Liposarcoma is one of the most common mesenchymal tumour in adults but it is rare to occur in the breast. Our case was a 50 year old single nulliparous woman who presented with a right breast mass for one year duration. The mass was progressively increasing in size in the last few months. Breast examination showed a huge mass measuring 5 x 8 x 6 cm occupying the entire right breast. Mammogram showed a large homogenous soft tissue mass occupying the entire right breast with foci of calcification. A trucut biopsy showed a cellular tumour which was thought to be an invasive carcinoma. The patient underwent right modified radical mastectomy with axillary clearance. Macroscopy showed a well circumscribed lobulated solid haemorrhagic yellowish tumour mass measuring 180 x 110 x 50 mm. Microscopically the tumour was heterogenous comprising cellular round nonlipogenic mesenchymal cells and loose myxoid areas containing small cells. The typical arborizing ‘chicken wire’ capillaries were observed. Vacuolated lipoblasts were seen. All eleven axillary lymph nodes sampled showed no metastasis. A diagnosis of a myxoid liposarcoma was made. To raise the suspicion of a possible mesenchymal tumour, it is very important for clinicians to relay the clinical and radiological findings to the pathologist to avoid misdiagnosis in a trucut biopsy.
Introduction: The Hedgehog (Hh) signalling pathway is a developmental signalling pathway involved in normal mammalian developmental and homeostasis of adult renewable tissues. In most adult tissues, this pathway remains silent and previous studies have shown that constitutive activation of Hedgehog signalling pathway leads to various types of malignancies including medulloblastomas, basal cell carcinoma, gastrointestinal, breast and prostate cancer. The purpose of this study was to investigate the immunohistochemical expression of Hedgehog pathway proteins in Diffuse Large B-cell Lymphoma and determine their association with overall survival (OS). Methods: Positive control using normal tonsils were included in each batch of immunohistochemical staining procedure. Results: PTCH1 proteins were highly expressed in DLBCL and showed strong staining intensity in 107 (100%) cases and SMO proteins were expressed in 105 (98.1%) cases. PTCH1 proteins were localised in the nucleus of tumour cells, whereas SMO proteins were mainly localised in the cytoplasm of tumour cells. Positive expression of PTCH1 and SMO proteins and overall survival of DLBCL patients were correlated with age, gender, race and tumour location. There was no significant correlation between the expression of these two proteins with any of the parameters. PTCH1 expression showed significant association with SMO expression (P=0.03). Conclusions: Our findings suggest that high expression of both PTCH1 and SMO may be important in the pathogenesis of DLBCL. However, additional mechanisms that may contribute to the activation of HH signalling in DLBCL needs to be further explored.