Lipomatous pleomorphic adenoma in the hard palate: Report of a rare case with cyto-histo correlation and review

Pleomorphic adenoma is the most common benign tumor of the salivary glands. They are usually composed of epithelial/myoepithelial cells and chondromyxoid stroma. Extensive lipomatous differentiation is very rare. We report a case of lipomatous pleomorphic adenoma (LPA) that presented with a mass in the hard palate of a 32-year-old woman. The fine-needle aspiration cytology material was reported as benign cytology consistent with adenoma with major adipocytic component. Histopathological examination of the excision material displayed that more than 90% of the tumor was adipocytic in texture, containing scant epithelial and myoepithelial cells and chondromyxoid stromal fragments. Preoperative cytodiagnosis of lipomatous pleomorphic adenoma on FNA is based on cytomorphology intimately associated pleomorphic adenomatous and lipomatous tissue elements. LPA should be on the mental list of the (cyto)pathologist in differential diagnosis of lipomatous tumors or non-tumorous lipomatosis or carcinoma invasion in the adipose tissue of the minor salivary gland of the hard palate

BRAFV600E Mutation, RET/PTC1 and PAX8-PPAR Gamma Rearrangements in Follicular Epithelium Derived Thyroid Lesions - Institutional Experience and Literature Review

Background: Thyroid cancers are the most frequently occurring endocrine malignancy worldwide. In Turkey, thyroid cancers are ranked 2nd on the incidence list in women, with a rate of 16.2%, but they are not included among the top 10 cancer types in men. Aims: To identify the contribution of the BRAFV600E mutation, and the RET/PTC1 and PAX8-PPARγ rearrangements in the diagnosis and differential diagnosis of follicular epithelial-derived thyroid lesions. Study Design: Retrospective clinical and molecular genetic study. Methods: A total of 86 thyroid cases diagnosed between 2001 and 2012 at the Department of Pathology were included in the retrospective study group. Samples best representing the lesion and comprising capsules were chosen in the selection of paraffin blocks pertaining to the cases. The BRAFV600E mutation, and the RET/PTC1 and PAX8-PPARγ rearrangements were investigated in all cases. Results: The BRAFV600E mutation was observed in 12 out of 37 papillary carcinoma cases (32.4%), in 1 out of 15 follicular carcinoma cases (6.6%), and in 1 out of 7 undifferentiated carcinoma cases (14.3%). No mutation was detected in benign lesions. The RET/PTC1 rearrangement was detected in 2 out of 7 undifferentiated carcinoma cases (28.6%), and in 1 out of 15 follicular carcinoma cases (6.6%). No gene rearrangement was detected in benign lesions. The PAX8-PPARγ rearrangement was detected in 5 out of 15 follicular thyroid carcinoma cases (33.3%) and in 1 out of 15 follicular adenoma cases (6.6%). Conclusion: The BRAFV600E mutation and RET/PTC1 rearrangement were effective in distinguishing the follicular epithelium-derived benign and malignant lesions of the thyroid in the resection materials. The BRAFV600E mutation was rather specific to papillary carcinoma in the thyroid, and in cases where the BRAFV600E mutation was detected, multi-centricity, lymph node metastasis and capsular invasion findings were observed more frequently compared to cases in which no mutation was observed. The PAX8-PPARγ rearrangement was observed to be more effective in the differentiation of adenomas and carcinomas in follicular neoplasms of the thyroid, whereas the RET/PTC1 analysis contributed to the differential diagnosis of papillary carcinoma histogenesis at a frequency of 29% in undifferentiated thyroid carcinomas

Molar dişlerde inley restorasyonların mekanik performansının incelenmesi: 3-boyutlu sonlu elemanlar analizi

In this study the mechanical performance of inlay restorations was evaluated using the finite element method. Material and Method: Three-dimensional mandibular molar tooth model was generated by I_DEAS program. A total of 450 N for ce was applied on the model, perpendicular to the cuspal faces. Three different inlay materials were used in the study: X1=direct com posite restoration, X2=indirect composite material, X3=ceramic inlay material. Loads were applied to the tooth structure according to the distribution of the forces on functional and non-functional cusps. Von-Mises stress, strain and displacement distributions were eva luated using the elastic 3-dimensional finite element method. Results: According to von Mises stress, indirect composite restorations were slightly better than direct composite inlays and the ce ramic inlays respectively. Strain values in the interface between the tooth structure and restorative material were observed. Minimum values of strain were evaluated in X3 models whilst maximum values were in X1 models. For displacement distribution values best re sult was obtained X3 models, whilst the worst result with X1. Conclusion: Direct composite restorations were found to be more indicated for bucco-lingually narrow cavities whilst indirect com posite and ceramic restorations for bucco-lingually wider cavities. The occlusal anatomy of the direct composite should be prepared so that the functional and non-functional cusps are equally active in chewing action.Amaç : Bu çalışmada farklı inley restorasyonların mekanik performansı 3-Boyutlu Sonlu Elemanlar Yöntemi kullanılarak incelenmiştir. Gereç ve Yöntem: Çalışmada, I-DEAS programı kullanılarak 3-Boyutlu alt molar diş modellenmiştir. Dişe uygulanan kuvvet, top lam 450 N olup tüberkül sırtlarına dik gelmektedir. Modelde, Xı=rezin kompozit restorasyon, X2=indirekt kompozit restorasyon, X3=porselen inlay restorasyon olmak üzere üç farklı uygulama gerçekleştirilmiştir. Kuvvetler, sırasıyla fonksiyonel ve fonksiyonel ol mayan tüberküllere dağılımına göre uygulanmıştır. Elastik 3-boyutlu sonlu elemanlar yöntemi kullanılarak modellerde meydana ge len Von-Mises gerilmesi, zorlanma ve deplasman özellikleri incelenmiştir. Bulgular: Von Mises gerilme dağılımlarına göre indirekt kompozit restorasyonlar, seramik inleyler ve direkt kompozit restorasyonlardan daha iyidir. Tüm modeller incelendiğinde ise maksimum zorlanma değerleri kompozit restorasyon modellerinde gözlemlenmiştir. Minimum zorlanma ise porselen inley modellerinde görülmüştür. En az deplasman porselen inley, en fazla deplasman ise rezin kompozit modellerine aittir. Sonuç: Çalışmamızın sonuçlarına göre geniş kavitelerde seramik ve kompozit inleylerin, dar kavitelerde ise rezin kompozit dolguların daha uygun olduğu söylenebilir. İndirekt kompozit ve seramik inleylerde ise fonksiyonel tüberküller, non fonksiyonel eşlerine göre daha belirgin olmalıdır

Cytomorphological findings in diagnosis of Warthin tumor

Background/aim: To define the cytomorphologic findings leading to difficulties in diagnosis of Warthin tumors (WTs).Materials and methods: Forty-eight histopathologically diagnosed WT patients who had fine needle aspiration cytology preoperativelywere reevaluated for defining the presence or absence of lymphocytes, oncocytic cell layer, oncocytic cell papillae, granular debrisbackground, mucoid background, macrophages, polymorphonuclear cells, mast cells, squamous-like cells, atypical vacuolatedcytoplasmic cells, and giant cells.Results: Forty-seven tumors were in the parotid gland and one in the submandibular gland. There were 37 (77%) male and 11 (23%)female patients. Cytopathologically in 36 patients the diagnosis was benign neoplasm (WT); in 6, other benign entities; and in 6,suspicious for malignancy. The main characteristic cytomorphologic features of WTs were as follows: 92% lymphoid cells, 83% oncocyticcell layers, and 67% granular debris background. These percentages were 67%, 17%, and 17% in the benign cytology group and 67%,50%, and 17% in the suspicious for malignancy group, respectively.Conclusion: Absence or lack of main features of WTs with or without presence of squamous-like cells, vacuolated cytoplasmic cells,and inflammatory reaction may cause diagnostic dilemma. The presence of the mast cells accompanied by epithelial tissue was strikingfor WT diagnosis.WOS:0005142836000202-s2.0-8507934416

Clinicopathological features of melanomas in our university and comparison of meta-analysis in a specific region

WOS: 000443414101346

TERT promoter mutation and HER2 gene amplification in malignant peripheral nerve sheath tumours: is there a molecular signature playing role in malignant transformation?

WOS: 000443414101089

Can Numeric Maturation Value Be Used as a Prognostic Indicator and Diagnostic Tool in Cutaneous Melanomas? A Morphometric Study

WOS: 000502985200004OBJECTIVE: Some melanocytic lesions can be difficult to diagnose because of ambiguous histological and immunohistochemical features. Morphometric features of melanocytes in the upper and lower parts of a challenging lesion may help to facilitate an accurate diagnosis. STUDY DESIGN: We studied 32 cases of invasive cutaneous melanoma, 35 cases of mild or moderate dysplastic nevus, and 31 cases of benign melanocytic nevus. All cases were immunostained with Sox10. The nuclear areas of 30 melanocytes were measured on each papillary (upper al1) dermis and reticular dermis/subcutaneous tissue (lower ILI) in all cases by using the Image J analysis program. Then, a maturation index (U/L) was calculated for each case. Also, cutaneous melanomas were categorized into 2 groups that displayed pseudo-maturation or the lack of it. RESULTS: Mean maturation index was 1.04 +/- 0.29 in melanomas, 1.23 +/- 0.28 in dysplastic nevi, and 1.52 +/- 0.33 in benign melanocytic nevi, respectively. There were statistically significant differences between melanoma and dysplastic nevus (p = 0.012) and between melanoma and benign melanocytic nevus (p < 0.001) for the maturation index. Although pseudo-maturation was associated with low mitotic activity and thin Breslow thickness, there was no significant difference between survival distributions of 2 melanoma groups. CONCLUSION: Calculation of the maturation index can be used as a supporting tool for the differential diagnosis of challenging cases. However, it may possess limitation for evaluation of nevoid melanoma, melanoma in situ, or clonal nevus