Original Observation of Primary Bladder Histiocytic Sarcoma: First Case Report.

Histiocytic sarcoma (HS) is a rare malignant lymphohematopoietic neoplasm; it has been cited in the recent World Health Organization (WHO) classification as a malignant proliferation of cells exhibiting morphological and immunophenotypic features of mature histiocytes. To our knowledge, the present case is the first to be described in the bladder of a patient without a history of lymphoma. Only one case has been reported so far regarding a secondary bladder presentation in the setting of a previous diffuse large B-cell lymphoma. We discuss the case of a 68-year-old male who presented with hematuria and dysuria. CT scan revealed a 4-cm intravesical mass that histological examination defined as HS. Our objective was to describe the clinical, histological, immunophenotypical, molecular characteristics and discuss the differential diagnoses of this first case of primary bladder HS. Our research was based on a review of selected articles obtained via the PubMed database. This extremely rare experience provided us with the opportunity to depict an interesting case, highlight its uniqueness, and build up new pathological evidence.

Iron Overload in Gastric Mucosa: Underdiagnosed Condition Rarely Documented in Clinical and Pathology Reports.

The iron-deficiency anemia is a common disorder worldwide. It is widely treated with oral iron supplements as ferrous sulfate compound in pill or tablet form, and continuous therapy can induce gastric diseases. The diagnosis of this unusual drug-induced disease is based on the endoscopic findings and the histopathological biopsy examination, because the clinical symptoms are vague and non-specific. Herein we report five cases of iron pill-induced gastritis after oral ferrous sulfate administration. The aim of this report is to underline that iron pill-induced gastritis is an under-diagnosed entity that must be kept in mind when patients undergo chronic iron-pill therapy because it can carry severe upper digestive tract complications. Moreover, we would speculate about the potential tumorigenic role of iron intake in iron-induced gastric inflammation.

Potential Difficulties in Cytological Approach of Basal Cell Adenoma of Salivary Glands: The Experience of a Single Institution.

OBJECTIVE: Basal cell adenoma (BCA) is an uncommon benign epithelial neoplasm of salivary glands, which was first described by Kleinsasser and Klein in 1967 and which derives its name from the monomorphic basaloid appearance of tumor cells. This tumor represents 1-2% of all salivary gland epithelial tumors; the most common site of occurrence is the parotid gland. It usually arises in adults over 50 years of age with slight female prevalence. STUDY DESIGN: We analyzed 5 cases of parotid lesions investigated by fine needle aspiration cytology at a single institution between 2002 and 2018. RESULTS: Our series was composed by 3 women and 2 men with a mean age of 62 years. The most important cytological criteria we observed were cohesive sharp-angled clusters of regular basaloid cells, palisaded by p63-positive myoepi-thelial cells, and bordered by basement membrane-like hyaline membrane in the absence of a myxochondroid stroma. Overall features were consistent with the diagnosis of BCA. CONCLUSIONS: Our aim is to highlight the cytological features of these rare lesions improving the awareness of cytological pitfalls of salivary gland basaloid neoplasms. Moreover, the goal of this paper is to add to the literature 5 additional cases of these unusual tumors.

Periprostatic tissues intraoperative frozen section during retrograde radical retropubic prostatectomy.

OBJECTIVE: To evaluate usefulness of periprostatic tissues intraoperative frozen sections (PTs IFSs) during RRP for prostate cancer, in order to find local extraprostatic neoplastic spreading and to eventually modify intervention and resection limits during surgery. MATERIAL AND METHODS: From January 1998 to June 2004, 259 consecutive patients underwent RRP at our department for clinically organ-confined prostate cancer; PTs IFSs were prospectively performed in all cases at membranous urethra after removal of prostatic apex, at whole neurovascular bundle (NVB) or at fibroadipose tissue subtended between prostatic capsule and NVB during extrafascial or nerve sparing (NS) RRP respectively, at middle portion of Denonvillier's fascia, at detrusor ring after removal of the prostate. IFSs positivity was followed by further excision at the corresponding site during intervention. RRP pathological specimen was handled and examined according to European Association of Urology (EAU) guidelines. Student's t-test and chi-square test were used for statistic analysis, matching patients with or without positive PTs IFSs for bioptic Gleason sum, preoperative serum PSA, clinical stage and lymph nodal involvement. RESULTS: PTs IFSs were positive 75 times in 63 patients out of 259. Pathological stage considering PTs IFSs overlapped 2002 TNM definitive pathological stage in 228 patients. The remaining 31 cases showed PTs neoplastic involvement at IFSs. These latter patients did not show prostatic capsular infiltration at definitive pathology. We demostrated intraoperative extraprostatic cancer spreading that was unrecognizable at definitive pathology. PTs neoplastic spreading changed NS RRP in extrafascial procedure in 17 patients out of 121 with preoperative planned NS RRP There were no significant statistic differences between patients with or without positive periprostatic margins (PMs), regarding preoperative serum PSA, bioptic Gleason sum and clinical stage (Student's t-test); lymph nodal involvement rate was not significantly different in both groups (chi-square test). CONCLUSIONS: PTs IFSs during RRP were feasible and effective in order to achieve better local pathological staging in 12% of patients, to modify planned nerve sparing RRP in extrafascial procedure in 14% of cases and to wide intraoperatively surgical resection margins in 24% of patients.