Follicular dendritic cell sarcoma associated with hyaline-vascular Castleman's disease.

Follicular dendritic cell sarcoma (FDCS) of the head and neck region, associated with Castleman's disease (CD), is an extremely rare entity. To the best of our knowledge, we report the first case demonstrating the transformation of the former into the latter as documented in the same lymph node disection material. A 45-year-old female presented to our hospital with right sided neck swelling. Radiologic imaging showed a well defined 3.5 x 3.5 cm mass of soft tissue at the right side of the neck with multiple bilateral cervical lymph nodes. Excision of the right neck mass with lymph node disection was performed. Microscopic examination and immunohistochemical findings showed features of follicular dendritic cell sarcoma. The associated lymph nodes exhibited changes consistent with hyaline-vascular type CD, follicular dendritic cell hyperplasia and foci of overgrowth in which FDCS possibly evolved. This report confirms the evolving of FDCS in the setting of follicular dendritic cell hyperplasia occurring in Castleman's disease.

Cystic adrenal lymphangioma--report of two cases and review of the literature.

Cystic adrenal lymphangiomas are very rare, benign vascular lesions. They are usually found during a work up for abdominal pain or incidentally during imaging studies for an unrelated cause. We report two cases of cystic adrenal lymphangiomas. They presented with flank discomfort, hypertension and flushing. Their laboratory findings were in normal limits. Radiologic imagings showed adrenal cystic neoplasm and the patients underwent adrenelectomy. Histopathologic examination and immunohistochemical findings were consistent with lymphangioma. Cystic lymphangiomas may imitate other adrenal neoplasms and must be kept in mind in the clinical and radiologic differential diagnosis of cystic adrenal lesions.

Effects of highly purified urinary FSH and human menopausal FSH on uterine myoelectrical dynamics.

The aim of the study was to investigate the effects of urinary follicle-stimulating hormone (FSH) compounds on the electrical activity of myometrium using signal-processing techniques. Thirty animals were involved in the experiment. After two successive normal estrous cycles, 15 of these animals were put into three equal subgroups. Group 1 was the control; animals were given solvent. Groups 2 and 3 were treated with Urofollitropin and Menotropin, respectively. The other 15 animals were ovariectomized and subjected to the same protocol. Their uterine myoelectrical signals were recorded over a period of at least 3 min at a sampling frequency of 500 Hz, and analyzed through software assisted signal processing. The results show the power and some characteristic spectral components of myoelectrical signal were differentially reduced with the administration of highly purified urinary FSH and human menopausal FSH but significant differences were not detected between their histology. In conclusion, uterine myoelectrical signals change with administration of urinary FSH preparations. Human menopausal FSH and more precisely highly purified FSH suppress the spectral components and modify the power of the myoelectrical signals which provides uterine quiescence.

Enhanced endometrial response to a magnetic intrauterine device: a preliminary study.

OBJECTIVE: To evaluate the effects of an intrauterine device producing a static magnetic field on the endometrial histology of rats. METHODS: The experiments involved 20 adult female Wistar albino rats that were divided into five groups. Group 1 was sham-operated; Groups 2, 3 and 4 had a copper intrauterine device (IUD), an uncovered intrauterine magnet (IUM) or an intrauterine silicone-coated IUM, respectively, inserted into one of the uterine horns; in Group 5 an uncovered IUM was implanted subcutaneously. Six days later the rats were sacrificed; endometrial and subcutaneous tissues were harvested and examined microscopically. RESULTS: Copper IUDs caused classical cellular infiltration through the endometrium. IUMs, producing a static magnetic field, also caused leucocyte and monocyte infiltration of the endometrium and, in addition, a significant leucocyte accumulation over the endometrial surface. CONCLUSION: This preliminary study reveals that an intrauterine magnet induces the accumulation of leucocytes in the uterine cavity in addition to the classic stromal infiltration caused by commercially available nonmagnetic IUDs. This activity could contribute to a greater efficacy of intrauterine contraception and should be investigated further.

Low-grade epithelial-myoepithelial carcinoma of bartholin gland: report of 2 cases of a distinctive neoplasm arising in the vulvovaginal region.

We report 2 cases of a distinctive neoplasm arising from Bartholin gland and presenting as a vulval or vaginal mass. The tumors occurred in patients aged 44 and 51 years and were 2 and 3 cm in maximum dimension. In both cases, normal Bartholin gland tissue was identified adjacent to the lesion. The neoplasms were unencapsulated and largely well circumscribed but with a focally infiltrative edge. They were composed of tubular, trabecular, or insular arrangements with a double layer of inner cuboidal cells with round nuclei and outer cells with ovoid nuclei and clear cytoplasm, corresponding to epithelial and myoepithelial cells, respectively. Luminal eosinophilic colloid-like material was present. In both cases, a minor proportion of the neoplasm consisted of cribriform arrangements, creating an appearance reminiscent of adenoid cystic carcinoma, although the overall morphology was not typical of that lesion. Mitotic figures were identified in both cases, the mitotic count being 1 and 5/10 high-power fields. Immunohistochemically, the inner cells were positive with epithelial markers, including broad-spectrum cytokeratins and epithelial membrane antigen, and the outer cell layer was positive with myoepithelial markers p63, calponin, and alpha-smooth muscle actin. Both neoplasms exhibited diffuse strong immunoreactivity of the epithelial cells with c-kit. Activating mutations in KIT exons 9, 11, 13, and 17 and in platelet-derived growth factor receptor alpha exons 12, 14, and 18 were searched for by polymerase chain reaction and direct sequencing but were not identified. We believe this represents a low-grade carcinoma arising from Bartholin gland composed of a dual population of epithelial and myoepithelial cells and closely resembling the salivary gland neoplasm termed epithelial-myoepithelial carcinoma. We propose the term low-grade epithelial-myoepithelial carcinoma of Bartholin gland.

Intertriginous plasmacytosis with plasmoacanthoma: report of a typical case and review of the literature.

Clinical manifestations of benign (reactive) plasma cell proliferations of the skin and mucosa consist of a relatively rare and distinct group in dermatologic disorders. They have generally been named according to their localization. We report a typical case of mucocutaneous plasmacytosis located on intertriginous areas of the skin as well as mucosa with a perianal tumoral mass diagnosed as plasmoacanthoma. To our knowledge, this is the first detailed case report, at least in English literature.

[Demodex spp. in hairy skin biopsy specimens]. / Saçli Deri Biyopsi Orneklerinde Demodex spp.

It has been reported that Demodex mites play a role in the pathogenesis of rosacea, acne vulgaris, perioral dermatitis, seborrhoeic dermatitis, micropapular-pruritic dermatitis, and blepharitis. Methods used for diagnostic purposes included cyanoacrylic adhesives, comedone extractor, cellophane tape preparations, skin scraping, punch biopsy and standardized surface skin biopsy. This study is a retrospective work. The aim of the present retrospective study was the investigation of the incidence of Demodex mites using histopathological examination of skin biopsy specimens of keratinized cysts, fungal spores, tricholemmal cysts, nevi, dermatitis, fibrosis, carcinoma and inflammation of the scalp. Fifty-nine biopsy specimens were examined histologically after staining with hematoxylen-eosin. Demodex mites (i.e., tricholemmal cyst, dermatitis, sebaceous cyst, carcinoma, keratose cysts, nevi, fungal spores) were found in 9 (15.3%) of them. It was concluded that since this parasite is found in pathological cases of the scalp, the possible role of Demodex in the pathogenesis of such diseases should also be evaluated.

Arrhythmogenic right ventricular dysplasia cases in forensic autopsies.

Arrhythmogenic right ventricular dysplasia or cardiomyopathy (ARVD or ARVC) is an increasingly recognized entity with clinical and forensic implications. This is the first series documenting ARVD in 5 separate cases in forensic autopsies from Turkey declared as natural sudden cardiac death following complete autopsy and toxicologic analysis. There was a male preponderance (M/F=4), with a mean age of 50.

A lingual osteoid mass originating from hyaline cartilage.

BACKGROUND: Lingual osseous and chondromatous growths are rare but well-defined entities. The cause of these growths is still unknown, but several theories have been proposed. CASE PRESENTATION: A mass measuring one cm in diameter on the dorsum of the tongue in a 28-year-old male causing discomfort was found to consist predominantly of hyaline cartilage with prominent bone transformation. CONCLUSION: This finding confirms that bony masses in the tongue may originate from cartilaginous precursors, in contrast to similar masses seen on the face which are (often) purely osseous.

Scalp ulcer as first sign of cholangiocarcinoma.

Metastases from distant primary tumors are rarely the first indicators of cancer. However, cutaneous metastases are not uncommon in cases of internal malignancy. This article describes the case of a 65-year-old man with cutaneous metastasis of cholangiocarcinoma who presented with a scalp ulcer as the only initial sign. This is only the third reported case of cholangiocarcinoma with distant cutaneous metastasis.

Amended forensic autopsy legal procedures in Turkey during integration with the European Union (EU).

European Union (EU) is expanding its territories, and Turkey has been making adaptive changes in many aspects for an integration with EU. In this regard, amendments on forensic autopsy procedures have been effective from June 1, 2005. This article delineates these changes, emphasizing the differences between the previous and the current procedures.

The effects of G-CSF and naproxen sodium on the serum TGF-beta1 level and fracture healing in rat tibias.

Local and systemic release of transforming growth factor beta 1 (TGF-beta1) is known to increase during the process of fracture healing and this cytokine stimulates bone healing. The majority of the non steroidal anti inflammatory drugs (NSAIDs) inhibit fracture healing. Granulocyte colony stimulating factor (G-CSF) is a hematopoietic growth factor that stimulates bone marrow. In this study, the effects of the NSAID naproxen sodium, G-CSF, and both of them in combination on the TGF-beta1 serum level in rats with tibia fractures were measured and fracture healing was evaluated by histopathologic and radiologic examination. The TGF-beta1 serum levels obtained on day one (24 h after fracture but before administration of naproxen or G-CSF) were found to be similar in all of the five groups (p > 0.05). At the end of the first week, TGF-beta1 levels were significantly lower in naproxen-treated rats than those of the other groups excluding control (p = 0.002). Similar changes in TGF-beta1 levels were found at the end of the second and fourth weeks. TGF-beta1 levels were significantly higher in G-CSF-treated rats at the end of the first, second and fourth weeks (p < 0.05). Fracture healing scores measured with histopathological and radiological methods were higher in G-CSF-treated rats than in naproxen-treated ones. When both naproxen and G-CSF were given, the scores resumed to normal. The results point to the negative effect of naproxen sodium on fracture healing is due to its decreasing effect on the level of TGF-beta1, which may be a new possible mechanism. Moreover, this negative effect can be inhibited by the use of G-CSF.

Histopathologic examination for Helicobacter pylori as a possible etiopathogenic factor in laryngeal carcinoma.

OBJECTIVE: We investigated the presence of Helicobacter pylori in laryngeal cancer specimens to reveal whether or not this is a risk factor in the development of squamous cell carcinoma of the larynx. METHODS: Sixty-nine total laryngectomy specimens with the pathologic diagnosis of squamous cell carcinoma and 30 laryngeal tissue samples that had been taken for the investigation of nonneoplastic (polyp, nodule) diseases were studied. Specimens of both tumor and control groups were stained with hematoxylin-eosin and modified Giemsa stains, and then they were examined under a light microscope. RESULTS: In both groups, H. pylori could not be found in any of the cases. CONCLUSION: The histologic examination of our series did not reveal any clue related to the possible etiologic association between H. pylori and squamous cell carcinoma of the larynx.

Urothelial carcinoma featuring lipid cell and plasmacytoid morphology with poor prognostic outcome.

An aggressive urothelial carcinoma classified as lipid cell variant with plasmacytoid features was diagnosed in a 67-year-old man. His overall survival was 18 months after limited surgery followed by chemotherapy. The histopathologic features were the same in the recurrences.

Gliofibroma: an incompletely characterized tumor.

Although gliofibroma is a rare and incompletely characterized tumor, recent publications have revealed new aspects of this entity. The case of a 16-year-old boy who was diagnosed as having a gliofibroma is presented here, and the problems regarding nosology are discussed in the light of the recent literature.

Internal mammary artery atherosclerosis in segments removed during coronary artery bypass grafting surgery and C.pneumoniae infection.

OBJECTIVE: Recent studies suggest the association of atherosclerotic cardiovascular disease with Chlamydia pneumoniae infection. We investigated C. pneumoniae DNA in internal mammarian artery (IMA) (used as a coronary bypass conduit) and its relationship with atherosclerosis. METHODS: Sixty-six consecutive patients who underwent coronary artery bypass grafting (CABG) during an eight-month period were included in this study. From all patients, we attempted to obtain surplus segments of harvested IMA grafts. The vessels were examined histopathologically, and presence of C. pneumoniae DNA in IMA grafts was assessed by polymerase chain reaction (PCR). RESULTS: C. pneumoniae DNA was found in 7 (10.6%) of 66 IMA specimens. The light microscopic examinations of IMA segments from the C. pneumonia positive group showed atherosclerotic intimal changes in four of the seven patients. These atherosclerotic changes were type II in three patients and type III in one patient according to the AHA classification. The rest of the IMA segments from 62 patients did not show any discernible atherosclerotic lesion. CONCLUSION: The IMA graft examination by PCR and histopathology may be helpful in the determination of future graft patency for IMA bypass surgery.

Serum and gastric fluid levels of cytokines and nitrates in gastric diseases infected with Helicobacter pylori.

This case control study presents data on the concentrations of nitrite and nitrate and a variety of pro-inflammatory cytokines such as interleukin-1 beta (IL-1 beta), interleukin-2R (IL-2R), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor TNF-alpha in gastric fluid and serum. Patients with gastritis, gastric ulcer and gastric cancer are studied and grouped according to infection by Helicobacter pylori. The 208 patients who underwent upper gastrointestinal endoscopic examination were classified as follows; H. pylori-positive gastritis (n = 32), H. pylori-negative gastritis (n = 32), H. pylori-positive ulcers (n = 34), H. pylori-negative ulcers (n = 34), 43 patients with H. pylori-positive gastric cancer in addition to 33 H. pylori-negative healthy control individuals. Gastric fluids and blood samples were taken concomitantly. Cytokines and nitrite and nitrate determinations were attempted as soon as possible after collection of the samples. Nitrite and nitrate levels of serum and gastric fluids of H. pylori-positive gastritis and ulcers were higher than H. pylori-negative gastritis and ulcers. The concentrations of total nitrite and nitrate and cytokines (TNF-alpha, IL-2R, IL-6, and IL-8) in gastric fluids and sera of H. pylori-positive gastric cancer patients were higher than H. pylori-negative control groups. IL-1 beta level was significantly elevated in gastric fluid of infected cancer patients but not in serum. Taken together, the results suggest that an increase in cytokine-NO combination in gastric mucosa previously reported by many studies is not restricted to local infected gastric tissue but also detected in gastric fluid and sera of H. pylori-positive subjects and may have an important role in the pathogenesis and development of common gastric diseases.