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A 31-year-old male presented with a history of vitiligo and extensive ulcerative colitis who developed relapsing polychondritis (RPC) manifesting as bilateral auricular chondritis, nasal chondritis, and polyarthritis. Despite the initial antibiotic treatment, the patient’s symptoms persisted and worsened, necessitating the initiation of prednisolone therapy, which led to complete resolution of the chondritis and arthritis symptoms within 2 weeks. This case underscores the importance of considering RPC in patients with inflammatory bowel disease presenting with unexplained inflammatory symptoms involving cartilaginous structures.

Objective: Diffuse large B-cell lymphoma (DLBCL) is a biologically heterogeneous disease that is classified into germinal center B-cell (GCB) and non-GCB subtypes, which are prognostically different. The Hans algorithm is the most widely used tool based on CD10, BCL6, and MUM1 expression, but some cases with the non-GCB phenotype are still known to be misclassified. In this study, we investigate the extent to which GCET1, HGAL, and LMO2 protein expressions reflect GCB phenotype together with their roles in determining the GCB phenotype of DLBCL and their contributions to the performance of the Hans algorithm. Materials and Methods: Sixty-five cases of DLBCL-not otherwise specified, 40 cases of follicular lymphoma (FL), and 19 non-GC-derived lymphoma cases were included in this study. The DLBCL cases were grouped as CD10+ (Group A) or only MUM1+ (Group B), and the remaining cases constituted the intermediate group (Group C). GCET1, HGAL, and LMO2 expressions were evaluated. Results: In the FL group, GCET1, HGAL, and LMO2 were positive in 85%, 77.5%, and 100% of the cases, respectively. Among the non-GCderived lymphoma cases, all three markers were negative in cases of small lymphocytic lymphoma, plasmablastic lymphoma, peripheral T-cell lymphoma, and anaplastic large cell lymphoma. GCET1 and HGAL were negative in cases of marginal zone lymphoma (MZL) and mantle cell lymphoma (MCL). Two of the 3 MZL and 2 of the 4 MCL cases were positive for LMO2. In the DLBCL group, the number of cases with GCET1, HGAL, and LMO2 positivity was 18 (90%), 17 (85%), and 20 (100%), respectively, in Group A and 0 (0%), 2 (13.3%), and 2 (13.3%), respectively, in Group B. Considering these rates, when the cases in the intermediate group were evaluated, it was concluded that 13 cases typed as non-GCB according to the Hans algorithm may have the GCB phenotype. Conclusion: GCET1, HGAL, and LMO2 are highly sensitive markers for determining the germinal center cell phenotype and can increase the accuracy of the subclassification of DLBCL cases, especially for cases that are negative for CD10.

Aims: Limited data about disease management strategies are available for pediatric patients with coronavirus disease-2019, particularly in Turkey. This study aimed to share the data on patients aged under 18 years in our country to be beneficial for understanding the disease course in children. Methods: A retrospective review of the medical records of pediatric patients aged under 18 years who were confirmed as coronavirus disease-2019 between March 11, and June 23, 2020, and were admitted to our hospitals was conducted. Results: A total of 220 pediatric patients with coronavirus disease-2019 were evaluated, of which 48.2% were boys, with a median age of 10 years, and 9.5% had underlying diseases. Patients were classified according to severity, with the percentages of asymptomatic, mild, moderate, and critical/severe cases determined to be 25.5%, 45%, 26.8%, and 2.7%, respectively. Extracorporeal membrane oxygenation was required in two patients (0.9%) and mechanical ventilation in three (1.4%). Targeted therapies were used in six patients (2.7%), with hydroxychloroquine being the most commonly used agent either alone (one patient) or in combination with favipiravir (five patients). Two patients (0.9%) died, and nine (4.1%) were still hospitalized during the study period. Conclusion: Although the disease course of coronavirus disease-2019 seems to be mild in children, critical illness is significant, and the treatment strategy primarily should consist of supportive care according to our preliminary observations.

Breast cancer is the second leading cause of cancer throughout the world, however neuroendocrine tumors of the breast are rarely encountered. Herein we present a 75-year-old patient who was admitted to our clinic due to a mass in her breast and was operated on with a preliminary diagnosis of invasive breast carcinoma, However she was diagnosed with a neuroendocrine tumor after pathologic evaluation. The patient is the oldest one among others with a neuroendocrine tumor in the breast reported in the literature.

Phyllodes tumor of the breast is a rare fi broepithelial lesion. Between January 1993 and January 2008, 19 patients diagnosed with phyllodes tumor, were retrospectively analyzed in terms of demographic and clinicopathologic features and treatment modalities. The median age was 43 (range, 20-65). For diagnosis, 11 patients underwent excisional biopsy, 4 cases had incisional biopsies, and 4 patients had core biopsies/fi ne needle aspiration cytology. One patient with T4 tumor and lung metastasis was considered inoperable and received chemotherapy alone. Thirteen patients had breast conservative surgery (lumpectomy or reexcision), whereas 5 patients underwent mastectomy. The median tumor size was 7 cm (range, 2-21 cm). The pathologic classifi cation of the tumors was as follows: benign (n=6, 31.5%), borderline (n=6, 31.5%), and malignant (n=7, 37%). Among those with malignant phyllodes, 2 patients received chemotherapy and radiotherapy followed by mastectomy, and three patients with lumpectomy had radiotherapy. Median follow-up time was 36 months (4-108). One patient with malignant phylloides with mastectomy had lung metastases at the 24th month followed by chemotherapy&radiotherapy, and died of metastatic disease 3 months later. Furthermore, another patient with benign phyllodes who underwent lumpectomy with unknown surgical margins was found to have a local recurrence as benign phyllodes at the 37th month. No other recurrences were noted. The 5-year overall survival of patients with borderline&malign phyllodes was 83%. In conclusion, margin negative surgery plays a major role in the management of patients diagnosed with phyllodes tumors. However, the survival benefi t of adjuvant chemotherapy or radiation treatment warrants further investigation.

AIMS: The aim of this study was to investigate the relationship between Ki- 67 proliferation index and prognosis in primary angiosarcoma of the breast (PAB). Hormonal status of PAB was also discussed, since PAB sometimes can be seen with coexistent pregnancy.METHODS: During a 17-year period 4 cases of PAB were established out of almost 5000 breast biopsies. Immunohistochemical analyzes were performed for antibodies against CD31, CD34, estrogen receptor (ER) and progesterone receptor (PR). Ki-67 proliferation index was also investigated.RESULTS: All patients clinically presented with a palpable mass. The mean patient age at diagnosis was 40.8 years (29-56). Two patients were at the end of their first trimester in pregnancy. The mean score of Ki-67 index was 28.7% (2-55%). Two patients with Grade I tumor and with the lowest Ki-67 index were alive with no evidence of disease 7-8 years after surgery. Proliferation index was detected to be 50% in Grade II tumor, and the patient has been receiving radiotherapy and chemotherapy because of distant metastases. The patient with Grade III tumor died with disseminated disease one year after the initial diagnosis. Positive immunoreactivity for ER and PR could not be detected in any tumor.CONCLUSIONS: Since, it was previously stated that grading is the most important prognostic indicator, we suggest that Ki-67 proliferation index may also be used for the same purpose. No evidence of an association with hormonal status could be drawn.

Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a rare benign tumoral lesion of mammary stroma containing complex anastomosing spaces. This uncommon proliferative lesion is in differential diagnosis with angiosarcoma in histopathological examinations. A 38 year-old woman was admitted to our clinic with a complaint to of mastalgia and a mass in her right breast since six years. Ultrasonographic examinations revealed 4 cm mass with a diagnosis of fibroadenoma. Total excision of the mass was performed without any complications. Histopathologic examimation revealed pseudoangiomatous stromal hyperplasia.