Squamous cell carcinoma of the penis: a clinicopathological study from a population with late circumcision.

Squamous cell carcinoma (SCC) of the penis has been subject to only a few studies in populations where late childhood circumcision is performed. To asses clinicopathological features and human papillomavirus (HPV) status of penile SCC in men with late circumcision, eight institutions in the country volunteered to collaborate and 15 cases of penile SCC were collected from their pathology archives. The presence and genotype of HPV were determined in addition to clinicopathological features of the tumors. Findings were correlated with disease outcome. The mean age of the patients evaluated was 66.5 years. Histological subtypes were usual SCC (6∕15), papillary (2∕15), mixed (2∕15), basaloid (2∕15), acantholytic (1∕15), pseudohyperplastic (1∕15), and warty-basaloid (1∕15) carcinomas. HPV was identified in 33.3% of samples; HPV16 was detected in 60% of positive cases and was associated with basaloid and/or warty morphology. Cause-specific 1-year and 2-year survivals were 76.9% and 54.5%, respectively. The usual subtype and nodal metastasis were associated with worse outcome (p=0.045 and p=0.047, respectively). As a conclusion, our results suggest an inclination for penile SCC to develop at a later age in a population with late circumcision than the patients from the regions of high penile cancer incidence. These men seem to have less frequent HPV association and their outcome appears poorer than other populations, although reaching substantial provision is not possible due to our limited case number.

Extragastrointestinal Stromal Tumor during Pregnacy.

Extragastrointestinal stromal tumors (EGISTs) are mesenchymal neoplasms without connection to the gastrointestinal tract. Gastrointestinal stromal tumors (GISTs) and EGIST are similar according to their clinicopathologic and histomorphologic features. Both of them most often express immunoreactivity for CD-117, a c-kit proto-oncogene protein. The coexistence of GIST and pregnancy is very rare, with only two cases reported in the literature. In this paper, we presented the first EGIST case during pregnancy in the literature.

Pathologic Features of Behçet's Disease in the Tubuler Gut.

Behçet's disease (BD) is a vasculitic disorder of relapsing acute inflammation characterized by recurrent oral ulcers, genital ulcers, uveitis, and skin lesions. The disease also affects other organs, including joints, the nervous system, blood vessels, and gastrointestinal (GI) system may also be involved and the lower GI tract is the mostly involved part, leading to severe morbidity. The frequency of GI involvement in BD varies among different ethnic groups. Although 50-60% of Japanese patients have GI disease, these manifestations are rare in patients from Mediterranean countries. The gastrointestinal manifestations of BD usually appear 4.5-6 years after the onset of the oral ulcers. The intestinal lesions are usually resistant to medical treatment and recur after surgery. The elementary lesion is apthous ulcer. Deep, round or oval ulcers with a punched-out appearance tend to perforate easily, so that many patients require urgent operation.

Histopathological changes seen in mycosis fungoides patients after phototherapy.

Early stage (IA, IB, IIA) mycosis fungoides (MF) has long been treated with various agents including oral psoralen plus UVA (PUVA), broadband and narrowband. The histopathological changes seen after phototherapy have not been clearly described. Twenty-three skin biopsy specimens of MF patients treated with phototherapy both UVA and UVB were evaluated before and 3 months after phototherapy. The clinical and histomorphological response were evaluated. Various types of epidermotropism: such as single cells, haloed cells, linearly arranged single cells, pagetoid spread, and Pautrier microabscesses were noted. Stratum corneum was classified as normal, hyperkeratotic, and parakeratotic. The epidermal thickness was noted as normal, atrophic, and hypertrophic. Spongiotic microvesiculation, presence of dilated dermal vessels, was investigated. Papillary dermis fibrosis, the presence of plasma cells, eosinophils, and extravasated erythrocytes were also examined. Epidermal hyperplasia, dermal fibrosis, loss of parakeratotic pattern, and inflammatory infiltrate were frequently observed after therapy. After phototherapy, the atypical cells rarely formed "Pautrier microabscess" or made a "linear pattern" at the base of epidermis. The cells other than lymphocytes (plasma cells, eosinophils, and erythrocytes) should also be considered regarding the phototherapy effect. A pathology report of a MF patient who has undergone successful phototherapy would describe changes resulting from phototherapy-such as fibrosis or "lack of dermal inflammation" and the absence of active epidermal cellular changes such as "Pautrier microabscess" or "linearly arranged cells."

An unusual cause of acute abdomen: mesenteric heterotopic pancreatitis causing confusion in clinical diagnosis.

Heterotopic pancreas is defined as the presence of pancreatic tissue that lacks anatomic and vascular continuity with the main body of the pancreas. Frequent symptoms and signs are epigastric pain, abdominal fullness and tarry stools. The most frequent locations of heterotopic pancreas tissue are the stomach and jejunum; however, there are a few reported cases of heterotopic pancreas in the mesentery of the small intestine. Heterotopic pancreas may or may not cause complications related to the pathologic conditions of the pancreas itself. Here we present a case showing an unusual cause of acute abdomen, which caused confusion in the clinical diagnosis preoperatively. The definitive diagnosis was achieved only after histopathologic examination in the postoperative period. Final diagnosis of the patient was mesenteric heterotopic pancreatitis, which was a complication of heterotopic pancreas itself with a rarely seen location. In conclusion, mesenteric heterotopic pancreatitis is seen very rarely and may be an unusual cause of acute abdomen. If the pathologic condition develops in the heterotopic tissue, as in the case of heterotopic pancreas, signs and symptoms of the disease may cause confusion in the clinical diagnosis. We agree that preoperative diagnosis of heterotopic pancreas is still difficult, even in a symptomatic patient.

The monitoring of progress in apoptosis of liver cells in bile duct-ligated rats.

BACKGROUND/AIMS: We aimed to determine the progress of lipid peroxidation and ultrastructural changes established in the rat liver after acute bile duct ligation. METHODS: Groups A1, B1, C1 and D1 were the controls of groups A2, B2, C2 and D2, which represented the 1st, 3rd, 5th and 8th days after bile duct ligation. Serum bilirubin and malondialdehyde, liver malondialdehyde and reduced glutathione levels, and inducible nitric oxide synthase expression were determined. Liver tissue was examined with light and electron microscopy. RESULTS: Serum bilirubin increased progressively. Serum and liver malondialdehyde and inducible nitric oxide synthase expression reached a peak level at day 3, reduced at the 5th day and continued at a constant rate. Reduced glutathione decreased progressively. Ductal proliferation increased progressively to a plateau at day 5. The marked electron microscopic changes were detected at day 3 (B2) and continued constantly. CONCLUSIONS: The first five days after acute bile duct ligation are the most critical.

The protective effect of selenium on ipsilateral and contralateral testes in testicular reperfusion injury.

This study was designed to investigate the effect of selenium on ipsilateral and contralateral testicular damage after unilateral testicular torsion/detorsion (T/D). Thirty-two male rats were divided into four groups, each containing eight rats. Torsion was created by rotating the right testis 720 degrees in a clockwise direction. Group 1 underwent sham operation to determine basal values for biochemical and histopathological evaluation. Sham operation was performed in group 2, and sodium selenate (0.2 mg/kg) was given intraperitoneally. Group 3 served as a T/D group, receiving 4-h torsion and 4-h detorsion. Similarly, in group 4 sodium selenate (0.2 mg/kg) was injected intraperitoneally 20 min before detorsion. Bilateral orchiectomies were performed for measurement of tissue malondialdehyde (MDA) levels and superoxide dismutase (SOD) activities and histopathologic examination. The results were compared statistically. The highest MDA and the lowest SOD values were determined in both testes in group 3. There were statistically significant differences in MDA levels and SOD activities in group 3 compared with group 4. Specimens from group 3 had a significantly greater histologic injury than other groups. These results suggest that ischemia-reperfusion injury occurred in both testes after unilateral testicular T/D and that selenium administration before detorsion prevents reperfusion injury in testicular torsion.