Is neurogenous hyperplasia a cause of appendiceal obliteration ? (a retrospective study of 1397 cases)

Amaç: Bu çalışmada çoğu akut appendisit ön tanısıyla çıkartılan appendektomi örneklerinde saptanan oblitere appendikslerdeki nöral doku komponentinin varlığı araştırılmış ve akut appendisit, karsinoid tümör gibi diğer appendiks lezyonlarıyla ilişkisi irdelenmiştir. Gereç ve yöntem: Retrospektif olarak taranan 1397 rutin appendektomi materyalinde " " tanısı almış 66 olgu bulundu. Ancak bunlardan uygun nitelikli 38 tanesi çalışma kapsamına alındı. Bu olguların hematoksilen-eosin ve Masson trikrom boyalı preparatları incelendi.Ayrıca materyallerde immünhistokimyasal olarak S-100 protein reaktivitesi araştırıldı. Bulgular: Işık mikroskopik düzeyde appendiks lümenlerinde nodül yapmaksızın gevşek dizilimli iğsi hücrelerin proliferasyonuyla oluşmuş obstrüksiyon izlendi. Miksoid zemin ve arada kısılı yağ dokusu da sıklıkla mevcuttu. 38 olgunun 18'inde(%47,3 ) iğsi hücrelerde S-100 protein immün reaktivitesi gözlendi. Sonuç: Bu çalışmada oblitere appendikslerde nöral hiperplazinin oldukça sık görülen bir antite olduğu ve çoğu kez fibröz obliterasyon olarak nitelenen lezyonun gerçekte nörojenik kökenli bir gelişim olabileceği vurgulanmaya çalışıldı.Aim: In this study the presence of neural tissue components was investigated in appendectomy specimens with an obliterated appendix. Relationship of the neural tissue presence with other appendical lesions such as carcinoid tumors and acute appendicitis was also evaluated. Material and method: Retrospective analysis of 1379 consecutive routine appendectomy specimens revealed 66 cases as "obliterated appendix" (an incidence of 4,2%). Only 38 appropriate cases have been included in this study. Results: By light microscopy, obliteration was located centrally in the appendix without nodule formation. Loose proliferation of spindle cells, usually in a myxoid background, and with entrapped fat tissue was frequently observed. The spindle cells were positive for S-100 protein in 18 of 38 cases (47,3 %). Conclusion: We emphasise that neurogenous hyperplasia in obliterated appendices is a rather common entity, andthatmost cases ofso-calledfibrous obliteration actuallyrepresentneurogenicappendicopathy

Extranodal Rosai-Dorfman disease with bilateral orbital involvement: Report of a case treated with systemic steroid alone

Safiye Yilmaz1, Melih Ture1, Ahmet Maden1, Mine Tunakan21Department of Ophthalmology, 2Department of Pathology, Izmir Atatürk Training and Research Hospital, Izmir, TurkeyAbstract: We report the case of a 41-year-old female with bilateral orbital Rosai-Dorfman disease (RDD) and the result of corticosteroid therapy. The patient developed a swollen mass of bilateral upper and lower eye-lid over a six-month period. Diagnosis was based on the characteristic histopathologic features. She was treated with oral corticosteroids 60 mg/per day for ten days and the dose of corticostreoid was tapered every week. She is currently being treated with 10 mg/per day for 4 months. In general, the prognosis is good, with experiencing remission following a course of oral corticosteroids. There is no evidence that corticosteroids are beneficial in the treatment of RDD in the literature, but data regarding such treatment are sparse. A more formalized surveillance of these cases would help to define more clearly the natural history of the disease and the effects of various treatment modalities.Keywords: Rosai-Dorfman Disease, orbital involvement, treatment, corticosteroi

A case of a sporadic malignant peripheral nerve sheath tumor of the urinary bladder with concomitant in situ urothelial carcinoma treated by transuretheral resection

Malignant peripheral nerve sheath tumor (MPNST) of the urinary bladder is a very rare clinical entity. The association of such a tumor with urothelial carcinoma is even more unusual. Differential diagnosis between coexisting two distinct primary tumors and carcinosarcoma of the urinary bladder is very important as both the treatment and prognosis vary widely. Herein, we report a case of an MPNST with a concomitant in situ urothelial carcinoma in a 53-year-old man. To our knowledge, this is the first documented case of MPNST of the bladder that is treated by transuretheral resection which is in contrast with the previous reports that used cystectomy

Lipofibromatosis in a two-year-old girl: a case report

Lipofibromatosis is a recently described rare benign soft tissue tumor of childhood. We report a case of a lipofibromatosis in a two-year-old girl with a painless mass on the plantar aspect of her right foot who developed local recurrence eight months after surgery. The tumor has a high rate of non-destructive recurrence, but there is no metastatic potential. Complete surgical resection is the mainstay of treatment. Nevertheless, the rareness of its presentation should be taken into account by the pediatric pathologist, and considerable surgical judgment is of great importance

Relation of hepatitis B core antigen expression with histological activity, serum HBeAg, and HBV DNA levels

Background: Hepatitis B virus (HBV) is a potentially life-threatening liver infection which may progress to liver failure and cirrhosis. Intrahepatic expression patterns of viral antigens detected by immunohistochemistry may have prognostic implications in disease process. Aim: In this study, we aimed to investigate the relationship between the HBV core antigen (HBcAg) expression and histological activity index (HAI), fibrosis, serum hepatitis B e-antigen (HBeAg) status and HBV DNA levels in patients with chronic HBV infection. Materials and Methods: A total of 114 liver biopsies from patients with chronic HBV infection were included in the study. Immunohistochemical expression of HBcAg and its relation with HAI, fibrosis, serum alanine aminotransferase (ALT) levels, HBeAg status and HBV DNA levels were assessed. Results: The presence of nuclear expression of HBcAg did not show any correlations with ALT levels, HAI and fibrosis score. When the groups were categorized according to the HBeAg status, nuclear HBcAg expression was found to be high in HBeAg positive patients. However, HBcAg nuclear expression showed significant correlations with HBV DNA levels and fibrosis scores in HBeAg negative but not HBeAg positive patients. HBV DNA levels were also significantly associated with HAI and fibrosis scores in HBeAg negative patients. Conclusions: Significant differences found between HBeAg positive and negative patients suggest that HBeAg negative disease is different from HBeAg positive disease, and also point outs that in HBeAg negative disease, patients with nuclear HBcAg expression and increased levels of HBV DNA levels are at a higher risk of developing progressive liver disease

The Role of CD34 and D2-40 in the Differentiation of Dermatofibroma and Dermatofibrosarcoma Protuberans

Objective: Dermatofibroma (DF) is a benign fibrohistiocytic tumor whereas dermatofibrosarcoma protuberans (DFSP) has intermediate malignant potential. CD34 is the most commonly used antibody in differentiating these tumors. Various studies have stated the rates of D2-40 expression as 0-50% in DFSPs and 86-100% in DFs. Our aim in this study was to determine the expression of CD34 and D2-40 in DFs and DFSPs and the possible use of D2-40 in the differential diagnosis of these lesions. Material and Method: This is a retrospective study including 30 DF and 15 DFSP cases which were reevaluated for epidermal changes, the presence of a transmission zone (Grenz zone), infiltration of soft tissues, infiltration pattern and histologic subtypes in addition to cellular pleomorphism, nuclear atypia, and necrosis. A manual immunohistochemistry procedure was performed with D2-40 and CD 34 antibodies using a representative paraffin block. Results: The average age was 37.36 and 42.86 years in the DF and DFSP cases. The average diameter was 0.9 and 5.03 cm, respectively, for the DFs and DFSPs. There was a significant correlation between the two entities for sex, localization and diameter of the lesion. A significant difference was found between the positivity of CD34 and D2-40 in DFs and DFSPs. Conclusion: Additional immunohistochemical markers may be needed in DFs with CD34 positivity. Our results showed the additional helpful role of this marker in problematic cases

Kit expression in spindle cell rhabdomyosarcoma can possibly create a different approach for its tumorigenesis and therapy

The use of a relatively nontoxic tyrosine kinase receptor inhibitor, imatimb mesylate (IM) (STI-571), has increasingly become a valuable therapeutic alternative in some KIT (CD117)-overexpressing neoplasms potentially because of the presence of KIT-activating mutations. As the treatment eligibility for this drug hinges on CD117 expression. KIT immunostaining has recently been widely examined in various different tumors

Primary Hydatid Cyst of the Axillary Region: A Case Report

Hydatid disease, which is caused by Echinococcus granulosus, is a common public health problem worldwide. The hydatid cysts may take many years to produce clinical symptoms. The liver is the organ most commonly affected. Diagnosis is made by a combination of clinical, imaging, serological and molecular techniques. Primary axillary hydatid disease is extremely rare and only 9 cases have been reported up to now. Herein, we reported a 48-year-old case with primary isolated hydatid disease in the axilla in whom total cystectomy was performed

Etiological role of brucellosis in autoimmune hepatitis

To show that brucellosis may trigger autoimmune hepatitis (AIH), in addition to nonspecific liver involvement and toxic hepatitis, due to a class effect of tetracycline family used for treatment. We present a female patient admitted to our hospital due to partially improved fatigue and elevated liver enzymes following doxycycline and streptomycin usage for brucellosis. Brucellosis is endemic in our country, Turkey. It may involve any organ in the body. Liver is frequently involved. Doxycycline used for treatment occasionally may lead to hepatotoxicity. AIH is a necroinflammatory disease of the liver. Certain drugs (e.g. minocycline), toxins, and viruses (hepatitis B, hepatitis C, EBV, etc.) can trigger AIH. Only one case of AIH probably caused by doxycycline and brucellosis was reported. We discuss the relationship between brucellosis, AIH, and hepatotoxicity of doxycycline. Brucellosis may trigger AIH. (C) 2005 The WJG Press and Elsevier Inc. All rights reserved