The dark (hyperchromatic) cerebriform nucleus was recently described as a frequent finding in histopathology sections of papillary carcinoma of the thyroid. In the present study, we tried to determine the frequency of dark cerebriform nuclei in the fine-needle aspiration (FNA) smears of papillary thyroid carcinomas and compared it with those of other thyroid lesions, such as follicular neoplasms and benign hyperplastic lesions. In addition to the above-mentioned nuclear feature, pale (hypochromatic) cerebriform nucleus and other well-established cytomorphological criteria used in the diagnosis of papillary thyroid carcinomas were analyzed. FNA smears of a total of 102 cases comprising of 61 papillary carcinomas, 10 cases of suspicious papillary carcinomas, 12 follicular neoplasms, and 19 benign hyperplastic lesions were studied. Both the dark and pale cerebriform nuclei were found in a significantly higher number of cases of papillary thyroid carcinomas compared with follicular neoplasms (P = 0.0003 and P < 0.0001, respectively) or benign hyperplastic lesions (P = 0.0004 and P < 0.0001, respectively). Review sections available in 24 cases showed agreement between the cytopathological and the histopathological diagnoses in 18 (94.7%) of 19 papillary carcinomas. Thus, the dark and pale cerebriform nuclei can be regarded as useful cytomorphological parameters in the diagnosis of papillary thyroid carcinoma.

The dearth of literature on intracranial tumors (ICT) in Kuwait has necessitated this study whose objective is epidemiological. It is based on the records of the Department of Pathology, Al-Sabah Hospital, Kuwait, where virtually all brain biopsies in Kuwait were examined. Between 1995 and 2009, 439 males (53.41%) and 383 females (46.59%) had primary intracranial tumors (PICT). Most (69%) were younger than 50 years, with 16% children and adolescents and 4% elderly (≥70 years); meningioma (28%), pituitary adenoma (19%), glioblastoma (15%), astrocytoma (13%), and medulloblastoma (5%) were the most common. In childhood and adolescence, astrocytoma (35.34%) and medulloblastoma (22.56%) predominated. The mean age-adjusted incidence rate/100,000 was: PICT: 3.02; astrocytic tumors: 0.93; meningioma: 0.96; pituitary adenoma: 0.44; and medulloblastoma: 0.13. All showed a declining trend which was only statistically significant for medulloblastoma (P = 0.007). A modest correlation between the percentage of elderly in the general population and incidence rates was found (r = 0.411). Tumors with significant male preponderance were high-grade astrocytic tumors, silent pituitary adenoma (SA), and nerve sheath tumor. Meningioma had a female to male ratio of 2.24. The peak frequency for functional pituitary adenoma and females was in the age range of 20-29 years, while for SA and males it was 40-49 years. About 5% of ICT were metastatic, with cancers of breast (26%), lung (17%) and gastrointestinal (11%) origin as the most common. In conclusion, the epidemiology of PICT in Kuwait is characterized by low incidence rates and a distinct age distribution.

Objective: To document the first case of clear cell adenocarcinoma of the rectum (a rare entity) in Kuwait. Clinical Presentation and Intervention: A 36-year-old female presented with a 1-year history of constipation and bleeding per rectum. Colonoscopy revealed an ulcerated mass 2 cm above the anal verge. After multiple biopsies an abdomino-perineal resection was performed for the rectal mass. Gross examination of the resected specimen revealed an anorectal mass measuring 5 cm in its long axis. Histopathological examination showed the tumor to be composed of lobules of mostly clear polygonal cells with round vesicular nuclei. Glandular formation was occasional. The tumor was rich in glycogen, focally displayed luminal mucin, and was associated with regional lymph node metastasis. Conclusion: This report illustrates a case of intestinal clear cell adenocarcinoma with lymph node metastasis that suggested a poor prognosis.

<i>Objective:</i> We report a case of plasma cell variant of Castleman’s disease confined to the meninges. <i>Clinical Presentation and Intervention:</i> A 53-year-old woman presented with severe headache lasting a few months, which was insidious in onset but followed a progressive course with associated vomiting, blurring of vision and diplopia. Investigations revealed a dural-based mass that was considered both radiologically and intraoperatively as a meningioma. Total surgical excision of the mass was performed. Histologically, it was a plasma cell variant of Castleman’s disease with ĸ light chain restriction. Laboratory investigations and whole body computerized tomography scan showed no significant abnormality. A short course of local radiotherapy was given. The patient is well 2 years after treatment. <i>Conclusion:</i> This report highlights the rarity of solitary intracranial Castleman’s disease and the difficulty in radiological and intraoperative diagnosis.

Rosai-Dorfman disease (RDD) is a rare but well-recognized idiopathic histioproliferative disease affecting the systemic lymph nodes. It is characterized by an unusual proliferation of histiocytic cells. Intracranial localization is a rare manifestation of RDD. The clinical and radiological differentiation from meningiomas is difficult, and can only be achieved after histological examination. This entity should be considered in the differential diagnosis of dural based lesions mimicking meningioma. We report 2 cases of isolated intracranial RDD. The first patient had a large frontal lesion in addition to smaller multiple intracranial lesions. The second patient had only one parasagittal lesion. The diagnosis was confirmed on histopathological examination after surgical excision. The pertinent literature is also reviewed.