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Benign natural killer cell enteropathy (NKCE) was first identified in the gastrointestinal (GI) tract. Notably, instances of NKCE have previously been observed at various sites other than the GI tract, including the gallbladder, lymph nodes, esophagus, and female genital tract. Typical NKCE manifests as an NK‐cell immunohistological phenotype, with or without TCR rearrangement, and is characterized by the absence of Epstein–Barr virus (EBV) infection and protracted clinical progression. The misdiagnosis of NKT‐cell lymphoma has resulted in some patients receiving chemotherapy, while in other instances, the patients' conditions resolved without treatment and showed no evidence of disease recurrence or progression during follow‐up examinations. In this paper, we describe a unique case of EBV‐negative NKCE occurring in the oral cavity, the first time such a case has been documented. The tumor completely resolved after an excisional biopsy, and subsequent follow‐up did not reveal any signs of disease recurrence. [ABSTRACT FROM AUTHOR]

The pelvic bone can be affected by a various diseases, including tumours. Cartilaginous tumours may develop in this area because it contains hyaline and fibrocartilage. The pelvis is known to host malignant tumours like chondrosarcoma. On the other hand, chondroma, a benign cartilaginous tumour, is occasional. Chondroma is known to occur in different osseous and extraosseous locations. Extraskeletal/soft-tissue chondroma, though rare, is known for its occurrence in various anatomical locations. Hereby, the authors present a case report of a chondroma in the prepubic space that manifested with urinary symptoms. A 58-year-old female, known to be diabetic, came with acute urinary retention. She experienced a recent onset of burning micturition and abdominal pain. Radiological and cytological findings were non diagnostic. During pelvic exploration, a solid mass of 3×3 cm was noted in the prepubic space without a connection to the urinary bladder or underlying bone. Excisional biopsy of the mass showed benign mature chondrocytes in a background of chondroid matrix, suggesting a benign cartilaginous tumour (chondroma). The patient is now free of her symptoms and is doing well during the follow-up at three months. Authors could not find any case reports of chondroma in the prepubic space in the literature. The present case of extraskeletal chondroma in the prepubic space is an infrequent entity at an unusual site.

The pelvic bone can be affected by a various diseases, including tumours. Cartilaginous tumours may develop in this area because it contains hyaline and fibrocartilage. The pelvis is known to host malignant tumours like chondrosarcoma. On the other hand, chondroma, a benign cartilaginous tumour, is occasional. Chondroma is known to occur in different osseous and extraosseous locations. Extraskeletal/soft-tissue chondroma, though rare, is known for its occurrence in various anatomical locations. Hereby, the authors present a case report of a chondroma in the prepubic space that manifested with urinary symptoms. A 58-year-old female, known to be diabetic, came with acute urinary retention. She experienced a recent onset of burning micturition and abdominal pain. Radiological and cytological findings were non diagnostic. During pelvic exploration, a solid mass of 3×3 cm was noted in the prepubic space without a connection to the urinary bladder or underlying bone. Excisional biopsy of the mass showed benign mature chondrocytes in a background of chondroid matrix, suggesting a benign cartilaginous tumour (chondroma). The patient is now free of her symptoms and is doing well during the follow-up at three months. Authors could not find any case reports of chondroma in the prepubic space in the literature. The present case of extraskeletal chondroma in the prepubic space is an infrequent entity at an unusual site. [ABSTRACT FROM AUTHOR]

Mucoceles occur due to blockage of the salivary gland ducts, while lipomas occur due to disorders of fat metabolism which are usually found subcutaneous and are very rarely found in the inner lip area. This current case reported two diagnoses for lumps which occurs in the inner lip in adjacent area that is lipomas and mucoceles. A 12 year old boy came with complaints of two lumps on the mucosa of the lower lip in adjacent regions. At least medical and dental history also provided the anatomical pathology examination revealed. The first lump contains cells that represent a mucocele, while the second lump indicates a lipoma. The treatment carried out is gradual excisional biopsy to avoid excessive trauma. It is important to confirm the diagnosis with an anatomical pathology examination so that right treatment can be determined. [ABSTRACT FROM AUTHOR]

Lymphadenopathy in an immunosuppressed patient raises the quintessential diagnostic dilemma: infection or malignancy? We present the case of a transplant recipient on anti-rejection prophylaxis admitted with acute fever, malaise and a swollen right axillary node. The patient had pancytopenia and tested positive for Epstein–Barr virus; nodal core biopsy demonstrated atypical plasma cell infiltration, immediately raising suspicion for post-transplant lymphoproliferative disorder. However, excisional biopsy and Bartonella henselae serology clarified a final diagnosis of cat-scratch disease—a potentially fatal zoonosis requiring a disparate treatment regimen. Here, we explore this patient's investigations, hospital course and recovery, with an emphasis on recognizing and differentiating these diagnostic mimics in post-transplant practice. [ABSTRACT FROM AUTHOR]

Chondroid syringoma is a rare tumor of sweat gland origin. Usually benign, malignant transformation is more commonly seen in tumors of pedal origin, making this a concerning clinical finding. This case study reviews the identification, diagnosis and treatment of a benign chondroid syringoma in the right second toe of a patient.

Fibreoptic mammography is widely recognised as the first screening method for pathologic papillary overflow due to its significant advantages in the diagnosis of ductal dilatation, intraductal papilloma and intraductal carcinoma. The use of fibreoptic ductoscopic excisional biopsy techniques, such as biopsy needles, vacuum negative pressure aspiration, biopsy forceps and grasping baskets, has not been promoted largely due to their existing deficiencies. The imaging effect of fibreoptic ductoscopy compared with electronic ductoscopy is also one of the important factors limiting the progress of microscopic excisional biopsy techniques. Finding a more suitable operating space for electronic fibreoptic ductoscopy and the use of electrosurgical excision biopsy techniques should be the focus of research in view of achieving accurate diagnoses in electronic fibreoptic ductoscopy and microscopic excision biopsy. In this review, the development history, clinical application and existing problems of fibreoptic ductoscopy are reviewed and assessed to provide references for the clinical diagnosis and treatment of pathologic papillary overflow.

Aim: Describe the results of brachytherapy in the prevention of recurrences in conjunctival melanoma (CM) and describe a dosimetric protocol. Methods: Retrospective and descriptive case report. Eleven consecutive patients with a confirmed histopathological diagnosis of CM treated with brachytherapy between 1992 and 2023 were reviewed. Demographic, clinical, and dosimetric characteristics as well as recurrences were recorded. Quantitative variables were represented by the mean, median, and standard deviation, and qualitative variables by frequency of distribution. Results: Of a total of 27 patients diagnosed with CM, 11 who were treated with brachytherapy were included in the study (7 female; mean age at time of treatment: 59.4 years). Mean follow-up was 58.82 months (range 11–141 months). Of a total of 11 patients, 8 were treated with ruthenium-106 and 3 with iodine-125. Brachytherapy was performed in 6 patients as adjuvant therapy after biopsy-proven CM on histopathology and in the other 5 patients after recurrence. The mean dose was 85 Gy in all cases. Recurrences outside of the previously irradiated area were observed in 3 patients, metastases were diagnosed in 2 patients, and one case of an ocular adverse event was reported. Conclusion: Brachytherapy is an adjuvant treatment option in invasive conjunctival melanoma. In our case report, only one patient had an adverse effect. However, this topic requires further research. Furthermore, each case is unique and should be evaluated by experts in a multidisciplinary approach involving ophthalmologists, radiation oncologists, and physicists. [ABSTRACT FROM AUTHOR]

Objective: Excisional lymph node biopsies are usually conducted in a minor procedure room under local anesthesia, and in some cases, they can also be carried out in an operating room under general anesthesia. Our study aims to compare the diagnostic accuracy, pathological results, and necessity for biopsy repetition of excisional lymph node biopsies performed in both the minor procedure room and the operating room. Materials and Methods: This study provides a retrospective analysis encompassing 60 patients who underwent excisional lymph node biopsy procedures. Within the ambit of this investigation, a comparative analysis is conducted on the outcomes of lymph node excision procedures, differentiating those carried out in the minor procedure room from those executed in the operating room. Results: Out of 47 excisional lymph node biopsy samples conducted in the minor procedure room, 45 had a diagnostic feature, while among the 13 excisional lymph node biopsy samples performed in the operating room conditions, 12 had a diagnostic feature. The entirety of samples obtained in the operating room concurred with pathology reports, and 88.9% of the samples taken in the minor procedure room demonstrated congruence between pathology report outcomes and clinical findings. In two cases where a definitive diagnosis could not be established, repeat biopsies were administered; however, alterations in the final biopsy results were observed in only one of these patients. Conclusion: Considering factors like cost and the achievement of similar outcomes in both methods, we believe that conducting excisional lymph node biopsies in the setting of a minor procedure room is a preferable option. [ABSTRACT FROM AUTHOR]

Objective: Surgical excisional biopsy is accepted as the standard of care approach in the diagnosis of lymphomas. Financial issues related to the increased cost and the invasive nature of the procedure forced physicians to use some alternative diagnostic methods. Percutaneous core needle biopsy, which gained a reputation for the diagnosis of lymphomas with the advent of improved pathological, immunohistochemical, and molecular analysis, made it possible to have an accurate diagnosis with limited tissue samples. In this retrospective study, we aimed to compare the diagnostic yield of surgical excisional biopsy and core needle biopsy. Materials and Methods: This study included 131 patients who were diagnosed with lymphoma with a nodal biopsy which was acquired via surgical excisional biopsy or core needle biopsy between 2014 and 2020 in our center. Around 68 patients underwent surgical excisional biopsy and the remaining 63 underwent core needle biopsy. Samples that allowed to the identification of the exact tumor type and/or subtype were accepted as fully diagnostic. Sufficient amount of tissue that the pathologist could have any suspicious findings considering malignant lymphoma was classified as partial diagnostic group. Inadequate samples were the ones who were not enough to report any final diagnosis. Results: The patients who underwent a core needle biopsy were significantly older than the patients who underwent to surgical excisional biopsy (56.8 vs. 47.6, P = .003). Despite the full diagnostic ability of surgical excisional biopsy outperformed core needle biopsy (95.2 % vs. 83.8 %, P = .035), in 92.6% of the patients whose tissue samples were obtained via core needle biopsy were accepted to have a sufficient diagnosis to initiate the treatment and not required a second biopsy, which was comparable with the ones achieved by surgical excisional biopsy (92.6% vs. 95.2%, P = .720). Conclusion: According to the results obtained in our study, we may conclude that core needle biopsy is a viable and comparable alternative to surgical excisional biopsy, offering a less invasive and less-expansive approach. [ABSTRACT FROM AUTHOR]

Although not as common as solitary lesions, multiple schwannomas do occur, even in single nerve lesions. We report a rare case of a 47-year-old female patient who presented with multiple schwannomas with inter-fascicular invasion in the ulnar nerve above the cubital tunnel. Preoperative MRI revealed a 10-cm multilobulated tubular mass along the ulnar nerve above the elbow joint. During excision under 4.5° loupe magnification, we separated three ovoid yellow-colored neurogenic tumors of different sizes, but there were still remaining lesions as it was difficult to completely separate lesions from the ulnar nerve due to the risk of iatrogenic nerve ulnar nerve injury. The operative wound was closed. Postoperative biopsy confirmed the diagnosis of the three schwannomas. During the follow-up, the patient recovered without neurological symptom or limitations in range of motion, and there were no neurological abnormalities. At 1 year after surgery, small lesions remained in the most proximal part. However, the patient had no clinical symptoms and was satisfied with the surgical results. Although a long-term follow-up is necessary for this patient, we were able to obtain good clinical and radiological results. [ABSTRACT FROM AUTHOR]

Lymph node biopsy is indicated in patients with suspected malignancy or lymphadenopathy due to unclarified reasons. Lymph node biopsy can be performed as fine needle aspiration biopsy, core biopsy, or excisional lymph node biopsy. In particular, the diagnosis of malignant lymphoma is considered insufficient for oncological treatment unless classified into subgroups. Core biopsy and excisional biopsy can be performed to diagnose lymphoma and classify it into subgroups. Core biopsy may also be limited in some cases for the diagnosis of lymphoma. Therefore, patients are referred to surgical departments for excisional lymph node biopsy. It was aimed herein to analyze the results of excisional lymph node biopsies performed for diagnostic purposes in our department. Data on 73 patients having undergone diagnostic excisional lymph node biopsy at Sakarya University Medical Faculty Training and Research Hospital between January 2008 and January 2020 were retrospectively analyzed. Patients were evaluated in terms of age, gender, biopsy site, pathological diagnosis, number and diameter of lymph nodes excised. Patients younger than 18 years of age, those with sentinel lymph node biopsies, and lymph node dissections performed for any known malignancy were excluded from the study. Statistical data analysis was done using SPSS statistical software. There were 37 (50.7%) female and 36 (49.3%) male patients, mean age 52.07 (18-90) years. Axillary lymph node biopsy was performed in 32 patients, inguinal lymph node biopsy in 29 patients, cervical lymph node biopsy in 3 patients, intra-abdominal lymph node biopsy in 6 patients, mediastinal lymph node biopsy in 1 patient, and supraclavicular lymph node biopsy in 2 patients. All of the lymph node biopsies were performed as excisional biopsy. Malignancy was detected in 36 (49.3%) patients. In 37 (50.3%) patients, the causes of lymphadenopathy were found to be benign pathologies. When the causes of malignant disease were examined, it was observed that 23 (31.5%) patients were diagnosed with lymphoma. Hodgkin lymphoma was detected in 5 patients diagnosed with lymphoma, and non-Hodgkin lymphoma was found in 18 patients. Metastatic lymphadenopathy was observed in 13 (17.8%) patients. Reactive lymphoid hyperplasia (26%) and lymphadenitis (20.5%) were found among the causes of benign lymphadenopathy. The number of excised lymph nodes was between 1 and 4, and their diameter was between 9 and 75 mm (mean: 29.53±15.56 mm). There was no statistically significant difference between benign and malignant patients according to gender, age, lymph node diameter, number of lymph nodes excised, and excisional lymph node biopsy site. For diagnostic lymph node biopsy, fine-needle aspiration biopsy and core biopsy should be performed primarily. If lymphoma is suspected in the diagnosis, fine-needle aspiration biopsy is not necessary. In this case, it is believed that it is more appropriate to perform core biopsy first. If the core biopsy is insufficient for diagnosis, it is more appropriate to perform surgical biopsy in order to cause no delay in diagnosis and treatment. Excisional biopsy is a method that can be safely performed and does not cause severe morbidity in palpable peripheral lymphadenopathies. Although it does not cause severe morbidity because it is an invasive procedure, excisional biopsy should be performed in a selected patient group.

The finding of lymphadenopathy is usually the consequence of a benign infection, although a neoplastic origin must always be excluded. Through a careful anamnesis, physical examination, and serological tests several differential diagnoses are frequently possible. Nevertheless, sometimes an excisional biopsy of superficial lymph nodes is required, which is the best means to reach a definitive diagnosis. More concerns arise when lymphadenopathy is only abdominal/retroperitoneal: percutaneous biopsy is often inconclusive and the excisional node biopsy becomes a surgical procedure, certainly indicated in case of malignancy but avoidable in case of inflammatory diseases. We present the case of a 30-year-old man with a deep iliac lymphadenopathy who was evaluated at the Hematological Unit of Sapienza University of Rome. The enlargement of an iliac lymph node is quite unusual for an infectious disease. Although symptoms such as pain, fever, and chills suggested it was the case, cat-scratch disease was not hypothesized. Radiological investigations did not exclude a malignant disease and a laparoscopic excisional biopsy was scheduled, but the slight improvement of his spontaneous symptoms suggested a careful follow-up. Given the lack of disappearance of lymphadenopathy, the lack of diagnosis, and an ipsilateral superficial (inguinal) lymph node with similar ultrasonographic and radiological features, the patient underwent biopsy, which disclosed a diagnosis of cat-scratch disease, avoiding more invasive surgical procedures.

Objective: To investigate the diagnostic value of dermoscopy in defining the tumor margin of cutaneous squamous cell carcinoma (cSCC) for the appropriate surgical margin. Methods: A total of 90 cSCC patients were enrolled in the study. All patients were recruited into two groups: those who preserved intact macroscopic features of neoplasms without or after incisional biopsy and those with uncertain residual tumors after excisional biopsy. A dermoscopy-defined surgical margin of 8mm outward was used according to the tumor boundaries observed with the naked eye and dermoscopy. All excised tumor specimens were divided into serial sections according to the four "3, 6, 9, 12" directions at every 4-mm interval from the dermoscopy-detected tumor margin. Pathological examination was performed at 0 mm, 4 mm, and 8 mm margins to confirm tumor remnants. Results: Retrospective analysis of dermatoscopic results showed inconsistent clinical and dermatoscopic borders in 43 of 90 cases (47.8%). The ability of dermoscopy to detect tumor borders showed no statistical difference between the two groups (p > 0.05). In the unbiopsy or incisional biopsy group, 66.6% of the tumors were resected with a 4-mm margin and 98.3% with an 8-mm margin, with significant differences (p = 0.047). For patients with inconspicuous clinical evidence of residual tumor after excisional biopsy, the tumor clearance rate was 53.3% at 0 mm, 93.3% at 4 mm, and 100.0% at 8 mm. Statistically significant differences were noted between 0mm and 4mm (p = 0.017), as well as between 0 mm and 8 mm (p = 0.043) but did not differ between 4 mm and 8 mm (p > 0.05). Conclusions: Dermoscopy defined the tumor margin of cSCC better than visual inspection alone. Direct dermoscopic-guided surgery with at least 8-mm expansion was recommended for high-risk cSCC. Dermoscopy also assisted in identifying surgical margins at the healing biopsy site, making 8 mm still the recommended expansion range. [ABSTRACT FROM AUTHOR]

Primary bone lymphoma is a rare entity, accounting for approximately 3-7% of malignant bone tumors, 5% of extra-nodal lymphomas and < 1% of all non-Hodgkin lymphomas. Primary spine localized lymphoma is 1.7% of all primary bone lymphomas. A 73 year-old female presented with a two month history of severe backache. T1W and T2W MRI showed a hypointense soft tissue component extending from the left posterior elements to Th7 corpus. The patient underwent Th6-7-8 total laminectomy. Th7-8 extradural mass was totally resected. Excisional biopsy was performed through Th7 left pedicle and vertebroplasty was applied. Significant reduction in pain was seen postoperatively. The patient was diagnosed with diffuse large B cell lymphoma. The patient received combined treatment with R-CHOP chemotherapy and local radiotherapy. Any other lesions were not detected after the examinations following 6 months period and it was accepted as primary bone lymphoma. [ABSTRACT FROM AUTHOR]

Background: To determine the clinical and histopathological characteristics of malignant tumors of the eyelid in terms of our region. Materials and Methods: 120 patients' files who were diagnosed with malignant eyelid tumor and followed up between January 2018 and September 2021 were scanned retrospectively in our clinic. Demographic and clinical characteristics, clinical and histopathological diagnoses, methods and follow-up results in surgical cases were recorded from the patients' files. Excisional biopsy material was obtained in all patients who underwent surgery. Results: 120 cases were included in the study. 54 (45%) of the patients were male and 66 (55%) were female. The mean age was 62.5 (35-80) years. The mean follow-up term was 20,4 months (3-36 months) for all cases. In 80% (n=96) of malignant eyelid tumors, clinical preliminary diagnosis and histopathological examination results were found to be compatible. Preoperative clinical diagnosis and postoperative histopathological diagnosis differed in 24 cases (20%). The recurrence rate was found to be 3% in all of our patients. The recurrence rates were 2% in Basal Cell Carcinoma cases and 5% in Squamous Cell Carcinoma cases. Considering the location of the tumors, 80 patients had left eyelid involvement and 40 patients had right eyelid involvement. Conclusions: Surgical excision and histopathological examination in malignant eyelid tumors are the most accurate and reliable options as they provide both diagnosis and treatment at the same time. When a malignant eyelid tumor is suspected, patients should be referred to an oculoplastic surgeon experienced in ocular oncology. [ABSTRACT FROM AUTHOR]

Background: The problem of unplanned surgical resection of breast cancer is a common clinical problem encountered in our practice. It represents a demanding challenge for oncoplastic surgeons that often limits the available options for definitive surgery due to unplanned skin incision, unreliable vascular anatomy, and obscure safety margin status. Patients and Methods: The authors retrospectively reviewed the data system of the hospital for patients diagnosed with breast cancer between June 2008 & June 2018. 490 patients had unplanned resected breast cancers (Tx) and were enrolled in this study. The epidemiologic, pathologic, and operative data of these patients were analysed. Results: The average annual rate of unplanned resected breast cancer (Tx) in our hospital was about 17% among the new cases diagnosed with breast cancer. The age of the patients ranged from 21 to 57 (median 42.2)years. 409 patients underwent mastectomy (MRM or radical) without reconstruction and 14 patients received conventional conservative breast surgery. While 10 patients had volume displacement oncoplastic surgery and 57 patients had volume replacement oncoplastic surgery. Subjective patient satisfaction was excellent in 55 cases, good in 22 cases, fair in 3 cases & poor in one case. Conclusion: Unplanned excision of breast cancer is still a surgical challenge; however, the application of oncoplastic techniques with wise selection results in a satisfactory aesthetic outcome, low morbidity, and comparable oncologic outcome. [ABSTRACT FROM AUTHOR]

Objective: Cervical lymphadenopathy (LAP) is one of the most common pathologies in adults and children. While ultrasonography (USG) and fine needle aspiration biopsy (FNAB) are the two methods used as diagnostic tests, excisional biopsy is the gold standard method for diagnosis. In this study, we aimed to show the relationship between USG findings and FNAB results with malignancy in patients with LAP. Materials and methods: Patients who visited our clinic with the complaint of cervical LAP between March 2020 and September 2022 and underwent excisional biopsy were included in this retrospective study. The number, distribution, side, size, cortical thickness, conglomeration, and necrosis characteristics of LAP were evaluated on USG. The sensitivity and specificity of the FNAB were calculated in patients in accordance with the histopathological results. Results: Of the patients included in the study, 45 were female and 42 were male. The overall mean age was 32.72 ± 20.02. The sensitivity of the FNAB was 43.5% and the specificity was 90.0%. Advanced age, presence of conglomeration, unilateral LAP, and generalized LAP were found to be statistically significant in terms of malignancy, while cortical thickness, the number and size of LAPs, and necrosis were not statistically significant. Conclusion: FNAB was not found to be a reliable test to rule out malignancy due to low sensitivity for determining malignancy and but was found to be a highly selective test, and the malignancy-suspected result detected the real patients quite successfully. The advanced age, unilateral LAP, generalized distribution, and conglomeration were the parameters supporting malignancy. [ABSTRACT FROM AUTHOR]

The finding of lymphadenopathy is usually the consequence of a benign infection, although a neoplastic origin must always be excluded. Through a careful anamnesis, physical examination, and serological tests several differential diagnoses are frequently possible. Nevertheless, sometimes an excisional biopsy of superficial lymph nodes is required, which is the best means to reach a definitive diagnosis. More concerns arise when lymphadenopathy is only abdominal/retroperitoneal: percutaneous biopsy is often inconclusive and the excisional node biopsy becomes a surgical procedure, certainly indicated in case of malignancy but avoidable in case of inflammatory diseases. We present the case of a 30-year-old man with a deep iliac lymphadenopathy who was evaluated at the Hematological Unit of Sapienza University of Rome. The enlargement of an iliac lymph node is quite unusual for an infectious disease. Although symptoms such as pain, fever, and chills suggested it was the case, cat-scratch disease was not hypothesized. Radiological investigations did not exclude a malignant disease and a laparoscopic excisional biopsy was scheduled, but the slight improvement of his spontaneous symptoms suggested a careful follow-up. Given the lack of disappearance of lymphadenopathy, the lack of diagnosis, and an ipsilateral superficial (inguinal) lymph node with similar ultrasonographic and radiological features, the patient underwent biopsy, which disclosed a diagnosis of cat-scratch disease, avoiding more invasive surgical procedures. [ABSTRACT FROM AUTHOR]

Background: Primary bone lymphoma is a rare type of lymphoid neoplasm with favorable prognosis, where Primary Non Hodgkin Lymphoma of bone (PB-NHL) is most common with the subtype. Amongst PB-NHL, diffuse large Bcell lymphoma represents the majority of cases. The mandible is a very uncommon site of involvement, presenting as a painful bone mass with high suspicion of osteomyelitis. Methods: We report the case of a 45-year-old male with no significant past medical history who was admitted to the hospital with a large right jaw mass and pain after recent tooth removal. The original tissue biopsy was not diagnostic, and cultures were found to be negative for microorganisms. Due to enlargement of the mass, a fine needle aspiration (FNA) was done. At the time of rapid onsite evaluation of the FNA, atypical lymphoid cells were seen, and material was obtained for flow cytometry (FC) evaluation. This revealed an aberrant clonal B-cell population. The consequent immunohistochemical evaluation of original material supported the diagnosis of PB-NHL. After chemotherapy patient improved. Results: After an extensive English language literature review, we identified and summarized the clinical presentations, diagnostic procedures, histopathologic features, treatment methods, and outcomes of forty-two cases of periodontal PB-NHL. Based on our findings, we propose a set of clinical features at initial presentation to increase the clinical suspicion of periodontal PB-NHL for practitioners. Conclusion: Based on our institution's experience and the literature review conclusions, we propose the University of Texas Medical Branch diagnostic approach for PB-NHL and suggest that FNA and FC should be utilized as the essential diagnostic component. The fast and efficient diagnosis of PB-NHL can facilitate the correct treatment and sufficiently improve patient care. [ABSTRACT FROM AUTHOR]

Purpose: When Core Needle Biopsy (CNB) demonstrates Atypical Ductal Hyperplasia (ADH), Flat Epithelial Atypia (FEA), Intraductal Papilloma (IDP), or Radial Scar/Complex Sclerosing Lesion (RS), excisional biopsy (EB) is often performed to rule out underlying malignancy with upstage rates (UR) ranging between 1 and 20%. The COVID-19 pandemic led to delayed EB for many patients. We sought to evaluate whether this delay was associated with higher UR. Methods: We performed a retrospective analysis of women who underwent CNB and then EB for ADH, FEA, IDP, or RS between 2017 and 2021 using an IRB-approved repository. UR was evaluated by days between CNB and EB. Results: 473 patients met inclusion. 55 were upstaged to cancer (11.6%). 178 patients had pure ADH on CNB and 37 were upstaged (20.8%). 50 patients had pure FEA and 3 were upstaged (6%). 132 had pure IDP and 7 were upstaged (5.3%). 98 had pure RS and 1 was upstaged (1%). 7/15 (46.7%) had a combination of diagnoses or diagnosis with palpable mass and were upstaged. Days between CNB and EB were < 60 for 275 patients (58.1%), 60–90 for 108 (22.8%), 91–120 for 43 (9.1%), and > 120 for 47 (9.9%). There was no significant difference in UR (10.9% for < 60, 14.8% for 60–90, 7% for 90–120, and 12.8% for > 120, p = 0.54). UR for ADH was clinically increased after 60 days (27.8 vs. 17.5%), but this did not reach statistical significance (p = 0.1). Conclusion: Surgical delay was not associated with an increased UR. [ABSTRACT FROM AUTHOR]

• Excisional biopsy was associated with less available pathologic data. • Missing pathologic data was associated with lower rates of neck dissection. • Missing pathologic data was associated with lower rates of radiation. • Excisional biopsy was associated with lower regional control. [ABSTRACT FROM AUTHOR]

Biopsy in simple terms means removal of a tissue from a living person for diagnostic purposes. It helps in differentiating an abnormal tissue from a normal one. It helps in diagnosis of various cancers, tumors or any unidentified growth seen during clinical examination. To evaluate the different types of intraoral biopsy procedures performed in an institutional setup in 1 year. It is designed as a retrospective study. A total of 234 patient records who had a growth intraorally and required investigation for the same were acquired. It was done analysing records of 86000 patient data who were treated from March 2019-March 2020. Descriptive statistics were used to analyse the frequency and percentage of the different intraoral biopsies performed. Chi square test was used to evaluate the correlation between age and gender with the different types of biopsy procedures performed. SPSS version 20 software was used to perform statistics. Out of the total data extracted, 80.3 percent underwent incisional biopsy, in 17.5% excisional biopsy was carried out, 1.3% underwent FNAC procedures and 0.9% other biopsy techniques were performed. Maximum biopsy procedures were carried out between the age group of 40-60 years. More cases were seen among the male population. Age had a positive relation with the type of biopsy performed when chi square test was done p value less than 0.05. Gender a negative correlation with the type of biopsy performed p value more than 0.05.Incisional biopsy was found to be the most commonly performed type of biopsy. Age had a positive correlation with the type of biopsy performed. Gender did not have a significant correlation with the type of biopsy performed. [ABSTRACT FROM AUTHOR]

This study was conducted to evaluate the diagnostic accuracy of the cervical biopsy under colposcopic vision. This retrospective study was performed on 190 women, who were selected from a total of 412 cases referring for colposcopy in one year. All patients underwent colposcopy and loop electrosurgical excision procedure (LEEP). After the investigation of demographic characteristics and data confirmation, colposcopic characteristics were examined. Then, the diagnostic indicators and diagnostic accuracy of the cervical biopsy under colposcopic vision were determined. The mean age of patients was 35.51± 5.91 years. In smokers, the percentage of cancer and CIN3 cases was higher than in normal individuals, and this difference was statistically significant in terms of the frequency of cancerous lesions (P = 0.2). A comparison of colposcopic biopsy with LEEP has shown that the frequency of advanced cases in LEEP has been detected more, and the correlation coefficient (kappa) indicated the weak agreement between the findings of colposcopically directed biopsy (CDB) and LEEP methods. (k = 0.23). The diagnostic accuracy of the cervical biopsy under colposcopic vision for cervical cancer is effectively high. It is recommended that this procedure be performed to diagnose cancerous lesions; however, contrary to what is seen in colposcopy, malignant cases may be spreading and follow-up of patients can affect therapeutic performance. [ABSTRACT FROM AUTHOR]

The present study reports a rare case of skin metastasis in a 26-year-old female patient with a history of PTC positive for the BRAF V600E mutation. During the 2.5-year follow-up period after the initial surgical treatment of PTC, no evidence of distant metastasis was found via thyroglobulin measurements, neck ultrasound, or neck and chest computed tomography. However, following this period, the patient reported two skin nodules on the left side of the neck. Ultrasound-guided punch biopsy was performed, and the pathology results demonstrated that the patient had skin metastases from the PTC. The patient received surgical resection and complete removal of nodules, and was subsequently discharged from the hospital. A literature review showed that there are numerous potential mechanisms for skin metastasis, and the treatments are diverse and dependent on the patient condition. While surgical treatment may effectively improve patient symptoms and prognosis, long-term surveillance for recurrence is recommended for high-risk cases. Skin metastasis of PTC should be suspected in patients who develop an upper body skin lesion with a history of PTC, even without evidence of disease metastasis. For high-risk patients with skin metastasis of PTC with BRAF and TERT gene mutations, long-term surveillance for recurrence should be recommended in cases with a poor prognosis, and further research of these cases should be conducted in the future to optimize surgical and medical care., Competing Interests: The authors declare that they have no competing interests., (Copyright: © 2024 Chu et al.)

Previously healthy Caucasian female in her 30s initially presented for progressively enlarging right-sided cervical lymphadenopathy with associated sore throat. After she completed 2 antibiotic regimens for presumed infection with no relief, a CT Neck with contrast was obtained which demonstrated multiple pathologic lymph nodes, the largest lymph node demonstrating central necrosis. Patient underwent fine needle aspiration with Otolaryngology, as well as core needle biopsy with Interventional Radiology, both of which were nondiagnostic. Subsequently, she underwent excisional lymph node biopsy with Otolaryngology. Pathology reported the presence of numerous budding, oval yeast-like cells in the necrotic areas, diagnostic of Histoplasma capsulatum lymphadenitis. She retrospectively received a CT Chest with contrast to confirm presence of pulmonary or mediastinal disease for disseminated histoplasma infection. Surprisingly, the CT Chest showed no evidence of disseminated disease, indicating a unique case of isolated histoplasma capsulatum cervical lymphadenitis., (Published by Elsevier Inc. on behalf of University of Washington.)

Background: The pathology and management of breast masses in pediatric patients is markedly different than in adults. The vast majority of lesions in children and adolescents are benign, but the rare malignant breast masses require prompt recognition and treatment. Pediatric surgeons navigating clinical evaluation of these masses must balance preservation of the developing breast with appropriate diagnosis and surgical management., Methods: The current English language literature was queried for pediatric and adolescent breast masses. Identified manuscripts were reviewed and classified by level of evidence. Based on these results, as well as expert consensus, an algorithm regarding clinical workup and management was established., Results: Evaluation of pediatric breast masses begins with a thorough history and physical exam. Palpable masses should then be further characterized using an ultrasound-guided algorithm. In select cases, observation without surgical resection is appropriate. Surgical management of presumed benign lesions, when performed, should prioritize conserving developing breast tissue and the nipple areolar complex. Excisional biopsy is preferable to core needle biopsy when technically feasible. Surgical management of malignant lesions varies depending on the type of malignancy., Conclusion: Pediatric surgeons are often the first point of contact after identification of a breast mass in a pediatric or adolescent patient, and therefore play a critical role in management. Based on literature review and expert consensus, we propose an algorithm to guide pediatric surgeons in the diagnosis and treatment of these predominantly benign lesions. For the rare malignant lesions, a multi-disciplinary team approach is recommended to optimize patient care., (Copyright © 2024. Published by Elsevier Inc.)

This study was conducted to evaluate the diagnostic accuracy of the cervical biopsy under colposcopic vision. This retrospective study was performed on 190 women, who were selected from a total of 412 cases referring for colposcopy in one year. All patients underwent colposcopy and loop electrosurgical excision procedure (LEEP). After the investigation of demographic characteristics and data confirmation, colposcopic characteristics were examined. Then, the diagnostic indicators and diagnostic accuracy of the cervical biopsy under colposcopic vision were determined. The mean age of patients was 35.51± 5.91 years. In smokers, the percentage of cancer and CIN3 cases was higher than in normal individuals, and this difference was statistically significant in terms of the frequency of cancerous lesions (P = 0.2). A comparison of colposcopic biopsy with LEEP has shown that the frequency of advanced cases in LEEP has been detected more, and the correlation coefficient (kappa) indicated the weak agreement between the findings of colposcopically directed biopsy (CDB) and LEEP methods. (k = 0.23). The diagnostic accuracy of the cervical biopsy under colposcopic vision for cervical cancer is effectively high. It is recommended that this procedure be performed to diagnose cancerous lesions; however, contrary to what is seen in colposcopy, malignant cases may be spreading and follow-up of patients can affect therapeutic performance.

PurposeTo present the case of a 12-year-old female with an epibulbar osseous choristoma.ObservationsThe patient presented with right-sided conjunctival mass, which caused her discomfort. Slit lamp examination revealed a 5×5-mm, firm nodule in the superotemporal quadrant of the bulbar conjunctiva. The nodule had feeder vessels, adhered firmly to the sclera, and lacked signs of malignancy. The patient underwent excisional biopsy under general anesthesia. During this procedure, great care was taken to avoid perforation of the globe. The pathologic sections were significant for well-circumscribed osseous tissue without atypia.Conclusions and importanceWe describe diagnosis and successful surgical management of osseous choristoma the rarest subtype of ocular choristoma. With only 65 cases reported since mid-19th century, the condition remains poorly described. This report provides additional information on diagnosis and treatment of this rare condition.

Masson's tumor or intravascular papillary endothelial hyperplasia (IPEH) is a benign vascular lesion usually involving the head-and-neck region. On histopathological examination, it consists of reactive proliferation of endothelial cells with papillary formations which is the key to diagnosis. This rare entity was first described in 1923 by Pierre Masson. Lesions involving orbit and eyelids have been reported before. Here, we report a case of Masson's tumor which occurred in the lid margin and later in the conjunctiva which regressed completely after excision.

Schwannomas, the most frequently occurring benign tumors of the peripheral nerve sheath, generally remain as painless swellings for several years before diagnosis. Multiple schwannomas involving different nerves within the same extremity are rare. We report a rare case of a 61-year-old female patient who presented with multiple schwannomas in the palmar common and proper digital nerves, 15 years after the resection of a median nerve schwannoma within the same upper extremity. Using pre-established diagnostic criteria, she was diagnosed with segmental schwannomatosis. After careful surgical resection, biopsy confirmed the diagnosis, and she recovered without neurological symptoms or limitations in the range of motion. A literature review revealed only four case series on segmental schwannomatosis, indicating its rarity. Postoperative sensory deficits are more likely in cases with multiple schwannomas in the common and proper digital nerves. We demonstrate that such complications can be avoided by meticulous dissection and separation of the tumors from the nerve fibers. [ABSTRACT FROM AUTHOR]

Peripheral ossifying fibroma (POF) is one of the inflammatory reactive exophytic nodular growth, commonly occurring on the gingiva. It is seen more often in females, in the interdental papilla and anterior part of the maxilla. It represents unique clinical characteristics and diverse histopathological features. Surgical excision is the treatment of choice but with a reported recurrence rate of 7%–45%. In the present case report, a 15-year-old female patient reported with the chief complaint of painless swelling in the mandibular anterior region. An excisional biopsy was obtained and sent for histopathological diagnosis. On histopathological examination, it was confirmed as POF. The purpose of this article is to present a case of POF and review the current literature on this condition, so that, such condition can be treated through proper diagnosis and treatment planning.

Introduction. Russia has a high mortality rate of cutaneous melanoma – 2.5 per 100,000 population whereas the incidence rate is 7.7 per 100,000 population, i.e. one in every three patients dies. In the foreign countries (the USA, Australia), melanoma mortality rate is 10-15%. Such high rates are explained by the fact that patients with early-stage disease do not seek medical advice, as in early stages a tumour does not cause inconvenience to a patient and looks like an ordinary mole.The purpose of the study was to confirm the advisability of removing a progressive dysplastic nevus (grade 3 lentiginous melanocytic dysplasia) with a view to prevent and make early diagnosis of cutaneous melanoma.Materials and methods. The authors removed 180 pigmented lesions that were clinically diagnosed as a progressive dysplastic nevus in the Surgery Department of Central Polyclinic of Literary Fund from 2009 to March 2020. The patients were referred to the Surgery Department by physicians, dermatologists and other specialists of the polyclinic. Following an oncologist consultation, excisional biopsy of a nevus was performed under local anesthesia.Results. Histological examination revealed 29 (16%) dysplastic nevi with grade 3 LMD and 18 (10%) early-stage melanomas.Conclusions. If excisional biopsy of a dysplastic nevus becomes routine in Ambulatory Surgery practice, it will increase the early diagnosis of melanoma and significantly reduce mortality rates of this disease. For excisional biopsy, the authors recommend to excise at a distance of 0.5 to 1.0 cm from the lesion boundaries, since it is not possible to clinically distinguish a progressive dysplastic nevus from early melanoma.

Reactive lesions of soft tissue are common oral lesions that are usually non-neoplastic growths without pain; however, they can interfere with oral hygiene and plaque control, and if present in the anterior segment, they can cause esthetics problems. In this case, there was a reactive lesion at the gingiva of the left maxillary central incisor area. The particular consideration about this case was the recurrence of a peripheral ossifying fibroma as a pyogenic granuloma, indicating the association between reactive gingival lesions. The history of several recurrences due to incomplete removal shows the importance of complete excision for preventing recurrence. Therefore, the lesion was completely excised, and the mucogingival defect was successfully augmented with periodontal plastic surgery.