Basal Cell Carcinoma in a Child

Basal cell carcinoma is the most commonly seen nonmelanoma skin cancer which is rarely encountered in the childhood period. An 11-year old child was admitted to our clinic due to an erythematous and a slightly pigmented lesion with a 3 × 4 cm diameter on his posterior scalp. Macroscopically, the lesion was excised with a 10 mm safety margin. Pathologic examination revealed a basal cell carcinoma. No symptoms or signs of a syndrome were observed both in the patient and his family

Histologic features of spindle cell lipoma and problems in the differential diagnosis

AMAÇ: İğsi hücreli lipomun histolojik ve tipik immunhistokimyasal özelliklerini araştırmak ve diğer subkutan yerleşimli benzer histolojik ve immunhistokimyasal özellikleri olan neoplazmlarla ayırıcı tanısını yapmaktır. YÖNTEMLER: İstanbul Eğitim ve Araştırma Hastanesi patoloji laboratuarında lipom tanısı almış 3100 olguda son Dünya Sağlık Örgütü Yumuşak Doku Tümörleri Sınıflamasına göre alt tipler belirlendi ve bunların içinden 22 İHL çalışmaya alındı. 22 iğsi hücreli lipom olgusunda klinik (yaş, lokalizasyon, cinsiyet, nüks), morfolojik özellikler (tümör boyutu, alt tip, histoloji, mast hücre varlığı ve immunhistokimya), tümörlerin natürü ve ayrıcı tanı problemleri değerlendirildi. BULGULAR: 3100 lipomun alt tiplere göre dağılımı şu şekildeydi: 2864 klasik lipom (%90), 293 anjiyolipom (%9), 1 kondroid lipom (%0.03), 1 miyolipom (%0.03 ve 22 iğsi hücreli lipom (% 0.7). 22 iğsi hücreli lipomların 9’u fibröz, 3’ü miksoid, 1’i anjiyomatoid ve 9’u nonfibröz alt tipti. Erkek kadın oranı 18/4 olarak belirlendi. Olguların 2’si sırt, 3’ü omuz, 1’i ön kol, 1’i oral olup 15’ü baş-boyun bölgesinde lokalize idi. Ortalama tümör çapı 3.2 cm olup en büyük ve küçük çaplar 1 cm ve 6.1 cm olarak ölçüldü. Fibromatöz alt tipte belirgin olmak üzere Toluidin blue boyasıyla her olguda mast hücresi mevcuttu. Mast hücre sayısı on büyük büyütme alanında ortalama 23 olarak bulundu. S–100 tüm iğsi hücrelerde negatif ve yağ hücrelerinde pozitif olarak tespit edildi. CD34 olguların 21’inde pozitif, 1’inde negatif bulundu. Hiçbir olguda nüks izlenmedi. SONUÇ: İğsi hücreli lipom, subkutan lokalizasyonlu, iyi sınırlı, iğsi hücreli komponenti CD34 pozitif, mast hücrelerinden zengin bir tümör olup birçok subkutan tümörle ayırıcı tanı yapılmasını gerektiren nadir bir antitedir.OBJECTIVE: To investigate the histologic and immunohistochemical properties of spindle cell lipoma and to make its differential diagnosis from other subcutaneous neoplasms having similar histologic or immunohistochemical charecteristics. METHODS: 3100 cases of lipoma diagnosed in the Pathology Laboratory of İstanbul Educational and Research Hospital were reclassified according to the recent classification of Soft Tissue Tumors by World Health Organization and 22 spindl cell lipomas were included in the study. Clinical (age, gender, location, and recurrences) and morphologic features (tumor size, subtype, histology, presence of mast cells, and immunohistochemistry) as well as tumor nature and problems in differential diagnosis were evaluated. RESULTS: The histologic subtypes of 3100 lipomas were as follows: 2864 classical lipoma (90 %), 293 angiolipoma (9 %), 1 chondroid lipoma (0.03 %), 1 myolipoma (0.03 %) and 22 spindl cell lipoma (% 0.7). Of the 22 spindl cell lipoma 9 were fibrous, 3 myxoid, 1 angiomatoid and 9 non-fibrous subtypes. Male to female ratio was 18: 4. 2 cases were localized in dorsal region, 3 in shoulders, 1 in forearm, 1 in oral cavity and 15 in head and neck. Average tumor diameter was 3.2 cm ranging from 1 to 6.1 cm. Mast cells highligtened by Toluidin blue were seen in all cases, most prominently in the fibrous subtype. Mast cell count in 10 high power field was 23. S–100 was negative in all spindle cells while lipomcytes were positive. CD34 was positive in 21 cases and negative in 1 case. No case recurred. CONCLUSION: Spindl cell lipoma is a subcutaneous, well-circumscribed tumor rich in mast cells with a CD34+ spindle cell component and is an uncommon entity requiring differential diagnosis with several subcutaneous tumors

Ascaris lumbricoides presenting as an omental mass

Introduction: Ascaris lumbricoides (AL), is an intestinal Parasite with various clinical presentations. It is common in underdeveloped rural areas both in Turkey and in the rest of the World; Ectopic localizations of AL are rare, and there only a few reported cases of mental localization. Case: We present a rare case in which an omental and a paratubal mass were detected during cesarean section in an asymptomatic pregnant patient. The histopathological examination revealed a granulomatous reaction and AL eggs inside the masses. Discussion: Infection With AL causes various intestinal complications like acute appendicitis, volvulus, invagination, intestinal perforation and gramdotnatous peritonitis. Conclusion: It should be kept in mind that granulomatous lesions presenting as mental masses may be randomly detected in asymptomatic individuals and pregnant woman infected with AL