KEYWORDSBloody nipple discharge; Intraductal papilloma; Sonography.Abstract Intraductal papillomatous lesions in the breast may be manifestations of different histological types of tumors, including papillomas and intraductal papillary carcinomas. Intraductal papillomas are relatively rare, with an incidence of 2e3%. They are benign tumors that arise from the mammary duct epithelium. We observed a tumor of this type in a 51-year-old woman who had noted bloody discharge from her right nipple. She was referred for breast sonography a few days later. The sonographic examination revealed a dilated duct enclosing a mass, which was surgically removed. Histological examination revealed that the lesion was benign (intraductal papilloma). This case illustrates the role of imaging in confirming clinical diagnoses of papillomatous lesions. Histological confirmation is always necessary, however, to rule out the presence of intraductal papillary carcinoma.Sommario Le alterazioni papillomatose intraduttali della mammella includono un vasto range di lesioni con caratteristiche diverse, tra cui il papilloma e il carcinoma papillare intraduttale. Il papilloma intraduttale è una lesione relativamente rara con un'incidenza relativa del 2 e3%. Si tratta di un tumore benigno che origina dall'epitelio dei dotti mammari. Riportiamo il caso di una donna di 51 anni presentatasi all'ambulatorio ecografico del nostro Istituto, dopo aver notato una secrezione ematica dal capezzolo di destra, pochi giorni prima. L'esame ecografico evidenziava un dotto dilatato con all'interno una vegetazione. Si procedeva a escissione chirurgica; l'esame istologico poneva la diagnosi di lesione benigna (papilloma intraduttale). Il caso in esame sottolinea il ruolo dell'imaging, che è quello di confermare la diagnosi clinica di lesione papillomatosa, mentre la diagnosi finale è sempre istologica in particolare la diagnosi differenziale con il carcinoma intraduttale papillare. ª

We report one case of metastatic synovial sarcoma (SS) to the parotid gland in a 93-year-old male. The patient had undergone upper left pulmonary lobectomy with mediastinal lymphadenectomy for SS of the lung 5 years before. The cytopathologic presentation and the immunocytochemical findings on the FNA sample were suggestive of a spindle cell myoepithelioma, while a SYT rearrangement was identified by a FISH performed on a cytological smear of the lesion. The diagnosis was further confirmed also by positive immunocytochemical expression of TLE1 on a section from the obtained cell block. The cytologic and immunophenotypic findings are shortly discussed in view of the reported immunophenotypic inconsistency of SS and of its differential diagnosis with spindle cell myoepithelioma of the salivary glands.The importance of the recently described TLE1 staining and its close correlation to SYT rearrangement is briefly discussed.