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Non-Hodgkin lymphoma of the breast is an uncommon entity accounting for approximately 0.5% of malignant breast neoplasms and around 3% of extranodal lymphomas. Most cases of anaplastic large cell lymphoma (ALCL) of the breast have been associated with breast implants, and a few ALCL arising de novo in patients without breast implants have been reported. We report a case of a 19-year-old female who presented with a lump in the right breast of 3 months' duration. Examination revealed an Eastern Cooperative Oncology Group performance status of 2 and a 6×5 cm2 lump in the right breast. Lumpectomy revealed large neoplastic cells positive for CD30, EMA, CD5, and anaplastic lymphoma kinase (ALK), suggestive of anaplastic large cell lymphoma. The patient underwent lumpectomy followed by 6 cycles of anthracycline-based chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone 3 weekly. On follow up, this patient had an event-free survival of 23 months. We are reporting this case of ALCL (ALK positive) in a patient with no breast implant previously, and, hence, it is of clinical importance.

Background and Purpose: Primary parotid lymphoma (PPL) is an unusual entity and comprises 5% of salivary gland neoplasms and 5% of extra nodal lymphomas. There is limited data in Indian population. Hence we undertook this retrospective observational study of primary parotid lymphoma at our centre in Southern India. Results: 7 consecutive cases diagnosed as PPL by tissue biopsy/superficial/deep parotidectomy confirmed by immunohistochemistry between 2007 and 2012 were included. Median age was 54 years(29-78), and it was more common in males. Diffuse large B cell lymphoma was seen in 6 and extra nodal marginal zone lymphoma in 1. According to Ann Arbor stage- Advanced stage (stage III and IV) was seen in 2(28.57%). According to the International Prognostic Index most were in low risk- 6 (85.7%). Overall survival range from 1-45 months, with a median survival of 24 months. Conclusions: To conclude, PPL presents more often in early stage and low IPI score. Surgery with chemoimmunotherapy with involved field radiotherapy remains the standard treatment at present.

Objective: To evaluate the efficacy of imatinib in chronic myeloid leukemia patients with variant translocations. Methods: Forty eight chronic myeloid leukemia patients carrying variant translocations and treated with imatinib at our institute were considered for the study. Survival and response rates were evaluated. Results: The median follow up was 48 months(m). Forty three (89.58%) patients achieved complete hematologic response. Thirty one (64.58%) patients achieved complete cytogenetic response and 19(39.58%) achieved major molecular response anytime during their follow up period. Only 18.75% of the patients achieved complete cytogenetic response and major molecular response within the stipulated time frames.The estimated overall survival at 48 m median follow up was 81.2%.The progression free survival was also 81.2% and the event free survival was 79.1%.There was no significant survival difference between low vs intermediate and high risk sokal group. Conclusion: We report suboptimal responses to imatinib in chronic myeloid leukemia with variant translocations. Further studies with imatinib and the newer more active drugs dasatinib and nilotinib are justified.

To evaluate the efficacy of imatinib in chronic myeloid leukemia patients with variant translocations. Methods: Forty eight chronic myeloid leukemia patients carrying variant translocations and treated with imatinib at our institute were considered for the study. Survival and response rates were evaluated. Results: The median follow up was 48 months(m). Forty three (89.58%) patients achieved complete hematologic response. Thirty one (64.58%) patients achieved complete cytogenetic response and 19(39.58%) achieved major molecular response anytime during their follow up period. Only 18.75% of the patients achieved complete cytogenetic response and major molecular response within the stipulated time frames.The estimated overall survival at 48 m median follow up was 81.2%.The progression free survival was also 81.2% and the event free survival was 79.1%.There was no significant survival difference between low vs intermediate and high risk sokal group. Conclusion: We report suboptimal responses to imatinib in chronic myeloid leukemia with variant translocations. Further studies with imatinib and the newer more active drugs dasatinib and nilotinib are justified.

Introduction Cytogenetic abnormalities are integral to the risk stratification of acute lymphoblastic leukemia (ALL). Objectives The present study aimed to highlight a rare, yet nonrandom cytogenetic abnormality notably dicentric (9;12), which was observed in ALL patients who presented to our institute. The study analyzed the frequency, clinicohematological features, and treatment response of these patients. Materials and Methods A single-group observational study was conducted from April 2014 to April 2020. Cytogenetic analysis was done on bone marrow aspirate samples of the patients referred to the cytogenetics laboratory with clinical diagnosis of acute leukemia. Cytogenetic, clinical, and hematological data were collected from respective departmental records, case files, and patients. Results Dic(9;12) was identified in 1.2% of ALL (19 out of 1,544 patients). They showed striking preponderance in teen and young adult males with characteristic precursor B cell immunophenotype. Majority of these patients displayed favorable risk profiles such as low total count, mild lymphadenopathy and splenomegaly, mild-to-moderate elevation of lactate dehydrogenase, and good response to first induction chemotherapy. Rare coexistence of dic(9;12) with well-established cytogenetic markers such as t(9;22) and t(1;19) was observed. Conclusion Dic(9;12) is one of the most specific cytogenetic markers of precursor B cell (pre-B) ALL. It defines a subgroup with favorable clinical and biological profile. We suggest inclusion of dic(9;12) in cytogenetic risk stratification of precursor B cell ALL. Long-term follow-up studies are recommended to establish the prognostic significance of this cytogenetic subgroup, which may benefit from less intensive chemotherapy. [ABSTRACT FROM AUTHOR]

BACKGROUND: The present era of individualized treatment for breast cancer is influenced by the initial disease status including the anatomical extent, grade, and receptor status. An accurate preoperative staging is the basis of treatment planning and prognostication. Our study aims to determine the discordance between the preoperative clinical and the postoperative pathological stages of breast cancer patients. METHODOLOGY: The medical records of all non-metastatic breast cancer patients from January 2017 to December 2018 who underwent upfront surgery were reviewed. They were staged as per the eighth AJCC and the concordance between the clinical (c) and pathological T (tumor), N (nodal), and final AJCC stage was studied. A Chi-square test was used to determine factors that significantly correlate with disease discordance. RESULTS: A total of 307 breast cancer patients were analyzed. Among these, 43.3% were hormone receptor-positive, 30.6% were Her2 positive and 26% were triple-negative. Overall stage discordance was seen in 48.5% (n = 149) patients (upstaging in 22.1%, downstaging in 26.4%). The discordance rate was 48.9% for T stage (cT versus pT) and 57.4% for N stage (cN versus pN). Among patients with clinically node-negative disease, 53.4% were found to have positive nodes on histopathology, while 27.2% had vice versa. Overall, the factors associated with upstaging were ER-positive, Her2 positive and triple-negative status (all p < 0.05), while none of the factors showed significant association with downstaging. CONCLUSIONS: About half of breast cancer patients had discordance between clinical and pathological staging with higher discordance in the nodal stage. This changes the disease prognosis, and may also affect the offered surgical treatment and radiotherapy. Thus highlighting the need for a precise pre-operative staging. Also, this information will aid clinicians in discussions with patients, keeping in mind the likelihood of change in disease staging and management. [ABSTRACT FROM AUTHOR]