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Anaplastic large cell lymphoma (ALCL) represents approximately 10 to 30% of all childhood non-Hodgkin lymphomas. It frequently involves both lymph nodes and extranodal sites whereas primary or secondary muscular involvements are quite uncommon. We describe a case of an 8-year-old boy presented with one month progressively swelling right buttock mass without association of lymphadenopathy or skin extension. Biopsy of the lesion showed large anaplastic cells with voluminous and abundant cytoplasm as well as folded nuclei. The tumour cells were positive for CD30, CD3, EMA and ALK-1. Chemotherapy resulted in durable remission status. This case emphasizes the occurrence of anaplastic large cell lymphoma in the soft tissue and the favourable outcome of ALK-positive anaplastic large cell lymphoma.

Endometrial stromal sarcoma (ESS) is rarely localized in extrauterine sites if metastasis or local extension of the primary uterine tumour are excluded, and diagnosis can be delayed because of the unusual site. We report a case of abdominal ESS in a 45-year-old woman who presented with an abdominal complaint. Ultrasound of the abdomen showed a large multiloculated cystic mass. The complete excision of the tumour revealed ESS arising in endometriosis. The tumour expressed hormonal receptors and the patient was administered hormonal therapy. ESS has a better prognosis than the sarcoma that is part of differential diagnosis, and is associated with endometriosis in about one-half of cases.

According to the WHO-EORTC classification of cutaneous lymphomas, primary cutaneous marginal zone B-cell lymphoma are now well characterized. We report here a case of primary cutaneous marginal zone B-cell lymphoma in a 51 year-old man in which the diagnosis was made using both histology and immunopathology. The patient had no remarkable medical history, no history of either acute inflammation or insect bite, and presented with a 5 cm solitary asymptomatic erythematous firm, multinodular and infiltrated plaque on the back for 12 months. Histological examination and immunohistochemical study of a cutaneous biopsy provided a differential diagnosis between B cell lymphoma and lymphocytoma cutis. Full body work up revealed no signs of extracutaneous dissemination. The patient underwent surgical excision of the nodule. Histological examination showed a histological and immunophenotyping profile typical of primary cutaneous marginal zone B-cell lymphoma. The lesion was completely excised with clear margins and no recurrence occurred after a 12 month-follow-up period. Primary cutaneous marginal zone B-cell lymphoma are low-grade lymphomas that have an indolent course and a high tendency to recur. They should be differentiated from lymphocytoma cutis and from the other types of cutaneous B cell lymphomas that have a different course and prognosis.

Malignant neoplasms arising in the epithelial component of breast fibroadenomas are rare. The most frequent types are lobular and ductal intra-epithelial carcinomas, with a minority of infiltrating carcinoma. We report a case of 36-year-old patient with invasive mucinous carcinoma (30 x 30 mm) arising in a complex breast fibroadenoma (130 x 60 x 30 mm). The patient underwent mastectomy with dissection of the axillary lymph nodes, which were free of tumour. The patient is alive without disease five years later. To the best of our knowledge, this is the first report of an invasive mucinous carcinoma arising within breast fibroadenoma. Our case provides information about the clinicopathologic characteristic of this unusual tumour.

Desmoplastic spitz nevus (DSN) is an uncommon melanocytic lesion. The histologic features of this benign tumour may mimic those of certain benign (dermatofibroma and desmoplastic cellular blue nevus) or malignant (metastatic carcinoma and malignant melanoma) neoplasms. We report the case of a male with a DSN, and also review the clinical characteristics, histologic features and differential diagnosis of this extremely rare lesion. The lesion is identified as an asymptomatic reddish-brown dome-shaped papule on the forearm. Microscopic examination showed a symmetric lesion in the dermis. The neoplastic cells were large and epithelioid-shaped, and were either isolated as individual cells or arranged in small nests in a paucicellular hyalinized stroma. Nuclei were large and vesicular with small nucleoli and no mitoses. Diffuse expression of S100 and the absence of staining with antibodies to melan-A and HMB45 was observed. A diagnosis of DSN with free margins was made. The histologic presentation of this benign lesion mimics both benign and malignant neoplasms. The immunohistochemical profile (S100 positive, HMB-45 negative and cytokeratin negative) may be helpful to differentiate it from other lesions.

Smooth muscle differentiation in stromal ovarian tissue has rarely been described in normal and tumoural ovaries, especially in granulosa-cell tumours. A moderately differentiated adult granulosa-cell tumour in an 83-year-old-woman is reported. Tumoural stroma included clusters of regular smooth muscle cells stained positively for smooth muscle actin. The presence of smooth muscle differentiation in an ovarian granulosa-cell tumour should be taken into consideration during diagnosis.

Small cell melanoma is a recognized rare variant of malignant melanoma. We report a case of a brown, ulcerated papule on the left third finger of an 80-year-old woman. Microscopic examination revealed the presence within the epidermis of diffuse sheets of monomorphic small to medium-sized cells. The nuclei were round or oval, and hyperchromatic with inconspicuous nucleoli. Melanin pigment was either absent or minimal. This case report draws attention to the difficulties encountered in the histological diagnosis of this rare variant of malignant melanoma.

We report a well-documented case of paraganglioma involving right ovary, which was initially misdiagnosed as a Sertoli-Leydig cell tumor and recurred one year later. The right ovarian tumor measured 105x90x60 mm and was associated to a subdiaphragmatic tumor measuring 80x60x35 mm, a peritoneal and a preureteral nodules measuring 10 mm either. Microscopically, tumor cells were arranged in trabeculae and cords separated by a delicate stroma. Their cytoplasm was abundant granular and eosinophilic. Their nuclei were enlarged and regular in size with coarse chromatine and a large nucleolus. The tumor expressed neuroendocrine markers (chromogranin, synaptophysin) epithelial membrane antigen and focally cytokeratin 7 and E-cadherin. Pathological ovarian paraganglioma diagnosis could be difficult but one should be aware of its bona fide existence. The clinical course is favourable in most of the cases.

Focal myxoid change is a well-recognised feature of synovial sarcoma, but the presence of a predominantly myxoid stroma is rare. We describe a new case of myxoid synovial sarcoma in which marked myxoid change initially obscured the diagnosis leading to confusion with malignant peripheral nerve sheath tumor. The patient was a 16 year old man who presented with a left dorsal foot tumor. The diagnosis of synovial sarcoma was suspected on histological and immunohistochemical studies and confirmed with cytogenetic analysis. Recognition of this rare histologic variant of synovial sarcoma is important because it can easily be mistaken for other myxoid spindle cell neoplasms, potentially resulting in suboptimal therapy.

Micropapillary carcinoma is an uncommon variant of urothelial carcinoma with apparent high metastatic potential. The reported cases in the literature were associated with high grade and stage of disease at presentation and a poor prognosis. Micropapillary carcinoma is considered a tumor with an aggressive behavior, even though the morphology may be deceptive. The presence of a micropapillary carcinoma component in bladder biopsies should alert the urologists to the potential of higher stage disease and deep biopsies should be obtained. Two cases of micropapillary carcinoma of the urinary bladder were presented. A 71-year-old woman and a 68-year-old man presented with urinary symptoms. Cystoscopy revealed a papillary tumor on the bladder wall in both cases. Pathologic examination of transurethral resection specimen showed an invasive micropapillary carcinoma; small solid nests lying in small clear spaces that were not stained with antibody CD34. Thus, the lacunar histological pattern did not appear to represent invasion of vascular spaces. Only one case showed an association with urothelial carcinoma. No case showed muscle invasion. No recurrence or metastasis were observed after the initial diagnosis in the two cases.

Background: Primary malignant mesenchymoma of the bone is a rare neoplasm consisting of two or more unrelated malignant mesenchymal components. The literature reports fewer than 20 cases, most of which were composed of osteosarcoma and liposarcoma., Observation: We report an exceedingly rare case of primary malignant mesenchymoma of bone composed of rhabdomyosarcoma, osteosarcoma, and a minor chondrosarcoma component, arising in the right proximal humerus of a 15-year-old girl. The rhabdomyosarcomatous component was present in the initial biopsy and persisted in surgical specimen following chemotherapy., Conclusion: Effect of chemotherapy is enigmatic since rhabdomyosarcomatous component could appear, persist or disappear after chemotherapy according to literature.

Primary synovial sarcomas of the heart are aggressive and extremely rare tumors. Only thirteen cases have been reported previously. We report the fourteenth case and review the previous ones. Our patient is a 45 year-old man who presented with congestive heart failure, which was related to a right atrial pedunculated tumor. The tumor was resected completely and the patient has remained disease-free after 5 years. The histopathologic examination and immunohistochemistry study confirmed the diagnosis. Thirteen cases are reported in the literature (11 men, 2 women) with a median age of 37.38 years (13 to 53 years). Most of the tumors occur in the right side (in 8 cases) particularly in the right atrium (in 5 cases). Ten patients died, seven within one year of diagnosis. However, in our case, the patient is still alive and free of disease.

We report an uncommon case of Hodgkin's disease confined to the nasopharynx. An isolated polypoid mass of the nasopharynx was observed in a 41-year-old man presenting with increasing bilateral nasal obstruction. Histological study revealed a mixed cellularity type of Hodgkin's disease. Immunohistochemical analysis revealed CD30 and LMP1 expression and a lack of reactivity to CD15, CD3 and CD20. Serological tests excluded recent infection with Epstein-Barr virus. HD of nasopharynx is rare, but has to be recognized as such in view of appropriate treatment.