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Gangrenous cystitis is an exceedingly uncommon diagnosis characterized by bladder mucosa and submucosal necrosis. The presence of non-specific symptoms and signs complicates the diagnostic process. Necrotizing fasciitis is a rare infection affecting the deep soft tissues, causing progressive destruction of the muscle fascia and rapid systemic spread. This study aimed to elucidate the atypical presentation of rare gangrenous cystitis in the literature, highlighting its potential to lead to necrotizing fasciitis. An 82-year-old female patient was admitted with abdominal and pelvic pain complaints. Computed tomography of the lower abdomen revealed free air-fluid densities in the pelvic region, raising the suspicion of intestinal perforation. Exploratory laparotomy diagnosed the patient with gangrenous cystitis and necrotizing fasciitis. Pathological examination confirmed the presence of necrosis. In patients presenting with acute abdominal symptoms, when free air-fluid levels are observed in imaging studies of the pelvis, rare diagnoses such as gangrenous cystitis should not be overlooked, even if the patient’s history indicates anuria.

Fibroepithelial polyps are rare, benign, non-epithelial tumors of the urinary system. They can occur throughout the entire urinary system, including the renal pelvis, ureter, bladder, and urethra, which are lined with urothelium. These polyps originate from the stromal structure, formed by the combination of mesodermal and urothelial cells. The most common clinical complaint of patients with fibroepithelial polyps is unilateral flank pain. In some cases, this pain may be accompanied by hematuria, dysuria, and pollakiuria, which are irritative lower urinary tract symptoms. In this case report, a case of a giant ureteral fibroepithelial polyp in a patient who was admitted to our clinic with macroscopic hematuria and left flank pain was presented. Following the diagnosis of a giant polyp in the left ureter, we treated the patient with endoscopic ablation using a Holmium-YAG laser device under ureteroscopy guidance.

Angiomyolipomas (AMLs) are mesenchymal tumors that typically originate from the kidneys and contain smooth muscle cells, fat cells, and blood vessels. They are usually benign in nature but can be fatal due to complications. AMLs almost always involve the kidneys, and only a few studies have reported the possibility of extrarenal involvement as a rare entity. In this study, we examined a patient who presented to our clinic with left-sided pain and was found to have a large AML measuring approximately 15 cm in size in the left kidney. The patient underwent a simple left nephrectomy, and AML was diagnosed after histopathological examination, with intact surgical margins. During the patient’s routine 6-month follow-up visits, approximately four years after nephrectomy, a mass of approximately 13 cm was observed in the nephrectomy bed and radiologically interpreted as a recurrent AML. A tru-cut biopsy of the mass confirmed AML diagnosis. The patient was treated with selective arterial embolization, which was successful without any complications. We believe that our rare case of recurrent large AML will contribute to the diagnosis and treatment choices for patients with recurrent renal and extrarenal AML in the future and will add to the existing literature.

Worldwide, clinically detected prostate cancer is the second most common malignancy, with an estimated 1.1 million new cases in 2012. Standard active treatments for prostate cancer include radiotherapy and/or radical prostatectomy (RP) (for clinically localized prostate cancer). Also active surveillance is a management strategy to avoid or delay the potential harms caused by radical treatments. At this point, a pathology report plays a major role. Appropriate handling and systematic examination of a RP specimen is essential for the identification of tumor characteristics such as grade, volume, pathological stage, and surgical margin status. Although some minor differences in macroscobic evaluation may be seen among authors, it is essential to paint and sample the entire prostatectomy specimen. Most prostate tumors are heterogeneous and multifocal compared to tumors of other organs. This makes macroscopic assessment of prostatectomy specimen challenging and sampling of a representative material from the main tumor focus difficult. Also determining tumor burden and to interpret all surgical margins total sampling of the material is essential.

The number of patients with type 2 diabetes using dipeptidyl peptidase-4 (DPP-4) inhibitors is increasing across the world. Although this class of antidiabetic medications is generally safe and associated with less side effects compared to other oral antidiabetic medications, they could also cause some side effects such as skin rashes. Herein we report a case of type 2 diabetes patient who developed a painful maculopapular rash induced by linagliptin, a widely used DPP-4 inhibitor. A localized painful maculopapular rash developed on the palmar faces of the patient’s hands almost 1 day after the initiation of the drug. The patient was using intensive insulin therapy before linagliptin was started. There was no eruption on the other body parts except the palmar faces of the hands. Following the discontinuation of the drug, the rash disappeared in about four days. The patient had no history of urticaria and did not use an ACE inhibitor. As far as we know, this is the first case report of a skin rash induced by linagliptin in the Turkish literature. This case report highlights a rare and lesser known side effect of linagliptin, a new member of DPP-4 inhibitors.

Objective: There is no other screening program close to the success rate of PAP test. Cervical cytology constitutes a large workload so that quality control in cervical cytology is important for the quality assurance of pathology laboratories. Material and Method: In this study, we collected the cervical cytology results from all over Turkey and discussed the parameters influencing the quality of the PAP test. The study was conducted with Turkish gynaecopathology working group and 38 centers (totally 45 hospitals) agreed to contribute from 24 different cities. The study was designed to cover the cervical cytology results during 2013. The results were evaluated from the data based on an online questionnaire. Results: The total number of Epithelial Cell Abnormality was 18,020 and the global Epithelial Cell Abnormality rate was 5.08% in the total 354,725 smears and ranging between 0.3% to 16.64% among centers. The Atypical squamous cells /Squamous intraepithelial lesion ratios changed within the range of 0.21-13.94 with an average of 2.61. When the centers were asked whether they performed quality assurance studies, only 14 out of 28 centers, which shared the information, had such a control study and some quality parameters were better in these centers. Conclusion: There is an increase in the global Epithelial Cell Abnormality rate and there are great differences among centers. Quality control studies including the Atypical squamous cells/Squamous intraepithelial lesion ratio are important. Corrective and preventive action according to quality control parameters is a must. A cervical cytology subspecialist in every center can be utopic but a dedicated pathologist in the center is certainly needed.

AbstractBACKGROUND:Hair follicle nevus is a rare, congenital hamartoma with follicular differentiation characterized histologically by numerous, tiny, mature hair follicles. Trichofolliculoma, the histopathological features of which are quite similar to those of hair follicle nevus, is also a hamartoma that differs from hair follicle. Accessory tragus is a relatively common, benign congenital abnormality of the external ear with an incidence rate of 1 to 10 per 1,000 live births.OBJECTIVE:This study seeks to assess the discriminatory value of currently available, histological criteria in the differential diagnosis of hair follicle nevus, accessory tragi and trichofolliculoma.METHODS:Twenty-one patients comprising 9 cases of hair follicle nevus, 8 accessory tragi patients and 4 trichofolliculoma cases, were recruited to perform the study.RESULTS:There were 10 males and 11 females in the study group. No significant difference was observed between the three study groups in terms of age, gender or histopathological parameters such as density of hair follicles, subcutaneous fat score and presence of connective tissue framework. Cartilaginous component was seen in 8 cases that were diagnosed as accessory tragi, while central cyst and radiating hair follicles were seen in 4 cases which were diagnosed as trichofolliculoma.CONCLUSION:The results of our study showed that diagnostic discrimination of these diseases could be made only with the clinicopathologic correlation because of their clinical and histopathological similarities.