Introduction Inflammation seems to play a critical role in the development and progression of numerous cancers. Peripheral blood leukocyte count is an easily assessable parameter of systemic inflammatory response. Objective The aim of this study was to investigate whether the pretreatment leukocyte counts can predict the prognosis of patients with oral cavity cancer. Methods Medical records of 471 oral cavity cancer patients diagnosed between January 2007 and December 2008 were retrospectively analyzed. Receiver operating characteristic curve analysis and Cox proportional hazards analyses were applied to evaluate the associations of leukocyte counts with overall survival. Results The overall five year's survival of the cohort was found to be 49.4%. On univariate analysis, elevated monocyte count (≥500/mm3) and neutrophil-to-lymphocyte ratio (NLR) (>2.38) were associated with poor overall survival (OS) (p = 0.001 and 0.000, respectively). Multivariate Cox proportional hazard analysis showed that higher monocyte and NLR levels were significant independent predictors of worse OS (HR = 1.385, 95% CI = 1.049 - 1.829; p < 0.05 and HR = 1.392, 95% CI = 1.045 - 1.855; p < 0.05, respectively). The advanced overall stage and lymph nodal involvement were also independent indicators for poor OS. Conclusions Higher pretreatment monocyte and NLR levels are independent predictors of poor prognosis for patients with oral cavity cancer. Thus, these easily accessed variables can serve as a potent marker to predict the outcomes of oral cancer patients.

Nomogram has been widely used in a number of cancers, but its application in oral cancer prognostication has not been explored. In this study, we have developed a nomogram that can accurately estimate 5-year OS in patients with oral cavity cancer. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1826-1831, 2016.

Plasmablastic lymphoma (PBL) can rarely be seen as a transformation from plasma cell myeloma (PCM), especially in late stages of the disease where it portends a poorer prognosis and a different line of management for the patient. When unrelated to PCM, PBL is considered to be a separate aggressive variant of B-cell lymphoma typically seen in the oral cavity of immunocompromised adults. We describe a case of plasmablastic transformation having a pan T-cell phenotype with CD3 and CD4 positivity, in an immunocompetent elderly lady diagnosed with PCM. This 60-year-old lady presented with worsening backache and a 2-cm skin nodule in the left cervical region, while she was on treatment with vincristine, cyclophosphamide, dexamethasone (VCD), and bortezomib. On biopsy, the skin nodule showed an infiltrating lymphoid tumor composed of immunoblastic cells with brisk mitosis and apoptosis. On Immunohistochemistry (IHC), lymphoid cells revealed plasma cell markers CD38, CD138, CD56, and MUM1. Pan-T-cell markers CD3 and CD4 were also diffusely expressed in tumor cells. B-cell markers CD20 and PAX5 were not expressed; c-Myc IHC and EBER by in situ hybridization (ISH) were negative in the tumor. Mitotic index by Ki67 was >95%. Thus, a diagnosis of plasmablastic transformation in a known PCM case was made. This is the first case, to the best of our knowledge, with a heterotropic T-cell phenotype in a plasmablastic transformation from PCM. It is critical to correctly diagnose such cases as they may occasionally be misinterpreted as T-cell neoplasms. Clinically, a more aggressive treatment is indicated for such patients. Further studies in these cases may enhance our understanding of complex underpinnings of lymphoma biology.

The rare entity of primary T-cell lymphoma of thyroid gland may pose great diagnostic and therapeutic challenges to the pathologist and clinician. There are very few case and short series reports of these tumors describing their varied clinicopathologic features in English literature. We report a case of mature T-cell lymphoma of thyroid in a 26 year old male, with unique pseudogranulomatous and lymphohistiocytic Lennert type of morphology, on a background of autoimmune thyroiditis. This man, diagnosed with Hashimoto's thyroiditis for the previous 2 years, underwent thyroidectomy for sudden onset of pressure symptoms. The diagnosis of T-cell lymphoma was made on the thyroid tissue based on histopathologic and immunophenotypic findings, in concert with the results of T-cell receptor gene rearrangement studies by polymerase chain reaction. Later, after about 3 months, similar findings were confirmed in an excision biopsy from a left cervical lymph node in the patient. The patient has been started on chemotherapy with gemcitabine, dexamethasone, and cisplatin along with involved field radiotherapy; however, he has shown a rapid upstaging of disease from stage IE to IIIE in a short period of 3 months with relatively well preserved clinical parameters until the latest follow up.

Overview Mesenchymal tumors of the breast are rare. Few epithelial tumors also have mesenchymal components. It is crucial to identify these as per histogenesis. This can be facilitated by markers of epithelial–mesenchymal transition (EMT) Objectives The aim of this study was to categorize the breast lesions with mesenchymal morphology and to study EMT on immunohistochemistry (IHC). Materials and Methods This is a retrospective study of 5-year duration from January 2015 to December 2019. Inclusion criteria: all breast lesions showing mesenchymal/nonepithelial morphology, complete or partial, on histology. Exclusion criteria: Mammary carcinomas without any mesenchymal/nonepithelial morphology, fibroadenomas, and lymphomas. Demographics, clinical, gross examination, histology, and IHC findings of selected cases were reviewed and recorded. Three additional markers p53, E-cadherin, and β-catenin were performed. Statistical Analysis Used Frequency calculation for each variable (IHC). Results Thirteen (2.5%) out of total 510 breast specimens showed mesenchymal histology. Of these, five (38.5%) were metaplastic breast carcinomas (MBC), four (31%) were phyllodes tumor (PT), and one (7.7%) case each of malignant peripheral nerve sheath tumor, primary stromal sarcoma of breast, pseudoangiomatous stromal hyperplasia, and myofibroblastoma. Loss of E-cadherin was seen in 4/5 (80%) MBCs and was retained in ductal component of PTs. p53 was not expressed in any of the tumors except 3/5 (60%) MBCs. β-Catenin was aberrant in all MBCs. Conclusions Primary breast tumors with mesenchymal morphology present a spectrum ranging from benign mesenchymal, fibroepithelial neoplasms to malignant tumors of mesenchymal and epithelial origin. Loss of E-cadherin, expression of p53, and aberrant expression of β-catenin are suggestive of EMT and molecular heterogeneity of MBCs.