Metin Karakok

Immunohistochemical study on histogenesis of congenital epulis and review of the literature

Congenital epulis is a very rare lesion found only in newborn infants. This tumor is multiple in about 10% of reported cases, rarely with the simultaneous involvement of the maxilla and mandibula, as in this article. In the presented case, light microscopy demonstrated large eosinophilic granular cells arranged in solid nests that are separated by thin fibrovascular areas. The tumors In the maxilla and mandibula were investigated with a panel of polyclonal and monoclonal antibodies, and using immunoperoxidase methods on formalin‐fixed, paraffin‐embedded sections. Immunohistochemical studies revealed strong and diffuse cytoplasmic staining for neuron specific enolase and vimentin. However, all other reactions were negative. These results suggest that the congenital epulis may be derived from uncommitted nerve‐related mesenchymal cells.

Urotensin-II Immunoreactivity in Children with Chronic Glomerulonephritis

Background. Human urotensin-II (hU-II) is one of the most potent vasoconstrictors in mammals. To our knowledge, there is no study about the role of U-II in childhood glomerulonephritis.We first determined the expression of h U‐II in kidneys of children with chronic glomerular diseases. Methods. Normal human kidneys were obtained from postmortem biopsies and compared with the kidney biopsy specimens of 24 children with membranoproliferative glomerulonephritis (MPGN) and 6 children with membranous GN. Kidney needle biopsies in 10% neutral buffered-formalin prior to routine processing through to embedded blocking sections were cut, and immunohistochemical reactions were performed on parafin-embedded tissue by an avidin-biotin peroxidase complex method. The antibodies used in the present study were hU-II. The positivities were revealed as weak (+), moderate (++), and severe (+++), according to the color intensity. Results. In kidneys of children with MPGN, differently fom the normal kidneys, more dense U-II immunoreactivity was seen in the glomerular basement membrane (GBM), glomerular mesangium, Bowman capsule, and tubules. Interestingly, we also observed U-II immunoreactivity in crescents. In children with MGN, U-II was mostly seen in GBM and Bowman capsule. Conclusion. Our findings suggest that U-II may have a possible autocrine/paracrine function in the kidneys, and may be an important target molecule in studying renal pathophsiology.

The association between silicone implants and both antibodies and autoimmune diseases

Silicones are widely used materials in many fields of medicine and largely are believed to be biologically inert. However, some investigators have reported that silicone implants are associated with an increased incidence of autoimmune disorders. In this study, we evaluated the capsular tissue of silicone implants and the sera of implant patients and controls for antisilicone antibodies and nonspecific immunoglobulins (IgG, IgA, IgM, and IgE). Our study group included 15 patients (eight men and seven women) undergoing reconstructive procedures for burn scars, in whom we used silicone implants, and 15 sex-matched controls undergoing reconstructive surgery for burn scars without using silicone implants. By immunofluorescence, we discovered strong capsular binding of IgG and weak capsular binding of IgM; antisilicone antibody levels were significantly higher in capsular tissue than elsewhere. Serum IgE also was higher in patient vs control subject sera. In conclusion, silicone materials do lead to an immune response consisting of antisilicone antibodies most evident immediately adjacent to the implant itself.

Colon carcinoma with synchronous subcutaneous and osseous metastasis: a case report.

Colon cancer usually metastasizes initially to regional lymphatics and later through the bloodstream. Hematogenous metastasis usually includes the liver, lungs, and brain. In colorectal cancer, osseous and/or subcutaneous metastasis without liver metastasis is a very uncommon event. We present here a case of colon adenocarcinoma, which synchronously metastasized to facial and other subcutaneous tissue and to bone within a short period after definitive therapy. Although such a pattern is uncommon, diagnostic biopsy for any new or suspicious lesion of the skin and bone scintigraphy for symptomatic patients should be done for patients with a colorectal cancer history.

Inflammatory myofibroblastic tumor (inflammatory pseudotumor) of the maxillary sinus mimicking malignancy: a case report of an unusual location (is that a true neoplasm?)

The inflammatory myofibroblastic tumor (IMT) is a space-occupying lesion of unknown etiology and a distinctive but controversial lesion. This type of tumor is recently considered neoplastic rather than inflammatory. It is usually occurring during childhood, composed of fascicles of bland myofibroblastic cells admixed with a prominent inflammatory infiltrate consisting of lymphocytes, plasma cells, and eosinophils. IMT of the maxilla is very rare. The diagnosis of IMT can be made on the basis of histopathology and immunohistochemistry. Herein, we presented a patient who had IMT of the maxillary sinus that was initially misinterpreted as a malignant neoplasm upon clinical and radiographic examinations. We discussed the diagnostic and therapeutic procedures and may consider it a true neoplasm.

Extensive inflammatory nevus comedonicus involving half of the body.

Nevus comedonicus is an uncommon variant of adnexal hamartoma without known cause. It usually occurs on the face, neck and chest and appears as groups of closely arranged dilated follicular openings with keratin plugs. We report extensive inflammatory nevus comedonicus in a 14‐year‐old boy involving half of his body, limited by the midline, with suppuration and residual scarring. The lesions first appeared at 3 years of age and worsened at the start of puberty. The clinical features, etiopathology, histopathology and treatment options of nevus comedonicus are briefly reviewed in the light of the literature.

Temporary stretch of the testicular pedicle may damage the vas deferens and the testis

BACKGROUND/PURPOSE The authors aimed to investigate the effects of temporary stretching of the spermatic cord, a commonly performed manipulation during inguinal surgery, on the vas deferens and the testis. METHODS Forty adult male Wistar-Albino rats were divided equally into 4 groups. The right spermatic cord and testis were exposed via a transverse suprascrotal incision. In the study groups, a continuous horizontal stretch force was applied to the vas deferens and vessels in a distal direction for 60 seconds. In group 1 (G1) a 1.25-Newton (N), and in group 2 (G2) a 0.75-N stretch force was applied. Group 3 (G3) and group 4 (G4) served as sham and control groups, respectively. The animals were killed 28 days later. Sections of the vas deferens were examined histologically and their dimensions measured. Both testes were excised, weighed, and examined microscopically. Kruskal-Wallis test and Mann-Whitney U test were used to compare means in the different groups. RESULTS The mean wall thickness of the vas deferens was 378 +/- 133 mum in G1 and was significantly diminished compared to G2, G3, and G4, in which the mean wall thickness was 497 +/- 142 mum, 500 +/- 10 mum and 521 +/- 95 mum, respectively (P <.05). The mean right testicular weights were 1.18 +/- 0.10 g and 1.23 +/- 0.17 g in G1 and G2, respectively, and each was significantly lower than in G3 (1.23 +/- 0.09 g) and G4 (1.25 +/- 0.08 g; P <.05). The mean right testicular weights showed no difference between G1 and G2 (P >.05). Necrosis was seen in the right testes in 50.0% and 42.9% of the animals in G1 and G2, respectively. No histopathologic alterations were observed in the vas deferens in all groups. Microscopic examination of the left testes was normal. CONCLUSIONS In an experimental animal model, temporary stretching of the spermatic cord resulted in significant thinning of the smooth muscle layer of the vas deferens and testicular atrophy.

Vascular plexus is a differentation criterion for muscularis mucosa from muscularis propria in small biopsies and transurethral resection materials of urinary bladder

Objective: Smooth muscle fibres are found within thesuperficial lamina propria of urinary bladder (Muscularis Mucosa). Thesemuscle fibres of muscularis mucosa should be distinguished from themuscularis propria in cases with urothelial carcinoma, because the depthof infiltration affects prognosis and therapy modalities. The aim of thepresent study was to evaluate whether the presence of vascular plexus isa criterion for muscularis mucosa and to distinguish it from muscularispropria in urinary bladder biopsies and transurethral resectionspecimens. Materials and methods: Hematoxylin-Eosin andMasson-Trichrome stained slides of 54 cases with urothelial carcinomawere reviewed. Results: In all cases (100%), thick walledvessels were observed within the lamina propria of urinary bladder.Smooth muscle layer of lamina propria was seen in 48 of 54 cases(88.8%), and these smooth muscle fibres were co-existed with thickwalled vessels. In invasive urothelial carcinoma; thin smooth musclefibres and thick walled vessels were seen within the lamina propria in22 of 24 cases (91.7%). There were two cases (8.3%)including only vessels in small biopsies of invasive urothelialcarcinoma cases. In cases with non-invasive urothelial carcinoma; musclefibres of muscularis mucosa and vessels were found within the laminapropia in 26 of 30 cases (86.7%). In this group, muscle fibreswere not detected in 4 cases (13.3%). Conclusion:Muscularis mucosa can be detected histologically in urinary bladderbiopsies and TUR materials. We emphasize that the presence of vascularnetwork is a useful criterion to determine muscularis mucosa of urinarybladder, even in the absence of muscle fibres.

Benign chondroid syringoma: a confusing clinical diagnosis

Abstract. Benign chondroid syringomas are benign adnexal tumors that occur most commonly in the head and neck region. There are two histological types of chondroid syringoma. They usually present as firm intradermal or subcutaneous nodules. Clinically these tumors are frequently misdiagnosed. The differential diagnosis is epidermal cyst, lipoma, and pilar cyst. We present the benign chondroid syringomas seen during the period of August 1995 to August 2001. There were 13 chondroid syringomas in 1921 skin lesions (1.07%).

Spinal epidural granulocytic sarcoma (chloroma) in a non-leukemic child

cord compression. It is rather rare in non-leukemic patients.1 Granulocytic sarcoma is a rare tumor composed of immature myeloid cells. It has more commonly been described in association with acute myeloid leukemia.2 Only eight nonleukemic cases with GS causing spinal cord compression have been reported in scientific reviews until August 1998.3 Here we describe a case of acute spinal cord compression due to GS in a non-leukemic child.