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Pseudoangiomatous stromal hyperplasia (PASH) is a benign lesion of breast composed of prolifereted stromal myofibroblastic cells. It is named due to presence of slit-like spaces without endothelial layer mimicing vascular structures. Most of the lesions detected incidentally in breast tissues resected with other causes. Occasionally it may presented as palpable or radiologically detectable mass. It may confused with malignancy or phylloides tumor in clinically or radiologically if it grows rapidly. Differential diagnosis includes angiosarcomas and other sarcomas on histopathological examination. In this report a PASH lesion presented with differential diagnostic criteria, detected in a 34 year of woman with a breast mass growing markedly in 6 months duration. [ABSTRACT FROM AUTHOR]

Adult intussusception is a rare clinical condition. In majority of adult cases, there is an underlying cause such as polyps or colon cancers. In the present study, a 29-year-old woman with intermittent and colicky abdominal pain, constipation, and painful defecation, accompanied with distention and sense of rectal fullness, was evaluated with computed tomography. Ileo-colo-colic intussusception was determined. Subtotal colectomy with posterior rectopexy was performed. After the surgery, she was doing well at 13-month follow-up. [ABSTRACT FROM AUTHOR]

Background/Aims: The role of cyst fluid carcinoembryonic antigen (CEA) level in differentiating mucinous pancreatic cystic lesions (PCLs) is controversial. We investigated the role of cyst fluid CEA in differentiating low-risk (LR)-intraductal papillary mucinous neoplasms (IPMNs) from high-risk (HR)-IPMNs and LR-mucinous cystic neoplasms (MCNs). Methods: This was a retrospective study of 466 patients with PCLs who underwent endoscopic ultrasound-guided fine-needleaspiration over a 7-year period. On histology, low-grade dysplasia and intermediate-grade dysplasia were considered LR, whereas high-grade dysplasia and invasive carcinoma were considered HR. Results: Data on cyst fluid CEA levels were available for 50/102 mucinous PCLs with definitive diagnoses. The median CEA (range) levels were significantly higher in HR cysts than in LR cysts (2,624 [0.5–266,510] ng/mL vs. 100 [16.8–53,445] ng/mL, p=0.0012). The area under the receiver operating characteristic curve (AUROC) was 0.930 (95% confidence interval [CI], 0.5–0.8; p<0.001) for differentiating LR-IPMNs from LR-MCNs. The AUROC was 0.921 (95% CI, 0.823–1.000; p<0.001) for differentiating LR-IPMNs from HR-IPMNs. Both had a CEA cutoff level of >100 ng/mL, with a negative predictive value (NPV) of 100%. Conclusions: Cyst fluid CEA levels significantly vary between LR-IPMNs, LR-MCNs, and HR-IPMNs. A CEA cutoff level of >100 ng/mL had a 100% NPV in differentiating LR-IPMNs from LR-MCNs and HR-IPMNs. [ABSTRACT FROM AUTHOR]

Introduction: During coronavirus disease-19 (COVID-19) pandemic, people did not take a risk by going to hospital to fear contagion. Some pandemic hospitals were referring patients to other hospitals because of the intensity. Therefore, hospital admissions for acute illnesses like acute appendicitis (AA) was delayed. We evaluate the increase in complications in AA cases due to admission difficulties during the pandemic. Method: In this retrospective observational study, patients older than 18 years who had appendectomy with the diagnosis of AA at our hospital before (March-December 2019) versus during a pandemic (March-December 2020) were selected. Patients without imaging who had previous abdominal surgery were excluded. IBM SPSS Statistics® 22.0 was used. p<0.05 is considered statistically significant. Results: A total of 446 patients (279 prepandemic, 167 during pandemic) were identified. Prepandemic group includes 113 female and 166 males whereas 58 females and 109 males during a pandemic. Mean age is 34±13 in prepandemic while 33±12 in postpandemic. Time from symptom onset to patient arrival at the hospital, the number of hospital-related late admission, C-reactive protein average, appendix diameter and percentage of postoperative ileus during a pandemic is statistically significantly high (p<0.01, p<0.01, p=0.003, p=0.002, p=0.027). The percentage of defense and rebound in prepandemic is statistically significantly high (p=0.001, p=0.01). The distribution of age and sex; the type of surgery; imagining, operation and pathological findings; the length of hospital stay and readmission have not meaningful difference. In prepandemic, the maximum length of hospital stay was 9 days whereas 19 days during a pandemic. Conclusion: Although it is observed a significant delay on admission to hospital; postoperative complications and hospital stay seems not to be affected. However; it is suggested to do further studies multicentric and with more patients. [ABSTRACT FROM AUTHOR]

Background. In this study, we retrospectively evaluated cases of patients who had undergone appendectomy in our hospital and aimed to present the efficiency of diagnostic tests and demographic data of cases. Pathological reports were analyzed for the following parameters: age, gender, and pathological diagnosis. In addition, the demographic and clinicopathologic characteristics of patients with unusual histopathologic findings were evaluated in detail, and reanalysis of archived resected appendix specimens was carried out. Methods. Files of 2047 patients (1329 males, 718 females, sex ratio: 1.85, age range: 1-87 years, mean age: 26, 50 years), who had been operated with a diagnosis of acute appendicitis in the emergency department of Bezmialem Vakıf University Medical Faculty from November 2011 to June 2014, were retrospectively evaluated. Results. Cases were separated into 2 groups. Cases with histopathologic examination reported as acute appendicitis constituted group 1 (n = 2013, 98.34%), and cases with pathologic findings other than acute appendicitis constituted group 2 (n = 34, 1.66%). The second group consisted of 8 low-grade mucinous neoplasms, 7 mucoceles, 6 carcinoid, 5 granulomatous inflammation, 4 intraluminal Enterobius vermicularis, 1 endometriosis externa, 1 adenocarcinoma infiltrated to serosa, 1 mesenteric cyst, and 1 low-grade adenocarcinoma formed in mucinous cystic neoplasm background. Conclusion. Acute appendicitis is the most common emergency surgical condition. Although most of the resected appendectomy specimens showed typical histopathologic findings, some (1.66%) showed unusual histopathologic findings. Even if the macroscopic appearance of the specimen is normal or acute appendicitis, we suggest routine histopathological examination. [ABSTRACT FROM AUTHOR]

Purpose: Pancreatic fistula is a potential postoperative complication with variable definitions, incidences and risk factors. We intended to evaluate its impact after gastric surgery. Materials and Methods: A total of 28 consecutive patients who underwent curative open gastrectomy with lymphadenectomy for gastric adenocarcinoma were retrospectively analyzed. Patients' demographics, perioperative and pathological data were collected. Pancreatic fistula that was diagnosed and graded according to International Study Group of Pancreatic Fistula's system was identified as main variable. Results: Mean age of patients was 58.8±10.1 years with a female to male ratio of 9/19. Grade A pancreatic fistula was diagnosed in six patients (21.4%). There was no grade B and C pancreatic fistula. Drain amylase level was significantly higher in patients with pancreatic fistula. There was no significant difference with regard to amount of drainage, length of hospital stay and duration of drains in patients with and without fistula. No significant association was shown between development of fistula and patients' demographics, peri-operative and pathological data. Conclusion: The development of grade A pancreatic fistula after gastric surgery does not appear to be a major complication with clinical consequences. High amylase level in the drainage fluid can be considered as a biochemical measure only. [ABSTRACT FROM AUTHOR]

Abstract: Papillary lesions have a broad spectrum of appearances on magnetic resonance imaging (MRI). The purpose of this study was to evaluate whether apparent diffusion coefficient (ADC) values of papillary lesions can be used to characterize lesion as benign or malignant. This retrospective study included 29 papillary lesions. Diagnostic values of dynamic contrast‐enhanced MRI (DCE‐MRI), DWI‐ADC, and DCE‐MRI plus DWI‐ADC were separately calculated. The malignant papillary lesions (0.744×10−3 mm2/s) exhibited significantly lower mean ADC values than the benign lesions (1.339×10−3 mm2/s). Addition of DWI to standard DCE‐MRI provided 100% sensitivity. We hypothesized that this combination may prevent unnecessary excisional biopsies. [ABSTRACT FROM AUTHOR]

Glomus tumor is a rare benign mesenchymal neoplasm derived from the glomus body, an arteriovenous shunt mainly located in dermis and subcutis. The most common localization of this tumor is extremities, especially nailbed. Glomus tumor in the gastrointestinal system is a rare condition. Here we report a gastric glomus tumor to raise awareness of this tumor and show the difficulties in the diagnosis. [ABSTRACT FROM AUTHOR]