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To assess the utility of Narrow Band Imaging (NBI) as a diagnostic tool in evaluating laryngeal pathology in patients presenting with hoarseness. Study design: Prospective cross sectional diagnostic study. Methods: 200 patients with voice change were recruited and laryngeal findings documented with high definition flexible endoscopy with both white light and narrow band light and the representative still images recorded for analysis. The NBI intraepithelial papillary capillary loop (IPCL) patterns was compared with the histopathology report. Of the 200 patients evaluated, 84 lesions were biopsied which included both benign and malignant lesions. The sensitivity obtained was 73.3% [54.1–87.7% with 95% CI] and the specificity was 87% [75.1–94.6% with 95% CI] for detecting malignant lesions. NBI can be considered as a useful diagnostic tool in evaluating laryngeal pathology and can be used to detect early premalignant and malignant lesions.

Guidelines generally focus on complete reporting of histopathology data in a standard format. We highlight the importance of effectively communicating the “message” to clinicians who do not view histology images. Communication issues related to each part of the histopathology report are outlined. We emphasize that reports must be unambiguous and include only relevant information so that the latter is not misunderstood or missed by the treating clinician. The specimen block key should be available to reporting and reviewing pathologists but does not have to be included in the report communicated to the clinical team. Pathologists should also be aware that they may be communicating directly with patients who read histopathology reports. Grade and stage represent biological continuums. In truly borderline cases, effective communication may be more important than precise grading or staging. We also provide advice on recording of other opinions that had been sought while reporting a case.

Chordoma is a rare and aggressive intracranial bone tumor that is difficult to diagnose and resect with a peak incident between the ages of 20–40 years old and high recurrence rate when not completely resected. We present the case of clival chordoma in an 11-year-old female patient, who reported with a chronic right-sided headache, progressive loss of vision, hoarseness of voice, and slurred speech. Fluid-fluid level on fluid-attenuated inversion recovery magnetic resonance imaging sequence can be an atypical radiological sign for clival chordoma. Thumbing of the pons as well as extension of the chordoma to the sinonasal, intracranial, vertebral, intraspinal, and orbital regions were observed. The patient underwent partial resection of the tumor and discharge home after by the end of the third week after the surgery. Histopathology report confirmed the diagnosis of chordoma.

Guidelines focus on the accurate, reproducible and complete recording of histopathology data items, that they generally categorize as either core (mandatory) or non-core (recommended but not mandatory). We highlight some issues with this traditional approach and describe an approach focusing on the clinical utility of histopathology data and the importance of effectively communicating this data to the clinical team. A data item that is critical in one clinical scenario may be clinically irrelevant in another setting. Awareness of how histopathology data is used to guide patient management could help pathologists focus limited resources for maximum clinical benefit. Clinicians do not generally view histological material and are often entirely dependent on the histopathology report. It is therefore critical that the histopathological information is appropriately communicated. Effective communication is more important than precision when reporting morphological/biological continuums such as tumour grade. Histopathology reports should be brief without redundant, unnecessary, or duplicated information.

Prostate biopsy data are critical for patient management. Guidelines focus of detailed criteria to ensure that these are precisely and reproducibly reported. However, conflicting recommendations by different expert groups have led to significant reporting variation that could negatively impact patient care. We describe a different approach focusing on optimising communication of histopathological parameters such as tumour extent and grade to the clinical team. Communication is crucial because clinicians usually do not view histological material and are dependent on the information included in the histopathology report. Precision could become less critical if the biopsy findings are effectively conveyed by the pathologist and correctly interpreted by the clinician. Strategies to effectively communicate the message in contentious scenarios such when a prostate needle biopsy set contains prostate cancer that is discontinuous, of borderline grade, of disparate grades or associated with intraductal carcinoma of the prostate are outlined.

Schwannoma of sinonasal origin are uncommon benign tumors of nerve sheath origin. Schwannomas arising from nasal septum usually come as a surprise in the histopathology report. Most of these tumors are amenable to complete removal via endoscopic approaches and no case of recurrence has been reported till date. The present report highlights a case of nasal septal schwannoma arising from posterior part of nasal septum in an elderly female, managed by complete surgical excision endoscopically under general anesthesia. The patient remains free of disease at 2 ½ years follow up. This case emphasizes a need of keeping this rare pathology in the list of differential diagnosis for nasal/ septal masses and a high index of suspicion for this condition for which a single stage low morbidity curative treatment can be offered to the patient.

La mucosectomía endoscópica ha probado ser una alternativa efectiva para el tratamiento del cáncer gástrico temprano; sin embargo, se requiere de un seguimiento estricto para asegurar una conducta de manejo adecuada en caso de recurrencia. Se presenta el caso de un paciente de 54 años, con hallazgo incidental de un carcinoma gástrico temprano, a quien se le realizó mucosectomía endoscópica, con un reporte final de histopatología compatible con adenocarcinoma gástrico temprano y márgenes de resección negativos, con un seguimiento endoscópico e histopatológico a 2 meses negativos para malignidad.

18F-2-fluoro-2-deoxy-D-glucose ([18F]-FDG) positron emission tomography (PET) CT has proven useful in the evaluation of high-grade glioma and is also useful as a predictor of the degree of malignancy in newly diagnosed brain tumors. It is commonly accepted that high-grade gliomas are characterized by increased FDG uptake, whereas the low-grade glioma demonstrates reduced or absent FDG uptake. [18F]-FDOPA is an amino acid PET tracer which is a marker of the proliferative activity of brain tumors and demonstrates positive uptake in all grades of brain tumors; however, the degree of tracer uptake is significantly higher in high-grade tumors as compared to low-grade tumors. Here, we discuss a case where both FDG and DOPA PET/CT scans raised suspicion of low-grade glioma; however, the final histopathology report confirmed WHO grade IV Glioblastoma.

The measurement of quality matrix has become increasingly important in current health care environment. Quality management system have been recommended by accreditation bodies to reduce errors in surgical pathology but there is strong need of standardization so that errors are kept to minimal thereby improved patient care. The histopathology report influences patient treatment decisions and therefore a good histopathology report should be reliable, timely, addressing to clinician demand. Any error has lethal consequences for patients. The paper gives a lucid review of quality control in histopathology. Keywords: Histopathology, Quality control, Laboratory.

This article will provide the practising obstetrician with a general guide to the structure and interpretation of the histopathology report, with a focus on placental and perinatal autopsy reports. The relevance and readability of a histopathology report is heavily dependent on the quality of clinical information provided by the referring clinician. Walkthroughs of example placental and autopsy reports are provided, along with examples of pathologies and their possible significance to the underlying diagnosis.

Gall bladder small cell carcinoma (scc) comprises of 0.5% of all GB cancers. It carries a poor prognosis in view of its aggressive nature. We here report a case of small cell carcinoma GB 55-year old lady presented with features of obstructive jaundice with significant weight loss. Examination revealed hard lump in right upper abdomen with multiple scratch marks all over the body. Clinically she had jaundice. Blood investigations revealed hyperbilirubinemia. Tumour markers showed raised CA 19-9. Staging CECT thorax and Abdomen reported polypoidal enhancing wall thickening of gall bladder with multiple metastatic deposits close to pancreatic head encasing main portal vein and common bile duct. Histopathology was suggestive of small cell carcinoma. Patient was referred to Oncology department and is receiving palliative cisplatin-etoposide chemotherapy

To determine the clinical outcome and significance of pathological necrosis after neoadjuvant chemotherapy.The retrospective study was conducted in Shaukat Khanum Memorial Cancer Hospital and Research Center and comprised data from January 2010 to December 2015 related to young with newly diagnosed Ewing sarcoma on histopathology. Data was collected on patients aged20 years of either gender along with primary tumour site, metastatic status, tumour volume, mode of local therapy, degree of necrosis post-surgery, tumour margins after resection, outcome at the end of treatment and at last follow-up visit. Tumours were categorised as grade I = little or no necrosis, grade II = 50-90% necrosis, grade III = 90-99% necrosis, and grade IV = 100% necrosis. Data was analysed using SPSS 20.Of the 124 patients, 89(72%) were non-metastatic; 35(28%) were metastatic; 37(29.8%) underwent surgery; 58(46%) received radiotherapy; 7(5.6%) received both surgery and radiotherapy; 22(17.7%) received no treatment. Histopathology report post-surgery showed little grade 1 necrosis in 10(8%) patients, grade II in 8(6.5%), grade III in 8(6.5%) and grade IV in 14(11%). Event-free survival in grade IV necrosis was 93% in 14 (11.3%) patients, EFS in grade III necrosis was 71% in 8(6.5%) patients , EFS in grade II necrosis was 22% seen in 9(7.3%) patients and EFS in grade- I necrosis was 35% seen in 14 (11.3%) patients. Overall survival in grade IV necrosis was 93% in 14 (11.3%) patients, OS in grade III 75% seen in 8(6.5%), OS in grade II 25% seen in 9(7.3%) and OS in grade I was 50% in 14(11.3%) patients. Event-free survival was 48 (38%) patients and overall survival of Ewing sarcoma patients was 52 (46.6%) patients respectively.Tumour necrosis and histopathological changes post-surgery were found to have great impact on survival outcome in Ewing Sarcoma.

Highlights • Warthin-like variant of Papillary thyroid carcinoma (WLPTC) is an uncommon variant of PTC. • The management of WLPTC patient is similar to that of PTC and depends on the stage of the disease. • This patient had lymph node metastasis, still she is doing well four years after treatment., Background Warthin-like variant of Papillary thyroid carcinoma (WLPTC) is an uncommon variant of PTC. They resemble Warthin tumour of salivary gland. Microscopically the tumour shows presence of papillae lined by oncocytic cells with typical nuclear features of PTC. The stalks of papillae were filled up with lymphoplasmacytic cells. WLPTC have good prognosis. Case report A 45-year-old lady presented with thyromegaly. She underwent total thyroidectomy with bilateral selective neck dissection (level II – level VI). Her final histopathology report was WLPTC, Right lobe with lymph nodal metastasis. Post-operatively, she received I131 radio-iodine therapy. She is under follow-up for last four years and is doing well. Conclusion Diagnosing WLPTC, a rare variant of PTC can be challenging. Definitive diagnosis helps in management.

Purpose: To report the long-term follow-up results after surgical excision of migrated Bio-Alcamid fillers to the Periorbita area. Methods: A retrospective case series of all patients who underwent surgical removal of migrated Bio-Alcamid fillers to the Periorbita area with minimal follow-up of 1 year from January 2009 to January 2018 was done. Results: 16 female patients (24–52 y) presented with an upper or lower eyelid swelling 3–7 years following a filler injection in the nasal bridge, temporal or malar area. All patients had surgical excision of a granulomatous mass ranging in size from 1–3.5 cm. The histopathology report revealed a giant cell reaction in all patients. Follow–up periods ranged from 1 to 8 years. One patient developed lid retraction and another had recurrence 3 years later; the remaining had an unremarkable course. Conclusions: Filler migration is one of the potential complications associated with Bio-Alcamid soft tissue injection. It is important for all physicians to assess nodules/masses/swelling in the facial area to be aware that soft tissue fillers may migrate to a location away from their intended site of injection years after the injection. Patients undergoing surgical excision tend to have favorable overall long-term outcomes in terms of aesthetics and incidence of recurrence. Keywords: Polyalkylimide, Filler, Periorbita, Permanent

Supernumerary teeth as mesiodentes in adults are a rare condition. Given that mesiodentes often interfere with the eruption of normal permanent incisors, the majority are diagnosed in teenagers. In some cases, this pathology is associated with the presence of a dentigerous cyst. Imaging techniques play a significant role in the diagnosis of cysts, particularly cone beam computed tomography (CBCT). Once the correct diagnosis is established, appropriate therapeutic measures – usually surgical – should be initiated promptly. The case presented here is that of a 55-year-old male with an extensive dentigerous cyst arising from a maxillary mesiodens. The decision was made to perform enucleation of the cyst along with the mesiodens inside it. The procedure was performed under general anesthesia. No complications were observed in the postoperative period. The histopathology report confirmed a dentigerous cyst. Radiograph images obtained 10 months post-surgery showed spontaneous bone tissue reconstruction.

The surgeon involved in the management of breast disease must work as part of an effective multidisciplinary team. The surgeon must work with all team members communicating effectively and working together. Histopathology provides diagnostic, prognostic and predictive information. The surgeon must understand the implications of the histopathology report for effective patient management. Improvements in core biopsy techniques have provided additional information resulting in lower open biopsy rates and improved pre-operative diagnostic rates for facilitating surgical planning. Assessment of margin status, lymph node status and prognostication are continually evolving and shaping surgical practice towards less surgical intervention in the field of breast disease.

Appendicular mucinous neoplasms are a collection of rare tumors with diverse clinical presentations and pathologic potential, which can cause diagnostic and therapeutic challenges. Traditionally, they are diagnosed by radiologic imaging or identified intraoperatively; however, rarely, they may be diagnosed during an endoscopic procedure. In this unusual case, we present the case of a 62-year-old Caucasian male undergoing routine surveillance colonoscopy due to a history of colonic neoplasia. During the colonoscopy, a submucosal, non-bleeding 1cm mass of benign appearance was found in the appendix. Further workup determined the mass was likely a mucocele, and surgical consultation was recommended. The patient denied any symptoms suggestive of a mucinous neoplasm prior to and during evaluation. A laparoscopic appendectomy was subsequently performed, and the histopathology report confirmed the diagnosis of a low-grade appendiceal mucinous neoplasm. The patient recovered without complications and continued to deny any symptoms during his postoperative course and follow-up care. Given their rare incidence and unpredictable nature, appendiceal mucinous neoplasms remain difficult to identify. Discovering a low-grade mucinous neoplasm in an asymptomatic patient via colonoscopy illustrates the spectrum of unique presentations and modalities for diagnosis.

Arsha is a gift of modern diets and busy lifestyles & many people are suffering from some sort of Anorectal disorder. It may be simple constipation to complex carcinoma, in which prominent disorder is Arsha. Derangement of Jatharagni leading to vitiation of Tridosha, mainly vata dosha these vitiated Doshas get localized in Gudavali and Pradhana dhamani which further vitiates Twak, Mamsa, and Meda Dhatus leads to development of Arsha. The perianal skin is most pain sensitive, due to rich nerve endings. Hence even a mild form of disorder can produce great discomfort to the patient. On the basis of observation and statistics we got positive response for this parameters Malabaddhata 23 (71.88%), Abhishyandiahar 23 (71.88%), Guruahar 27 (84.38%), Diwaswap 18 (56.25%), Adhyashana 27 (84.38%), Prushtayana 29 (90.63%), Vegavidharana 32 (100%), Shavathu 24 (75%), Mamsashotha 19 (59.38%), Siragranthi 26 (81.25%), Amlika 21 (65.62%), Paridaha 18 (56.25%), Atop 28 (81.25%), Antrakujan 22 (68.76%), Gudaparikartan 32 (100%). In histopathology report we found fibromuscular tissue, stratified squamous epithelium, dilated and congested blood vessels which is the moolsthana of mamsavaha strotas. That means mamsavaha strotas dusti is co related with bahya arsha. This shows that there is significant correlation of origin of Bahya Arsha from Mamsavaha strotas dushti. Keywords- Arsha, mamsavaha srotas, dushti, malabaddhata, guda, histopathology

Fallopian tubal molar pregnancy is extremely rare, and the main diagnostic tool is the post-operative histopathological diagnosis, as the pre-operative diagnosis is difficult. We report a case of ectopic partial molar pregnancy in the right fallopian tube of a 35-year-old lady that was sent for routine histopathological examination with the clinical diagnosis of ectopic pregnancy and the histopathology report revealed an unusual result.

To evaluate and compare the diagnostic accuracy of detecting malignant cervical lymph nodes using Clinical evaluation, CT scan and Ultrasonography and conrmation with histopathology in patients with squamous cell carcinoma. Atotal number of 30 patients, of both sexes, with carcinoma of different regions of the oral cavity, conrmed with incisional biopsy were included in this study. We found USG to be most sensitive (83.5%), followed by CT (78.3%) and clinical evaluation (63.7%). Similarly, CT scan was found to be most specic (81.5%), followed by USG (78.2%) and clinical evaluation (60.7%).

OSSEOUS CHORISTOMA OF THE TONGUE: A RARE ENTITYDilpreet Kaur 1, Dr Aznim Hani2 Otorhinolarngology Department of Hospital Putrajaya, Pathology Department of Hospital Putrajaya, MalaysiaIntroductionAn Osseous Choristoma is a rare benign lesion composed of normal matured bone tissue seen in a location where bone tissue is not normally found. This is a case report of a Osseous Choristoma found on the tongue in a 16-year-old female who presented to our clinic in Hospital Putrajaya. She first noticed a swelling two years ago which has been recently increasing in size although was not causing any problems to her.Physical examination showed a 1.5 x 1.5 cm smooth surfaced lesion located on the left side of the tongue. On palpation the lesion was stony hard. Mobility of the tongue was normal.A wide local excision was done under general anesthesia and the histopathology report was a Osseous choristoma. She came for follow up a month after the procedure and there was no evidence of any recurrence.Objective: To report a rare case of Osseous choristoma of the tongueMethod: - Result: -Conclusion: Lingual Osseous choristoma is a rare benign oral lesion. The management is complete wide local excision.

Introduction Teratoma is a germ cell tumor composed of elements from one or more of the three embryonic germ layers. The most common sites of occurrence in childhood are the sacrococcygeal region, gonads, mediastinum, and pineal region and rarely head and neck.[1–6] Cervical teratoma is a rare congenital disease that constitutes about 1–6% of all pediatric teratoma.[3,5] Few of these cervical tumors are very rarely located entirely in the thyroid gland which are called thyroid teratomas.[3,5–8] Case presentation 17 days old female neonate born to a 32 years old Para III mother presented with right lateral neck swelling and respiratory distress since birth. The neonate underwent surgical excision at age of 20 days through a right transverse cervical incision and the intraoperative finding was a lobulated well defined capsulated cervical tumor measuring 4 * 4 cm with a cystic and solid component. The right lobe of the thyroid gland was not localized, but the left lobe of the thyroid gland was present laterally. Since the tumor has raised from the right lobe of the thyroid gland than from the soft tissue of the neck the tumor is defined as thyroid teratoma instead of cervical teratoma. Besides, the histopathology report confirmed this diagnosis which showed tissue composed of cystic and solid components consisting of the thyroid gland, brain tissue, and skin with the appendages with no immature tissues seen. Conclusion thyroid teratoma is extremely rare and about 41 cases have been reported in the English literature so far.[5] It is usually benign; however, if not treated properly they can lead to death because of large growth and local effect on vital structures like airway compression.

Background It is common for patients to enter Barrett's oesophagus (BO) surveillance based on endoscopic appearances before the diagnosis is histologically confirmed. We set out to review this practice by establishing the accuracy of endoscopic diagnoses of BO. Methods All gastroscopy reports in which a diagnosis of BO was recorded were reviewed over one year. These were compared to the histopathological reports to assess diagnostic accuracy. Results BO was diagnosed in 84 procedures. This diagnosis was incorrect according to histology in 42.9% (n=36) of cases. Diagnostic accuracy was higher with gastroenterologists (38.8% incorrect, n=21) compared to surgeons (50% incorrect, n=15). Diagnostic accuracy was higher with consultants (34.9% incorrect, n=22) compared to registrars (66.7% incorrect, n=14). The dose of sedation used had no impact on accuracy. Unnecessary surveillance was booked in 36.1% (n=13) of cases. Conclusion It is insufficient to rely on endoscopic appearances alone to diagnose BO, irrespective of speciality or experience. The diagnosis should only be made after reviewing the histopathology report. This can eliminate unnecessary repeat endoscopy procedures, sparing patients from unjustifiable risk and helping to cut down on long waiting lists in endoscopy departments. The implementation of the Prague classification and Seattle protocol can improve diagnostic accuracy.

Purpose: Guaiac fecal occult blood test (gFOBT) has been the standard for colorectal screening but it has low sensitivity and specificity. This study evaluated the use of fecal tumor M2-pyruvate kinase (M2-PK) for detection of colorectal cancer and to compare with the current surveillance tool; gFOBT in symptomatic adult subjects underwent colonoscopy.Methods: Stool samples were collected prospectively from symptomatic adults who had elective colonoscopy from September 2014 to January 2016 and were analyzed with the ScheBo M2-PK Quick test and laboratory detection of fecal hemoglobin.Results: The results were correlated to the colonoscopy findings and/or histopathology report. Eighty-five subjects (age of 56.8 ± 15.3 years [mean ± standard deviation]) were recruited with a total of 17 colorectal cancer (20.0%) and 10 colorectal adenoma patients (11.8%). The sensitivity of M2-PK test in colorectal cancer detection was higher than gFOBT (100% vs. 64.7%). M2-PK test had a lower specificity when compared to gFOBT (72.5% vs. 88.2%) in colorectal cancer detection. The positive and negative predictive values were 47.2% and 100% for M2-PK test and 57.9% and 90.9% for gFOBT.Conclusion: Fecal M2-PK Quick test has a high sensitivity for detection of colorectal cancer when compared to gFOBT, making it the potential choice for colorectal tumor screening biomarker in the future.

Background/Aim. The outcome of rectal cancer is dependant on the stage of the tumour. There are several classification systems used to describe the extent of the disease. The aim of this study was to compare the efficacy of transrectal ultrasonography (TRUS) in preoperative local staging of rectal cancer using endosonographic probes with different views (180? vs 360?), as well as an influence of experience of an endoscopist on the TRUS performance. Methods. TRUS was performed in 127 patients with rectal carcinoma by two endoscopists. Seventy-one patients were examined with a 180? endosonographic probe (group A) and 56 patients with a 360? rotating probe (group B). All findings were compared with a histopathology report. Results. TRUS had a diagnostic overall accuracy of 91.3% for the tumor (T) category (k = 0.866, SE (k) = 0.038, p < 0.0001) and 71.7% for the node (N) category (? = 0.374, SE (k) = 0.082, p < 0.0001). In the group A, TRUS had a diagnostic overall accuracy of 88.7% for the T category (? = 0.805, SE (k) = 0.063, p < 0.0001), and 70.4% for the N category (? = 0.376, SE (k) = 0.101, P < 0.0001). In the group B, TRUS had a diagnostic overall accuracy of 94.6% for the T category (? = 0.920, SE (k) = 0.044, p < 0.0001), and 73.2% for the N category (? = 0.379, SE (k) = 0.131, p = 0.004). Experience of the endoscopist had no significant influence on results of preoperative staging of rectal cancer by using TRUS. Conclusion. The accuracy rate of TRUS in the preoperative local staging of rectal cancer is high. Our results imply no significant difference in the overall accuracy rates when using endosonographic probes with different views (180? vs 360?). Also, there was no significant influence of endoscopist experience on results obtained.

Angiomyolipoma (AML) is a mesenchymal tumor that arises from perivascular epithelioid cells most commonly seen in the kidney and rarely in extrarenal sites. Adrenal AML is a rare clinical entity with only 16 cases reported in the literature according to the World Health Organization report in 2017. We present a 68-year-old male evaluated in our emergency room with worsening chronic right upper quadrant abdominal pain. Computerize tomography (CT) revealed a large right adrenal mass. Adrenelectomy was performed, and the histopathology report confirmed the diagnosis and the tumor size was the largest ever reported. Patient was discharged uneventfully.

Introduction. Gleason score, the most widely used grading system for prostatic adenocarcinoma, is the most powerful predictor of patient’s clinical outcome and is used to customize treatment strategies. It possesses an inherent degree of subjectivity, as inter-observer and intra-observer variability does exist. Moreover, there are currently no structured histopathology report guidelines for prostate needle biopsies in our setting, making relevant information overlooked by pathologists and interpretation of report between laboratories challenging. Objective. With these in mind, we sought to study the interobserver variability of Gleason score and completeness of histopathology report in prostate needle biopsy specimens. Methdology. A set of 19 prostate needle biopsy slides was sent to 18 general pathologists from different institutions in the Philippines for histopathologic analysis of Gleason scores and completeness of reporting. The interobserver agreement of each pathologist will be evaluated using Spearman’s rank correlation coefficient. Results. Overall, there was moderate correlation between the interobserver’s Gleason score and Gleason grade group. Low to moderate correlation was seen in primary grade while negligible correlation was seen in secondary grade. Best agreement was seen in poorly differentiated neoplasms. Undergrading was more common than overgrading. Most respondents gave an incomplete histopathology report. Conclusion. There is an overall moderate correlation between Gleason score. A non-standardized histopathology report is currently used, leaving out relevant histopathologic findings.

Introduction: Involving approximately 4% of malignancies in women, ovarian cancer remains one of the most fatal cancers. However, it is important to consider conditions which are not primary ovarian diseases, but mimic their behaviors. In the present study, the epidemiological characteristics of extra-ovarian conditions mimicking ovarian masses are evaluated. Methods: This cross-sectional study was conducted on patients with a primary diagnosis of ovarian mass who underwent surgery by gynecologists between January 2012 and March 2016. The surgeon’s primary diagnosis and the final histopathology assessment report were evaluated for each patient. In cases where the final histopathology report was not in the spectrum of gynecologic pathology, possible reasons for incompatibility were investigated. Results: Ultimately, 1876 patients with a mean age of 48.26±15.4 years underwent analysis. Among these patients, 27 (1.4%) had masses of a non-gynecologic origin. The final diagnoses were divided into four main categories: masses with a gastrointestinal origin (55.5%), infectious (18.5%), those with a retroperitoneal origin (18.5%), and embryologic-origin masses (7.4%). Conclusion: The results suggest that extra-ovarian diseases should be considered in differential diagnoses of patients with a primary diagnosis of ovarian cancer. Furthermore, it was found that metastases from gastrointestinal tract tumors and infectious diseases are the most common pathologies among extra-ovarian conditions.

Introduction. Improving the quality of surgical resections by evaluating surgical specimens is probably the most important feedback a surgeon can receive. Moreover, prognosis of patients with colon cancer is based on achieving appropriate resection margins and assessment of lymph node status. For these reasons we aim to provide a retrospective analysis on colon cancer specimens operated by a single surgical team. Materials and Methods. 88 patients operated between 2013 and 2016 were included in the study. Data were gathered prospectively and assessed by multivariate analysis for the main variables (age, gender, tumor staging, specimen length, distance to closest resection margin, number of lymph nodes, and number of positive lymph nodes). Results. The mean number of lymph nodes excised was 31,9, with more after right colectomies (39.6) than after left colonic resections (29.1). The average specimen length was 29.2cm after right colectomies, 35.6cm after left hemicolectomies and 18cm after segmental colectomies. There was a significant correlation between the number of lymph nodes, specimen length, and age of patients. Conclusion. Lymph node status is correlated with specimen length and age. The standard of 12 lymph nodes was achieved and surpassed, being comparable to the benchmark literature. Standards on colon resections need to be reevaluated as many surgeons are pressured by quality measurements which do not always reflect sound oncologic principles.

Nasopharyngeal masses in young males, first of all presumes Juvenile Nasopharyngeal Angiofibroma (JNA) in the mind, but other benign or malignant tumors should be considered for successful and adequate management of patients and also for minimizing morbidity from unnecessary interventions. We herein present a patient with nasopharyngeal carcinoma (NPC) mimicking JNA. The patient was presumed as JNA and underwent excessive surgical intervention and the final histopathology report was NPC. The aim of our case report is to highlight the importance of complete clinical examination and preoperative imaging in differentiating and ideal management of nasopharyngeal masses.

Introduction and aims Double-balloon enteroscopy has been improving the visualization of the entire intestine for more than a decade. It is a complementary method in the study of intestinal diseases that enables biopsies to be taken and treatments to be administered. Our aim was to describe its main indications, insertion routes, diagnostic/therapeutic efficacy, and complications. Materials and methods All patients referred to our unit with suspected small bowel pathology were included. The insertion route (oral/anal) was determined through diagnostic suspicion. The variables measured were: insertion route, small bowel examination extent, endoscopic diagnosis/treatment, biopsy/histopathology report, complications, and surgical findings. Results The study included 28 double-balloon enteroscopies performed on 23 patients, of which 10 were women and 13 were men (mean age of 52.95 years). The oral approach was the most widely used (n = 21), the main indication was overt small bowel bleeding (n = 16), and the general diagnostic rate was 65.21%. The therapeutic intervention rate was 39.1% and the procedure was effective in all the cases. The most widely used treatment was argon plasma therapy (n = 7). The complication rate was 8.6%; one patient presented with low blood pressure due to active bleeding and another had deep mucosal laceration caused by the argon plasma. Conclusions Double-balloon enteroscopy is a safe and efficacious method for the study and management of small bowel diseases, with an elevated diagnostic and therapeutic rate.

The diagnosis and confirmation of oral SCC (squamous cell carcinoma) is still dependent on histopathology report in spite of development of radiological investigations. It is, thus important to understand the underlying molecular mechanisms and how the alterations in metabolic pathways effect the tumor development and progression. The simultaneous and comprehensive information about the presence and absence of small molecule metabolites and their relative concentrations has been provided by 1 H HR-MAS NMR spectroscopy on tissue specimens. In this paper a unique case study was presented in order to correlate histological and NMR spectroscopic findings. The patient’s initially lesion was found to be non-malignant in nature based on histological findings but its periodic localized recurrence even after laser ablation prompted us to perform HR-MAS based analysis and its role in identifying the metabolic alterations in known pathways occurring during its progressions. Thus it was confirmed after analysis that HR-MAS NMR can also be used as an analytical tool which is reliable in order to distinguish between malignant and non-malignant tissues, in combination with histopathology.

Lipoblastoma is a rare benign tumour which originates from an adipose tissue. In this study we report the case of a three year old boy who presented with a large intrathoracic tumour occupying the whole of the left hemithorax. He presented in severe respiratory distress. A chest X-ray showed total opacity of the left hemithorax, and CT-scan showed a low attenuation mass inkeeping with fat in the left hemithorax. A complete resection of a tumour was undertaken, with histopathology report confirming the diagnosis of lipoblastoma. The relevant literature review was done. At three and six months follow up, there was no recurrent tumour on imaging and the child had started thriving well.

El cáncer de la glándula tiroides es una neoplasia cuya detección, diagnóstico y tratamiento se realiza de manera interdisciplinaria, por lo tanto, el diagnóstico definitivo histopatológico debe ser completo y claro; de modo que pueda ser interpretado de la misma manera por parte del grupo médico tratante. De manera frecuente, los médicos no patólogos que reciben el reporte de un estudio histopatológico de tiroides se enfrentan con dificultades al momento de interpretar el reporte histopatológico y, por lo tanto, en definir la posterior conducta médica. El objetivo de este primer artículo es revisar de manera breve algunos de los diferentes temas que más generan dudas en la interpretación del reporte histopatológico y de las técnicas diagnósticas usadas en patología por parte de los médicos tratantes que tienen un impacto en las decisiones clínicas originadas a partir de la clasificación, estadificación, pronóstico y seguimiento de la enfermedad. Cancer of the thyroid gland is a neoplasia for which its detection, diagnosis and treatment is interdisciplinary. For this reason, the definitive diagnosis by histopathology should be complete and clear so that it can be interpreted in the same way by the treating medical group. Non-pathology physicians who receive the report of a histopathological study of the thyroid often have difficulties when interpreting the report and therefore in defining the subsequent medical behaviour. The objective of this first article is to review briefly some of the different subjects that generate most doubts in the interpretation of the histopathology report, and the diagnostic techniques used in pathology by the attending physicians that have an impact on clinical decisions arising from the classification, staging, prognosis, and follow-up of the disease

Descriptive pathology is essential for writing histopathological reports. It is often performed the pressure of time and accuracy. Precision is important because the patient is still alive and the pathologists must act quickly on the diagnosis. Most of the reports are reviewed and produced by a single pathologist. Therefore, it is possible to make errors or mistakes. Therefore, it is usually possible to make mistakes in writing a biopsy report A clear unambiguous writing style is important to meet the report's requirements. This review article provides a comprehensive review of different parameters to be considered in writing oral lesion histopathology report

Lipoblastoma/Lipoblastomatosis is a rare benign neoplasm that derives from embryonic adipose tissue, most often encountered as a rapidly growing painless mass in infants and children. The treatment of choice includes a complete, but conservative excision and surveillance of recurrence. Long-term follow-up is required since this tumor locally recurs in up to 25% of the cases. The authors describe a 13-year-old female who underwent tumor resection of a mass localized in the abdominal wall. A complete resection was undertaken, with histopathology report confirming the diagnosis of lipoblastoma. She maintains free of disease with a follow-up of 8 months. A relevant literature review was done. The authors want to make aware of and remind this rare entity when diagnosing children with rapid-growing mass and also describe current management paradigms for this uncommon tumor. Keywords: Lipoblastoma, Pediatric, Benign tumor