Discrepancies in Lymphoma Diagnosis Over the Years: A 13-Year Experience in a Tertiary Center

Objective: In the past, accurate diagnosis of lymphoma was challenging since there were multiple competing classification systems that caused confusion and debate. After establishment of the World Health Organization lymphoma classification, lymphomas still remain a diagnostic challenge among general pathologists. The purpose of this study was to examine whether the discordance among centers has declined over the years

Endocervical glandular involvement, multicentricity, and extent of the disease are features of high-grade cervical intraepithelial neoplasia

WOS: 000322347900007PubMed ID: 23665088This study aimed to evaluate the rate of endocervical glandular involvement, positive surgical margins, multicentricity, and disease extent between low-grade and high-grade cervical intraepithelial lesions after loop electrosurgical excision procedure (LEEP). Pathology medical records of patients who underwent LEEP were reviewed retrospectively. Patients with negative LEEP results were excluded. Loop electrosurgical excision procedure reports of patients with cervical intraepithelial neoplasia (CIN) 1, 2, and 3 were compared. There was no statistically significant difference between patients with CIN 1 (n = 24), CIN 2 (n = 27), and CIN 3 (n = 64) when age and surgical margin positivity were considered. Endocervical glandular involvement, multicentricity, and disease extent were higher in patients with CIN 3 (P = .001, P = .002, and P = .001, respectively). In conclusion, we recommend that patients with endocervical glandular involvement, lesions involving more than two-thirds of the LEEP specimen, and multicentricity be followed up more closely. (C) 2013 Elsevier Inc. All rights reserved

Xanthogranulomatous sialadenitis clinically mimicking a malignancy: case report and review of the literature

Background Xanthogranulomatous tissue reaction is a welldocumented process that is most common in kidney. There are other uncommon sites being documented as case reports in the literature. We would like to describe the clinicopathologic findings in a case of xanthogranulomatous sialadenitis that involved the parotid gland, which was clinically thought to be a tumoral mass, and compare it with the 4 previously reported cases

The Role of Epstein-Barr Virus LMP-1 Immunohistochemical Staining in Childhood Hodgkin Lymphoma

Background: There are a few published studies about prognostic markers of Epstein-B virus (EBV) related to outcomes in pediatric Hodgkin Lymphoma (HL)

Biologic markers guiding the treatment of non-small cell lung cancer: RRM-1, class III beta tubulin, and ERCC-1.

49th Annual Meeting of the American-Society-of-Clinical-Oncology (ASCO) -- MAY 31-JUN 04, 2013 -- Chicago, ILWOS: 000335419604655…Amer Soc Clin Onco

Does it take three to tango? An unsuspected multimorbidity of CD8+ T cell lymphoproliferative disorder, malaria, and EBV infection

Abstract Background Malaria is known to cause acute and deadly complications. However, malaria can cause unforeseen pathologies due to its chronicity. It increases the risk of endemic Burkitt Lymphoma development by inducing DNA damage in germinal centre (GC) B cells, and leading higher frequency of Epstein–Barr virus (EBV)-infected cells in GCs. EBV is well known for its tropism for B cells. However, less is known about EBV’s interaction with T cells and its association with T cell lymphoma. Case presentation A 43-year-old Sudanese male admitted to hospital in Istanbul, Turkey, a non-endemic country, with hyperpigmented painful skin rashes on his whole body. A complete blood count and a peripheral blood smear during admission revealed large granular lymphocytes (LGLs) with abnormally higher CD8 T cell numbers. Additional skin biopsy and pathology results were compatible with CD8+ T cell lymphoproliferative disorder with skin involvement. Patient was treated and discharged. However, a pathologist noticed unusual structures in skin tissue samples. Careful evaluation of skin biopsy samples by polarized microscopy revealed birefringent crystalloid structures resembling malarial haemozoin mainly loaded in macrophages and giant histiocytes. After purification of DNA from the skin biopsy samples, nested PCR was performed for the detection of Plasmodium parasites and Plasmodium falciparum DNA was amplified. Because, the co-presence of EBV infection with malaria is a well-known aetiology of lymphoma, EBV-early RNA (EBER) transcripts were investigated in paraffin-embedded tissue samples and found to be positive in macrophage-like histiocytes. Conclusions This is a unique case of malaria and EBV infection in a T-LGL lymphoma patient who presented in a non-endemic country. This case emphasizes the clinical importance of EBV monitoring in T-LGL patients with skin involvement. Notably, Plasmodium infection should be examined in patients from malaria endemic regions by pathological and molecular investigations

Endometrial polipe metastaz yapan meme karsinomu- olgu sunumu ve literatürün gözden geçirilmesi

Kadın genital sistemde metastazlar en sık overlerde görülür ve uterus için ekstragenital organlar dışından metastaz alımı çok nadirdir. Endometrial polipe metastaz ististani bir durum olup, literatürde olgu sunumları şeklinde yer almaktadır. Sunulan olgu 52 yaşında, metastatik invaziv duktal tip meme karsinomu olan kadın hastadır. Hasta jinekoloji bölümüne postmenapozal kanama şikayeti ile başvurdu. Patolojik incelemede hiperplastik tipte endometrial polip ve fokal bir alanda stroma içinde epiteloid hücre infiltrasyonu izlendi. İmmunohistokimyasal incelemede bu hücrelerin CD10 negatif, Pansitokeratin ve GCDFP-15 ile pozitif olduğu görüldü. Patolojik tanı fokal karsinom infiltrasyonu (meme kanseri ile uyumlu) içeren hiperplastik polip olarak raporlandı. Meme karsinomu tanısı ile takip edilen hastalara ait küretaj materyalleri patoloji rutininde sıkça yer almaktadır. Metastatik hastalık olasılığı akılda tutulmalı, materyalin tamamı incelemeye alınmalı ve patolojik inceleme; metastatik hastalığı ekarte etmek üzere dikkatle yapılmalıdır.Metastasis to female genital tract are most commonly seen in the ovaries and it is very rare for uterus to have metastasis from extragenital organs. Metastatic carcinoma in an endometrial polyp is exceptional and presented as case reports in the literature. The presented case was a 52 year old woman, having metastatic breast carcinoma of invasive ductal type. She admitted to the gynecology department, with the complaint of postmenapausal bleeding. The pathological examination revealed a hyperplastic endometrial polyp, having a focus of epiteloid cellular infiltration in the stroma. The immunohistochemical staining showed these cells to be CD 10 negative, Pancytkeratin and GCDFP-15 positive. Pathological diagnosis was hyperplastic polyp, with focal carcinoma infiltration (compatible with breast carcinoma). The curettage specimens of the patients being followed for breast carcinoma is frequently seen in the daily routine of the pathology. The probability of metastatic disease must be kept in mind and the whole curretage materials must be evaluated. The pathological examination must be carefully made for the exclusion of a metastatic carcinoma

The Predictive and Prognostic Significance of c-erb-B2, EGFR, PTEN, mTOR, PI3K, p27, and ERCC1 Expression in Hepatocellular Carcinoma

WOS: 000314117000013PubMed ID: 23162604Background: Hepatocellular carcinoma (HCC) is the fifth most common fatal cancer and an important healthcare problem worldwide. There are many studies describing the prognostic and predictive effects of epidermal growth factor receptor 2 (c-erb-B2) and epidermal growth factor receptor 1 (EGFR), transmembrane tyrosine kinases that influence cell growth and proliferation in many tumors. Objectives: The current study aimed to investigate the expression levels of c-erb-B2, EGFR, PTEN, mTOR, PI3K, p27, and ERCC1 in hepatocellular carcinoma (HCC) and their correlation with other clinicopathologic features. Patients and Methods: Fifty HCC cases were stained immunohistochemically with these markers. Correlations between the markers and clinicopathologic characteristics and survival rates were analyzed. Results: No membranous c-erb-B2 staining was seen, whereas cytoplasmic positivity was present in 92% of HCC samples, membranous EGFR was observed in 40%, PI3K was found in all samples, and mTOR was seen in 30%, whereas reduced or absent PTEN expression was observed in 56% of samples and loss of p27 was seen in 92% of the cases. c-erb-B2 and mTOR overexpression, as well as reduced expression of p27, all correlated with multiple tumors (P = 0.041, P < 0.001, and P < 0.001, respectively). P27 loss, and mTOR and EGFR positivity were significantly correlated with AFP (P = 0.047, P = 0.004, and P = 0.008, respectively). Angiolymphatic invasion was more commonly seen in EGFR- and ERCC1-positive cases (P = 0.003 and P = 0.005). EGFR was also correlated with histological grade (P = 0.039). No significant correlations were found among PTEN, PI3K, and the clinicopathological parameters. Disease-free or overall survival rates showed significant differences among therapy modalities, AFP levels, angiolymphatic or lymph node invasions, and ERCC1 and p27 expression levels (P < 0.05). Conclusions: c-erb-B2, EGFR, mTOR, ERCC1 overexpression levels, and loss of p27 may play roles in hepatocarcinogenesis and may be significant predictors of aggressive tumor behavior. These markers were found to be correlated with certain clinicopathologic features, therapy modalities, and survival rates in the current study. These findings may help in planning new, targeted treatment strategies. Published by Kowsar Corp, 2012. cc 3.0.National Liver Transplantation SocietyThis study was supported by National Liver Transplantation Society. This study was partially accepted to be presented as a poster at 24th European Congress of Pathology in Prague, September 08-12, 2012

Comparison of KRAS Mutation Tests in Colorectal Cancer Patients

WOS: 000297263500015PubMed ID: 21699410The KRAS pathway and studies evaluating KRAS as a prognostic marker in colorectal cancer are discussed along with advances in KRAS gene mutation testing. Highly sensitive real-time polymerase chain reaction (PCR) methods were developed for this purpose. We examined the applicability of direct sequencing and two real-time PCR methods in the diagnosis of KRAS mutations. We used real-time PCR and direct sequencing-based methods to determine applicability of these KRAS mutation tests in 64 colorectal cancers. The two DNA samples found to be mutation positive by real-time PCR were analyzed again after diluting 100-fold. The results were the same. When we applied the same strategy for the direct sequencing, even a 10-fold dilution did not show the mutations. Therefore, we found that sequencing may not be informative when there are only a few mutant cells in the tumor. KRAS mutation screening on formalin-fixed, paraffin-embedded DNA is very efficient with real-time PCR methods in comparison to direct sequencing. The development and adoption of guidelines for KRAS mutation testing are crucial for success