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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.

Mucocele-like lesion (MLL) of the breast has been firstly described as a benign lesion resembling mucinous carcinoma of the breast. Subsequently, it has also been reported to be associated with ductal hyperplasia or breast carcinoma. The risk of cancer development in the long term is unknown. Therefore, the approach to pure MLL of the breast detected during percutaneous biopsy is controversial. In this report, a mucocele-like breast lesion in a 47-year-old woman was first noticed during a core biopsy and later detected to be associated with ductal carcinoma in-situ focuses in excisional biopsy material is presented. The aim of this paper was to provide an overview of this rare and controversial lesion and its variabilities with regard of the presented case.

Objective:Breast carcinomas positive for the estrogen receptor (ER+) but negative for the progesterone receptor (PR−) have unfavorable prognostic features and are resistant to tamoxifen therapy. The goal of this study was to highlight the significance of PR− breast carcinomas.Methods:Therefore, 146 breast carcinomas comprising 87 ER+/ PR+ and 59 ER+/PR− carcinomas were examined. These two groups were compared in terms of age; tumor type; tumor size; histologic grade; presence of an in situ component; lymphovascular and perineural invasion; and ER, PR, c-Erb B2, Ki-67, and epidermal growth factor receptor (EGFR) status.Results:While the number of metastatic lymph node and related pN2+pN3 tumors were found to be significantly higher in the ER+/PR− group, the differences with respect to the tumor size, metastatic lymph node size, and frequency of lymphovascular invasion were nearly significant.Conclusion:ER+/PR− tumors have an unfavorable prognosis and show a clinical behavior closer to triple negative ones, although classified as luminal tumors. Revealing the mechanisms causing these differences will enhance the success of breast cancer therapy.

Systemic vasculitis such as Wegener’s granulomatosis (WG), giant cell arteritis (GCA), and poliarteritis nodosa (PAN) may produce tumor-like masses in various organs. GCA may affect large vessels and also rarely present with primary visceral involvement in the breast. In these situations, GCA may confuse with malignancy because of characteristics such as tenderness, redness, and mass formation. This article presents a case report on an 87-year-old woman with palpable mass in her breast and was diagnosed as GCA in the biopsied lesion.

Objective:Thyroid transcription factor-1 (TTF-1) immunoexpression is frequently determined in small-cell lung carcinomas, as well as primary lung adenocarcinomas. While dealing with metastatic carcinomas, TTF-1 immunoexpression is a significant indicator of primary lung carcinomas. Recent studies have revealed that TTF- 1 immunoexpression is also defined in non-lung cancers, such as squamous cell carcinomas of different sites and certain neuroendocrine tumors. The verified data obtained from these studies indicate that a straightforward diagnosis of primary lung carcinoma in cases with positive TTF-1 immunoexpression can cause diagnostic contradictions. The aim of our study is to investigate the immunoexpression status of TTF-1 in common non-lung tumors.Methods:A total of 85 cases that were diagnosed in our institute between the years 2011-2012 were included in our study. After a review of the pathological slides prepared from these tumors [colon adenocarcinoma (n: 15), renal cell carcinoma (n: 15), prostate adenocarcinoma (n: 15), invasive papillary urothelial carcinoma (n: 15), invasive ductal carcinoma of breast (n: 15), and neuroendocrine tumors (n: 10)] TTF-1 immunohistochemistry was applied. Semiquantative evaluation based on the distribution and intensity of the staining was performed by two pathologists, respectively.Results:Positive immunostaining was evident in only 1 case of colon adenocarcinoma out of 85 cases.Conclusion:Our study demonstrated that TTF-1 immunoexpression is a very rare finding (1%) in non-lung tumors. This result provides that anti-TTF-1 is a reliable antibody in the interpretation of primary lung carcinomas. In fact, further studies with a large number of cases are needed to confirm the sensitivity and specificity of TTF-1.

Mucous membrane plasmacytosis is a rare reactive process characterized by plasma cell infiltration of mucous membranes for unknown reasons. It may be confused with malignancy because of its exophytic structure and pavement appereances. A laryngeal polypoid lesion was sent to the pathology department, clinically called fibroma, and presented to emphasize the diagnostic and differential diagnostic criteria.

Amaç: Testiküler germ hücreli tümörler (TGHT), genç yetişkin erkeklerde sık görülen ve bu dönemdeki kanser ilişkili ölümlerin önemli bir sebebi olan solid neoplazmlardır. Histopatolojik sınıflandırma ve evrelemedeki değişiklikler, prognoz ve tedaviyi etkilemektedir. Bu çalışmanın amacı, TGHT tanısı almış olguların analizini yapmak, prognostik parametreleri ve bu parametrelerin insitu germ hücreli neoplazi (İGHN), intratubuler ve intertubuler tümörlerin varlığı ile ilişkilerini gözden geçirmektir.Gereç ve Yöntemler: Bu çalışmada TGHT tanısı almış 77 olgunun Hematoksilen&Eozin boyalı preparatları yeniden değerlendirildi. İGHN, intratubuler ve intertubuler germ hücreli tümör varlığı kaydedildi. Amerikan Birleşik Kanser Komitesi (American Joint Committee on Cancer, AJCC) 8. basımındaki değişiklikler temel alınarak yeniden histopatolojik sınıflama ve evreleme yapıldı.Bulgular: Olguların büyük çoğunluğu (n=42) seminom tanısı aldı, bunu mikst germ hücreli tümör (n=33) ve spermatositik tümör (n=2) izledi. Olguların 30’unda rete testis invazyonu, 6’sında epididim invazyonu, 10’unda hiler yumuşak doku invazyonu, 1’inde tunika vaginalis invazyonu, 4’ünde spermatik kord invazyonu ve 22’sinde ise lenfovasküler invazyon görüldü. İntertubuler seminom 25, intratubuler karsinom 16, İGHN ise 73 olguda saptandı.Sonuç: Histopatolojik tanı, patolojik tümör evresi, serum tümör belirteçleri ve metastaz olup olmaması tedaviyi belirleyen başlıca kriterlerdir. AJCC 8. basıma göre, hiler yumuşak dokuya invazyonun evrelemeye eklenmesi ile pT2 olgularımız arttı. Ayrıca, spermatik kord içerisinde devamlılık göstermeksizin damar trombüsünden yumuşak doku invazyonun pM1 olarak kabul edilmesi de metastatik testis tümörlerinin sayısını artırmıştır.

Metastatic tumors of thyroid are rare and constitute 1.2% of all thyroid malignancies. Metastasis to thyroid gland from head and neck region occurs usually via direct spread. Hematogenous metastases are mostly seen in kidney, breast, and lung tumors and malignant melanomas. Thyroid gland metastasis is usually seen in widespread diseases. Solitary metastasis in this gland is extremely rare. A 68-year-old male patient was admitted to the general surgery clinic with swelling in the neck. The patient had undergone right lobectomy in another hospital due to lung cancer two years ago. Ultrasonography revealed the presence of nodules in both lobes with maximum diameter of 4.5 cm in the right lobe and 2 cm in the left lobe. Bilateral total thyroidectomy was performed. Nodules with diameter of 4.5 and 3.5 cm were observed in the right lobe. In the histopathologic examination of a small nodule, adenocarcinoma infiltration which was 2 cm in diameter was observed. Tumoral infiltration was not observed in nodule capsule and thyroid capsule. Immunohistochemically, tumor was positive for carcinoembryonic antigen (CEA), weakly positive for thyroid transcription factor-1 (TTF-1), and negative for thyroglobulin, chromogranin A, and calcitonin. Slides of lobectomy material were reexamined and it was observed that the two tumors had the same properties. The case was reported as “pulmonary adenocarcinoma metastasis in thyroid.” No other metastasis was observed in the whole body scan of the patient. In conclusion, in the presence of nodule in thyroid gland, possibility of metastasis should be considered if a history of malignancy exists.

Objective:Cavitation and coagulation necrosis due to high temperature caused by application of the high intensity focused ultrasound (HIFU) to a focal area occurs. This feature makes HIFU possible to use in the destruction of cancerous tissue. In this study, it was aimed to determine the effect of HIFU on Balb/c mice with Ehrlich ascites tumor model to reach effective usage of HIFU with its clinical and experimental applications in various types of cancer.Methods:Ehrlich ascites tumor cells were obtained from the intraperitoneal region of a donor mouse. Fresh ehrlich ascites tumor cells were injected into 24 mice that were randomly distributed after tumor formation as a control (Group 1), sham treatment (Group 2) and HIFU treatment (Group 3). HIFU application was performed under ultrasound image until conversion of the hypoechoic tumor tissues to hyperechoic appearances. Tumor size and volumes were measured.Results:Tumor sizes and volumes in all groups showed an increase after the treatment. Pathologically all tumors were solid carcinoma with an expansive growth pattern. Necrosis percentages in Group 1, Group 2 and Group 3 were 70±9.6, 70±9.4 and 75.6±4.17, respectively. With regard to Volume 2, there were significant differences between Group 2 and both Group 1 and 3 (p=0.004 and p=0.0001, respectively).Discussion:High intensity focused ultrasound is an effective method in Ehrlich ascites tumor model via prevention of tumor growth and production of necrosis. To achieve a reduction in tumor volume, increasing the duration of HIFU treatment and/or repeatedly application of the treatment is thought to be effective.

Primary gastric adenosquamous carcinomas are extremely rare tumors. A gradual transition between the malignant glandular and squamous components of the tumor is seen on performing a histopathological evaluation. These tumors are known to have poorer clinical outcomes than conventional adenocarcinomas. We aimed to present two cases of primary adenosquamous carcinomas that were diagnosed at the later stage in our institute.

Objective To investigate the role of positron emission tomography (PET) and magnetic resonance imaging (MRI) in evaluating the feasibility of skin-sparing mastectomy in patients with locally-advanced breast cancer (LABC) who will undergo neoadjuvant chemotherapy (NAC) by evaluating the sensitivity and specificity of PET and MRI compared with skin biopsy results before and after NAC treatment. Methods Patients with LABC who were treated with NAC between November 2013 and November 2015 were included in this study. Demographic, clinical, radiological and histopathological features of the patients were recorded. Results A total of 30 patients were included in the study with a mean age of 52.6 years (range, 35–70 years). Sensitivity and specificity for detecting skin involvement in LABC was 100%/10% (62%/85%) with MRI and 60%/80% (12%/92%) with PET before (after) NAC, respectively. When radiological skin involvement was assessed in relation to the final histopathological results, the preNAC PET results and histopathological skin involvement were not significantly different; and there was no difference between postNAC MRI and histopathological skin involvement. Conclusions As preNAC PET and postNAC MRI more accurately determined skin involvement, it might be possible to use these two radiological evaluation methods together to assess patient suitability for skin-sparing mastectomy in selected patients.

Objective:Renal cell carcinoma (RCC) is the 14th most common tumor in the world. In 2010, the protocol for the examination of kidney specimens with invasive carcinoma of renal tubular origin was updated. The aim of our study was to review 1-year RCC patients of our hospital according to the new protocol, classification, and staging systems with respect to their morphological and immunohistochemical features.Methods:The medical records of 54 RCC patients between July 2012 and July 2013 were retrospectively reviewed. They were classified according to the WHO 2004 classification system and newly defined subtypes. The following variables were determined in each case: age, sex, histological subtype, stage, and Fuhrman nuclear grade.Results:In our study, 30 (55.6%) men and 24 (44.4%) women were diagnosed with RCC out of 54 patients. The median age was 56 years. In total, 21 patients had (55.2%) right- and 17 had (44.74%) left-sided tumors. Thirty-eight (70.3%) clear cell, 6 (11.1%) papillary, 7 (12.96%) chromophobe, 1 (1.85%) multilocular, 1 (1.85%) unclassified, and 1 (1.85%) tubulocystic RCC were seen. According to primary tumor, 33 (61.1%) pT1, 10 (18.51%) pT2, 9 (16.66%) pT3, and 2 (3.70%) pT4 patients were reported. Chromophobe RCCs were excluded from the Fuhrman grading (G) system; of the remaining 2 (4.17%) were G1, 30 (62.5%) were G2, 13 (27.08%) were G3, and 3 (6.25%) were G4 tumors.Conclusion:Although RCC constitutes the majority of renal tumors, different subtypes are also encountered. In our study, clear cell RCCs were the most common type of tumors consistent with the literature. The remarkable point was that chromophobe RCCs were more frequent in our study. Because of infrequency, more examples are required to distinguish newly defined subtypes.