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Background Recently the International Academy of Cytology (IAC) introduced a new reporting system for breast fine‐needle aspiration cytology that classifies cytologic diagnoses into five‐categories: (I) insufficient material, (II) benign, (III) atypical, (IV) suspicious of malignancy, and (V) malignant. The current study was undertaken to categorize the breast lesions utilizing the newly proposed IAC Yokohama classification system and evaluate the risk of malignancy (ROM) for respective categories and the diagnostic yield of this technique. Methods All FNAs of breast lesions over 2.5 years were categorized retrospectively using the newly proposed IAC Yokohama reporting system. The ROM was calculated along with sensitivity, specificity, positive and negative predictive value, diagnostic accuracy, false positive, and false‐negative rate using the histological diagnosis as the gold standard. Results The 512 cases were distributed as follows: Category I (insufficient material) 7.4%, Category II (benign) 74%, Category III (atypical) 5.7%, Category IV(suspicious) 1.4%, and Category V (malignant) 11.5%. Histopathological correlation was available in 285 (55.7%) cases. The respective ROM calculated was 33.3%, 0.5%, 13.3%, 83.3%, and 100% for Category I‐V. The Sensitivity, Specificity, Positive and Negative Predictive Value, and Diagnostic accuracy were 95%, 99.5%, 98.27%, 98.6, and 98.5% respectively. Conclusions Despite previous attempts to establish a standardized diagnostic terminology, there has been a lack of a single internationally approved standardized reporting system allowing substantial diagnostic clarity and incorporating distinct diagnostic categories, each linked with a specific ROM and recommended management. This System also provides enhanced communication between pathologists and attending clinicians for the benefit of the patient.

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The neuroendocrine tumors (NETs) originate from the neuroendocrine (NE) cells that produce various types of amines and peptides. 1 NETs of the breast are rare slow-growing tumors and accounts for less than 1% of all NETs and less than 0.1% of all breast cancer. Focal NE differentiation can be associated with different histologic subtypes of breast carcinomas like in situ carcinoma and invasive ductal, lobular, colloid, or papillary carcinoma. 2 Sapino et al proposed the first diagnostic criteria in 2001 according to which the term Neuroendocrine Carcinoma of Breast (NECB) was entitled to those tumors expressing NE markers-Synaptophysin and/or Chromogranin in more than 50% of the tumor. 3 However, in the 2012 World Health Organization (WHO) classification, it was concluded that a 50% threshold for NE marker expression was arbitrary, hence it was removed. 4 Diagnostic requirements for primary NECB includes the histological presence of an in situ component and exclusion of any evidence of metastatic NEC. 2 According to WHO classification 2012, NECs were subdivided into three categories-well-differentiated NET, poorly differentiated NE carcinoma/small cell carcinoma, and invasive breast carcinoma with NE differentiation. 4 However, in a recently proposed consensus statement by the WHO and International Agency for Research on Cancer (IARC), the term "neuroendocrine neoplasm (NEN)" was adopted harmonizing with those of other organ systems to provide a uniform classification framework. NENs encompasses both welldifferentiated NETs corresponding to Grade 1 (carcinoid-like) and Grade 2 (atypical carcinoid-like) tumors (regarded as carcinomas in the breast) and poorly differentiated NECs, represented by small-cell and large-cell carcinoma. 5,6 A 78-year-old female presented to the Surgery Outpatient Department with the complaint of a left-sided breast lump for 2 months. On examination, a hard, tender, 3 × 3 cm size lump was palpated above the nipple and areola of the left breast. There was no history of nipple discharge or nipple retraction. No history of breast trauma or any other significant family history was elicited.

Gallbladder tumors are the fifth most common cancers of the gastrointestinal tract with poor prognosis and low survival. The most common type is adenocarcinoma of which the clear cell type is an unusual histologic variant with alpha-fetoprotein (AFP)-producing gallbladder carcinoma, reported extremely rarely, which makes the index case an uncommon entity. AFP secretion by gallbladder carcinomas may occur given the similar embryological origin of liver and gallbladder. Herein we report a case of an incidental carcinoma of the gallbladder in a 60-year-old woman with an elevated serum AFP concentration at presentation, who underwent cholecystectomy for cholelithiasis and was rendered the diagnosis of AFP-producing clear cell carcinoma of the gallbladder through histopathology and immunohistochemistry. Her postoperative laboratory tests showed a decline in AFP levels to normal respectively. The clinical and pathologic importance of AFP production by clear-cell adenocarcinoma of the gallbladder (CCG) has thus far remained completely obscure. However, we must recognize the entity of this tumor because accurate and early diagnosis of CCG is imperative to avoid misdiagnosis as possible secondary metastasis and consequent delay in appropriate surgical intervention. Relevant medical history of a patient, various imaging studies, foci of classical adenocarcinoma within the tumor, and an efficient immunohistochemical panel can be informative and assist in arriving at an accurate diagnosis.