OBJECTIVE:We aimed to analyze the clinical presentation, imaging, histopathology, and surgical management of pediatric intraabdominal cysts, which are relatively common but diverse lesions that pose diagnostic challenges.MATERIALS AND METHODS:We conducted a retrospective analysis of pediatric intraabdominal cysts from 2010 to 2021 in a single tertiary center. We collected data on demographics, symptoms, radiological findings, surgical approaches, and histopathological diagnoses and compared them with the current literature.RESULTS:A total of 36 cases were included. There were 30 females and 6 males, aged 1 to 16 years. Abdominal pain was the most common symptom, followed by tenderness and distention. Diarrhea and vomiting were also reported in some cases. The cysts varied in size, location, and origin and were diagnosed as lymphangioma, mucinous cystadenoma, paratubal cyst, lowgrade mucinous neoplasm, mature cystic teratoma, duplication cyst, mesothelial cyst, pseudocyst, serous cystadenoma, and simple hepatic cyst. The surgical management depended on the type and location of the cysts and involved excision, oophorectomy, appendectomy, or resection.CONCLUSION:Pediatric intraabdominal cysts are heterogeneous lesions that require timely diagnosis and surgical resection. They may present with various symptoms and complications, depending on their size and location. Radiological and histopathological evaluation is essential for accurate diagnosis and optimal treatment.

Background: Ependymomas (EPNs) of the spinal region are a heterogeneous group of tumors that account for 17.6 % in adults. Four types have been recognized: subependymoma, spinal ependymoma (Sp-EPN), myxopapillary ependymoma (MPE), and Sp-EPN-MYCN amplified, each with distinct histopathological and molecular features. Methods: This study investigated the clinical and pathological characteristics and MYCN expression levels of 35 Sp-EPN and MPE cases diagnosed at a tertiary university hospital over a decade -long period. Results: Twenty-five cases were Sp-EPN and 10 cases were MPE, and were graded as WHO grade 2, except for 1 Sp-EPN case with grade 3 features. The most common symptoms were lower back pain and difficulty in walking. Radiology showed different tumor sizes and locations along the spinal cord, with MPEs exclusively in the lumbosacral region. Surgery was the main treatment, and gross total resection was achieved in all cases except for one. Immunohistochemistry showed low Ki-67 proliferation indices in all cases, and no MYCN expression. During follow-up, 3 (8.6 %) cases recurred and/or metastasized and 5 cases (14.3 %) died. No significant difference was found in disease -free survival or overall survival between Sp-EPN and MPE cases. However, 3 cases with grade 2 histology demonstrated recurrence and/or metastasis, despite the lack of MYCN expression. Conclusion: Our results underscore the multifactorial nature of tumor aggressiveness in EPNs of the spinal region. This study enhances our knowledge of the clinical and pathological features of Sp-EPNs and MPEs and highlights the need for better diagnostic and prognostic markers in these rare tumors.

Helicobacter pylori ( H. pylori ) is a widespread pathogenic bacterium, impacting over 4 billion individuals globally. It is primarily linked to gastric diseases, including gastritis, peptic ulcers, and cancer. The current histopathological method for diagnosing H. pylori involves labour-intensive examination of endoscopic biopsies by trained pathologists. However, this process can be time-consuming and may occasionally result in the oversight of small bacterial quantities. Our study explored the potential of five pre-trained models for binary classification of 204 histopathological images, distinguishing between H. pylori -positive and H. pylori -negative cases. These models include EfficientNet-b0, DenseNet-201, ResNet-101, MobileNet-v2, and Xception. To evaluate the models’ performance, we conducted a five-fold cross-validation, ensuring the models’ reliability across different subsets of the dataset. After extensive evaluation and comparison of the models, ResNet101 emerged as the most promising. It achieved an average accuracy of 0.920, with impressive scores for sensitivity, specificity, positive predictive value, negative predictive value, F1 score, Matthews’s correlation coefficient, and Cohen’s kappa coefficient. Our study achieved these robust results using a smaller dataset compared to previous studies, highlighting the efficacy of deep learning models even with limited data. These findings underscore the potential of deep learning models, particularly ResNet101, to support pathologists in achieving precise and dependable diagnostic procedures for H. pylori . This is particularly valuable in scenarios where swift and accurate diagnoses are essential.

Neoplasms originating from the urachus are exceptionally uncommon, comprising only 0.17% of all bladder neoplasms. Among these, the mucinous cystic tumor of low malignant potential (MCTLMP) is particularly rare, with only 25 documented cases in medical literature. Despite their rarity, it is essential to identify MCTLMPs given the possibility of severe complications. Fortunately, surgical removal offers promising cure rates. In this report, A 40-year-old female patient presented to the hospital with abdominal pain. Subsequently, a CT scan showed a 9-cm cystic mass pressing the bladder. The lesion was surgically excised and histopathological examination was performed. Grossly, the specimen consisted of a cyst with a smooth external surface and mucinous content. Microscopically, the cyst was lined by columnar mucinous epithelial cells that included basally-located hyperchromatic nuclei and scattered Goblet cells consistent with an intestinal phenotype. The epithelial cells show mild atypia with focal papillary formations and flattening due to compression. Immunohistochemically, the epithelial tumor cells expressed cytokeratin 20, CDX2, beta-catenin (membranous); and were negative for cytokeratin 7. The location, histopathological, and immunohistochemical findings were consistent with a diagnosis of MCTLMP. In this report, we present an instance of urachal MCTLMP, which represents less than 30 cases documented in the medical literature. This case study marks the importance of early identification of MCTLMP due to their potential for severe complications, despite the tumor’s low malignant potential and to exclude more aggressive tumors with areas of intraepithelial or invasive carcinoma.

Background: Central nervous system (CNS) lymphomas, either primary or secondary in origin, are rare malignant tumors affecting the brain, spinal cord, or leptomeninges. Diagnosis of CNS lymphomas is complicated by their diverse clinical presentations, radiological features, and histopathological characteristics. Although frozen sec-tion (FS) analysis is commonly employed for various CNS tumors, its role and accuracy in CNS lymphoma diagnosis are less explored. In this study, we conducted a comparative analysis to assess the impact of knowledge of preoperative imaging on enhancing the accuracy of FS diagnosis in CNS lymphomas. Methods: Data collection involved a retrospective review of CNS lymphoma patients from January 2009 to August 2021. Patients who underwent intraoperative consultation were included, excluding those with prior cortisone treatment. The dataset incorporated patient demographics, classification as primary or secondary lymphoma, radiological preliminary diagnoses, FS diagnosis, and permanent section diagnosis. We employed various archived materials, including FSs, touch imprint slides, crush cytology slides, H&E-stained sections, and immunohistochemical stains, and re-evaluated all slides for diagnostic validation.Results: Our study included 25 patients, of whom 60 % were female and had a mean age of 56.5 years. Preoperative radiology data were available for 80 % of cases, with preliminary diagnoses commonly including lymphoma and/or metastasis. Intraoperative consultation results indicated lymphoma in 18 (72 %) patients, with discordance observed in 28 % of cases when compared to permanent section diagnoses. Most permanent section diagnoses were diffuse large B-cell lymphomas (92 %), with the remainder being T-cell non-Hodgkin lymphoma (4 %) and follicular lymphoma (4 %). Intraoperative misdiagnoses were significantly associated with the absence of knowledge of preoperative imaging.Conclusion: Our study demonstrates the reliability of FS diagnosis for CNS lymphomas during surgery, with a favorable complete concordance rate of 72 % when compared to permanent diagnoses. Importantly, lack of knowledge of preoperative imaging significantly impaired diagnostic accuracy in FS, emphasizing the need for close collaboration between pathologists and radiologists.

Background Primary intra-axial Ewing sarcoma (EWS) is extremely rare and a highly aggressive small blue round cell tumor in the central nervous system (CNS). We reported a case of primary intra-axial CNS-EWS in a 30-year-old male and presented an extensive literature review of CNS-EWS cases. Case presentation A 30-year-old male had been diagnosed with a grade 2 astrocytoma in the left frontal lobe a year ago and had received chemotherapy and radiotherapy. He presented with a right-sided mass, which was revealed to be a 6 cm contrast-enhancing lesion with heterogeneous hemorrhagic areas in the right frontal lobe. The patient underwent emergent craniotomy for surgical excision. Histologically, the tumor was composed of high-grade, small, blue, round cells forming trabecular islands and rosettes which were separated by fibrovascular tissues. In immunohistochemical (IHC) examination, the tumor cells were positive for CD99 and FLI-1. Fluorescence in situ hybridization analysis revealed the presence of EWSR1 gene rearrangement. The histopathological, IHC, and molecular findings were consistent with a diagnosis of EWS. Further imaging did not show evidence of another primary site. The patient was followed up without further therapy and succumbed to the disease three months after the diagnosis. Conclusion EWS is very rare but an aggressive neoplasm in the CNS. Chemoradiotherapy may promote secondary cancers but it is unclear whether the development of EWS was associated with chemoradiotherapy that our case had received for astrocytoma. EWS should be considered when diagnosing a CNS tumor that shows small, blue, round cell tumor morphology. A combination of IHC and molecular tests is required for accurate diagnosis to ensure that all patients receive the most appropriate treatment to optimize outcomes.

Objective: Echinococcosis is characterized by cystic structures formed by Echinococcus parasites in various organs, particularly liver, lung, and spleen. Our aim is documenting echinococcosis cases detected in Batman province in Turkey. Methods: Clinicopathological data of all echinococcosis cases with histopathological diagnosis in Batman province between 2010-2022 were retrospectively recorded. Descriptive analyses of the data were made using the IBM SPSS 22.0 package program. Results: A total of 55 echinococcosis cases, 23 male (41.8%) and 32 female (58.2%) were identified. The average age is 30 (3-77). Of 33 cases with known clinical complaints, 22 (66.7%) had abdominal pain, two (6.1%) had chest pain, two (6.1%) had cough, and seven (21.2%) had other complaints. One case was diagnosed incidentally in the post-traumatic examination. The mean diameter was 8.5 cm (2.8-25 cm) in 43 lesions of known diameter. The localization was liver in 36 (65.5%) cases, lung in 10 (18.2%) cases, and spleen in three (5.5%) cases. In three cases (5.5%), there was more than one organ involvement. In addition, echinococcosis was detected in the brain, kidney, and arm in three cases (5.5%). Of 45 cases with known data, 32 (71.1%) were unifocal and 13 (28.9%) were multifocal. Excision was performed in 34 (61.8%) cases, resection in 20 (36.4%), and aspiration in one (1.8%) case. Conclusion: Echinococcosis can be seen in all age groups and present with a variety of findings depending on the organ involvement. It should be kept in mind in the differential diagnosis of cystic lesions in Turkey, which is among the endemic countries.

Transmissible venereal tumor (TVT) is a transmissible cancer that typically affects the external genital organs in canines. It can spread to other parts of the body via autoand hetero-transplantation in a way that neoplastic cells are inoculated into the degraded mucosa or skin during the interaction of the animals, such as licking and sniffing, or less commonly via hematogenous or lymphatic routes. Here, we presented the clinical, cytological, and histopathological characteristics of two rare cases of TVT that developed ocular involvement and were associated with a poor prognosis. Fine needle aspiration biopsy was the initial method of choice in the diagnosis which is rapid, minimally invasive, and effective. It was diagnostic in one case and aided in the diagnosis in the other. The latter was considered a malignant round cell tumor in the cytological examination that needed further clinical and histopathological examination for definitive diagnosis. TVT is a round cell tumor that should be considered in the differential diagnosis of ocular lesions in canines.

A strong association has been reported between chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) and malignant melanoma (MM). In rare cases of MM, lymphoid malignancies may be detected incidentally during sentinel lymph node biopsies. In this case, we found a unique collision of MM and CLL infiltration in the skin. An 88-year-old male patient presented with a mass on the nasal root. Histopathological examination of the skin biopsy specimen revealed a deeply infiltrative, atypical spindle cell proliferation in the background of a collagenous stroma. Accompanying this lesion, there were foci of monotonous lymphoid cell populations involving skin appendages. In the immunohistochemical studies, the spindle cells were diffusely positive for S100, and focally positive for Melan-A and HMB45; the lymphoid cells were positive for CD20, CD5, and Bcl-2 and negative for CD3, Bcl-6, CD10, and Cyclin D1. Histopathological and immunohistochemical findings were consistent with diagnoses of spindle cell melanoma and CLL. Interestingly, these two tumors together in their same morphological appearance were confirmed in a subsequent liver biopsy. Active skin surveillance of patients with CLL may be important to detect MM at an early stage that correlates with a better prognosis.

Objective: Basal markers [cytokeratin 5/6 (CK5/6) and epidermal growth factor receptor (EGFR) are used in identifying the basal-like breast carcinoma subtype, which is associated with a poor prognosis. However, the clinicopathological significance in early-stage invasive carcinoma of no special type (IC, NST) has not been well established. Material and Method: In a five-year period, 133 female patients with early-stage IC, NST with a median follow-up time of 89 months were included. The immunohistochemistry-based molecular subtypes were identified according to ASCO/CAP guidelines in 2013. The cutoff values for basal positivity were determined as 10% for each marker. Results: Basal positivity was recorded in 83.3% (5/6) of triple-negative breast cancers, 50% (2/4) of HER2-enriched, 18.6% (13/70) of luminal B, and 8.3% of luminal A (4/48) subtype. CK5/6 and EGFR positivity were significantly associated with ER negativity (p < 0.001). EGFR positive cases were significantly associated with PR negativity and HER2 positivity compared to negative cases. However, basal positivity was not associated with the patient outcome (p = 0.006 and p- 0.004, respectively). Conclusion: Basal positive IC, NSTs were associated with hormone receptor negativity and HER2 overexpression; these patients would therefore be less likely to respond to hormonotherapy and more likely to benefit from anti-HER2 treatment as well as dual-kinase inhibitors. The lack of standardization of the definition of basal marker positivity may contribute to the conflicting results of prognostic studies. Hence, further studies focusing on developing a standard protocol for determining basal marker positivity are needed not only for IC, NST but also for other histological types of breast cancer.

Cancer stem cells (CSCs) are self-renewable and can be differentiated into different cell types. They play an important role in oncogenic signaling pathways, tumor cell heterogeneity, metastasis, and therapeutic resistance. Aldehyde dehydrogenase 1 (ALDH1) was identified as a specific marker for breast CSCs. The study included a total of 105 patients with a diagnosis of invasive ductal carcinoma (IDC) who underwent mastectomy and with sufficient pathology material for histopathological examination. Patient demographics, tumor location, tumor diameter, the presence of lymphovascular and perineural invasion and lymph node metastasis, surgical margin status, and immunohistochemistry (IHC) staining results were obtained from patients' records. The tumors were classified into IHC-based molecular subtypes according to the St. Gallen Consensus Conference in 2013. A four-tiered scoring system was used based on ALDH1 staining percentage in tumor cells. The tumor was determined as positive if the score was 2 or higher. Clinical, histopathological findings, and ALDH1 staining results were correlated. Twenty-five cases (23.8%) were ALDH1 positive. The ALDH1 positive group compared to the negative group was found to be associated with ER negativity (p = 0.044), but there was no correlation with other clinical and histopathological findings. ALDH1-positive IDCs may be less sensitive to hormonal therapy and associated with aggressive behavior.

This guide provides an overview of social media (SoMe) use with the recent updates for the "cytopathologists and the ones interested in". Our aim was to introduce the basic terms and rules, the potential benefits and risks, and some tips and tricks for using SoMe. The two most popular SoMe platforms, Facebook and Twitter, were the focus of this article. Thus far, many pathologists have already proved how efficiently the SoMe services could be utilized; the same applies specifically to the community of cytopathology. In our opinion, the more CPs are involved in SoMe, the more connected, productive, and stronger the community will become.

This guide provides an overview of social media (SoMe) use with the recent updates for the “cytopathologists and the ones interested in”. Our aim was to introduce the basic terms and rules, the potential benefits and risks, and some tips and tricks for using SoMe. The two most popular SoMe platforms, Facebook and Twitter, were the focus of this article. Thus far, many pathologists have already proved how efficiently the SoMe services could be utilized; the same applies specifically to the community of cytopathology. In our opinion, the more CPs are involved in SoMe, the more connected, productive, and stronger the community will become.

Malignant tumors consist of both carcinoma cells and tumor associated host cells. Host cells has started to receive more attention regarding their role in tumor progression such as invasion and metastasis. Fibroblasts that are incorporated in the tumoral stroma are called as peritumoral fibroblasts, reactive stroma, cancer-related fibroblasts or myofibroblasts. In general fibroblasts next to nich of cancer cells express alpha–smooth muscle actin (α-SMA) which is an important marker for differentiated myofibroblasts. Our aim is to investigate the role of α-SMA positive myofibroblasts in the development and progression of laryngeal carcinoma. The proportion of α-SMA positive myofibroblasts are scored from (1 +) to 3( +) in laryngeal dysplasia (n = 17) and microinvasive and invasive squamous cell carcinoma (n = 66). α-SMA expression in invasive carcinoma and dysplasia was analyzed statistically. No stromal myofibroblast was detected in mild dysplasia (score 0). Among 12 cases of moderate-severe dysplasia, in only 3 cases low α-SMA expression (score 1) was observed and in 9 cases there were no stromal myofibroblasts (score 0) were. In most cases of invasive carcinoma, high α-SMA expression (score 2, 3) was seen. α-SMA positive stromal myofibroblasts were significantly higher in invasive laryngeal squamous cell carcinoma compared to dysplasia (p < 0.05). Results of our study suggested that α-SMA positive stromal myofibroblasts play an important role in creating the permissive environment for tumor invasion in laryngeal squamous cell carcinoma. According to this data, we think that the presence of stromal myofibroblasts might be used as a helpful criterion in the differential diagnosis of true invasion and pseudoinvasion.

•This is one of the largest series reporting the clinical and histopathological characteristics of gastrointestinal tract IFPs•The characteristic histopathologic features of IFPs are onion skinning appearance and eosinophil infiltration•The presence of short fascicular pattern and multinucleated giant cells should also raise suspicion for a diagnosis of IFP•Immunohistochemically CD34 positivity and CD117 negativity are the most helpful for differential diagnosis

Context Noninvasive encapsulated anaplastic thyroid carcinomas (NE-ATCs) have been described in few case reports, and consistently associated with favorable outcome compared to the classical ATCs. Objective Our aim is to remark a rare histological finding in ATCs, encapsulation, which has been associated with a favorable outcome. Design We have documented a rare case of an NE-ATC with its clinical, pathological, and molecular features. We also provided a thorough discussion of all the encapsulated ATCs reported in the literature. Subjects and Methods A 50-year-old woman with an unremarkable medical history, who presented with a thyroid nodule, and diagnosed as "follicular lesion of undetermined significance" by fine needle aspiration biopsy. The patient was lost to follow-up for six years and revisited upon her neck disturbances and underwent total thyroidectomy. Results Sections of the right lobe revealed a grossly encapsulated nodular lesion, measuring 75x55x55 mm. Histologically, the tumor consisted of both carcinomatous and sarcomatous components supported by immunohistochemical stains. Necrosis and atypical mitotic figures were evident. Capsular and/or vascular invasion was not identified. There were no BRAF codon 600, KRAS, NRAS mutations and RET/PTC rearrangement. During three-month follow-up, the patient was free of disease without adjuvant therapy. Conclusion Encapsulated ATCs tend to follow a favorable clinical course and may deserve conservative treatment approaches.