Granulomatous Lobular Mastitis: Clinicopathologic Presentation of 90 Cases

Objective: Granulomatous lobular mastitis is a rare benign chronic breast disease first described by Milward in 1970, and then by Kessler and Wolloch in 1972. In this study, we aimed to present clinicopathologic features of granulomatous lobular mastitis with literature data. Material and Method: In this study, the archives of Uludag University Medical Faculty Department of Pathology were screened for granulomatous lobular mastitis cases between 2005 and 2017. Results: A total of 90 patients with granulomatous lobular mastitis diagnosed between 2005 and 2017 were identified. All of the cases were female. The mean age was 34+8.3 (range 21-60 years). There was sarcoidosis in one case and tuberculosis in another case, but no systemic disease was found in the charts of the other cases. Histopathological evaluation of 90 cases revealed non-necrotizing granulomas involving lobule-restricted, epithelioid histiocytes and Langhans-type multinuclear giant cells. There was no case of necrosis, including our only case with a history of tuberculosis. Conclusion: We conclude that our granulomatous lobular mastitis cases have similar characteristics with the series reported earlier, when all features are taken into consideration

Fibrous Dysplasia: Clinicopathologic Presentation of 36 Cases

Objective: Fibrous dysplasia is a slowly progressing bone lesion resulting from displacement of the normal medullary bone with abnormal fibroosseous tissue. The aim of this study was to assess the similarities and differences of our cases in relation to published reports. Material and Method: In this study, the archives of the Uludag University Medical Faculty Department of Pathology were screened for fibrous dysplasia cases between 2004 and 2016. Results: Within the mentioned period, there were 36 cases diagnosed as fibrous dysplasia. There were 21 male, and 15 female cases with an average age of 27.8±14.8 years (range 7-79 years). The most frequently affected sites were femur, costae, and craniofacial bones. There was one case localized to metacarpal bone, a very rare affection site. There were 4 polyostotic cases including 2 cases of McCune-Albright syndrome. Pelvic bone was affected in the polyostotic type, similar to published reports. Unlike former reports, however, long tubular bones were affected in male patients in our series. In our series, 32 cases had classical fibrous dysplasia, 3 cases had fibrocartilaginous, and one case had fibroosseous variants. Four cases localized to costae were accompanied by aneurysmal bone cyst. The presenting symptom was pathological fractures in a total of 4 cases, 3 localized to the femur, and 1 to the costa. Recurrence occurred in 5 cases treated with curettage. Two of the monostotic fibrous dysplasia cases developed malignant transformation into osteosarcoma. Conclusion: We conclude that our series of fibrous dysplasia cases have slight differences and mainly similar characteristics with the series reported earlier, when all features are taken into consideration

Liver metastasis of breast carcinoma: An unusual presentation and growth pattern

Breast carcinoma is one of the tumors that frequently metastasize to the liver. Extramedullary hematopoiesis (EMH) usually occurs due to insufficient medullary hematopoiesis. In this case report, we present a female patient with sinusoidal breast carcinoma metastasis and extramedullary hematopoiesis in liver biopsy. A 63-year-old female patient with history of breast carcinoma was admitted to our center with respiratory distress. Pleural effusion was detected and thoracentesis was planned. Treatment was given after detection of non-mycobacterial tuberculosis bacillus in the thoracentesis fluid. Antibiotherapy was terminated due to elevation of liver enzymes and bilirubin. The patient's clinical status was evaluated and treatment was re-initiated. The patient did not have any mass lesion in the liver. Tru-cut biopsy was performed to evaluate a possible tuberculosis involvement in the liver. The diagnosis of metastatic breast carcinoma located in the sinusoidal area and cholestatic liver with extramedullary hematopoiesis foci was given using the histomorphological, immunohistochemical and histochemical findings. Radiological evaluation has an important role in staging of malignancies. However, it should be kept in mind that hepatic metastases may present without formation of a mass lesion, and unexpected laboratory results of cases without abnormal radiological features should raise the suspicion of a metastasis. Such materials should be evaluated in detail by making multiple serial sections in the pathology laboratory. Rare metastatic tumor growth patterns not causing a mass lesion such as sinusoidal or portal pattern, should also be kept in mind

Radical Surgery with a Multidisciplinary Approach in a Case of Radiation Induced Rhabdomyosarcoma of Breast Invading the Chest Wall, Lung and Heart

Sarcoma of the breast is usually seen following radiation therapy. Radiation-induced sarcoma treatment modalities include chemotherapy, radiotherapy and surgery. Even conservative treatment can achieve treatment response, locally advanced tumors should be removed with negative surgical margins. Unfortunately, the literature lacks of prospective data regarding the disease rarity. Clinicians should seek for individualised treatment options considered in multidisciplinary tumor boards. Here we present a radiation-induced chemotherapy resistant breast sarcoma patient successfully managed with en-bloc radical surgical removal and reconstruction under the provision multidisciplinary team