitral valve replacement followed by adjuvant chemotherapy. No recurrence was reported on his second 6 monthly follow-ups.

Background: After cardiovascular problems, cancer is the 2nd biggest cause of mortality globally. Globally, breast cancer is recognized as the second most prevalent cancer in general, the most prevalent cancer in women, and the 5th major cause of cancer-related death. Objectives: To study the Morphologic Spectrum of Breast Carcinoma and correlation of hormone receptors and HER2/neu status with clinic-pathologic parameters Methods: A total of 97 consecutive cases of modified radical mastectomy were evaluated in the department of histopathology, Rehman Medical Institute Peshawar from February 2019 to December 2020. Expression of PR, ER and Her2/neu were scored similar to College of American Pathologist’s (CAP) guidelines. The analysis of data was done by using SPSS version. Results: Mean age of presentation was 49.6 years. The most prevalent histological subtype was invasive carcinoma of no particular type (72.2%). Grade II tumors were most frequent (43.3%). Lymphovascular and perineural invasion were present in 53.6% and 40.2% of cases respectively. Pathologic stage pT2 was most frequent (56.7%). Macrometastasis was noted in 61.8% of cases. ER and PR showed positivity in 59.8% and 51.5% of cases and Her2/neu was over expressed in 30.9% of cases. ER positivity inversely correlated with Her2/neu but directly with tumor size. Strong association was found between ER/PR positivity and HER2/neu with histologic grade. Conclusion: Our study showed a diverse spectrum of special type carcinomas, none of which showed HER2/neu over expression. Majority of our patients belong to a younger age group and presented with advanced disease. Triple negative breast cancer (TNBC) was commonest in our population after luminal A. HER2/neu overexpression was limited to grade 2 and 3 of invasive ductal carcinoma Keywords: Morphologic Spectrum; Breast Carcinoma; Hormone receptors