Gastric marginal zone lymphoma of mucosa-associated lymphoid tissue and signet ring cell carcinoma, synchronous collision tumour of the stomach: a case report

To report a rare case of synchronous marginal zone lymphoma of mucosa-associated lymphoid tissue [MALT] signet ring cell carcinoma occurring as a collision tumour in the stomach. Clinical Presentation and Intervention: A 53-year-old man was diagnosed initially with signet ring cell carcinoma of the stomach. The microscopy of the subsequent total gastrectomy revealed a collision tumour of MALT lymphoma and signet ring cell carcinoma associated with Helicobacter pylori gastritis. This case highlighted the importance of a careful evaluation of the accompanying lymphoid population in the biopsy samples of gastric adenocarcinoma and underlined the need for multiple endoscopic biopsies to detect these rare synchronous tumours

Primary yolk sac [endodermal sinus] tumour of the vulva: a case report

To report a case of primary yolk sac [endodermal sinus] tumour [YST] of the vulva which is very rare and to highlight some unusual features of this tumour in the vulva. A 23-year-old woman presented with a 1-month swelling in the right labium majus that was non-tender and rapidly increasing in size. The mass was excised; it grossly measured 6 x 5 x 3 cm and was firm with a grey white cut surface. Microscopically it showed features of YST. The patient returned to the clinic only after 2 months with a recurrent mass of almost the same size with ipsilateral lymphadenopathy. At that time serum a-fetoprotein showed only a mild increase [13.4 micro g/l, normal: 0-10 micro g/l]. Further management was not possible as she decided to return to her native country for treatment. A literature review shows that local excision with lymphadenectomy followed by cisplatin-based chemotherapy is the best mode of treatment for primary YST of the vulva. This case is presented for its rarity and to highlight the fact that serum a-fetoprotein estimation may not aid in the primary diagnosis or detection of recurrence in patients on follow-up for YST arising in the vulva unlike those seen in the gonads

Static image telepathology in routine surgical pathology diagnosis: a report on the first experience in the arab word from Kuwait

Telepathology [TP] diagnosis is currently practiced in several countries. The present study presents the first documented experiment of static-image TP in Kuwait and the Arab world. Materials and Paraffin or frozen tissue sections of 100 cases of routine surgical pathology consisting of 40 malignancies, 10 benign neoplasms and 50 nonneoplastic conditions were studied. Diagnostic microscopic images captured by a microscope-attached digital camera were selected by a pathologist in each case and sent with the clinical history to a second pathologist via E-mail across the Internet. The diagnosis was sent back to the referring pathologist via E-mail. The specificity, sensitivity and diagnostic accuracy of TP was calculated. For malignant versus benign lesions, the diagnostic accuracy was 97% with 3 false-negative and no false-positive results [100% specificity]. Correct diagnosis by exact category was 92%. The deferral rate awaiting special stains was 5%, immunohistochemistry 6%, and extra images 2%. In 2 cases [2%], there was a request for original tissue glass slides. A simple E-mail-based TP system provides a high diagnostic accuracy for routine surgical pathology diagnosis. It can be utilized either as a primary or a secondary diagnostic tool

Ovarian tumors in Kuwait

After examination of the case histories of 301 primary ovarian neoplasms in the surgical pathology files of four hospitals in Kuwait from 1984 to 1989, we have reviewed and classified these cases as recommended by the WHO Ovarian Tumors Panel. Standard histopathological techniques were supplemented with special stains in order to increase diagnostic accuracy. Benign cystic teratoma was the single most common tumor in the series. Overall, germ cell tumors were more common than epithelial tumors. However, 75.7% of malignant tumors were epithelial. A higher proportion of epithelial tumors, relatively rare in children and adolescents worldwide, was found in patients under 20 years