Clinical and pathological features of adrenal myelolipoma and myelolipomatous metaplasia cases in our hospital over 13 years

BACKGROUND/AIMS: The development and widespread use of abdominal imaging techniques has increased the incidence of unexpected adrenal tumors called adrenal incidentaloma. Adrenal myelolipomas are the second most common incidentalomas. Similar myelolipomatous morphology appears as a secondary degenerative change in other adrenal lesions and is called myelolipomatous metaplasia. This study investigated the adrenal entities of the last 13 years which had myelolipomatous components.MATERIALS AND METHODS: In this retrospective observational study, cases diagnosed as adrenal myelolipoma or myelolipomatous metaplasia between January, 2009 and January, 2022 were re-examined regarding their age, gender, localization, lesion size, and secondary histopathological changes, accompanying pathological diagnoses as well as clinical and radiological data.RESULTS: Eleven adrenal myelolipoma cases and 6 myelolipomatous metaplasia cases were detected. In myelolipomas, the mean age was 55.45 years, 73% were female and 82% were located on the right side. The lesions were encapsulated and their mean size was 7 cm. One case had a diagnosis of subclinical Cushing's syndrome and the others were hormonally inactive. Some cases were accompanied with hypertension (27%), type 2 diabetes (18%), and asthma (18%). All myelolipomatous metaplasias, which are non-encapsulated, were detected in adrenocortical adenomas. The mean age was 58 years; nonencapsulated and 67% were located on the right side with no gender predilection. Concomitant hypertension (50%), diabetes /33%, and asthma (33%) were frequent.CONCLUSION: Adrenal myelolipoma and myelolipomatous metaplasia both contain adipose and myeloid components. Myelolipoma is a benign and encapsulated neoplasia which is usually detected incidentally. They frequently coexist with chronic diseases such as hypertension, diabetes and asthma

BRAF V600E mutation in papillary thyroid cancer is correlated with adverse clinicopathological features but not with iodine exposure

Introduction: BRAFV600E activating mutation is the most frequent genetic abnormality in the pathogenesis of papillary thyroid carcinoma. We aimed to evaluate the association between BRAFV600E mutation and well-established prognostic clinicopathological characteristics as well as iodine exposure. Material and methods: From 2000 to 2012, the data of PTC patients admitted to Dr. Lutfi Kirdar Kartal Education and Research Hospital in Turkey were reviewed retrospectively. Clinicopathological parameters were collected. BRAFV600E mutation was analysed by DNA sequencing method in tumour specimens. We hypothesised that BRAFV600E mutation prevalence is positively correlated with prolonged iodine exposure and expected to be higher in the second half of the recruitment period due to the increment in time spent from the iodisation process of the table salt in our country. Thus, iodine exposure was categorised as short-term (2000–2006) and long-term (2006–2012). Results: A total of 197 patients were accrued. The study population predominantly consisted of conventional variant. A statistically significant relationship was observed between BRAFV600E mutation presence and age (p = 0.03), conventional variant PTC (p = 0.00002), T4 stage (p = 0.002), vascular invasion (p = 0.036), thyroid capsule invasion (p < 0.00001), extrathyroidal tissue invasion (p < 0.00001), and lymph node metastasis (p < 0.00001). When categorised as long-term and short-term, iodine exposure was not statistically significantly related with BRAFV600E mutation; however, there were far more PTC cases in the long-term group (86.3% vs. 13.7%). Conclusion: We revealed that BRAFV600E mutation is associated with adverse clinicopathological parameters. There appeared to be no relation between long-term iodine exposure and BRAFV600E.

Calcifying aponeurotic fibroma: A case report

Kalsifiye aponörotik fibrom nadir rastlanan, histopatolojik özellikleri iyi tanımlanmış, benign fibröz bir tümördür. Genellikle çocuk ve gençlerde distal ekstremitelerde görülür. Yirmi üç yaşında erkek hastada sol el palmar yüzde yaklaşık beş yıldır var olan ağrısız serbest yumuşak doku kitlesi cerrahi olarak çıkarıldı. Histopatolojik incelemede kalsifikasyon ve kondroid metaplazi alanlarını çevreleyen fibroblastik proliferasyon alanları ve yoğun kollajenöz stroma izlendi. Lezyona kalsifiye aponörotik fibrom tanısı kondu. Hastanın bir yıllık izleminde nüks görülmedi.Calcified aponeurotic fibroma is a rare benign fibrous tumor with well-characterized histopathologic features. It is usually seen in distal extremities of children and youngsters. A 23-year-old male patient underwent surgical excision of a free, painless soft tissue mass that developed in the palmar aspect of the left hand. Histopathologic examination showed fibroblastic proliferation areas and dense collagenous stroma surrounding calcifications and chondroid metaplasia. The diagnosis was made as calcified aponeurotic fibroma. No recurrences were detected within a year follow-up

Heterotopic thyroid tissue presenting as a porta hepatis mass

WOS: 00024945460075

Ecthyma gangrenosum without bacteremia in a previously healthy man: a case report.

INTRODUCTION: Ecthyma gangrenosum is known as a characteristic lesion of Pseudomonas aeruginosa sepsis and is usually seen in immunocompromised patients. CASE PRESENTATION: A previously healthy 63-year-old man was admitted with sloughy necrotic ulcerations of the skin over his sternum. He was afebrile and in good condition. A skin biopsy revealed ecthyma gangrenosum. Blood cultures remained sterile, but a culture of biopsy material grew Pseudomonas aeruginosa. CONCLUSION: Ecthyma gangrenosum may develop even in the absence of bacteremia and even in immunocompetent patients. It should be considered as a possible diagnosis even when a previously healthy patient has negative blood cultures

Thyroid Papillary Carcinoma Follicular Variant: Which Surgical Approach?

In general, fine needle aspiration biopsy (FNAB) is insufficient and inadequate in the diagnosis of follicular variant of thyroid papillary carcinoma. Especially in capsulated forms of the carcinoma, diagnostic difficulties are pronounced because of the histopathologic structures. Clinical behaviour of the carcinoma varies from slow progression to aggressive spread. Furthermore, surgical treatment modality is controversial. In this paper, we present six patients who were diagnosed with capsulated follicular variant of thyroid papillary carcinoma in whom fine needle aspiration biopsy results and post operative pathological diagnosis were different. Surgical treatment choice was thyroid lobectomy in one patient due to single nodule, subtotal thyroidectomy in two patients and total thyroidectomy in three patients. According to the postoperative pathology reports, three patients underwent total thyroidectomy. In this study, we emphasized that the follicular variant should be taken into account in patients whose fine needle aspiration biopsy results are not malignant

Thyroid Papillary Carcinoma Follicular Variant: Which Surgical Approach?

In general, fine needle aspiration biopsy (FNAB) is insufficient and inadequate in the diagnosis of follicular variant of thyroid papillary carcinoma. Especially in capsulated forms of the carcinoma, diagnostic difficulties are pronounced because of the histopathologic structures. Clinical behaviour of the carcinoma varies from slow progression to aggressive spread. Furthermore, surgical treatment modality is controversial. In this paper, we present six patients who were diagnosed with capsulated follicular variant of thyroid papillary carcinoma in whom fine needle aspiration biopsy results and post operative pathological diagnosis were different. Surgical treatment choice was thyroid lobectomy in one patient due to single nodule, subtotal thyroidectomy in two patients and total thyroidectomy in three patients. According to the postoperative pathology reports, three patients underwent total thyroidectomy. In this study, we emphasized that the follicular variant should be taken into account in patients whose fine needle aspiration biopsy results are not malignant

Aspergillus Spondylodiscitis and Paravertebral Abscess in an Immunocompetent Patient

Although osseous infections associated with Aspergillus species are more common in immunocompromised patients, they may also rarely develop in immunocompetent patients with an intact immune system, who are not predisposed to invasive aspergillus infections. The osseous infection due to Aspergillus most frequently involves the lumbar vertebrae, with low back pain being the most prominent symptom. A. fumigatus is known to be the primary cause in the etiology. Surgical intervention and systemic antifungal therapy should be the mainstay of treatment. In this report, we present a case of spondylodiscitis and paravertebral abscess due to A. fumigatus, which developed in an immunocompetent patient. The treatment included surgery and voriconazole