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Objective: Only a few papers in the literature aimed to evaluate biopsy core lengths. Additionally, studies evaluated the core length with different approaches. We aimed to determine whether prostate cancer (PCa) detection is affected from core lengths according to three different approaches in a large standard cohort and compare our cut-off values with the published cut-offs. Material and methods: We retrospectively analyzed 1,523 initial consecutive transrectal ultrasound-guided 12-core prostate biopsies. Biopsies were evaluated with respect to total core length (total length of each patients' core) average core length (total core length divided by total number of cores in each patient), and mean core length (mean length of all cores pooled), and compared our cut-off values with the published cut-offs. The prostate volumes were categorized into four groups (<30, 30-59.99, 60-119.99, ≥120 cm³) and PCa detection rates in these categories were examined. Results: PCa was found in 41.5% patients. There was no difference between benign and malignant mean core lengths of the pooled cores (p>0.05). Total core length and average core length were not significantly associated with PCa in multivariate logistic regression analyses (p>0.05). The core lengths (mean, average and total core lengths) increased (p<0.001) and PCa rates decreased (p<0.001) steadily with increasing prostate volume categories. PCa percentages decreased in all categories above the utilized cut-offs for mean (p>0.05), average (p<0.05), and total core lengths (p>0.05). Conclusion: There was no difference between mean core lengths of benign and malignant cores. Total core length and average core length were not significantly associated with PCa. Contrary to the cut-offs used for mean and average core lengths in the published studies, PCa rates decrease as these core lengths increase. Larger studies are necessary for the determination and acceptance of accurate cut-offs. [ABSTRACT FROM AUTHOR]

Objective: Inter-observer differences in the diagnosis of HPV related cervical lesions are problematic and response of gynecologists to these diagnostic entities is non-standardized. This study evaluated the diagnostic reproducibility of "cervical intraepithelial neoplasia" (CIN) and "squamous intraepithelial lesion" (SIL) diagnoses. Material and Method: 19 pathologists evaluated 66 cases once using H&E slides and once with immunohistochemical studies (p16, Ki-67 and Pro-ExC). Management response to diagnoses was evaluated amongst 12 gynecologists. Pathologists and gynecologists were also given a questionnaire about how additional information like smear results and age modify diagnosis and management. Results: We show moderate interobserver diagnostic reproducibility amongst pathologists. The overall kappa value was 0.50 and 0.59 using the CIN and SIL classifications respectively. Impact of immunohistochemical evaluation on interpretation of cases differed and there was lack of statistically significant improvement of interobserver diagnostic reproducibility with the addition of immunohistochemistry. We saw that choice of treatment methods amongst gynecologists varied and overall concordance was only fair to moderate. The CIN2 diagnostic category was seen to have the lowest percentage agreement amongst both pathologists and gynecologists. We showed that pathologists had diagnostic "styles" and gynecologists had management "styles". Conclusion: In summary each pathologist had different diagnostic tendencies which were affected not only by histopathology and marker studies, but also by the patient management tendencies of the gynecologist that the pathologist worked with. The two-tiered modified Bethesda system improved diagnostic agreement. We concluded that immunohistochemistry should be used only to resolve problems in select cases and not for every case. [ABSTRACT FROM AUTHOR]

Benign osteoblastoma is an uncommon bone tumor, representing 1% of all benign tumors and 3% of all primary bone tumors. Intranasal or paranasal osteoblastoma is particularly rare. Osteoblastoma occurs more frequently in males, at a peak age between 10 and 20 years. We report an osteoblastoma of the nasal septum in an 11-year-old boy who presented with swelling of the nasal septum. The diagnosis and management of this unusual lesion, as well as the histopathology and imaging characteristics, are reviewed. Magnetic resonance imaging (MRI) revealed a solid midline nasal mass originating from the septum with intense contrast enhancement. There was no evidence of osteoid or chondroid matrix mineralization on computed tomography (CT). Biopsy was performed. Histologically, the tumor contained abundant plump osteoblast-like cells, with eosinophilic cytoplasm and large nuclei that were frequently juxtaposed to the newly formed osteoid. Conservative excision was performed. The literature concerning occurrence of osteoblastoma in this unusual location is reviewed. [ABSTRACT FROM AUTHOR]

The present study investigated how reflux-induced esophagitis affects the smooth muscle reactivity of the esophageal body. Two different esophagitis models were used: acid gastric and mixed duodenogastric reflux. All test animals apart from the controls developed gross and histologic evidence of esophagitis. Contractile (carbachol and KCI) and relaxant (isoproterenol) esophageal smooth muscle responses were significantly decreased in the presence of acid- and mixed reflux-induced esophagitis. Similar relaxant responses to serotonin and papaverine were found in the three groups. Our study demonstrated impaired esophageal smooth muscle reactivity when esophagitis was induced by acid or mixed reflux. These changes may correspond to the functional motor abnormalities of the esophagus seen in patients with reflux esophagitis. KEY WORDS: gastroesophageal reflux; duodenogastric reflux; smooth muscle; rat. [ABSTRACT FROM AUTHOR]

Uterine prolapsus constitutes a major indication for hysterectomy in clinical practice. In this study, we evaluated the incidental histopathologic findings in hysterectomy specimens removed for uterine prolapsus. All patients treated with hysterectomy—with or without salpingo- oophorectomy—between 1997 and 2004 for the diagnosis of uterine prolapse were retrieved from the histopathology files. There were 68 cases available. The mean age of the patients was 59.5 years (range, 38–77 years), and 69.1% were over 50 years of age. Incidental findings were identified in 36 of 68 cases (52.94%). Microscopic abnormalities of no clinical relevance in uterus included leiomyoma (20 cases), adenomyosis (14 cases), endometrial polyp (three cases), and one case of endometritis. Cases with significant microscopic findings were identified as five cases of simple hyperplasia and one case of endometrioid adenocarcinoma. Additionally, a case with a focal CIN 2 was identified in the cervix. We strongly encourage a microscopic evaluation of all the normal-looking hysterectomy specimens, as the occasional presence of malignant tumors—either in the endometrium or the cervix—can only be accurately diagnosed by microscopic examination. (J GYNECOL SURG 21:133) [ABSTRACT FROM AUTHOR]

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.

Objective: Inter-observer differences in the diagnosis of HPV related cervical lesions are problematic and response of gynecologists to these diagnostic entities is non-standardized. This study evaluated the diagnostic reproducibility of "cervical intraepithelial neoplasia" (CIN) and "squamous intraepithelial lesion" (SIL) diagnoses., Material and Method: 19 pathologists evaluated 66 cases once using H&E slides and once with immunohistochemical studies (p16, Ki-67 and Pro-ExC). Management response to diagnoses was evaluated amongst 12 gynecologists. Pathologists and gynecologists were also given a questionnaire about how additional information like smear results and age modify diagnosis and management., Results: We show moderate interobserver diagnostic reproducibility amongst pathologists. The overall kappa value was 0.50 and 0.59 using the CIN and SIL classifications respectively. Impact of immunohistochemical evaluation on interpretation of cases differed and there was lack of statistically significant improvement of interobserver diagnostic reproducibility with the addition of immunohistochemistry. We saw that choice of treatment methods amongst gynecologists varied and overall concordance was only fair to moderate. The CIN2 diagnostic category was seen to have the lowest percentage agreement amongst both pathologists and gynecologists. We showed that pathologists had diagnostic "styles" and gynecologists had management "styles"., Conclusion: In summary each pathologist had different diagnostic tendencies which were affected not only by histopathology and marker studies, but also by the patient management tendencies of the gynecologist that the pathologist worked with. The two-tiered modified Bethesda system improved diagnostic agreement. We concluded that immunohistochemistry should be used only to resolve problems in select cases and not for every case.

Sinonasal teratocarcinosarcoma is an extremely rare malignant neoplasm presenting with the characteristics of a malignant teratoma and carcinosarcoma. The most common sites of origin of teratocarcinosarcomas are the nasal cavity and paranasal sinuses. The clinical presentation is usually with nasal obstruction and episodes of epistaxis. Teratocarcinosarcomas are aggressive and rapidly growing tumors with a poor prognosis. The incidence of sinonasal teratocarcinomas is higher in men than women. Treatment is primarily surgery, followed by radiotherapy. In this article, we report a 46-year-old male case of sinonasal teratocarcinosarcoma who was admitted with complaints of pain and swelling around the right eye and treated surgically followed by radiotherapy.

In childhood mature cystic teratomas are the most common type of ovarian germ cell tumors. Tumors of neuroepithelial origin are extremely rare in mature teratomas. To the authors' knowledge, this is the first case report oligodendroglioma arising in a mature cystic ovarian teratoma in children. A 13-year-old girl presented with a history of pelvic pain for 2 months. An ultrasound examination showed a monolateral multicystic, calcific ovarian mass, measuring approximately 6 x 5 cm, arising in the left over and adnexia, suggesting a teratoma. An exploratorative laparotomy and ooferectomy were performed. On histopatological examination, various samples from cystic areas had mature tissues from all 3 germ cell layers, including skin, bone, bronchial structures, and cerebellum. Sections from solid areas showed uniform population of monotonous, rounded cells with indistinct cytoplasm and having perinuclear halo (fried-egg appearance) on a fibrillary, neuropilic background. Microcalcifications as calcospherites were noted in the stroma. Based on the typical morphological features, the cased was diagnosed as mature cystic teratoma with low-grade oligodendroglioma. To the authors' knowledge, there are a few reports in the literature of an oligodendroglioma arising in an ovarian teratoma in adults and this presented patient is the first case in childhood.

Objective: To evaluate the effect of a copper intrauterine device on the expression of mucin- 1 (MUC1) and İntegrin β1 in the luteal phase endometrium., Material and Methods: 25 regularly menstruating women (25-35 years) who were willing to use copper intrauterine device contraception participated in this study. Endometrial sampling via a Pipelle canulla was performed on the 24(th) day of their cycle and repeated three months after insertion of TCu380A IUD. Immunohistochemical staining was performed for MUC1 and integrin β1 in the endometrial sections. Staining intensity was graded under the conventional light microscope., Results: The mean age of the study population was 32.8±5.3 years (25-35). MUC1 expression of the endometrial luminal epithelium cytoplasm and the luminal epithelium increased significantly after three months of IUD usage (p=0.01; p<0.001 respectively). Neither integrin β1 expression of endometrial luminal epithelium cytoplasma nor of the endometrial stroma changed after three months of IUD usage (p=0.16; p=0.22 respectively)., Conclusion: The increase of the embryo implantation inhibitor MUC1 synthesis may be responsible for the IUD's mechanism of action for pregnancy prevention. Integrin β1 expression of the endometrial luminal epithelium cytoplasm and stroma are not affected by the use of copper IUD.

Skin metastasis from laryngeal carcinoma is rare and indicates a poor prognosis. A case of laryngeal carcinoma with unusual metastasis to the skin of the hand is reported. The patient underwent total laryngectomy, left radical neck dissection, and right functional neck dissection. After the operation, the patient received radiotherapy. In the postoperative 18th month, a mass was observed in the left hand. It was found to be a metastatic tumor from laryngeal carcinoma, histopathologically as well as immunohistochemically. Metastatic potential in malignant neoplasms is generally correlated with reduced cellular adhesiveness. We investigated the expression of the vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9), and E-cadherin. Interestingly, the immunohistochemical expression characteristics of such an aggressive tumor were not positive.