Chronic gastritis in a gastric diverticulum misdiagnosed as a left adrenal mass.

Gastric diverticula are rare and usually asymptomatic. They are most frequently located on the posterior wall of the stomach. Many of them were reported as adrenal masses. Here, we present a 48-year-old male with a gastric fundus diverticulum that was misdiagnosed as a left adrenal mass on magnetic resonance imaging (MRI). Laparoscopic resection of the diverticulum was successfully performed, and histopathological examination revealed a true gastric diverticulum with moderate chronic gastritis. Although most cases of gastric diverticula are asymptomatic, to the best of our knowledge, this is the first reported case of chronic gastritis that developed in a gastric diverticulum.

The significance of Wilms Tumor Gene (WT1) and p53 expression in curettage specimens of patients with endometrial carcinomas.

In this retrospective experimental study, we assessed the immunohistochemical expression of Wilms Tumor Gene (WT1) and p53 in endometrial biopsies of patients with endometrial cancer, and correlated their expression with the final pathological findings. Sixty-two patients with primary endometrial cancer who underwent surgical treatment were investigated. Immunohistochemical expression of Wilms Tumor Gene (WT1) and p53 was assessed in curettage specimens, and the final pathology reports from hysterectomy specimens were reviewed. The expression of these markers seems to play a role in curettage specimens as they correlate with the final tumor characteristics of hysterectomy specimens. Five out of sixty-two endometrial cancer specimens (8.1%) were WT1-positive, and 21 specimens (33.9%) were P53-positive. Positive expression of WT1 and P53 was significantly associated with the non-endometrioid type (p value of 0.019 and 0.005, respectively). Positive WT1 expression was significantly associated with high grade lesions, deep myometrial invasion, and advanced stage disease. Moreover, a statistically significant inverse relationship was observed between the positivity of WT1 and P53, and the positivity of ER and PR. We think that examination for WT1 and p53 in curettage specimens might help to predict the final pathological diagnosis in patients with endometrial cancer. This might be useful for the identification of high risk groups and, therefore, of candidates for more radical surgery.

Malignant adenomyoepithelioma of the breast with lymph node metastasis: a detailed immunohistochemical study.

Malignant adenomyoepithelioma of the breast is a rare tumour with around 30 cases reported in the literature. Metastases associated with these tumours are usually haematogenous. Axillary lymph node metastases are thought to be unusual, and it has been recently suggested that axillary node dissection is not indicated unless clinically palpable. We here present a case of a 63-year-old woman, who developed a malignant adenomyoepithelioma with axillary lymph node metastasis, that included epithelial and myoepithelial elements, in spite of the absence of clinically enlarged nodes. We suggest that histological examination of axillary sentinel node(s) or node sampling may be worthwhile in this condition.

Sclerosing angiomatoid nodular transformation of the spleen.

Sclerosing angiomatoid nodular transformation (SANT) is a recently recognized nonneoplastic vascular lesion of the spleen with fewer than 30 cases described. Microscopically, SANT consists of multiple well-circumscribed vascular/angiomatoid nodules showing plump endothelial cell and extravasated erythrocytes. The nodules are surrounded by a variable lymphoplasmacytic infiltrate, spindle cells, and collagenous stroma. The vascular nodules display a complex mixture of endothelial phenotypes resembling splenic sinusoids (CD34-/CD31+/CD8+), capillaries (CD34+/ CD31+/CD8-), and small veins (CD34-/CD31+/CD8-). Focal expression of CD68 can also be seen. The differential diagnosis of SANT includes splenic hamartoma, inflammatory myofibroblastic tumor, littoral cell angioma, and hemangioendothelioma. It has been postulated that SANT represents a peculiar hamartomatous transformation of splenic red pulp in response to an exaggerated nonneoplastic stromal proliferation. SANT has a benign clinical course with splenectomy being curative.

Adenocarcinoma in situ arising in a tubulopapillary apocrine hidradenoma of the peri-anal region.

We report the case of a 67-year-old woman who presented with a peri-anal skin tag. Histologically, the excised lesion showed features of tubulopapillary apocrine hidradenoma, with an area showing features of carcinoma in situ. The lesion also had papillary and cribriform growth patterns, reminiscent of breast lesions. Similar to vulvar lesions, peri-anal apocrine tumours are believed to arise in mammary like glands (MLGs). To the best of our knowledge, this is the first description of a peri-anal adenocarcinoma in situ arising in a tubulopapillary apocrine hidradenoma. The relationship to MLGs is also discussed.