Xanthogranulomatous Endometritis: A Challenging Imitator of Endometrial Carcinoma

Xanthogranulomatous inflammation is a distinguished histopathological entity affecting several organs, predominantly the kidney and gallbladder. So far, only a small number of cases of xanthogranulomatous inflammation occurring in female genital tract have been described, most frequently affecting the endometrium and histologically characterized by replacement of endometrium by xanthogranulomatous inflammation composed of abundant foamy histiocytes, siderophages, giant cells, fibrosis, calcification and accompanying polymorphonuclear leucocytes, plasma cells and lymphocytes of polyclonal origin. We present a case of a 69-year-old female complained of post menopausal bleeding and weight loss. Clinical preliminary diagnoses were endometrial carcinoma or hyperplasia and ultrasound was supposed to be endometrial malignancy, hyperplasia or pyometra by radiologist. Histopathological examination of uterus revealed xanthogranulomatous endometritis. Since xanthogranulomatous endometritis may mimic endometrial malignancy clinically and pathologically as a result of the replacement of the endometrium and occasionally invasion of the myometrium by friable yellowish tissue composed of histiocytes, knowledge of this unusual inflammatory disease is needed for both clinicians and pathologists

Recurrence rate of odontogenic keratocyst treated by enucleation and peripheral ostectomy : retrospective case series with up to 12 years of follow-up

Odontogenic keratocysts have been reported with high recurrence rates in the literature so various treatment modalities from simple enucleation to resection have been performed to achieve the cure. The purpose of this retrospective study was to investigate the recurrence rate of odontogenic keratocysts (OKCs) treated by enucleation and peripheral ostectomy. An electronic search of the database of the Hacettepe University, Faculty of Medicine, Department of Pathology, was undertaken to identify patients histologically diagnosed with OKCs treated at Department of Oral and Maxillofacial Surgery between 2001 and 2015. In total, 81 patients were studied. The mean age at the time of diagnosis was 42 years, and the male:female ratio was 1:0.7. OKCs were located primarily in the posterior mandibular region (41%). Twenty-seven patients were re-examined to determine the recurrence rate. The mean follow-up period was 5 years (range, 1?12 years). The recurrence rate was 14.8%. The relationship between location of the lesion and recurrence was not statistically significant (p = 0.559). There was also no statistically significant relation between the recurrence rate and treatment option of teeth involved in the lesion (p = 0.579). The authors conclude that treatment of OKCs by enucleation with peripheral ostectomy is associated with minimal morbidity and is preferred over other aggressive treatment modalities. Meticulous radiographic examination and careful surgical resection may decrease the recurrence rate of OKCs

The situation of consultation practice in pathology in Turkey Türkiye'de patoloji konsültasyonlarının durumu

Objective: There are some suggestions regarding the methods of consultation practice in the literature including which case will be consulted, to whom, by which transport means, the payment methods as well as the ethical issues. There are no standards for consultations in Turkey. The standardization committee of the Federation of Turkish Pathology Societies has conducted a survey to detect the current situation, determine the problematic aspects, compare the situation with international methods and offer methods specific to Turkey. Material and Method: A survey has been prepared to cover all the aspects of consultation practice using the literature and referring to the current methods used in Turkey. The survey has been announced on the internet and 83 replies were collected. Results: Multiple choice questions were evaluated in terms of percentages and open ended questions were grouped according to the answer contents. It was seen that problems could be grouped as follows: absence of written procedures covering each step, means of transport, reaching the consultant, payment, reporting and ethical issues. The absence of procedures and issues regarding the payment methods were the interfering factors for each step of consultation. Conclusion: There are many problematic issues in consultation practice in pathology in Turkey. The basis of these problems is the absence of written regulations for procedural and payment methods. Regulations addressing these issues should be developed

Wilms' tumor 1 protein expression in endometrial adenocarcinoma and endometrial intra-epithelial neoplasia

AimTo investigate the expression of Wilms' tumor 1 (WT1) protein in endometrial adenocarcinoma (EC) and endometrial intra-epithelial neoplasia (EIN). MethodsWT1 protein expression was determined on immunohistochemistry in 30 EC patients and in 20 EIN patients. WT1 protein expression in proliferative (n = 7), secretory (n = 9) and atrophic endometrium (n = 9) and benign endometrial polyps (n = 28) was used as the control group. Cellular and vascular WT1 staining was scored semiquantitatively. ResultsCellular WT1 staining was 67% and vascular positivity was 73% in the EC group. In the EIN group the cellular staining was 100% and vascular staining was 85%. Although all EIN samples were positive for cellular WT1 staining, median cellular staining score was similar to that of EC (median, 2; range, 1-3; IQR, 1.75 vs 2, 0-3, 0.75, respectively). Increasing EC grade and stage were not associated with cellular or vascular WT1 staining score. ConclusionWT1 is expressed in EIN

A Case of Tubo - Ovarian Actinomycosis

We presented a case of tubo-ovarian actinomycosis in a patient with an intrauterine device (IUD). The patient was referred to our clinic with a diagnosis of pelvic inflammatory disease. Magnetic resonance imaging analysis indicated a cystic lesion (6.6x8x8 cm) on the left over. After performing total abdominal hysterectomy and bilateral salpingo-oopherectomy, histopathological studies showed a tubo-ovarian abscess and typical sulphur granules surrounded by neutrophils associated with actinomycosis. This case indicated that if clinicians are aware of actinomycosis in patients using IUCDs, the formation of tubo-ovarian abscess and thus excessive surgical procedures can be prevented

Focal Endometrial Adenocarcinoma in Atypical Polypoid Adenomyoma of Low Malignant Potential

Atypical polypoid adenomyoma is a rare and benign polypoid lesion of uterus with proliferation of irregular endometrial glands embedded in a smooth muscle stroma. If the lesion contains glands that are sufficiently complex to satisfy the criteria for adenocarcinoma, it is called as atypical polypoid adenomyoma of low malignant potential. Patients most commonly present with abnormal uterine bleeding and more than 90% of patients are premenopausal. Although the lesion is benign, it may occasionally be found to coexist with or to precede endometrial adenocarcinoma. This necessitates a careful management which involves hysterectomy in perimenopausal or postmenopausal patients and hysteroscopy with multiple biopsies in younger women desiring future fertility. This report describes a perimenopausal woman with atypical polypoid adenomyoma of low malignant potential with focal adenocarcinoma on endometrial biopsy who subsequently underwent hysterectomy in which no residual malignant lesion was found

Fordyce Spot of Vulva Confused with Condyloma Accuminatum

Fordyce spots are ectopic sebaceous glands which are most commonly seen on lips and oral mucosa. Patients are asymptomatic and do not require treatment unless cosmetic concerns arise. Fordyce spots can also be seen on vulva. However, in such patients, more common vulvar disorders including condyloma accuminatum may be considered clinically instead of Fordyce spots. Therefore, any vulvar lesion without typical appearance should be sampled and examined histopathologically before initiating treatment. A woman with vulvar Fordyce spots who was misdiagnosed to have condyloma accuminata is presented. The patient admitted to a gynecologist with a complaint of chronic vulvar pruritus. After vulvar inspection, topical imiquimod cream was given with a presumed diagnosis of condyloma accuminatum. The patient then admitted to our hospital without commencing therapy. She was subjected to biopsy after examination due to atypical lesions. Papules located on both labia minora were reported to be Fordyce spots and random biopsy was consistent with chronic inflammation. Therefore, she was given topical corticosteroid instead of imiquimod

Laparoscopic Management of Ectopic Pregnancy Occurring Ten Years After Tubal Sterilization

Ectopic pregnancy is still one of the leading causes of maternal mortality. Due to the popularity of elective sterilization procedures, the incidence of ectopic pregnancies following tubal sterilization began to increase in recent years and post-sterilization ectopic pregnancies account more than 10% of all ectopic pregnancies. This case report describes a 41-year-old woman with a diagnosis of an ectopic tubal pregnancy 10 years after laparoscopic tubal sterilization who was successfully managed via laparoscopy. Also, the incidence and risk factors for tubal sterilization failures, mechanisms of failure, and outcomes of failed cases are discussed