Metaplastic breast cancer is a rare form of primary breast cancer. It contains a mixture of adenocarcinoma with metaplastic elements. It is important to differentiate with primary sarcoma of the breast which carries different treatment strategies and prognosis. A 55-year-old lady previously diagnosed to have a left breast cancer in the year 2000 and carcinoma of the endometrium in 2009, presented with a right breast lump. A trucut biopsy reported as an infiltrating ductal carcinoma with background of chondromyxoid and cartilagenous matrix,
most probably metaplastic carcinoma. A wide local excision with sentinel lymph node biopsy was performed, and the final histology was consistent with metaplastic chondroid carcinoma of the breast with no evidence of metastsis. The surgery was followed by adjuvant radiotherapy and currently free from any recurrence. The diagnostic dilemma on this very rare condition is reviewed.
Thyroid nodules are common but thyroid malignancies are not. Fine needle aspiration (FNA) cytology is a diagnostic tool used to screen patients with thyroid nodules who require surgery. We study the diagnostic accuracy of FNA as the initial diagnostic modality in the clinical assessment of thyroid nodules. Between January 1995 until December 2000, 2131 FNA of thyroid nodules were performed. Four hundred and forty-one (20.7%) of these were unsatisfactory and 1690 (79.3%) cases were satisfactory for cytological evaluation. Histopathological diagnosis were available for 361 cases. Cyto-histopathological correlation was carried out for these cases. Our results showed a diagnostic accuracy of 96.2% with sensitivity and specificity rates of 87.7% and 98.4% res- pectively. Our positive predictive value is 93.4% and our negative predictive value is 96.8%. From this study, we conclude that fine needle aspiration is an important initial screening diagnostic tool for the investigation of thyroid nodules.