This approach can facilitate treatment selection by accurately predicting the subtype in undifferentiated NSCLC biopsies, reducing to 7% the proportion of cases without a definite or probable histologic subtype.

SB3-positive immunohistochemistry score of 2 or more (>10% tumor cells positive) identifies a subgroup of patients with stage IV NSCLC who have a poor survival (median 120 days) when treated with PtC, similar to that estimated for untreated or chemo-refractory stage IV NSCLC. Further prospective qualification using biospecimens from randomized studies is needed, but SB3 seems to be a useful biomarker that identifies a highly resistant subgroup in whom PtC should be avoided.

tions or in apparently healthy men, and thus has a role in male fertility. Several questions remain to be elucidated, such as the exact origin of those epithelial cells (i.e. rete testis, efferent ductules, epididymis, vas deferens) and the rate of disposal of spermatozoa and leucocytes by this means. Morphometric analysis with a large sample of infertile (infected and uninfected) and healthy men may be useful to assess this latter point. 1. Sutovsky P, Moreno R, Romalho-Santos J, Dominko T, Thompson WE, Schatten G. A putative ubiquitin-dependent mechanism for the recognition and elimination of defective spermatozoa in the mammalian epididymis.tural findings in semen samples of infertile men infected with Chlamydia trachomatis and mycoplasmas. Fertil. Steril. 2009; 91; 915-919. 4. Moulder JW. Interaction of chlamydiae and host cells in vitro. Microbiol. Rev. 1991; 55; 143-190. 5. Dallo SF, Baseman JB. Intracellular DNA replication and long-term survival of pathogenic mycoplasmas. Microb. Pathog. 2000; 29; 301-309.

Background First described in 1955 Primary mediastinal seminomas are rare. Only 1–4% of mediastinal tumours are germ cell tumors; majority of which are teratomas. They typically present in men aged between 20 and 40 years. Very few cases are reported in the literature. Florid follicular lymphoid hyperplasia can obscure the malignant cells and is a rarer finding still. We present a rare case of a 48 year old man with a primary mediastinal seminoma with florid follicular lymphoid hyperplasia; found following excision of a clinically presumed thymoma. Case presentation A 48 year old man was referred for excision of a thymic mass. The presumed diagnosis was a thymoma; following preoperative investigations. The mass was incidentally found on a radiological imaging. However, the patient did report mid-sternal discomfort on lying flat and breathlessness. The patient underwent a thymectomy via a partial median sternotomy with good recovery. Histological assessment was that the mass was in fact a primary mediastinal seminoma with florid follicular lymphoid hyperplasia. A primary testicular malignancy was excluded and the patient required no further oncological treatment. Conclusions Only 11 cases have previously been reported of primary mediastinal seminoma with florid follicular lymphoid hyperplasia. Although rare, a primary mediastinal seminoma should be considered as a differential diagnosis for presentations with a thymic mass. Tumour markers can be helpful, however are only positive in third of cases. Ultrasound imaging of the gonads is essential to exclude a primary gonadal lesion. Pure seminomas are radiotherapy and chemotherapy sensitive however the mainstay treatment of primary mediastinal seminomas remains surgical excision. Radiotherapy is reserved postoperatively for incomplete surgical margins.

SUMMARY Personalized medicine for patients with non-small-cell lung cancer is a reality now and its use will only increase in the future. Pathology is key in supporting this approach to treatment decision-making, by performing the most complete and accurate histological subtyping of tumors possible, supported by predictive immunohistochemistry and the assessment of relevant biomarkers. The need for these extra diagnostic steps