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Non-endometrioid endometrial carcinoma seems to be less common with a poor prognosis. Due to the lack of standard treatment options and worse survival rates of non-endometrioid endometrial carcinoma, we aimed to investigate these patients inclusively. In total, 492 women with endometrial cancer who were treated in a gynecologic oncology center were examined. Patients with a final histopathologic diagnosis of non-endometrioid endometrial carcinoma were evaluated in respect of demographic characteristics, prognostic aspects, and survival outcomes. We identified 94 patients with the histopathologic results of non-endometrioid endometrial carcinoma. The performance of the systematic lymphadenectomy and adjuvant treatment rate were 96.9% and 92.6%, respectively. Recurrence of the disease was detected in 32 (34%) women and disease-related mortality occurred in 28 (29.8%) women. Multivariate Cox proportional regression analyses determined tumor size, adnexal involvement, and lymphovascular space invasion as independent predictors of overall survival. Larger tumor size, adnexal, and lymphovascular space invasion are important factors in determining prognosis in non-endometrioid endometrial carcinoma patients according to our findings. Besides, high rates of surgical staging and adjuvant chemotherapy and radiation therapy may contribute to improved survival outcomes; in addition to having potential advantages of providing prognostic information. Therefore, a multidisciplinary therapeutic approach should be planned from the early stages for all patients in this group. Nevertheless, comprehensive prospective studies are necessary to optimize the treatment strategies and support successful treatment modalities. [ABSTRACT FROM AUTHOR]

Objective: Breast carcinomas with neuroendocrine (NE) differentiation are extremely rare. The aim was to discuss breast cancer cases with NE differentiation in the light of World Health Organization 2019 classification and literature information. Material and Methods: The pathology records of 56 cases diagnosed as neuroendocrine tumor (NET) and/or breast cancers with NE differentiation presenting to a single center between January 2010 and June 2020 were evaluated. The patients were evaluated in terms of age, tumor size, location, histological grade, hormone profiles (ER, PR, HER2), guideline American Joint Committee on Cancer, lymph node status, stage, metastases, progression, survival, radiological features, surgery type and therapy modality. Results: The age of the patients ranged from 34 to 81 years. Average tumor size was 2.3 cm. Median (range) follow up time was 31.5 (1-73 month). Metastatic lymph nodes were found in 20 cases. In our series, NE differentiation mostly accompanied invasive carcinoma of no special type, less frequently solid papillary carcinoma, and mucinous carcinoma. Four patients had a history of neoadjuvant chemotherapy. Response to treatment was very poor in all four cases. Synaptophysin and chromogranin were positive in 38 cases. No correlation was found among tumor size, grade, age, lymph node status, and presence of distant metastasis in our series. Conclusion: Clinical features and morphology may not help to distinguish NET from other subtypes of breast cancer. Therefore, the morphologic findings of a nested or trabecular architecture, nuclear or cytoplasmic features of NE differentiation, mucin production, or solid papillary growth pattern should prompt a pathologist to order NE markers. [ABSTRACT FROM AUTHOR]

Background/aim: To investigate the utility of preoperative serum cancer antigen 125 (CA 125) levels in type 1 endometrial carcinoma (EC) as a marker for determining poor prognostic factors and survival. Material and methods: All patients with endometrial cancer, who had been treated between 2012 and 2020, were retrospectively reviewed, and finally, 256 patients with type 1 endometrium carcinoma were included in the study. The relationship between the clinicopathological characteristics, CA 125 level, and survival rates were analyzed. The cut-off value for the preoperative serum CA 125 level was defined as 16 IU/L. Results: The median serum CA 125 levels were significantly higher in patients with deep myometrial invasion, lymph node metastasis, lymphovascular space invasion, cervical stromal and adnexal involvement, advanced stage, positive peritoneal cytology, recurrence, and adjuvant therapy requirement. Serum CA 125 cut-off values determined according to clinicopathologic factors ranged from 15.3 to 22.9 IU/L (sensitivity 61%--77%, specificity 52%--73%). The disease-specific survival rate was significantly higher in patients with CA 125 levels < 16 IU/L (P = 0.047). Conclusion: The data showed that choosing a lower threshold value for the CA 125 level (16 IU/L) instead of 35 IU/L, could be more useful in type 1 EC patients with negative prognostic factors. [ABSTRACT FROM AUTHOR]

Objective: To analyze the histopathologic outcomes of patients with atypical glandular cells (AGC) in cervicovaginal cytology examinations. Material and Methods: Patients with AGC in cervicovaginal cytology were included in this study between March 2011 and March 2018 and patient data were collected retrospectively among all cytology results. AGC classification of cervicovaginal cytology were based on the Bethesda 2001 classification system. Results: The total prevalence of cervical epithelial cell abnormality and AGC were found as 4.2% and 0.2%, respectively, in the study cohort. AGC-favor neoplasia (AGC-FN) was the subgroup of AGC with the highest malignancy rate with 62.5% (p=0.06). The incidence of malignancy in the postmenopausal group (33.3%) was detected higher than in the premenopausal group (8.3%) (p=0.07). Conclusion: The probability of malignancy in AGC-FN cytology is more commonly associated with malignancy in the postmenopausal group. Therefore, histopathologic examination is strongly recommended in these patients with AGC smears because of the high risk for malignancy in this group. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the pathological and radiological features, hormone profiles, surgery and treatment methods of metaplastic breast carcinoma cases diagnosed at our center in the light of current literature. Material and Method: A total of 38 metaplastic breast cancer cases diagnosed between 2006-2018 at our center were included in the study. The patients were evaluated in terms of age, tumor size, localization, histological grade, hormone profiles (ER, PR, Her2-neu), American Joint Committee on Cancer (AJCC) Tumor, Lymph node status, Metastases (TNM) stage, progression, survival, radiological features, types of surgery and therapy modalities (chemotherapy and / or radiotherapy). Results: The age of the patients ranged between 32 and 95 years. Pathological evaluation of cases showed that 14 were pure epithelial (IC-NST + squamous cell carcinoma) and 24 were metaplastic carcinomas with mesenchymal differentiation. Ductal carcinoma in situ (DCIS) was accompanying an invasive component in twenty cases. Seventeen patients had lymph node metastasis. Twelve patients developed distant metastasis. Thirty patients were triple negative for hormone receptors. The mean follow-up period of the patients was 34 months. The estimated life expectancy was 116 months. All of the patients received chemotherapy and 28 patients received adjuvant radiotherapy. There was no correlation between tumor size and lymph node or distant metastasis in our series. Our findings are consistent with the literature. Conclusion: Metaplastic breast carcinoma is a rare entity among breast carcinomas. Metaplastic carcinomas of the breast draw attention with the differences in their clinical course and the radiological and pathological heterogeneity. [ABSTRACT FROM AUTHOR]

Primary breast sarcomas are very rare and account less than 1% of invasive breast carcinomas. Primary sarcomas of breast are leiomyosarcoma, angiosarcoma, liposarcoma, fibrosarcoma, rhabdomyosarcoma, malignant peripheral nerve sheath tumor and pleomorphic sarcoma. Recently, a new CD10 positive group of sarcoma was identified. These tumors cannot be classified as a soft tissue sarcoma and show diffuse strong positive staining pattern with CD10 (NSCD10). Herein we report clinical and morphological characteristics of two cases diagnosed with not otherwise specified-type sarcoma with CD10 expression by histologically and immunohistochemical findings with the literature. NSCD10 shows similarity with leiomyosarcoma and sarcomatoid-type metaplastic carcinoma histomorphologically among specific sarcomas of breast. CD10 expression should be taken into consideration in the presence of not diagnosed and not specified tumors and CD10 should be added to the immunohistochemical panel. [ABSTRACT FROM AUTHOR]

This study aimed presenting a case of a 64-year-old woman with a rare diagnosis of myofibroblastoma (MFB). MFB is one of the rare, benign, spindle-like stromal tumors arising from the connective tissue of the breast. MFBs are often confused with fibroadenomas and hamartomas because of their benign characteristic appearance on breast imaging and are diagnosed after excisional biopsies. Their differential diagnosis with malignant neoplasia of the breast is important because of their wide morphological spectrum. Our case also demonstrated a breast mass with benign imaging characteristics and a needle core biopsy revealing a benign, spindle-like stromal tumor. The pathological examination performed after the excision of the lump demonstrated a collagenous-/fibrous-type MFB. This case report emphasizes the rare but important place of MFB variants of the breast in the differential diagnosis of breast mass. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Pathologists Purview of Breast Calcifications" by S. Sankaye and S. Kachewas.

A letter to the editor is presented discussing thymolipoma which is associated with myasthenia gravis.

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.

This pictorial essay presents the common radiological (mammography and/or ultrasonography) and pathological findings observed in unusual malignant breast lesions, which include well-differentiated subtypes of invasive ductal carcinoma not otherwise specified (tubular, mucinous, papillary, and medullary carcinomas), metaplastic carcinoma, and metastases. This study also includes unusual ultrasonographic appearances of a plasmacytoma.

Lymphoepithelial cysts are usually benign lesions of unknown etiopathogenesis. They develop in the lateral aspect of the neck and their diagnosis is mainly made with histopathologic examination. Total excision is the primary method for treatment. A 43-year-old woman presented with a swelling on the left side of her neck. Computed tomography of the neck showed a cystic lesion. Fine needle aspiration cytology yielded a diagnosis of benign epithelial cyst. The lesion was totally excised. Histopathologic examination of the specimen was reported as lymphoepithelial cyst. No complications were encountered in the postoperative period.