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Pilomatricomaisa benign skin adnexal tumor that is derived from hair matrix. Pilomatricomas usually present in children and adolescents but can occur at any age. Pilomatricomas are generally asymptomatic and found mainly in the head and neck area. Upper extremities not a common site for this lesion. It israrely identified on the chest, trunk, or lower extremities. They areeasily diagnosed on histology due to their typical histological features but diagnosis in cytology is generally difficult as the features may mimic other skin lesions and leads to misdiagnosis. Here we describe a case of pilomatricoma of left arm in a 25 year old male, which was diagnosed on cytology. The cytological smears were cellular and consist of aggregates of anucleate squames, basaloid cells and shadow cells. Subsequent histopathologyof the excised lesion confirmed the diagnosis of Pilomatricoma. Through thisreport we highlight the cytomorphological features that helps us in arriving the correct diagnosis of Pilomatricomaon Fine needle aspiration cytology (FNAC) smears.

Background: Pediatric Hodgkin lymphoma (HL) has been treated successfully with risk-adapted and response-adapted therapy. While risk factors like Ann Arbor staging system, B symptoms, bulky disease, and erythrocyte sedimentation rate were measured objectively, B symptoms are subjective tools. We evaluated whether the neutrophil-to-lymphocyte ratio (NLR) and inflammatory marker levels correlated with B symptoms and disease burden.Materials and Methods: We conducted a retrospective chart review of all children ≤ 14 years old with pathology-confirmed HL treated at our institution. Data included clinical and pathologic features, pretreatment erythrocyte sedimentation rate, ferritin levels; monocyte, neutrophil, and lymphocyte counts; and NLR. Optimum cutoffs of variables significantly associated with B symptoms were determined based on receiver operating characteristic curves.Results: Sixty-four patients were included in the analysis. Sixteen patients (25%) had B symptoms. Patients with B symptoms had higher ferritin levels (P < 0.0001), monocyte counts (P = 0.0060), neutrophil counts (P = 0.0003) and NLR (P < 0.0001), and lower lymphocyte counts (P = 0.0017). Multiple receiver operating characteristic curves were generated to identify the optimum cutoff. Sensitivities and specificities of NLR (cutoff, 3.5) and ferritin (cutoff, 173 ng/mL) were the highest (81.25% and 81.25% [P < 0.0001] and 89.36% and 75% [P < 0.0001], respectively). Patients with NLR > 3.5 and ferritin > 173 (ng/mL) had significantly higher stage, bulky disease, and B symptoms. NLR and ferritin are not predictive of worst outcome in the cohort analyzed.Conclusions: NLR and ferritin levels were associated with high disease burden and B symptoms. Therefore, these variables can be used as measurable tools for B symptoms that can help stratify patients with HL. Larger and prospective studies are needed to validate these findings.