Atypical teratoid rhabdoid tumor is a rare highly malignant embryonal tumor of the central nervous system that is often seen in early childhood. It is very important to distinguish it from other brain tumors because it has a very poor prognosis and there are differences in its treatment. A case of atypical teratoid rhabdoid tumor in a six-week-old male baby is presented. The tumor was located at posterior fossa. Histopathologically, the tumor has rhabdoid tumor cells and mesenchymal components beside the undifferentiated small cells. While EMA, vimentin, synaptophysin and smooth muscle actin have been stained with immunohistochemical staining, desmin, chromogranin, CD 99 and CD 56 have not been stained. The patient died four months after surgery despite the chemotherapy given. In conclusion, morphological characteristics can vary to a large extent that it is difficult to recognize atypical teratoid rhabdoid tumor. Immunohistochemical panel and molecular genetic study will help to establish the correct diagnosis.

Objective:

Eccrine porocarcinoma is a rare malignant tumor of eccrine sweat glands. It may arise de novo, but it usually develops in pre-existing eccrine poroma. Here we report a case of eccrine porocarcinoma in the grafted area on the scalp of a male patient who had recurrent basal cell carcinoma of the scalp, with clinical, histopathological and, immunohistochemical features. Case: We report a case of eccrine porocarcinoma in 78-year-old male patient who had recurrent basal cell carcinoma of the scalp. The tumor was polypoid, granular and heterogenous colored. Microscopic examination revealed a tumor composed of basaloid-poroid neoplastic cells in the dermis which showed solid and cystic areas. Focal clear cell change, and atypical and frequent mitoses were also observed. Neoplastic cells were diffusely positive with pankeratin. There was focal positivity with EMA and CEA.

Conclusion:

Eccrine porocarcinoma is a rare tumor. There are no large series that evaluate the diagnosis, monitoring and treatment of these tumors. In addition, this entity has to be kept in mind in the differential diagnosis of epidermal and skin appendix tumors.

Warthin-like tumor of the thyroid is a recently described rare variant of thyroid papillary carcinoma. The distinguishing histological feature of this variant is papillary foldings lined by oncocytic neoplastic cells with clear nuclei and nuclear pseudoinclusions, accompanied by prominent lymphocytic infiltrate in the papillary stalks. Its prognosis has been reported to be almost similar to conventional papillary carcinoma. In this case series, we report four cases with Warthin-like papillary carcinoma of the thyroid, diagnosed at Dokuz Eylul University Faculty of Medicine Department of Pathology in 2008 and 2009. Three patients were female. The mean patient age was 39 years (range, 20-56) and the mean tumor size was 1.7 cm (range, 0.9-2.0 cm). All of the cases had lymphocytic thyroiditis in the background. None of the tumors showed lymphovascular invasion. The patients are free of any recurrence and/or distant metastasis with a mean follow-up of 25 months. This rare variant of thyroid papillary carcinoma with distinct histopathological features should be indicated in pathology reports. Further studies and long-term follow-up of patients are needed to highlight the biological behavior of this variant.

Systemic amyloidosis is one of the serious complications of Familial Mediterranean Fever (FMF). Amyloid accumulation secondary to FMF can cause pressure symptoms in thyroid gland rarely. A 17-year-old male patient with the diagnosis of FMF performed the complaints of dyspnea during his follow-up period. He has demonstrated a rapidly increasing mass localized in front of his neck within the last three months that was diagnosed as a diff use, hyperplasic and pressuring thyroid gland. Total thyroidectomy was performed. Histopathological investigation of the material obtained aft er thyroidectomy revealed diff use lipid infiltration in parenchyma, intense amyloid accumulation around and between the follicles that caused pressure on the follicles, and cystic areas in the tissue. Squamous metaplasia foci in cyst epithelium were detected. Upon these findings the case was diagnosed as amyloid goiter accompanied by metaplastic variations. In conclusion, it can be appropriate to take into account the possibility that metaplastic variations could accompany amyloid goiter in patients with long-term FMF.

Filariasis is a common public health problem in Asian countries. In this report, the authors have described detection of microfilaria in the cytological specimen of adrenal lymphoma. To the best of our knowledge, this is the first reported case in the literature where microfilaria was seen in an adrenal gland involved by lymphoma. The literature is briefly reviewed.

Large cell neuroendocrine tumor of the urinary bladder is very rare. It is a type of neuroendocrine carcinoma that is morphologically different from small cell carcinoma. This manuscript describes a 67-year-old man who presented with hematuria. Ultrasonogrophic and computer tomography revealed a 5 cm mass in right posterolateral wall of the bladder that invaded perivesical tissue and he subsequently underwent transurethral resection. Microscopic examination showed a tumor with a sheet-like and trabecular growth pattern comprising necrotic areas which infiltrated the muscularis propria. Tumoral cells had coarse chromatin, prominent nucleoli, moderate amount of cytoplasm and immunohistochemically stained strongly positive with synaptophysin, chromogranin and CD56. There are only few case reports of large cell neuroendocrine tumor of the urinary bladder so the biological behavior and the treatment protocol of these tumors are still obscure. Appropriate management protocols and prognostic estimation could be achived by the increased number of cases being reported. Therefore in a case of a poorly differentiated tumor in bladder, although rare, it is important to consider large cell neuroendocrine carcinoma in differential diagnosis.

Objective:

The association of tubular carcinoma, columnar cell lesions and lobular carcinoma in situ, also known as the "Rosen Triad", may be encountered in breast biopsies performed for evaluation of mammographically detected microcalcifications. Case Report: A case in which tubular carcinoma and columnar cell hyperplasia were associated with a histologically unusual form of signet ring lobular carcinoma in situ is presented. Signet ring non-invasive lobular carcinoma is classified as high-grade lobular carcinoma in situ, but herein is associated with changes that belong to the molecular pathway of low-grade mammary neoplasia.

Conclusion:

We reported the case of lobular carcinoma in situ associated with columnar cell hyperplasia and tubular carcinoma, in which the lobular carcinoma in situ was presented in a histologically unexpected form comprised predominantly of signet ring cells.

Objective:

The aim of this study was to assess the relationship between clinical, radiological and histopathological findings in nasal polyposis. Material and Method: This was a retrospective study of 85 patients with nasal polyposis who were treated by endoscopic sinus surgery between the years of 2005 and 2010. All patients underwent preoperative paranasal sinus Computerized Tomography scan in the coronal plane and these images was evaluated with Lund-Mackay scores. The biopsy materials diagnosed as nasal polyp were identified by archive scanning at the pathology department. The Haematoxylin-Eosin stained preparations of the biopsy materials were re-evaluated. All of the results were analyzed by using the SPSS 13.0 soft ware program. Statistical significance was determined as p-value < 0.05.

Results:

When the patients with (16.4%) and without (83.6%) bronchial asthma were compared regarding the eosinophil, lymphocyte, neutrophil, macrophage, mast cells and goblet cells/ epithelial cell rate, no statistical significance was found (p > 0.05). There was a positive relationship between the preoperative complaint durations and the total Lund-Mackay scores (r=0.270, p=0.012). The neutrophil amount (16.53±19.87) on the preparations of the patients with metaplasia was higher than the neutrophil amount (8.71±23.98) on the preparations of the patients without metaplasia (p=0.001). Radiologically, there was a positive correlation between the infiltration of anterior-posterior sinuses by the polyp tissues and the Lund-Mackay score of the nasal cavity.

Conclusion:

There was a positive correlation between preoperative complaint duration and squamous metaplasia; and there was also a positive correlation between the preoperative complaint duration and the total Lund-Mackay score. There was no histopathological difference between the polypoid infiltration of the front and rear group sinuses.

Objective:

We examined the contribution of neonatal postmortem needle biopsy in circumstances of autopsy denial where magnetic resonance imaging cannot be performed. Material and Method: 247 postmortem needle biopsy specimens of 76 neonatal cases who died in the neonatal intensive care ward of a tertiary hospital between 2005 and 2010 and where the family did not give permission for an autopsy were retrospectively evaluated.

Results:

90 needle biopsy attempts (36.4%) were unsuccessful among the 247 biopsies. Liver needle biopsies were found to yield the most valuable diagnostic contribution. A total of 53 liver biopsies provided clinical information that contributed to the diagnosis.

Conclusion:

The postmortem needle biopsy should be applied in all cases in which standard biopsy cannot be performed. Success rates and level of information gained by extrahepatic needle organ biopsies in neonates were found to be quite low whereas needle biopsies of the liver yielded valuable results. We believe it is more appropriate to perform percutaneous postmortem biopsies solely on the liver in neonates.

Objective:

Mardin is an area of low socioeconomic level with low rates of contraceptive method use. Our aim in this study was to evaluate the effects of the contraceptive methods used in the area on epithelial cell abnormalities and vaginal flora changes. Material and Method: Cervical smear samples received at the Pathology Department between 2010 and 2012 of 526 patients who had used a contraceptive method and 112 who had never used one were included in the study. The cases were divided into 3 groups as those using hormonal contraception (107, 20.3%), those using an intrauterine device (343, 65.2%) and those using a barrier method (76, 14.4%). The evaluation was made using the Bethesda 2001 criteria for cervical epithelial abnormalities and specific cervicovaginal infections.

Results:

There was no significant difference between the groups for epithelial cell abnormalities while bacterial vaginitis (12%, p=0.03) and Trichomonas vaginalis (7.6%) were more common in the IUD users. The Actinomyces rate in RIA users was 1.3%. There was only 1 case of bacterial vaginitis in the barrier group and none of the other patients had a specific infection. Discussion: We did not find a significant cytopathic effect of using a IUD or hormonal contraception in our study. There was a low rate of epithelial abnormality in the barrier method group. IUD was seen to increase the incidence of bacterial vaginitis, Trichomonas vaginalis and Actinomyces. We did not find a significant effect of hormone use on the vaginal flora.